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Progress of Clients with Mood and Anxiety Disorders in a Day Hospital Program: Examination of Clinical, Functional and Recovery Outcomes

  • Pascal Lambert-Comeau
  • Malika Cossette-Lavallée
  • Gabrielle Sirois-Giguère
  • Kimberly Pham
  • Véronique-Colette Gaudet
  • Nadine Larivière
Original Article

Abstract

Psychiatric day hospitals have been part of the continuum of care in mental health for several decades, with reasonable support as an alternative to inpatient care for acute illnesses. However, more needs to be explored for those with mood and anxiety disorders, including recovery outcomes. Integrating a collaborative program evaluation perspective, a naturalistic pre-post study of 68 persons with a mood and/or anxiety disorder was done. Participants completed validated questionnaires representing clinical outcomes of interest, that is, depressive and anxious symptoms, substance use disorder, mindfulness, social participation and perception of recovery at admission, at the end of the day hospital program and 6 months afterwards. Findings showed a significant and positive change for all studied outcomes during the day hospital program and maintenance of gains at 6 months, with a continued improvement in those who responded to all three times regarding global realization of social participation. No clinical variable at baseline significantly affected recovery perception during the day hospital program. Single participants seemed to improve more with regards to anxiety symptoms. Satisfaction toward services was high and family involvement was an aspect that could be improved.

