title: Adherence to guidelines for treatment of depression in in-patients.
abstract: BACKGROUND
  Adherence to treatment guidelines enhances treatment outcome. However, in clinical practice many patients with depression do not receive appropriate treatment.
  
  
  OBJECTIVE
  To evaluate the treatment of depression in in-patients of German psychiatric hospitals with respect to treatment outcome and adherence to guidelines.
  
  
  METHODS
  We recruited 1202 in-patients with depression from ten different hospitals. Quality data concerning treatment were collected at admission, during the treatment course and at discharge.
  
  
  RESULTS
  The level of depression was significantly decreased and most patients were satisfied with treatment. Many aspects of the treatment routine adhered to guideline recommendations. Adherence to guidelines could be improved with respect to adjustment of antidepressant dosage, reduction of benzodiazepine prescription, enhanced use of electroconvulsive therapy and wider use of interpersonal therapy.
  
  
  CONCLUSIONS
  The study reveals a high standard of psychiatric treatment of in-patients with depression. Nevertheless there is still room for improvement. Differences between hospitals in adherence to guidelines indicates the need for individual application of quality management tools.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Aachen RWTH, Pauwelsstrasse 30, 52074 Aachen, Germany. fschneider@ukaachen.de
authors.forename: Frank
authors.initials: F
authors.lastname: Schneider
authors.forename: Martin
authors.initials: M
authors.lastname: Härter
authors.forename: Silke
authors.initials: S
authors.lastname: Brand
authors.forename: Petra
authors.initials: P
authors.lastname: Sitta
authors.forename: Ralph
authors.initials: R
authors.lastname: Menke
authors.forename: Ursula
authors.initials: U
authors.lastname: Hammer-Filipiak
authors.forename: Ralf
authors.initials: R
authors.lastname: Kudling
authors.forename: Andrea
authors.initials: A
authors.lastname: Heindl
authors.forename: Kurt
authors.initials: K
authors.lastname: Herold
authors.forename: Ulrich
authors.initials: U
authors.lastname: Frommberger
authors.forename: Olivier
authors.initials: O
authors.lastname: Elmer
authors.forename: Günter
authors.initials: G
authors.lastname: Hetzel
authors.forename: Gabriele
authors.initials: G
authors.lastname: Witt
authors.forename: Manfred
authors.initials: M
authors.lastname: Wolfersdorf
authors.forename: Mathias
authors.initials: M
authors.lastname: Berger
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Gaebel
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D004334:Drug Administration Schedule; D004565:Electroconvulsive Therapy / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006302:Health Services Research; D006760:Hospitalization; D006778:Hospitals, Psychiatric / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents