Variability of inpatient child and adolescent psychiatry - results of a multicenter study.

Variability of impatient child and adolescent psychiatry - results of a multicenter study. Objective: For the first time in the German-speaking countries a complete evaluation of all 1236 inpatient treatment episodes within one year of investigation was carried out. Method: Case-related patient documentation at all of the 13 clinics for child and adolescent psychiatry in Lower Saxony and Bremen were evaluated. Results: Data from all clinics agreed widely on the folowing: 1. the divergent family structures of the young patients compared to those of the general public, 2. a high degree of individual psychotherapy, and 3. the inclusion of the patient's social circumstances in the individual psychotherapy. Nonetheless, results for most of the variables assessed differed strongly. Inpatient child and adolescent psychiatric care thus seems to vary highly among clinics within the same epidemiological area. Conclusions: Hence, even when the reported number of episodes is high, no general conclusions on inpatient child and juvenile psychiatric treatment can be drawn on the basis of admissions data for individual clinics. Interinstitutional comparisons must be made on the assumption that there is no prototype clinic for child and adolescent psychiatry. Additional general conclusions include the lack of a disorder-specific approach to treatment. The entry of a large number of patients into foster or state homes following inpatient treatment reflects the impact upon them of abnormal psychosocial circumstances, as well as their decreased psychosocial adaption.