Pre-Discharge Predictors of 1-Year Rehospitalization in Adolescents and Young Adults with Severe Mental Disorders: A Retrospective Cohort Study

Abstract

Background and objectives: Readmissions of youths hospitalized for a severe mental disorder are common events and bear a remarkable human, social, and economic burden. The current study aimed at evaluating predictors of 1-year rehospitalization in a sample of adolescents and young adults with severe mental disorders. Materials and Methods: Data for ≤25-year-old inpatients with a severe mental disorder and consecutively admitted between 1 January 2016 and 30 June 2019 were collected. Subjects were retrospectively assessed over a follow-up period of one year after the index discharge to track readmissions—i.e., the primary outcome variable. Standard descriptive statistics were used. The association between variables and 1-year rehospitalization was estimated using the univariate Cox proportional hazards regression model. We then carried out a multivariable Cox regression model, also estimating the covariate-adjusted survivor function. Hazard ratios (HRs) with related 95% confidence intervals (95% CIs) were provided. Results: The final sample included 125 individuals. The multivariable Cox regression model estimated that co-occurring substance use disorders (HR = 2.14; 95% CI: 1.08 to 4.26; p = 0.029) and being admitted for a suicide attempt (HR = 2.49; 95% CI: 1.13 to 5.49; p = 0.024) were both significant predictors of 1-year rehospitalization. Conclusions: Our study showed that comorbid substance use disorders and being admitted for a suicide attempt were predictors of early readmission in youths with severe mental disorders. Although their generalizability is limited, our findings could contribute to improve the quality of young patients’ mental health care by identifying vulnerable subjects who may benefit from tailored interventions to prevent rehospitalizations.

Disentangling the Association between ADHD and Alcohol Use Disorder in Individuals Suffering from Bipolar Disorder: A Systematic Review and Meta-Analysis

“…Among them, alcohol use disorder (AUD) is one of the most frequent, involving about one quarter of individuals suffering from BD [ 3 ]. The comorbidity between AUD and BD leads to worse clinical outcomes, possibly characterized by poor response to treatment [ 4 ], mood instability and greater symptom severity [ 5 ], increased suicidality [ 6 ], heightened risk of hospitalization [ 7 , 8 ], and cognitive dysfunctions [ 9 ]. Among different clinical correlates perhaps explaining this comorbidity, a role for ADHD, which is, in turn, a frequent co-occurring condition in BD [ 10 , 11 ], can be hypothesized.…”

Thwarted belongingness, perceived burdensomeness, and acquired capability for suicide among university students of Bangladesh: Scales validation and status assessment

“…We measured the reliability in the form of internal consistency expressed as Cronbach's alpha coefficient where a cut-off of ≥0.70 was considered acceptable. We assessed the face and content validities during the translation and back-translation stages (19). Construct validity was assessed by performing the factor analysis.…”

“…Suicidal ideation may indicate mental health problem, risky sexual and criminal behaviors which consume health services (18). One study identified that suicidal attempt is an important predictor for readmission among youths with severe mental illness (19). Psychometrically valid scales in native languages would help to identify the mental events of suicidal behavior, promote research and better mental health services as well (20,21).…”

Adverse and traumatic exposures, posttraumatic stress disorder, telomere length, and hair cortisol – Exploring associations in a high-risk sample of young adult residential care leavers

“…First, research in high-risk populations, such as children in residential care and those leaving the care systems – is strongly needed as results across the entire spectrum of adversity exposure may not generalize to the top end of the spectrum. Adding psychoneuroendocrinological stress-measures to such studies or to routine care in the long run might help to better predict adverse outcomes in the long run as for instance rehospitalization in those with history of adversity or severe mental illness ( Bartoli et al, 2020 ). Second, clearer agreed-upon conceptualization and comprehensive measurement of adversity and stressors is needed to move the field forward, this should include incorporation of non-invasive biological measures of stress such as hair cortisol to expand the stress-phenotype measured ( Crosswell and Lockwood, 2020 ; Epel et al, 2018 ; McLaughlin, 2016 ).…”