title: Symptom course in inpatient and day clinic treatment of depression: Results from the INDDEP-Study.
abstract: BACKGROUND
  In major depression (MDD), hospital treatment is an option in more severe cases or if outpatient treatment failed. Psychosomatic hospitals in Germany provide treatment programs with multimodal psychotherapy, either in an inpatient or a day hospital setting. In the context of health care research, this study aimed (1) to compare characteristics of patients treated in psychosomatic day hospitals and inpatient units, (2) to compare the effectiveness of both treatment modalities.
  
  
  METHODS
  A naturalistic design was chosen to achieve external validity. 604 consecutive patients were assessed at admission, discharge and a 3-month follow-up. Primary outcome was defined as a reduction of depressive symptomatology (QIDS-C), secondary outcomes comprise overall functioning and quality of life. For a comparison of effectiveness, inpatient and day hospital samples were matched according to known predictors of outcome.
  
  
  RESULTS
  The few differences found between the inpatient and day hospital sample were related to severity of depression and physical impairment. Inpatients more often got antidepressant medication. Additionally, inpatients were treated significantly longer, due to a subgroup of patients with somatic co-morbidity. There were no differences when comparing effectiveness.
  
  
  CONCLUSIONS
  When comparing treatment effectiveness, possible bias cannot be ruled out. There was no randomization or untreated control group.
  
  
  CONCLUSIONS
  In patients with a more severe depression and somatic co-morbidity, inpatient treatment might be preferred as compared to day hospital treatment. However, most patients can be treated in both settings.
authors: Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital, Freiburg, Germany. Electronic address: almut.zeeck@uniklinik-freiburg.de.
authors: Almut
authors: A
authors: Zeeck
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Ulm, Germany.
authors: Jörn
authors: J
authors: von Wietersheim
authors: Department of Psychosomatic Medicine and Psychotherapy, Robert-Bosch-Krankenhaus, Stuttgart, Germany.
authors: Heinz
authors: H
authors: Weiß
authors: Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital, Freiburg, Germany; Thure-von-Uexküll-Klinik, Glottertal, Germany.
authors: Carl
authors: C
authors: Eduard Scheidt
authors: Rhein Klinik, Bad Honnef, Germany.
authors: Alexander
authors: A
authors: Völker
authors: Rhein Klinik, Bad Honnef, Germany.
authors: Astrid
authors: A
authors: Helesic
authors: Department of Psychosomatic Medicine and Psychotherapy, Bürgerhospital, Stuttgart, Germany.
authors: Annegret
authors: A
authors: Eckhardt-Henn
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Mainz, Germany.
authors: Manfred
authors: M
authors: Beutel
authors: Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital, Freiburg, Germany.
authors: Katharina
authors: K
authors: Endorf
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Ulm, Germany.
authors: Jamie
authors: J
authors: Knoblauch
authors: Department of Psychosomatic Medicine and Psychotherapy, Fürst Stirum-Klinikum, Bruchsal, Germany.
authors: Peter
authors: P
authors: Rochlitz
authors: Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital, Freiburg, Germany.
authors: Armin
authors: A
authors: Hartmann
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003631:Day Care, Medical / Q000523:psychology* / Q000706:statistics & numerical data; D003865:Major Depressive Disorder / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007297:Inpatients / Q000523:psychology* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods; D011788:Quality of Life / Q000523:psychology; D015203:Reproducibility of Results; D013001:Somatoform Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents
keywords: Day hospital; Depression; Inpatient; Outcome