RETROSPECTIVE STUDY OF 2,200 INVOLUNTARY PSYCHIATRIC ADMISSIONS AND READMISSIONS

Objective: The authors describe demographic data, the distribution of diagnoses, and comorbid psychoactive substance use in a large sample o f patients involuntarily admitted to a psychiatric hospital from multi ple crisis centers and explore the relative roles these variables may play in service utilization and admission rates. Method: Data on demog raphic characteristics and comorbid psychoactive substance use in 2,20 0 consecutive involuntary hospital admissions of 1,755 psychiatric pat ients were gathered. Pertinent demographic and comorbidity data at fir st admission for the 1,755 patients, 314 of whom were admitted more th an once, were analyzed; then the data for the 1,441 single-admission p atients and the data at first admission for the 314 patients who had m ultiple admissions were compared. Finally, the diagnostic distribution and comorbid psychoactive substance use in all 2,200 admissions were investigated, with attention to a subgroup of 88 high-risk patients (t hose with three or more admissions) who represented a total of 307 adm issions. Results: Specific demographic characteristics were represente d in the patient group at a high level of statistical significance. Th e diagnosis of schizophrenia was significantly overrepresented. Schizo phrenia and psychosis not elsewhere classified clustered in the subgro up with a high risk of readmission. Conclusions: The results suggest a specific profile for the patient with heightened risk of hospital adm ission: a young, unmarried, African American male who has schizophreni a without comorbid substance abuse. An effect size data analysis ident ified marital status and a diagnosis of schizophrenia as the variables associated with the greatest likelihood of admission. Unexpectedly, t he impact of comorbid psychoactive substance use was relatively modest and showed a uniform distribution among diagnostic groups.