Psychiatric hospitalization following psychosis onset: A retrospective cohort study using health administrative data.

Abstract

There is limited evidence examining admissions in early psychosis. We sought to estimate the proportion of people with a psychiatric admission within 2 years of the first diagnosis of psychosis, and to identify associated risk factors. We constructed a cohort of incident non-affective psychosis cases using health administrative data and identified the first psychiatric hospitalization after psychosis onset. We compared hospitalization rates across sociodemographic, clinical and service-use factors. One in three patients had an admission within 2 years of first diagnosis. Younger age, migrant status, diagnosis of psychosis not otherwise specified, and prior substance use were associated with increased hospitalization rates, whereas family physician involvement in diagnosis was protective. Adolescents, immigrants and people presenting with diagnostic instability or prior substance use issues may benefit from interventions aimed at reducing hospitalization risk. Increasing primary care access and utilization among youth with early psychosis may also reduce hospitalization rates.