Çocuk ve Ergenlerin Yatarak Tedavisinde İyileşme Ne Kadar Kalıcı Oluyor?

Abstract

Objective: Although it is widely accepted that inpatient psychiatric treatment of children and adolescents is effective, it is also essential to evaluate its effectiveness by assessing the treatment compliance following discharge and the persistence of treatment effects in the long run. The aim of this study is to assess the effectiveness of inpatient treatment provided in one of the rare units in our country via evaluation of the achievement of treatment goals, changes in risk assessment scores, treatment compliance following discharge, and psychological functioning as reflected in the current relationships with the family, peers and school. Methods: This study was conducted in patients who had received at least 2 weeks of inpatient treatment in Dokuz Eylul University Hospital, the Child and Adolescent Mental Health Inpatient Unit between February 2008 and January 2009. Achievement of treatment goals, changes in risk assessment scores, treatment compliance following discharge, and the level of general functioning were assessed 1 year after the discharge. Socio-demographic variables, psychiatric diagnosis, and duration of hospital stay were recorded for each patient. Treatment goals questionnaire, risk assessment procedure, assessment of treatment compliance following discharge, relations with peers, family and school, and general functioning were assessed with the The Children's Global Assessment Scale (CGAS). Results: Forty-six patients with a mean (Standard Deviation, SD) age of 16.2 (1.6) years were included in the study. It was observed that 84.7% of patients had good compliance with the outpatient treatment plans. The mean (SD) CGAS scores calculated at admission, discharge and 1 year following the inpatient treatment were 40.6 (8.8), 60.7 (9.0) and 65.1 (1.7), respectively. The change in CGAS scores was found to be statistically significant (p=0.000). Additionally, the risk assessment scores were significantly lower 1 year following the discharge (p=0.000). Conclusion: Data obtained from the study display that the inpatient treatment of children and adolescents showed marked improvements in their psychiatric morbidities, peer, family and school functioning and outpatient treatment compliance. These findings could indicate the necessity of establishing and improving child and adolescent inpatient units in our country. (Archives of Neuropsychiatry 2010; 47: 319-23)