"Day Hospital in Child and Adolescent Psychiatry: Is It Effective for Whom?" Effectiveness of Infant Psychiatric Day Hospital

Abstract

The infant day hospital is a therapeutic option to patients with high complexity neuropsychiatric disorders. It is essential to evaluate its effectiveness and the patients' profile that better respond to this type of intervention so the national resources are better invested. Objectives:(1) to describe the population admitted in a psychiatric infant day hospital (HDI); (2) to evaluate the clinical response to this intervention and (3) to identify predictive factors of dropout.Methods: All patients (n=62) admitted to our HDI unit were evaluated and received multidisciplinary treatment for a 3-month period from 2011 to 2014. The psychiatric diagnostic interviews, patients´ records analysis and the clinical scales Children's Global Assessment Scale (CGAS) and Clinical Global Impressions Scale (CGI) were the measures used for outcome evaluation. Results:The mean age was 13 years old (SD: 3.1 years). Thirty-five patients (56.5%) were male and 53 patients (83.9%) referred occurrence of family conflicts. The most prevalent initial diagnostic was Mood Disorder (n=28, 45.1%). The mean C-GAS increased from 36 to 52 (p=0,00) and the mean CGI decreased from 5 to 2 (p=0.00) during the period. Older patients presented higher odds to abandon the treatment in HDI (OR= 0.448; p=0.019) as well as those with a relative with affective disorder (OR = 2.303; p=0.003). Conclusion:The HDI was effective in promoting clinical stabilization of severe psychiatric disorders in children and adolescents. It is important to address factors such as the age of the patients and the psychopathology in the family to try to decrease dropout rates.

Demographic & clinical correlates of admission into a specialized psychiatric inpatient service for children and adolescents in Egypt: An observational retrospective study

“…This high percentage might reflect the cultural tendency to give attention to behavioural problems more in males rather than in females. Although the percentage of children living with both parents is less in our admitted than in outpatient group, this percentage among admitted young people is still less than reported in other cultures (Mendonca et al, 2017), a finding that might reflect the conservative nature of Egyptian culture but might also reflect the need to reach out to more troubled families and residential homes in our community. Unsurprisingly, we reported clear associations between physical and sexual abuse of children and admission, readmission, and longer duration of admission among our inpatient sample of young individuals, a finding previously reported in several studies (Bobier & Warwick, 2005;Mendonca et al, 2017).…”

Demographic & Clinical Correlates of Admission into a Specialized Psychiatric Inpatient Service for Children and Adolescents in Egypt: An Observational Retrospective Study

“…This high percentage might re ect the cultural tendency to give attention to behavioral problems more in males rather than in females. Although the percentage of children living with both parents is less in our admitted than in outpatient group, this percentage among admitted youth is still less than reported in other cultures (Mendonca, Pantano, Casella, & Scivoletto, 2017), a nding that might re ect the conservative nature of Egyptian but might also re ect the need to reach out to more troubled families and residential homes in our community. Unsurprisingly, we report a clear association between physical and sexual abuse of children and admission, readmission, and longer duration of admission among our inpatient sample of youth, a ning previously reported in several studies (Bobier & Warwick, 2005;Mendonca et al, 2017).…”