Factors Affecting Time to Rehospitalization for Chinese Patients with Bipolar I Disorder in Taiwan

Abstract

Objective: Bipolar disorder is a recurrent disorder for the vast majority of patients, and hospitalization is normally used to control severe symptoms. The goals of treating bipolar disorder include symptomatic remission, full return of psychosocial functioning, and prevention of relapses/recurrences. Rehospitalization, however, becomes necessary with the relapse/recurrence of severe symptoms. The purpose of the present study was therefore to investigate the risk factors affecting the time to rehospitalization. Method: Rehospitalization status was monitored for all patients with bipolar I disorder discharged from Kai-Suan Psychiatric Hospital between 1 January 2002 and 31 December 2004. Patients were followed up with respect to rehospitalization until 31 December 2005. The KaplanÁMeier method was used to calculate the mean time to rehospitalization within 1 year after discharge. Risk factors associated with rehospitalization were examined using Cox proportional hazards regression model. Results: Four hundred and twenty patients were recruited for the study. Two hundred and eleven patients (50.2%) were readmitted, and the mean time to rehospitalization was 231 days (SD 07). Bipolar depression at index hospitalization, age at onset, and the number of previous hospitalizations were found to be predictors for time to rehospitalization. Conclusion: Bipolar depression at index hospitalization, the earlier the onset of an affective episode, and a higher number of previous hospitalizations were associated with a shorter time to rehospitalization. Further studies in this field should test risk factors in a prospective study and be conducted in various mental health systems.

Factors Associated with Length of Stay and the Risk of Readmission in an Acute Psychiatric Inpatient Facility: A Retrospective Study

“…As recently reported for patients with bipolar I disorder [ 39 ], the number of previous admissions within the past 12 months predicted the risk of readmission. Therefore it will be useful to identify the characteristics of ‘frequent users’ of acute psychiatric inpatient services.…”

Identifying Some Risk Factors of Time to Recurrent Relapses in Bipolar I Disorder Patients using Frailty Model of Survival Analysis

“…There are some studies about relationship of factors and onset of BD but little is known about the factors that may precipitate relapse [10]. Few studies have assessed time to relapse, remission and recovery of patients, using Kaplan-Meier estimator or Cox regression, but most of them failed to account the repeated feature of relapses and correlation caused by recurrent events whit-in subjects [17][18][19][20][21][22][23]. In order to study time to relapses, with respect to repeated characteristic of bipolar disorder, we need recurrent event analyzing techniques of survival analysis.…”