Klinische und soziale Risikofaktoren für Wiederaufnahmen in die stationäre Psychiatrie bei Patienten mit Schizophrenie: Eine Langzeitanalyse

Abstract

In recent years, admission rates to psychiatric inpatient care have steadily increased, whilst the number of beds has progressively decreased, at least in german-speaking countries. A better understanding of risk factors concerning psychiatric readmissions is indispensable in order to avoid unnecessary inpatient treatment. The aim of our study was to test the influence of various clinical and social factors on the time to readmission. We analysed data of an observational study considering especially vulnerable patients with schizophrenia (N = 103). We applied multivariate time-hazards models (survival analysis) to examine the predictors of the time to readmission within 12 months. Independent variables were either time-varying (e.g. Needs for care Assessment Scale (NCA)) or time-invariant (e.g. age). About 50% of the patients were readmitted during the observation period, many of them within the first few weeks. In the final models clinical needs, and a social need increased the risk of readmission, whereas the use of neuroleptic medication reduced the risk. There was an interaction effect between social support and time. Both, clinical and social factors influence the risk of psychiatric readmission. Therefore, the prevention of readmissions should focus on the patients' skills to manage his/her illness and on the social support that the patients receive.