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Predictors of clinical and social outcomes following involuntary hospital admission: a prospective observational study

  • Stefan PriebeEmail author
  • Christina Katsakou
  • Ksenija Yeeles
  • Tim Amos
  • Richard Morriss
  • Duolao Wang
  • Til Wykes
Original Paper

Abstract

The Study aimed to assess clinical and social outcomes following involuntary admissions over 1 year and identify socio-demographic and clinical patient characteristics associated with more or less favourable outcomes. Seven hundred and seventy-eight involuntary patients admitted to one of 22 hospitals in England were assessed within the first week after admission and at 1 month, 3 month and 12 month follow-ups. Outcome criteria were symptom levels, global functioning, objective social outcomes, and subjective quality of life (SQOL). Baseline characteristics and patients’ initial experience were tested as predictors. Symptom levels and global functioning improved moderately. Objective social outcomes showed a small, but statistically significant deterioration, and SQOL a small, but significant improvement at 1 year. In multivariable analyses, admission due to risk to oneself and receiving benefits predicted poorer symptom outcomes. Female gender and higher perceived coercion were associated with better objective social outcomes, whilst higher initial satisfaction with treatment predicted more positive SQOL at follow-ups. Over a 1-year period following involuntary hospital admission, patients on average showed only limited health and social gains. Different types of outcomes are associated with different predictor variables. Patients’ initial experience of treatment, in the form of perceived coercion or satisfaction with treatment, has predictive value for up to a year following the admission.

Keywords

Commitment of mentally ill Coercion Patient admission Outcome assessment (health care) Inpatients 

Notes

Acknowledgments

This study was funded by a grant from the Department of Health, United Kingdom (com. no. 0230072). This work was undertaken by the Unit for Social and Community Psychiatry, Barts’ and the London School of Medicine and Dentistry, Queen Mary University of London, and the views expressed in the publication are those of the authors and not necessarily those of the Department of Health. The funding source had no role in the study design and conduct of the study, data collection, management, data analysis, data interpretation, or writing of the report and preparation, review or approval of the manuscript. All authors report no conflicts of interest. The study was supported by the NIHR UK Mental Health Research Network. We are also grateful to all interviewed patients, the supporting staff in all participating organisations, and the research assistants who collected the data.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Stefan Priebe
    • 1
    Email author
  • Christina Katsakou
    • 1
  • Ksenija Yeeles
    • 1
  • Tim Amos
    • 2
  • Richard Morriss
    • 3
  • Duolao Wang
    • 4
  • Til Wykes
    • 5
  1. 1.Unit for Social & Community Psychiatry, Barts and the London School of MedicineQueen Mary University of LondonLondonUK
  2. 2.Academic Unit of PsychiatryUniversity of BristolBristolUK
  3. 3.School of Community Health Sciences, The Institute of Mental HealthUniversity of NottinghamNottinghamUK
  4. 4.London School of Hygiene and Tropical MedicineLondonUK
  5. 5.Institute of PsychiatryKing’s College LondonLondonUK

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