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Feedback-informed treatment in emergency psychiatry; a randomised controlled trial.

van Oenen FJ, Schipper S, Van R, Schoevers R, Visch I, Peen J, Dekker J - BMC Psychiatry (2016)

Bottom Line: After 3 months, symptom improvement in FB (ES 0.60) did not significantly differ from TAU (ES 0.71) (p = 0.505).After 6 weeks, FB patients (ES 0.31) actually improved less than TAU patients (0.56) (p = 0.019).Patients with psychiatric problems and severe distress seeking emergency psychiatric help did not benefit from direct feedback.

View Article: PubMed Central - PubMed

Affiliation: Arkin, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands. flipjanvanoenen@gmail.com.

ABSTRACT

Background: Immediate patient feedback has been shown to improve outcomes for patients in mild distress but it is unclear whether psychiatric patients in severe distress benefit equally from feedback. This study investigates the efficacy of an immediate feedback instrument in the treatment of patients with acute and severe psychosocial or psychiatric problems referred in the middle of a crisis.

Methods: A naturalistic mixed diagnosis sample of patients (N = 370) at a Psychiatric Emergency Centre was randomised to a Treatment-as-Usual (TAU) or a Feedback (FB) condition. In the FB condition, feedback on patient progress was provided on a session-by-session basis to both therapists and patients. Outcomes of the two treatment conditions were compared using repeated measures MANCOVA, Last Observation Carried Forward and multilevel analysis.

Results: After 3 months, symptom improvement in FB (ES 0.60) did not significantly differ from TAU (ES 0.71) (p = 0.505). After 6 weeks, FB patients (ES 0.31) actually improved less than TAU patients (0.56) (p = 0.019).

Conclusions: Patients with psychiatric problems and severe distress seeking emergency psychiatric help did not benefit from direct feedback.

Trial registration: Dutch Trial Register, NTR3168 , date of registration 1-9-2009.

No MeSH data available.


Related in: MedlinePlus

Participant flow
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Fig1: Participant flow

Mentions: Between 2009 and 2012, a total of 861 patients were referred to the Psychiatric Emergency Centre. The 222 patients who were unable to fill out a questionnaire at intake were excluded. A group of 269 patients were offered only one session for crisis evaluation, resulting in either immediate admission to a psychiatric hospital or referral to the patient's own general practitioner/therapist (when no indication for acute psychiatric help was found). In 370 patients the crisis intervention was followed by brief therapy, which was defined as more than two sessions (including the first crisis evaluation session). Of these patients, 83 terminated treatment within six weeks, making it impossible to assess their progress at the first time point (T6). The study sample therefore included 287 patients (Fig. 1). As 94 patients terminated treatment before T12, 49 (17.1 %) did not complete the questionnaires at this time and 15 (5.2 %) refused to participate, a total of 129 patients had received either TAU (57) or TAU + FB (72) at 12 weeks.Fig. 1


Feedback-informed treatment in emergency psychiatry; a randomised controlled trial.

van Oenen FJ, Schipper S, Van R, Schoevers R, Visch I, Peen J, Dekker J - BMC Psychiatry (2016)

Participant flow
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837581&req=5

Fig1: Participant flow
Mentions: Between 2009 and 2012, a total of 861 patients were referred to the Psychiatric Emergency Centre. The 222 patients who were unable to fill out a questionnaire at intake were excluded. A group of 269 patients were offered only one session for crisis evaluation, resulting in either immediate admission to a psychiatric hospital or referral to the patient's own general practitioner/therapist (when no indication for acute psychiatric help was found). In 370 patients the crisis intervention was followed by brief therapy, which was defined as more than two sessions (including the first crisis evaluation session). Of these patients, 83 terminated treatment within six weeks, making it impossible to assess their progress at the first time point (T6). The study sample therefore included 287 patients (Fig. 1). As 94 patients terminated treatment before T12, 49 (17.1 %) did not complete the questionnaires at this time and 15 (5.2 %) refused to participate, a total of 129 patients had received either TAU (57) or TAU + FB (72) at 12 weeks.Fig. 1

Bottom Line: After 3 months, symptom improvement in FB (ES 0.60) did not significantly differ from TAU (ES 0.71) (p = 0.505).After 6 weeks, FB patients (ES 0.31) actually improved less than TAU patients (0.56) (p = 0.019).Patients with psychiatric problems and severe distress seeking emergency psychiatric help did not benefit from direct feedback.

View Article: PubMed Central - PubMed

Affiliation: Arkin, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands. flipjanvanoenen@gmail.com.

ABSTRACT

Background: Immediate patient feedback has been shown to improve outcomes for patients in mild distress but it is unclear whether psychiatric patients in severe distress benefit equally from feedback. This study investigates the efficacy of an immediate feedback instrument in the treatment of patients with acute and severe psychosocial or psychiatric problems referred in the middle of a crisis.

Methods: A naturalistic mixed diagnosis sample of patients (N = 370) at a Psychiatric Emergency Centre was randomised to a Treatment-as-Usual (TAU) or a Feedback (FB) condition. In the FB condition, feedback on patient progress was provided on a session-by-session basis to both therapists and patients. Outcomes of the two treatment conditions were compared using repeated measures MANCOVA, Last Observation Carried Forward and multilevel analysis.

Results: After 3 months, symptom improvement in FB (ES 0.60) did not significantly differ from TAU (ES 0.71) (p = 0.505). After 6 weeks, FB patients (ES 0.31) actually improved less than TAU patients (0.56) (p = 0.019).

Conclusions: Patients with psychiatric problems and severe distress seeking emergency psychiatric help did not benefit from direct feedback.

Trial registration: Dutch Trial Register, NTR3168 , date of registration 1-9-2009.

No MeSH data available.


Related in: MedlinePlus