Researchers in Denmark have discovered that treatment in specialized mood disorder clinics following a hospitalization significantly reduce hospital readmission rates.
In their study, published in the British Journal of Psychiatry and titled “Treatment in a specialised out-patient mood disorder clinic v. standard out-patient treatment in the early course of bipolar disorder: randomised clinical trial,” Lars Vedel Kessing et al. followed 158 patients who were discharged from their first, second, or third hospital admission with a single manic episode or bipolar disorder.
72 patients received treatment in specialized mood disorder clinics, which combined evidence-based psychopharmacology treatment with group psychoeducation once a week for 12 weeks followed by three additional booster sessions. The remaining 86 patients received standard care from a primary care physician, private psychiatrist, or local community mental health center.
The rate of readmission to the hospital was significantly decreased for patients who received treatment in the mood disorder clinic. In the six years following discharge from the clinic, the rate of readmission to a hospital was 36.1% for the group receiving treatment in the mood disorder clinic versus 54.7% of the group receiving standard treatment. The duration of readmission stays in the hospital were also shorter: 12 versus 22 days for the first readmission and 33 versus 49 days for cumulative readmissions over the course of six years.
Researchers also found that those who received treatment in the mood disorders clinic more often used a mood stabilizer or an antipsychotic and their satisfaction with treatment was more prevalent than among patients who received standard treatment.
These findings are not very surprising. Most psychiatrists would agree that people who receive some sort of intensive outpatient care following a hospitalization will generally have a more positive prognosis. I might add the importance of including family members in some sort of outpatient counseling programs, particularly psychoeducation for families who are dealing with bipolar for the first time.
I am curious about other potential benefits of this type of clinic. Do these clinics help to prevent hospitalizations overall? Do they act sooner and/or more intensively when symptoms of an episode appear? Are such clinics more effective at keeping people in care between episodes?
In the U.S., these clinics are most commonly found at University Centers where research is being conducted. Many people don’t live near these types of centers. Is there potential for creation of free-standing types of clinics that could reach more people? What about accessing these mood centers through technology for people who live further away? Can we develop a more integrated system that would provide mechanisms for community-based psychiatrists and mental health centers to receive support and consultation from specialty mood disorder clinics?
I will be looking forward to seeing more research in this area and in working with colleagues, patients, and families to harness the power of advances in communications, information systems, and technology to assist us in translating these findings into real world help for people with bipolar disorder.
Let us know what you think.
You may also want to check out “Mood Disorder Clinics Help Many Bipolar Patients Avoid Hospital” also on PsychCentral, by Traci Pedersen, Associate News Editor.
Depressed girl photo available from Shutterstock
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Last reviewed: 14 Feb 2013