Predictors of short-term deterioration and compliance in psychiatric emergency patients: a prospective study of 457 patients referred to the emergency room of a general hospital

The aim of this study was to identify predictors of (1) short-term outcome and (2) short-term compliance with treatment (for non-hospitalized patients ) in psychiatric emergency patients. Subjects comprised 457 patients referr ed to the emergency ward of a French general hospital and requiring examina tion by a psychiatrist. Clinical and therapeutic assessments were carried o ut at baseline, using DSM-IV diagnoses and overall psychopathological scori ng scales [Brief Psychiatric Rating Scale (BPRS) and Symptom Checklist-90 R evised]. Clinical outcome and compliance were assessed 3 weeks after entry. For each of the two issues assessed, stepwise logistic regression analysis was performed following univariate comparisons. The three best predictors of deterioration at 3 weeks were lack of compliance to treatment, presence of a previous psychiatric history, and a low BPRS hebephrenic factor score. The best predictors of compliance in non-hospitalized patients were a prev ious psychiatric history, marital status, a low BPRS hostility factor score , and older age. The main predictor of deterioration was non-compliance. Th us, we emphasize the importance of improving compliance, especially among y oung patients with no previous psychiatric history. (C) 2001 Elsevier Scien ce Ireland Ltd. All rights reserved.