Psychiatric Treatment Outcome Research Articles

Psychiatric treatment outcome following traumatic brain injury

Psychiatric treatment outcome following traumatic brain injury

Somatic comorbidity in personality disorder inpatients: Effect On Treatment Outcome In A 3-Year Follow-Up Study

Few studies have been published on the effects of physical comorbidity on the course or outcome of psychiatric inpatient treatment. In a psychiatric ward specializing in the psychotherapeutic treatment of borderline disorders, changes in symptoms and social management of 42 patients were monitored during an average hospitalization period of 91 days (range, 21-296 days) and a 3-year follow-up period. Physical health status was estimated during a follow-up interview on the basis of the medical records of the general hospital in question. Ages of the patients varied between 20 and 59 years (median, 41 years). Only 21% had no diagnosed physical illness. The others had mild or temporary (62%) or serious (17%) physical illnesses. During the entire study period, relief of symptoms as assessed on the basis of the Hamilton Depression Rating Scale (HDRS) or the Beck Depression Inventory (BDI) was most marked in patients without physical illness. Depression and anxiety continued to decrease after the end of inpatien...

The assessment of outcome and value of psychiatric hospital treatment.

The assessment of outcome and value of psychiatric hospital treatment.

Factors predicting outcome of psychiatric hospital treatment in patients with borderline personality organization

The aim of the present study was to identify factors predicting the outcome of psychiatric hospital treatment carried out on a ward specializing in psychotherapeutic treatment of borderline personality disorders. The sample included patients admitted during 1989 to an open psychiatric ward at the Department of Psychiatry of Kuopio University Hospital in Finland (n=66). The success of treatment was assessed by means of the Beck and Hamilton depression scales, on the basis of which the sample was divided into two groups: those who benefited from treatment and those who did not. Fifty independent variables reflecting the patients' background, previous treatment and expectations were evaluated. A statistically significant association was found between 14 variables and the outcome of the treatment. A good outcome was predicted by subjective symptoms such as tension and suicidal tendencies at the beginning of treatment and a poor outcome by fear of delusions. Active and positive expectations of symptom decline ...

Development of outcome measures in acute psychiatry

This study is an evaluation of the use of two health status measures for monitoring the outcome of acute psychiatric treatment. The measures are the Sickness Impact Profile (SIP) and the Classification of Illness States (CIS). The SIP is a measure of the impact of sickness on patients' daily activities and behaviour. The CIS was initially developed to measure ‘morbidity states’ after hospital treatment and can be used to generate the ‘Rosser Index’, both of which have been shown to be valid and reliable measures (Rosser, 1988).

Outcome at Discharge for Patients in an Ongoing Follow-up Study of Hospital Treatment

Methodological and practical difficulties have limited the growth of knowledge about outcome of psychiatric hospital treatment. The authors report on outcome at hospital discharge for 103 long-term and 93 short-term patients treated at the C. F. Menninger Memorial Hospital, part of an ongoing follow-up study of hospital treatment. Discharge outcome is based mainly on ratings of symptoms, global functioning, and therapeutic alliance as well as on patients' reports of satisfaction. At discharge both long- and short-term patients were found to have low levels of symptoms (based on the Brief Psychiatric Rating Scale) and a relatively adequate level of functioning (in the 51-to-60 range on the Global Assessment Scale) and to have been highly satisfied with treatment.

Brochure Illustrates Psychiatric Treatment Outcomes

Brochure Illustrates Psychiatric Treatment Outcomes

Using the axis V scale to evaluate therapeutic outcome of psychiatric treatment.

This study examined whether the Axis V scale of DSM-III was a useful instrument for coding and evaluating psychiatric patients' response to treatment. It compared outpatients' functional responses to treatment, measured by the Axis V scale used to assess current functioning, with their symptomatic changes. It found that the Axis V scale provided a different dimension of patients' outcome than the symptomatic one. Overall, only 19% of the patients were rated on Axis V as improved functionally, at discharge, as compared to 55% rated as improved symptomatically. However, as outpatients completed more treatment sessions, increasingly larger percentages were rated as improved on the Axis V scale, ranging from 8.5% improved functionally after completing 1-5 sessions to 44.5% improved after 41+ sessions. Symptomatic ratings plateaued after 6-10 sessions, with 80% of the patients being rated as improved symptomatically after completing treatment, no matter how many more treatment sessions they received before discharge. The report discusses the implications of these findings for assessment of psychiatric patients' treatment needs, goals of their treatment programs, and evaluation of treatment outcomes.

The DST and its relationship to psychiatric diagnosis, symptoms and treatment outcome.

