Siciliano Rachel E, McGonigle Trey W, Benningfield Margaret M, Vandekar Simon, Owens Margaret V, Felts Brandi, Anderson Allegra S, Cole David A, Bettis Alexandra H
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
Evid Based Pract Child Adolesc Ment Health. 2025;10(1):56-71. doi: 10.1080/23794925.2024.2358494. Epub 2024 Jun 13.
Partial hospitalization programs (PHPs) offer an alternative to inpatient care for youth with acute psychiatric needs. PHP treatment is effective for adults, but fewer studies have examined adolescent programs. In the current study, we describe a large sample of adolescents enrolled in a PHP and evaluate symptom change over treatment. Demographic information, insurance, treatment length, readmission status (i.e., repeat admissions), the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Columbia Suicide Severity Rating Scale (C-SSRS) were extracted from electronic health records. The sample (N=1237, ages 12-18) was predominantly female assigned at birth (70%), White (84%), and non-Hispanic/Latine (92%). Approximately 25% of adolescents reported suicidal thoughts and behaviors (STBs) and 8% were readmissions. Anxiety and depression symptoms decreased significantly over the course of treatment ( < 0.001). Female patients reported more severe symptoms than males ('s < 0.001), and patients who identified as racial and/or ethnic minorities reported higher anxiety and depression ( < 0.05) over treatment. Past month STBs was associated with higher anxiety ( = 0.003) and depression ( < 0.001) symptoms at admission, though these youth experienced similar symptom reduction. Readmission status did not predict symptoms at admission or change over treatment. This naturalistic study suggests that PHP treatment reduces anxiety and depression symptoms for adolescents with STBs and those with repeat admissions. Demographic factors impacted symptom severity and suggested that patients identified as racial and/or ethnic minorities may experience barriers to accessing treatment. Treatment needs and considerations for adolescents in PHPs are discussed.
部分住院治疗项目（PHPs）为有急性精神需求的青少年提供了一种替代住院治疗的选择。PHP治疗对成年人有效，但针对青少年项目的研究较少。在本研究中，我们描述了一大群参加PHP治疗的青少年样本，并评估了治疗过程中的症状变化。从电子健康记录中提取了人口统计学信息、保险情况、治疗时长、再入院状态（即重复入院）、广泛性焦虑障碍量表-7（GAD-7）、患者健康问卷-9（PHQ-9）以及哥伦比亚自杀严重程度评定量表（C-SSRS）。样本（N = 1237，年龄12 - 18岁）中，出生时被指定为女性的占大多数（70%），白人（84%），非西班牙裔/拉丁裔（92%）。约25%的青少年报告有自杀想法和行为（STBs），8%为再入院患者。焦虑和抑郁症状在治疗过程中显著减轻（< 0.001）。女性患者报告的症状比男性更严重（< 0.001），并且在治疗过程中，自我认定为种族和/或族裔少数群体的患者报告的焦虑和抑郁程度更高（< 0.05）。过去一个月的STBs与入院时较高的焦虑（= 0.003）和抑郁（< 0.001）症状相关，不过这些青少年的症状减轻情况相似。再入院状态并不能预测入院时的症状或治疗过程中的变化。这项自然主义研究表明，PHP治疗可减轻有STBs的青少年以及再入院青少年的焦虑和抑郁症状。人口统计学因素影响症状严重程度，表明自我认定为种族和/或族裔少数群体的患者在获得治疗方面可能存在障碍。文中讨论了青少年在PHP治疗中的需求和注意事项。
