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Erschienen in:
01.07.2008 | ORIGINAL ARTICLE
The determinants and outcomes of long-stay psychiatric admissions
A case–control study
Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 7/2008
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Background
Acute psychiatric admissions lasting over 6 months (long-stays) continue to occur in England. Previous studies have suggested an association between long-stay and both schizophrenia and challenging behaviour, as well as rehousing or placement difficulties, but no UK study to date has compared such cases with control admissions.
Methods
We performed a case–control study. All long-stay patients present on acute general psychiatric wards serving the London Boroughs of Croydon, Lambeth, Lewisham and Southwark on November 1st 2004 were compared with a group of ‘next admitted’ controls. We followed up long-stay cases 1 year later to determine whether they were still in hospital, and, if not, where they were living.
Results
In unadjusted comparisons long stay was associated with schizophrenia, non-white ethnicity, admission not due to suicidality, violence, severe illness and need for rehousing. A logistic regression was used to adjust for associations among exposures and only violence, severity of illness and need for rehousing remained associated with long-stay. After 1 year, two-thirds of cases were living out of hospital.
Conclusions
Case–control studies may usefully contribute to the study of the complex social phenomenon of long-stay. Further research should address how the combination of individual and socially-determined effects that we found operate together over the course of admission to generate long-stays.