Psychiatric Partial Hospitalization Programs: Following World Health Organization Guidelines with a Special Focus on Women with Delusional Disorder

Alexandre González-Rodríguez,Aida Alvarez,Mary V Seeman,Rafael Penadés,Armand Guàrdia,José Antonio Monreal,Javier Labad,Diego J Palao

doi:10.3390/women1020008

Abstract

The World Health Organization (WHO) developed a 7-year Mental Health Action Plan in 2013, which recommends integration of health and social care services into community-based settings, implementation of strategies for health promotion and prevention of illness, and support of research. In this review, we highlight partial hospitalization programs (PHPs) for delusional disorder (DD), with a special focus on the health and psychosocial needs of women. We suggest that PHPs are, in many ways, ideal settings for carrying out WHO recommendations. PHPs are multidisciplinary and consequently are able to provide a wide range of flexible program offerings. Programming in PHPs is able to address, with proven efficacy, individual needs, such as those presented by women at the various stages of their reproductive life. PHPs are a community bridge between hospital and outpatient services and can quickly adapt to specific needs as affected by gender, but also by age and cultural origins. They are ideal settings for professional training and for conducting clinical research. PHPs operate on the principle of shared decision making, and thus more readily than many other treatment sites, engaging difficult-to-treat patients, such as those with DD, by successfully establishing long-term relationships of trust.

Highlights

We propose targets and actions that need to be developed in partial hospitalization programs (PHPs) programs and that can add to the evidence base of interventions that benefit women with DD
Prevalence of DD is higher in neighborhoods with high frequency of psychosocial and socioeconomic risk factors
Coordination and cooperation among health professionals is recommended in community based mental health teams, including collaboration with other medical services

Summary

Introduction

Delusional disorder (DD) has been perceived by health professionals as a treatment-resistant disorder [1]. DD is reported as being problematic for family members, partly because DD patients adhere poorly to prescribed medications, do not willingly attend treatment appointments, and seem often to be unaware that they are ill [2]. It is, possible to help families develop home-based therapeutic skills while patients receive specialized treatment in the community [3]. The current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), defines DD as a disorder characterized by the presence of one or more delusions lasting for at least one month, without

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