Drug usage as a treat to the stability of treatment outcome: a one-year follow-up study of adolescent psychiatric patients

Abstract

Objective: To examine the stability of treatment outcome one year after discharge from an inpatient treatment programme for adolescents with severe behavioural problems combined with psychiatric disorders.

Method: Symptom Check List-90 Revised (SCL-90 R) ratings were obtained at admission, discharge and one-year follow-up for 75 patients. Treatment outcome was determined by calculating clinically significant change on the SCL-90 R Global Severity Index (GSI) between admission and discharge. Stability of treatment outcome was determined by comparing the clinically significant changes on the GSI between admission and discharge, and between admission and follow-up.

Results: Compared to baseline, 46.7% of the patients recovered (reliable change was found and their GSI at discharge was below the cutoff point for the functional population), 20% improved (reliable change was found, but the GSI was still above the cutoff point). For the other patients no reliable change was found (12.0%) or they deteriorated (21.3%). At follow-up, compared to the base score, 52.0% recovered, 13.3% improved, 12.0% showed no reliable change, and 22.7% deteriorated. Although for the whole sample no significant change was found between discharge and follow-up, some individual patients continued to improve after discharge, while others deteriorated. Analyses show that drug usage during the follow-up period is a strong predictor for these changes.

Conclusion: The results indicated that the majority of the patients recovered or improved during treatment and this treatment outcome was relatively stable at one-year follow-up. However, in a minority of patients the treatment results deteriorated during the one-year follow-up period. Drug usage turned out to be an important predictor for this deterioration.