title: Predictors of admission and readmission to hospital for major depression: A community cohort study of 52,990 individuals.
abstract: BACKGROUND
  Our current knowledge about predictors of admission and re-admission to hospital as a result of major depressive disorder (MDD) is limited. Here we present a descriptive analysis of factors which are associated with MDD hospitalisations within a large population cohort.
  
  
  METHODS
  We linked participants of the Scottish Health Survey (SHS) to historical and prospective hospital admission data. We combined information from the SHS baseline interview and historical hospitalisations to define a range of exposure variables. The main outcomes of interest were: (1) first time admission for MDD occurring after the SHS interview; and (2) readmission for MDD. We used Cox regression to determine the association between each predictor and each outcome, after adjusting for age, gender and deprivation quintile.
  
  
  RESULTS
  52,990 adult SHS participants were included. During a median follow-up of 4.5 years per participant, we observed 530 first-time admissions for MDD. A relatively wide range of factors - encompassing social, individual health status, and lifestyle-related exposures - were associated with this outcome (p<0.05). Among the 530 participants exhibiting a de novo admission for MDD during follow-up, 118 were later re-admitted. Only older age (over 70) and a prior non-depression related psychiatric admission were associated with readmission for MDD.
  
  
  CONCLUSIONS
  MDD was defined using records of International Classification of Disease hospital discharge codes rather than formal diagnostic assessments.
  
  
  CONCLUSIONS
  These findings have implications for mental health service organisation and delivery and should stimulate future research on predictive factors for admission and readmission in MDD.
authors.affiliation: Glasgow Caledonian University, School of Health and Life Sciences, Glasgow, UK. Electronic address: hamish.innes@gcu.ac.uk.
authors.forename: Hamish
authors.initials: H
authors.lastname: Innes
authors.affiliation: University of Glasgow, Institute of Health and Wellbeing; Glasgow, UK.
authors.forename: James
authors.initials: J
authors.lastname: Lewsey
authors.affiliation: University of Glasgow, Institute of Health and Wellbeing; Glasgow, UK.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D006113:United Kingdom / Q000453:epidemiology
keywords: Depression; Predictors