OBJECTIVE: Because previous studies of day treatment as an alternative
to inpatient treatment had major disadvantages or methodological
shortcomings, the authors conducted a randomized controlled trial to
estimate and predict the extent to which day treatment is feasible for
unselected patients referred for inpatient treatment. METHOD: Of 160
patients, 57 were randomly assigned to the control condition and 103 were
assigned to the experimental condition. Control patients received standard
clinical care. In the experimental condition, day treatment was attempted
as soon as the patient's condition permitted. The average number of nights
per week that experimental patients spent away from the hospital was
compared to the average number of nights away for patients under standard
care. RESULTS: Day treatment was satisfactory for 40% of the experimental
patients but was completely infeasible for another 40%. The level of
surveillance needed in the first week, physical illness, number of previous
admissions, depressive symptoms, and treatment by qualified psychiatrists
versus registrars were variables predictive of these differences.
CONCLUSIONS: In this unselected group of patients, no absolute
contraindications against day treatment were found. This suggests that the
selection criteria applied in nearly all other controlled studies on the
subject were unwarranted. The approach used in this study facilitated
treatment in the least restrictive environment possible.Abstract Teaser