Motivation for in-patient psychotherapy among patients of a psychosomatic pain clinic

Objective. For a number of pain patients inpatient psychotherapy is an adequate treatment. Many of these patients are lacking in motivation, though. The present study aimed at identifying factors associated with acceptance or rejection of inpatient psychotherapy. Methods. 63 patients of a psychosomatic pain clinic underwent a multimodal assessment based on a psychosomatic interview as well as a set of psychodiagnostic questionnaires regarding sociodemographic factors, symptomatology (pain intensity, BSS, SCL-90-R, BDI), state of chronification, psychological defense mechanisms (DSQ) and biographic traumatisation (risk index). Results. 71 % of the patients were recommended in-patient psychotherapy. Among those, 63% accepted the recommendation, 27% rejected it. Among the patients who accepted in-patient psychotherapy, the extent of total psychological impairment as well as severity of depression and anxiety were more severe and the state of chronification tended to be less marked than in the rejecting group. Referring to sociodemographic variables, pain intensity, physical impairment and severity of biographic traumatisation, no significant difference between the groups could be shown. Conclusions. In our highly selected population the extent of psychiatric comorbidity and the state of chronification determined motivation for in-patient psychotherapy. Further studies should focus on unselected pain-patients and on differences in motivation between various forms of psychotherapy.