title: Hospital revisit rate after a diagnosis of conversion disorder.
abstract: OBJECTIVE
  To estimate the hospital revisit rate of patients diagnosed with conversion disorder (CD).
  
  
  METHODS
  Using administrative data, we identified all patients discharged from California, Florida and New York emergency departments (EDs) and acute care hospitals between 2005 and 2011 with a primary discharge diagnosis of CD. Patients discharged with a primary diagnosis of seizure or transient global amnesia (TGA) served as control groups. Our primary outcome was the rate of repeat ED visits and hospital admissions after initial presentation. Poisson regression was used to compare rates between diagnosis groups while adjusting for demographic characteristics.
  
  
  RESULTS
  We identified 7946 patients discharged with a primary diagnosis of CD. During a mean follow-up of 3.0 (±1.6) years, patients with CD had a median of three (IQR, 1-9) ED or inpatient revisits, compared with 0 (IQR, 0-2) in patients with TGA and 3 (IQR, 1-7) in those with seizures. Revisit rates were 18.25 (95% CI, 18.10 to 18.40) visits per 100 patients per month in those with CD, 3.90 (95% CI, 3.84 to 3.95) in those with TGA and 17.78 (95% CI, 17.75 to 17.81) in those with seizures. As compared to CD, the incidence rate ratio for repeat ED visits or hospitalisations was 0.89 (95% CI, 0.86 to 0.93) for seizure disorder and 0.32 (95% CI 0.31 to 0.34) for TGA.
  
  
  CONCLUSIONS
  CD is associated with a substantial hospital revisit rate. Our findings suggest that CD is not an acute, time-limited response to stress, but rather that CD is a manifestation of a broader pattern of chronic neuropsychiatric disease.
authors: Department of Neurology, Weill Cornell Medical College, New York, New York, USA.
authors: Alexander E
authors: AE
authors: Merkler
authors: Department of Neurology, Weill Cornell Medical College, New York, New York, USA.
authors: Neal S
authors: NS
authors: Parikh
authors: Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA.
authors: Simriti
authors: S
authors: Chaudhry
authors: Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA.
authors: Alanna
authors: A
authors: Chait
authors: Department of Psychiatry, Montefiore Medical Center, Bronx, New York, USA.
authors: Nicole C
authors: NC
authors: Allen
authors: Department of Neurology, Weill Cornell Medical College, New York, New York, USA Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, New York, New York, USA.
authors: Babak B
authors: BB
authors: Navi
authors: Department of Neurology, Weill Cornell Medical College, New York, New York, USA Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, New York, New York, USA.
authors: Hooman
authors: H
authors: Kamel
mesh_terms: D000328:Adult; D020236:Amnesia, Transient Global / Q000453:epidemiology; D003291:Conversion Disorder / Q000453:epidemiology* / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D012640:Seizures / Q000453:epidemiology; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: EPIDEMIOLOGY; NEUROPSYCHIATRY; PSYCHIATRY