Sexual orientation differences in treatment expectation, alliance, and outcome among patients at risk for suicide in a public psychiatric hospital.

Détails

ID Serval
serval:BIB_615B83FBA8E4
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Sexual orientation differences in treatment expectation, alliance, and outcome among patients at risk for suicide in a public psychiatric hospital.
Périodique
BMC psychiatry
Auteur(s)
Plöderl M., Kunrath S., Cramer R.J., Wang J., Hauer L., Fartacek C.
ISSN
1471-244X (Electronic)
ISSN-L
1471-244X
Statut éditorial
Publié
Date de publication
15/05/2017
Peer-reviewed
Oui
Volume
17
Numéro
1
Pages
184
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Sexual minority (SM) individuals (gay, lesbian, bisexual, or otherwise nonheterosexual) are at increased risk for mental disorders and suicide and adequate mental healthcare may be life-saving. However, SM patients experience barriers in mental healthcare that have been attributed to the lack of SM-specific competencies and heterosexist attitudes and behaviors on the part of mental health professionals. Such barriers could have a negative impact on common treatment factors such as treatment expectancy or therapeutic alliance, culminating in poorer treatment outcomes for SM versus heterosexual patients. Actual empirical data from general psychiatric settings is lacking, however. Thus, comparing the treatment outcome of heterosexual and SM patients at risk for suicide was the primary aim of this study. The secondary aim was to compare treatment expectation and working alliance as two common factors.
We report on 633 patients from a suicide prevention inpatient department within a public psychiatric hospital. Most patients were at risk for suicide due to a recent suicide attempt or warning signs for suicide, usually in the context of a severe psychiatric disorder. At least one indicator of SM status was reported by 21% of patients. We assessed the treatment outcome by calculating the quantitative change in suicide ideation, hopelessness, and depression. We also ran related treatment responder analyses. Treatment expectation and working alliance were the assessed common factors.
Contrary to the primary hypothesis, SM and heterosexual patients were comparable in their improvement in suicide ideation, hopelessness, or depression, both quantitatively and in treatment responder analysis. Contrary to the secondary hypothesis, there were no significant sexual orientation differences in treatment expectation and working alliance. When adjusting for sociodemographics, diagnosis, and length of stay, some sexual orientation differences became significant, indicating that SM patients have better outcomes.
These unexpected but positive findings may be due to common factors of therapy compensating for SM-specific competencies. It may also be due to actual presence of SM competencies - though unmeasured - in the department. Replication in other treatment settings and assessment of SM-specific competencies are needed, especially in the field of suicide prevention, before these findings can be generalized.

Mots-clé
Adult, Bisexuality/psychology, Female, Homosexuality/psychology, Hospitals, Psychiatric, Humans, Male, Middle Aged, Sexual Behavior/psychology, Suicide/psychology, Suicide, Attempted/psychology, Common factors, Gay, Lesbian, Suicide, Treatment
Pubmed
Web of science
Open Access
Oui
Création de la notice
23/05/2017 16:42
Dernière modification de la notice
20/08/2019 14:18
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