Suicidality, prior hospitalization length risk factors for psychiatric re-hospitalization
Click Here to Manage Email Alerts
Factors for risk for rehospitalization for those with psychiatric disorders included suicidal ideation, suicide attempt, previous hospitalization and longer stay in hospital, according to a study published in BMC Psychiatry.
“Psychiatric rehospitalization negatively affects the quality of life and the life expectancy of patients with psychiatric disorders,” Isabella Berardelli, of the department of neurosciences, suicide prevention center, mental health and sensory organs at Sant’Andrea Hospital, Sapienza University of Rome, and colleagues wrote. “Psychiatric rehospitalization is often associated with severe psychological distress for both patients and their families, a worse course for the illness and a loss of social and employment functioning.”
Berardelli and colleagues conducted the study for two purposes: to examine the readmission rate in a large sample of inpatients with a psychiatric disorder, and to investigate the role of demographic and clinical features impacting rehospitalization.
Their retrospective study included 1,001 adult participants (510 men; mean age 40.5 years) consecutively admitted to the University Psychiatric Clinic at Sant'Andrea Hospital, Sapienza University of Rome between January 2018 and January 2022.
To identify risk factors for psychiatric rehospitalization, individuals were divided into three subgroups: the Zero-Re group, which had no readmission after the index hospitalization, the One-Re group with patients readmitted only once, and the Two-Re cohort with at least two readmissions. An individual’s first admission was considered the initial one during the study interval, and only those lasting more than 48 hours were included in analysis.
Results showed that 790 participants (78.9%) were not rehospitalized during the course of the study, 211 patients (21.1%) were rehospitalized, with 132 individuals rehospitalized once and 79 rehospitalized at least twice. In addition, among those rehospitalized, 69 individuals recorded an incident of suicidal ideation and 33 had attempted suicide at the time of their rehospitalization.
Researchers additionally found that, compared with the Zero-Re group, the patients in the One-Re group were more likely to have a previous hospitalization (OR = 2.28; 95% CI, 1.48-3.51). Patients in the Two-Re group were more likely to have a previous hospitalization (OR = 3.13; 95% CI, 1.68-5.82), a history of suicide attempts (OR = 2.09; 95% CI, 1.21-3.62), and a longer length of stay (OR = 1.03; 95% CI, 1.01-1.05), but had a lower age at onset (OR = 0.97; 95% CI, 0.95-0.99) compared with patients in the No-Re group.
“Results of the present study suggest that identifying patients at risk of rehospitalization could help predict future re-hospitalization and facilitate the design of ad hoc prevention strategies,” Berardelli and colleagues wrote.