Behandlungsevaluation in der stationären Psychiatrie: Transdiagnostische Faktoren als Korrelate des Behandlungsergebnisses

Zusammenfassung

Ziel Eine stationäre psychiatrisch-psychotherapeutische Behandlung wurde in einem naturalistischen Setting im Sinne der Effectiveness-Forschung evaluiert. Transdiagnostische Faktoren wurden als Korrelate des Behandlungsergebnisses untersucht.

Methoden Die Datenerhebung mit Selbstberichtsfragebogen fand zum Eintritts- und Austrittszeitpunkt statt. Die Patientenpopulation (N = 378) bestand aus Frauen und Männern (16–80 Jahre; M = 40,4; SD = 15,8) mit Primärdiagnosen einer depressiven, Angst- oder Essstörung. Die durchschnittliche Behandlungsdauer betrug 8,2 Wochen (SD = 3,8). Primäre Ergebnisvariablen waren die Symptomausprägung und das psychosoziale Funktionsniveau. Als transdiagnostische Korrelate wurden Selbstwert, Selbstwirksamkeitserwartung und Emotionsregulation in die Regressionsanalysen einbezogen.

Ergebnisse Die Veränderung der transdiagnostischen Faktoren erklärte einen signifikanten Anteil der Varianz am Behandlungsergebnis auf (Varianzaufklärung: 8–27 % Selbstwirksamkeit, 23–42 % Selbstwert, 10–26 % Emotionsregulation).

Diskussion/Schlussfolgerung Diese Studie zeigt, dass die Evaluation der Wirksamkeit von Behandlungen in einem naturalistischen klinischen Setting praktikabel ist. Transdiagnostisch bedeutsame Faktoren klärten störungsübergreifend einen substanziellen Teil der statistischen Varianz am Behandlungsergebnis auf. Aussagen über Kausalität sind anhand des vorliegenden Studiendesigns zwar nicht möglich, dennoch unterstreichen die Ergebnisse die Relevanz störungsübergreifender Trainings (z. B. der Emotionsregulation) zur Verbesserung der Wirksamkeit von Behandlungsansätzen.

Abstract

Aim An inpatient psychiatric-psychotherapeutic treatment was evaluated in a naturalistic setting (effectiveness research). Transdiagnostic factors were examined as correlates of treatment outcome.

Methods Self-report questionnaires were administered at the beginning and the end of the inpatient treatment. The sample (N = 378) consisted of women and men (16–80 years, M = 40.4, SD = 15.8) with primary diagnoses of depressive, anxiety or eating disorders. The average treatment duration was 8.2 weeks (SD = 3.8). Primary outcome variables were severity of symptoms and level of psychosocial functioning. As transdiagnostic correlates, self-esteem, self-efficacy, and emotion regulation were included in the regression analyses.

Results The change in transdiagnostic factors explained a significant proportion of the treatment outcome (explained variance: 8–27 % self-efficacy, 23–42 % self-esteem, 10–26 % emotion regulation).

Discussion/conclusion The present study shows that the evaluation of a treatment in a naturalistic clinical setting is feasible. Transdiagnostic factors explained a substantial part of the statistical variance in treatment outcome across all disorders. Even if the present study design does not allow conclusions about causality, the results underline the relevance of transdiagnostic trainings (e. g., in emotion regulation) to improve effectiveness of treatment approaches.

Schlüsselwörter

Behandlungsevaluation - Effectiveness-Forschung - stationäre Psychiatrie - transdiagnostische Faktoren - Emotionsregulation - Selbstwert - Selbstwirksamkeit

Keywords

treatment evaluation - effectiveness research - inpatient psychiatry - transdiagnostic factors - emotion regulation - self-esteem - self-efficacy

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