Predicting the "revolving door" phenomenon among patients with schizophrenic, schizoaffective, and affective disorders.
Predicting the "revolving door" phenomenon among patients with schizophrenic, schizoaffective, and affective disorders.
复制标题
预测精神分裂症、情感分裂和情感障碍患者的“旋转门”现象。
DOI：
10.1176/ajp.152.6.856
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Lewis,DA
中科院分区：
文献类型：
--
作者：
Haywood,TW;Kravitz,HM;Grossman,LS;CavanaughJr,JL;Davis,JM;Lewis,DA
目的慢性精神病患者的一个亚群，有时被称为“旋转门”患者，经常被重新送入精神病室。本研究探讨了4所公立医院住院患者的人口学特征、诊断特征和住院次数之间的关系。方法对135例符合精神分裂症、分裂性情感障碍、单相抑郁障碍和双相情感障碍研究诊断标准的住院患者进行问卷调查。犯罪历史通过逮捕记录进行评估。结果卡方检验和趋势检验表明，药物滥用和药物不依从性与较高的住院次数显著相关。多元回归模型包括酒精/药物问题、用药不依从性和六个社会人口学和诊断变量(年龄、性别、种族、婚姻状况、受教育年限和诊断)，在预测住院频率的能力中占有相当大的比例。这种可预测性的一半是由于药物滥用和用药不依从性与住院次数的关系。结论酒精/药物问题和不依从性是影响住院次数的最重要因素。通过患者教育预防这些行为可能会降低再住院率。
ObjectiveA subpopulation of chronically mentally ill patients, sometimes referred to as" revolving door" patients, are frequently readmitted to psychiatric units. This study examined the relationships among demographic features, diagnostic characteristics, and frequency of hospitalization of patients from four state hospitals.MethodTwo semistructured, standardized instruments, the Schedule for Affective Disorders and Schizophrenia and a life events history, were administered to 135 inpatients who met the Research Diagnostic Criteria for schizophrenia (N= 56), schizoaffective disorder (N= 33), unipolar major depressive disorder (N= 23), and bipolar disorder (N= 23). Criminal history was assessed by arrest records. The main outcome measure was the number of hospitalizations.ResultsChi-square and trend test analyses indicated that substance abuse and noncompliance with medication regimens were significantly associated with higher frequencies of hospitalization. A multiple regression model, which included alcohol/drug problems, medication noncompliance, and six sociodemographic and diagnostic variables (age, gender, race, marital status, years of education, and diagnosis) accounted for a significant proportion of the ability to predict frequency of hospitalization. Half of this predictability was due to the relationship of substance abuse and medication noncompliance with number of hospitalizations.ConclusionsAlcohol/drug problems and noncompliance with medication were the most important factors related to frequency of hospitalization. Preventing these behaviors through patient education may reduce rehospitalization rates.