"Day Hospital in Child and Adolescent Psychiatry: Is It Effective for Whom?" Effectiveness of Infant Psychiatric Day Hospital
Author(s): Renata Mendonca, Telma Pantano, Caio Borba Casella and Sandra Scivoletto
The infant day hospital is a therapeutic option to patients with high complexity neuropsychiatric disorders. It is essential to evaluate its effectiveness and the patients’ profile that better respond to this type of intervention so the national resources are better invested.
Objectives: (1) to describe the population admitted in a psychiatric infant day hospital (HDI); (2) to evaluate the clinical response to this intervention and (3) to identify predictive factors of dropout.
Methods: All patients (n=62) admitted to our HDI unit were evaluated and received multidisciplinary treatment for a 3-month period from 2011 to 2014. The psychiatric diagnostic interviews, patients´ records analysis and the clinical scales Children’s Global Assessment Scale (CGAS) and Clinical Global Impressions Scale (CGI) were the measures used for outcome evaluation.
Results: The mean age was 13 years old (SD: 3.1 years). Thirty-five patients (56.5%) were male and 53 patients (83.9%) referred occurrence of family conflicts. The most prevalent initial diagnostic was Mood Disorder (n=28, 45.1%). The mean C-GAS increased from 36 to 52 (p=0,00) and the mean CGI decreased from 5 to 2 (p=0.00) during the period. Older patients presented higher odds to abandon the treatment in HDI (OR= 0.448; p=0.019) as well as those with a relative with affective disorder (OR = 2.303; p=0.003).
Conclusion: The HDI was effective in promoting clinical stabilization of severe psychiatric disorders in children and adolescents. It is important to address factors such as the age of the patients and the psychopathology in the family to try to decrease dropout rates.