Die tagesklinische Behandlung in der Kinder- und Jugendpsychiatrie
Abstract
Zusammenfassung:Fragestellung: Die Geschichte der Tagesklinik in der Kinder- und Jugendpsychiatrie ist sehr kurz. Entsprechend beschäftigen sich Tageskliniken weiterhin mit Konzepten, Outcome-Studien sowie Indikationen und Kontraindikationen tagesklinischer Behandlungen. Methoden: Die englisch- und deutschsprachige Literatur zwischen 1960 und 2000 wurde auf empirische Studien zur tagesklinischen Behandlung in der Kinder- und Jugendpsychiatrie hin ausgewertet. Outcome-Studien werden referiert und diskutiert. Ergebnisse: Die Ergebnisse empirischer Studien sind heterogen und lassen bislang kaum Rückschlüsse auf Indikationen und Kontraindikationen tagesklinischer Behandlungen zu. Insgesamt sind für sehr unterschiedliche Störungsbilder positive Behandlungsergebnisse dokumentiert worden. Die elterliche Mitarbeit im therapeutischen Prozess wird weitgehend übereinstimmend als prädiktiv für ein positives Behandlungsergebnis angesehen. Schlussfolgerungen: Über randomisierte kontrollierte Outcome-Studien hinaus ist in künftigen Studien zu evaluieren, für welche Patienten in einer gegebenen regionalen Versorgungslandschaft mit welchen Therapiezielen und -ergebnissen sowie mit welchen Kosten von Tageskliniken ein Beitrag zur Versorgung geleistet werden kann.
Objectives: The history of day treatment in child and adolescent psychiatry in Germany is brief. Accordingly, day treatment programs deal primarily with programming, outcome studies and indications/contraindications. Methods: This article reviews the English- and German-language literature between 1960 and 2000 relevant to the outcome of day treatment in child and adolescent psychiatry. Outcome studies are discussed. Results: Outcome studies do not yet allow decisions about for whom day treatment does or does not exactly work. Nonetheless, evidence from the literature suggests that day treatment does work for many different disorders in child and adolescent psychiatry. The predictive value of parental involvement in therapy for outcome is supported by several studies. Conclusions: In addition to randomized controlled outcome studies, effectiveness studies of single day treatment programs are useful and should deliver the data on the kinds of children, treatment goals and results for which a program in a specific regional mental health care system is effective.
Literatur
Outcome in Psychoeducational Day School Programms: A Review.. American Journal of Orthopsychiatry, 56, 263– 270 (1986).
A day treatment program for severely disturbed young children.. Hospital and Community Psychiatry, 27, 174– 179 (1976).
American Association for Partial Hospitalization Child and AdolescentSpecial Interest Group: Standards for child and adolescent parital hospitalization programs.. International Journal of Parital Hospitalization, 7, 13– 21 (1991).
A psychoeducational approach to day care treatment.. Journal of the American Academy of Child and Adolescent Psychiatry, 11, 492– 510 (1972).
A psychoeducational treatment program: Its characteristics and results.. In Blom, G.E.; Farley, G.K. (Eds.): Reports on Activities of the Day Center of the University of Colorado Medical Center to the Commonwealth Foundation. University of Colorado Medical Center Press, Denver (1973).
Reductions in criminality subsequent to group, individual and family therapy in adolescents.. International Journal of Group-Psychotherapy, 48, 307– 322 (1999).
Outcome evaluation of a therapeutic day treatment program for delayed and disturbed preschoolers.. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 687– 693 (1987a).
Predictors of the outcome of treatment in a therapeutic preschool.. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 829– 833 (1987b).
Relationships with family and friends in young adulthood: A follow-up of children treated in a day-hospital.. International Journal of Partial Hospitalization, 4, 97– 115 (1987).
Clinical and demographic characteristics of child and adolescent partial hospital patients.. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 66– 69 (1989).
