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Citation
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van Alphen NR, Stewart JG, Esposito EC, Pridgen B, Gold J, Auerbach RP. J. Clin. Psychiatry 2016; 78(5): 592-598. |
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Affiliation
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Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA. |
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Abstract
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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.
© Copyright 2016 Physicians Postgraduate Press, Inc.
Language: en |