Rehospitalizations among psychiatric patients whose first admission was involuntary: a 10-year follow-up

Abstract

Objectives: To examine the characteristics of patients whose first admission to Israel's psychiatric units was involuntary, and to identify a specific profile of the patients at increased risk for future readmissions. Our hypothesis was that when the first admission of a patient was involuntary, the number and duration of future hospitalizations would be greater.

Method: We used information extracted from the National Psychiatric Case Registry on all patients admitted for the first time during 1991 (N=2150) and on their follow-up over the next ten years. Chi-square statistics were used to test for significance differences in demographic and clinic variables between patients hospitalized voluntarily and those hospitalized involuntarily. Multiple regression analysis was performed to identify a specific profile of risk of recidivism during a ten-year period (1991-2000).

Results: Compared with patients admitted voluntarily, those who were admitted involuntarily had a significantly greater number and duration of rehospitalizations. They were more likely be diagnosed as suffering from schizophrenia while the voluntarily admitted patients were more likely be diagnosed as having an affective disorder. Risk factors for the number of readmissions included: young age, legal status (involuntary) of the first admission, as well as period of residence in the country. Risk factors affecting the duration of readmissions were single/widowed status, native born and a suicide attempt in the two months prior to the first admission.

Conclusions: Two distinct profiles for the number ofreadmissions and inpatient days were identified. A diagnosis of schizophrenia and selected demographic variables were better at predicting risk of recidivism than the involuntary legal status of the first admission.