A Randomized Trial of Psychiatric Day Treatment for Patients With Affective and Personality Disorders

Department of Psychiatry, University of Alberta, Edmonton, Canada.
Hospital & community psychiatry 09/1993; 44(8):757-63. DOI: 10.1176/ps.44.8.757
Source: PubMed


The outcome of a day treatment program for psychiatric outpatients with affective and personality disorders was evaluated. The program was dynamically oriented, intensive, group focused, and time limited (18 weeks).
The prospective trial used a randomized treatment-versus-control (delayed-treatment) design to examine 17 outcome variables covering five areas: interpersonal functioning, symptomatology, self-esteem, life satisfaction, and defensive functioning. Those variables, plus individualized treatment objectives, were monitored before and after the treatment and control periods and at follow-up an average of eight months later.
Treated patients showed significantly better outcome than control patients for seven of the 17 outcome variables: social dysfunction, family dysfunction, interpersonal behavior, mood level, life satisfaction, self-esteem, and severity of disturbance associated with individual goals of treatment as rated by an independent assessor. The findings could not be accounted for by diagnosis or use of medication. Benefits were maintained over the follow-up period. The average treatment-versus-control effect size for all 17 variables was .71.
The study supports the efficacy of an intensive day treatment program for patients who manifest significant difficulties associated with affective and personality disorders.

Download full-text


Available from: Anthony Joyce, Oct 06, 2015
33 Reads
  • Source
    • "993 ) evaluated the effectiveness of a multimodal day program on young children with disruptive disorder , as compared with a waiting list control group . Erker et al . ( 1993 ) researched long - term follow - up study of children who had received either residential or day treatment in a private psychiatric facility approximately 10 years before . Piper et al . ( 1993 ) researched 120 patients who had completed day treatment and control conditions ( delayed treatment ) whilst Matzner et al . ( 1998 ) compared the pre / post outcome data of young people who had attended a traditional outpatient service and then attended a day treatment program ."
    [Show abstract] [Hide abstract]
    ABSTRACT: A day treatment program is an important component on the continuum of care for young people with moderate to severe mental health issues. The aim of this research was to investigate whether adolescents who participate in a structured day treatment program demonstrate greater mental health gains than adolescents receiving less intensive outpatient treatment. In addition, the research investigated whether mental health gains were related to intake diagnosis and whether parents reported higher levels of mental health gain than the client in their self-report ratings. The setting for the research was The Cottage, an adolescent day treatment program, run by the Child and Adolescent Mental Health Service (CAMHS) in the Australian Capital Territory. The program provides intense multi-faceted treatment within a therapeutic milieu environment for clients aged 12-18 years with moderate to severe mental health issues. The study involved a Day Program group of 22 clients from The Cottage and included a comparison group of 20 outpatient clients from CAMHS. Results indicated that individuals in both treatment approaches had statistically significant reductions in anxiety and depression symptomology and improvements in outcome measures, but there were no significant differences between the two treatment groups. The data indicated a statistically significant difference in return to school rates, whereby approximately 82% of individuals in the day treatment program had returned to school/employment, whilst only 30% of individuals in outpatient treatment had returned to school/employment within three months post treatment. The results did not demonstrate that the degree of mental health gain was dependent upon intake diagnosis and although not statistically significant, parents rated their children as more severe in terms of psychopathology than the client.
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study had two main aims: to determine the stability over time of the diagnosis borderline personality disorder (BPD) in a psychiatric hospital population; and to assess the quality and effectiveness of treatment offered within state mental health service. The case notes of 47 psychiatric hospital patients followed up for 3 years after the index admission were analysed. The mean number of previous psychiatric hospital admissions was 9.0, and at least 74% of the sample had further admissions (mean 3.7) during the 3 year follow-up. Comorbidity with schizophrenia and schizoaffective disorder was rare, and was only 13% with major depression. Longitudinal stability of diagnosis was very high. The study firmly supported BPD as a valid diagnosis. Its treatment within the state mental health system was generally haphazard and ineffective. Post-discharge plans were implemented for only 3 subjects. Current moves toward community psychiatric treatment represent a unique opportunity for improving treatment of BPD by using existing resources more effectively.
    Australian and New Zealand Journal of Psychiatry 10/1995; 29(3):409-14. DOI:10.3109/00048679509064948 · 3.41 Impact Factor
  • Source
    X Congreso de la FAPE, Chiclana, Cadíz,1997; 01/1997
Show more