检查人格障碍患者精神科急诊再入院因素:一项6年回顾性研究

Vincent Besch, Charline Magnin, Christian Greiner, Paco Prada, Martin Debbané, Emmanuel Poulet
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引用次数: 1

摘要

人格障碍(pd)的人往往是入院精神科急诊服务,由于频繁的急性危机的重复。这项研究利用了ICD诊断记录的2634名pd患者,他们在6年的时间里住进了一个专门的精神危机住院病房。采用多重逻辑回归和生存回归来检验PD类别、性别以及其他个体、人际和诱发因素是否与再入院和再入院时间相关。结果显示再入院率为16.1%。其中,99.5%的再入院发生在首次入院后的4年内。性别是与再入院和再入院时间相关的主要因素:虽然男性再入院更快,但总共有更多的女性再次入院接受第二次精神病紧急住院治疗。研究结果还表明,再入院率和再入院时间随PD类别的不同而不同:再入院率为1-2(反社会和偏执型PD为8% - 10%,冲动性和边缘性PD为19%-21%),再入院时间为1-5(神经质和依赖型PD为1个月,冲动性、戏剧性和焦虑回避型PD为5个月)。这项自然主义研究的局限性包括缺乏自我报告的措施,以及在不太专业的紧急情况下的普遍性。未来的研究应包括使用标准化可扩展测量工具的前瞻性纵向设计,以提高急诊精神病学短暂住院后涉及风险和再入院时间的心理过程数据的完整性和准确性。(PsycInfo数据库记录(c) 2023 APA,版权所有)。
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Examining readmission factors in psychiatric emergency care for individuals with personality disorders: A 6-year retrospective study.

People with personality disorders (PDs) are often admitted to psychiatric emergency services due to the frequent repetition of acute crises. This study drew on the ICD diagnostic records of 2,634 individuals with PDs who were admitted to a specialized inpatient psychiatric crisis unit over a 6-year period. Multiple logistic regressions and survival regressions were performed to examine whether PD categories, gender, and other individual, interpersonal, and precipitating factors were associated with readmission and time-to-readmission. The results showed a 16.1% readmission rate. Of these, 99.5% of readmissions occurred within 4 years following the first admission. Gender was the main factor associated with both readmission and time-to-readmission: while men were readmitted faster, more women in total were readmitted for a second psychiatric emergency hospitalization. Findings also indicated that readmission rate and time-to-readmission differed following the category of PD: readmission rate in a ratio of 1-2 (from 8% to 10% for dissocial and paranoid PD up to 19%-21% for impulsive and borderline PD), and time-to-readmission in a ratio of 1-5 (from 1 month for anankastic and dependent, to 5 months for impulsive, histrionic and anxious-avoidant PD). Limitations of this naturalistic study include a lack of self-reported measures and generalizability to less specialized emergency settings. Future research should include a prospective longitudinal design using standardized scalable measurement tools to improve the completeness and accuracy of the data concerning the psychological processes involved in risk and time-to-readmission after brief hospitalizations in emergency psychiatry. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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