Graf Daniel, Lerch Stefan, Böhnke Ulrich, Reichl Corinna, Kaess Michael
University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Stöckli, Bern, 3000, 60, Switzerland.
Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
Eur Child Adolesc Psychiatry. 2025 Mar 10. doi: 10.1007/s00787-025-02677-x.
Home Treatment (HT) in child and adolescent psychiatry is an increasingly important topic in the current context of global crises and strained mental health systems. We implemented a HT program provided by a multiprofessional treatment team and compared long-term outcomes of 27 patients (48% female, Ø15.15 ± 2.77 years) with those of 48 patients (69% female, Ø16.35 ± 2.87 years) who received inpatient treatment as usual (I-TAU). Psychopathology was assessed using the Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA[-SR]) and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF) at admission, discharge, and 18-24 months after discharge. Treatment outcomes were analyzed using mixed models. The results showed that patients in the HT arm had significantly lower HoNOSCA scores at follow-up (β = -4.25 [95%CI: -7.64 to -0.86], SE = 1.73, p = 0.014) and higher GAF scores (β = 12.09 [95%CI: 4.48 to 19.70], SE = 3.88, p = 0.002) compared to those in the I-TAU arm. No significant differences were observed in HoNOSCA-SR scores (β = -2.46 [95%CI: -9.16 to 4.30], SE = 3.43, p = 0.48) and readmission rates (OR = 1.23 [95%CI = 0.47 to 3.20], p = 0.67). These results highlight the potential of HT in improving long-term functional and psychopathological outcomes in youth mental health. HT may be an equally effective and even more sustainable type of treatment for child and adolescent mental disorders. The trial was preregistered at the German Clinical Trials Register (DRKS00025424, 05/27/2021).
在全球危机和心理健康系统紧张的当前背景下，儿童和青少年精神病学中的家庭治疗（HT）是一个日益重要的话题。我们实施了一个由多专业治疗团队提供的家庭治疗项目，并将27名患者（48%为女性，平均年龄15.15±2.77岁）的长期结果与48名接受常规住院治疗（I-TAU）的患者（69%为女性，平均年龄16.35±2.87岁）的结果进行了比较。使用儿童和青少年国家健康结果量表（HoNOSCA[-SR]）评估精神病理学，并在入院、出院时以及出院后18 - 24个月使用功能总体评估（GAF）评估心理社会功能。使用混合模型分析治疗结果。结果显示，与I-TAU组相比，家庭治疗组患者在随访时的HoNOSCA得分显著更低（β = -4.25 [95%CI：-7.64至-0.86]，SE = 1.73，p = 0.014），GAF得分更高（β = 12.09 [95%CI：4.48至19.70]，SE = 3.88，p = 0.002）。在HoNOSCA-SR得分（β = -2.46 [95%CI：-9.16至4.30]，SE = 3.43，p = 0.48）和再入院率（OR = 1.23 [95%CI = 0.47至3.20]，p = 0.67）方面未观察到显著差异。这些结果突出了家庭治疗在改善青少年心理健康长期功能和精神病理学结果方面的潜力。家庭治疗可能是治疗儿童和青少年精神障碍同样有效甚至更具可持续性的一种治疗方式。该试验已在德国临床试验注册中心预注册（DRKS00025424，2021年5月27日）。
