Evaluation of the burden management in a psychiatric day center: distress and recovery style Valutazione del carico gestionale in un centro diurno psichiatrico: gravosità e recovery style

In psychiatric rehabilitation, the Day Center is the structure of the Department of Mental Health in which therapeutic/rehabilitation programs and re-socialization activities take place in semi-residential setting. The aim of these activities is the recovery of personal and social skills in patients with chronic psychiatric illness1. In this setting, which foresees a long-lasting therapeutic relationship with patients with many management problems, SUMMARY. Aim. In psychiatric rehabilitation the individual treatment plan can be formulated from tools that provide a multidimensional assessment of the patient. This study aims to analyze the relationship between distress and recovery style (integration and sealing over) from the psychosis. Assuming that this relationship affects the burden management, the study has the additional target of gaining more elements to direct the formulation of more effective therapeutic / rehabilitation programs. Methods. The study was carried out in a psychiatric day center, semi-residential structure of mental health services of the National Health System in Italy. 45 patients enrolled have been evaluated by the Neuropsychiatric Inventory (NPI Italian version) and Integration / Sealing Over Scale (ISOS Italian version), within three months (MarchJune 2014). Results. In the sample, the symptoms which cause a greater distress in the health workers, in an absolute sense, are uninhibition, irritability and apathy. Moreover, the results indicate that depression and anxiety cause a greater degree of distress in sealer patients. Discussion and conclusion. Uninhibition, irritability and apathy were more burdensome for mental health workers, because they require a greater engagement in the therapeutic relationship. Anxious and depressive symptoms cause a greater degree of distress in the sealers patients, reporting lower endurance of the denial of psychosis. The data seem to prove that knowing, differentiating and deepening the different aspects of the recovery style of each patient enable us to estimate the burden management, starting from the taking in charge, and to reduce the distress and the risk of burn out of the mental health workers.