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      Patient satisfaction and outcomes of crisis resolution home treatment for the management of acute psychiatric crises: a study during the COVID-19 pandemic in Madrid

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          Abstract

          Background

          Crisis Resolution Home Treatment (CRHT) seem to offer comparable results to the traditional hospitalization model, at a lower cost and offering greater flexibility and scope. However, in Madrid, its implementation in Mental Health did not occur until the midst of the COVID-19 pandemic. In this work we analysed the effectiveness of a mental health CRHT unit promoted during the COVID-19 pandemic, as well as the degree of satisfaction of patients and their families.

          Methods

          90 patients were treated by the CRHT unit in the period between October 2020 and June 2022. All patients met the inclusion criteria: (1) Acute psychopathological decompensation in patients suffering from psychotic disorders, major affective disorder, obsessive compulsive disorder, personality disorder and other severe mental disorders causing functional disability, according to ICD-10 diagnostic criteria; (2) Ages between 18–90 years old; (3) Living in the urban area of Vallecas, Madrid; and (4) Counting with sufficient social and family support. The effectiveness of the intervention was evaluated with the SF-36 health questionnaire, the caregiver burden with the Zarit questionnaire, and patient satisfaction with a survey specifically designed for this work.

          Results

          55 (61.1%) patients completed the SF-36 at baseline and at the end of hospitalization. Statistically significant improvements were observed in the 8 dimensions of the SF-36 ( p < 0.05). However, CRHT did not achieve a statistically significant decrease in caregiver burden. Regarding the satisfaction of the patients with the attention and care received, an average score of 47.72/50 was obtained.

          Conclusion

          The Crisis Resolution Home Treatment intervention resulted in significant improvement in patients’ quality of life with high satisfaction scores. However, it did not effectively reduce caregiver burden. Future research should focus on randomized controlled trials with long-term follow-up to assess the effectiveness of CRHT compared to traditional hospitalization and utilize specific assessment scales for different mental disorders.

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          Most cited references35

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          Validating the SF-36 health survey questionnaire: new outcome measure for primary care.

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            The stigma of mental illness: effects of labelling on public attitudes towards people with mental disorder.

            Aim of the study is to examine the impact of labelling on public attitudes towards people with schizophrenia and major depression. In Spring 2001, a representative survey was carried out in Germany involving adults of German nationality (n = 5025). Labelling as mental illness has an impact on public attitudes towards people with schizophrenia, with negative effects clearly outweighing positive effects. Endorsing the stereotype of dangerousness has a strong negative effect on the way people react emotionally to someone with schizophrenia and increases the preference for social distance. By contrast, perceiving someone with schizophrenia as being in need for help evokes mixed feelings and affects people's desire for social distance both positively and negatively. Labelling has practically no effect on public attitudes towards people with major depression. Our findings illustrate the need for differentiation, differentiation between the different components of stigma as well as differentiation between the various mental disorders.
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              • Article: not found

              Patients' perspectives on electroconvulsive therapy: systematic review.

              To ascertain patients' views on the benefits of and possible memory loss from electroconvulsive therapy. Descriptive systematic review. Psychinfo, Medline, Web of Science, and Social Science Citation Index databases, and bibliographies. Articles with patients' views after treatment with electroconvulsive therapy. 26 studies carried out by clinicians and nine reports of work undertaken by patients or with the collaboration of patients were identified; 16 studies investigated the perceived benefit of electroconvulsive therapy and seven met criteria for investigating memory loss. The studies showed heterogeneity. The methods used were associated with levels of perceived benefit. At least one third of patients reported persistent memory loss. The current statement for patients from the Royal College of Psychiatrists that over 80% of patients are satisfied with electroconvulsive therapy and that memory loss is not clinically important is unfounded.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                05 September 2023
                2023
                05 September 2023
                : 14
                : 1197833
                Affiliations
                [1] 1Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor , Madrid, Spain
                [2] 2Department of Medicine and Medical Specialities, University of Alcala , Alcala de Henares, Madrid, Spain
                [3] 3Ramón y Cajal Institute of Sanitary Research (IRYCIS) , Madrid, Spain
                [4] 4PeRTICA Análisis Estadísticos , Madrid, Spain
                [5] 5Department of Legal and Psychiatry, Complutense University , Madrid, Spain
                Author notes

                Edited by: Renato de Filippis, Magna Græcia University, Italy

                Reviewed by: Gabriel Obukohwo Ivbijaro, NOVA University of Lisbon, Portugal; Torfinn Hynnekleiv, Innlandet Hospital Trust, Norway

                *Correspondence: Miguel Angel Alvarez-Mon, maalvarezdemon@ 123456icloud.com
                Article
                10.3389/fpsyt.2023.1197833
                10507704
                37732079
                c6b5954f-8224-4731-94b2-5478c1f4a4b0
                Copyright © 2023 Moreno-Alonso, Nieves-Carnicer, Noguero-Alegre, Alvarez-Mon, Rodriguez-Quiroga, Dorado, Mora and Quintero.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 31 March 2023
                : 27 July 2023
                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 35, Pages: 6, Words: 4937
                Categories
                Psychiatry
                Original Research
                Custom metadata
                Public Mental Health

                Clinical Psychology & Psychiatry
                crisis resolution home treatment,covid-19 pandemic,acute psychiatric crises,inpatient treatment,caregiver burden

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