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Coping strategies, hope, and treatment efficacy in pharmacoresistant inpatients with neurotic spectrum disorders.

Ociskova M, Prasko J, Kamaradova D, Grambal A, Kasalova P, Sigmundova Z, Latalova K, Vrbova K - Neuropsychiatr Dis Treat (2015)

Bottom Line: The mean scores for all scales measuring the severity of the disorders (BAI, BDI-II, subjective and objective CGI) significantly decreased during the treatment.Multiple regression was used to find out which factors were the most significant predictors of the therapeutic outcomes.According to our results, a group of patients with a primary neurotic disorder, who prefer the use of maladaptive coping strategies, feel hopelessness, and have tendencies to dissociate, showed poor response to treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, Faculty of Arts, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic ; Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic.

ABSTRACT

Background: Approximately 30%-60% of patients with neurotic spectrum disorders remain symptomatic despite treatment. Identifying the predictors of good response to psychiatric and psychotherapeutic treatment may be useful for increasing treatment efficacy in neurotic patients. The objective of this study was to investigate the influence of hope, coping strategies, and dissociation on the treatment response of this group of patients.

Methods: Pharmacoresistant patients, who underwent a 6-week psychotherapeutic program, were enrolled in the study. All patients completed the Clinical Global Impression (CGI) - both objective and subjective forms, Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI)-II at baseline and after 6 weeks. The COPE Inventory, the Adult Dispositional Hope Scale (ADHS), and the Dissociative Experiences Scale (DES) were completed at the start of the treatment.

Results: Seventy-six patients completed the study. The mean scores for all scales measuring the severity of the disorders (BAI, BDI-II, subjective and objective CGI) significantly decreased during the treatment. Several subscores of the COPE Inventory, the overall score of ADHS, and the overall score of DES significantly correlated with the treatment outcome. Multiple regression was used to find out which factors were the most significant predictors of the therapeutic outcomes. The most important predictors of the treatment response were the overall levels of hope and dissociation.

Conclusion: According to our results, a group of patients with a primary neurotic disorder, who prefer the use of maladaptive coping strategies, feel hopelessness, and have tendencies to dissociate, showed poor response to treatment.

No MeSH data available.


Related in: MedlinePlus

Linear regression of the overall score of ADHS (WS) and the relative change measured by objCGI.Notes:F=10.71, DFn, DFd =1.000, 69.00; P<0.005.Abbreviations: ADHS, Adult Dispositional Hope Scale; DFd, degree of freedom for the denominator; DFn, degree of freedom for the numerator; objCGI, objective Clinical Global Impression; WS, whole score.
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f2-ndt-11-1191: Linear regression of the overall score of ADHS (WS) and the relative change measured by objCGI.Notes:F=10.71, DFn, DFd =1.000, 69.00; P<0.005.Abbreviations: ADHS, Adult Dispositional Hope Scale; DFd, degree of freedom for the denominator; DFn, degree of freedom for the numerator; objCGI, objective Clinical Global Impression; WS, whole score.

Mentions: Because of the relatively high number of the factors significantly correlating with the primary outcome measures, we decided to apply a multiple regression (precisely, a backward stepwise regression analysis) to find out which factors were the most significant predictors of the therapeutic outcome. The dependent variable was the objCGI change; the independent variables were the factors that correlated the strongest with the dependent variable. The chosen independent variables were: the overall score of ADHS, the overall rating of DES, and several subscales of the COPE Inventory – Active coping, Planning, Substance use, Behavioral disengagement, and Acceptance. These variables explained a small part of the objCGI change variance (R-square adjusted =0.160, significance =0.012). The only significant predictors of the treatment efficacy were the overall level of hope (beta =0.283, standard error (SE) =0.008, significance =0.013) and the overall level of dissociation (beta =−0.316, SE =0.007, significance =0.006) (Figures 2 and 3). To determine the effect size, we computed Cohen’s f2. Its value (0.28) indicated that the effect size of the final model with the two predictors was medium.58


Coping strategies, hope, and treatment efficacy in pharmacoresistant inpatients with neurotic spectrum disorders.

