Open wards versus locked wards of general hospitals in the treatment of psychiatric patients with medical comorbidities: a cross-sectional study in Tokyo.
OBJECTIVE
Treatment of medical comorbidities among psychiatric patients is an expected role of general hospital psychiatric wards. The purpose of this study was to clarify whether locked wards of general hospitals are necessary in the treatment of psychiatric patients with severe medical comorbidities.


METHODS
A cross-sectional study concerning patients who required admission due to both somatic and psychiatric diseases was performed all over Tokyo during a 2-month period. Demographic and clinical characteristics of patients who were admitted to locked wards of general hospitals were compared with those of patients admitted to open wards of general hospitals.


RESULTS
In locked wards, the rate of organic mental disorders, median Lack of Judgment and Insight from the Positive and Negative Syndrome Scale, and rate of diseases requiring surgery were significantly higher than those in open wards. The rate of patients with medical comorbidities who could not be admitted was significantly higher for open wards than for locked wards. Furthermore, the rate of patients with both medical comorbidities and attempted suicide who could not be admitted was significantly higher for open wards than for locked wards.


CONCLUSIONS
Locked wards may be necessary to treat severe psychiatric patients with severe medical comorbidities.
Hatta
Kotaro
K
Department of Psychiatry, Juntendo University School of Medicine, Tokyo, Japan.
Usui
Chie
C
Nakamura
Hiroyuki
H
Kurosawa
Hisashi
H
Arai
Heii
H
D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006769:Hospitals, General / Q000458:organization & administration*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D011567:Psychiatric Department, Hospital / Q000458:organization & administration*; D011569:Psychiatric Status Rating Scales; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D014041:Tokyo / Q000453:epidemiology