Does Clinical Depression Respond Better to Inpatient or Outpatient Treatment?
When clinical depression strikes, what is the best way to receive treatment? Are patients better off checking into a 24-hour treatment facility where they can receive round-the-clock help, or are they better served by day programs, which allow them to maintain much of their daily life while working to overcome their depression?
A Small Study Asking a Big Question
In a recent study published in the Journal of Psychotherapy and Psychosomatics, researchers followed 44 patients with diagnosed depression. The majority (97.7 percent) had experienced clinical depression, and one patient had a less severe form of depression known as dysthymia. The participants were randomly assigned to either inpatient or outpatient treatment for two months.
As detailed on the website ScienceDaily, the two groups were treated by the same staff members and received identical amounts of psychotherapy. Some participants entered the study already using antidepressant medications. Six of those patients had their dosage lowered or were weaned off the drugs entirely during the study period. Another four patients either began antidepressant therapy or had their dosages increased.
Results Look About the Same for Both Groups
A single participant was switched from one antidepressant drug class to another class. By the end of the study, 51.4 percent of the participants were using antidepressant medications. Perhaps most intriguing, the researchers found no link between starting a patient on antidepressants or upping the amount of antidepressant medication the person was taking and a lowering of depression symptoms.
The investigators witnessed an overall improvement for participants, but they did not detect any notable differences in efficacy between inpatient versus outpatient treatment. In fact, three participants in each group achieved remission. Eight of the inpatient subjects were considered responders while six of the outpatient subjects were identified responders. Given the significant differences in cost between the two approaches, identifying areas where one achieves better results than another is an important question.
Larger Study Needed to Identify Who Benefits from Which Form of Treatment
There may yet be patients who would receive greater benefit from inpatient care though this study suggests that more study is needed in order to identify which patient profiles would be best suited. The severity of a patient’s depression may determine whether inpatient or outpatient level care is required.
This study indicates that there is not a one-size-fits-all solution, but a willingness to stick with the program regardless of which one is being pursued appears to be a key to success. One limitation of this study is its small size. Large-scale studies are needed to verify the findings of this investigation.