Hospital admission in adolescents with acute psychiatric disorder: how long should it be?
OBJECTIVE
To determine the length of stay in hospital for youth with acute psychiatric illness, and the treatment outcome.


METHODS
Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) psychiatric diagnosis, clinical outcome and the length of stay were systematically gathered for admissions over an 18 month period at the Christchurch Youth Inpatient Unit (YIU). Clinical outcome data were collected at admission, 3 weeks after admission and at discharge, using the Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA). The length of stay was determined retrospectively. Discharge was decided on clinical grounds.


RESULTS
During the 18 months of the investigation, 72 subjects were admitted for the treatment of acute mental illness. The most common diagnostic category was mood disorder (n=39, 54%), followed by anxiety or adjustment disorder (n=18, 25%), and major psychosis (n=15, 21%). The mean length of admission for the whole population was 27.3 days, 23.7 days for mood disorders, 18.9 days for anxiety disorders and 46.9 days for the major psychosis diagnostic groups. According to HoNOSCA clinician ratings, the major portion of the improvement occurred during the first 3 weeks of admission.


CONCLUSIONS
For the majority of youth with acute psychiatric illness, a relatively short stay in hospital is feasible, because most health gains tend to occur early during an admission.
Swadi
Harith
H
Youth Inpatient Unit, Princess Margaret Hospital, Christchurch, New Zealand. harith.swadi@cdhb.govt.nz
Bobier
Candace
C
D000208:Acute Disease; D000293:Adolescent; D001315:Australia; D003156:Community Mental Health Services / Q000458:organization & administration; D003422:Critical Care; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome