LINKING INPATIENTS WITH SCHIZOPHRENIA TO OUTPATIENT CARE

Objective: This study focused on inpatients with schizophrenia or schi zoaffective disorder who were scheduled to begin outpatient care with clinicians who had not previously treated them. The authors evaluated the effects of communication between the patients and their outpatient clinicians before discharge on patients' referral compliance, psychia tric symptoms, and community function at follow-up three months after discharge. Methods: In total of 104 adult inpatients with schizophreni a or schizoaffective disorder who were scheduled to receive outpatient care from clinicians who had not previously treated them were evaluat ed at hospital discharge and again three months later. Comparisons wer e made between patients who had telephone or face-to-face contact with an outpatient clinician before hospital discharge and patients who di d not have such contact. Results: About half (51 percent) of the inpat ient sample communicated with an outpatient clinician before leaving t he hospital. Compared with patients who had no communication, those wh o spoke with an outpatient clinician were significantly more likely to complete the outpatient referral. After baseline scores and other cov ariates were controlled for, predischarge contact with an outpatient c linician was associated with a significantly lower total Brief Psychia tric Rating Scale score at follow-up and less self-assessed difficulty controlling symptoms. Nonsignificant trends toward improved medicatio n compliance and a lower rate of homelessness were also found. The two patient groups did not significantly differ in the proportion who wer e readmitted to the hospital or who made a psychiatric emergency room visit during the follow-up period. Conclusions: Direct communication b etween inpatients and new outpatient clinicians may help smooth the tr ansition to outpatient care and thereby contribute to improved control of clinical symptoms.