A Systematic Analysis of Treatment Effects on Depressive Symptom Severity by Level of Coercion.
Few studies examine the effect of interpersonal, regulatory or legal coercion on the treatment of depressive symptoms. This retrospective case-control study compared the recovery rates of 574 adults whose level of coercion was scored on a 0-3 scale from fully voluntary to severe coercion when admitted to the Menninger Clinic between 2009 and 2014. The change in Patient Health Questionnaire-9 (PHQ-9) scores (measuring depression severity) from admission to discharge served as the primary outcome measure. Level of coercion was not associated with a difference in rate of improvement in PHQ-9 score. Greater improvement in PHQ-9 scores was associated with (a) older age, (b) lack of a psychotic spectrum disorder diagnosis, (c) stronger working alliance with treatment team, and (d) less difficulty with emotional regulation [lower Difficulties in Emotion Regulation Scale (DERS) scores]. DERS scores were the most impactful factor. This study suggests that licensure boards can continue to mandate treatment despite concerns that coercion may decrease treatment effectiveness.
['Scott Johnson|R|R|', 'Christopher Fowler|J|J|', 'Jani|Suni N|SN|', 'Eichelberger|Hillary L|HL|', 'Oldham|John M|JM|', 'Poa|Edward|E|', 'Graham|David P|DP|']
D000328:Adult D000367:Age Factors D016022:Case-Control Studies D003068:Coercion D003299:Cooperative Behavior D003863:Depression D003866:Depressive Disorder D003865:Depressive Disorder, Major D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D011369:Professional-Patient Relations D011618:Psychotic Disorders D012189:Retrospective Studies D000068356:Self-Control D012720:Severity of Illness Index D016896:Treatment Outcome D055815:Young Adult
Depression Coercion PHQ-9 Fitness for duty