Inpatient care and its outcome in a specialist psychiatric unit for peoplewith intellectual disability: a prospective study

The outcome of treatment in care units has been thought to reflect the effe ctiveness of treatment. There have been only a few studies describing inpat ient care and its outcome in patients with intellectual disability and psyc hiatric symptoms. The present study describes the psychiatric inpatient tre atment in the specialist psychiatric unit of the Special Welfare District o f Southwest Finland and the need for aftercare among people with intellectu al disability and psychiatric disorders (n = 40). As an outcome measure of care, the level of psychiatric symptoms was evaluated either with the Brief Psychiatric Rating Scale (BPRS) or with the Diagnostic Assessment for the Severely Handicapped (DASH) scale; self-reports (visual analogue scale) wer e also used. Patients' psychotic symptoms were reduced significantly on the BPRS during inpatient care and aftercare, but non-psychotic symptoms were reduced significantly only during aftercare. For one patient, the psychiatr ic symptoms were reduced significantly during inpatient care on the DASH sc ale, while the psychiatric symptoms remained the same for three patients. P atients and their primary carers considered the patient's psychiatric condi tion to have improved significantly during inpatient care, but not during a ftercare. The specialist unit filled the gap in the care of people with int ellectual disability and psychiatric problems in Southwest Finland. It is c oncluded that psychotic patients particularly benefit from the inpatient ca re in the specialist psychiatric unit. The care in the unit should include support for primary carers. All patients' outpatient treatment should also be re-evaluated. The present study poses two important questions. Firstly, could these treatment outcomes have been achieved with other interventions! Secondly, what are the necessary services for people with intellectual dis ability?