Verma Dileep Kumar, Khanra Sourav, Goyal Nishant, Das Basudeb, Khess Christoday Raja Jayant, Munda Sanjay Kumar, Ram Daya
Central Institute of Psychiatry, Ranchi, Jharkhand, India.
Indian J Psychol Med. 2020 Jul 20;42(5):456-463. doi: 10.1177/0253717620929182. eCollection 2020 Sep.
Absconding from psychiatric hospitals is of great concern for patients and caregivers. Absconding affects not only the treatment and safety of these patients but also patient's caregivers and the community. Further investigation is needed to examine the pattern of this event and the characteristics of patients who abscond. Hence, our study was aimed to examine the sociodemographic and clinical profiles of inpatients who absconded from a psychiatric hospital in five years and to compare them with matched controls.
A retrospective chart review of inpatients who absconded and matched control inpatients during the specified period of five years from January 2014 to December 2018 was done at a psychiatric hospital. Each control was matched with a corresponding absconding case on the following order: (a) admission ward, (b) admission period, (c) diagnosis, and (d) age. Results: Among 20,052 adult admissions during the specified period, 38 patients absconded, with a rate of 1.8 per 1,000 admissions. Most of them were male, from a younger age group, diagnosed with schizophrenia or mood disorder, and having comorbid substance use disorder, irritable affect, impaired judgment, and absent insight. Most of the events occurred within the first two weeks of admission. About 11% of them had a history of prior absconding from the hospital.
Knowledge about the associated sociodemographic and clinical profile would help clinicians and mental health care professionals to prevent absconding. Further risk assessment using a patient's profile would help to reduce absconding events from psychiatric hospitals in the future.
精神病院患者逃跑是患者及其照料者极为关注的问题。逃跑不仅影响这些患者的治疗与安全,还会波及患者的照料者及社区。需要进一步调查以审视这一事件的模式及逃跑患者的特征。因此,我们的研究旨在调查五年内从一家精神病院逃跑的住院患者的社会人口学和临床特征,并将其与匹配的对照组进行比较。
在一家精神病院对2014年1月至2018年12月这五年特定时间段内逃跑的住院患者及匹配的对照住院患者进行回顾性病历审查。每个对照组按照以下顺序与相应的逃跑病例进行匹配:(a)入院病房,(b)入院时间,(c)诊断,(d)年龄。结果:在特定时间段的20,052例成人入院患者中,有38例逃跑,逃跑率为每1000例入院患者中有1.8例。他们大多为男性,年龄较轻,被诊断为精神分裂症或心境障碍,且伴有物质使用障碍、易激惹情绪、判断力受损和自知力缺失。大多数逃跑事件发生在入院的前两周内。其中约11%有过从医院逃跑的历史。
了解相关的社会人口学和临床特征将有助于临床医生和精神卫生保健专业人员预防逃跑事件。利用患者特征进行进一步的风险评估将有助于未来减少精神病院的逃跑事件。