title: Predictors of clinical and social outcomes following involuntary hospital admission: a prospective observational study.
abstract: The Study aimed to assess clinical and social outcomes following involuntary admissions over 1 year and identify socio-demographic and clinical patient characteristics associated with more or less favourable outcomes. Seven hundred and seventy-eight involuntary patients admitted to one of 22 hospitals in England were assessed within the first week after admission and at 1 month, 3 month and 12 month follow-ups. Outcome criteria were symptom levels, global functioning, objective social outcomes, and subjective quality of life (SQOL). Baseline characteristics and patients' initial experience were tested as predictors. Symptom levels and global functioning improved moderately. Objective social outcomes showed a small, but statistically significant deterioration, and SQOL a small, but significant improvement at 1 year. In multivariable analyses, admission due to risk to oneself and receiving benefits predicted poorer symptom outcomes. Female gender and higher perceived coercion were associated with better objective social outcomes, whilst higher initial satisfaction with treatment predicted more positive SQOL at follow-ups. Over a 1-year period following involuntary hospital admission, patients on average showed only limited health and social gains. Different types of outcomes are associated with different predictor variables. Patients' initial experience of treatment, in the form of perceived coercion or satisfaction with treatment, has predictive value for up to a year following the admission.
authors.affiliation: Unit for Social & Community Psychiatry, Barts and the London School of Medicine, Queen Mary University of London, Academic Unit, UK. s.priebe@qmul.ac.uk
authors.forename: Stefan
authors.initials: S
authors.lastname: Priebe
authors.forename: Christina
authors.initials: C
authors.lastname: Katsakou
authors.forename: Ksenija
authors.initials: K
authors.lastname: Yeeles
authors.forename: Tim
authors.initials: T
authors.lastname: Amos
authors.forename: Richard
authors.initials: R
authors.lastname: Morriss
authors.forename: Duolao
authors.initials: D
authors.lastname: Wang
authors.forename: Til
authors.initials: T
authors.lastname: Wykes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003068:Coercion; D004739:England; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D008875:Middle Aged; D019370:Observation; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D055815:Young Adult