[Effectiveness of treatment in day hospital versus inpatient ward evaluated by patients' psychopathological symptoms and subjective quality of life (QoL) analysis].
OBJECTIVE
The authors analyzed patients' psychopathological symptoms and subjective quality of life (QoL) for evaluating the effectiveness of treatment in day hospital versus inpatient wards. Analyses concerned patients from Wrocław and recruited within the framework of an EU funded multi-centre study EDEN.


METHODS
238 patients admitted to the Psychiatric Hospital in Wrocław were randomly assigned to treatment in either day hospital (n=l15) or inpatient ward (n=123). Patients were interviewed at 4 time-points comprising their stay in hospital. Differences between settings in terms of dynamics of psychopathological symptoms and subjective QoL were expressed in mean scores of BPRS subscales and MANSA. Two parameters of effectiveness were considered: the static--the score on the scale at a given time-point and average score level, and the dynamic--describing dynamics of changes (gradients). Statistical methods included ANOVA and ANCOVA with co-variables.


RESULTS
In terms of manic and excitement symptoms inpatient wards proved to be more effective as measured at discharge, no differences in dynamics between settings were found. Day hospital was superior in alleviating negative symptoms during treatment but improvement in that respect was quicker in the inpatient ward. In terms of alleviating positive symptoms, the inpatient ward was more effective only at the beginning of the treatment. Day hospital was more effective in handling symptoms of depression and anxiety but only at the beginning of treatment. Dynamics of subsiding of the symptoms at the beginning of hospitalization was better for the inpatient ward. No differences in QoL in both settings were found.


CONCLUSIONS
Taking into consideration the static and the dynamic parameters of effectiveness of treatment, the superiority of inpatient treatment over day hospital has not been, therefore, definitely proven.
Adamowski
Tomasz
T
Katedra i Klinika Psychiatrii AM we Wroclawiu.
Hadryś
Tomasz
T
Rymaszewska
Joanna
J
Kiejna
Andrzej
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000592:standards*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome