P-601 - Understanding the revolving door syndrome

Abstract

The term “revolving door” describes a subpopulation of chronically mentally ill patients frequently readmitted to psychiatric units. Policy of deinstitutionalization in mental health services during the past decades has highlighted the theme. Literature review indicates that patients at higher risk for revolving-door phenomenon are more likely to be younger, single males, with a diagnosis of a psychotic illness and high number of previous admissions. Patients with poor support networks, lower levels of education and challenging social environments are likely to remain well for shorter periods. Non-adherence to prescribed medications contributes significantly to relapse rates. The most consistently identified predictor is the number of previous hospitalizations. Authors pretend to identify patients with a high number of admissions to Coimbra University Hospitals (CUH), analyze their clinical and socio-demographic characteristics, causes of readmission and social network, and give examples. Retrospective cohort study, in which the medical records of individuals admitted to CUH during the last year were analyzed to identify those with the highest frequency of inpatient admissions (at least more than two within 18 months). Our preliminary results are consistent with those from the literature, regarding the clinical and social characteristics of patients with revolving-door phenomenon, however the most severe cases are found between female patients. Considering the social burden and the pressure on inpatient services caused by revolving door patients, it is important to understand the factors that may contribute to this phenomenon to develop interventions that could reduce the prevalence of recidivism.