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Randomised Controlled Trial of Day and In-patient Psychiatric Treatment. 2: Comparison of Two Hospitals

Published online by Cambridge University Press:  02 January 2018

Francis Creed ,
Dawn Black ,
Phil Anthony ,
Madeline Osborn ,
Phil Thomas ,
David Franks ,
Richard Polley ,
Stuart Lancashire ,
Packeerrowther Saleem  and
Barbara Tomenson
Francis Creed*
Affiliation:
Department of Psychiatry, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL
Dawn Black
Affiliation:
Department of Psychiatry, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL
Phil Anthony
Affiliation:
Department of Psychiatry, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL
Madeline Osborn
Affiliation:
Department of Psychiatry, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL
Phil Thomas
Affiliation:
Department of Psychiatry, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL
David Franks
Affiliation:
Department of Psychiatry, Queen's Park Hospital, Blackburn
Richard Polley
Affiliation:
Department of Psychiatry, Queen's Park Hospital, Blackburn
Stuart Lancashire
Affiliation:
Department of Psychiatry, Queen's Park Hospital, Blackburn
Packeerrowther Saleem
Affiliation:
Department of Psychiatry, Queen's Park Hospital, Blackburn
Barbara Tomenson
Affiliation:
Manchester Royal Infirmary
*
∗Correspondence
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Abstract

Acutely ill patients presenting for admission in two district psychiatric services were randomly allocated to day-hospital or in-patient care. In both services a quarter of all admissions could not be allocated because they were too ill (half of these were compulsory admissions); these patients were predominantly manic and schizophrenic patients with pronounced psychotic symptoms and disturbed behaviour. In one service 80% (41/51) of patients randomly allocated to day-hospital treatment were successfully engaged in treatment compared with 54% (19/35) in the other service. This difference arose because only patients with mildly disturbed behaviour could be treated at the second day hospital. For patients who were successfully allocated, the outcome of treatment was similar in terms of psychiatric symptoms and social functioning. The results of a treatment trial for acutely ill patients in one district service cannot be generalised to other district services without due attention to the factors, such as staffing levels, which determine the degree of disturbed behaviour that can be tolerated in the day hospital.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 158 , Issue 2 , February 1991 , pp. 183 - 189
Copyright
Copyright © Royal College of Psychiatrists, 1991 

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