Keywords

Day hospital Recovery Program evaluation 

References

  1. 1.
    Marshall M, Crowther R, Sledge WH, Rathbone J, Soares-Weiser K. Day hospital versus admission for acute psychiatric disorders. In: The Cochrane Collaboration, editor. Cochrane database of systematic reviews [Internet]. Chichester: Wiley; 2011.Google Scholar
  2. 2.
    Russell V, Mai F, Busby K, Attwood D, Davis M, Brown M. Acute day hospitalization as an alternative to inpatient treatment. Can J Psychiatry. 1996;41(10):629–37.CrossRefPubMedGoogle Scholar
  3. 3.
    Schene AH. Chapter 17 day hospital and partial hospitalization programmes. In: Thornicroft G, Szmukler G, Mueser KT, Drake RE, editors. Oxford textbook of community mental health [Internet]. Oxford: Oxford University Press; 2010.Google Scholar
  4. 4.
    Boisvert D, Lacomte Y. Hôpital de jour: une nouvelle chance: Hôpital de jour du Centre hospitalier Pierre Janet. Gatineau: Santé mentale au Québec; 2005.Google Scholar
  5. 5.
    Neffinger GG. Partial hospitalization: an overview. J Community Psychol. 1981;9(3):262–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Serero M, Gagnon J, Association des hôpitaux du Québec. Portrait des hôpitaux de jour en psychiatrie adulte au Québec. Montréal: Association des hôpitaux du Québec; 2000.Google Scholar
  7. 7.
    Sledge WH, Tebes J, Rakfeldt J, Davidson L, Lyons L, Druss B. Day hospital/crisis respite care versus inpatient care, Part I: clinical outcomes. Am J Psychiatry. 1996;153(8):1065–73.CrossRefPubMedGoogle Scholar
  8. 8.
    Creed F, Black D, Anthony P, Osborn M, Thomas P, Tomenson B. Randomised controlled trial of day patient versus inpatient psychiatric treatment. BMJ. 1990;300(6731):1033–7.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Glick I. A controlled study of transitional day care for non-chronically-ill patients. Am J Psychiatry. 1986;143(12):1551–6.CrossRefPubMedGoogle Scholar
  10. 10.
    Howes JL, Haworth H, Reynolds P, Kavanaugh M. Outcome evaluation of a short-term mental health day treatment program. Can J Psychiatry. 1997;42(5):502–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Larivière N, Desrosiers J, Tousignant M, Boyer R. Who benefits the most from psychiatric day hospitals? A comparison of three clinical groups. J Psychiatr Pract. 2010;16(2):93–102.CrossRefPubMedGoogle Scholar
  12. 12.
    Horvitz-Lennon M, Normand SL, Gaccione P, Frank RG. Partial versus full hospitalization for adults in psychiatric distress: a systematic review of the published literature (1957–1997). Am J Psychiatry. 2001;158(5):676–85.CrossRefPubMedGoogle Scholar
  13. 13.
    Larivière N, Desrosiers J, Tousignant M, Boyer R. Multifaceted impact evaluation of a day hospital compared to hospitalization on symptoms, social participation, service satisfaction and costs associated to service use. Int J Psychiatry Clin Pract. 2011;15(3):228–40.CrossRefPubMedGoogle Scholar
  14. 14.
    Priebe S, Jones G, McCabe R, Briscoe J, Wright D, Sleed M, et al. Effectiveness and costs of acute day hospital treatment compared with conventional in-patient care: randomised controlled trial. Br J Psychiatry J Ment Sci. 2006;188:243–9.CrossRefGoogle Scholar
  15. 15.
    Priebe S, McCabe R, Schützwohl M, Kiejna A, Nawka P, Raboch J, et al. Patient characteristics predicting better treatment outcomes in day hospitals compared with inpatient wards [Internet]. Psychiatr Serv. 2011;62(3):278–84.CrossRefPubMedGoogle Scholar
  16. 16.
    Priebe S, Barnicot K, McCabe R, Kiejna A, Nawka P, Raboch J, et al. Patients’ subjective initial response and the outcome of inpatient and day hospital treatment. Eur Psychiatry. 2011;26(7):408–13.CrossRefPubMedGoogle Scholar
  17. 17.
    Zeeck A, von Wietersheim J, Weiss H, Scheidt CE, Völker A, Helesic A, et al. Prognostic and prescriptive predictors of improvement in a naturalistic study on inpatient and day hospital treatment of depression. J Affect Disord. 2016;197:205–14.CrossRefPubMedGoogle Scholar
  18. 18.
