PhD-student
Lotte Kring
The Faculty of Health Sciences, Department of Psychology, SDU
| Projekt styring | ||
| Projekt status | Open | |
| Data indsamlingsdatoer | ||
| Start | 01.08.2023 | |
| Slut | 03.03.2027 | |
DEPRE-ST - the patient perspective: A mixed methods study of treatment outcome in psychotherapy for patients with chronic treatment resistant depression
Short summary
This PhD project will use a mixed methods approach to investigate patients' expectations and experiences with psychotherapeutic treatment for chronic treatment-resistant depression (CTRD). The project will compare patients' perspectives with those of their relatives and therapists, as well as with outcomes at the symptom and functional levels. The aim is to gain knowledge on whether the assessment of treatment success aligns with the patients' needs.
Rationale
Studies show that evidence-based treatment for chronic treatment-resistant depression (CTRD) cures one-third of patients. Until now, the assessment of treatment effectiveness has focused on symptom measures based on diagnostic categories. The method in randomized trials also emphasizes a quantifiable primary outcome, which consequently becomes the basis for treatment guidelines and quality monitoring. However, it is unclear whether focusing on symptoms as the primary goal of treatment effectiveness is as valuable to the patient as it is to the treatment system. Therefore, it is necessary to involve patients and their relatives to gain more knowledge about their expectations of what constitutes a successful treatment. So far, there is only limited research in this area, and existing studies show that symptom reduction is often not the only or most important treatment goal for patients. Additionally, there are significant differences in perspectives on treatment success between patients and therapists.
Description of the cohort
The Ph.D. project is based on an ongoing research project (DEPRE-ST) being conducted in a total of four psychiatric departments in the Region of Southern Denmark and the Capital Region of Denmark. DEPRE-ST is an RCT study investigating the treatment of chronic treatment-resistant depression (CTRD) with the psychotherapy form schema therapy (ST) compared to Treatment As Usual (TAU). This project recruits from this population. The project employs a mixed methods approach, primarily using qualitative methods (in-depth interviews and participant observation). Twenty patients are recruited to participate in semi-structured interviews before and after their treatment in the RCT study. Ten of these patients are recruited as key informants, which means that the patient's close relatives also participate in interviews, and the Ph.D. student visits the patient and the relative in their home and follows them in daily life situations (participant observation) to gain increased knowledge about relevant aspects of their personal recovery. A total of 10 individual pre-treatment interviews with patients and 10 joint pre-treatment interviews with patients and their relatives are conducted. Additionally, 10 individual post-treatment interviews with patients and 10 joint post-treatment interviews with patients and their relatives are conducted. During the course of treatment, 1-2 joint interviews are conducted with all key informants, amounting to an additional 10-20 interviews. Finally, 20 interviews with the patients' primary therapists are conducted at the start of treatment. Thus, a total of 70-80 qualitative interviews are conducted, all of which are recorded and subsequently transcribed. The qualitative data is analyzed using general principles of ethnographic analysis and reflexive thematic analysis (RTA). The project will also compare the qualitative patient interviews with quantitative measures through PSYCHLOPS. PSYCHLOPS is a short questionnaire where the patient defines and reports 1-2 problems that bother them the most and scores the severity of these on a 6-point Likert scale. PSYCHLOPS is administered in the main study at the start and end of treatment. The post-treatment measurement will thus indicate the effect of the treatment in relation to the patient's individual, self-defined treatment goals. It is expected that PSYCHLOPS is a more precise and individualized quantitative measure of treatment success than traditional outcome measures.
Data and biological material
(See above.)
Collaborating researchers and departments
Psychiatric departments in the Region of Southern Denmark and the Capital Region of Denmark.