Emotional crisis in a naturalistic context: characterizing outpatient profiles and treatment effectiveness.

Détails

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Etat: Public
Version: Final published version
Licence: Non spécifiée
ID Serval
serval:BIB_AEA749704C89
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Emotional crisis in a naturalistic context: characterizing outpatient profiles and treatment effectiveness.
Périodique
BMC psychiatry
Auteur(s)
Zanello A., Berthoud L., Bacchetta J.-P.
ISSN
1471-244X (Electronic)
ISSN-L
1471-244X
Statut éditorial
Publié
Date de publication
07/04/2017
Peer-reviewed
Oui
Volume
17
Numéro
1
Pages
130
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Crisis happens daily yet its understanding is often limited, even in the field of psychiatry. Indeed, a challenge is to assess the potential for change of patients so as to offer appropriate therapeutic interventions and enhance treatment program efficacy. This naturalistic study aimed to identify the socio-demographical characteristics and clinical profiles at admission of patients referred to a specialized Crisis Intervention Center (CIC) and to examine the effectiveness of the intervention.
The sample was composed of 352 adult outpatients recruited among the referrals to the CIC. Assessment completed at admission and at discharge examined psychiatric symptoms, defense mechanisms, recovery styles and global functioning. The crisis intervention consisted in a psychodynamically oriented multimodal approach associated with medication.
Regarding the clinical profiles at intake, patients were middle-aged (M = 38.56, SD = 10.91), with a higher proportion of women (62.22%). They were addressed to the CIC because they had attempted to commit suicide or had suicidal ideation or presented depressed mood related to interpersonal difficulties. No statistical differences were found between patients dropping out (n = 215) and those attending the crisis intervention (n = 137). Crisis intervention demonstrated a beneficial effect (p < 0.01) on almost all variables, with Effect Sizes (ES) ranging from small to large (0.12 < ES < 0.75; median = 0.49). However, the Reliable Change Index indicated that most of the issues fall into the undetermined category (range 41.46 to 96.35%; median = 66.20%).
This study establishes the profile of patients referred to the CIC and shows that more than half of the patients dropped out from the crisis intervention before completion. Our findings suggest that people presenting an emotional crisis benefit from crisis intervention. However, given methodological constraints, these results need to be considered with caution. Moreover, the clinical significance of the improvements is not confirmed. Thus, the effectiveness of crisis intervention in naturalistic context is not fully determined and should be more rigorously studied in future research.

Mots-clé
Adult, Crisis Intervention/methods, Defense Mechanisms, Emergency Services, Psychiatric, Female, Humans, Male, Mental Disorders/therapy, Middle Aged, Outpatients/psychology, Patient Selection, Referral and Consultation, Suicide/prevention & control, Suicide, Attempted/prevention & control, Treatment Outcome, Young Adult, Brief psychiatric rating scale, Community mental health services, Crisis intervention, Defense mechanisms, Recovery style, Treatment effectiveness
Pubmed
Web of science
Open Access
Oui
Création de la notice
25/04/2017 17:59
Dernière modification de la notice
05/09/2019 10:00
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