The Ohio State University College of Medicine, 370 West 9th Avenue, Columbus, OH 43210, United States.
The Ohio State University College of Medicine, 370 West 9th Avenue, Columbus, OH 43210, United States; Division of Epidemiology, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210, United States.
Gen Hosp Psychiatry. 2020 Jul-Aug;65:33-42. doi: 10.1016/j.genhosppsych.2020.05.004. Epub 2020 May 15.
A systematic review of research assessing factors associated with inpatient psychiatric readmission of children and adolescents.
In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we searched 8 databases (1994-2018) to identify relevant articles on factors associated with youth psychiatric readmission. Selected articles addressed one or more factors associated with psychiatric readmission for children and adolescents (≤21 years of age) admitted to a psychiatric hospital in the United States for a primary mental health diagnosis. Two authors independently reviewed article abstracts, titles, and text.
Of 7903 retrieved articles, 30 studies met inclusion criteria. Analyzed variables were categorized according to child demographic and clinical characteristics; family, provider, and community characteristics; and treatment and aftercare characteristics. Available studies were markedly heterogeneous in methodology and outcomes. Factors associated with an increased risk of readmission included greater symptom severity, clinical diagnoses such as psychosis and affective disorders, suicidal behavior and self-injury, poor family functioning, and longer lengths of index hospital stay.
Controlled trials of interventions to improve care and reduce recidivism for psychiatrically hospitalized youth are needed. Future research will benefit from a guiding theoretical framework, more representative samples, and standardized exposure/outcome measures.
系统评价评估儿童和青少年住院精神科再入院相关因素的研究。
根据系统评价和荟萃分析的首选报告项目（PRISMA），我们搜索了 8 个数据库（1994-2018 年），以确定与美国精神病院因主要心理健康诊断而住院的青年精神科再入院相关因素的相关文章。选定的文章探讨了与儿童和青少年（≤21 岁）精神科再入院相关的一个或多个因素。两名作者独立审查了文章摘要、标题和文本。
在检索到的 7903 篇文章中，有 30 篇符合纳入标准。分析的变量根据儿童人口统计学和临床特征、家庭、提供者和社区特征以及治疗和康复后护理特征进行分类。现有研究在方法和结果上存在明显的异质性。与再入院风险增加相关的因素包括症状严重程度增加、精神病和情感障碍等临床诊断、自杀行为和自残、家庭功能不良以及指数住院时间延长。
需要对改善精神科住院青少年护理和减少复发性疾病的干预措施进行对照试验。未来的研究将受益于指导理论框架、更具代表性的样本和标准化的暴露/结果衡量标准。
