Changes in Vocational and Social Inclusion in Patients Discharged from Day Treatment Program for Treatment of Psychotic Patients
Authors:
O. Pěč 1; E. Dragomirecká 2; D. Čechová 3; J. Pěčová 3
Authors‘ workplace:
ESET, Psychoterapeutická a psychosomatická klinika, Praha
; ředitelé MUDr. O. Pěč, PhDr., J. Růžička, PhD.
Psychiatrické centrum Praha
1; ředitel prof. MUDr. C. Höschl, DrSc., FRCPsych.
Katedra psychologie FF UK, Praha
2; vedoucí PhDr. I. Gillernová, CSc.
3
Published in:
Čes. a slov. Psychiat., 104, 2008, No. 7, pp. 343-349.
Category:
Original Article
Overview
Only insufficient number of studies was dedicated to the evaluation of day treatment programs treating patients with psychosis. Several present studies show some improvements in social competency and social skills of these patients being treated in group psychotherapy, complex programs of cognitive rehabilitation and social skills training. The aim of this study was to show if there might be some improvements in vocational and social inclusion in patients with psychosis after attending day treatment program consisting of these therapeutic methods. The other aim was to find out if there is any difference between the results in patients attending nine months of the program in comparison and the results of those who attended the program for a shorter period of time.
The retrospective survey of a sample of patients with prevailing schizophrenic and schizoaffective disorder who attended psychotherapeutic program consisting of group psychotherapy, cognitive rehabilitation, art therapy and social skills training in the length from 3 to 9 months found out that a status of vocational and social inclusion of these patients changed in comparison to the condition before the treatment. The status of inclusion was evaluated by a present employment status or by a present attendance of resocialization programs. Sixty nine per cent of these patients improved their status and 6.8% of them maintained it in 6 months follow-up (N=117) in a comparison to the status 6 months before the intervention. Analogically 78.9 % patients improved and 9.47 % maintained their status in 12 months follow-up (N=95) in comparison to the status 6 months before treatment. These results were statistically significantly different. The results of vocational and social inclusion in patients who attended 9 months of the treatment were only non-significantly better than in patients who attended less then 9 months of the treatment program.
The results indicate that there might be improvements in vocational and social inclusion in patients with psychosis who are feasible for day care. There were no significant changes between the results of the longer and shorter time of the treatment.
Key words:
psychotherapy, schizophrenia, day treatment program, vocational rehabilitation, employment rates.
Sources
1. Brenner, H. D., Hodel, B., Kube, G., Roder, V.: Kognitive Therapie bei Schizophrenen: Problemanalyse und empirische Ergebnisse. Nervenarzt, 58, 1987, pp. 72-83.
2. Češková, E., Tůma, I., Přikryl, R., Pěč, O.: Schizofrenie. In: Raboch, J., Anders, M., Praško, J., Hellerová, P (eds.), Psychiatrie. Doporučené postupy psychiatrické péče II. Praha, Infopharm, 2006.
3. Dilk, M. N., Bond, G. R.: Meta-analytic evaluation of skills training research for individuals with severe mental illness. Journal of Consulting and Clinical Psychology, 64, 1996, 6, pp. 1337-1346.
4. Garlipp, P., Seidler, K. P., Amini, K., Machleidt, W., Haltenhof, H.: Behandlungsabbruch in der psychiatrischen Tagesklinik – Plädoyer für eine differenzierte Betrachtungsweise, Psychiatr. Prax., 28, 2001, 6, pp. 262-266.
5. Gillis, K., Russel, V. R., Busby, K.: Factors associated with unplanned discharge from psychiatric day treatment programs. A multicenter study. Gen. Hosp. Psychiatry, 19, 1997, 5, pp. 355-361.
6. Hogarty, G. E., Flesher, S., Ulrich, R., Carter, M., Greenwald, D., Pogue-Geile, M., Kechavan, M., Cooley, S., Di Barry, A. L., Garrett, A., Parepally, H., Zoretich, R.: Cognitive enhancement therapy for schizophrenia: effects of a 2-year randomized trial on cognition and behavior. Arch. Gen. Psychiatry, 61, 2004, 9, pp. 866-876.
7. Hogg, L. I., Brooks, N.: New chronic schizophrenic patients: a comparison of daypatients and inpatients. Acta Psychiatr. Scand., 81, 1990, 3, pp. 271-276.
8. Howardová, A., Kitzlerová, E., Půbal, K., Kališová, L., Sekot, M., Baková, N., Číhal, L., Raboch, J.: Ekonomické aspekty denní psychiatrické péče I. Randomizační proces, sociodemografické a klinické charakteristiky. Česká a slovenská psychiatrie, 101, 2005, 3, s. 142-147.
