title: Frequent visits to a French psychiatric emergency service: diagnostic variability in psychotic disorders.
abstract: OBJECTIVE
  This study examined characteristics of frequent visitors to a psychiatric emergency service in a French public teaching hospital over six years. Diagnostic variability of psychotic disorders was documented.
  
  
  METHODS
  A retrospective review of the service's administrative and medical databases identified 1,285 patients with more than one visit during the period who were given at least one diagnosis of a psychotic disorder. A total of 317 patients with six or more visits (frequent visitors) were compared with 968 patients with between two and five visits (occasional visitors).
  
  
  RESULTS
  Frequent visitors were significantly more likely to be single and homeless and to have diagnostic variability, substance use disorders, and personality disorders. A total of 177 patients experienced diagnostic variability, which was found mainly in three diagnostic categories: schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features.
  
  
  CONCLUSIONS
  Future studies should further examine the link between increased use of emergency services and diagnostic variability.
authors.affiliation: Department of Public Health, La Timone University Hospital, Assistance Publique-Hôpitaux de Marseille, 13 385 Marseille, France. laurent.boyer@ap-hm.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Boyer
authors.forename: Daniel
authors.initials: D
authors.lastname: Dassa
authors.forename: Raoul
authors.initials: R
authors.lastname: Belzeaux
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Henry
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Samuelian
authors.forename: Karine
authors.initials: K
authors.lastname: Baumstarck-Barrau
authors.forename: Christophe
authors.initials: C
authors.lastname: Lancon
mesh_terms: D000328:Adult; D000367:Age Factors; D001714:Bipolar Disorder / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006703:Ill-Housed Persons; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017533:Marital Status; D015999:Multivariate Analysis; D011618:Psychotic Disorders / Q000628:therapy*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000628:therapy