Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-05T14:29:52.219Z Has data issue: false hasContentIssue false
  • English
  • Français

Predictors for readmission risk in schizophrenia

Published online by Cambridge University Press:  09 July 2009

P. B. Mortensen  and
W. W. Eaton
P. B. Mortensen*
Affiliation:
Institute of Basic Psychiatric Research, Department of Psychiatric Demography, Psychiatric Hospital, Risskov, Denmark; and Johns Hopkins University, School of Hygiene and Public Health, Department of Mental Hygiene, Baltimore, Maryland, USA
W. W. Eaton
Affiliation:
Institute of Basic Psychiatric Research, Department of Psychiatric Demography, Psychiatric Hospital, Risskov, Denmark; and Johns Hopkins University, School of Hygiene and Public Health, Department of Mental Hygiene, Baltimore, Maryland, USA
*
1Address for correspondence: Dr Preben Bo Mortensen, Department of Psychiatric Demography, Psychiatric Hospital, DK-8240 Risskov, Denmark.
Get access Rights & Permissions [Opens in a new window]

Synopsis

Readmission risk was assessed at the first and subsequent discharges in a total Danish national sample consisting of 8705 first admitted patients who had been discharged alive at least once with a diagnosis of schizophrenia. Predictors for readmission risk were identified using the Cox proportional hazards model. Following the first discharge, 19% of the surviving patients had not been readmitted after 10 years of follow-up. Readmission risk increased with the number of previous admissions. At the first discharge readmission risk decreased with increasing age and was significantly predicted by clinical subtype and gender. At later discharges (5th, 10th, and 15th) the effect of these variables gradually disappeared. At the 15th discharge readmissions were mainly predicted by the duration of the latest admission and discharge periods. Both the increase in readmission risk with the number of previous admissions and the evolving pattern of predictors for readmission risk are interpreted as supporting the existence of a smaller subpopulation among schizophrenic patients with frequent relapses.

