Revolving Door Phenomenon and Related Factors in Schizophrenia, Bipolar Affective Disorder and Other Psychotic Disorders

Koparal, Buket; Unler, Mehmet; Utku, Hayriye Cisem; Candansayar, Selçuk

doi:10.24869/psyd.2021.18

Cited by 9 publications

(27 citation statements)

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“…One study associated being homeless or living in a residential facility with high utilization of inpatient psychiatric services (Morlino et al, 2011), whereas another associated living in an institutionalized or precarious setting ('no private housing') with a diminished risk for rehospitalization (Frick et al, 2013). However, place of residence was not statistically significant in five other studies (di Lorenzo et al, 2016;Haywood et al, 1995;Koparal et al, 2021;Oyffe et al, 2009;Schmutte et al, 2009).…”

Section: Sociodemographic Factorsmentioning

confidence: 97%

“…Five of those studies revealed that the RD phenomenon is greater among younger age groups (Gastal et al, 2000;Kastrup, 1987aKastrup, , 1987bMorlino et al, 2011;Neto & da Silva, 2008;Woogh et al, 1977), particularly those aged between 15 and 24 years (Kastrup, 1987a, Kastrup 1987bWoogh et al, 1977), 15 and 35 years (Gastal et al, 2000) or 16 and 45 years (Morlino et al, 2011), and one study suggests that older age is a protective variable, associated with lower readmission risk (Frick et al, 2013). Five studies concluded that there was no significant difference regarding age between RD patients and non-RD patients (di Lorenzo et al, 2016;Bobo et al, 2004;Koparal et al, 2021;Oyffe et al, 2009;Schmutte et al, 2009). Males were more likely to have multiple hospitalizations, according to some authors (Gastal et al, 2000;Haywood et al, 1995;Kastrup, 1987a, 1987bKoparal et al, 2021 but the majority of the studies concluded that neither gender was significantly associated with the RD phenomenon (Bobo et al, 2004;di Lorenzo et al, 2016;Frick et al, 2013;Neto & da Silva, 2008;Schmutte et al, 2009;Woogh et al, 1977).…”

Section: Sociodemographic Factorsmentioning

confidence: 99%

“…Five studies concluded that there was no significant difference regarding age between RD patients and non-RD patients (di Lorenzo et al, 2016;Bobo et al, 2004;Koparal et al, 2021;Oyffe et al, 2009;Schmutte et al, 2009). Males were more likely to have multiple hospitalizations, according to some authors (Gastal et al, 2000;Haywood et al, 1995;Kastrup, 1987a, 1987bKoparal et al, 2021 but the majority of the studies concluded that neither gender was significantly associated with the RD phenomenon (Bobo et al, 2004;di Lorenzo et al, 2016;Frick et al, 2013;Neto & da Silva, 2008;Schmutte et al, 2009;Woogh et al, 1977).…”

Section: Sociodemographic Factorsmentioning

confidence: 99%

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The revolving door phenomenon in severe psychiatric disorders: A systematic review

Barbosa

Marques

2023

Int J Soc Psychiatry

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Background: The treatment of psychiatric patients has suffered a major change over the last decades, with long-term hospitalizations being replaced by short-term stays and appropriate aftercare in outpatient services. Some chronically ill patients exhibit a pattern of multiple hospitalizations, designated as the Revolving Door (RD) phenomenon. Aims: This review aims to analyse the existing literature regarding sociodemographic, clinical and other factors associated with multiple hospitalizations in psychiatric facilities. Method: The search performed in the PubMed database for the terms revolving[Title] AND (psyc*[Title] OR schizo*[Title] OR mental[Title]) presented 30 citations, 8 of which met the eligibility criteria. Four other studies found in references of these articles were also included in the review. Results: Albeit the use of different criteria to define the RD phenomenon, it is more likely to be associated with patients who are younger, single, with low educational level, unemployed, diagnosed with a psychotic disorder, particularly schizophrenia, and with alcohol and/or substance use. It is also associated with a younger age on disease onset, suicidality, noncompliance and voluntary type of admission. Conclusion: Recognizing patients with a RD pattern of admissions and prediction of rehospitalization can help the development of preventive intervention strategies and identify potential limitations in existing health care delivery systems.

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Section: Sociodemographic Factorsmentioning

confidence: 97%

Section: Sociodemographic Factorsmentioning

confidence: 99%

Section: Sociodemographic Factorsmentioning

confidence: 99%

See 1 more Smart Citation

The revolving door phenomenon in severe psychiatric disorders: A systematic review

Barbosa

Marques

2023

Int J Soc Psychiatry

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“…The main factors linked to the RD phenomenon remain uncertain ( 9 ). Studies found that revolving door patients are younger, single, with low education and unemployed.…”

Section: The Revolving Door Phenomenonmentioning

confidence: 99%

Avoiding revolving door and homelessness: The need to improve care transition interventions in psychiatry and mental health

et al. 2022

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“…The authors have indicated that young males are at higher risk for RD, as well as higher scores on measures of psychosis and noncompliance with medication were found to be strong predictors for RD ( 14 , 16 ). Additionally, patient-related factors as low social support, low functioning, low education level, unemployment, and living alone are determinants of frequent re-hospitalization ( 17 ). Environmental factors may also influence this phenomenon: the “urban living,” and family conflicts, may increase re-hospitalizations ( 18 , 19 ).…”

Section: Introductionmentioning

confidence: 99%

Case report: Successful administration of cariprazine in a young, severely ill patient with recurrent relapses of schizophrenia and persistent negative symptoms

Vrubļevska

2023

Front. Psychiatry

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The present case report describes a young man diagnosed with schizophrenia and presents a “revolving door” (RD) phenomenon. He was hospitalized in an acute psychiatric clinic three times in 1 year. After each hospitalization, he was discharged with incompletely reduced psychotic symptoms, persistent negative symptoms, low functioning, lack of insight, and adherence. He had an insufficient response to maximally tolerated doses of antipsychotic monotherapy with haloperidol and risperidone. Moreover, his treatment was complicated due to the low accessibility of long-acting injectable atypical antipsychotics (LAI) in the country and his refusal of the only available atypical LAI paliperidone palmitate and refusal to take clozapine. Due to limited alternatives, the decision to administer combinations of antipsychotics was made. Since his diagnosis, he received several combinations of antipsychotics, i.e., haloperidol + quetiapine, risperidone + quetiapine, haloperidol + olanzapine, risperidone + olanzapine, but without sufficient clinical effectiveness. Although combinations of antipsychotics reduced his positive symptoms to some degree, persistent negative symptoms and extrapyramidal side effects were observed. After initiating cariprazine, which was combined with olanzapine, improvement in the patient’s positive symptoms, negative symptoms, and overall functioning was detected. The combination of medications mentioned above facilitated the therapeutic alliance, thus providing control over the symptoms and preventing psychiatric hospitalizations.

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Revolving Door Phenomenon and Related Factors in Schizophrenia, Bipolar Affective Disorder and Other Psychotic Disorders

Cited by 9 publications

References 0 publications

The revolving door phenomenon in severe psychiatric disorders: A systematic review

The revolving door phenomenon in severe psychiatric disorders: A systematic review

Avoiding revolving door and homelessness: The need to improve care transition interventions in psychiatry and mental health

Case report: Successful administration of cariprazine in a young, severely ill patient with recurrent relapses of schizophrenia and persistent negative symptoms

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