Partial psychiatric hospitalization and differences in clinical outcome

Abstract

Introduction

Intensive treatment in partial hospitalization unit may represent an efficient alternative to traditional inward hospitalization. However, there is evidence suggesting that this clinical resource may not be equally effective for every psychiatric disorder.

Objectives

We aimed to study possible differences in the effectiveness of treatment in a partial hospitalization regime for different psychiatric disorders.

Methods

Three hundred and thirty-one patients were admitted to the Valdecilla acute psychiatric day hospital between January 2013 and January 2015. Clinical severity was assessed using BPRS-E and HoNOS scales at admission and discharge. Other relevant clinical and socio-demographic variables were recorded. For statistical comparisons, patients were clustered into 4 wide diagnostic groups (non-affective psychosis; bipolar disorder; depressive disorder; personality disorder).

Results

We observed a significant difference in the status of discharge (χ² = 12.227; P = 0.007). Thus, depressive patients were more frequently discharged because of clinical improvement, while patients with a main diagnose of personality disorder abandoned the treatment more frequently (23% vs. 4,0%)

When analysing the clinical outcome at discharge, we found that patients with a diagnosis of bipolar disorder showed greater improvement in BPRS (F = 5.305; P = 0.001) than those diagnosed of psychosis or depressive disorder. Interestingly, we found no significant differences between diagnoses in hospital re-admission in the following 6 months after being discharged.

Conclusions

Our results suggest that acute treatment in partial hospitalization regime may be more effective for bipolar and depressive disorder, and particularly less effective for those patients with a personality disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.