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An Innovative Approach to Assessing Outcome of Long-Term Psychiatric Hospitalization
Jon G. Allen; Gerald Tarnoff; Lolafaye Coyne; Herbert E. Spohn; James R. Buskirk; Michael W. Keller
Psychiatric Services 1986; doi:
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The authors thank Glen O. Gabbard, M.D., for providing reliability data on the risk-assessment scales and Donald B. Colson, Ph.D., Leonard Horwitz, Ph.D., Paul W. Pruyser, Ph.D., and William H. Smith, Ph.D., for their comments on an earlier draft.

C.F. Menninger Memorial Hospital

The Yale University Child Study Center

The Menninger Foundation

Menninger Memorial Hospital

1986 American Psychiatric Association

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The failure of research on longterm hospital treatment to show consistent relationships between length of stay and treatment outcome may reflect a need for more refined measures to evaluate long-term treatment. The authors developed an individualized method of assessing improvement in patients' major areas of impairment over the course of treatment. Using the new approach and two more traditional methods, the authors evaluated the outcome of 37 discharged long-term patients of a private psychiatric hospital who had been rated at admission and discharge on 21 variables related to ego function; affective symptoms; risk of suicide, self-destructiveness, and violence; substance abuse; level of treatment alliance; and, at discharge only, on overall level of improvement. Although the traditional methods failed to show a correlation between length of stay and most of the variables, the individualized approach found that a longer hospital stay was related to greater improvement in areas of most impaired functioning.

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