COPING AND THE DECISION TO HOSPITALIZE IN EMERGENCY PSYCHIATRY

This study was done to clarify whether and in what way a patient's cop ing repertoire can be linked to the disposition decision in a psychiat ric emergency service. For 1 year, all consultations (N = 1439) of a p sychiatric emergency service were documented in a detailed questionnai re covering socio-demographic and diagnostic data as well as informati on about the disposition decision. Depending on disposition, three gro ups were identified: outpatients (N = 530), inpatients (N = 481), and a nonintervention group (N = 428). In addition, over a 5-month period, patients were requested to fill in the ''Bernese Coping Modes'' quest ionnaire. Thus, a sample of 28 patients undergoing outpatient crisis i ntervention and 28 patients referred to inpatient treatment wits obtai ned. Statistical analysis included Chi square-test, t-test, Mann-Whitn ey U-test, and logistic regression analysis. Assessment of coping repe rtoire contributed move than the diagnosis to the decision to hospital ize. Outpatients have ct larger coping repertoire (t = 3.48, p = 0.001 ) than inpatients and shaw higher values in ''acceptance-stoicism,'' ' 'dissimulation,'' ''tackling,'' ''giving meaning,'' ''altruism,'' ''op timism,'' and ''relativizing.'' Logistic regression revealed relativiz ing, altruism, and optimism as being most important. Self-referral to emergency psychiatry was also correlated with outpatient treatment. Ot her criteria such as being without work, living alone, history of prev ious hospitalization, and the diagnosis of a psychotic or mood disorde r were significantly correlated with referral to inpatient treatment. More attention should be paid to patients' coping repertoires in emerg ency services when deciding about the need for inpatient treatment.