Abstract
The duration of psychiatric hospital stays becomes increasingly important as economic pressures on medicine mount. Psychiatric hospitals, in particular, search for ways to cut costs without sacrificing efficiency. There is no doubt that clinical depression is one of the most important cost factors in psychiatry. Former studies have concentrated mainly on the influence of clinical variables such as the severity or subtype of depression on the length of stay (LOS). However, it can also be assumed that life situations or psychosocial variables in general might influence LOS. Data from 736 admissions between January 1983 and 1991 with a diagnosis of depression were examined to test the hypothesis that psychosocial and clinical variables influence LOS. Results showed a significant influence of age, marital status and gender, as well as severity and type of depression, on duration of inpatient treatment. Age, female gender, being widowed or divorced, the diagnosis of “endogenous depression” and severity were all associated with longer LOS. There was an interaction of gender, marital status and perceived loneliness, as well as an interaction of severity of depression with gender, both of which were associated with LOS.
Similar content being viewed by others
References
AMDP (1981) Manual zur Dokumentation psychiatrischer. Befunde. Springer, Berlin Heidelberg New York
Angst J (1987) Epidemiologie der affektiven Psychosen. In: Kisker KP, et al. (eds) Psychiatrie der Gegenwart (Band 5). Springer, Berlin Heidelberg New York, pp 51–66
Angst J (1987) Verlauf der affektiven Psychosen. In: Kisker KP, et al. (eds) Psychiatrie der Gegenwart (Band 5). Springer, Berlin Heidelberg New York, pp 115–133
Bellack AS, Herson M, Himmelhock J (1981) Social skills training compared with pharmacotherapy and psychotherapy in the treatment of unipolar depression. Am J Psychiatry 138: 1562–1567
Bloom JA, Spiegel D (1984) The relationship of two dimensions of social support to the psychological well-being and social functioning of women with advanced breast cancer. Soc Sci Med 19:831–837
Buxton MJ (1992) Health economics in the 1990s. Satellite Symposium 18th CINP
Crowther JH (1985) The relationship between depression and marital maladjustment: a descriptive study. J Nerv Ment Dis 173:227–231
Depue RA, Monroe SM (1978) The unipolar-bipolar distinction in the depressive disorder. Psychol Bull 85:1001–1029
Gebhardt R, Klimitz H (1983) Zur Validierung der AMDP-Syndromskalen. Arch Psychiatr Nervenkr 233: 509–523
Gove WR (1972) Sex, marital status, and suicide. J Health Soc Bahav 13:204–213
House JS, Landis KR, Umberson D (1987) Social relationships and health. Science 241:540–545
ICD 9 (1978) Diagnoseschlüssel und Glossar psychiatrischer Krankheiten. Springer, Berlin Heidelberg New York
de Jong R, Treiber R, Heinrich G (1987) Therapieverläufe medikamentös und verhaltenstherapeutisch behandelter depressiver Patienten. In: Gerber WD, et al. (eds) Verhaltensmedizin: Ergebnisse und Perspektiven interdisziplinärer Forschung. VCH, Weinheim
Jönsson B, Bebbington P (1992) The cost of depression and the cost effectiveness of pharmacological treatment. Satellite Symposium 18th CINP
Kovess V, Soyris D (1994) Medical information departments and medical program of information system in psychiatry. Feasibility and consequences. Encephale 20:27–45
Kuny S, et al. (1983) Interrater reliability of AMDP and AMDP symptoms. In: Bobon D, Baumann U, Angst J, Helmchen H, Hippius H (eds) The AMDP-system in pharmacopsychiatry. Karger, Basel, pp 143–160
Langeheine R (1980) Loglineare Modelle zu multivariaten Analysen qualitativen Daten. Oldenbourg Verlag, Munich
Markowitz J, Brown R, Sweeney J, Mann JJ (1987) Reduced length and cost of hospital stay for major depression in patients treated with ECT. Am J Psychiatry 144:1025–1029
McCrone P, Phelan M (1994) Diagnosis and length of psychiatric in-patient stay. Psychol Med 24:1025–1030
Rosset N, Andreoli A (1995) Crists intervention and affective disorders: a comparative cost-effectiveness study. Soc Psychiatry Psychiatr Epidemiol 30:231–235
Roth P, et al. (1982) A comparison of self control therapy and combined self control therapy and antidepressant medication in the treatment of depression. Behav Ther 13:133–144
Ruberman W, Weinblatt E, Goldberg JD, Chaudhary BS (1984) Psychosocial influences on mortality after myocardial infarction. N Engl J Med 13A:641–654
Wiklund I, et al. (1988) Prognostic importance of somatic and psychosocial variables after a first myocardial infarction. Am J Epidemiol 128:786–795
Williams A, Ware J Jr, Donald C (1981) A model of mental health, life events, and social support applicable to general populations. J Health Soc Behav 22:324–336
Wilson KG, Kraitberg NJ, Brown JH, Bergman JN (1991) Electroconvulsive therapy in the treatment of depression: the impact on length of stay. Compr Psychiatry 32:345–354
Wortman CB (1984) Social support and the cancer patient. Conceptual and methodologic issues. Cancer 53:2339–2360
Schubert DSP, Yokley J, Sloan D, Gottesman H (1995) Impact of the interaction of depression and physical illness on a psychiatric unit's Length of Stay. Gen Hosp Psychiatry 17: 326–334
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Barnow, S., Linden, M. & Schaub, R.T. The impact of psychosocial and clinical variables on duration of inpatient treatment for depression. Soc Psychiatry Psychiatr Epidemiol 32, 312–316 (1997). https://doi.org/10.1007/BF00805434
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00805434