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Cited by 37Psychiatric care and mental health servicesTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Modeling Trajectory of Depressive Symptoms Among Psychiatric Inpatients: A Latent Growth Curve Approach

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Clapp, Joshua D., Grubaugh, Anouk L., Allen, Jon G., Mahoney, Jane, Oldham, John M., Fowler, J. Christopher, Ellis, Tom, Elhai, Jon D. +1 more·2013·The Journal of Clinical Psychiatry
DOI 10.4088/jcp.12m07842PMC PMC4313384
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Abstract

OBJECTIVE: Changes in the parameters of inpatient psychiatric care have inspired a sizable literature exploring correlates of prolonged intervention as well as symptom change over varying lengths of hospitalization. However, existing data offer limited insight regarding the nature of symptom change over time. Objectives of this longitudinal research were to (1) model the trajectory of depressive symptoms within an inpatient psychiatric sample, (2) identify characteristics associated with unique patterns of change, and (3) evaluate the magnitude of expected gains using objective clinical benchmarks. METHOD: Participants included 1,084 psychiatric inpatients treated between April 2008 and December 2010. Latent growth curve modeling was used to determine the trajectory of Beck Depression Inventory II depressive symptoms in response to treatment. Age, gender, trauma history, prior hospitalization, and DSM-IV diagnoses were examined as potential moderators of recovery. RESULTS: Results indicate a nonlinear model of recovery, with symptom reductions greatest following admission and slowing gradually over time. Female gender, probable trauma exposure, prior psychiatric hospitalization, and primary depressive diagnosis were associated with more severe trajectories. Diagnosis of alcohol/substance use, by contrast, was associated with more moderate trajectories. Objective benchmarks occurred relatively consistently across patient groups, with clinically significant change occurring between 2-4 weeks after admission. CONCLUSIONS: The nonlinear trajectory of recovery observed in these data provides insight regarding the dynamics of inpatient recovery. Across all patient groups, symptom reduction was most dramatic in the initial week of hospitalization. However, notable improvement continued for several weeks after admission. Results suggest that timelines for adequate inpatient care are largely contingent on program-specific goals.

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  • The finding that improvement was most rapid after psychiatric hospitalization is consistent with earlier studies reporting depressive symptoms and suicide ideation reduction following the first week of admission or even brief intervention.

    “their improvement was most rapid after psychiatric hospitalization, consistent with earlier studies that reported depressive symptoms and suicide ideation reduction following the first week of admission or even brief intervention”

    From Time in treatment: Examining mental illness trajectories across inpatient psychiatric treatment (2020) · cites this paper as Clapp et al., 2013

    The Conclusions report that depressive-symptom recovery was most rapid in the first week of admission and was consistent with earlier research finding symptom reduction after brief intervention. The paper does not report a reduction in suicidal ideation, so that part of the attributed claim is unsupported. Page numbers are unavailable in our copy. (LLM, conf=0.86)

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  • Hospitalization history and diagnoses of schizophrenia, major depression, and other psychotic disorders are correlated with extended length of stay, whereas substance use is associated with reduced length of stay.

    “Hospitalization history and diagnoses of schizophrenia, major depression, and other 72 psychotic disorders were correlated with extended LOS, whereas substance use was 73 associated with reduced LOS (Blader, 2011; Clapp et al., 2013; Cohen and Casimir, 74 1989; Hallak et al., 2003; Stevens et al., 2001; Warnke and Rossler, 2008).”

    From Time in treatment: Examining mental illness trajectories across inpatient psychiatric treatment (2020) · cites this paper as Clapp et al., 2013

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Authors
Clapp, J. D., Grubaugh, A. L., Allen, J. G., Mahoney, J., Oldham, J. M., Fowler, J. C., Ellis, T., Elhai, J. D., & Frueh, B. C.
Affiliations
  • Medical University of South Carolina (US)
  • Baylor College of Medicine (US)
  • University of Toledo (US)
  • University of Hawaii System (US)
Corresponding author
Clapp, Joshua D.
ORCID
Venue
The Journal of Clinical Psychiatry
Publisher
Physicians Postgraduate Press, Inc
Published
2013-05-15
Volume
74
Issue
05
Pages
492-499
ISSN
0160-6689 (ISSN-L)
DOI
10.4088/jcp.12m07842
PMC
PMC4313384
OpenAlex
W2027615607
Cited by
37
References
55
Citations by year
2026: 2 · 2025: 2 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 1 · 2018: 4 · 2017: 4 · 2016: 4 · 2015: 4 · 2014: 4
FWCI
4.45
Type
journal article
Language
en
Open access
Locations
  • The Journal of Clinical Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Menninger Clinic
  • University of South Carolina
  • National Institute of Mental Health (T32 MH18869, MH18869, T32MH018869)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
depressive symptoms, psychiatric inpatient care, length of hospital stay, trauma exposure, gender differences, alcohol and substance use disorders, Beck Depression Inventory-II
MeSH terms
Adult, Depression, Female, Hospitals, Psychiatric, Humans, Inpatients, Male, Middle Aged, Models, Psychological, Psychiatric Status Rating Scales, Time Factors, Treatment Outcome

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