Abstract
ObjectiveDepressive disorders are among the most common psychiatric disorders. For severely depressed patients, day clinic and inpatient settings represent important treatment options. However, little is known about patients’ perceptions of the different levels of care. This study aimed to obtain an in-depth analysis of depressive patients’ experiences of day clinic and inpatient treatment in a combined clinical setting.MethodsFollowing a randomized controlled trial comparing day clinic and inpatient psychotherapy for depression (Dinger et al. in Psychother Psychosom 83:194–195, 2014), a sample of depressive patients (n = 35) was invited to participate in a semi-structured interview during an early follow up 4 weeks after discharge. A qualitative analysis of interview transcripts was performed following the principles of constructivist thematic analysis.ResultsFollowing analysis, 1355 single codes were identified from which five main categories and 26 themes were derived for both groups. In regard to patient group integration and skill transfer to everyday life, distinct differences could be observed between the day clinic and inpatient group.ConclusionWhile adjustment to therapeutic setting and patient group integration seem to be facilitated by inpatient treatment, the day clinical setting appears to promote treatment integration into patients’ everyday contexts, aiding treatment-related skill transfer to everyday life as well as alleviating discharge from clinic treatment. Further studies on depressive subject groups in day clinic and inpatient treatment should investigate aspects of group cohesion and treatment integration in relation to therapeutic outcome.
Highlights
With a life-time prevalence rate of up to 24 % for major depressive episodes [1,2,3], depressive disorders are among the most common psychiatric disorders
Following analysis, 1355 single codes were identified from which five main categories and 26 themes were derived for both groups
Patients were included in the study if they were diagnosed with a current major depressive episode (MDE) or dysthymia, were aged between 18 and 60, and lived within 60 km of the treatment hospital
Summary
With a life-time prevalence rate of up to 24 % for major depressive episodes [1,2,3], depressive disorders are among the most common psychiatric disorders. The commonly recognized main advantage of the day clinic treatment setting, namely the possibility of providing patients with a combination of intense, multimodal treatment while keeping continuous contact to their home environment and everyday stressors, is at the same time one of its most difficult challenges [13]. The time division between therapy and the home environment (“half-and-half ’’) allows patients to maintain social contacts [15], and to continue to care for children and relatives, if necessary [9]. This is in line with treatment models focusing on recovery oriented mental health care [16]. The multimodal approach allows for very intensive treatment within a relatively short time frame
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