Anxiety and Depression Symptoms Improve in Partial Hospitalization Treatment for Adolescents with and without Suicidal Thoughts and Behaviors: Leveraging Measurement-Based Care and Electronic Health Record Data

部分住院治疗可改善有或无自杀念头和行为的青少年患者的焦虑和抑郁症状:利用基于测量数据的护理和电子健康记录数据

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Abstract

Partial hospitalization programs (PHPs) offer an alternative to inpatient care for youth with acute psychiatric needs. PHP treatment is effective for adults, but fewer studies have examined adolescent programs. In the current study, we describe a large sample of adolescents enrolled in a PHP and evaluate symptom change over treatment. Demographic information, insurance, treatment length, readmission status (i.e., repeat admissions), the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Columbia Suicide Severity Rating Scale (C-SSRS) were extracted from electronic health records. The sample (N=1237, ages 12-18) was predominantly female assigned at birth (70%), White (84%), and non-Hispanic/Latine (92%). Approximately 25% of adolescents reported suicidal thoughts and behaviors (STBs) and 8% were readmissions. Anxiety and depression symptoms decreased significantly over the course of treatment (p < 0.001). Female patients reported more severe symptoms than males (p's < 0.001), and patients who identified as racial and/or ethnic minorities reported higher anxiety and depression (p's < 0.05) over treatment. Past month STBs was associated with higher anxiety (p = 0.003) and depression (p < 0.001) symptoms at admission, though these youth experienced similar symptom reduction. Readmission status did not predict symptoms at admission or change over treatment. This naturalistic study suggests that PHP treatment reduces anxiety and depression symptoms for adolescents with STBs and those with repeat admissions. Demographic factors impacted symptom severity and suggested that patients identified as racial and/or ethnic minorities may experience barriers to accessing treatment. Treatment needs and considerations for adolescents in PHPs are discussed.

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