Patients discharged against medical advice from a lock-and-key psychiatric institution

Over half of patients discharged a.m.a. from the psychiatric department of the Neuro-Psychiatric clinic in Sarajevo leave within the first two weeks of hospitalization. Over the same period only 8% of patients leave the department w.m.a. On the average patients discharged a.m.a. belong to the age group younger than patients discharged w.m.a. This difference is less marked when a correction is made by diagnostic groups. In a significantly greater number of cases patients discharged a.m.a. are of a higher educational level than patients discharged w.m.a. (p less than .0001). 2. In patients discharged a.m.a. personality disturbances and tentamen suicidii are diagnosed in significantly greater number of cases (p less than .0001 and p less than .0001) than in the patients discharged w.m.a. A comparison of patients in the experimental group (a.m.a.) with patients in the control group (w.m.a.) from the aspect of factors stimulating or initiating discharges a.m.a. has shown that for patients leaving a.m.a. the situation of the closed psychiatric ward is more trying and that it causes in them a concealed or open revolt. 3. The declared motives of discharges a.m.a. have confirmed the above finding. 4. No difference has been established as to the number of readmissions and the adjustment level between patients discharged w.m.a. and those discharged a.m.a.