9. Jenkins, J.: Towards a system of outcome indicators for mental health care. British Journal of Psychiatry, 157, 1990, pp. 500-514.
10. Kanas, N.: Group therapy with schizophrenics: a review of controlled studies. International Journal of Group Psychotherapy, 36, 1986, pp. 339-351.
11. Kitzlerová, E., Howardová, A., Půbal, K., Kališová, L., Sekot, M., Baková, N., Číhal, L., Raboch, J.: Ekonomické aspekty denní psychiatrické péče II. Porovnání pacientů v denní péči a klasické hospitalizaci. Česká a slovenská psychiatrie, 101, 2005, 3, s. 148-154.
12. Kitzlerová, E., Pěč, O., Raboch, J., Howardová, A., Stárková, L., Baková, N., Sekot, M., Peichlová, J.: Mapování denních stacionářů v České republice. Česká a slovenská psychiatrie, 99, 2003, 6, s. 299-305.
13. Klyczek, J. P., Mann, W. C.: Therapeutic modality comparisons in day treatment. Am. J. Occup. Ther., 40, 1986, 9, pp. 606-611.
14. Konieczynska, Z., Pietrzykowska, B., Zajborowski, B.: Follow-up studies of psychotic patients receiving inpatient treatment or alternative forms of psychiatric care. Psychiatr. Pol., 31, 1997, 5, pp. 615-624.
15. Marshall, M., Crowther, R., Almaraz-Serrano, A., Creed, F., Sledge, W., Kluiter, H., Roberts, C., Hill, E., Wiersma, D., Bond, G. R., Huxley, P., Tyrer, P.: Systematic reviews of day care for people with severe mental disorders (1) acute day hospital versus admission; (2) vocational rehabilitation; (3) day hospital versus outpatient care. Health Technol. Assess., 5, 2001, 21, pp. 1-75.
16. Mojtabai, F., Nicholson, R. A., Carpetner, B. N.: Role of psychological treatments in management of schizophrenia: a meta-analytic review of controlled outcome studies. Schizophrenia Bulletin, 24, 1998, 4, pp. 569-588.
17. Motlová, L., Dragomirecká, E., Čermák, J. a kol.: Day treatment program for schizophrenia: the 6-week follow-up concerning psychopathology and quality of life. Psychiatrie, 11, 2007, Suppl. 3, pp. 26-29.
18. Pěč, O., Koblic, K., Lorenc, J., Beránková, A.: Denní stacionáře s psychoterapeutickou péčí. Česká a slovenská psychiatrie, 99, 2003, Suppl. 2, s. 10-16.
19. Pěč, O.: Vliv některých regionálních služeb na délku hospitalizace. In: Vyhodnocení tří regionálních modelů komunitní péče o duševně nemocné. Edice Terénní modely, Praha, Centrum pro rozvoj péče o duševní zdraví, 1998, s. 48-56.
20. Roder, V., Brenner, H. D., Kienzle, N., Hodel, B.: Schizofrenie. Integrovaný psychoterapeutický program pro schizofrenní pacienty. Přeložil O. Pěč. Praha, Triton, 1993.
21. Slade, M.: What outcomes to measure in routine mental health services, and how to assess them: a systematic review. Australian and New Zealand Journal of Psychiatry, 36, 2002, pp. 743-753.
22. Spaulding, W. D., Reed, D., Sullivan, M., Richardson, C., Weiler, M.: Effects of cognitive treatment in psychiatric rehabilitation. Schizophrenia Bulletin, 25, 1999, 4, pp. 657-676.
23. Stárková, L., Raboch, J., Kitzlerová, E., Baková, N., Sekot, M., Howardová, A., Peichlová, J., Kallert, T.: Hodnocení klinického stavu, spokojenosti s léčbou a kvality života u dvou skupin pacientů léčených formou denního stacionáře a klasickou hospitalizací – mezinárodní studie EDEN (Konečné výsledky období léčby). Česká a slovenská psychiatrie, 99, 2003, 5, s. 260-264.
Labels
Addictology Paediatric psychiatry PsychiatryArticle was published in
Czech and Slovak Psychiatry
2008 Issue 7
Most read in this issue
- Homosexual Pedophilia in a Female
- Shared Psychotic Disorder and Simple Inductions
- Negative Symptoms of Schizophrenia
- Sexual Juvenile Offenders – Assessment, Treatment and other Intervention