Universität zu Köln

Wagner, Christoph J. ORCID: 0000-0002-1728-8720, Dintsios, Charalabos Markos, Metzger, Florian G. ORCID: 0000-0002-8236-1170, L'Hoest, Helmut, Marschall, Ursula, Stollenwerk, Björn ORCID: 0000-0002-3189-409X and Stock, Stephanie ORCID: 0000-0002-1726-9300 (2018). Longterm persistence and nonrecurrence of depression treatment in Germany: a four-year retrospective follow-up using linked claims data. Int. J. Methods Psychiatr. Res., 27 (2). HOBOKEN: WILEY. ISSN 1557-0657

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Abstract

ObjectivesTo measure persistence and nonrecurrence of depression treatment and investigate potential risk factors. MethodsWe retrospectively observed a closed cohort of insurees with new-onset depression treatment in 2007 and without most psychiatric comorbidity for 16 quarters (plus one to ascertain discontinuation). We linked inpatient/outpatient/drug-data per person and quarter. Person-quarters containing specified depression services were classified as depression-treatment-person-quarters (DTPQ). We defined longterm-DTPQ-persistence as 16+1 continuous DTPQ and longterm-DTPQ-nonrecurrence as 12 continuous quarters without DTPQ and used multivariate logistic regression to explore associations with these outcomes. ResultsWithin first 16 quarters, 28,348 patients' first period (total time) persisted for a mean/median 5.4/3 (8.7/8) quarters. Fourteen percent had longterm-DTPQ-persistence, associated (p<.05) with baseline hospital (odds ratio, OR=1.80), psychotherapy/specialist-interview and antidepressants (OR=1.81), age (years, OR=1.03), unemployment (OR=1.21), retirement (OR=1.31), and insured as a dependent (OR=1.32). Thirty-four percent had longterm-DTPQ-nonrecurrence, associated with psychotherapy/specialist-interview (OR=1.40), antidepressants (OR=0.54), female sex (OR=0.84), age (years, OR=0.99), retirement (OR=1.18), and insured as a dependent (OR=0.88). Women differed for episodic and not chronic treatment. ConclusionTreatment measures compared to survey's symptoms measures. We suggest further research on treatment-free-time. Antidepressants(-) and psychotherapy/specialist-interview(+) were significantly associated with longterm-DTPQ-nonrecurrence. This was presumably moderated by possible short-time/low-dosage antidepressants use(-) and selective therapy assignment(+). Sample selectivity limited data misclassification.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wagner, Christoph J. UNSPECIFIED orcid.org/0000-0002-1728-8720 UNSPECIFIED Dintsios, Charalabos Markos UNSPECIFIED UNSPECIFIED UNSPECIFIED Metzger, Florian G. UNSPECIFIED orcid.org/0000-0002-8236-1170 UNSPECIFIED L'Hoest, Helmut UNSPECIFIED UNSPECIFIED UNSPECIFIED Marschall, Ursula UNSPECIFIED UNSPECIFIED UNSPECIFIED Stollenwerk, Björn UNSPECIFIED orcid.org/0000-0002-3189-409X UNSPECIFIED Stock, Stephanie UNSPECIFIED orcid.org/0000-0002-1726-9300 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-184770
DOI:	10.1002/mpr.1607
Journal or Publication Title:	Int. J. Methods Psychiatr. Res.
Volume:	27
Number:	2
Date:	2018
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1557-0657
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Sonstiges > Zentrum für Versorgungsforschung Köln
Subjects:	Psychology Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language MAJOR DEPRESSION; INTERPERSONAL PSYCHOTHERAPY; RANDOMIZED-TRIAL; SEX-DIFFERENCES; RELAPSE RATES; RECOVERY; PREDICTORS; RECURRENCE; DISORDERS; COMORBIDITY Multiple languages Psychiatry Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18477