Ociskova M, Prasko J, Kamaradova D, Grambal A, Kasalova P, Sigmundova Z, Latalova K, Vrbova K - Neuropsychiatr Dis Treat (2015)

Linear regression of the overall score of ADHS (WS) and the relative change measured by objCGI.Notes:F=10.71, DFn, DFd =1.000, 69.00; P<0.005.Abbreviations: ADHS, Adult Dispositional Hope Scale; DFd, degree of freedom for the denominator; DFn, degree of freedom for the numerator; objCGI, objective Clinical Global Impression; WS, whole score.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4440432&req=5

f2-ndt-11-1191: Linear regression of the overall score of ADHS (WS) and the relative change measured by objCGI.Notes:F=10.71, DFn, DFd =1.000, 69.00; P<0.005.Abbreviations: ADHS, Adult Dispositional Hope Scale; DFd, degree of freedom for the denominator; DFn, degree of freedom for the numerator; objCGI, objective Clinical Global Impression; WS, whole score.
Mentions: Because of the relatively high number of the factors significantly correlating with the primary outcome measures, we decided to apply a multiple regression (precisely, a backward stepwise regression analysis) to find out which factors were the most significant predictors of the therapeutic outcome. The dependent variable was the objCGI change; the independent variables were the factors that correlated the strongest with the dependent variable. The chosen independent variables were: the overall score of ADHS, the overall rating of DES, and several subscales of the COPE Inventory – Active coping, Planning, Substance use, Behavioral disengagement, and Acceptance. These variables explained a small part of the objCGI change variance (R-square adjusted =0.160, significance =0.012). The only significant predictors of the treatment efficacy were the overall level of hope (beta =0.283, standard error (SE) =0.008, significance =0.013) and the overall level of dissociation (beta =−0.316, SE =0.007, significance =0.006) (Figures 2 and 3). To determine the effect size, we computed Cohen’s f2. Its value (0.28) indicated that the effect size of the final model with the two predictors was medium.58

Bottom Line: The mean scores for all scales measuring the severity of the disorders (BAI, BDI-II, subjective and objective CGI) significantly decreased during the treatment.Multiple regression was used to find out which factors were the most significant predictors of the therapeutic outcomes.According to our results, a group of patients with a primary neurotic disorder, who prefer the use of maladaptive coping strategies, feel hopelessness, and have tendencies to dissociate, showed poor response to treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, Faculty of Arts, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic ; Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic.

ABSTRACT

Background: Approximately 30%-60% of patients with neurotic spectrum disorders remain symptomatic despite treatment. Identifying the predictors of good response to psychiatric and psychotherapeutic treatment may be useful for increasing treatment efficacy in neurotic patients. The objective of this study was to investigate the influence of hope, coping strategies, and dissociation on the treatment response of this group of patients.

Methods: Pharmacoresistant patients, who underwent a 6-week psychotherapeutic program, were enrolled in the study. All patients completed the Clinical Global Impression (CGI) - both objective and subjective forms, Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI)-II at baseline and after 6 weeks. The COPE Inventory, the Adult Dispositional Hope Scale (ADHS), and the Dissociative Experiences Scale (DES) were completed at the start of the treatment.

Results: Seventy-six patients completed the study. The mean scores for all scales measuring the severity of the disorders (BAI, BDI-II, subjective and objective CGI) significantly decreased during the treatment. Several subscores of the COPE Inventory, the overall score of ADHS, and the overall score of DES significantly correlated with the treatment outcome. Multiple regression was used to find out which factors were the most significant predictors of the therapeutic outcomes. The most important predictors of the treatment response were the overall levels of hope and dissociation.

Conclusion: According to our results, a group of patients with a primary neurotic disorder, who prefer the use of maladaptive coping strategies, feel hopelessness, and have tendencies to dissociate, showed poor response to treatment.

No MeSH data available.


Related in: MedlinePlus