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The manic readmissions explosion in Edinburgh

Published online by Cambridge University Press:  13 June 2014

Anthony J Mander
Anthony J Mander*
Affiliation:
Graylands Hospital, Brockway Rd, Mount Claremont, WA 6010, Australia University Department of Psychiatry, Royal Edinburgh Hospital, Edinburgh EH10 5HF
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Abstract

Between 1975 and 1985 there was a significant increase in the total number of admissions for mania and schizophrenia and a significant decrease for personality disorder to the Royal Edinburgh Hospital. All admissions for 1975 and 1985 in these three groups were subsequently examined retrospectively. The number of first admissions for personality disorder dropped significantly and the number of readmissions for mania increased significantly. Patients with schizophrenia and personality disorder had shorter admissions and a shorter relapse-free interval in 1985 but the overall effect of these changes was to reduce the total number of bed days used by these groups. For mania there was no change in admission length but significant shortening of the relapse-free interval leading to a substantial increase in total bed days used. There was no evidence that a change of diagnostic practice had occurred or that patients admitted with mania in 1985 were less ill. Although there were changes in referral and after-care arrangements, these were not specific to mania. Further work should specifically address the issue of aftercare arrangements and their influence on prognosis in mania, and the resource implications of the continuing rise in admissions.

Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 9 , Issue 1 , May 1992 , pp. 26 - 29
Copyright
Copyright © Cambridge University Press 1992

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References

1.Symonds, RL, Williams, P. Lithium and the changing incidence of mania. Psychol Med 1981; 11: 193–196.CrossRefGoogle ScholarPubMed
2.Baldessarini, RJ. Frequency of diagnosis of schizophrenia versus affective disorder from 1944 to 1968. Am J Psychiatry 1970; 127: 759–763.CrossRefGoogle ScholarPubMed
3.Parker, H, O'Donnell, M, Walter, S. Changes in the diagnosis of the functional psychoses associated with the introduction of lithium. Br J Psychiatry 1985; 146: 377–382.CrossRefGoogle ScholarPubMed
4.Mander, AJ. Diagnosis change, lithium use and admissions for mania in Edinburgh. Acta Psychiatr Scand 1989; 80: 434–436.CrossRefGoogle ScholarPubMed
5.Horgan, D. Change of diagnosis to manic depressive illness. Psychol Med 1981; 11: 517–523.CrossRefGoogle ScholarPubMed
6.Eagles, JM, Whalley, LJ. Decline in the diagnosis of schizophrenia among first admissions to Scottish mental hospitals from 1969-1978. Br J Psychiatry 1985; 146: 151–154.CrossRefGoogle Scholar
7.Eagles, JM, Hunter, D, McCance, C. Decline in the diagnosis of schizophrenia among first contacts with psychiatric services in northeast Scotland 1969-1984. Br J Psychiatry 1988; 152: 793–798.CrossRefGoogle ScholarPubMed
8.Lipkowitz, MH, Idupugaiti, S. Diagnosis of schizophrenia in 1982: the effect of DSM III. Am J Psychiatry 1985; 142: 634–637.Google ScholarPubMed
9.Dickson, WE, Kendell, RE. Does maintenance lithium therapy prevent recurrences of mania under ordinary clinical conditions? Psychol Med 1986; 16: 521–530.CrossRefGoogle ScholarPubMed
10.World Health Organisation. Mental disorders, glossary and guide to their classification in accordance with the ninth revision of the International Classification of Diseases (ICD-9). Geneva: WHO, 1978.Google Scholar
11.Fleiss, JL, Dunner, DL, Stallone, F, Fieve, RR. The life table – a method for analysing longitudinal studies. Arch Gen Psychiatry 1976; 33: 107–112.CrossRefGoogle Scholar
12.Masterton, G, Mander, AJ. Psychiatric emergencies, Scotland and the World Cup finals. Br J Psychiatry 1990, 156: 475–478.CrossRefGoogle ScholarPubMed
13.Scottish Home and Health Department. The Mental Health (Scotland) Act 1984. Scotland: HMSO 1984.Google Scholar
14.Mander, AJ. The use of lithium and early relapse in manic depressive illness. Acta Psychiatr Scand 1988; 78: 198–200.CrossRefGoogle ScholarPubMed
15.American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed (DSM III). Washington DC: APA, 1980.Google Scholar
16.Mander, AJ, Loudon, JB. The rapid recurrence of mania following abrupt discontinuation of lithium Lancet 1988; ii: 15–17.Google Scholar
17.Mander, AJ. Is lithium justified after one manic episode? Acta Psychiatr Scand 1986; 73: 60–67.CrossRefGoogle ScholarPubMed
18.Markar, HR, Mander, AJ. Efficacy of lithium prophylaxis in clinical practice. Br J Psychiatry 1989; 155: 496–500.CrossRefGoogle ScholarPubMed
19.Mander, AJ. Mania: the first illness [thesis for degree of MPhil]. Edinburgh: Univ of Edinburgh, 1986.Google Scholar