title: Predictors of Rehospitalization for Depressed Adolescents Admitted to Acute Psychiatric Treatment.
abstract: OBJECTIVE
  Presently, little is known about what factors predict adolescent psychiatric rehospitalization. Thus, the present study tested whether a battery of demographic and clinical characteristics predicted readmission within 6 months of discharge.
  
  
  METHODS
  Participants were 165 adolescents (112 females) aged 13-19 years (mean = 15.61, SD = 1.48) admitted to an acute residential treatment program between November 25, 2013, and November 18, 2014. Patients met diagnostic criteria (DSM-IV-TR) for current major depressive disorder or dysthymia. At admission, participants completed a battery of clinical interviews and questionnaires assessing demographics, early life stress, comorbid diagnoses, psychiatric symptoms, suicidality, self-injury, and risky behavior engagement. At discharge, psychiatric symptoms were reassessed. Readmission to the same residential service was monitored over a 6-month period following discharge.
  
  
  RESULTS
  Overall, 12.1% of adolescents were rehospitalized. We conducted a series of Cox regression survival analyses to test demographic and clinical predictors of patients' time to readmission. More frequent self-injurious behaviors in the month prior to hospitalization was significantly associated with a more rapid time to rehospitalization (β = 0.05, SE = .02, Wald₁ = 4.35, P = .037, OR = 1.05, 95% CI = 1.003-1.10).
  
  
  CONCLUSIONS
  It is critical to more effectively manage self-injury during the treatment of depressed adolescents, as this is the strongest predictor of later rehospitalization.
authors.affiliation: Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands.|Division of Child and Adolescent Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.
authors.forename: Nienke R
authors.initials: NR
authors.lastname: van Alphen
authors.affiliation: Division of Child and Adolescent Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.|Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA.
authors.forename: Jeremy G
authors.initials: JG
authors.lastname: Stewart
authors.affiliation: Division of Child and Adolescent Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.|Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA.
authors.forename: Erika C
authors.initials: EC
authors.lastname: Esposito
authors.affiliation: Division of Child and Adolescent Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.|Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Pridgen
authors.affiliation: Division of Child and Adolescent Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.|Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Gold
authors.affiliation: McLean Hospital, 115 Mill St, Mailstop 331, de Marneffe Bldg, Room 240, Belmont, MA 02478. rauerbach@mclean.harvard.edu.|Division of Child and Adolescent Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.|Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA.
authors.forename: Randy P
authors.initials: RP
authors.lastname: Auerbach
mesh_terms: D000293:Adolescent; D019090:Case Management; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016013:Likelihood Functions; D008297:Male; D008404:Massachusetts; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D012114:Residential Treatment; D018570:Risk Assessment / Q000706:statistics & numerical data; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D011795:Surveys and Questionnaires