Background
Methods
Catchment area and central psychiatric register
Sample and data basis
Statistical analyses
Variables | N (%) N = 2,004 | N (%) N = 3,220 | N (%) N = 5,224) |
---|---|---|---|
Sociodemography | |||
Age (Median, IQR) | 44 (59-33) **** | 43 (54-32) **** | 43 (56-32) |
Sex, male | 1109 (55.3) | 1697 (52.7) | 2806 (62.3) |
Marital status, married | 351 (18.8) | 603 (19.9) | 954 (19.5) |
Employment status, employed | 488 (26.8) | 873 (27.9) | 1361 (27.5) |
Living situation, own home | 1068 (74.2) | 1958 (72.1) | 3026 (72.8) |
Clinical variables
| |||
Psychiatric disorder, only main diagnosis | |||
Organic disorder (ICD-10, F0), yes | 182 (9.1) **** | 190 (5.9) **** | 372 (7.1) |
Substance disorder (ICD-10, F1), yes | 444 (22.2) | 728 (22.6) | 1172 (22.4) |
Psychotic disorder (ICD-10, F2), yes | 495 (24.7) **** | 946 (29.4) **** | 1441 (27.6) |
Affective disorder (ICD-10, F3), yes | 332 (16.6) ** | 642 (19.9) ** | 974 (18.6) |
Anxiety disorder (ICD-10, F4), yes | 165 (8.2) * | 324 (10.1) * | 489 (9.4) |
Behavioural, psychosomatic disorders (ICD-10, F5), yes | 6 (0.3) | 8 (0.2) | 14 (0.3) |
Personality disorder (ICD-10, F6), yes | 148 (7.4) | 245 (7.6) | 393 (7.5) |
Severity of illness at admission, markedly to extremely ill | 1446 (80.2) **** | 2176 (70.4) **** | 3622 (74.0) |
Psychosocial Functioning (Median, IQR) §
| 45 (55-35) | 45 (56-33) | 45 (55-33) |
Severity of illness at discharge (improvement during hospital stay), unchanged to extremely worse | 228 (13.2) | 381 (12.8) | 609 (12.9) |
Length of stay †
| 21 (42-9) * | 23 (45-10) * | 22 (44-10) |
Variables | LOS ≤ median (N = 1,629) | LOS > median (N = 1,591) | Total (N = 3,220) |
---|---|---|---|
Sociodemography | |||
Age (Median, IQR) | 40 (50-31) **** | 46 (60-34) **** | 43 (54-32) |
Sex, male | 909 (55.8) **** | 788 (49.5) **** | 1697 (52.7) |
Marital status, married | 288 (18.7) **** | 315 (21.1) **** | 603 (19.9) |
Employment status, employed | 449 (28.2) | 424 (27.6) | 873 (27.9) |
Living situation, own home | 1004 (71.6) | 954 (72.5) | 1958 (72.1) |
Clinical variables
| |||
Psychopathological syndromes | |||
Paranoid-hallucinatory syndrome > 0 (median), yes | 488 (30.0) **** | 613 (38.5) **** | 1101 (34.2) |
Depressive syndrome > 4 (median), yes | 678 (41.6) **** | 815 (51.2) **** | 1493 (46.4) |
Psycho-organic syndrome > 0 (median), yes | 418 (25.7) **** | 528 (33.2) **** | 946 (29.4) |
Manic syndrome > 0 (median), yes | 230 (14.1) | 412 (25.9) | 642 (19.9) |
Hostility syndrome > 2 (median), yes | 202 (12.4) | 122 (7.7) | 324 (10.1) |
Vegetative syndrome > 0 (median), yes | 341 (20.9) **** | 420 (26.4) **** | 761 (23.6) |
Apathy > 3 (median), yes | 653 (40.1) **** | 846 (53.2) **** | 1499 (46.6) |