Effekte einer teilstationären Behandlung verhaltensauffälliger und entwicklungsrückständiger Vorschulkinder.. Zeitschrift für Kinder- und Jugendpsychiatrie, 17, 131– 139 (1989).
Residential versus day treatment for children: a long-term follow-up study.. Child Psychiatry and Human Development, 24, 31– 39 (1993).
Partial hospitalization: Criteria for admission.. International Journal of Partial Hospitalization, 4, 75– 83 (1987).
Tagesklinik Pionierstraße, Klinik undAmbulanz f. Kinder- und Jugendpsychiatrie-Psychotherapie: Konzeption (unveröffentlicht).. 25. Geburtstag der Tagesklinik Pionierstraße, Köln (1994).
Day-care treatment for multiple drug abusing adolescents: social factors linked with completing treatment.. Journal of Psychoactive Drugs, 19, 335– 344 (1987).
Social Skills Training within a Day Treatment Program for Emotionally Disturbed Adolescents. 139– 152 (1983).
Effects of psychiatric symtomatology on treatment outcome for adolescent male drug abusers.. Journal of Nervous and Mental Disease, 175, 425– 430 (1987).
Outcome of a unique youth drug abuse program: a follow-up study of clients of Straight, Inc.. Journal of Substance Abuse Treatment, 6, 259– 268 (1989).
Outcome in children's day-treatment programs: Review of the literature and recommendations for future research.. International Journal of Partial Hospitalization, 3, 261– 271 (1986).
Day treatment outcome with severely disturbed children.. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 479– 482 (1988).
Aggressive children in a day treatment program: Changed outcome and possible explanations.. Child Abuse and Neglect, 14, 515– 523 (1990).
Adolescent Day Hospital: A Cost-effective treatment alternative.. International Journal of Partial Hospitalization, 4, 167– 173 (1987).
Behavioral and academic gains of conduct problem of children in different classroom settings.. Exceptional Child, 37, 441– 446 (1971).
Treatment of childhood schizophrenia. A three year comparison of day and residential treatment.. Archives of General Psychiatry, 14, 119– 128 (1966).
Evaluation of the effectiveness of a psychodynamically oriented day treatment program for children with behaviour problems: a pilot study.. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 35, 519– 525 (1990).
A comparison of the cost-effectiveness of day treatment and residential treatment for children with severe behaviour problems.. Canadian Journal of Psychiatry, 37, 393– 400 (1992).
A comparison of day treatment and outpatient treatment for children with disruptive behaviour problems.. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 38, 432– 435 (1993a).
Effectiveness of a multimodal day treatment programm for children with disruptive behavior problems.. Journal of theAmerican Academy of Child and Adolescent Psychiatry, 32, 127– 134 (1993b).
Predicting outcome in a multimodal day treatment program for children with severe behaviour problems.. Canadian Journal of Psychiatry, 39, 557– 562 (1994).
Depression and hopelessness in children with disruptive behavior disorders.. Canadian Journal of Psychiatry, 39, 277– 282 (1994).
Outcome of multimodal day treatment for children with severe behavior problems: A five-year follow-up.. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 989– 997 (1997).
Day treatment as an aid to mainstreaming troubled children.. community Mental Health Journal, 14, 319– 326 (1978).
Day-hospitals and centers for children and adolescents in Great Britain.. International Journal of Partial Hospitalization, 5, 3– 13 (1988).
The day hospital for children in Zurich, Switzerland, and the concept of dialogics.. International Journal of Parital Hospitalization, 5, 49– 59 (1988).
Tagesbehandlung seelisch kranker Kinder.. Schwabe & Co. AG, Basel (1998).
Child and Adolescent Parital Hospitalization.. In Lewis, M. (Ed.): Child andAdolescent Psychiatry: A comprehensive Textbook, 883-890. Williams & Wilkins, Baltimore (1996).
Outcome after partial-hospital treatment of severely disturbed adolescents.. International Journal of Partial Hospitalization, 6, 139– 153 (1990).
