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Articles   |    
Predictors of Hospitalization Two Years After Treatment for First-Episode Psychosis
Mark A. Turner, Ph.D.; Joseph M. Boden, Ph.D.; Roger T. Mulder, M.B., Ph.D.
Psychiatric Services 2013; doi: 10.1176/appi.ps.201200388
View Author and Article Information

Dr. Turner is with Statistics New Zealand, Christchurch, New Zealand. Dr. Boden and Dr. Mulder are with the Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, University of Otago, P.O. Box 4345, Christchurch 8140 New Zealand (e-mail: joseph.boden@otago.ac.nz).

Copyright © 2013 by the American Psychiatric Association

Abstract

Objective  This study examined the predictors of inpatient hospital admission after early intervention for psychosis services (EIPS) treatment. Specifically, the study examined the sociodemographic and clinical factors that were associated with hospital admissions in the two years after discharge from EIPS.

Methods  The characteristics of 231 patients enrolled in an EIPS program in Christchurch, New Zealand, between 2000 and 2005 were examined. Information about post-EIPS hospital admissions was obtained from the New Zealand Health Information Service. Poisson regression models were used to estimate bivariate and multivariate associations between number of post-EIPS hospital admissions and a range of predictors, including hospitalization history.

Results  A majority of patients (78%) were hospitalized before or during EIPS treatment, and 29% were hospitalized after the program. Older age, Māori ethnicity, a domestic partnership at referral, lower Global Assessment of Functioning scores, and hospitalization before and during treatment were significant predictors of the number of post-EIPS hospitalizations.

Conclusions  The results of the study suggest that the number of hospital admissions after participation in the EIPS program may be reduced by addressing issues related to the cultural appropriateness of treatment, engagement with partners and families, and overall adjustment and functioning and by efforts to limit hospitalization before and during EIPS treatment.

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Table 1Associations between patient characteristics and other factors and number of hospital admissions two years after treatment for first-episode psychosis
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a Wald chi square test of linear association from Poisson regression

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b Possible scores range from 0 to 4, with higher scores indicating greater engagement with program.

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c GAF, Global Assessment of Functioning. Possible scores range from 0 to 100, with higher scores indicating a greater level of functioning.

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d HoNOS, Health of the Nation Outcome Scales. Possible scores range from 0 to 60, with higher scores indicating a lower level of functioning.

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e Measured by the Schedule for the Assessment of Insight. Possible scores range from 0 to 14, with higher scores indicating greater insight.

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f PANSS, Positive and Negative Syndrome Scale. Possible scores range from 7 to 49, with higher scores indicating greater levels of positive symptoms.

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g QLS, Quality of Life Scale. Possible scores range from 0 to 126, with higher scores indicating greater quality of life.

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Table 2Multivariate model of predictors of the total number of hospital admissions among patients treated for first-episode psychosis
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a Wald chi square

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b EIPS, early intervention for psychosis services

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c GAF, Global Assessment of Functioning

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d PANSS, Positive and Negative Syndrome Scale

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