Effectiveness of a Community-Based Crisis Resolution Team for Patients with Severe Mental Illness in Greece: A Prospective Observational Study.

This prospective observational study evaluated the effectiveness of a crisis resolution team (CRT) for outpatient treatment of psychiatric patients experiencing an acute episode of severe mental disorder. The effectiveness of the CRT (n = 65) was assessed against the care-as-usual [CAU group (n = 65)]. Patients' clinical state, overall functioning, quality of life and satisfaction were respectively evaluated at baseline, post intervention and three-month post-intervention.CRT patients compared to the CAU group, had significantly improved outcomes concerning clinical state and patient satisfaction at post intervention phase. Statistically significant improvement was also recorded for the dimensions of environment, physical and psychological health related to quality of life. No significant differences were observed between the two groups regarding overall functioning.On the basis of these results, reforming of existing crisis-management services, in Greece, using the CRT model may improve substantially the services offered to psychiatric patients.

Psychiatric admission as a risk factor for posttraumatic stress disorder.

Psychiatric hospitalization poses a risk for Posttraumatic Stress Disorder (PTSD), partly because of coercion. However, the role of legal status is less clear, while factors like insight, exposure to violence and affective disorders have not been addressed adequately. The present study aims at assessing PTSD rates after hospitalization and evaluating the potential role of these factors. 98 inpatients were assessed for PTSD, insight, main diagnosis, adverse events during hospitalization and legal status. Assessment took place at discharge (T1) and three months later (T2). Three months after discharge, 74.2% of patients with affective disorders met symptom-criteria for PTSD. Voluntarily hospitalized patients had more severe PTSD-symptoms. This relation vanished after controlling for affective disorders. The latter, as well as exposure to violence were the most significant risk factors at T2. Female gender, marital status (not married) and employment status (not employed), were additional risk factors at T1, while involuntary medication had a negative effect on PTSD-symptoms. Voluntarily hospitalized patients are more vulnerable to PTSD, due to higher rates of affective disorders. Females suffering from affective disorders who are not married and not employed should be monitored for PTSD symptoms during and after hospitalization, especially if exposed to violence.

The use of the Symptom Checklist 90-R in exploring the factor structure of mental disorders and the neglected fact of comorbidity.

The Symptom Checklist 90-R (SCL-90-R) is a popular instrument, accessing nine different symptom clusters of psychopathology, although its original factor structure is widely questioned. However, most validation studies seem to ignore the possible effect of comorbidity. We aimed at validating the factor structure of the SCL-90-R and to draw additional information about the role of comorbidity in the factor structure of mental disorders. We thus introduced a comorbidity index within the SCL-90-R and validated the Greek version of the SCL-90-R in a sample of 914 participants, consisting of 688 individuals from the general population and 226 psychiatric outpatients. We showed that the original 9-factor model was superior to the second order factor and the bi-factor model. This may reflect lower comorbidity traits in our sample, rather than the accuracy of the original 9-factor structure of the SCL-90-R, which has to be further assessed by concurrent validity for each individual scale on selected samples. In this regard, we showed that the depression subscale was an excellent screening tool in a subgroup of patients with a confirmed major depressive episode.