Multnomah Community Ability Scale (MCAS), a measure assessing community functioning and independence of daily living. We created 3 categories for ...
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5 or more Previous Hospitalizations (n = 276)
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• Our findings are consistent with the view that demographic factors are closely related to number of hospitalizations. • Demographic factors, including social and community functioning, residence, education, and employment, are significantly associated with number of previous hospitalizations. • Clinical factors, such as the presence of hallucinations, delusions, and disorganization, do not appear to be associated with recurrent hospitalizations. • The association between both age and duration of illness and number of hospitalizations was expected. • There is a significant association between diagnosis and number of hospitalizations, which is consistent with the more severe disease course in SZ. • When age, age of onset , duration of illness, and MCAS scores were each entered into ANOVA as continuous variables, the results were consistent with the findings from chi-square testing with categorical variables. We plan to conduct additional analyses on these data using multiple regression approaches in the future. • This study underscores the need for higher levels of community support and increasing employment and education opportunities for patients in order to minimize recurrent hospitalizations and to reduce the financial and emotional burden of patients and their caregivers.
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FINDINGS/DISCLOSURES
This study was funded by the Frazier Research Institute at McLean Hospital
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Mean Age of Onset (SD) Mean Duration (yrs) of Illness (SD) MCAS Total Lifetime Hallucinations % Lifetime Delusions % Lifetime Disorganization % Lifetime Negative Symptoms %
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Clinical Factors Are Less Associated With Number Of Hospitalizations 140
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Mean Age (SD)
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Chi-Square Results
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Lifetime Diagnosis % (BD/SZ/SZA/PNOS)
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1-4 Previous Hospitalizations (n = 166)
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No Previous Hospitalizations (n = 150)
Demographic and Clinical Variables
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Demographics of sample
Demographic Factors Are More Associated With Number Of Hospitalizations
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We enrolled a total of 592 participants with diagnoses of BD (n=280), SZ (n=141), SZA (n=145), and PNOS (n=26) from inpatient and outpatient settings. Patients were excluded if they were under the age of 18 or over the age of 89, if their symptoms were due to a general medical condition, or if they had experienced substantial head trauma prior to the onset of their psychiatric symptoms. Participants were excluded if unable to provide informed consent. Trained research staff assessed participants using the SCID as well as the Multnomah Community Ability Scale (MCAS), a measure assessing community functioning and independence of daily living. We created 3 categories for number of hospitalizations by grouping together those with no previous hospitalizations, those with 1-4 hospitalizations, and those with 5 or more hospitalizations. We converted the dependent variables that were continuous (age, duration of illness, age of onset, and MCAS total) into categorical variables by creating bins. This enabled us to perform chi-square analyses to measure the associations between specific variables and number of hospitalizations. The lifetime prevalence of hallucinations, delusions, and other psychotic symptoms, was assessed using the SCID.
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Chi-Square Results
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MATERIALS AND METHODS
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RESULTS
• Recurrent psychiatric hospitalizations are common among people with psychosis. • Hospitalizations are costly and have a major impact on patients and caregivers. • The number of hospitalizations per person may be associated with both clinical and demographic factors. • Factors associated with recurrent hospitalizations are not easily understood.
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McLean Hospital, Belmont, MA and Harvard Medical School, Boston, MA
Background: Psychiatric hospitalizations are common among people with psychotic disorders. Recurrent hospitalizations can reduce an individual’s sense of competence and social skills and disrupt his or her career and interpersonal relationships. Recurrent hospitalizations also add to family and caregiver stress, and the high cost of numerous hospitalizations can burden the healthcare system as a whole. This analysis investigates the association between clinical and demographic features of patients with psychotic disorders and number of previous hospitalizations. Methods: We analyzed data from 592 patients with bipolar I disorder (BD; n=280), schizophrenia (SZ; n=141), schizoaffective disorder (SZA; n=145), and psychosis not otherwise specified (PNOS; n=26). Participants underwent comprehensive clinical interviews using the Structured Clinical Interview for DSM-IV (SCID-IV) and provided additional diagnostic and demographic information. Results: Demographic variables such as type of residence (χ2(N=592)=31.50, p
