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Doidge, N. Simon, B. Lancee, W.J. First, M. Brunshaw, J. Brauer, L. Grant, D.C. Stevens, A. Oldham, J.M. Mosher, P. (2002). Psychoanalytic Patients in the U.S., Canada, and Australia: I. DSM-III-R Disorders, Indications, Previous Treatment, Medications, and Length of Treatment. J. Amer. Psychoanal. Assn., 50(2):575-614.

(2002). Journal of the American Psychoanalytic Association, 50(2):575-614

Psychoanalytic Patients in the U.S., Canada, and Australia: I. DSM-III-R Disorders, Indications, Previous Treatment, Medications, and Length of Treatment

Norman Doidge, Barry Simon, William J. Lancee, Michael First, Jacqueline Brunshaw, Lee Brauer, Donald C. Grant, Annette Stevens, John M. Oldham and Paul Mosher

To determine the demographics, DSM-III-R disorders diagnosed, indications used in recommending psychoanalysis, previous treatment histories, use of medication, and length of treatment in patients in psychoanalysis in the U.S., Canada, and Australia, a mail survey of practice was sent to every other active member of the American Psychoanalytic Association and every member of the Australian Psychoanalytical Society. This supplemented an earlier survey sent to all Ontario psychoanalysts. The response rates were 40.1 % (n = 342) for the U.S., 67.2% (n = 117) for Canada, and 73.9% (n = 51) for Australia. Respondents supplied data on 1,718 patients. The employment rate for patients increases as analysis progresses (p < .0001). The mean number of concurrent categories of disorders (Axis I,3.


Norman Doidge, Training and Supervising Analyst, Canadian Institute of Psychoanalysis, Toronto Branch; research faculty, Columbia University Center for Psychoanalytic Training and Research; Head, Long-term Psychotherapy, Psychotherapy Program, and Assistant Professor, Department of Psychiatry, University of Toronto. Barry Simon, Assistant Professor, Department of Psychiatry, University of Toronto. Lee Brauer, consultant to the Committee on Psychoanalytic Practice, American Psychoanalytic Association. Donald C. Grant, member, Australian Psychoanalytical Society. Michael First, Research Psychiatrist, Biometrics Research Department, New York State Psychiatric Institute; Associate Professor of Clinical Psychiatry, Columbia University. Jacqueline Brunshaw, candidate, Clinical Psychology Program, York University, Toronto. William J. Lancee, Head of Research, Department of Psychiatry, Mount Sinai Hospital; Assistant Professor, Department of Psychiatry, University of Toronto. Annette Stevens, clinical faculty, Division of Community Mental Health, Department of Psychiatry, University of British Columbia. John M. Oldham, Professor and Chair, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina. Paul Mosher, founding board member, Psychoanalytic Electronic Publishing.

This work was supported by research grants from the American Psychoanalytic Association, the Australian Psychoanalytical Society, and the Toronto Psychoanalytic Society. Henry Bachrach, Norman Clemens, Charles Hanly, J. Christopher Perry, Robert Pynoos, and Robert Spitzer served as consultants. Arthur Fish, S.J., supervised ethics. Submitted for publication February 8, 2001.

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Axis II, and Disorders First Evident in Childhood) per patient at the start of treatment is 5.01 (SD=3.66; median=4; mode=3). There are no statistically significant differences across countries. Mood, anxiety. sexual dysfunction, and personality disorders are most common. American Psychiatric Association / American Psychoanalytic Association peer review criteria for indicating psychoanalysis are followed for 86.5% of patients. Over 80% of patients in all three countries had undergone previous treatments prior to analysis. In the U.S., 18.2% of analysands are on concurrent psychoactive medication; in Australia, 9.6%. The mean length of analyses conducted in the U.S. is 5.7 years, in Australia 6.6, and in Canada 4.8. Psychoanalytic patients in all three countries have similar rates of DSM-III-R psychopathology, and many indications of chronicity.

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