Almut Zeeck1, Jörn von Wietersheim2, Heinz Weiß3, Carl Eduard Scheidt4, Alexander Völker5, Astrid Helesic5, Annegret Eckhardt-Henn6, Manfred Beutel7, Katharina Endorf8, Jamie Knoblauch2, Peter Rochlitz9, Armin Hartmann8. 1. Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital, Freiburg, Germany. Electronic address: almut.zeeck@uniklinik-freiburg.de. 2. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Ulm, Germany. 3. Department of Psychosomatic Medicine and Psychotherapy, Robert-Bosch-Krankenhaus, Stuttgart, Germany. 4. Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital, Freiburg, Germany; Thure-von-Uexküll-Klinik, Glottertal, Germany. 5. Rhein Klinik, Bad Honnef, Germany. 6. Department of Psychosomatic Medicine and Psychotherapy, Bürgerhospital, Stuttgart, Germany. 7. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Mainz, Germany. 8. Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital, Freiburg, Germany. 9. Department of Psychosomatic Medicine and Psychotherapy, Fürst Stirum-Klinikum, Bruchsal, Germany.
Abstract
BACKGROUND: In major depression (MDD), hospital treatment is an option in more severe cases or if outpatient treatment failed. Psychosomatic hospitals in Germany provide treatment programs with multimodal psychotherapy, either in an inpatient or a day hospital setting. In the context of health care research, this study aimed (1) to compare characteristics of patients treated in psychosomatic day hospitals and inpatient units, (2) to compare the effectiveness of both treatment modalities. METHODS: A naturalistic design was chosen to achieve external validity. 604 consecutive patients were assessed at admission, discharge and a 3-month follow-up. Primary outcome was defined as a reduction of depressive symptomatology (QIDS-C), secondary outcomes comprise overall functioning and quality of life. For a comparison of effectiveness, inpatient and day hospital samples were matched according to known predictors of outcome. RESULTS: The few differences found between the inpatient and day hospital sample were related to severity of depression and physical impairment. Inpatients more often got antidepressant medication. Additionally, inpatients were treated significantly longer, due to a subgroup of patients with somatic co-morbidity. There were no differences when comparing effectiveness. LIMITATIONS: When comparing treatment effectiveness, possible bias cannot be ruled out. There was no randomization or untreated control group. CONCLUSIONS: In patients with a more severe depression and somatic co-morbidity, inpatient treatment might be preferred as compared to day hospital treatment. However, most patients can be treated in both settings.
BACKGROUND: In major depression (MDD), hospital treatment is an option in more severe cases or if outpatient treatment failed. Psychosomatic hospitals in Germany provide treatment programs with multimodal psychotherapy, either in an inpatient or a day hospital setting. In the context of health care research, this study aimed (1) to compare characteristics of patients treated in psychosomatic day hospitals and inpatient units, (2) to compare the effectiveness of both treatment modalities. METHODS: A naturalistic design was chosen to achieve external validity. 604 consecutive patients were assessed at admission, discharge and a 3-month follow-up. Primary outcome was defined as a reduction of depressive symptomatology (QIDS-C), secondary outcomes comprise overall functioning and quality of life. For a comparison of effectiveness, inpatient and day hospital samples were matched according to known predictors of outcome. RESULTS: The few differences found between the inpatient and day hospital sample were related to severity of depression and physical impairment. Inpatients more often got antidepressant medication. Additionally, inpatients were treated significantly longer, due to a subgroup of patients with somatic co-morbidity. There were no differences when comparing effectiveness. LIMITATIONS: When comparing treatment effectiveness, possible bias cannot be ruled out. There was no randomization or untreated control group. CONCLUSIONS: In patients with a more severe depression and somatic co-morbidity, inpatient treatment might be preferred as compared to day hospital treatment. However, most patients can be treated in both settings.
Authors: Monika Sadlonova; Julia Katharina Löser; Christopher M Celano; Christina Kleiber; Daniel Broschmann; Christoph Herrmann-Lingen Journal: Front Psychiatry Date: 2022-08-25 Impact factor: 5.435
Authors: Rüdiger Zwerenz; Carlotta Baumgarten; Jan Becker; Ana Tibubos; Martin Siepmann; Rudolf J Knickenberg; Manfred E Beutel Journal: J Med Internet Res Date: 2019-10-24 Impact factor: 5.428