    Mazza M, Barbarino E, Capitani S, Sarchiapone M, De Risio S. Day hospital treatment for mood disorders. Psychiatr Serv. 2004;55(4):436–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Yanos PT, Vreeland B, Minsky S, Fuller RB, Roe D. Partial hospitalization: compatible with evidence-based and recovery-oriented treatment? J Psychosoc Nurs Ment Health Serv. 2009;47(2):41–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Provencher HL. L’expérience du rétablissement : perspectives théoriques. Santé Ment Au Qué. 2002;27(1):35.CrossRefGoogle Scholar
  21. 21.
    Gelder MG, editor. New Oxford textbook of psychiatry. 2nd ed. Oxford: Oxford University Press; 2009.Google Scholar
  22. 22.
    Patton MQ. Essentials of utilization-focused evaluation. Los Angeles: SAGE; 2012. p. 461.Google Scholar
  23. 23.
    Brousselle A, editor. L’évaluation: concepts et méthodes. 2e édition. Montréal: Les Presses de l’Université de Montréal; 2011.Google Scholar
  24. 24.
    Alkin MC, editor. Evaluation roots: tracing theorists’ views and influences. Thousand Oaks: SAGE; 2004.Google Scholar
  25. 25.
    Corrigan PW, Salzer M, Ralph RO, Sangster Y, Keck L. Examining the factor structure of the recovery assessment scale. Schizophr Bull. 2004;30(4):1035–41.CrossRefPubMedGoogle Scholar
  26. 26.
    Beck AT, Steer RA, Brown GK. BDI-II: manual. 2nd ed. San Antonio: Pearson, PsychCorp; 1996.Google Scholar
  27. 27.
    Bourque P, Beaudette D. Etude psychometrique du questionnaire de dépression de Beck auprès d’un échantillon d’étudiants universitaires francophones. Can J Behav Sci Can Sci Comport. 1982;14:211–8.CrossRefGoogle Scholar
  28. 28.
    Gauthier J, Bouchard S. Adaptation canadienne-française de la forme révisée du State-Trait Anxiety Inventory de Spielberger. Can J Behav Sci Rev Can Sci Comport. 1993;25(4):559–78.CrossRefGoogle Scholar
  29. 29.
    Yao SN, Note I, Fanget F, Albuisson E, Bouvard M, Jalenques I, et al. Social anxiety in patients with social phobia: validation of the Liebowitz social anxiety scale: the French version. L’Encephale. 1999;25(5):429–35.PubMedGoogle Scholar
  30. 30.
    Hasin DS, O’Brien CP, Auriacombe M, Borges G, Bucholz K, Budney A, et al. DSM-5 criteria for substance use disorders: recommendations and rationale. Am J Psychiatry. 2013;170(8):834–51.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Heeren A, Douilliez C, Peschard V, Debrauwere L, Philippot P. Cross-cultural validity of the Five Facets Mindfulness Questionnaire: adaptation and validation in a French-speaking sample. Eur Rev Appl Psychol. 2011;61(3):147–51.CrossRefGoogle Scholar
  32. 32.
    Loas G, Fremaux D, Marchand MP. Factorial structure and internal consistency of the French version of the twenty-item Toronto Alexithymia Scale in a group of 183 healthy probands. L’Encephale. 1995;21(2):117–22.PubMedGoogle Scholar
  33. 33.
    Bagby RM, Parker JDA, Taylor GJ. The twenty-item Toronto Alexithymia scale—I. Item selection and cross-validation of the factor structure. J Psychosom Res. 1994;38(1):23–32.CrossRefPubMedGoogle Scholar
  34. 34.
    Ruest M, Lacroix M-P, Trudeau M-H, Blouin A, Larivière N. The LIFE-H to assess social participation of mental health service users. J Psychosoc Rehabil Ment Health. 2016;3(1):15–20.CrossRefGoogle Scholar
  35. 35.
    Noreau L, Noreau E. L’Evaluation des situations de handicap: La “Mesure des habitudes de vie” appliquee aux personnes ayant une lesion de la moelle epiniere. Can J Rehabil. 1996;10(2):81–98.Google Scholar
  36. 36.
    Corbière M, Lesage A, Lauzon S, Ricard N, Reinharz D. French validation of the Verona Service Satisfaction Scale-VSSS-54F. L’Encephale. 2003;29(2):110–8.PubMedGoogle Scholar
  37. 37.
    Ruggeri M, Dallagnola R, Agostini C, Bisoffi G. Acceptability, sensitivity and content validity of the VECS and VSSS in measuring expectations and satisfaction in psychiatric patients and their relatives. Soc Psychiatry Psychiatr Epidemiol. 1994;29(6):265–76.CrossRefPubMedGoogle Scholar
  38. 38.
    Lecomte T, Leclerc C, editors. Manuel de réadaptation psychiatrique. Sainte-Foy: Presses de l’Université du Québec; 2004.Google Scholar
  39. 39.
    Larivière N, Melançon L, Fortier L, David P, Cournoyer J, Baril M-C, et al. A qualitative analysis of clients’ evaluation of a psychiatric day hospital. Can J Commun Ment Health. 2009;28(1):165–79.CrossRefGoogle Scholar
