Patient and hospital treatment clusters.

Patient admission data and treatment data collected for 536 cases from 11 collaborating private psychiatric hospitals were subjected to cluster analysis. From the patient admission data, four large clusters and three small clusters emerged. Two very large and general clusters and four very small clusters were obtained from the treatment data. Both sets of clusters were cross-classified against diagnosis, length of hospital stay, and attainment of therapeutic goals. There were several significant but small relationships between clusters and these criteria. There was little overlap between diagnosis and the patient data or treatment data clusters. Length of stay related only to the treatment clusters which included a number of variables measuring different treatment amounts. The method seems potentially useful because it groups individuals along dimensions of interest, but further effort must be spent on more specific treatment descriptions and better outcome variables.

Profile of 1,300 admissions to Central Neuropsychiatric Hospital Association Collaborative Research Hospitals.

A collaborative effort to describe patients at admission led to the development of the Central Data Set, a 32-item profile of demographic and clinical variables which was used to sample 1,302 admissions across 10 hospitals in 1982. Weighted estimates indicated that this group of adult patients admitted to CNPHA-member hospitals were younger than those admitted to other private psychiatric hospitals, almost half had more than one previous psychiatric hospitalization, about one-fourth had made a previous suicide attempt, and two-thirds had engaged in psychotherapy or counseling prior to his admission. Most common diagnoses at admission were major affective disorders (36%), personality disorders (36%), substance abuse (30%), schizophrenic disorders (13%), and depressive neuroses (13%).

Addition of time-limited psychotherapy to medical treatment in a general medical clinic. Results at one-year follow-up.

This study compares 72 patients screened for significant emotional problems and treated only by internists of a general medical clinic with 62 patients also treated by internists but completing in addition 10 weekly psychotherapeutic visits. Forty-one patients did not keep their initial appointments and 69 patients dropped out of treatment but are not considered in this report. These patients, from inner-city Baltimore, were socially and economically a highly disadvantaged group. At intake, the 62 patients who completed psychotherapy and the 72 patients treated only by internists were equal demographically and in diagnosed physical illnesses. The two groups were approximately equal in the extent of emotional disturbance. All patients were followed up at 4 months and 1 year after intake. Methods of evaluation included a 7-point self-report of global improvement, the 58-item Hopkins Symptom Checklist, the primary target complaint, scaled clinical estimates of psychosocial adjustment, and scaled data from systematic review of medical charts. Significantly more patients undergoing the psychotherapy remained improved at 1-year follow-up, independent of age, sex, degree of disability, diagnosed medical illnesses, level of emotional disturbance, and employment status. While there was evidence of a common denominator to therapeutic results in both groups, the data strongly suggests specific effects of psychotherapy.