Predictors of psychiatric re-hospitalization in older adults with severe mental illness.

Ching Yu, Jean-Daniel Sylvestre, Marilyn Segal, Karl J Looper, Soham Rej
Author Information
  1. Ching Yu: Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, McGill University, Montreal, Canada.
  2. Jean-Daniel Sylvestre: Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, McGill University, Montreal, Canada.
  3. Marilyn Segal: Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, McGill University, Montreal, Canada.
  4. Karl J Looper: Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, McGill University, Montreal, Canada.
  5. Soham Rej: Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, McGill University, Montreal, Canada.

Abstract

OBJECTIVE: Many patients with severe recurrent mental illness are approaching late life; however, little is known about psychiatric re-hospitalization in this population. Our objective was to identify predictors of psychiatric re-hospitalization.
METHODS: This was a retrospective cohort study of all 226 geriatric patients (age ≥65 years) admitted to a tertiary care Canadian inpatient psychiatric unit between 2003 and 2008. The main outcome was psychiatric re-hospitalization in 5-year follow-up post-discharge (e.g. 2008-2013 if a patient had been first admitted in 2008). Multivariate Cox regression analyses were used to identify potential predictors of re-hospitalization.
RESULTS: Over 5-year follow-up, 32.3% (73/226) required psychiatric re-hospitalization. Prior lifetime history of psychiatric admission, currently living in a supervised setting and bipolar disorder diagnosis all independently predicted a lower time to psychiatric re-hospitalization (HRs > 2.0, p < 0.05).
CONCLUSIONS: The rate of psychiatric re-hospitalization is high in older adults admitted for severe mental illness. Clinicians should be aware of the especially high rates of re-hospitalization in geriatric psychiatric inpatients with bipolar disorder, previous psychiatric admissions, or those living in a supervised setting. Future research could investigate approaches to prevent psychiatric re-hospitalization in these vulnerable sub-populations.

Keywords

MeSH Term

Age Factors
Aged
Aged, 80 and over
Canada
Comorbidity
Female
Hospitalization
Humans
Length of Stay
Male
Mental Disorders
Mental Health Services
Middle Aged
Patient Readmission
Regression Analysis
Retrospective Studies
Risk Factors

Word Cloud

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