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Outcome following child psychiatric hospitalization
S D Mayes1, S L Calhoun, V F Krecko
1Department of Psychiatry, Pennsylvania State University, College of Medicine, P.O. Box 850, Hershey, PA 17033, USA.
Insights
Child psychiatric unit stays significantly improved psychological functioning. While gains slightly decreased post-discharge, children remained less impaired long-term, supporting inpatient treatment effectiveness.
Area of Science:
- Child and Adolescent Psychiatry
- Clinical Psychology
- Evidence-Based Practice
Background:
- Child psychiatric inpatient units provide intensive interventions for youth with significant psychological impairment.
- Assessing the long-term effectiveness of inpatient psychiatric treatment is crucial for evidence-based practice.
- Understanding treatment effects beyond the acute hospitalization phase is essential for continued care.
Purpose of the Study:
- To evaluate the changes in psychological functioning of children during and after inpatient psychiatric treatment.
- To determine if improvements observed during hospitalization are maintained at 1- and 6-month follow-ups.
- To assess the contribution of inpatient intervention to observed functional gains.
Main Methods:
- Longitudinal evaluation of 110 children admitted to a child psychiatric unit.
- Utilized admission, discharge, and 1- and 6-month follow-up assessments.
- Employed a simple, empirically supported assessment instrument to measure psychological functioning.
Main Results:
- Significant improvement in children's psychological functioning during the mean 14-day hospitalization.
- Functional gains were partially maintained at 1- and 6-month follow-ups, with children remaining significantly less impaired than at admission.
- No significant decline in functioning was observed between the 1- and 6-month follow-up points.
Conclusions:
- Inpatient psychiatric treatment yields significant, lasting improvements in child psychological functioning.
- The observed improvements are consistent with a treatment effect attributable to the inpatient intervention (ABA design).
- The study demonstrates a clinically feasible method for documenting patient progress in accordance with evidence-based practice principles.
Abstract:
Admission, discharge, and follow-up evaluations of 110 children admitted to a child psychiatric unit (mean 14 days) showed that the children's psychological functioning improved significantly during hospitalization. Gains were not fully maintained at follow-up (1 and 6 months), but the children were still significantly less impaired after discharge than at admission. A nonsignificant difference existed between follow-up scores, indicating no loss of progress or decline in functioning from 1- to 6-month follow-up. The results are consistent with an ABA (A = no inpatient intervention, B = inpatient intervention, A = no inpatient intervention) treatment effect. They are not explained by removal from and return to an unsatisfactory home environment. Psychological functioning after admission was significantly better than after 1 to 6 months of post-discharge psychiatric services. This study offers a clinically feasible approach to evidence-based practice by documenting patient improvement during and after inpatient treatment using a simple, empirically supported assessment instrument.