Prospective evaluation of specialist inpatient treatment for refractory affective disorders
| Autor: | Lena Rane, Catherine Donaldson, Mary Cowan, Catherine Tunnard, Mario Francisco Juruena, Kalypso Markopoulou, Moya Tomlinson, Brendan Masterson, Sarah C. Wooderson, L. Poon, Abebaw Fekadu, Clodagh Commane, Jacek Donocik, Anthony J. Cleare |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Bipolar Disorder Psychiatric Department Hospital Statistics Nonparametric Pharmacotherapy Rating scale medicine Humans Prospective Studies Treatment Failure Bipolar disorder Psychiatry Prospective cohort study Referral and Consultation Depression (differential diagnoses) Patient Care Team Psychiatric Status Rating Scales Depressive Disorder Chi-Square Distribution Mood Disorders business.industry Middle Aged medicine.disease Combined Modality Therapy Antidepressive Agents United Kingdom Hospitalization Psychiatry and Mental health Clinical Psychology Treatment Outcome Emergency medicine Female Observational study business Chi-squared distribution Treatment-resistant depression Specialization |
| Zdroj: | Journal of Affective Disorders. 131:92-103 |
| ISSN: | 0165-0327 |
| DOI: | 10.1016/j.jad.2010.11.002 |
| Popis: | Background Little data exist to inform the treatment of severe and resistant affective disorders. We report here the effectiveness of specialist multimodal inpatient treatment for refractory affective disorders. Methods Prospective evaluation of 225 consecutive patients admitted to the National Affective Disorders Unit between 2001 and 2008. Results Patients were highly treatment-resistant: most had already received ECT, lithium augmentation and over 10 prior treatment trials. Even so, sequential assessment with the Hamilton Depression Rating Scale found that 69% showed a clinical response (≥ 50% reduction in Hamilton score) to intensive therapy during admission; 50% continued to sustain a full response and 71% at least a partial response on discharge. Patients' self-ratings (57% very much or much improved, 24% slightly improved) and relative and referrer reports (75% and 68% respectively rated patients as improved) gave similar levels of improvement. Limitations This was an observational study, without any untreated control group. The generalisability of the findings is limited by the highly specialised nature of the unit. Conclusions Most patients with depression highly resistant to prior treatment respond to specialist and intensive multimodal inpatient therapy. |
| Databáze: | OpenAIRE |
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