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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*
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

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
Copyright
Copyright © Royal College of Psychiatrists, 1994 

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