title: Factors influencing compulsory admission in first-admitted subjects with psychosis.
abstract: 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.
authors.affiliation: Equipe Accueil 3676 MP2S, IFR 99 of Public Health, Université Victor Segalen Bordeaux 2, Bordeaux, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Cougnard
authors.forename: Ester
authors.initials: E
authors.lastname: Kalmi
authors.forename: Alain
authors.initials: A
authors.lastname: Desage
authors.forename: David
authors.initials: D
authors.lastname: Misdrahi
authors.forename: François
authors.initials: F
authors.lastname: Abalan
authors.forename: Hélène
authors.initials: H
authors.lastname: Brun-Rousseau
authors.forename: Louis Rachid
authors.initials: LR
authors.lastname: Salmi
authors.forename: Hélène
authors.initials: H
authors.lastname: Verdoux
mesh_terms: 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