Do patients improve in general psychiatric outpatient care? Problem severity among patients and the effectiveness of a psychiatric outpatient unit.

This study evaluated a routine psychiatric outpatient unit that admitted a variety of diagnoses and was staffed with a multi-professional team. The aim was to describe the problem severity among patients of a routine psychiatric outpatient unit in Sweden and to evaluate the statistical and clinical effectiveness of routine care assessed at the termination of treatment. Newly admitted patients were diagnosed according to the ICD-10 and completed questionnaires at the beginning and end of their treatment regarding symptoms (Brief Symptom Inventory) and interpersonal problems (Inventory of Interpersonal Problems); 98.6% of the patients belonged to the dysfunctional group at pre-treatment, showing that there were considerable sufferings among new patients. There were significant improvements in most of the variables. The effect size regarding symptoms (Global Severity Index) was d=0.76 and 0.43 in the interpersonal total score. No difference between different diagnostic groups was found. As for the clinical significant change, the results showed that 64.5% of the patients were improved regarding symptom remission but also that a considerable number of patients (60.5%) still belonged to the dysfunctional group after the treatment. The study indicates that the effectiveness of a routine psychiatric outpatient practice seems to be similar to results obtained from speciality research clinics and randomized controlled trial studies. However, the results also show that there is a considerable amount of patients still in the dysfunctional group after the treatment, a fact that implies that further improvements of the treatment could be made.