Stability of treatment outcome in short-term psychiatric care. A six-month follow-up of a controlled study of patient involvement.

The general trend of avoiding and shortening in-patient treatment raises the question of the stability of treatment gains made during hospitalization. A 6-month follow-up was made for patients treated on a short-term psychiatric ward. The origin was a controlled study of two models of patient involvement in treatment planning. Patients benefiting most from a cooperation procedure during hospitalization were those with socio-psychological treatment objectives and those treated in a Basic Activation Group on the ward. The superior outcome for these patients was not stable during the period of follow-up, resulting in an incongruence between in-hospital and post-hospital adjustment. Furthermore, these patients at time of follow-up showed an increased confidence in the staff of the ward and a decrease in the rated importance of their social network. It is suggested that this is the result of dependency reactions and a separation process from the therapeutic milieu of the ward which were not resolved at time of discharge. Greater concern should be invested in formulating the treatment contract in an out-patient context in order to place the emphasis on the real life situation of the patient.