EPA-0659 – Multimodal Inpatient Treatment for Depression: Effectiveness and Predictors

Abstract

Introduction and Objective:

Depressive disorders have the highest inpatient utilization rates in German health care. The aim of this study was to evaluate response, remission and non-response rates as well as predictors of response in depressive inpatients.

Methods:

Consecutively admitted inpatients with a depressive episode (F32.0-2, F33.0-2) were assessed at admission and at discharge for depression (Beck depression inventory II, BDI-II) and general psychopathology (Brief Symptom Inventory, BSI). Most frequent cause for admission was nonresponse to prior outpatient treatment.

Results:

A total of 2323 inpatients with depression (M=48.02 years, SD=11.79) was included. 46.7% of patients received concomitant antidepressants. Mean duration of inpatient treatment was 53.16 days (SD=23.31). For completers, BDI-II decreased from 29.36 (SD=9.36) at admission to 14.00 (SD=10.96) at discharge (Effect size: 1.64). Response rates were 75.5% (BDI-II) and 68.7% (BSI) and remission rates 62.2% (BDI-II) and 40.8% (BSI). Non-response rates, also including minor responders, varied between 23.4% (BDI-II) and 27.4% (BSI). A comparison between patients with and without concomitant antidepressants showed a significant time and group effect, but no significant interaction effect.

Responders showed significantly higher depressive symptoms (BDI-II) and higher scores on the scales anxiety and phobic anxiety (BSI) at admission. They had fewer inpatient pretreatments before index admission. Furthermore, therapy motivation was identified as predictor for response.

Conclusions:

The results demonstrate that about two thirds of depressive patients show response after a multimodal inpatient treatment. Future studies should focus on early identification of non-responders as well as on the development of treatment strategies for these patients.