Progress monitoring and feedback in psychiatric care reduces depressive symptoms.
BACKGROUND
To date, the monitoring of patient progress using standardized assessments has been neglected in hospital-based psychiatric care. Findings in outpatient psychotherapy have demonstrated clinically significant benefits for providing feedback to the sizeable minority of patients who were otherwise unlikely to experience positive outcome (Lambert, 2007). However, a similar system for presenting feedback on patient progress has not yet been assessed for group therapy within psychiatric inpatient settings. The current study aimed to develop and evaluate the effectiveness of a feedback system suitable for use in psychiatric services.


METHODS
In a nonrandomized trial, 1308 consecutive inpatients and day patients, whose diagnoses were primarily depressive and anxiety disorders, completed the World Health Organization's Wellbeing Index (WHO-5) routinely during a ten-day cognitive behavioral therapy group. The first cohort (n=461) received treatment as usual. The second cohort (n=439) completed monitoring measures without feedback, and for patients in the third cohort (n=408), feedback on progress was provided to both clinicians and patients midway through the treatment period.


RESULTS
Feedback was effective in reducing depressive symptoms (F(1,649)=6.29, p<.05) for those patients at risk of poor outcome, but not effective in improving wellbeing (F(1,569)=1.14, p>.05).


CONCLUSIONS
The current findings may be generalized to patient samples that exhibit largely depressive disorders, however rigorous follow-up is warranted.


CONCLUSIONS
Similar to outpatient settings, feedback appears to be beneficial for improving symptom outcomes but further time may be required for wellbeing to be affected.
Newnham
Elizabeth A
EA
The University of Western Australia, Perth, Western Australia, Australia. Elizabeth.Newnham@uwa.edu.au
Hooke
Geoff R
GR
Page
Andrew C
AC
D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D015331:Cohort Studies; D003631:Day Care, Medical; D003866:Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D030141:Feedback, Psychological; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011615:Psychotherapy, Group; D011788:Quality of Life / Q000523:psychology; D012944:Social Support; D014904:Western Australia; D055815:Young Adult