Compulsory syndrome > 0 (median), yes | 74 (4.5)* | 101 (6.3)* | 175 (5.4) |
Neurological syndrome > 0 (median), yes | 106 (6.5) *** | 153 (9.6) *** | 259 (8.0) |
Substance disorder (ICD-10, F1), yes | 602 (36.9) **** | 303 (19.0) **** | 905 (28.1) |
Personality disorder (ICD-10, F6), yes | 214 (13.1) **** | 121 (7.6) **** | 335 (10.4) |
Severity of illness at admission, markedly-extremely ill | 984 (62.5) **** | 1192 (78.5) **** | 2176 (70.4) |
Psychosocial Functioning (Median, IQR) | 49 (60-35) **** | 44 (55-30)**** | 45 (56-33) |
Severity of illness at discharge (improvement during hospital stay), unchanged to extremely worse | 283 (18.2) **** | 98 (6.9) **** | 381 (12.8) |
Admission-specific variables
| |||
Type of referral, self | 456 (30.2) **** | 311 (22.8) **** | 767 (26.7) |
Insurance type, public | 1571 (96.4) **** | 1483 (93.2) **** | 3054 (94.8) |
Compulsory admission, yes | 554 (34.0) | 505 (31.7) | 1059 (32.9) |
Previous admission, yes | 457(28.1) ** | 374 (23.5) ** | 831 (25.8) |
Treatment variables
| |||
Compulsory medication, yes | 65 (4.1) **** | 110 (7.6) **** | 175 (5.8) |
Social seclusion, yes | 70 (4.4) **** | 111 (7.7) **** | 181 (6.0) |
Other compulsory interventions, yes | 62 (3.9) **** | 97 (6.7) **** | 159 (5.3) |
Crisis intervention, yes | 842 (53.7) **** | 293 (20.5) **** | 1135 (37.9) |
Psychotherapy, yes | 64 (4.1) **** | 167 (11.7) **** | 231 (7.7) |
Integrated treatment, yes | 213 (13.6) **** | 278 (19.5) **** | 491 (16.4) |
Advisory service | 27 (1.7) | 25 (1.8) | 52 (1.6) |
Results
Demographic characteristics
Comparison with respect to LOS
Predictors of the length of stay
Linear regression models | Logistic regression models †
| |||||||
---|---|---|---|---|---|---|---|---|
r ** | EXP (B)+
| EXP (95% CI)+
| Corr. R2
| rφ **
| EXP (B) | EXP (95% CI) | Nagelkerke R2
| |
Syndrome scores
|
Model 1
|
Model 2
| ||||||
Intercept | 16.22 | 15.29-17.09 | 0.564 | |||||
Apathy | 0.211 | 1.04 | 1.04-1.06 | 0.040 | 0.131 | 1.39 | 1.19-1.62 | 0.023 |
Paranoid-hallucinatory syndrome | 0.112 | 1.02 | 1.01-1.03 | 0.047 | 0.090 | 1.41 | 1.20-1.63 | 0.031 |
Psycho-organic syndrome | 0.108 | 1.02 | 1.01-1.03 | 0.050 | 0.090 | 1.33 | 1.15-1.54 | 0.036 |
Depressive syndrome | 0.096 | 1.36 | 1.16-1.59 | 0.042 | ||||
Neurological syndrome | 0.057 | 1.34 | 1.03-1.75 | 0.044 | ||||
Symptoms
|
Model 3
|
Model 4
| ||||||
Intercept | 17.88 | 17.13-18.67 | 0.76 | |||||
Social withdrawal (apathy) | 0.159 | 1.23 | 1.14-1.35 | 0.025 | 0.123 | 1.64 | 1.39-1.93 | 0.020 |
Memory disturbance (short-term) (psycho-organic syndrome) | 0.104 | 1.43 | 1.10-1.86 | 0.033 | ||||
Morning depressiveness (depressive syndrome) | 0.130 | 1.57 | 1.33-1.85 | 0.036 | 0.110 | 2.71 | 1.82-3.98 | 0.044 |
