title: Patterns of psychiatric hospitalizations in schizophrenic psychoses within the Northern Finland 1966 Birth Cohort.
abstract: We report patterns of hospitalization in schizophrenic psychoses by age 34 in a longitudinal population-based cohort. We test the predictive ability of various demographic and illness-related variables on patterns of hospitalization, with a special focus on the length of the first psychiatric hospitalization. All living subjects of the Northern Finland 1966 Birth Cohort with DSM-III-R schizophrenia (n=88) and other schizophrenia spectrum cases (n=27) by the year 1997 in the Finnish Hospital Discharge Register were followed for an average of 10.5 years. Measures of psychiatric hospitalization included time to re-hospitalization (as continuous and as re-hospitalization within 2 years) and the number of hospital episodes. Length of the first hospitalization, other illness-related and various socio-demographic predictors were used to predict hospitalization patterns. After adjusting for gender, age at first admission and number of hospital days a short (1-14 days) first hospitalization (reference >30 days; adjusted odds ratio 6.39; 95% CI 2.00-20.41) and familial risk of psychosis (OR 3.36; 1.09-10.39) predicted re-hospitalization within 2 years. A short first hospitalization also predicted frequent psychiatric admissions defined as the first three admissions within 3 years (OR 13.77; 3.92-48.36). A short first hospitalization was linked to increased risk of re-hospitalizations. Although short hospitalization is recommended by several guidelines, there may be a group of patients with schizophrenic psychoses in which too short a hospitalization may lead to inadequate treatment response.
authors.affiliation: Department of Psychiatry, University of Oulu, PO Box 5000, FIN-90014, Finland. jouko.miettunen@oulu.fi
authors.forename: Jouko
authors.initials: J
authors.lastname: Miettunen
authors.forename: Erika
authors.initials: E
authors.lastname: Lauronen
authors.forename: Juha
authors.initials: J
authors.lastname: Veijola
authors.forename: Hannu
authors.initials: H
authors.lastname: Koponen
authors.forename: Outi
authors.initials: O
authors.lastname: Saarento
authors.forename: Matti
authors.initials: M
authors.lastname: Isohanni
mesh_terms: D000328:Adult; D017677:Age Distribution; D002391:Catchment Area, Health; D015331:Cohort Studies; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005387:Finland / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D012008:Recurrence; D012042:Registries; D012559:Schizophrenia / Q000453:epidemiology* / Q000534:rehabilitation*; D012720:Severity of Illness Index