Predictors of the course of medium-range treatments in inpatient child andadolescent psychiatry

Citation
R. Schepker et al., Predictors of the course of medium-range treatments in inpatient child andadolescent psychiatry, PRAX KINDER, 49(9), 2000, pp. 656-676
Citations number
44
Categorie Soggetti
Psychiatry
Journal title
PRAXIS DER KINDERPSYCHOLOGIE UND KINDERPSYCHIATRIE
ISSN journal
00327034 → ACNP
Volume
49
Issue
9
Year of publication
2000
Pages
656 - 676
Database
ISI
SICI code
0032-7034(200011)49:9<656:POTCOM>2.0.ZU;2-3
Abstract
Predictors of the course of medium-range treatments in inpatient child and adolescent psychiatry Purpose of this study is to identify predictors of th e length of stay (LOS) in child and adolescent psychiatry (CAP) and the suc cess of inpatient treatment. All child and adolescent inpatients that had b een dismissed over a year's time from a non-university hospital after a med ium-length-treatment were rated by their therapists (crisis interventions f or <2 weeks excluded). The group featured a low drop-out-rate (9.8 %) and a high percentage of "problematic patients". The TCD-IO diagnoses were irrel evant for the prediction of LOS and success of treatment. The Global Assess ment of Function scale (axis VI) correlated significantly with LOS, and fun ctioning in all areas improved with a longer LOS. By the degree of initial psychopathology therapeutic success as well as LOS could be predicted fairl y well. Concerning adolescents, motivation for treatment and the degree of cooperation both correlated with LOS and improvement, which implies the imp ortance of their participation. For children under 12, cumulated psychosoci al adversities (axis V) predicted a less positive outcome, cooperation of p arents and patients raised the chance of success. Shortened lengths of stay will not lead to comparable success. As a system like DRGs for reimburseme nt of hospitalization in CAP will not prove to be efficient, other variable s deserve more attention in future health economy planning. More intervenin g variables, such as psychosocial adversities, motivation, and cooperation have to be considered.