Changing patient perspectives after compulsory admission and the risk of re-admission during 5 years of follow-up: The Amsterdam Study of Acute Psychiatry IX.

OBJECTIVE

Given increasing numbers of compulsory admissions, it is important to assess patient risk profiles and identify factors that are appropriate for intervention.

METHODS

A sample of 116 patients who were compulsorily admitted was studied. Socio-demographic and clinical characteristics were recorded. Patients were interviewed twice using the Verona Service Satisfaction Scale and the Birchwood Insight Scale. Changes in insight and satisfaction during 2 years were linked to the incidence of involuntary re-admissions in the next three follow-up years.

RESULTS

A higher mean score for patient satisfaction was found (mean=3.77, standard deviation (SD)=0.56; p⩽.001) in the second interview than in the baseline interview (mean=3.26, SD=0.65). There was also an improvement in insight (in the second interview: mean=7.22, SD=2.86 and in the baseline interview: mean=6.34, SD=3.18; p=.027). There was an inverse correlation between increasing satisfaction (in years 1-2) and the incidence of involuntary admission in years 3-5 (odds ratio (OR)=0.445, 95% confidence interval (CI)=0.252-0.793; p=.006). This association proved to be dependent on a history of involuntary admission.

CONCLUSION

Increasing patient satisfaction in the first 2 years was associated with a lower risk of compulsory re-admission in the subsequent follow-up period, but this association proved to be dependent on a history of involuntary admissions in these first two follow-up years. Increase in insight during the same period did not show any effect whatsoever.