Effectiveness of inpatient versus outpatient complex treatment programs in depressive disorders: a quasi-experimental study under naturalistic conditions
Abstract Background Due to long waiting periods for outpatient psychotherapy and the high resource requirements of inpatient treatment, there is a need for alternative treatment programs for patients with depressive disorders. Thus, we investigated the effectiveness of the “Bielefeld Outpatient Inte...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-12-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-019-2371-5 |
| _version_ | 1818854319633465344 |
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| author | Martin Driessen Philipp Schulz Silvia Jander Hedda Ribbert Stefanie Gerhards Frank Neuner Steffi Koch-Stoecker |
| author_facet | Martin Driessen Philipp Schulz Silvia Jander Hedda Ribbert Stefanie Gerhards Frank Neuner Steffi Koch-Stoecker |
| author_sort | Martin Driessen |
| collection | DOAJ |
| description | Abstract Background Due to long waiting periods for outpatient psychotherapy and the high resource requirements of inpatient treatment, there is a need for alternative treatment programs for patients with depressive disorders. Thus, we investigated the effectiveness of the “Bielefeld Outpatient Intensive Treatment Program of Depression” (BID) in comparison with a typical inpatient treatment program by using a prospective quasi-experimental observational study. We assumed (i) that both complex programs are effective in pre-post analyses after 6 weeks and (ii) that inpatient treatment is more effective compared with the outpatient program. Methods Four hundred patients with depressive psychopathology – a majority with depressive episodes (ICD-10 F3X) - took part in the BID and 193 in the inpatient program. Different self- (i.e., BDI) and expert measures (i.e., MADRS) of psychopathology at baseline (t1) and 6 weeks later (t2) were applied to examine treatment effects. Results Treatment effects were high in separate analyses of both groups with Cohen’s d ranging from 1.10 to 1.76., while ANOVA comparative analyses did not reveal any significant differences between both treatment settings nor did a set of independent covariates analyzed here. Response rates of BDI (p = .002) and MADRS (p = .001) were higher in the outpatient group. Results indicate BID not to be inferior compared to an inpatient program, although diverging pathways to treatment, higher rates of clinical recurrent depressive disorders and severe episodes as well as lower rates of employment and partnership in the inpatient treatment group have to be considered. Conclusion Outpatient intensive treatment programs may represent a solution for patients needing more than a treatment session once per week but less than a complex inpatient or day clinic program. |
| first_indexed | 2024-12-19T07:50:49Z |
| format | Article |
| id | doaj.art-7d82a44e52074cb4a8b5463c53cbdbad |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-12-19T07:50:49Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-7d82a44e52074cb4a8b5463c53cbdbad2022-12-21T20:30:11ZengBMCBMC Psychiatry1471-244X2019-12-0119111010.1186/s12888-019-2371-5Effectiveness of inpatient versus outpatient complex treatment programs in depressive disorders: a quasi-experimental study under naturalistic conditionsMartin Driessen0Philipp Schulz1Silvia Jander2Hedda Ribbert3Stefanie Gerhards4Frank Neuner5Steffi Koch-Stoecker6Klinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum BethelKlinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum BethelKlinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum BethelKlinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum BethelKlinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum BethelDepartment of Psychology, Faculty of Psychology and Sports Science, Work Unit Clinical Psychology and Psychotherapy, Bielefeld UniversityKlinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum BethelAbstract Background Due to long waiting periods for outpatient psychotherapy and the high resource requirements of inpatient treatment, there is a need for alternative treatment programs for patients with depressive disorders. Thus, we investigated the effectiveness of the “Bielefeld Outpatient Intensive Treatment Program of Depression” (BID) in comparison with a typical inpatient treatment program by using a prospective quasi-experimental observational study. We assumed (i) that both complex programs are effective in pre-post analyses after 6 weeks and (ii) that inpatient treatment is more effective compared with the outpatient program. Methods Four hundred patients with depressive psychopathology – a majority with depressive episodes (ICD-10 F3X) - took part in the BID and 193 in the inpatient program. Different self- (i.e., BDI) and expert measures (i.e., MADRS) of psychopathology at baseline (t1) and 6 weeks later (t2) were applied to examine treatment effects. Results Treatment effects were high in separate analyses of both groups with Cohen’s d ranging from 1.10 to 1.76., while ANOVA comparative analyses did not reveal any significant differences between both treatment settings nor did a set of independent covariates analyzed here. Response rates of BDI (p = .002) and MADRS (p = .001) were higher in the outpatient group. Results indicate BID not to be inferior compared to an inpatient program, although diverging pathways to treatment, higher rates of clinical recurrent depressive disorders and severe episodes as well as lower rates of employment and partnership in the inpatient treatment group have to be considered. Conclusion Outpatient intensive treatment programs may represent a solution for patients needing more than a treatment session once per week but less than a complex inpatient or day clinic program.https://doi.org/10.1186/s12888-019-2371-5DepressionOutpatient treatmentInpatient treatmentClinical trialEffectiveness |
| spellingShingle | Martin Driessen Philipp Schulz Silvia Jander Hedda Ribbert Stefanie Gerhards Frank Neuner Steffi Koch-Stoecker Effectiveness of inpatient versus outpatient complex treatment programs in depressive disorders: a quasi-experimental study under naturalistic conditions BMC Psychiatry Depression Outpatient treatment Inpatient treatment Clinical trial Effectiveness |
| title | Effectiveness of inpatient versus outpatient complex treatment programs in depressive disorders: a quasi-experimental study under naturalistic conditions |
| title_full | Effectiveness of inpatient versus outpatient complex treatment programs in depressive disorders: a quasi-experimental study under naturalistic conditions |
| title_fullStr | Effectiveness of inpatient versus outpatient complex treatment programs in depressive disorders: a quasi-experimental study under naturalistic conditions |
| title_full_unstemmed | Effectiveness of inpatient versus outpatient complex treatment programs in depressive disorders: a quasi-experimental study under naturalistic conditions |
| title_short | Effectiveness of inpatient versus outpatient complex treatment programs in depressive disorders: a quasi-experimental study under naturalistic conditions |
| title_sort | effectiveness of inpatient versus outpatient complex treatment programs in depressive disorders a quasi experimental study under naturalistic conditions |
| topic | Depression Outpatient treatment Inpatient treatment Clinical trial Effectiveness |
| url | https://doi.org/10.1186/s12888-019-2371-5 |
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