S202. EFFICACY OF LONG-TERM RESIDENTIAL TREATMENT FOR PERSISTENT MENTAL ILLNESS

Abstract

Results: Of the 43 patients included in the study, 20 were male, and the other 23 were female. The mean age of all participants was 41.44 years (SD=15.89). Patients were taking the following antipsychotics and anti-depressants: clozapine (n=6), amisulpride (n=9), aripiprazole (n=5), olanzapine (n=18), risperidone (n=1), quetiapine (n=20), haloperidol (n=1), paliperidone (n=5), chlorpromazine (n=1), blonanserin (n=1), escitalopram (n=7), sertraline (n=1), mirtazapine (n=2), duloxetine (n=1), venlafaxine (n=3), amitriptyline (n=1), trazodone (n=1), bupro-pion (n=1). Participants took an average of 1.91 (SD=1.02, range 0-5) different psychotropic drugs during ECT. The mean number of types of antipsychotics and antidepressants used were 1.53 (SD=0.74, range 0-3) and 0.37 (SD=0.76, range 0-4), respectively. Multivariate regression analyses showed positive correlations between initial ST and the total chlorpromazine-equivalent dose of antipsychotics (β = 0.363, p < 0.05). The total fluoxetine-equivalent dose of antidepressants was positively correlated to ΔST10th (β = 0.486, p < 0.05) and mean ΔSTlast (β = 0.472, p < 0.01). Discussion: Our study elucidated possible effects of psychotropic drugs on ST in patients undergoing ECT. We revealed that larger doses of antipsy-chotics are associated with higher initial ST, whereas higher doses of anti-depressants are associated with stronger shifts of ST during the course of treatment. We believe that our findings provide a basis for creating safer and more efficient ECT protocols. Background: In the United States, the number of public and private psychiatric hospital beds has steadily declined in recent years, despite the lack of intensive intermediate care alternatives in the community. The design and implementation of intensive residential treatment programs are not currently guided by controlled studies, but these studies are necessary to determine the clinical and economic utility of such programs. We present clinical and outcome data on an initial sample of patients treated over the last 5 years. Methods: Naturalistic, non-controlled assessment of symptomatic and functional outcome in an initial sample of young adults with persistent mental illnesses treated in a community-based residential program. Patients were treated with an individualized combination of modalities such as Illness Education and Management, Supported Employment, Individual, Group and Family Psychotherapies and Psychopharmacology. Standard clinical rating scales were used during the period of treatment and all discharged patients were contacted on an annual basis in order to complete a survey of clinical outcome. Results: 101 patients had been admitted and treated since the facility opened in October 2011. Median age of the patients was 25 years, mean illness duration was 12.6 years, and the mean number of prior hospitalizations was 6.5. Diagnostic distribution was: 36.7% psychotic disorders, 27.7% unipolar mood disorders, 19.8% bipolar mood disorders, 7.9% autism spectrum disorders, and 7.9% post-traumatic stress disorder or other anxiety conditions. 37% of residents met criteria for personality disorders, the majority of which was borderline personality disorder. 42% of residents also met criteria for a substance use disorder in the year prior to admission. Ratings on the Multnomah Community Ability Scale improved by 16%, ratings on the Brief Psychiatric Rating Scale declined by 20% and ratings on the Montgomery-Asberg Depression Rating Scale declined by 37%. The average survey response rate after discharge was 59%. With regard to community engagement: 40.3% of current residents and 35.1% of discharged residents were competitively employed. 16.7% of current residents and 17.8% of discharged residents worked as volunteers, and 23.3% of current