Abstract
Background: Early intervention services aim to improve clinical outcomes of people with psychotic disorders. Understanding which individuals are most likely to need hospital admission would help to better direct these services. A cohort study was performed to investigate how diagnosis was associated with risk of hospital admission in a large clinical dataset of people presenting with psychosis.
Method: Data were obtained from 9,929 people presenting with their first diagnosis of a psychotic disorder to the South London and Maudsley NHS Trust (SLaM), Europe’s largest provider of specialist mental healthcare. Data were extracted from anonymised electronic health records on age, gender, ethnicity, marital/employment/accommodation status and psychotic diagnosis. These factors were analysed using multivariable logistic and multiple linear regression to investigate their association with compulsory hospital admission (under the UK Mental Health Act) and number of days spent in hospital in the 12 months following presentation to SLaM.
Results: People with mania were more likely to be compulsorily admitted (OR 2.39, 95% CI 1.96–2.92) while those with psychotic depression were less likely (0.58, 0.49–0.69). However, among people who were admitted to hospital, those with schizophrenia spent longer in hospital than those with mania (B coefficient –15.8 days, 95% CI –26.5, –5.2).
Conclusions: Compulsory hospital admission was more likely among people with mania. However, a diagnosis of schizophrenia was associated with greater number of days spent in hospital. These findings highlight variations in clinical outcomes depending on psychotic diagnosis and illustrate a potential need to stratify early intervention services accordingly.
Method: Data were obtained from 9,929 people presenting with their first diagnosis of a psychotic disorder to the South London and Maudsley NHS Trust (SLaM), Europe’s largest provider of specialist mental healthcare. Data were extracted from anonymised electronic health records on age, gender, ethnicity, marital/employment/accommodation status and psychotic diagnosis. These factors were analysed using multivariable logistic and multiple linear regression to investigate their association with compulsory hospital admission (under the UK Mental Health Act) and number of days spent in hospital in the 12 months following presentation to SLaM.
Results: People with mania were more likely to be compulsorily admitted (OR 2.39, 95% CI 1.96–2.92) while those with psychotic depression were less likely (0.58, 0.49–0.69). However, among people who were admitted to hospital, those with schizophrenia spent longer in hospital than those with mania (B coefficient –15.8 days, 95% CI –26.5, –5.2).
Conclusions: Compulsory hospital admission was more likely among people with mania. However, a diagnosis of schizophrenia was associated with greater number of days spent in hospital. These findings highlight variations in clinical outcomes depending on psychotic diagnosis and illustrate a potential need to stratify early intervention services accordingly.
Original language | English |
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Article number | C102 |
Pages (from-to) | 159-159 |
Number of pages | 1 |
Journal | Early Intervention in Psychiatry |
Volume | 8 |
Issue number | S1 |
DOIs | |
Publication status | Published - 11 Nov 2014 |