Outcomes of inpatients with severe mental illness: a naturalistic descriptive study

Gabriela L. Nuernberg, Fernanda L. Baeza, Marcelo P. Fleck, Neusa S. Rocha

To describe and evaluate the response and predictors of remission during inpatient treatment in a psychiatric unit in a general hospital based on symptomatology, functionality, and quality of life (QoL). Patients were admitted to a psychiatric unit in a tertiary general hospital in Brazil from June 2011 to December 2013 and included in the study if they met two of the severe mental illness (SMI) criteria: Global Assessment of Functioning (GAF) ≤ 50 and duration of service contact ≥ 2 years. Patients were assessed by the Brief Psychiatric Rating Scale (BPRS), the Clinical Global Impression (CGI) Severity Scale , GAF, the World Health Organization Quality of Life Instrument - Abbreviated version (WHOQOL-Bref), and specific diagnostic scales. A total of 239 patients were included. BPRS mean scores were 25.54±11.37 at admission and 10.96±8.11 at discharge (p < 0.001). Patients with manic episodes (odds ratio: 4.03; 95% confidence interval: 1.14-14.30; p = 0.03) were more likely to achieve remission (CGI ≤ 2 at discharge) than those with depressive episodes. Mean length of stay was 28.95±19.86 days. All QoL domains improved significantly in the whole sample. SMI patients had marked improvements in symptomatic and functional measures during psychiatric hospitalization. Patients with manic episodes had higher chance of remission according to the CGI.