title: Pretreatment and process predictors of nonresponse at different stages of inpatient psychotherapy.
abstract: Up to 50% of psychotherapeutic treatments end without significant improvements. While there is first evidence about predictors of nonresponse in outpatient psychotherapy, there are currently no studies investigating predictors of nonresponse in inpatient settings. Based upon a previous systematic literature review, we analyzed the predictive value of initial patient characteristics on nonresponse in symptom distress.
  
  
  
  Treatment episodes from 546 patients, treated for at least 4 weeks, were assessed under naturalistic conditions. Nonresponse status (i.e., lack of a reliable improvement in symptom distress) was investigated at four different time points: at week 4, at discharge, and at a two follow-ups (3 and 12 months after discharge). Hierarchical binary logistic regression models were used to predict nonresponse. Sociodemographic data, clinical variables, and the previous response status were entered subsequently in the model.
  
  
  
  A moderate or functional level of initial symptom distress, a comorbid personality disorder, and previous nonresponse were the most consistent predictors of nonresponse.
  
  
  
  The results point to the importance of early outcome assessment and suggest the implementation of more symptom-specific treatments.
authors.affiliation: a Universitätsklinikum Freiburg, Zentrum für psychische Erkrankungen, Klinik für psychosomatische Medizin und Psychotherapie , Freiburg im Breisgau , Germany.|b Institut für Psychosoziale Medizin und Psychotherapie , Friedrich-Schiller Universität , Jena , Germany.
authors.forename: Laurence
authors.initials: L
authors.lastname: Reuter
authors.affiliation: c Psychologische Hochschule Berlin , Berlin , Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Munder
authors.affiliation: b Institut für Psychosoziale Medizin und Psychotherapie , Friedrich-Schiller Universität , Jena , Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Altmann
authors.affiliation: a Universitätsklinikum Freiburg, Zentrum für psychische Erkrankungen, Klinik für psychosomatische Medizin und Psychotherapie , Freiburg im Breisgau , Germany.
authors.forename: Armin
authors.initials: A
authors.lastname: Hartmann
authors.affiliation: b Institut für Psychosoziale Medizin und Psychotherapie , Friedrich-Schiller Universität , Jena , Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Strauss
authors.affiliation: a Universitätsklinikum Freiburg, Zentrum für psychische Erkrankungen, Klinik für psychosomatische Medizin und Psychotherapie , Freiburg im Breisgau , Germany.
authors.forename: Carl Eduard
authors.initials: CE
authors.lastname: Scheidt
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data*; D011613:Psychotherapy / Q000379:methods / Q000706:statistics & numerical data*; D017211:Treatment Failure
keywords: effectiveness; failure; inpatient treatment; nonresponse; outcome; relapse