Gender Specific Characteristics of Revolving Door Adolescents in Acute Psychiatric Inpatient Care

Abstract

This study examined the impact of clinical and family related factors on adolescent revolving door (RD) phenomenon, defined as having three or more psychiatric hospitalizations before the age of 18. A clinical sample of adolescents (N = 508) aged 13-17 years, admitted to psychiatric inpatient care between April 2001 through March 2006, were interviewed using the k-SADS-PL and the EuropASI instruments. The national Finnish Care Register for Health Care provided life-time data on child and adolescent psychiatric inpatient hospitalizations. RD boys were shown to be significantly more likely than non-RD boys to be admitted to psychiatric inpatient care from child welfare placements and have previous self-mutilative behavior (SMB) and suicide attempts. RD girls were more likely to come from child welfare placements, have unemployed mothers and a history of SMB. Mortality in RD boys was significantly higher compared to non-RD boys. Frequent use of psychiatric inpatient care warrants comprehensive assessment of suicidal behavior in adolescents.

Demographic & clinical correlates of admission into a specialized psychiatric inpatient service for children and adolescents in Egypt: An observational retrospective study

“…This duration is similar to that reported in Spain between 1990 and 2000 (Case et al, 2007). Given that the major portion of the improvement was suggested to occur during the first 3 weeks of admission (Swadi & Bobier, 2005), the "ultrashort" period of hospitalization which became a trend in the United States in the last decade (Case et al, 2007) was criticized as it might interfere with the long-term recovery process and increase rates of short term readmission in the so called "revolving door phenomenon" (Glick et al, 2011;Simila et al, 2018). Better outcomes were independently predicted by longer length of stay in the inpatient setting (Green et al, 2007).…”

Changes in Revolving-Door Mental Health Hospitalizations during the COVID-19 Pandemic: A 5-Year Chart Review Study

“…A preponderance of certain diagnostic categories was also observed among RD hospitalizations, including psychotic, personality, and substance use disorders as well as intellectual disability. Profiling patients at risk of RD is particularly relevant, as it may help to develop strategies to prevent RD hospitalizations from occurring with the goal of mitigating their health and economic burdens [ 4 , 5 , 6 ].…”

“…Over the last five decades, following the implementation of deinstitutionalizing policies [ 1 ], a phenomenon called “revolving-door” (RD) has become evident in mental healthcare [ 2 ], with a low number of patients consuming a high proportion of resources due to frequent re-hospitalizations [ 3 ]. RD hospital stays are considered a negative outcome, not only in terms of healthcare costs, but especially because of their detrimental effects on patients’ wellbeing and mortality risk [ 4 , 5 , 6 ]. Despite not being completely clear, RD is considered to be a multifaceted phenomenon, where multiple individuals and environmental and clinical factors come into play [ 7 , 8 ].…”

Determinants of Revolving Door in an Acute Psychiatric Ward for Prison Inmates

“…Even in countries with a long-standing community-based mental health system, a small but substantial part of patients fall into this category (7). Repeated admissions to a psychiatric facility are considered as a poor outcome, since they have a negative impact on patient well-being and mortality and dramatically rises mental health-related costs (8,9). Despite the fact that RD is both an economical and quality issue in psychiatry (8), its clinical and social determinants remain poorly explored.…”