Predicting treatment response during the acute phase of hospitalization.

Objective: This study sought to determine if an initial assessment for an acute inpatient population was able to predict treatment response as measured by progress through clinical pathways. In addition, we sought to analyze the impact of comorbidity on treatment response.

Method: A total of 170 adults (18-75 years) admitted for an acute inpatient hospitalization, received a full assessment including the Brief Symptom Inventory. Based on assessment results, patients were placed on one of five clinical pathways. Treatment response was measured by the number of days spent on each level of the clinical pathway.

Results: Results revealed an unexpected, significant negative correlation between symptom severity on admission and movement through the clinical pathway; that is, patients with more severe symptomatic presentations at assessment made more rapid progress through the clinical pathways. However, comorbidity showed the strongest relationship with treatment response. Taken together, these variables explained 52% of the variance in treatment response.

Conclusions: Responsiveness to antipsychotic medications, as well as high levels of subjective distress and the consequent motivation to achieve relief, may help explain the unexpected relationship between symptom severity and treatment response. Findings also demonstrated the utility of an initial assessment in predicting treatment response.