TY - JOUR
T1 - Diferencias en la efectividad clínica y funcional, entre trastornos psiquiátricos, de un hospital de día psiquiátrico de agudos para pacientes con enfermedad mental aguda
AU - Vázquez-Bourgon, Javier
AU - Gómez Ruiz, Elsa
AU - Hoyuela Zatón, Fernando
AU - Salvador Carulla, Luis
AU - Ayesa Arriola, Rosa
AU - Tordesillas Gutiérrez, Diana
AU - Crespo Facorro, Benedicto
N1 - Publisher Copyright:
© 2019 SEP y SEPB
PY - 2021/1/1
Y1 - 2021/1/1
N2 - 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 4 wide 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.
AB - 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 4 wide 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.
KW - Acute day psychiatric hospital
KW - Acute partial psychiatric hospitalization
KW - Effectiveness
KW - Outcome
KW - Predictors
KW - Psychopathology
UR - http://www.scopus.com/inward/record.url?scp=85066307230&partnerID=8YFLogxK
U2 - 10.1016/j.rpsm.2019.04.001
DO - 10.1016/j.rpsm.2019.04.001
M3 - Article
C2 - 31160228
AN - SCOPUS:85066307230
SN - 1888-9891
VL - 14
SP - 40
EP - 49
JO - Revista De Psiquiatria Y Salud Mental
JF - Revista De Psiquiatria Y Salud Mental
IS - 1
ER -