Factors predicting readmissions in personality disorders and other nonpsychotic illnesses. A retrospective study on 64 first‐ever admissions to the Psychiatric Clinic of Turku, Finland

Abstract

A retrospective study of factors predicting readmissions and follow-up treatment was undertaken of all first-ever episodes of inpatient care (age under 65), excluding psychotic and organic mental disorders, during 1987 and 1988 in University Psychiatric Clinic in Turku City Hospital, Finland. The cohort consisted of 64 subjects, 24 men and 40 women. The study was carried out in the end of 1993, thus allowing about 5 years of follow-up. The diagnosis of personality disorder did not predict readmission. The only factor predicting readmission nearly significantly was not having a relationship. The incidence of the revolving door syndrome, defined as 4 or more admissions within 5 years, was 12.5%. Women had a greater risk of readmission, but not that of the revolving door. Patients who had psychotherapy as follow-up treatment showed a frequency of 8% for 4 or more admissions, whereas patients who had no follow-up treatment had a frequency of 21% for 4 or more readmissions. The only factor significantly predicting follow-up treatment arrangement was previous treatment contact.

Overview of post-discharge predictors for psychiatric re-hospitalisations: a systematic review of the literature

“…Having a referral to a psychiatric aftercare program (e.g. outpatient care, foster care, or a group home) significantly increased the risk of rehospitalisation within six months of discharge [56] as well as the aftercare provider being a psychiatrist vs. a non-psychiatrist [57] but the setting where the care was provided (locus of care) had no significant effect [58]. The use/lack of use of the Community Mental Health Centre (CMHC) as regular source of care was equally found to have no effect by one study [30].…”

“…However, a change in medication within the last month had no distinctive impact on readmissions [36]. Receipt of psychotherapy was included in three studies, but was not significant in any of them [33, 58, 59]. In summary, more medication in the post-discharge period is a risk factor but receipt of psychotherapy has no impact on readmission rates.…”

“…In terms of aftercare intensity, the number of visits for medication prescription only or the number of mental health care visits of any type during a six month follow-up did not influence the readmission outcome for patients diagnosed with a psychotic illness [59], neither did the number of contacts with mental health providers [63] and four others could not prove that the extent of subsequent patient mental health is a valid predictor for readmission [25, 28, 34, 58]. …”