[The adherence of clinical management in a randomized controlled trial. Results from a psychotherapy study].
CM is increasingly used as a control condition in depression research. In the present study, the adherence of standardized CM sessions and their influence on outcome in depressed inpatients was investigated for the first time. In a randomized controlled trial, 43 inpatients with a diagnosis of Major Depression received medication treatment plus three-weekly CM sessions for 5 weeks. The 17-item version of the Hamilton Depression Rating Scale was the outcome measure. A total of 167 randomly selected audiotapes of CM sessions were evaluated using an adherence scale. The CM sessions delivered by psychiatric residents showed overall a high quality and included extensive support by the physician. The length of sessions was extended. The purity of sessions was associated with higher response rates. A diagnosis of Axis II-disorders or -traits and the clinical experience of the physician in years were predictors for less adherend treatments. However, both of them did not function as moderator variables.
Zobel
Ingo
I
Abteilung für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg.
Karim
Arian
A
Kech
Sabine
S
Berger
Mathias
M
Schramm
Elisabeth
E
D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy; D019090:Case Management; D003627:Data Interpretation, Statistical; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome