Why do Adolescents Return to an Acute Psychiatric Unit?

Barker, Dawn; Jairam, Rajeev; Rocca, Antonella; Goddard, L.C.; Matthey, Stephen

doi:10.3109/10398562.2010.501380

Cited by 21 publications

(40 citation statements)

References 16 publications

(21 reference statements)

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“…Previous admission is an important predictor of subsequent inpatient admission in other studies of emergency care [17, 18, 35]. A study conducted in a general PES for factors affecting inpatient hospitalization found different risk factors for inpatient admission than our sample exhibited: Clinical severity, age, gender, race, homelessness, and employment status were significant predictors [30].…”

Section: Discussionmentioning

confidence: 70%

“…The scope of the study used a two-year time frame to investigate the prevalence of returning patients to the PIRC. Studies of pediatric patients presenting to emergency rooms and inpatient hospital admissions found periods from 30 days to 5 years for returning patients [15, 17, 18, 21], therefore a two-year period seemed a reasonable middle ground for investigation. The study employed a random systematic ten percent sampling frame of paper medical charts.…”

Section: Methodsmentioning

confidence: 99%

“…Readmission is a significant problem in pediatric psychiatric inpatient admission. The average youth psychiatric inpatient readmission rate ranges from 30% to 60% [15, 17, 18]. At least one-third of children and adolescents are more likely to be rehospitalized within the first 3 months to two years after the first admission [15–17].…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for rehospitalization and inpatient care among pediatric psychiatric intake response center patients

Tossone

Jefferis

Bhatta

et al. 2014

Child Adolesc Psychiatry Ment Health

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BackgroundThe study sought to explore the characteristics, risk factors for inpatient recommendation, and risk factors for revisits to a pediatric psychiatric intake response center (PIRC). There are three research questions: 1. What is the general profile of pediatric patients who present at the PIRC? 2. What are the risk factors for patients who repeatedly visit the PIRC? 3. What are the risk factors for PIRC patients who are recommended to inpatient care?MethodsThe study utilized a retrospective medical chart review of a random sample (n = 260). A PIRC profile was created using frequency and prevalence calculations, in addition to a survival analysis of patients who return to the PIRC in order to determine how long it takes for PIRC patients to return to the PIRC. Factors that contribute to increased odds of returning to PIRC and being recommended for inpatient treatment were calculated using two logistic regression analyses.ResultsThe average pediatric PIRC patient is about 13 years old, Caucasian, with Medicaid and comes from a divorced or single parent household. About 43% of patients presented at PIRC for suicidal thoughts, ideation, intentions or actions. At least 63% of patients have a history of victimization. The average time to return to PIRC is about 90 days. Patients with a history of victimization, suicidal behavior, learning problems, problems with peers, and a history of violence were at an increased odds of returning to the PIRC. Those patients who were previously admitted to inpatient care and had a family history of mental health issues were at increased odds of being recommended to inpatient treatment.ConclusionsThis sample presents with a multitude of issues that contribute to increased odds of revisits to PIRC and inpatient recommendation. These issues seem to come from multiple levels of influence. Future research should expand to similar treatment facilities and use a prospective design to confirm risk factors. Treatment for pediatric psychiatric patients may focus on multiple factors that influence patients’ mental health.

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Section: Discussionmentioning

confidence: 70%

Section: Methodsmentioning

confidence: 99%

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Risk factors for rehospitalization and inpatient care among pediatric psychiatric intake response center patients

Tossone

Jefferis

Bhatta

et al. 2014

Child Adolesc Psychiatry Ment Health

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“…In terms of demographic correlates, some studies show that rehospitalization is associated with younger age 8,9,15 and male sex, 7 while others do not find these effects. 8,9,12,15 Research on ethnicity has focused exclusively on the effect of identifying as white or nonwhite, and no significant effects were found.…”

mentioning

confidence: 99%

“…7–9 These rehospitalizations are associated with a substantial economic burden 10 and have a pronounced psychosocial toll on adolescents and their families. 11,12 For patients, repeated hospitalizations may disrupt social support and result in greater stigmatization.…”

mentioning

confidence: 99%

Predictors of Rehospitalization for Depressed Adolescents Admitted to Acute Psychiatric Treatment

Alphen¹,

Stewart²,

Esposito³

et al. 2017

J. Clin. Psychiatry

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Objective Presently, little is known about what factors predict adolescent psychiatric rehospitalization. Thus, the present study tested whether a battery of demographic and clinical characteristics predicted readmission within 6 months of discharge. Methods Participants were 165 adolescents (112 females) aged 13–19 years (mean = 15.61, SD = 1.48) admitted to an acute residential treatment program between November 25, 2013, and November 18, 2014. Patients met diagnostic criteria (DSM-IV-TR) for current major depressive disorder or dysthymia. At admission, participants completed a battery of clinical interviews and questionnaires assessing demographics, early life stress, comorbid diagnoses, psychiatric symptoms, suicidality, self-injury, and risky behavior engagement. At discharge, psychiatric symptoms were reassessed. Readmission to the same residential service was monitored over a 6-month period following discharge. Results Overall, 12.1% of adolescents were rehospitalized. We conducted a series of Cox regression survival analyses to test demographic and clinical predictors of patients’ time to readmission. More frequent self-injurious behaviors in the month prior to hospitalization was significantly associated with a more rapid time to rehospitalization (β = 0.05, SE = .02, Wald1 = 4.35, P = .037, OR = 1.05, 95% CI = 1.003–1.10). Conclusions It is critical to more effectively manage self-injury during the treatment of depressed adolescents, as this is the strongest predictor of later rehospitalization.

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