Predictors of 30-day rehospitalization in a sample of hospitalized patients with Bipolar I disorder.

The transition from psychiatric hospitalization to home is marked by high clinical vulnerability, characterized by risk of symptom rebound, exposure to preexisting stressors, and challenges with outpatient treatment linkage. Rates of rehospitalization during this post-discharge period, particularly for those with bipolar disorder, are reported to be high. This study evaluated demographic and clinical predictors of early rehospitalization (within 30 days) in a sample of hospitalized adults with Bipolar I disorder (BD-I). A chart review was conducted for 215 patients with BD-I admitted to an academically-affiliated psychiatric hospital within one calendar year. A computer algorithm was used to extract relevant demographic, clinical, and treatment information. Univariate and multivariate logistic regression models were used to examine predictors of early rehospitalization. Overall, 12% of participants were readmitted within 30 days of discharge. Controlling for other clinical and demographic variables, patient functioning and pre-admission psychiatric polypharmacy, but not comorbid psychiatric diagnoses, predicted early readmission in patients with BD-I. Findings highlight the relative importance of considering low psychosocial functioning, and medication regimens containing multiple psychiatric medications, during hospitalizations. These features may indicate a subset of patients with BD-I who require more comprehensive discharge planning and support to transition to the community following a psychiatric hospitalization.