Deteriorated and unchanged patients in psychological treatment in Swedish primary care and
psychiatry
Engelsk titel: Deteriorated and unchanged patients in psychological treatment in Swedish primary care and
psychiatry
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Författare:
Mechlera, Jakob
;
Holmqvist, Rolf
Email: rolf.holmqvist@liu.se
Språk: Eng
Antal referenser: 35
Dokumenttyp:
Artikel
UI-nummer: 16033380
Sammanfattning
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.