The determinants and outcomes of long-stay psychiatric admissions: a case-control study.
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Authors
Tulloch, Alex D
Fearon, Paul
David, Anthony S
Issue Date
2008-03-17
Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Journal Article
Research Support, Non-U.S. Gov't
Language
en
Keywords
Alternative Title
Abstract
Acute psychiatric admissions lasting over 6 months (long-stays) continue to occur in England. Previous studies have suggested an association between long-stay and both schizophrenia and challenging behaviour, as well as rehousing or placement difficulties, but no UK study to date has compared such cases with control admissions.
We performed a case-control study. All long-stay patients present on acute general psychiatric wards serving the London Boroughs of Croydon, Lambeth, Lewisham and Southwark on November 1st 2004 were compared with a group of 'next admitted' controls. We followed up long-stay cases 1 year later to determine whether they were still in hospital, and, if not, where they were living.
In unadjusted comparisons long stay was associated with schizophrenia, non-white ethnicity, admission not due to suicidality, violence, severe illness and need for rehousing. A logistic regression was used to adjust for associations among exposures and only violence, severity of illness and need for rehousing remained associated with long-stay. After 1 year, two-thirds of cases were living out of hospital.
Case-control studies may usefully contribute to the study of the complex social phenomenon of long-stay. Further research should address how the combination of individual and socially-determined effects that we found operate together over the course of admission to generate long-stays.
We performed a case-control study. All long-stay patients present on acute general psychiatric wards serving the London Boroughs of Croydon, Lambeth, Lewisham and Southwark on November 1st 2004 were compared with a group of 'next admitted' controls. We followed up long-stay cases 1 year later to determine whether they were still in hospital, and, if not, where they were living.
In unadjusted comparisons long stay was associated with schizophrenia, non-white ethnicity, admission not due to suicidality, violence, severe illness and need for rehousing. A logistic regression was used to adjust for associations among exposures and only violence, severity of illness and need for rehousing remained associated with long-stay. After 1 year, two-thirds of cases were living out of hospital.
Case-control studies may usefully contribute to the study of the complex social phenomenon of long-stay. Further research should address how the combination of individual and socially-determined effects that we found operate together over the course of admission to generate long-stays.
Description
Citation
Tulloch, A. D., Fearon, P., & David, A. S. (2008). The determinants and outcomes of long-stay psychiatric admissions: a case-control study. Social psychiatry and psychiatric epidemiology, 43(7), 569–574. https://doi.org/10.1007/s00127-008-0332-2
Publisher
License
Journal
Social psychiatry and psychiatric epidemiology
Volume
43
Issue
7
PubMed ID
ISSN
0933-7954