The dexamethasone suppression test (DST) was administered shortly after admission to 102 consecutive in-patients with a Hamilton depression score greater than or equal to 16. Post-dexamethasone cortisol exceeded 6 micrograms/dl in 16 cases, and levels correlated significantly with Hamilton scores; with the AMP syndromes 'hypochondria', 'apathy' and 'catatonia'; and with the IMPS 'retarded depressive' syndrome. The criterion of suppression/non-suppression did not distinguish significantly between diagnostic categories (RDC or ICD), nor between endogenous and neurotic depression. (Newcastle scale). Both base-line and post-dexamethasone cortisol levels were reduced by prior treatment with minor tranquillisers, but not by major tranquillisers or antidepressants. DST results cannot be used as straightforward indicators of prognosis.

The Influence of Parental Attitudes on Psychiatric Treatment Outcome

A study of young adult inpatients and their parents sought to find relationships among parental attitudes and characteristics, social work involvement, and the outcome of a psychodynamically oriented treatment program. The strong, positive relationships indicated by the data have significant implications for the field.

Third-party payers: to pay or not to pay.

Insurance companies have traditionally been wary of providing coverage for mental illness for two reasons: 1) they fear that people would bring a mental illness on themselves or would use treatment for self-actualization, and 2) they fear the risk of providing never-ending treatment for "incurable" illness. The author states that the insurers' fears are groundless but suggests that psychiatrists research the utilization and costs of their treatments in insurance plans collaboratively with the actuaries who determine policy and premiums. Retrospective and prospective criteria for outcome and effectiveness of psychiatric treatment must be developed and applied.

The outcome study in psychiatric evaluation research. Issues and methods.

The pressing need for data on the immediate, midrange, and longterm outcomes of psychiatric treatment demands new and viable research approaches. The outcome study in psychiatric evaluation research is discussed with emphasis on overcoming some of the methodological problems encountered in conducting research in the natural setting. When carefully planned to coincide with use of a standardized record keeping system, outcome evaluation can become a routine part of ongoing evaluation activities. Outcome research in nonexperimental situations can be a vital accompaniment to controlled studies of treatment outcome in the endeavor to compile cumulative data on the outcome of psychiatric treatment.

HEALTH CARE OF THE AGED STUDY

items is the Psychosomatic Scale from the Neuropsychiatric Screening Adjunct developed for Selective Service during World War II. Ignoring their owIn caveats and demand for more research on the relation of such symptoms to disability in role functioning, the investigators accept results obtained with this scale at face value, and make it bear a heavy weight of their interpretations of some extremely anomalous findinigs. Another quarrel that I have is with the authors' failure to make use of parental social class in analyses of such major issues as the relative importance of class-associated social factors as against severity of illness in outcome. Moreover, by relying on the patient's class position in 1960 for the investigation of community adjustment, they accentuate the problem of interpreting the direction of relations betweein class and some of their most important indicators of outcome. Nevertheless, this is a meticulously conducted and reported case study of the outcome of psychiatric treatment in public facilities just prior, for the most part. to recent changes in patieint care. It points to a complex of social factors that may be either causes or effects of treatment outcome. Further investigations should now be designed to unravel the fascinating tangle so painstakingly (lescribed here. BRUCE P. DOHRENWEND

Social and Clinical Outcomes of Psychiatric Treatment

Social and Clinical Outcomes of Psychiatric Treatment

Social and Clinical Outcomes of Psychiatric Treatment

THIS PAPER presents evidence drawn from comparisons of the state of mind and life situation of applicants for psychiatric treatment at the time of their application and six months later. The study was done at the Psychiatric Receiving Center in Kansas City, Mo. This facility is a municipally supported intensive treatment center with inpatient, day hospital, and after-care services and an outpatient clinic. 1 During the months May through October, 1963, there were 847 applicants for treatment. Of these applicants, 54 had incomplete records. There were 400 with whom it was impossible to conduct follow-up interviews six months later. This attrition was due, in 166 cases, to known geographical moves, confinement in institutions, including other mental hospitals, and death; 89 applicants flatly refused a follow-up interview, 145 applicants were untraceable with the means at our command. Thus, the data for this paper are drawn from

The Evaluation of Psychiatric Treatment.

Here is a book written by a number of men and two very able women, Lauretta Bender and Barbara Fish. As usually happens with books written by a number of people, the chapters are of unequal value, but some are excellent, such as chapter 9 by Lauretta Bender. For years she has studied childhood schizophrenia with an open mind, and she tells much about it in her presidential address. Dr. Freyhan is a very able man who discusses the psychopathological issues in judging the outcome of psychiatric treatment. Dr. Howard Davidman has an interesting chapter on the evaluation of psychoanalysis—a clinician's view. Unfortunately, the results of his study are not convincing. Dr. Franz Alexander, in his evaluation of psychotherapy, did not express himself as being at all hopeful of using statistical techniques. He thought the patients too different in their makeup to be studied statistically. The chapters by Drs. Bender,