Treatment outcome in psychiatric inpatients: the discriminative value of self-esteem

Self-esteem has been identified as an important clinical variable within various psychological and psychiatric conditions. Surprisingly, its prognostic and discriminative value in predicting treatment outcome has been understudied.

The current study aims to assess, in an acute psychiatric setting, the comparative role of self-esteem in predicting treatment outcome in depression, anxiety, and global symptom severity, while controlling for socio-demographic variables, pre-treatment symptom severity, and personality pathology.

Treatment outcome was assessed with pre- and post-treatment measures.

A heterogeneous convenience sample of 63 psychiatric inpatients completed upon admission and discharge self-report measures of depression, anxiety, global symptom severity, and self-esteem.

A significant one-way repeated-measures multivariate analysis of variance (MANOVA) followed up by analyses of variance (ANOVAs) revealed significant reductions in depression (eta2 = .72), anxiety (eta2 = .55), and overall psychological distress (eta2 = .60). Multiple regression analyses suggested that self-esteem was a significant predictor of short-term outcome in depression but not for anxiety or overall severity of psychiatric symptoms. The regression model predicting depression outcome explained 32% of the variance with only pre-treatment self-esteem contributing significantly to the prediction.

The current study lends support to the importance of self-esteem as a pre-treatment patient variable predictive of psychiatric inpatient treatment outcome in relation with depressive symptomatology. Generalization to patient groups with specific diagnoses is limited due to the heterogeneous nature of the population sampled and the treatments provided. Implications for clinical practice and future research are discussed.