Decertification Outcomes for Bipolar Disorder in an Inpatient Community Mental Health Treatment Center: Impact on Subsequent Service Use Over Two Years

Abstract

This study investigated differences in usage of inpatient and outpatient mental health services over a 2-year period following the index hospitalization between 50 decertified and 48 certified subjects with bipolar manic or mixed episode from an inpatient mental health treatment center. The decertified group had higher number of rehospitalization over the 2-year period compared to certified group (mean = 2.26, SE = 0.41 vs. mean = 1.19, SE = 0.24; Wald χ ² = 5.50, p = 0.02). Median time to first rehospitalization was 40 weeks in the certified and 17 weeks in the decertified group, but the difference in time to rehospitalization failed to achieve statistical significance (p = 0.18). History of prior hospitalization was associated with higher numbers of rehospitalizations and crisis room visits (both p < 0.01) and with shorter time before first rehospitalization (p < 0.001).