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

Autor: Vázquez-Bourgon J; 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. Electronic address: javier.vazquez@scsalud.es., Gómez Ruiz E; Departamento de Psiquiatría, Hospital Universitario Marqués de Valdecilla-Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, España., Hoyuela Zatón F; Departamento de Psiquiatría, Hospital Universitario Marqués de Valdecilla-Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, España., Salvador Carulla L; Centre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia., Ayesa Arriola R; 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., Tordesillas Gutiérrez D; Departamento de Psiquiatría, Hospital Universitario Marqués de Valdecilla-Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, España; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Santander, España; Unidad de Neuroimagen y Servicios Tecnológicos, IDIVAL, Santander, España., Crespo Facorro B; 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.
Jazyk: English; Spanish; Castilian
Zdroj: Revista de psiquiatria y salud mental [Rev Psiquiatr Salud Ment (Engl Ed)] 2021 Jan-Mar; Vol. 14 (1), pp. 40-49. Date of Electronic Publication: 2019 Jun 01.
DOI: 10.1016/j.rpsm.2019.04.001
Abstrakt: 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.
(Copyright © 2019 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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