title: [Home treatment - especially effective among boys with externalizing disorders? Age- and sex-specific effectiveness of home treatment for internalizing and externalizing disorders].
abstract: OBJECTIVE
  Indications for home treatment for specific diagnoses in child and adolescent psychiatry have not yet been evaluated.
  
  
  METHODS
  In a recent intervention study (primary outcome: length of stay), 92 patients aged 5 to 17 years were randomized into an intervention group (early discharge followed by home treatment in combination with inpatient treatment, where needed) and a control group (regular length inpatient treatment). The aim of this explorative analysis was to retrieve additional information on “what works for whom.” Outcome parameters were as follows: Children’s Global Assessment Scale (CGAS), Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), Strengths and Difficulties Questionnaire (SDQ) and Columbia Impairment Scale (CIS) at T1 (within 14 days after intake), T2 (end of treatment) and T3 (∅ 8.4-month follow-up). Multiple regression was used to investigate the association between diagnoses, treatment setting, age, sex, and improvement in both groups.
  
  
  RESULTS
  In children externalizing disorders were predominant, whereas in adolescents internalizing disorders were prominent. Patients improved equally under both types of treatment. Home treatment, however, was rated by the patients to be significantly more effective in adolescents (SDQ p = .017), boys (CIS p = .009, SDQ p < .001), and with externalizing disorders (SDQ p = .005).
  
  
  CONCLUSIONS
  Home treatment may be considered an alternative to inpatient treatment, especially in boys with externalizing disorders.
authors.affiliation: 1 ZfP Südwürttemberg, Akademisches Lehrkrankenhaus der Universität Ulm, Ravensburg.
authors.forename: Isabel
authors.initials: I
authors.lastname: Boege
authors.forename: Lucia
authors.initials: L
authors.lastname: Mayer
authors.forename: Rainer
authors.initials: R
authors.lastname: Muche
authors.forename: Nicole
authors.initials: N
authors.lastname: Corpus
authors.forename: Renate
authors.initials: R
authors.lastname: Schepker
authors.forename: Joerg M
authors.initials: JM
authors.lastname: Fegert
mesh_terms: D000293:Adolescent; D000359:Aftercare; D000367:Age Factors; D000553:Ambulatory Care; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003631:Day Care, Medical; D005196:Family Therapy; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006792:House Calls; D006801:Humans; D007389:Internal-External Control; D007902:Length of Stay; D008297:Male; D010351:Patient Discharge; D010552:Personality Assessment; D012737:Sex Factors; D012917:Social Adjustment
keywords: Behandlungseffektivität; Externalisierende Störungen; Home treatment; Kinder und Jugendliche; Stationäre Regelbehandlung; children and adolescents; externalizing disorders; inpatient care; treatment-effectiveness