A Followup Study of Manic‐Depressive and Schizoaffective Psychoses after Systemic Family Therapy

Retzer, Arnold; Simon, Fritz B.; Weber, Gunthard; Stierlin, Helm; Schmidt, Gunther

doi:10.1111/j.1545-5300.1991.00139.x

Cited by 26 publications

(19 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This small investment saved $25,405 per patient in the cost of additional hospital days in comparison with the untreated depressed group. Cost data were not provided by Retzer et al (34), but the relapse rate, as measured by hospital admissions, was dramatically lower after family therapy than before family therapy. The average family received 6.6 sessions of family therapy.…”

Section: Studies In Which Treatment Was Not Randomly Assignedmentioning

confidence: 99%

The economic impact of psychotherapy: a review

Gabbard

Lazar²,

Hornberger³

et al. 1997

AJP

150

View full text Add to dashboard Cite

studies designed to investigate the effect of psychotherapy on subsequent medical care utilization. Of these studies, 26 were naturalistic time-series studies that compared medical care utilization before and after psychotherapy. Thirty-two studies were experimental in design, in that patients were assigned to treatment conditions randomly (or through a thoughtful matching system). The authors found that 85% of the studies reported a decrease in utilization of medical care following psychotherapy. Of the 22 methodologically rigorous studies that used random assignment, psychotherapeutic interventions reduced medical inpatient stays by approximately 1.5 days below the control groups' average of 8.5 days.The Mumford et al. review is now substantially outdated. It was published at a time when reimbursement for medical services was considerably different from what it is today and when fewer psychopharmacology options were available. In addition, psychotherapy was defined so broadly in the review that interventions such as educating patients before surgery were considered under the rubric of psychotherapy. Perhaps the most dated aspect of the study is that it concentrated rather narrowly on cost offset (i.e., reductions of medical care costs due to the addition of psychotherapy) rather than on the broader issue of cost-effectiveness. In the last decade or so, the emphasis in the mental health field has shifted away from cost offset to a more complex understanding of the economic impact of psychosocial inter-

show abstract

Section: Studies In Which Treatment Was Not Randomly Assignedmentioning

confidence: 99%

The economic impact of psychotherapy: a review

Gabbard

Lazar²,

Hornberger³

et al. 1997

AJP

150

View full text Add to dashboard Cite

show abstract

“…Again, reported methods of assessment varied, and conclusions may be limited by deficiencies in sample representativeness, random assignment to treatment alternatives, and objective and reliable assessment of symptomatic and functional status at study entry and completion. Despite these limitations, several reports noted reductions in morbidity, 29,[58][59][60][61][67][68][69]76,77,80,81,88,89 and improved social [60][61][62]67,70,71,76,79,85,88,89 and vocational 60,68,89 functioning. Several studies also concluded that medication compliance was enhanced by adjunctive educational and follow-up visits, or illness-related inability to assimilate or retain information.…”

Section: Discussionmentioning

confidence: 99%

“…29,[65][66][67]73,78,88,97 A particularly reassuring finding in all 11 studies that considered the matter was reduced risk of rehospitalization with various psychosocial interventions (see Table 4). 29,[58][59][60][61][67][68][69]76,77,81 Interpretation and generalization of these findings are complicated by major changes in indications for and financing of psychiatric hospitalization in recent years. However, reductions in hospitalization rate and duration offer the advantages of apparent quantifiability and objectivity, as well as opportunities for estimates of savings in a major cost of long-term care of the severely mentally ill. 8 If formal cost-benefit analyses can support cost-effectiveness of specific types of adjunctive psychosocial treatments in bipolar disorders, their feasibility and acceptability to insurers and care-managers, as well as to clinicians and patients, should be greatly enhanced.…”

Section: Discussionmentioning

confidence: 99%

“…The six controlled studies of family therapy 76 psychoeducation and seven [73][74][75][76][77][78]81 used interpersonal or process therapies, with single families, groups of families, or one or more patient-spouse pairs. The six family therapy studies involving either comparison treatments or quantitative pre-vs. posttreatment comparisons can be summarized as follows: Davenport and colleagues 76 followed 12 patients for an average of 47 months after they entered weekly psychodynamically based couples group therapy during hospitalization.…”

