Who walks through the 'revolving-door' of a British psychiatric hospital?

Factors associated with multiple re-admission to a psychiatric hospital

“…There were some differences between the current and previous study in terms of accommodation at discharge, diagnosis, and social living status. Conclusions: Several variables were shown to predict membership in the ''revolving-door'' group and findings replicate Langdon et al (2001), although there were differences. ''Revolving-door'' patients may have more enduring and chronic mental illnesses, but were similar to their ''non-revolving door'' counterparts on some variables.…”

“…However, there is also a degree of inconsistency between studies with respect to some factors being associated with re-admission. For example, some studies have reported that ''revolvingdoor'' patients tend to be younger (Kastrup, 1987;Korkelia et al, 1998;Langdon et al, 2001;Lewis & Joyce, 1990;Vogel & Huguelet, 1997;Woogh, 1986) while others have reported that ''revolving-door'' patients tend to be older (Haywood et al, 1995;Rabinovitz et al, 1995). Others still have suggested that there may be a relationship between sex and diagnosis which may affect re-admission rates (Daniels et al, 1998;Lewis & Joyce, 1990;Vogel & Huguelet, 1997).…”

“…As Langdon, Yaguez Brown & Hope (2001) pointed out, there appears to be three main reasons associated with this difficulty. First, the methodology employed by studies may vary considerably (e.g., cross-sectional vs. longitudinal).…”

“…Second, there is no consensus within the literature as to the definition of a ''revolving-door'' patient. For example, some studies have defined ''revolving-door'' patients as those with three or more admissions within their lifetime (Langdon et al, 2001;Vogel & Huguelet, 1997), while other researchers have suggested four or more admissions within their lifetime (Rabinovitz, Mark, Popper, & Slyuzberg, 1995), whiles others still have suggested those re-admitted within three years (Bernardo & Forchuck, 2001) or those readmitted within 30 days of discharge (Swett, 1995). Further still, Kastrup (1987) identified two patterns of re-admission amongst a large national cohort of psychiatric patients: (a) those with four or more re-admissions within 10 years and, (b) those with four or more re-admissions within 2.5 years.…”

“…These factors include: (a) diagnosis of a psychotic illness (Bernardo & Forchuck, 2001;Daniels, Kirkby, Hay, Mowry, & Jones, 1998;Hodgson, Lewis, & Boardman, 2001;Kastrup, 1987;Lewis, & Joyce, 1990;Korkelia, Lehtinen, Tuori, & Helenius, 1998;Rabinovitz et al, 1995), (b) being young (Kastrup, 1987;Langdon et al, 2001;Lewis & Joyce, 1990;Vogel & Huguelet, 1997;Woogh, 1986), (c) being male (Appleby et al, 1996;Haywood, Kravitz, Grossman, & Cavanaugh, 1995;Kastrup, 1987;Korkelia et al, 1998;Lewis & Joyce, 1990), (d) being divorced or unmarried (Bernardo & Forchuck, 2001;Hodgson et al, 2001;Rabinovitz et al, 1995), (e) substance misuse (Haywood et al, 1995;Langdon et al, 2001;Woogh, 1986), (f) greater symptom severity regardless of diagnosis (Swett, 1995;Postrado & Lehman, 1995;Lyons et al, 1997), (g) unemployment (Bernardo & Forchuck, 2001;Haywood et al, 1995;Rabinovitz et al, 1995), (h) mode of admission (Hodgson et al, 2001;Korkelia et al, 1998;Vogel & Huguelet, 1997), (i) higher level of education (Bernardo & Forchuck, 2001;Rabinovitz et al, 1995), (j) non-compliance with medication (Haywood et al, 1995;Weiden & Glazer, 1997), (k) quality of life (Postrado & Lehman, 1995), and (l) disrup...…”