Differences between psychiatric disorders in the clinical and functional effectiveness of an acute psychiatric day hospital, for acutely ill psychiatric patients.

Rev Psiquiatr Salud Ment (Engl Ed)

Departamento de Psiquiatría, Hospital Universitario Marqués de Valdecilla-Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, España; Facultad de Medicina, Universidad de Cantabria, Santander, España; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Santander, España.

Published: October 2021

AI Article Synopsis

  • The study examines the effectiveness of acute day-care psychiatric units compared to inpatient care, focusing on different psychiatric disorders.
  • Non-affective psychosis, bipolar disorder, depressive disorder, and personality disorders were identified as main diagnostic groups, with bipolar patients showing the most significant improvement in clinical assessments.
  • Longer treatment duration and higher initial severity were linked to better outcomes, while readmission rates were low across all diagnostic groups, indicating the program's overall effectiveness.

Article Abstract

Introduction: Intensive treatment in acute day-care psychiatric units may represent an efficient alternative to inpatient care. However, there is evidence suggesting that this clinical resource may not be equally effective for every psychiatric disorder. The primary aim of this study was to explore differences between main psychiatric diagnostic groups, in the effectiveness of an acute partial hospitalization program. And, to identify predictors of treatment response.

Material And Methods: The study was conducted at an acute psychiatric day hospital. Clinical severity was assessed using BPRS, CGI, and the HoNOS scales. Main socio-demographic variables were also recorded. Patients were clustered into 4wide diagnostic groups (i.e.: non-affective psychosis; bipolar; depressive; and personality disorders) to facilitate statistical analyses.

Results: A total of 331 participants were recruited, 115 of whom (34.7%) were diagnosed with non-affective psychosis, 97 (28.3%) with bipolar disorder, 92 (27.8%) with affective disorder, and 27 (8.2%) with personality disorder. Patients with a diagnosis of bipolar disorder showed greater improvement in BPRS (F=5.30; P=0.001) and CGI (F=8.78; P<0.001) than those suffering from psychosis or depressive disorder. Longer length of stay in the day-hospital, and greater baseline BPRS severity, were identified as predictors of good clinical response. Thirty-day readmission rate was 3%; at long-term (6 months after discharge) only 11.8% (N=39) of patients were re-admitted to a psychiatric hospitalization unit, and no differences were observed between diagnostic groups.

Conclusions: Intensive care in an acute psychiatric day hospital is feasible and effective for patients suffering from an acute mental disorder. However, this effectiveness differs between diagnostic groups.

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http://dx.doi.org/10.1016/j.rpsm.2019.04.001DOI Listing

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