Citation

Rubenson MP, Gurtovenko K, Simmons SW, Thompson AD. J. Am. Acad. Child Adolesc. Psychiatry 2024; 63(2): 136-153.

Copyright

(Copyright © 2024, American Academy of Child Adolescent Psychiatry, Publisher Lippincott Williams and Wilkins)

DOI

10.1016/j.jaac.2023.03.022

PMID

37271333

Abstract

OBJECTIVE: Partial hospitalization programs (PHPs) are designed to help stabilize patients with acute mental health problems and are considered more cost-effective than inpatient care for patients who do not require 24-hour monitoring. Many PHPs treat transdiagnostic adolescents to reduce suicidality, self-harm, and other high-risk behaviors; however, the effectiveness of such programs is unknown. We aimed to review the existing evidence for the effects of PHPs on adolescent mental health symptoms and functioning.

METHOD: We retrieved peer-reviewed evaluations of PHPs treating adolescents with a range of disorders that reported quantitative clinical outcomes. We followed PRISMA guidelines for systematic reviews and included studies published since 2000.

RESULTS: Fifteen studies of 10 PHPs in North America, Europe, Asia, and Australia met inclusion criteria, 5 of which used comparison groups. Most participants were White and female with depressive disorders. All studies found improvements in adolescents' functioning and mental health from admission to discharge; however, only 1 study tested PHP relative to other levels of care, and only 1 study included follow-up data. Dialectical behavior therapy (DBT) may be an effective theoretical orientation for PHP settings, but evidence is limited.

CONCLUSION: Evidence for effectiveness of PHPs relative to other models is limited. Currently available research suggests that many high-risk transdiagnostic adolescents tend to improve during PHP treatment; however, controlled studies with follow-up data are needed to determine whether partial hospitalization is effective and, if so, how effective, and whether treatment gains persist after discharge.

Language: en

Keywords

Adolescent; Day Care, Medical; depression; Dialectical Behavior Therapy; Female; Humans; Mental Disorders; Mental Health; partial hospitalization programs; self-harm; Self-Injurious Behavior; treatment outcomes; youth suicide