OBJECTIVE: To investigate prospectively factors that might have an impact on the outcome of psychiatric patients treated at a day-hospital. METHODS: Thirty-four patients admitted to the day-hospital of Botucatu Medical School -- UNESP during a period of one year were interviewed and their sociodemographic data and their clinical course were assessed. Psychiatric diagnoses were reviewed using the Composite International Diagnostic Interview, the psychiatric symptomatology was assessed using the Brief Psychiatric Rating Scale (BPRS) and the psychosocial incapacitation was evaluated using the Psychiatric Disability Assessment Schedule (DAS). All patients were followed up during the study period and their relatives were also interviewed. RESULTS: Most patients were women (76%), young (61,8%), not married (71%), unemployed (82.4%), diagnosed as having an affective disorder (44.1%), and with previous psychiatric hospitalizations (44%). Only 4 patients (12%) presented a "major syndrome" according to BPRS. However, patients showed substantial incapacitation regarding social functioning. Higher income was associated with better treatment outcome. Hospitalizations lasted 74 days on average. Patients who had been previously hospitalized had a shorter stay in the day-hospital. CONCLUSIONS: Patients with affective disorders and non-psychotic symptoms generally do not need in-patient care in a psychiatric hospital. However, the studied patients had had many previous psychiatric admissions, probably because they needed a more intensive treatment than outpatient services can offer. On the other hand, those patients who had had many previous hospitalizations (probably the most severe cases) remained for shorter periods of time in the day-hospital, which requires an examination of these patients' compliance with outpatient treatment as well as the factors influencing treatment compliance. Since there has been an expressive growth in the number of day-care services in Brazil in the last years, there is a need of further studies to determine these services' benefits and who can benefit from them.
Day hospital; Mental disorders; Mental health; Health policy
