Hospital discharge status and long-term outcome for patients with schizophrenia, schizoaffective disorder, borderline personality disorder, and unipolar affective disorder.
The prognosis of self-discharged inpatients has seldom been studied, especially by diagnosis, and is frequently assumed to be poor. This study evaluated the long-term (15-year average) outcome of inpatients discharged with medical advice (WMA), against medical advice (AMA), or by transfer for patients with schizophrenia (N = 113), schizoaffective disorder (N = 46), borderline personality disorder (N = 63), and unipolar affective disorder (N = 33) from a follow-up study. Results showed that outcome among discharge cohorts varied considerably depending on diagnostic category. Within each diagnostic cohort, outcome of transferred patients was poorest. The outcome of AMA-discharged patients was poorer than the outcome of patients discharged with medical advice only in the unipolar cohort, except that AMA discharge in schizoaffective patients correlated significantly with suicide.
McGlashan
T H
TH
Chestnut Lodge Research Institute, Rockville, MD 20850.
Heinssen
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RK
D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000523:psychology; D003134:Commitment of Persons with Psychiatric Disorders; D003657:Decision Making; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010352:Patient Dropouts; D010360:Patient Transfer; D010554:Personality Disorders / Q000175:diagnosis*; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology