[Pilot study on a modular outpatient treatment programme following public order placements because of endangerment in patients with psychotic disorders]

Fortschr Neurol Psychiatr. 2014 Aug;82(8):464-70. doi: 10.1055/s-0034-1366586. Epub 2014 Aug 8.
[Article in German]

Abstract

Patients with psychotic disorders who were detained by public order because of endangerment, can be regarded as a population at risk of further endangerment, public order placements and a forensic course. Concepts of specific aftercare for this subgroup are lacking thus far. The present pilot study explores the feasibility of a modular therapeutic outpatient programme that is tailored to specific subgroup needs and is applied over six months. Readmission rates during the intervention period are regarded exploratively.Consecutive screening of all patients placed in general psychiatry by public order during 05 to 11/2012. Included patients received baseline measurements followed by six-month intervention. Individual utilisation of treatment modules and number of readmissions, differentiated according to legal bases were assessed.Inclusion rate: 17.4 % of all screened subjects (115) and 57 % of all potentially includable subjects, dropout rate: 15 %. Mean utilisation rate: 23.5 therapeutic contacts per 6 months. Readmission rate: 50 %, of these 60 % on voluntary legal basis.Study inclusion, mean utilisation and dropout rates attest the feasibility and acceptance of the intervention in the population under study. A preponderance of voluntary vs. compulsory readmissions to hospital during the intervention indicates that in the majority of patients a higher degree of therapeutic cooperativeness can be reached. Further study on reduction of compulsory readmissions and on avoidance of a forensic course by application of the here introduced intervention in combination with methods of risk assessment in a consecutive main project seems justified.

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care / methods*
  • Ambulatory Care / statistics & numerical data
  • Commitment of Mentally Ill*
  • Female
  • Germany
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Patient Acceptance of Health Care
  • Patient Readmission / statistics & numerical data
  • Pilot Projects
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / psychology*
  • Psychotic Disorders / therapy*
  • Self-Injurious Behavior