Follow-Up Treatment After Inpatient Therapy of Patients With Unipolar Depression—Compliance With the Guidelines?
To date, there is only a limited number of studies evaluating the implementation and effects of treatment guidelines. Therefore, this study aimed to determine how many patients diagnosed with a major depression were treated in compliance with the German treatment guideline after hospital treatment,...
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| Published in: | Frontiers in psychiatry Vol. 11; p. 796 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
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07.08.2020
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| ISSN: | 1664-0640, 1664-0640 |
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| Abstract | To date, there is only a limited number of studies evaluating the implementation and effects of treatment guidelines. Therefore, this study aimed to determine how many patients diagnosed with a major depression were treated in compliance with the German treatment guideline after hospital treatment, and whether a deviation from the guideline resulted in a less favorable development.
Five hundred two patients, which originally participated in the INDDEP-study, were included. Data were collected at admission and discharge from eight different psychosomatic (psychotherapeutic) hospitals in Germany as well as 3 months and 1 year after hospital treatment. Data on depressive symptomatology were assessed by QIDS-C (clinical interviews). By phone interviews, the clinical course and the outpatient treatments were assessed. Statistical analyses compared patients who were treated in compliance with the German treatment guideline with those who were not.
Seventy-nine point one percent of the outpatient treatments complied with the treatment guideline. Eleven point eight percent of the patients were treated with medication only, 60.2% with psychotherapy only, and 28.0% with a combination. There was no difference in the clinical outcome (depression) with regard to guideline compliance. Cases in which deviation from the guideline occurred (20.9%) were younger and had a less severe depressive symptomatology at admission and after hospital treatment.
After treatment in a psychosomatic hospital or day hospital, the majority of patients with a depressive disorder received adjacent treatment in accordance with the German guideline and with a clear focus on psychotherapy. Deviations from the guideline did not result in a less favorable course of the illness.
ISRCTN20317064, retrospectively registered 31.07.2012. |
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| AbstractList | To date, there is only a limited number of studies evaluating the implementation and effects of treatment guidelines. Therefore, this study aimed to determine how many patients diagnosed with a major depression were treated in compliance with the German treatment guideline after hospital treatment, and whether a deviation from the guideline resulted in a less favorable development.OBJECTIVETo date, there is only a limited number of studies evaluating the implementation and effects of treatment guidelines. Therefore, this study aimed to determine how many patients diagnosed with a major depression were treated in compliance with the German treatment guideline after hospital treatment, and whether a deviation from the guideline resulted in a less favorable development.Five hundred two patients, which originally participated in the INDDEP-study, were included. Data were collected at admission and discharge from eight different psychosomatic (psychotherapeutic) hospitals in Germany as well as 3 months and 1 year after hospital treatment. Data on depressive symptomatology were assessed by QIDS-C (clinical interviews). By phone interviews, the clinical course and the outpatient treatments were assessed. Statistical analyses compared patients who were treated in compliance with the German treatment guideline with those who were not.METHODSFive hundred two patients, which originally participated in the INDDEP-study, were included. Data were collected at admission and discharge from eight different psychosomatic (psychotherapeutic) hospitals in Germany as well as 3 months and 1 year after hospital treatment. Data on depressive symptomatology were assessed by QIDS-C (clinical interviews). By phone interviews, the clinical course and the outpatient treatments were assessed. Statistical analyses compared patients who were treated in compliance with the German treatment guideline with those who were not.Seventy-nine point one percent of the outpatient treatments complied with the treatment guideline. Eleven point eight percent of the patients were treated with medication only, 60.2% with psychotherapy only, and 28.0% with a combination. There was no difference in the clinical outcome (depression) with regard to guideline compliance. Cases in which deviation from the guideline occurred (20.9%) were younger and had a less severe depressive symptomatology at admission and after hospital treatment.RESULTSSeventy-nine point one percent of the outpatient treatments complied with the treatment guideline. Eleven point eight percent of the patients were treated with medication only, 60.2% with psychotherapy only, and 28.0% with a combination. There was no difference in the clinical outcome (depression) with regard to guideline compliance. Cases in which deviation from the guideline occurred (20.9%) were younger and had a less severe depressive symptomatology at admission and after hospital treatment.After treatment in a psychosomatic hospital or day hospital, the majority of patients with a depressive disorder received adjacent treatment in accordance with the German guideline and with a clear focus on psychotherapy. Deviations from the guideline did not result in a less favorable course of the illness.CONCLUSIONAfter treatment in a psychosomatic hospital or day hospital, the majority of patients with a depressive disorder received adjacent treatment in accordance with the German guideline and with a clear focus on psychotherapy. Deviations from the guideline did not result in a less favorable course of the illness.ISRCTN20317064, retrospectively registered 31.07.2012.CLINICAL TRIAL REGISTRATIONISRCTN20317064, retrospectively registered 31.07.2012. ObjectiveTo