Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-17T19:08:10.783Z Has data issue: false hasContentIssue false
  • English
  • Français

Which Patients with Non-affective Functional Psychosis are not Admitted at First Psychiatric Contact?

Published online by Cambridge University Press:  02 January 2018

David J. Castle ,
Michael Phelan ,
Simon Wessely  and
Robin M. Murray
David J. Castle*
Affiliation:
Institute of Psychiatry, London
Michael Phelan
Affiliation:
PRiSM (Psychiatric Research in Service Measurement), Institute of Psychiatry, London
Simon Wessely
Affiliation:
Institute of Psychiatry, and Department of Psychological Medicine, King's College Hospital, London
Robin M. Murray
Affiliation:
Genetics Section, Institute of Psychiatry, and Department of Psychological Medicine, King's College Hospital, London
*
Dr D. J. Castle, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
Get access Rights & Permissions [Opens in a new window]

Extract

Background

We wished to explore the sociodemographic and clinical characteristics associated with admission to hospital in patients with a non-organic non-affective psychosis.

Method

Subjects were 484 first-contact patients with a non-affective functional psychosis from an inner-city catchment area over 20 years from the mid-1960s. Sociodemographic and clinical characteristics associated with admission to hospital were analysed.

Results

Around 20% of patients were not admitted, and the proportion did not change significantly over the years. Ethnicity, sex, and marital and employment status did not predict admission. Factors associated with admission included police involvement, and violence to self or others. A diagnosis of schizoaffective disorder, and persecutory delusions, auditory hallucinations, and bizarre behaviour were all more common in patients admitted to hospital.

Conclusions

The study indicates biases which might arise in research based exclusively on patients admitted to hospital.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 165 , Issue 1 , July 1994 , pp. 101 - 106
Copyright
Copyright © Royal College of Psychiatrists, 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

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Balarajan, R., Yuen, P. & Machin, D. (1992) Deprivation and general practitioner workload. British Medical Journal, 304, 116–130.Google Scholar
Castle, D. J. & Murray, R. M. (1991) The neurodevelopmental basis of sex differences in schizophrenia. Psychological Medicine; 21, 565–575.Google Scholar
Castle, D. J., Wessely, S., Der, G. & Murray, R. M. (1991). The incidence of operationally defined schizophrenia in Camberwell, 1965 to 1984. British Journal of Psychiatry, 159, 790–794.CrossRefGoogle Scholar
Cooper, J. E., Goodhead, D., Craig, T., et al (1987) The incidence of schizophrenia in Nottingham. British Journal of Psychiatry, 151, 619–626.Google Scholar
Dean, C. & Gadd, E. M. (1990) Home treatment for acute psychiatric illness. British Medical Journal, 301, 1021–1023.Google Scholar
Der, G., Gupta, S. & Murray, R. M. (1990) Is schizophrenia disappearing? Lancet, 335, 513–516.Google Scholar
Dunn, J. & Fahy, T. A. (1990) Police admissions to a psychiatric hospital: Demographic and clinical differences between ethnic groups. British Journal of Psychiatry, 156, 373–378.Google Scholar
Geddes, J. R. & Kendell, R. E. (1992) A case control study of schizophrenic patients who have never been admitted to hospital. Paper presented at Royal College of Psychiatrists Annual Meeting, Dublin, 24th–27th July.Google Scholar
Graham, P. M. (1990) Trends in schizophrenia. Lancet, 335, 852.Google Scholar
Gupta, S. (1991) Psychosis in migrants from the Indian subcontinent and English-born controls. A preliminary study on the use of psychiatric services. British Journal of Psychiatry, 159, 222–225.Google Scholar
Hafner, H. & Gattaz, W. F. (1991) Is schizophrenia disappearing? European Archives of Psychiatry and Clinical Neurosciences, 240, 374–376.Google Scholar
Johnstone, E. C., Crow, T. J., Johnson, A. L. & MacMillan, J. F. (1986) The Northwick Park Study of First Episodes of Schizophrenia. 1. Presentation of the illness and problems relating to admission. British Journal of Psychiatry, 148, 115–120.Google Scholar
Keith, S. J., Regier, D. A. & Rae, D. S. (1991) Schizophrenic disorders. In Psychiatric Disorders in America (eds Regier, L. N. Robins A D. A.), pp 33–52. New York: Free Press.Google Scholar
Kendell, R. E., Malcolm, D. E. & Adams, W. (1993) The problem of detecting changes in the incidence of schizophrenia. British Journal of Psychiatry, 162, 212–218.CrossRefGoogle ScholarPubMed
McGuffin, P., Farmer, A. E. & Harvey, I. (1991) A polydiagnostic application of operational criteria in studies of psychotic illness: development and reliability of the OPCRIT system. Archives of General Psychiatry, 48, 764–770.Google Scholar
Muijen, M., Marks, I., Connolly, J. & Audini, B. (1992) Home based care and standard hospital care for patients with severe mental illness: A randomised controlled trial. British Medical Journal, 304, 749–754.Google Scholar
Munk-Jørgensen, P. (1985) The schizophrenia diagnosis in Denmark: A register-based investigation. Acta Psychiatrica Scandinavica, 72, 266–273.Google Scholar
Murray, R. M., Gupta, S. & Der, G. (1991) Is schizophrenia disappearing? European Archives of Psychiatry and Clinical Neurosciences, 240, 377–378.Google Scholar
Prince, M. J. & Phelan, M. C. (1990) Trends in schizophrenia. Lancet, 335, 851–852.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–782.CrossRefGoogle ScholarPubMed
Shepherd, M., Watt, D. & Falloon, I. (1989) The natural history of schizophrenia: a five year follow-up study of outcome prediction in a representative sample of schizophrenics. Psychological Medicine, monograph suppl. 15. Cambridge: Cambridge University Press.Google Scholar
Tyrer, P., Turner, R. & Johnson, A. L. (1989) Integrated hospital and community psychiatric services and use of inpatient beds. British Medical Journal, 299, 298–300.Google Scholar
Wessely, S. & Castle, D. (1992) How valid are psychiatric case notes for assessing criminal convictions? Journal of Forensic Psychiatry, 3, 359–363.CrossRefGoogle Scholar
Wessely, S. & Castle, D., Der, G., et al (1991) Schizophrenia and AfroCaribbeans: A case control study. British Journal of Psychiatry, 159, 795–801.CrossRefGoogle ScholarPubMed
World Health Organization (1980) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD–9). Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.