Ratings of Early Major Depressive Disorder Symptom Change During a Brief Psychiatric Hospitalization

Pettit, Jeremy W.; Averill, Patricia M.; Wassef, Adel; Gruber, Nelson P.; Schneider, Laurie

doi:10.1007/s11089-005-5579-x

Cited by 13 publications

(12 citation statements)

References 19 publications

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“…Admission scores at this facility were characteristic of those observed in other inpatient samples. 7,30–32 Scores at each assessment were univariate normal with excellent internal consistency (α = .93–.94). 33 …”

Section: Methodsmentioning

confidence: 95%

“…To date, research comparing outcome across varying lengths of hospitalization is equivocal. Whereas symptom reduction from admission to discharge is noted consistently, shorter hospitalization has been associated with less, 6 greater, 7 and comparable 8–9 improvement across individual studies. Research examining correlates of admission length is more consistent.…”

mentioning

confidence: 89%

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Modeling Trajectory of Depressive Symptoms Among Psychiatric Inpatients

Clapp¹,

Grubaugh²,

Allen³

et al. 2013

J. Clin. Psychiatry

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Objectives Changes in the parameters of inpatient psychiatric care have inspired a sizable literature exploring correlates of prolonged intervention as well as symptom change over varying lengths of hospitalization. However, existing data offer limited insight regarding the nature of symptom change over time. Objectives of this longitudinal research were to (a) model the trajectory of depressive symptoms within an inpatient psychiatric sample, (b) identify characteristics associated with unique patterns of change, and (c) evaluate the magnitude of expected gains using objective clinical benchmarks. Methods Participants included psychiatric inpatients treated between April 2008 and December 2010. Latent growth curve modeling was used to determine the trajectory of Beck Depression Inventory II depressive symptoms in response to treatment. Age, gender, trauma history, prior hospitalization, and DSM-IV diagnoses were examined as potential moderators of recovery. Results Results indicate a nonlinear model of recovery, with symptom reductions greatest following admission and slowing gradually over time. Female gender, probable trauma exposure, prior psychiatric hospitalization, and primary depressive diagnosis were associated with more severe trajectories. Diagnosis of alcohol/substance use, by contrast, was associated with more moderate trajectories. Objective benchmarks occurred relatively consistently across patient groups with clinically significant change occurring between 2–4 weeks post-admission. Conclusion The nonlinear trajectory of recovery observed in these data provides insight regarding the dynamics of inpatient recovery. Across all patient groups, symptom reduction was most dramatic in the initial week of hospitalization. However, notable improvement continued for several weeks post-admission. Results suggest timelines for adequate inpatient care are largely contingent on program-specific goals.

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Section: Methodsmentioning

confidence: 95%

mentioning

confidence: 89%

Modeling Trajectory of Depressive Symptoms Among Psychiatric Inpatients

Clapp¹,

Grubaugh²,

Allen³

et al. 2013

J. Clin. Psychiatry

View full text Add to dashboard Cite

show abstract

“…Over the past several decades, the LOS for patients requiring psychiatric hospitalisation has decreased from months to weeks, driven not only by economic pressures but by advances in clinical practice with a focus on treatment in outpatient settings [13–15]. There is some debate as to the optimum LOS in psychiatric patients; some studies argue that patients with depression who are discharged after a brief inpatient treatment are more depressed and more globally impaired on discharge [13], while other studies suggest that shorter stay is as effective or more effective than long-term inpatient programmes among depressed patients [16,17], or patients with severe mental illness [18]. …”

Section: Discussionmentioning

confidence: 99%

Hospital stay in patients admitted for acute bipolar manic episodes prescribed quetiapine immediate or extended release: a retrospective non-interventional cohort study (HOME)

et al. 2014

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BackgroundBipolar manic episodes often require hospital admission to ensure patient safety. The antipsychotic quetiapine is a common treatment for bipolar mania and is available in immediate release (IR) and extended release (XR) formulations; however, outcomes in patients receiving these different formulations have not been directly compared in an acute hospital setting.MethodsWe conducted a multinational, observational, retrospective cohort study to describe and compare hospital stay in patients admitted for an acute bipolar manic episode treated with quetiapine IR or XR from 1 October 2009–1 October 2010. The primary outcome measure was comparison of length of stay (LOS) using zero-truncated negative binomial regression.ResultsIn total, 1230 patients were included (659 in the IR cohort; 571 in the XR cohort). The median LOS (interquartile range) was 18.0 days (12.0, 28.0) in the IR cohort and 20.0 days (12.0, 34.0) in the XR cohort, respectively. LOS was not significantly associated with quetiapine formulation irrespective of whether or not clinical characteristics were taken into account (p = 0.820 and p = 0.386, respectively). Overall, 84.2% and 84.4% of patients in the IR and XR cohorts, respectively, had not previously used quetiapine; of these patients, 78.7% and 68.9% received one total daily dose, and 14.4% and 23.9% received dose titration. Over half of patients received antipsychotic monotherapy (53.1% and 58.3% in the IR and XR cohorts, respectively) and most received a daily quetiapine dose ≥ 400 mg (64.9% and 71.8%, respectively, for quetiapine monotherapy and 59.9% and 80.3%, respectively, for combination treatment).As a secondary outcome, multivariate analysis was used to identify other factors that affect LOS. Factors associated with a longer hospital stay included public funding versus private, maximum number of new medications administered, did not receive lithium and did not receive anxiolytics, sedatives/hypnotics (all p < 0.0001). Factors associated with a shorter hospital stay included presence of drug/alcohol abuse, living accompanied and having a psychiatric medical history (all p < 0.05).ConclusionsLOS was not found to be associated with quetiapine formulation. However, most patients received only one total daily dose of quetiapine without dose titration, which was unexpected and contrary to current recommendations.Trial registrationTrial registration: NCT01239589Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-014-0246-3) contains supplementary material, which is available to authorized users.

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“…If patients would have had severe major depression, it's unlikely they would have had such a dramatic improvement in 3-15 days of an inpatient stay [26]. Such dramatic improvement in depression and distress suggests that the short inpatient stay acted as a "holding environment" [26][27][28] for our patients.…”

Section: Discussionmentioning

confidence: 96%