A study of repeat visits to a psychiatric emergency room.

The authors examined the records of 3,824 patients making their first visit to a psychiatric emergency room of a teaching hospital. Data on the patients who made repeat visits (17.7 percent) were analyzed to determine variables that may correlate with repeating for follow-up periods of 90 and 360 days. Although no factors present in the initial visit allowed a useful level of prediction of repeat visits, psychiatric history, cognitive difficulties, and a diagnosis of more severe psychopathology were validated as correlates of repeating. Results suggested there were two subgroups of repeaters: those who repeated within 30 days and who were distinguished from nonrepeaters solely by their previous psychiatric contact, and those who repeated after 30 days and who appeared chronically ill and afflicted with profound psychological, social, and economic problems. Implications for the emergency room are discussed.