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Deteriorated and unchanged patients in psychological treatment in Swedish primary care and psychiatry
Stockholms Lans Landsting, Sweden.
Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
2016 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 70, no 1, 16-23 p.Article in journal (Refereed) PublishedText
Abstract [en]

Background: Despite substantial effect sizes for psychological therapy among different diagnosis groups and in different treatment contexts, many studies show that a large proportion of patients do not attain reliable improvement and a substantial portion are worse off after treatment. Previous studies suggest that patients in psychiatry may have worse outcome than patients in primary care. Aims: In this practice-based study of psychological treatment in Swedish primary care and adult psychiatry, the proportions of patients who did not improve and who deteriorated were assessed. Methods: Proportions of reliably improved, unchanged, and reliably deteriorated patients among 840 patients in primary care and 317 patients in specialist psychiatry were assessed by self-ratings using the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM). Results: More than half of the patients did not change reliably. About 2% of the patients in primary care and 7% in psychiatry deteriorated. Multilevel analyses of the data from primary care indicated that there were no therapist effects. Conclusions: The results emphasize the importance of monitoring treatment continuously in order to increase results for patients who do not improve.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD , 2016. Vol. 70, no 1, 16-23 p.
Keyword [en]
Adult specialist psychiatry; Deteriorated; Primary care; Treatment outcome; Unchanged
National Category
Basic Medicine
URN: urn:nbn:se:liu:diva-124092DOI: 10.3109/08039488.2015.1028438ISI: 000365719100003PubMedID: 25994483OAI: diva2:897217
Available from: 2016-01-25 Created: 2016-01-19 Last updated: 2016-01-25

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Holmqvist, Rolf
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