Type
Original Articles
Information
Psychological Medicine , Volume 24 , Issue 1 , February 1994 , pp. 223 - 232
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Angermeyer, M. C., Goldstein, J. M. & Kuehn, L. (1989). Gender differences in schizophrenia: rehospitalization and community survival. Psychological Medicine 19, 365–382.CrossRefGoogle ScholarPubMed
Angermeyer, M. C., Kühn, L. & Goldstein, J. M. (1990). Gender and the course of schizophrenia: differences in treated outcomes. Schizophrenia Bulletin 16, 293–307.CrossRefGoogle ScholarPubMed
Breslow, N. E. & Day, N. E. (1987). Statistical Methods in Cancer Research. The design and analysis of cohort studies. IARC Scientific Publications No. 82: Lyon.Google ScholarPubMed
Ciompi, L. (1980). Catamnestic long-term study on the course of life and aging of schizophrenics. Schizophrenia Bulletin 6, 606–618.CrossRefGoogle ScholarPubMed
Dixon, W. J. (1988). BMDP Statistical Software Manual, Vol. 2. University of California Press: Berkeley, California.Google Scholar
Dupont, A. (1983). A national psychiatric case register as a tool for mental health planning, research, and administration. The Danish model. In Information Support to Mental Health Programs. An International Perspective (ed. Laska, E. M., Gulbinat, W. H. and Regier, D. A.), pp. 257–274. Human Sciences Press: New York.Google Scholar
Eaton, W. W. (1974). Mental hospitalization as a reinforcement process. American Sociological Review 39, 252–260.CrossRefGoogle ScholarPubMed
Eaton, W. W., Mortensen, P. B., Herrman, H., Freeman, H., Bilker, W., Burgess, P. & Wooff, K. (1992 a). The long-term course of hospitalization for schizophrenia. Part I. Risk for rehospitalization following first discharge for schizophrenics in four register areas. Schizophrenia Bulletin 18, 217–227.CrossRefGoogle Scholar
Eaton, W. W., Bilker, W., Haro, J. M., Herrman, H., Mortensen, P. B., Freeman, H. & Burgess, P. (1992 b). The long-term course of hospitalization for schizophrenia. Part II. Change in rate of hospitalization with passage to time. Schizophrenia Bulletin 18, 229–241.CrossRefGoogle Scholar
Fenton, W. S. & McGlashan, T. H. (1991). Natural history of schizophrenia subtypes. II. Positive and negative symptoms and long-term course. Archives of General Psychiatry 48, 978–986.CrossRefGoogle ScholarPubMed
Harrow, M. & Westermeyer, J. F. (1987). Process-reactive dimension and outcome for narrow concepts of schizophrenia. Schizophrenia Bulletin 13, 361–368.CrossRefGoogle ScholarPubMed
Harrow, M., Westermeyer, J. F., Silverstein, M., Strauss, B. S. & Cohler, B. J. (1986). Predictors of outcome in schizophrenia: the process-reactive dimension. Schizophrenia Bulletin 12, 195–207.CrossRefGoogle ScholarPubMed
Kalbfleish, J. D. & Prentice, R. L. (1980). The Statistical Analysis of Failure Time Data. Wiley: New York.Google Scholar
Kastrup, M. (1987). The heavy users of psychiatric services, now and in the future. In Psychiatric Epidemiology. Progress and Prospects (ed. Cooper, B.), pp. 361–371. Croom Helm: London.Google Scholar
Lützhøft, J. H., Löffler, W., Fätkenheuer, B., Maurer, K., Riecher-Rössler, A. & Häfner, H. (1992). Symptom predictors for the clinical schizophrenia diagnosis. Paper presented at The VIth European Symposium. AEP Association of European Psychiatrists Section Committee. Psychiatric Epidemiology and Social Psychiatry.Zürich, Switzerland,8–10 April 1992.Google Scholar
Munk-Jørgensen, P. (1987). Why has the incidence of schizophrenia in Danish psychiatric institutions decreased since 1970? Acta Psychiatrica Scandinavica 75, 62–68.CrossRefGoogle ScholarPubMed
Munk-Jørgensen, P. & Mortensen, P. B. (1989). Schizophrenia: a 13-year follow-up. Diagnostic and psychopathological aspects. Acta Psychiatrica Scandinavica 79, 391–399.Google Scholar
Munk-Jørgensen, P. & Mortensen, P. B. (1992). Incidence and other aspects of the epidemiology of schizophrenia in Denmark, 1971–89. British Journal of Psychiatry 161, 489–495.CrossRefGoogle Scholar
Munk-Jørgensen, P., Mortensen, P. B. & Machon, R. A. (1991). Hospitalization patterns in schizophrenia. A 13-year follow-up. Schizophrenia Research 4, 1–9.CrossRefGoogle ScholarPubMed
Olbrich, R. K. & Strauss, E. (1988). Verlaufsuntersuchungen zur Schizophrenie seit dem 2. Weltkrieg: Eine Literaturrecherche. In Prospective Verlaufs-forschung in der Psychiatrie (ed. Olbrich, R. K.), pp. 12–19. Springer-Verlag: Berlin.CrossRefGoogle Scholar
Rosen, B., Klein, D. f. & Gittleman-Klein, R. (1971). The prediction of rehospitalization: the relationship between age of first psychiatric treatment contact, marital status and premorbid asocial adjustment. Journal of Nervous and Mental Disease 152, 17–22.CrossRefGoogle ScholarPubMed
Shepherd, M., Watt, D., Falloon, I. & Smeeton, N. (1989). The Natural History of Schizophrenia: A Five-year Follow-up Study of Outcome and Prediction in a Representative Sample of Schizophrenics. Psychological Medicine Monograph supplement 15. Cambridge University Press: Cambridge.Google Scholar
Strauss, J. S. & Carpenter, W. T. (1972). The prediction of outcome in schizophrenia. I. Characteristics of outcome. Archives of General Psychiatry 27, 739–746.CrossRefGoogle ScholarPubMed
Westermeyer, J. F. & Harrow, M. (1988). Course and outcome in schizophrenia. In Handbook of Schizophrenia. Nosology, Epidemiology and Genetics of Schizophrenia (ed. Tsuang, M. T. and Simpson, J. C.), pp. 205–244., Elsevier Science Publishers: Amsterdam.Google Scholar
World Health Organization (1979). Schizophrenia. An International Follow-up Study. Wiley: New York.Google Scholar
Zigler, E. & Levine, J. (1981). Age at first hospitalization of schizophrenics: a developmental approach. Journal of Abnormal Psychology 96, 458.Google Scholar