A naturalistic study of outcomes in a general psychiatry day hospital

Abstract

Psychiatric day hospitals have potential advantages compared with inpatient and/or outpatient treatment, but results are inconsistent and thus their use is controversial. Moreover, few data are available on the factors influencing the treatment success; this is particularly the case regarding Swiss day hospitals. This paper has three goals; first, to give an insight into the population attending a new general day hospital in Canton Fribourg; second, to assess different treatment outcome indicators, and third, to assess treatment improvement predictors. Results, relying on therapist-assessed data from all day hospital stays gathered over more than 3 years, show that, within a wide diversity, overall patients had a significant improvement in their functioning level during the stay. Moreover, our results indicated that patients with a substance-related disorder benefited less from the treatment, whereas patients with an affective disorder benefited more. Additionally, patients starting with a lower functioning level improved more, whereas patients with a longer disorder history improved less. Suicidality and self-harming behaviour did not affect the outcome. Most importantly for clinical implications, longer treatment and more frequent attendance at the day hospital predicted a better outcome. Results are discussed in the context of the existing literature and their potential utility for further treatment and research.