The multicenter effectiveness study of inpatient and day hospital treatment in departments of psychosomatic medicine and psychotherapy in Germany

Stephan Doering; Stephan Herpertz; Magdalena Pape; Tobias Hofmann; Matthias Rose; Katrin Imbierowicz; Franziska Geiser; Antonie Louise Bierling; Kerstin Weidner; Jörg Rademacher; Silke Michalek; Eva Morawa; Yesim Erim; Per Teigelack; Martin Teufel; Armin Hartmann; Claas Lahmann; Eva Milena Johanne Peters; Johannes Kruse; Dirk von Boetticher; Christoph Herrmann-Lingen; Mariel Nöhre; Martina de Zwaan; Ulrike Dinger; Hans-Christoph Friederich; Alexander Niecke; Christian Albus; Rüdiger Zwerenz; Manfred Beutel; Heribert Christian Sattel; Peter Henningsen; Barbara Stein; Christiane Waller; Karsten Hake; Carsten Spitzer; Andreas Stengel; Stephan Zipfel; Katja Weimer; Harald Gündel; Henrik Kessler

doi:10.3389/fpsyt.2023.1155582

The multicenter effectiveness study of inpatient and day hospital treatment in departments of psychosomatic medicine and psychotherapy in Germany

Front Psychiatry. 2023 Aug 7:14:1155582. doi: 10.3389/fpsyt.2023.1155582. eCollection 2023.

Authors

Stephan Doering^#^{1

2}, Stephan Herpertz^#³, Magdalena Pape³, Tobias Hofmann⁴, Matthias Rose⁴, Katrin Imbierowicz⁵, Franziska Geiser⁵, Antonie Louise Bierling^{6

7

8}, Kerstin Weidner⁶, Jörg Rademacher⁹, Silke Michalek⁹, Eva Morawa¹⁰, Yesim Erim¹⁰, Per Teigelack¹¹, Martin Teufel¹¹, Armin Hartmann¹², Claas Lahmann¹², Eva Milena Johanne Peters^{13

14}, Johannes Kruse^{13

14}, Dirk von Boetticher¹⁵, Christoph Herrmann-Lingen¹⁵, Mariel Nöhre¹⁶, Martina de Zwaan¹⁶, Ulrike Dinger^{9

17}, Hans-Christoph Friederich¹⁷, Alexander Niecke¹⁸, Christian Albus¹⁸, Rüdiger Zwerenz¹⁹, Manfred Beutel¹⁹, Heribert Christian Sattel²⁰, Peter Henningsen²⁰, Barbara Stein²¹, Christiane Waller²¹, Karsten Hake²², Carsten Spitzer²², Andreas Stengel²³, Stephan Zipfel²³, Katja Weimer²⁴, Harald Gündel²⁴, Henrik Kessler^{3

25}

Affiliations

¹ Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria.
² Comprehensive Clinical Center for Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Vienna, Austria.
³ Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany.
⁴ Charité Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
⁵ Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
⁶ Department of Psychotherapy and Psychosomatic Medicine, Carl Gustav Carus Faculty of Medicine, Technische Universität, Dresden, Germany.
⁷ Institute for Material Science and Nanotechnology, Technical University of Dresden, Dresden, Germany.
⁸ Department of Clinical Psychology, Friedrich-Schiller University, Jena, Germany.
⁹ Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
¹⁰ Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.
¹¹ Clinic of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany.
¹² Department of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
¹³ Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University of Giessen, Giessen, Germany.
¹⁴ Department of Psychosomatic Medicine and Psychotherapy, Philipps-University of Marburg, Marburg, Germany.
¹⁵ Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany.
¹⁶ Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany.
¹⁷ Department of General Internal Medicine and Psychosomatics, University Hospital, Heidelberg University, Heidelberg, Germany.
¹⁸ Department of Psychosomatic Medicine and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
¹⁹ Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
²⁰ Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Technical University of Munich, Munich, Germany.
²¹ Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany.
²² Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany.
²³ Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.
²⁴ Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany.
²⁵ Department of Psychosomatic Medicine and Psychotherapy, Campus Fulda, University of Marburg, Marburg, Germany.

^# Contributed equally.

Abstract

Background: Reliable outcome data of psychosomatic inpatient and day hospital treatment with a focus on psychotherapy are important to strengthen ecological validity by assessing the reality of mental health care in the field. This study aims to evaluate the effectiveness of inpatient and day hospital treatment in German university departments of Psychosomatic Medicine and Psychotherapy in a prospective, naturalistic, multicenter design including structured assessments.

Methods: Structured interviews were used to diagnose mental disorders according to ICD-10 and DSM-IV at baseline. Depression, anxiety, somatization, eating disorder and posttraumatic stress disorder (PTSD) symptoms, as well as personality functioning were assessed by means of questionnaires on admission and at discharge.

Results: 2,094 patients recruited by 19 participating university hospitals consented to participation in the study. Effect sizes for each of the outcome criteria were calculated for 4-5 sub-groups per outcome domain with differing severity at baseline. Pre-post effect sizes for patients with moderate and high symptom severity at baseline ranged from d = 0.78 to d = 3.61 with symptoms of PTSD, depression, and anxiety showing the largest and somatization as well as personality functioning showing somewhat smaller effects.

Conclusions: Inpatient and day hospital treatment in German university departments of Psychosomatic Medicine and Psychotherapy is effective under field conditions.

Clinical trial registration: https://drks.de/search/de/trial/DRKS00016412, identifier: DRKS00016412.

Keywords: eating disorders; inpatient; personality functioning; psychosomatic treatment; somatoform disorders.

Copyright © 2023 Doering, Herpertz, Pape, Hofmann, Rose, Imbierowicz, Geiser, Bierling, Weidner, Rademacher, Michalek, Morawa, Erim, Teigelack, Teufel, Hartmann, Lahmann, Peters, Kruse, von Boetticher, Herrmann-Lingen, Nöhre, de Zwaan, Dinger, Friederich, Niecke, Albus, Zwerenz, Beutel, Sattel, Henningsen, Stein, Waller, Hake, Spitzer, Stengel, Zipfel, Weimer, Gündel and Kessler.