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Frequent visits to a French psychiatric emergency service: diagnostic variability in psychotic disorders
Laurent Boyer1, Daniel Dassa, Raoul Belzeaux
1Department of Public Health, La Timone University Hospital, Assistance Publique-Hôpitaux de Marseille, 13 385 Marseille, France. laurent.boyer@ap-hm.fr
Objective:
This study examined characteristics of frequent visitors to a psychiatric emergency service in a French public teaching hospital over six years. Diagnostic variability of psychotic disorders was documented.
Methods:
A retrospective review of the service's administrative and medical databases identified 1,285 patients with more than one visit during the period who were given at least one diagnosis of a psychotic disorder. A total of 317 patients with six or more visits (frequent visitors) were compared with 968 patients with between two and five visits (occasional visitors).
Results:
Frequent visitors were significantly more likely to be single and homeless and to have diagnostic variability, substance use disorders, and personality disorders. A total of 177 patients experienced diagnostic variability, which was found mainly in three diagnostic categories: schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features.
Conclusions:
Future studies should further examine the link between increased use of emergency services and diagnostic variability.
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