Memory disturbance (long-term) (psycho-organic syndrome) | 0.103 | 1.51 | 1.11-2.03 | 0.047 | ||||
Disturbance of vitality (depressive syndrome) | 0.101 | 1.16 | 1.06-1.27 | 0.043 | ||||
Cognitive inhibition (apathy) | 0.128 | 1.25 | 1.09-1.45 | 0.047 | ||||
Anxious (other) | 0.106 | 1.14 | 1.05-1.24 | 0.049 | ||||
Lethargy (apathy) | 0.106 | 1.13 | 1.03-1.25 | 0.051 |
Linear regression models | Logistic regression models †
| |||||
---|---|---|---|---|---|---|
EXP (B) * | EXP (95% CI) * | Corr. R2
| EXP (B) | EXP (95% CI) | Nagelkerke R2
| |
Syndrome scores & further characteristics
|
Model 5
|
Model 6
| ||||
Intercept | 21.08 | 18.33-24.23 | 0.925 | |||
Crisis intervention, yes | 0.53 | 0.49-0.56 | 0.158 | 0.29 | 0.24-0.34 | 0.152 |
Apathy | 1.03 | 1.02-1.04 | 0.182 | |||
Acute care, yes | 0.73 | 0.67-0.78 | 0.202 | 0.47 | 0.39-0.58 | 0.176 |
Substance disorder, yes | 0.78 | 0.72-0.83 | 0.219 | 0.53 | 0.44-0.64 | 0.203 |
Severity of illness, moderate to severe | 1.27 | 1.19-1.37 | 0.233 | 1.72 | 1.43-2.06 | 0.221 |
Age | 1.01 | 1.00-1.01 | 0.238 | 1.01 | 1.01-1.02 | 0.232 |
Psychotherapy, yes | 1.27 | 1.12-1.43 | 0.241 | 1.83 | 1.32-2.53 | 0.237 |
Depressive syndrome | 1.30 | 1.10-1.54 | 0.240 | |||
Compulsory medication, yes | 1.33 | 1.16-1.53 | 0.244 | 1.64 | 1.15-2.33 | 0.243 |
Compulsory admission, yes | 0.91 | 0.85-0.99 | 0.246 | |||
Personality disorder | 0.72 | 0.55-0.95 | 0.245 | |||
Symptoms & further characteristics
|
Model 7
|
Model 8
| ||||
Intercept | 21.18 | 18.42-24.37 | 0.879 | |||
Crisis intervention, yes | 0.52 | 0.49-0.56 | 0.158 | 0.29 | 0.24-0.34 | 0.152 |
Acute care, yes | 0.73 | 0.68-0.79 | 0.181 | 0.48 | 0.39-0.58 | 0.176 |
Substance disorder, yes | 0.78 | 0.73-0.84 | 0.202 | 0.54 | 0.45-0.65 | 0.203 |
Severity of illness, moderate to severe | 1.27 | 1.18-1.36 | 0.221 | 1.68 | 1.40-2.02 | 0.221 |
Social withdrawal (apathy), moderate to severe | 1.17 | 1.08-1.26 | 0.232 | |||
Age | 1.00 | 1.00-1.01 | 0.237 | 1.02 | 1.01-1.02 | 0.232 |
Social withdrawal (apathy), moderate to severe | 1.46 | 1.21-1.77 | 0.239 | |||
Disturbance of vitality (depressive syndrome), moderate to severe | 1.13 | 1.04-1.23 | 0.241 | |||
Psychotherapy, yes | 1.25 | 1.22-1.41 | 0.244 | 1.85 | 1.34-2.55 | 0.244 |
Compulsory medication, yes | 1.31 | 1.13-1.49 | 0.247 | |||
Ruminating (depressive syndrome), moderate to severe | 1.11 | 1.02-1.21 | 0.249 | |||
Morning depressiveness (depressive syndrome), moderate to severe | 1.21 | 1.03-1.42 | 0.250 | 1.83 | 1.17-2.86 | 0.247 |
Compulsory medication, yes | 1.60 | 1.13-2.28 | 0.249 | |||
Lethargy (apathy), moderate to severe | 1.09 | 1.01-1.21 | 0.251 | |||
Personality disorder, yes | 0.90 | 0.81-0.99 | 0.252 | 0.75 | 0.57-0.99 | 0.251 |