Adolescent partial hospitalisation. Some preliminary outcome data.. Journal of Clinical Child Psychology, 14, 130– 144 (1985).
A survey of child and adolescent day-treatment programs: establishing definitions and standards.. International Journal of Partial Hospitalization, 3, 247– 259 (1986).
A comparison of intensive psychiatric services for children and adolescents: Cost of day treatment versus hospitalization.. International Journal of Partial Hospitalization, 4, 17– 27 (1987).
Child and adolescent day treatment: Population profile.. International Journal of Partial Hospitalization, 5, 287– 305 (1988).
The current practice of child and adolescent partial hospitalization: Results of a national survey.. Journal of theAmerican Academy of Child and Adolescent Psychiatry, 34, 1336– 1342 (1995).
Results of treatment one year later: child and adolescent parital hospitalization.. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 81– 90 (1996).
Bundweite Erhebung zurEvaluation der Psychiatrie-Personalverordnung.. Nomos-Verlag, Baden-Baden (1998).
A psychiatric day treatment center and school for young children and their parents.. American Journal of Orthopsychiatry, 30, 468– 482 (1960).
Day treatment center and school. Seven years' experience.. American Journal of Orthopsychiatry, 35, 160– 169 (1995).
A behavioral-psychodynamic approach to day treatment for emotionally disturbed children.. Child Welfare, 56, 613– 619 (1977).
Das Konzept der Tagesklinik Zentralkrankenhaus Bremen Ost (unveröffentlicht).. Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Zentralkrankenhaus Bremen Ost (1998).
Intensive day program for psychiatrically disturbed truant adolescents.. American Journal of Orthopsychiatry, 68, 135– 141 (1998).
Outcome and Follow-up Study of an Adolescent Psychiatric Day Treatment School Program.. Journal of the American Academy of child and Adolescent Psychiatry, 39, 320– 328 (2000).
Die Kinder- und jugendpsychiatrische Tagesklinik.. Nervenarzt, 58, 509– 513 (1987).
Therapieevaluation in der Kinder- und Jugendpsychiatrie: Stationäre Behandlung, tagesklinische Behandlung und Home Treatment im Vergleich.. Zeitschrift für Kinder- und Jugendpsychiatrie, 16, 124– 134 (1988).
Long-term effects of treatment in a pre-school day centre: a controlled study.. British Journal of Psychiatry, 142, 71– 77 (1983).
Psychotherapie: Bedarf, Kosten und Nutzen.Beitrag der Psychologie zur Psychotherapie anlässlich der Verabschiedung von Prof. Dr. V. Hobi (unveröffentlicht).. Basel (1999).
Follow-up study of children admitted to a psychiatric day centre.. South African Medical Journal, 56, 1129– 1131 (1979).
A long-term follow-up study of a children's psychiatric day treatment centre.. Child Psychiatry and Human Development, 18, 58– 68 (1987).
Studies of the effectiveness of day treatment programs for children.. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 36, 246– 253 (1991).
When emotionally troubled children grow up.. Child Psychiatry and Human Development, 23, 175– 182 (1993).
Day versus residential treatment for juvenile offenders: The impact of program evaluation.. Child Welfare, 64, 145– 156 (1985).
Parental involvement and the effectiveness of an adolescent dy treatment program.. Journal of Youth and Adolescence, 21, 487– 497 (1992).
A controlled evaluation of the therapeutic effectiveness of a psychiatric day centre for pre-school children.. British Journal of Psychiatry, 132, 349– 355 (1978).
Behavior and personality changes in emotionally disturbed children enrolled in a psychoeducational day treatment center.. Journal of the American Academy of Child and Adolescent Psychiatry, 19, 240– 256 (1980).
Day treatment of children in the United States.. Journal of the American Academy of Child and Adolescent Psychiatry, 24, 732– 738 (1985).
Child partial hospitalization: World view and status.. International Journal of Partial Hospitalization, 4, 243– 256 (1987).
