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- Title
Is psychiatric residential facility discharge possible and predictable? A multivariate analytical approach applied to a prospective study in Italy.
- Authors
Girolamo, G.; Candini, V.; Buizza, C.; Ferrari, C.; Boero, M.; Giobbio, G.; Goldschmidt, N.; Greppo, S.; Iozzino, L.; Maggi, P.; Melegari, A.; Pasqualetti, P.; Rossi, G.
- Abstract
Background: A growing number of severely ill patients require long-term care in non-hospital residential facilities (RFs). Despite the magnitude of this development, longitudinal studies surveying fairly large resident samples and yielding important information on this population have been very few. Aims: The aims of the study were (1) to describe the socio-demographic, clinical, and treatment-related characteristics of RF patients during an index period in 2010; (2) to identify predictors and characteristics associated with discharge at the 1-year follow-up; (3) to evaluate clinicians' predictions about each patient's likelihood of home discharge (HD). Methods: A prospective observational cohort study was conducted involving all patients staying in 23 medium-long-term RFs of the St John of God Order with a primary psychiatric diagnosis. A comprehensive set of socio-demographic, clinical, and treatment-related information was gathered and standardized assessments (BPRS, HONOS, PSP, PHI, SLOF, RBANS) were administered to each participant. Logistic regression analyses were run to identify independent discharge predictors. Results: The study involved 403 patients (66.7 % male), with a mean age of 49 years (SD = 10). The participants' average illness duration was 23 years; median value for length of stay in the RF was 2.2 years. The most frequent diagnosis was schizophrenia (67.5 %). 104 (25.8 %) were discharged: 13.6 % to home, 8.2 % to other RFs, 2.2 % to supported housing, and 1.5 % to prison. Clinicians' predictions about HD were generally erroneous. Conclusions: Very few patients were discharged to independent accommodations after 1 year. The main variables associated with a higher HD likelihood were: illness duration of <15 years and effective social support during the previous year. Lower severity of psychopathology and higher working skill levels were also associated with a significantly greater HD likelihood.
- Subjects
PEOPLE with mental illness; CARE of people; COMMITMENT &; detention of people with mental illness; MENTAL health services; MENTAL health facilities; LONG-term care facilities; PSYCHIATRIC diagnosis
- Publication
Social Psychiatry & Psychiatric Epidemiology, 2014, Vol 49, Issue 1, p157
- ISSN
0933-7954
- Publication type
Article
- DOI
10.1007/s00127-013-0705-z