![]() For both depression and anxiety, functional impairment or (absence of) work often is a predictor, just like having a comorbid personality disorder. Sometimes age seems a predictor, but often not. For example, for depression or anxiety sometimes gender is a predictor of treatment outcome, but often not. However, even the most obvious patient characteristics are not unequivocally predictive of treatment outcome. On the other hand, reasons for responding or not responding to treatment are generally sought in patient characteristics. On the one hand, it has often been suggested that differences in treatment outcome between mental health care practice and randomized controlled trials (RCT) are attributable to the different populations, but this has not been empirically confirmed. Despite having received treatment, a considerable proportion of patients suffer from their symptoms for a very long time and develop persisting symptoms and impairments, for instance in functioning in their social roles. ![]() Nevertheless, in everyday practice, a large number of patients do not benefit from their treatment. In the last decades, remarkable progress has been made in outpatient mental health care with the introduction of evidence-based, clinical guidelines for mental disorders. Despite organizational obstacles, more effort should be made to start treatment quickly by an effective frequency of session. This association seems not to be limited to a specific diagnostic group, but was found in a large group of patients with common mental disorders (depression and anxiety disorders) and patients with a personality disorder. In addition to severity at start of treatment and other predictors of outcome, a low frequency of initial treatment sessions might lead to a less favorable outcome and a more chronic course of the mental disorder. For improvement, this effect diminished after three years in treatment however, for recovery this association was sustained. In all diagnostic groups, both improvement and recovery were associated with a higher frequency of sessions during the first three months of treatment. Improvement and recovery were associated with symptom severity and functional impairment at start of treatment, the year the treatment started, number of measurements, the treatment program (anxiety disorders, depressive disorders, and personality disorders) and receiving group therapy other than psychotherapy. Using Cox-proportional-hazard models, we explored the associations between initial frequency and improvement (reliable significant change) and recovery (reliable and clinically significant change). Frequency of sessions was assessed for the first three months of treatment. Patients’ treatment outcome was routinely monitored with the Outcome Questionnaire-45 (OQ-45.2), every 12 weeks. MethodsĪnonymized data were analyzed from 2,634 patients allocated for anxiety disorders, depressive disorders, and personality disorders to outpatient treatment programs in a large general mental health care facility. The aim of this naturalistic study was to explore the impact of the initial frequency of treatment sessions on treatment outcome in a diverse mental health care population. ![]() ![]() This occurs especially in the first phase of treatment, while the first phase seems vital for the rest of treatment. Unfortunately, there is a diversity of factors that interfere with an adequate frequency of sessions. An adequate frequency of treatment might be a prerequisite for a favorable outcome. ![]()
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