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Predicting aftercare in psychiatric emergencies.

Ronny Bruffaerts1, Marc Sabbe, Koen Demyttenaere

  • 1Dept. of Psychiatry, University Hospital Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium. ronny.bruffaerts@uz.kuleuven.ac.be

Social Psychiatry and Psychiatric Epidemiology
|September 21, 2005
PubMed
Summary

Psychiatric emergency room visits result in varied aftercare dispositions, including admission, outpatient care, crisis intervention, or refusal. Patient characteristics significantly predict these outcomes, highlighting the need for tailored follow-up strategies.

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Area of Science:

  • Psychiatry
  • Emergency Medicine
  • Health Services Research

Background:

  • Traditional psychiatric emergency care often limits aftercare options to admission or non-admission.
  • The predictive factors influencing a broader range of aftercare dispositions following psychiatric emergency room (PER) visits remain underexplored.

Purpose of the Study:

  • To describe and predict various aftercare dispositions after psychiatric emergency referrals.
  • To investigate the influence of sociodemographic and clinical characteristics on aftercare outcomes.

Main Methods:

  • Observational study of 3,719 patients referred from a university hospital's psychiatric emergency room (March 2000-March 2002).
  • Data collection included sociodemographic and clinical characteristics, and health service utilization.

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  • Aftercare dispositions analyzed: admission, onsite crisis intervention program (CIP), refusal of aftercare, and outpatient aftercare.

    • Main Results:

    • Forty-four percent of patients were admitted, 38% received outpatient aftercare, 9% refused any aftercare, and the remainder were referred to the CIP.
    • Psychotic patients (ORs 5.98-6.52), suicidal patients (OR=2.25), and those utilizing outpatient services (OR=1.43) were more likely to be admitted.
    • Younger patients (OR=3.36) and those with anxiety disorders (OR=2.03) were more likely to be referred to outpatient care, while personality disorder patients (OR=1.81) were at higher risk of refusal.

    Conclusions:

    • Despite the availability of a short-term crisis intervention program (CIP), most patients were admitted after psychiatric emergency room referral.
    • The CIP may have reduced the number of patients refusing all aftercare.
    • Further research is required to better understand and predict aftercare dispositions in psychiatric emergencies.