Who Benefits from Home Treatment? Predictors of Treatment Outcome in an Acute Psychiatric Setting: an Observational Study.

Abstract

Systematic reviews have confirmed that home treatment (HT) is an appropriate alternative to conventional inpatient treatment. So far, research on predictors for treatment outcomes of HT has been rather inconsistent, and potential predictors have not been systematically investigated yet. This exploratory study has a prospective naturalistic design with repeated measurements of symptoms, well-being, and self-efficacy at baseline, at post-assessment (discharge from HT) and at follow-up. Repeated measures analysis of variance (ANOVA) was carried out to measure changes between assessment points. Changes in emotion regulation were analysed between baseline and post-assessment using t-tests. Potential predictor variables were assessed at baseline. Linear regression models were estimated with post scores of symptoms, well-being, self-efficacy and emotion regulation as dependent variables and potential predictors as independent variables. 58 patients participated in the study. Significant differences between baseline and post-assessment were found for psychiatric symptoms, well-being, self-efficacy and emotion regulation. No significant changes were found at follow-up. Of the investigated potential predictors, three significantly predicted outcome of HT: Patients with former treatments in a psychiatric institution had significantly higher post-assessment in symptoms (β = .26, p = .04) and lower well-being (β = -.28, p = .02) compared to patients without former treatment in a psychiatric institution. Furthermore, hope for change and symptoms of anxiety were found to be predictors of outcome. General improvement in symptoms and well-being indicate that HT was effective. Previous psychiatric history, hope of improvement and anxiety were identified as predictors of treatment outcome.