Abstract
BackgroundVictimization is associated with worse social and clinical outcomes of individuals with severe mental illness (SMI). A relapse of SMI may be one of the clinical consequences of assaultive trauma. As far as we know, there is no published study that analyzes nationwide health registers to assess the risk of SMI rehospitalization following assault.AimWe aimed to assess whether exposure to assault is associated with an increased risk of psychiatric hospitalization in those with SMI.MethodsWe utilized data from the Czech nationwide registers of all-cause hospitalizations and all-cause deaths. We defined exposed individuals as those discharged from a hospitalization for SMI between 2002 and 2007, and hospitalized for serious injuries sustained in an assault in the subsequent 7 years. For each assaulted individual, we randomly selected five counterparts, matched on SMI diagnosis, age and sex, who were not assaulted in the examined time period. We used mixed effect logistic regression to assess the effect of assault on the risk of SMI rehospitalization within the following 6 months. We fitted unadjusted models and models adjusted for the number of previous SMI hospitalizations and drug use disorders.ResultsThe sample consisted of 248 exposed and 1 240 unexposed individuals. In the unadjusted model, assaulted individuals were almost four times more likely to be rehospitalized than their non-assaulted counterparts (odds ratio (OR) = 3.96; 95% CI 2.75; 5.71). After adjusting for all covariates, the OR remained threefold higher (OR = 3.07; 95% CI 2.10; 4.49).ConclusionPeople with a history of SMI hospitalization were approximately three times more likely to be rehospitalized for SMI within 6 months after an assault than their non-assaulted SMI counterparts. Soon after a person with SMI is physically assaulted, there should be a psychiatric evaluation and a close follow-up.
Highlights
Severe mental illness and relapse Severe mental illness (SMI) is defined as schizophrenia, schizoaffective disorder, bipolar disorder, or major depressive disorder
Covariates Hospitalization for drug use disorder in 7 years prior to the start of the follow‐up Drug use is associated with increased risk for assault in people with mental disorders [7], we considered the history of drug use disorders (DUD) as a potential confounder
6% of assaulted individuals were hospitalized for DUD in the past, whereas in non-assaulted it was 2%
Summary
Severe mental illness and relapse Severe mental illness (SMI) is defined as schizophrenia, schizoaffective disorder, bipolar disorder, or major depressive disorder. It leads to a substantive reduction of quality of life, affecting both individuals and their. [3, 4] Recurrent SMI hospitalizations drive up the cost of psychiatric care, and can further impair quality of life [5]. Relapses in individuals with SMI are associated with an increased risk of long-term disability and suicide attempts [6]. Victimization is associated with worse social and clinical outcomes of individuals with severe mental illness (SMI). A relapse of SMI may be one of the clinical consequences of assaultive trauma. As far as we know, there is no published study that analyzes nationwide health registers to assess the risk of SMI rehospitalization following assault
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