[Treatment motivation and results of inpatient psychotherapy for women with depressive disorders: a prospective study].
Whether the treatment results in inpatient psychotherapy are significantly influenced by the patient's motivation is a subject of discussion. The goal of this study was to assess whether the primary motivation for therapy in depressive women influences the results of psychotherapeutic treatment. In a prospective study, the monitored results from 64 female inpatients (32 who were highly motivated to enter therapy, and 32 who were minimally motivated) were compared to each other. The period of observation was six weeks. As instruments of assessment, the Fragebogen zur Therapiemotivation (FMP) (Questonnaire on Motivation for Entering Therapy) and the Beck Depression Inventory (BDI) were aministered upon admission; after the fourth and sixth weeks of therapy, the Veränderungsfragebogen des Erlebens und Verhaltens (VEV) (Questionnaire of Changes in Experience and Behavior) was administered as well. All patients who had applied for a pension were found in the group of less motivated patients and consolidated into a subgroup. The analysis was carried out according to the intent-to-treat principle. The variance analysis for the repeat measurements showed significant differences on all the FMP scales and on the BDI (all P< 0.001). The measurements with VEV likewise resulted in a significant difference (P< 0.01). The subgroup of "pension patients" showed significantly less change in all three of the above measurements. Patients with depressive symptomology who essentially are relatively highly motivated for therapy could profit significantly more from inpatient psychosomatic treatment than those who are less motivated. Establishing and developing motivation prior to inpatient hospitalization could possibly contribute to more efficient and cost-effective clinical treatment. Where legal proceedings pertaining to a pension are pending, relatively less motivated patients fare significantly worse not only in their motivational development for therapy, but also in their final treatment results. It should be noted, however, that the relatively small random sample, the restricted blinding, which was only partially possible, could have led to possible distortions.
Nickel
C
C
Inntalklinik, Fachklinik für Psychosomatik, Simbach/Inn, Deutschland.
Muehlbacher
M
M
Kettler
C
C
Tritt
K
K
Egger
C
C
Lahmann
C
C
Pedrosa Gil
F
F
Leiberich
P
P
Bachler
E
E
Buschmann
W
W
Forthuber
P
P
Fartacek
R
R
Mitterlehner
F
F
Rother
W
W
Loew
T
T
Nickel
M
M
D001294:Attitude to Health; D003866:Depressive Disorder / Q000453:epidemiology* / Q000628:therapy*; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008875:Middle Aged; D009042:Motivation; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010415:Pensions / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies; D011613:Psychotherapy / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome