Symptom change trajectories during inpatient psychotherapy in routine care and their associations with long-term outcomes
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Symptom change trajectories during inpatient psychotherapy in routine care and their associations with long-term outcomes. / Melchior, Hanne; Schulz, Holger; Kriston, Levente; Hergert, Anika; Hofreuter-Gätgens, Kerstin; Bergelt, Corinna; Morfeld, Matthias; Koch, Uwe; Watzke, Birgit.
In: PSYCHIAT RES, Vol. 238, 30.04.2016, p. 228-35.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Symptom change trajectories during inpatient psychotherapy in routine care and their associations with long-term outcomes
AU - Melchior, Hanne
AU - Schulz, Holger
AU - Kriston, Levente
AU - Hergert, Anika
AU - Hofreuter-Gätgens, Kerstin
AU - Bergelt, Corinna
AU - Morfeld, Matthias
AU - Koch, Uwe
AU - Watzke, Birgit
N1 - Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
PY - 2016/4/30
Y1 - 2016/4/30
N2 - This study examined symptom change trajectories during inpatient psychotherapy and the association of these changes with long-term outcomes. In an observational multicenter study, weekly measurements of symptom severity were performed during inpatient treatment and 6 months after discharge. The symptom severity was measured using the 18-item scale of the Hamburg Modules for the Assessment of Psychosocial Health. The sample included 576 inpatients (mean age: 43.9 years; 77.6% female; main diagnoses: depressive (57.2%), adjustment (15.8%), anxiety (7.4%), and eating disorders (7.2%); mean treatment duration: 42.0 days). With empirically and clinically informed growth mixture models four subgroups of symptom change were revealed: gradual response (71%), early response (9%), delayed response (5%), and nonresponse (11%). Particularly low educational level, non-employment and chronic disorders were associated with unfavorable symptom courses (non- and delayed response). Long-term outcomes differed systematically across subgroups (p<0.001; η(2)=0.165). The patients who responded early presented the highest rates of clinically significant improvement (43.9%) from admission to follow-up. Nearly all of these patients (92.7%) showed reliable improvement. Due to the high association of symptom change trajectories with long-term outcomes, results may contribute to interventions that are tailored to the needs of patients and may foster longer lasting therapeutic effectiveness.
AB - This study examined symptom change trajectories during inpatient psychotherapy and the association of these changes with long-term outcomes. In an observational multicenter study, weekly measurements of symptom severity were performed during inpatient treatment and 6 months after discharge. The symptom severity was measured using the 18-item scale of the Hamburg Modules for the Assessment of Psychosocial Health. The sample included 576 inpatients (mean age: 43.9 years; 77.6% female; main diagnoses: depressive (57.2%), adjustment (15.8%), anxiety (7.4%), and eating disorders (7.2%); mean treatment duration: 42.0 days). With empirically and clinically informed growth mixture models four subgroups of symptom change were revealed: gradual response (71%), early response (9%), delayed response (5%), and nonresponse (11%). Particularly low educational level, non-employment and chronic disorders were associated with unfavorable symptom courses (non- and delayed response). Long-term outcomes differed systematically across subgroups (p<0.001; η(2)=0.165). The patients who responded early presented the highest rates of clinically significant improvement (43.9%) from admission to follow-up. Nearly all of these patients (92.7%) showed reliable improvement. Due to the high association of symptom change trajectories with long-term outcomes, results may contribute to interventions that are tailored to the needs of patients and may foster longer lasting therapeutic effectiveness.
KW - Adult
KW - Chronic Disease
KW - Female
KW - Follow-Up Studies
KW - Hospitalization
KW - Humans
KW - Inpatients
KW - Male
KW - Mental Disorders
KW - Middle Aged
KW - Psychotherapy
KW - Time Factors
KW - Treatment Outcome
KW - Journal Article
KW - Multicenter Study
KW - Research Support, Non-U.S. Gov't
U2 - 10.1016/j.psychres.2016.02.046
DO - 10.1016/j.psychres.2016.02.046
M3 - SCORING: Journal article
C2 - 27086238
VL - 238
SP - 228
EP - 235
JO - PSYCHIAT RES
JF - PSYCHIAT RES
SN - 0165-1781
ER -