Hängen die Stundenkontingente für ambulante Psychotherapie zur Behandlung von Depressionen mit deren Schweregrad zusammen?

OBJECTIVE: This study investigated how the number of sessions for outpatient psychodynamic psychotherapy among patients with depressive disorders is associated with the severity of the disease. METHODS: From a random sample of 1000 applications for reimbursement of outpatient psychodynamic psychotherapy, we selected those in which a diagnosis of depression with a severity rating (ICD-10 F32 or F33) was coded. The association of levels of depression severity (mild, moderate, and severe) with the number of sessions requested and the number of sessions endorsed by the reviewer was investigated using Spearman’s rank correlation. If the application was for a continuation of an ongoing therapy, the previous sessions were taken into account too. RESULTS: A total of 521 (52%) applications contained a diagnosis of F32 and/or F33. Out of these, 63 (12%) were coded as mild, 349 (67%) as moderate, and 50 (10%) as severe. There were 75 sessions applied for in patients with mild depression (median), 50 in patients with moderate depression, and 50 in patients with severe depression, whereby the range within each severity group was considerable (10 to 327 sessions) and the correlation was low (Rho −0.10). The median number of endorsed sessions was 74 in patients with mild depression, 50 in patients with moderate, and 50 in patients with severe depression. Here, too, the range was high (0 sessions to 327 sessions) and the association weak (Rho −0.11). DISCUSSION: There is no evidence that psychotherapists determine the necessary number of sessions solely based on the severity of the diagnosis.