[Compulsory admissions in psychiatry: comparative analysis between sensitive urban zones and other areas]

Abstract

Objectives: To compare compulsory and non-compulsory psychiatric hospitalization rates between Sensitive Urban Zones (SUZ) and other areas. An association between Compulsory Admission at the Request of a State Representative (CARSR) and SUZ was then investigated among compulsory admission patients.

Methods: This retrospective observational study identified hospitalized patients in a French psychiatric hospital territory from 2012 to 2013. Legal methods of admission, medical and demographic data, as well as place of residence (SUZ or not) were extracted from the hospital information system. Hospitalization rate analysis was based on 2010 INSEE census data. Multivariate analysis among compulsory admission patients was performed by logistic regression.

Results: 2,677 patients were hospitalized from 2012 to 2013. The hospitalization rate during the two years of the study was about 6.25 patients per 1,000 inhabitants in SUZ and about 3.93 in other areas (p < 0.0001). Although a statistically significant association was observed between CARSR and SUZ among compulsory admission patients (p = 0.003), multivariate analysis did not confirm this result (OR = 1.29, 95% CI [0.90 ; 1.85], p = 0.16). Characteristics related to CARSR were male gender (OR = 3.72, 95% CI [2.56 ; 5.51], p < 0.0001), schizophrenia (OR = 1.84, 95% CI [1.28 ; 2.66], p=0.001) and personality and behavioral disorders (OR = 1.83, 95% CI [1.30 ; 2.56], p = 0.0005).

Conclusion: Psychiatric hospitalization rates and the proportion of patients admitted at the request of a state representative were higher in SUZ than in other areas, but this association was not confirmed by multivariate analysis.