  40. 40.
    Kallert TW, Priebe S, McCabe R, Kiejna A, Rymaszewska J, Nawka P, et al. Are day hospitals effective for acutely ill psychiatric patients? A European multicenter randomized controlled trial. J Clin Psychiatry. 2007;68(2):278–87.CrossRefPubMedGoogle Scholar
  41. 41.
    Gariepy G, Honkaniemi H, Quesnel-Vallee A. Social support and protection from depression: systematic review of current findings in Western countries. Br J Psychiatry. 2016;209(4):284–93.CrossRefPubMedGoogle Scholar
  42. 42.
    Paquet L. Les troubles de l’humeur en hôpital de jour: identification des facteurs thérapeutiques perçus comme efficaces par les patients. Thèse de doctorat inédite, Université du Québec; 2013.Google Scholar
  43. 43.
    Dixon L, McFarlane WR, Lefley H, Lucksted A, Cohen M, Falloon I, et al. Evidence-based practices for services to families of people with psychiatric disabilities. Psychiatr Serv. 2001;52(7):903–10.CrossRefPubMedGoogle Scholar
  44. 44.
    National Collaborating Centre for Mental Health. Depression: the treatment and management of depression in adults: NICE guideline (CG90). Leicester: British Psychological Society and The Royal College of Psychiatrists; 2009.Google Scholar
  45. 45.
    Bélanger S, Delorme A, Lepage J, Duhamel M, Québec (Province), Ministère de la santé et des services sociaux et al. Faire ensemble et autrement: plan d’action en santé mentale 2015–2020 [Internet]. 2016.Google Scholar
  46. 46.
    Falloon IRH. Family interventions for mental disorders: efficacy and effectiveness. World Psychiatry. 2003;2(1):20–8.PubMedPubMedCentralGoogle Scholar
  47. 47.
    Meis LA, Griffin JM, Greer N, Jensen AC, MacDonald R, Carlyle M, et al. Couple and family involvement in adult mental health treatment: a systematic review. Clin Psychol Rev. 2013;33(2):275–86.CrossRefPubMedGoogle Scholar
  48. 48.
    Reinares M, Bonnín CM, Hidalgo-Mazzei D, Sánchez-Moreno J, Colom F, Vieta E. The role of family interventions in bipolar disorder: a systematic review. Clin Psychol Rev. 2016;43:47–57.CrossRefPubMedGoogle Scholar
  49. 49.
    Henken T, Huibers MJH, Churchill R, Restifo KK, Roelofs JJ. Family therapy for depression. In: The Cochrane Collaboration, editor. Cochrane database of systematic reviews [Internet]. Chichester: Wiley; 2007.Google Scholar
  50. 50.
    Justo L, de Soares BGDO, Calil H. Family interventions for bipolar disorder. In: The Cochrane Collaboration, editor. Cochrane database of systematic reviews [Internet]. Chichester: Wiley; 2007.Google Scholar
  51. 51.
    Fiorillo A, Del Vecchio V, Luciano M, Sampogna G, De Rosa C, Malangone C, et al. Efficacy of psychoeducational family intervention for bipolar I disorder: a controlled, multicentric, real-world study. J Affect Disord. 2015;172:291–9.CrossRefPubMedGoogle Scholar
  52. 52.
    Miller IW, Keitner GI, Ryan CE, Uebelacker LA, Johnson SL, Solomon DA. Family treatment for bipolar disorder: family impairment by treatment interactions. J Clin Psychiatry. 2008;69(5):732–40.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Lyman DR, Braude L, George P, Dougherty RH, Daniels AS, Ghose SS, et al. Consumer and family psychoeducation: assessing the evidence. Psychiatr Serv. 2014;65(4):416–28.CrossRefPubMedGoogle Scholar
  54. 54.
    Creed F, Black D, Anthony P. Day-hospital and community treatment for acute psychiatric illness. A critical appraisal. Br J Psychiatry J Ment Sci. 1989;154:300–10.CrossRefGoogle Scholar
  55. 55.
    Hummelen B, Wilberg T, Karterud S. Interviews of female patients with borderline personality disorder who dropped out of group psychotherapy. Int J Group Psychother. 2007;57(1):67–92.CrossRefPubMedGoogle Scholar

Copyright information

© Springer (India) Private Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Faculty of Medicine and Health SciencesUniversité de SherbrookeSherbrookeCanada
  2. 2.Department of Psychiatry, Faculty of Medicine and Health SciencesUniversité de SherbrookeSherbrookeCanada
  3. 3.Faculty of Medicine and Health Sciences, School of ReadaptationUniversité de SherbrookeSherbrookeCanada

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