Predictors of short-term deterioration and compliance in psychiatric emergency patients: a prospective study of 457 patients referred to the emergency room of a general hospital.
The aim of this study was to identify predictors of (1) short-term outcome and (2) short-term compliance with treatment (for non-hospitalized patients) in psychiatric emergency patients. Subjects comprised 457 patients referred to the emergency ward of a French general hospital and requiring examination by a psychiatrist. Clinical and therapeutic assessments were carried out at baseline, using DSM-IV diagnoses and overall psychopathological scoring scales [Brief Psychiatric Rating Scale (BPRS) and Symptom Checklist-90 Revised]. Clinical outcome and compliance were assessed 3 weeks after entry. For each of the two issues assessed, stepwise logistic regression analysis was performed following univariate comparisons. The three best predictors of deterioration at 3 weeks were lack of compliance to treatment, presence of a previous psychiatric history, and a low BPRS hebephrenic factor score. The best predictors of compliance in non-hospitalized patients were a previous psychiatric history, marital status, a low BPRS hostility factor score, and older age. The main predictor of deterioration was non-compliance. Thus, we emphasize the importance of improving compliance, especially among young patients with no previous psychiatric history.
Cremniter
D
D
Department of Psychopathology, Hôpital Henri Mondor, 51, Avenue du Mal de Lattre de Tassigny, F-94010 Créteil Cedex, France. didier.cremniter@easynet.fr
Payan
C
C
Meidinger
A
A
Batista
G
G
Fermanian
J
J
D000328:Adult; D000553:Ambulatory Care; D004637:Emergency Services, Psychiatric; D005260:Female; D005602:France; D006769:Hospitals, General; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D011613:Psychotherapy; D011619:Psychotropic Drugs / Q000008:administration & dosage* / Q000009:adverse effects; D012017:Referral and Consultation; D012307:Risk Factors; D016312:Treatment Refusal / Q000523:psychology
D011619:Psychotropic Drugs