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
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.