Inpatient treatment decreases depression but antidepressants may not contribute. A prospective quasi-experimental study

• Main Authors: Reinhard Maß, Kerstin Backhaus, Dietmar Hestermann, Claudia Balzer, Michael Szelies
• Format: Article
• Language: English
• Published: Elsevier 2019-10-01
• Series: Comprehensive Psychiatry
• Online Access: http://www.sciencedirect.com/science/article/pii/S0010440X19300471

Objective: The aim of the study is the evaluation of psychiatric-psychotherapeutic inpatient treatment utilizing a naturalistic design. Methods: In a sample of 574 consecutively admitted patients, depression (64.5%), personality disorders (19.5%), schizophrenia (4.2%), bipolar disorder (3.3%), obsessive-compulsive disorder (2.3%) or other mental disorders (6.4%) were diagnosed. All patients were treated with psychotherapy, most with antidepressants. Depression was measured using the Beck Depression Inventory–II (BDI-II). 180 patients formed a waiting list control group. The regularly discharged patients (N = 489) were asked to participate in a six-month follow-up, with 62.6% taking part. Results: From the time of admission to discharge, there was a strong decline in depression (31.5 vs. 13.2 points on the BDI-II), as well as from admission to follow-up (31.2 vs. 18.3 points). In the control group, there was a weak symptom decline (34.6 vs. 32.1 points) until admission, which was independent of the waiting period duration. For the success of treatment, it did not matter whether the patients received antidepressants. In the follow-up, 81.0% of patients retrospectively considered psychotherapy to be important for treatment outcome, only 2.3% considered medications to be important. Conclusions: Psychiatric inpatient treatment reduces depression significantly at discharge and follow-up; the decrease in depression is rather due to psychotherapy than to antidepressants. Keywords: Inpatient treatment, Psychotherapy, Antidepressants, 6-month follow-up, Control group