[Clinical courses of depressive and anxiety disorders over 1 year : Direct comparison of four treatment settings in psychiatry and psychosomatic medicine-results of the PfAD study].

backgroundInpatient care for patients with depressive and anxiety disorders (ICD-10 F3/F4 diagnoses) is provided in Germany in different settings of psychiatry and psychosomatic medicine.

objectiveApart from the question of the effectiveness of treatment, it is of interest whether the course of the disease differs between four different settings up to a period of 1 year after discharge. MATERIAL AND

methodsA total of 320 patients with main clinical diagnoses from the ICD-10 F3/F4 spectrum were recruited and interviewed consecutively in four treatment settings (psychiatric depression unit, psychiatric crisis intervention unit, psychiatric day hospital, psychosomatic acute hospital). The interviews were conducted after admission, before discharge and 6 and 12 months after discharge.

resultsOverall, treatment in all four settings was shown to be highly effective. The slight increase in symptoms in the postinpatient phase described in the literature was observed across all settings. In terms of treatment intensity, those treated in the crisis intervention unit received the most services after index treatment; however, this group was also the one with the most pronounced symptom burden at admission. Patients treated in the psychosomatic department had the lowest symptom burden at admission and overall received the least inpatient services over the observation period; however, outpatient follow-up treatment was apparently used most by those patients.

conclusionThe treatments proved to be effective in the long-term in both psychiatric and psychosomatic units. The different settings seem to be successful in adapting the treatments to the respective patient groups.