Low levels and lack of predictors of somatotherapy and psychotherapy received by depressed patients

Arch Gen Psychiatry. 1986 May;43(5):458-66. doi: 10.1001/archpsyc.1986.01800050064007.

Abstract

We examined the treatment of 338 patients with nonbipolar major depressive disorders during the first eight weeks after entry into the National Institute of Mental Health-Clinical Research Branch Collaborative Program on the Psychobiology of Depression: Clinical Study. Of the 250 entered as inpatients, 31% received either no antidepressant somatotherapy or very low or unsustained levels, and only 49% received at least 200 mg of imipramine hydrochloride (or its equivalent) for four consecutive weeks. Of these patients, 19% received less than 30 minutes of psychotherapy per week. Among the 88 who entered as outpatients, 29% received no antidepressant somatotherapy; another 24% received very low or unsustained levels; only 19% received at least 200 mg of imipramine hydrochloride or its equivalent for four consecutive weeks. Of these patients, 52% received less than 30 minutes of psychotherapy per week. Only a few clinical factors were found to be predictive of treatment intensity. Very large differences in the amount and type of treatment across the five collaborating university centers do not appear to be related to differences in patient characteristics.

Publication types

  • Clinical Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Ambulatory Care
  • Antidepressive Agents / administration & dosage
  • Antidepressive Agents / therapeutic use*
  • Clinical Trials as Topic
  • Combined Modality Therapy
  • Depressive Disorder / diagnosis
  • Depressive Disorder / drug therapy
  • Depressive Disorder / therapy*
  • Electroconvulsive Therapy*
  • Female
  • Hospitalization
  • Humans
  • Imipramine / administration & dosage
  • Imipramine / therapeutic use
  • Lithium / administration & dosage
  • Lithium / therapeutic use*
  • Lithium Carbonate
  • Male
  • Outcome and Process Assessment, Health Care
  • Patient Compliance
  • Probability
  • Psychiatric Status Rating Scales
  • Psychotherapy*
  • Time Factors

Substances

  • Antidepressive Agents
  • Lithium Carbonate
  • Lithium
  • Imipramine