Wolff Jennifer C, Frazier Elisabeth A, Weatherall Sarah L, Thompson Alysha D, Liu Richard T, Hunt Jeffrey I
1 Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University , Providence, Rhode Island.
2 Department of Psychiatry, Bradley Hospital , Riverside, Rhode Island.
J Child Adolesc Psychopharmacol. 2018 Jul/Aug;28(6):409-414. doi: 10.1089/cap.2017.0135. Epub 2018 Apr 12.
This study evaluated the feasibility and initial efficacy of an empirically informed psychosocial intervention on an adolescent psychiatric inpatient unit.
Data were obtained for 463 adolescents 12-16 years of age on a psychiatric inpatient unit. Information collected included demographics, psychiatric diagnoses, length of inpatient stay, completion of four treatment modules, rehospitalizations, and emergency room visits during 12 months after discharge from index admission.
Around 98.70% of patients completed at least one out of the four treatment modules and 93.95% of patients completed two modules. There were no significant barriers to completing treatment modules on the basis of participant characteristics (demographics, psychiatric diagnosis, number of diagnoses, or length of stay). Completion of the four treatment modules, particularly modules on developing a safety plan and enhancing life, predicted lower risk for rehospitalization and emergency room contact in the 12 months postdischarge.
Findings suggest that the intervention is feasible to implement regardless of common barriers in an inpatient psychiatric setting, such as complex psychopathology and brief duration of hospitalization. Completion of treatment modules significantly reduces risk for subsequent emergency intensive service utilization, suggesting this intervention may be an effective method for reducing acute clinical events.
本研究评估了一种基于经验的心理社会干预措施在青少年精神科住院单元实施的可行性和初步疗效。
收集了某精神科住院单元463名12至16岁青少年的数据。收集的信息包括人口统计学资料、精神科诊断、住院时间、四个治疗模块的完成情况、再次住院情况以及首次入院出院后12个月内的急诊就诊情况。
约98.70%的患者完成了四个治疗模块中的至少一个，93.95%的患者完成了两个模块。基于参与者特征（人口统计学资料、精神科诊断、诊断数量或住院时间），完成治疗模块不存在显著障碍。完成四个治疗模块，尤其是制定安全计划和改善生活的模块，可预测出院后12个月内再次住院和急诊就诊的风险较低。
研究结果表明，无论住院精神科环境中存在诸如复杂精神病理学和住院时间短暂等常见障碍，该干预措施实施起来都是可行的。完成治疗模块可显著降低后续急诊强化服务利用的风险，表明这种干预措施可能是减少急性临床事件的有效方法。