date, there is only a limited number of studies evaluating the implementation and effects of treatment guidelines. Therefore, this study aimed to determine how many patients diagnosed with a major depression were treated in compliance with the German treatment guideline after hospital treatment, and whether a deviation from the guideline resulted in a less favorable development.MethodsFive hundred two patients, which originally participated in the INDDEP-study, were included. Data were collected at admission and discharge from eight different psychosomatic (psychotherapeutic) hospitals in Germany as well as 3 months and 1 year after hospital treatment. Data on depressive symptomatology were assessed by QIDS-C (clinical interviews). By phone interviews, the clinical course and the outpatient treatments were assessed. Statistical analyses compared patients who were treated in compliance with the German treatment guideline with those who were not.ResultsSeventy-nine point one percent of the outpatient treatments complied with the treatment guideline. Eleven point eight percent of the patients were treated with medication only, 60.2% with psychotherapy only, and 28.0% with a combination. There was no difference in the clinical outcome (depression) with regard to guideline compliance. Cases in which deviation from the guideline occurred (20.9%) were younger and had a less severe depressive symptomatology at admission and after hospital treatment.ConclusionAfter treatment in a psychosomatic hospital or day hospital, the majority of patients with a depressive disorder received adjacent treatment in accordance with the German guideline and with a clear focus on psychotherapy. Deviations from the guideline did not result in a less favorable course of the illness.Clinical Trial RegistrationISRCTN20317064, retrospectively registered 31.07.2012 To date, there is only a limited number of studies evaluating the implementation and effects of treatment guidelines. Therefore, this study aimed to determine how many patients diagnosed with a major depression were treated in compliance with the German treatment guideline after hospital treatment, and whether a deviation from the guideline resulted in a less favorable development. Five hundred two patients, which originally participated in the INDDEP-study, were included. Data were collected at admission and discharge from eight different psychosomatic (psychotherapeutic) hospitals in Germany as well as 3 months and 1 year after hospital treatment. Data on depressive symptomatology were assessed by QIDS-C (clinical interviews). By phone interviews, the clinical course and the outpatient treatments were assessed. Statistical analyses compared patients who were treated in compliance with the German treatment guideline with those who were not. Seventy-nine point one percent of the outpatient treatments complied with the treatment guideline. Eleven point eight percent of the patients were treated with medication only, 60.2% with psychotherapy only, and 28.0% with a combination. There was no difference in the clinical outcome (depression) with regard to guideline compliance. Cases in which deviation from the guideline occurred (20.9%) were younger and had a less severe depressive symptomatology at admission and after hospital treatment. After treatment in a psychosomatic hospital or day hospital, the majority of patients with a depressive disorder received adjacent treatment in accordance with the German guideline and with a clear focus on psychotherapy. Deviations from the guideline did not result in a less favorable course of the illness. ISRCTN20317064, retrospectively registered 31.07.2012. |
| Author | Weiß, Lukas von Wietersheim, Jörn Zeeck, Almut Hartmann, Armin Weiß, Heinz Rottler, Edit |
| AuthorAffiliation | 3 Department of Psychosomatic Medicine and Psychotherapy, Robert-Bosch-Krankenhaus , Stuttgart , Germany 1 Department of Psychosomatic Medicine and Psychotherapy, University Medical Center , Ulm , Germany 2 Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital , Freiburg , Germany |
| AuthorAffiliation_xml | – name: 3 Department of Psychosomatic Medicine and Psychotherapy, Robert-Bosch-Krankenhaus , Stuttgart , Germany – name: 2 Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital , Freiburg , Germany – name: 1 Department of Psychosomatic Medicine and Psychotherapy, University Medical Center , Ulm , Germany |
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| Cites_doi | 10.1097/01.mlr.0000254574.23418.f6 10.13109/zptm.2011.57.4.399 10.1016/j.euroneuro.2009.11.011 10.3109/09540261.2011.606803 10.1016/S0140-6736(99)03171-2 10.1186/1471-244X-13-100 10.1016/S0006-3223(02)01866-8 10.1016/j.jad.2008.07.011 10.3390/healthcare4030036 10.1146/annurev-clinpsy-050817-084833 10.1177/0004867415617657 10.1007/s00115-004-1705-8 10.1093/schbul/sbu065 10.1016/j.psychres.2018.03.086 10.1007/s00406-014-0495-7 10.1111/j.1600-0447.2007.01016.x 10.1016/j.jad.2015.07.025 10.1055/s-2004-830145 10.1176/ajp.149.9.1148 10.1001/archpsyc.1987.01800180050009 10.3310/hta8060 10.1016/j.jad.2016.03.039 10.1186/1471-244X-9-38 10.1186/1472-6947-8-38 |
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| Copyright | Copyright © 2020 Weiß, Zeeck, Rottler, Weiß, Hartmann, von Wietersheim and The INDDEP Study Group. Copyright © 2020 Weiß, Zeeck, Rottler, Weiß, Hartmann, von Wietersheim and The INDDEP Study Group 2020 Weiß, Zeeck, Rottler, Weiß, Hartmann, von Wietersheim and The INDDEP Study Group |
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| Keywords | antidepressants psychotherapy compliance with guideline treatment guideline major depression |
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| License | Copyright © 2020 Weiß, Zeeck, Rottler, Weiß, Hartmann, von Wietersheim and The INDDEP Study Group. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 This article was submitted to Psychosomatic Medicine, a section of the journal Frontiers in Psychiatry Edited by: Christoph Pieh, Danube University Krems, Austria Reviewed by: Bárbara Oliván Blázquez, University of Zaragoza, Spain; Elke Humer, Danube University Krems, Austria |
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| Title | Follow-Up Treatment After Inpatient Therapy of Patients With Unipolar Depression—Compliance With the Guidelines? |
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