The Effectiveness of a Day Hospital Model for Integrated Therapy of Psychotic Patients / 신경정신의학

ABSTRACT

OBJECTIVES: A day hospital has been remodeled after a vision to help psychotic patients quickly recover their psychological and social functions and lessen their induced regressions caused by long-term hospitalization, thereby enhancing their social abilities. The authors concerned once developed a day hospital model of an integrated therapy for psychotic patients suitable for Korean situation in their previous paper. Based on it, the present study was to determine how effective a day hospital would be, in comparison of the following two paired groups day hospital group with experience of hospitalization(hereinafter abbreviated as DH group) & day hospital parents group with experience of hospitalization(hereinafter abbreviated as DH parents group) and OPD group with experience of hospitalization(hereinafter abbreviated as OPD group) & OPD parents group with experience of hospitalization(hereinafter abbreviated as OPD parents group). METHODS: During the 18-month long research period(from May to 1996 October 1997), 17 day hospital patients with experience of hospitalization & their parents and the same number of OPD patients with experience of hospitalization & their parents were corespondingly paired with at random, who identified themselves closest in the following categories diagnosis, age, sex and function. All of them were asked to check questionnaires on their respective quality of life, insight, and their attitude about drug. Day hospital patients with experience of hospitalization and their parents were checked from the first day they were treated while OPD patients with experience of hospitalization and their parents were examined after discharge from hospital, commonly at the interval of 2 weeks, 3 months, 6 months, 12 months, and 18 months. RESULTS: 1) The quality of life scored higher in DH group than in OPD group. It turned increased significantly at the 3rd month and continued the same until the 12th month. At the 18th month, it showed a significant downturn. Meanwhile, DH group showed a significant upturn at the 3rd month and it turned down at 12 month. 2) The insight of DH group and DH parents group scored higher compared with OPD group and OPD parents group between the 3rd and 18th month, with the 3rd and 6th month showing a particular strength as well. Meanwhile, it continued unchanging for day DH group and DH parents group from the date on, of their discharge from hospital. 3) Attitude towards drugs scored higher in DH group than in OPD group at the 3rd and 6th month. It continued unchanging between the 6th and 18th month. It didn't score significantly higher in DH parents group than in their counterparts. 4) Satisfaction on the therapy started upward in DH group at the 3rd and 6th month, and scored higher in them than in their counterparts during the period form the 6th and 18th month. It started upward as well in DH parents group at the 3rd and 6th month, and scored higher in them than in their counterparts during the period form the 6th to the 18 month. 5) Number, and duration of DH group totalled lower than those by OPD group during the research period. CONCLUSION: The day hospital model, developed by the authors concerned, has proved a highly effective treatment for psychotic patients, as the data scored higher in the day hospital patients and their parents than in the OPD patients with experience of hospital and their parents in terms of "quality of life" by patients, insight, attitude toward drugs and satisfaction on its therapy.