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检查人格障碍患者精神科急诊再入院因素:一项 6 年回顾性研究。

Examining readmission factors in psychiatric emergency care for individuals with personality disorders: A 6-year retrospective study.

机构信息

Faculty of Psychology and Educational Sciences, University of Geneva.

Department of Psychiatry, Edouard Herriot Hospital.

出版信息

Personal Disord. 2023 May;14(3):321-333. doi: 10.1037/per0000616. Epub 2023 Feb 9.

Abstract

People with personality disorders (PDs) are often admitted to psychiatric emergency services due to the frequent repetition of acute crises. This study drew on the ICD diagnostic records of 2,634 individuals with PDs who were admitted to a specialized inpatient psychiatric crisis unit over a 6-year period. Multiple logistic regressions and survival regressions were performed to examine whether PD categories, gender, and other individual, interpersonal, and precipitating factors were associated with readmission and time-to-readmission. The results showed a 16.1% readmission rate. Of these, 99.5% of readmissions occurred within 4 years following the first admission. Gender was the main factor associated with both readmission and time-to-readmission: while men were readmitted faster, more women in total were readmitted for a second psychiatric emergency hospitalization. Findings also indicated that readmission rate and time-to-readmission differed following the category of PD: readmission rate in a ratio of 1-2 (from 8% to 10% for dissocial and paranoid PD up to 19%-21% for impulsive and borderline PD), and time-to-readmission in a ratio of 1-5 (from 1 month for anankastic and dependent, to 5 months for impulsive, histrionic and anxious-avoidant PD). Limitations of this naturalistic study include a lack of self-reported measures and generalizability to less specialized emergency settings. Future research should include a prospective longitudinal design using standardized scalable measurement tools to improve the completeness and accuracy of the data concerning the psychological processes involved in risk and time-to-readmission after brief hospitalizations in emergency psychiatry. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

摘要

人格障碍患者 (PD) 常因急性危机频繁发作而被收入精神科急诊。本研究利用 ICD 诊断记录,对 6 年内 2634 名 PD 患者在专门的住院精神科危机病房接受治疗的情况进行了分析。采用多项逻辑回归和生存回归分析,考察 PD 类别、性别和其他个体、人际和诱发因素与再入院和再入院时间的关系。结果显示,再入院率为 16.1%。其中,99.5%的再入院发生在首次入院后 4 年内。性别是与再入院和再入院时间相关的主要因素:男性再入院更快,但总体上有更多女性因第二次精神科急诊住院而再次入院。研究结果还表明,PD 类别与再入院率和再入院时间有关:PD 再入院率比为 1-2(从社交和偏执 PD 的 8%-10%到冲动和边缘 PD 的 19%-21%),再入院时间比为 1-5(从依赖型和强迫型的 1 个月到冲动型、表演型和焦虑回避型 PD 的 5 个月)。本自然研究的局限性包括缺乏自我报告的测量方法和对非专门急诊环境的普遍性。未来的研究应采用前瞻性纵向设计,使用标准化可扩展的测量工具,以提高涉及在急诊精神病学中短暂住院后风险和再入院时间的心理过程的完整度和准确性。(APA,2023 版权所有)。

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