Treatment engagement of depressed patients with and without psychosis in a partial hospital program: Dropout, symptom reduction, and satisfaction

BACKGROUND: The ways patients with psychosis and depression engage in therapeutic treatment is not well understood. To determine if an intensive outpatient psychotherapy program could benefit patients experiencing psychotic symptoms, it is important to know how these individuals engage with psychotherapeutic treatment.

METHODS: The present study from the Rhode Island Hospital Methods to Improve Diagnostic Assessment and Services (MIDAS) project compared dropout rates, treatment response, and satisfaction among 219 individuals with psychosis and major depressive disorder (MDD) to 2,545 individuals with MDD at a general, Acceptance and Commitment Therapy–based partial hospital program (PHP).

RESULTS: Those with psychosis were significantly less likely to complete treatment. Approximately one-fifth of all patients experienced at least a 50% reduction in depressive and anxiety symptoms. The vast majority of patients with psychosis were highly satisfied with treatment.

CONCLUSIONS: Findings suggest patients with psychosis have a higher risk of premature dropout. Patients with psychosis demonstrated a reduction in symptoms during PHP treatment and self-reported high satisfaction with treatment. This study calls for the implementation of practices to reduce premature dropout for patients with psychosis, and for future research on the effectiveness of general psychiatric treatment for those with psychotic symptoms.

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