Social Psychiatry and Psychiatric Epidemiology

, Volume 49, Issue 11, pp 1719–1727

Rehospitalization risk of former voluntary and involuntary patients with schizophrenia

  • Carmen Pfiffner
  • Tilman Steinert
  • Reinhold Kilian
  • Thomas Becker
  • Karel Frasch
  • Gerhard Eschweiler
  • Gerhard Längle
  • Daniela Croissant
  • Wiltrud Schepp
  • Prisca Weiser
  • Susanne Jaeger
Original Paper

DOI: 10.1007/s00127-014-0892-2

Cite this article as:
Pfiffner, C., Steinert, T., Kilian, R. et al. Soc Psychiatry Psychiatr Epidemiol (2014) 49: 1719. doi:10.1007/s00127-014-0892-2

Abstract

Background

The aim of the study was to examine the differences between former involuntary and voluntary patients with a schizophrenic disorder with regard to time to and frequency of rehospitalization.

Methods

In this prospective observational study, 374 patients with a diagnosis of schizophrenia or schizoaffective disorder were included. At the time of inclusion, 290 (77.5 %) were hospitalized voluntarily and 84 (22.5 %) involuntarily. Follow-up assessments were conducted half-yearly over a 2-year period with measures of PANSS, GAF, sociodemographic data and cognitive functioning. These data served as covariates for adjustment in statistical models that included a Cox regression model, a random-effect logit model and a random-effect tobit model.

Results

After adjustment for other relevant covariates, the Cox regression showed that involuntary treatment is a significant risk factor of subsequent rehospitalization (HR = 1.53; CI = 1.06, 2.19; p = 0.02). The involuntary group had higher half-year incidence rates of rehospitalization, and in case of rehospitalization the duration of hospital stay was longer.

Conclusions

Involuntary hospitalization seems to be associated with a higher risk of rehospitalization and longer subsequent hospital stays in patients with schizophrenia and schizoaffective disorders. Further studies are needed to examine in detail the processes and interventions that are suitable for interrupting circles of repeated hospitalizations, especially in former involuntary patients.

Keywords

Schizophrenia Involuntary hospitalization Rehospitalization Readmission Coercion 

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Carmen Pfiffner
    • 1
  • Tilman Steinert
    • 1
  • Reinhold Kilian
    • 2
  • Thomas Becker
    • 2
  • Karel Frasch
    • 2
  • Gerhard Eschweiler
    • 3
  • Gerhard Längle
    • 3
    • 4
  • Daniela Croissant
    • 5
  • Wiltrud Schepp
    • 6
  • Prisca Weiser
    • 7
  • Susanne Jaeger
    • 1
  1. 1.Department of Psychiatry and Psychotherapy I, Centres for Psychiatry SüdwürttembergUlm UniversityRavensburgGermany
  2. 2.Department of Psychiatry and Psychotherapy IIUlm University, Bezirkskrankenhaus GünzburgGünzburgGermany
  3. 3.Department of Psychiatry and PsychotherapyUniversity of TübingenTübingenGermany
  4. 4.Centres for Psychiatry SüdwürttembergBad SchussenriedGermany
  5. 5.PP.rt Hospital for Psychiatry, Psychotherapy and PsychosomaticsReutlingenGermany
  6. 6.Department of Forensic Psychiatry and PsychotherapyBezirksklinikum RegensburgRegensburgGermany
  7. 7.Department of Psychosomatic Medicine, Psychotherapy/PsychiatryUniversity of MainzMainzGermany

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