Factors influencing compulsory admission in first-admitted subjects with psychosis.
BACKGROUND
There is a growing body of evidence that patients with early psychosis have undesirable pathways to care, yet few studies have explored the factors related to compulsory admission in patients with psychosis. The aim of the present study was to examine the demographic and clinical factors and pathways to care influencing compulsory admission in first-admitted subjects with psychosis.


METHODS
Pathways to care, clinical and demographic characteristics, were assessed using multiple sources of information in 86 subjects with psychosis first admitted in two hospitals of South-Western France. Characteristics independently associated with compulsory admission were explored using logistic regressions.


RESULTS
Nearly two-thirds of the subjects (61.6%) were compulsorily admitted. Compulsory admission was independently predicted by being a male (adjusted OR = 3.2, 95 % CI 1.2-8.6, p = 0.02), having a diagnosis of schizophrenia broadly defined (adjusted OR = 2.8, 95 % CI 1.02-7.4, p = 0.04) and absence of depressive or anxiety symptoms (adjusted OR = 0.05, 95% CI 0.005-0.5, p=0.01).


CONCLUSIONS
These results suggest that factors related to the disease itself play an important role in decisions concerning compulsory admission. The high frequency of compulsory admission as the first mode of contact with psychiatric hospital in subjects with psychosis constitutes a major public health issue. Further research on the strategies aimed at avoiding compulsory admission in subjects with incipient psychosis is necessary.
Cougnard
Audrey
A
Equipe Accueil 3676 MP2S, IFR 99 of Public Health, Université Victor Segalen Bordeaux 2, Bordeaux, France.
Kalmi
Ester
E
Desage
Alain
A
Misdrahi
David
D
Abalan
François
F
Brun-Rousseau
Hélène
H
Salmi
Louis Rachid
LR
Verdoux
Hélène
H
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data; D019091:Critical Pathways; D003657:Decision Making; D005260:Female; D005602:France; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders; D012307:Risk Factors; D012559:Schizophrenia