Predictors of compulsory admission in schizophrenia-spectrum patients: excitement, insight, emotion perception.
OBJECTIVE
We explored socio-demographic and clinical variables associated with compulsory admissions (CA) compared with voluntary admissions in schizophrenia-spectrum patients; moreover, we investigated the ability of excitement, emotion perception, and lack of insight to predict CA.


METHODS
119 consecutive schizophrenia-spectrum patients admitted to the Servizio Psichiatrico di Diagnosi e Cura (SPDC = PES = psychiatric emergency service) of the Department of Neuroscience and Mental Health-San Giovanni Battista Hospital of Turin in the period between December 2007 and December 2009 were enrolled in the study. A backward stepwise logistic regression was used to test factors contributing to CA.


RESULTS
CA rate in our sample was 28.5%. Previous CAs, drop-out, severity of illness, positive symptoms, excitement, emotion perception, and insight were significantly different in CA patients compared to voluntary ones. After backward selection of variables, three variables predicted CA in our sample: excitement, impaired emotion perception and lesser insight. Finally, the effect of excitement on CA status seemed partially mediated by emotion perception, the prediction model accounting for 53.8% of the variance of CA status. Conversely, insight seemed not to be a mediator of excitement on CA.


CONCLUSIONS
Understanding CA patterns in special populations represents a first step towards improving clinical decision-making and developing appropriate interventions and service-provision.
Department of Neuroscience, Psychiatric Section, University of Turin, Turin, Italy.
Cristiana
C
Montemagni
Alessandra
A
Badà
Filomena
F
Castagna
Tiziana
T
Frieri
Giuseppe
G
Rocca
Mara
M
Scalese
Vincenzo
V
Villari
Paola
P
Rocca
D000293:Adolescent; D000328:Adult; D000368:Aged; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data; D003192:Compulsive Behavior / Q000209:etiology* / Q000523:psychology; D004644:Emotions / Q000502:physiology*; D005145:Face; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010343:Patient Admission / Q000706:statistics & numerical data*; D010465:Perception / Q000502:physiology*; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000209:etiology*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D055815:Young Adult