Altmann Uwe, Thielemann Désirée, Strauß Bernhard
Institut für Psychosoziale Medizin und Psychotherapie, Universitätsklinikum Jena.
Psychiatr Prax. 2016 Oct;43(7):360-366. doi: 10.1055/s-0042-115616. Epub 2016 Oct 12.
There is a growing body of literature recognizing the importance of outpatient psychotherapy. Several studies investigated the efficacy of outpatient psychotherapy and aspects of the health care system under natural conditions. This paper gives an overview of studies from German speaking countries (TRANS-OP-, TK-, PAP-S- and QS-PSY-BAY-study).The results of the different studies indicate both, positive outcome of the therapies (e. g., reduction of symptoms with an average ES of 1,03; improvement of symptoms despite premature termination) as well as an economic benefit (end of treatment depending on treatment outcome and not limited by therapy sessions; extensions of psychotherapy only if patient is highly impaired and therapeutic alliance is positive; high reduction of supply costs and sick leave). However, the low health care density in rural areas and the waiting periods before starting therapy are indicators of structural problems of the health care system with respect to outpatient psychotherapy.The efficacy of outpatient psychotherapies under natural conditions is sufficiently supported. Future studies should investigate structural aspects of the health care system, for example by focussing on the establishment of inter-sectoral connections between different professional groups and a reduction of bureaucratic actions.
越来越多的文献认识到门诊心理治疗的重要性。多项研究在自然条件下调查了门诊心理治疗的疗效以及医疗保健系统的各个方面。本文概述了来自德语国家的研究（TRANS-OP研究、TK研究、PAP-S研究和QS-PSY-BAY研究）。不同研究的结果表明，治疗既有积极效果（例如，症状减轻，平均效应量为1.03；尽管提前终止治疗，症状仍有改善），也有经济效益（治疗结束取决于治疗结果，不受治疗疗程限制；仅当患者严重受损且治疗联盟积极时才延长心理治疗；大幅降低供应成本和病假率）。然而，农村地区医疗保健密度低以及开始治疗前的等待期是医疗保健系统在门诊心理治疗方面存在结构问题的指标。自然条件下门诊心理治疗的疗效得到了充分支持。未来的研究应调查医疗保健系统的结构方面，例如通过关注不同专业群体之间跨部门联系的建立以及减少官僚行为。