Section: Family Psychotherapymentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of Psychosocial Treatments in Bipolar Disorder: State of the Evidence

Huxley

Parikh

Baldessarini

2000

Harvard Review of Psychiatry

View full text Add to dashboard Cite

Cost-effective psychotherapeutic interventions can enhance pharmacotherapy and improve outcomes in major depression and schizophrenia, but they are rarely studied in bipolar disorder, despite its often unsatisfactory response to medication alone. Following a literature search, we compiled and evaluated research reports on psychotherapeutic interventions in bipolar disorder patients. We found 32 peer-reviewed reports involving 1052 patients-14 studies on group therapy, 13 on couples or family therapy, and five on individual psychotherapy-all supplementing standard pharmacotherapy. Methodological limitations were common in these investigations. Nevertheless, important gains were often seen, as determined by objective measures of increased clinical stability and reduced rehospitalization, as well as other functional and psychosocial benefits. The results should further encourage rising international interest in testing the clinical and cost-effectiveness of psychosocial interventions in these common, often severe and disabling disorders.

show abstract

“…Esse estudo verificou que o tratamento em grupo esteve associado com melhoras no funcionamento social e com menor gravidade e duração dos episódios de humor. Retzer et al (1991), avaliando 20 pacientes com transtorno bipolar e 10 pacientes esquizofrênicos, demonstraram uma diminuição da recorrência de episódios de humor em um período de seguimento de três anos, comparado ao período de pré-tratamento e uma mudança no ponto de vista sobre a doença nos pacientes e nos familiares. Os outros estudos também demonstraram desfechos positivos subjetivos como "bem-estar" (Hallensleben, 1994) e no aprendizado sobre a doença, assim como conviver com ela.…”

Section: Terapia Psicodinâmicaunclassified

Abordagens psicoterápicas no transtorno bipolar

Knapp¹,

Isolan²

2005

Rev. psiquiatr. clín.

View full text Add to dashboard Cite

ResumoEmbora o tratamento farmacológico seja essencial para o tratamento do transtorno bipolar, apenas 40% de todos os pacientes que aderem às medicações permanecem assintomáticos durante o período de seguimento, o que tem levado ao desenvolvimento de intervenções psicoterápicas associadas. O objetivo deste artigo é examinar as evidências atuais da eficácia de intervenções psicoterápicas no tratamento do transtorno bipolar. Foi realizada uma pesquisa bibliográfica por meio do MedLine, PsychoINFO, Lilacs e Cochrane Data Bank, até o ano de 2004, em que foram procurados artigos originais e revisões sobre as abordagens psicoterápicas utilizadas no tratamento do transtorno bipolar. Há várias abordagens que podem se mostrar úteis no tratamento do transtorno bipolar. A psicoeducação e a terapia cognitivo-comportamental apresentam as evidências mais consistentes e são as técnicas mais amplamente estudadas. As intervenções envolvendo familiares e a terapia interpessoal e de ritmo social se mostram tratamentos eficazes em determinadas situações. Há alguns estudos empregando a terapia psicodinâmica no transtorno bipolar, mas são estudos com limitações metodológicas. Apesar de haver evidências demonstrando a eficácia de determinadas abordagens psicoterápicas no transtorno bipolar, ainda é necessária a realização de estudos posteriores que comprovem tais dados e que desenvolvam tratamentos baseados em modelos etiológicos e que identifiquem tratamentos específicos para as diferentes fases e tipos de transtorno bipolar.

show abstract

A Followup Study of Manic‐Depressive and Schizoaffective Psychoses after Systemic Family Therapy

Cited by 26 publications

References 25 publications

The economic impact of psychotherapy: a review

The economic impact of psychotherapy: a review

Effectiveness of Psychosocial Treatments in Bipolar Disorder: State of the Evidence

Abordagens psicoterápicas no transtorno bipolar

Contact Info

Product

Resources

About