VARIABILITY OF INPATIENT CHILD AND ADOLES CENT-PSYCHIATRY - RESULTS OF A MULTICENTER STUDY

Variability of impatient child and adolescent psychiatry - results of a multicenter study. Objective: For the first time in the German-speak ing countries a complete evaluation of all 1236 inpatient treatment ep isodes within one year of investigation was carried out. Method: Case- related patient documentation at all of the 13 clinics for child and a dolescent psychiatry in Lower Saxony and Bremen were evaluated. Result s: Data from all clinics agreed widely on the folowing: 1. the diverge nt family structures of the young patients compared to those of the ge neral public, 2. a high degree of individual psychotherapy, and 3. the inclusion of the patient's social circumstances in the individual psy chotherapy. Nonetheless, results for most of the variables assessed di ffered strongly. Inpatient child and adolescent psychiatric care thus seems to vary highly among clinics within the same epidemiological are a. Conclusions: Hence, even when the reported number of episodes is hi gh, no general conclusions on inpatient child and juvenile psychiatric treatment can be drawn on the basis of admissions data for individual clinics. Interinstitutional comparisons must be made on the assumptio n that there is no prototype clinic for child and adolescent psychiatr y. Additional general conclusions include the lack of a disorder-speci fic approach to treatment. The entry of a large number of patients int o foster or state homes following inpatient treatment reflects the imp act upon them of abnormal psychosocial circumstances, as well as their decreased psychosocial adaption.