Changes in distress of psychiatric in-patients after the changeover of junior psychiatric trainees as a function of attachment style: A pilot study

background and objectives: therapists, including psychiatrists, may act as attachment figures. rotational training schemes necessitate the regular and frequent ending of therapeutic relationships. the effects on patients are rarely studied. this is a pilot prospective study to evaluate whether relative distress in adult psychiatric in-patients follows change in trainee psychiatrists; whether differences in distress are mediated by patient attachment style; and to provide data for power calculation. methods: twenty adult in-patients were assessed using the mental health inventory 5 (mhi-5) scale before and after changeover of psychiatric trainees; attachment style was assessed prior to the changeover. qualitative data were also collected. results: the average mhi-5 scores improved with time (p = 0.021). less improvement correlated with higher score on preoccupied attachment (rho = 0.41, p1-tail <0.05). a non-significantly stronger improvement was seen with secure/dismissing styles compared to preoccupied/fearful styles (p1-tail = 0.08). based on these results, a study of at least 87 patients is likely to produce a statistically significant result. most patients were not aware a staff change was due and would like to be informed by their clinical team. conclusions: relative distress following junior trainee changeover may have a link with patients' attachment styles.