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Nord J Psychiatry. 2016;70(1):16-23. doi: 10.3109/08039488.2015.1028438. Epub 2015 May 20.

Deteriorated and unchanged patients in psychological treatment in Swedish primary care and psychiatry.

Author information

1
a Jakob Mechler, Stockholms läns landsting, Norra Stockholms psykiatri , Sweden.
2
b Rolf Holmqvist, Linköping University , Sweden.

Abstract

BACKGROUND:

Despite substantial effect sizes for psychological therapy among different diagnosis groups and in different treatment contexts, many studies show that a large proportion of patients do not attain reliable improvement and a substantial portion are worse off after treatment. Previous studies suggest that patients in psychiatry may have worse outcome than patients in primary care.

AIMS:

In this practice-based study of psychological treatment in Swedish primary care and adult psychiatry, the proportions of patients who did not improve and who deteriorated were assessed.

METHODS:

Proportions of reliably improved, unchanged, and reliably deteriorated patients among 840 patients in primary care and 317 patients in specialist psychiatry were assessed by self-ratings using the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM).

RESULTS:

More than half of the patients did not change reliably. About 2% of the patients in primary care and 7% in psychiatry deteriorated. Multilevel analyses of the data from primary care indicated that there were no therapist effects.

CONCLUSIONS:

The results emphasize the importance of monitoring treatment continuously in order to increase results for patients who do not improve.

KEYWORDS:

Adult specialist psychiatry; Deteriorated; Primary care; Treatment outcome; Unchanged

PMID:
25994483
DOI:
10.3109/08039488.2015.1028438
[Indexed for MEDLINE]

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