Community Mental Health Journal

, Volume 48, Issue 6, pp 761–764

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

  • Glen L. Xiong
  • Ana-Maria Iosiff
  • Michael Brooks
  • Charles L. Scott
  • Donald M. Hilty
Brief Report


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 χ2 = 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).


Bipolar disorder Involuntary treatment Decertification Discharge against medical advice 


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Glen L. Xiong
    • 1
  • Ana-Maria Iosiff
    • 2
  • Michael Brooks
    • 3
  • Charles L. Scott
    • 4
  • Donald M. Hilty
    • 1
  1. 1.Department of Psychiatry and Behavioral SciencesUniversity of California at DavisDavisUSA
  2. 2.Deparment of Public Health SciencesUniversity of California at DavisDavisUSA
  3. 3.Department of PsychologyRosalind Franklin University of Medicine and ScienceNorth ChicagooUSA
  4. 4.Division of Psychiatry and Law, Department of Psychiatry and Behavioral SciencesUniversity of California at DavisDavisUSA

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