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The Revolving Door Phenomenon in an Italian Acute Psychiatric Ward

Rosaria Di Lorenzo · Marco Sagona · Giulia Landi · Lisa Martire · Chiara Piemonte · Cinzia Del Giovane

52 citations0/0 files storedThe Journal of Nervous and Mental Disease

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Psychiatric care and mental health services Historical Psychiatry and Medical Practices Mental Health Treatment and Access

Abstract

To highlight the revolving door (RD) phenomenon in an acute psychiatric ward, we retrospectively identified the patients hospitalized three or more times in a calendar year from 1/1/2009 to 31/12/2013 as RD patients (RDP). We collected sociodemographic and clinical variables of RDP and statistically analyzed the potential RD risk factors. We divided RDP into "high" and "extremely high" utilizers and evaluated the variables related to more frequent readmissions. RDP represented 5.68% of all patients and their hospitalizations (RDH) 25% of all admissions. The statistically significant risk factors for all RDH were "disability pension," "substance abuse/dependence," "mild/severe aggressiveness," and "psychiatric and social rehabilitative programs". The comparison between "high" and "extremely high" utilizers showed that "manic episodes" and "personality disorders," among the diagnoses, "familial relational conflicts" and "violence/suicidality", among the hospitalization reasons, were statistically significant risk factors for more frequent readmissions. RD phenomenon was greatly affected by severe clinical conditions with social disability.

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References

2011Factors Associated with Length of Stay and the Risk of Readmission in an Acute Psychiatric Inpatient Facility: A Retrospective Study 2009The revolving door phenomenon in psychiatry: comparing low-frequency and high-frequency users of psychiatric inpatient services in a developing country 1995Symptom severity and number of previous psychiatric admissions as predictors of readmission 2004Factors contributing to frequent use of psychiatric inpatient services by schizophrenia patients 2009A Case-Control Study of Factors Associated With Multiple Psychiatric Readmissions 2000Predicting the revolving door phenomenon among patients with schizophrenic, affective disorders and non-organic psychoses 2002Understanding those who seek frequent psychiatric hospitalizations 2010Predicting Time to Readmission in Patients With Recent Histories of Recurrent Psychiatric Hospitalization

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