objects: The purpose of this study was to investigate the transformation of dreams in terms of its therapeutic significance in accordance with clinical improvement by pharmacotherapy.
methods: Materials were 160 dreams of the 80 neurotics and psychotics among 132 cases who had been treated with pharmacotherapy at the psychiatric departments of 4 hospitals, located in the city of Pusan. Subjects were instructed write their dreams before and after clinical improvement. The severity of clinical symptoms was measured by standardized Symptom Checklist-90-Revision and the criteria of clinical improvement was 20% of improvement. The method of dream analysis used the functional scoring system that had been designed by Correire et al, subsuming process scales and content scales. In process scales, feeling intensity, dreamer activity, dream clarity, and dreamer expression were assessed with the means and standard deviation of rating in each scale. As content scales, origin of feeling, dream setting, age of dreamer, dream charatcters, and overall rating were evaluated with the percentage of dreams in each category of scales.
Results: Average feeling intensity was reduced with the progression of pharmacotherapy without statistical significance between before-and after-improvement phases. The dreamer activity and dream clarity was also reduced with the progression of pharmacotherapy without statistical significances. But dreamer expression was reduced with the progression of pharmacotherapy with statistical significance9p<0.05). The proportion of symbolic dreams increased as pharmacotherpay progressed, whereas that of real dreams decreased, but the there were no statistical significances. Dreams that would make clear reference to dreamer’s personal present life, dream characters that dreamer personally knows, and the origin of feeling which are evidently about people or events in dreamer’s present situations decreased in proportion without statistical significances as pharmacotherapy continued. However, the proportions of each classification in the age of dreamer showed little changes with the progression of pharmacotherapy.
Conclusion: The above findings indicate that the transformation of dreams does not occur in terms of its therapeutic significance in accordance with clinical improvement by pharmacotherpy except dreamer expression. In addition, those findings are contrary to the results of various studies on the transformation of dreams in accordance with the progression of psychotherapy. In case of psychotherapy, feeling intensity, dreamer activity and expression, dream clarity, and real dreams dreams significantly increased as psychotherapy progressed. It supports conventional understanding that two modalities of pharmacotherapy and psychotherapy act on different foci of a patient’s problem. Accordingly, it suggests that pharmacotherapy and psychotherapy should not be competing to each other, but complementary.
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