Citation

Markota M, McKean AJ, Romanowicz M, Schak KM, Croarkin PE, Vande Voort JL. Gen. Hosp. Psychiatry 2018; 55: 10-14.

Affiliation

Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: vandevoort.jennifer@mayo.edu.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.genhosppsych.2018.08.010

PMID

30193205

Abstract

OBJECTIVE: Psychiatric rehospitalizations results in a significant burden to patients, families, and health care systems. Understanding psychiatric rehospitalizations offers an opportunity to identify weaknesses in current systems of care. The objective of this study was to test the hypothesis that a history of trauma or ongoing bullying increases the risk of psychiatric rehospitalization.

METHOD: Retrospective cohort study of 366 individual patients (71% female) admitted to a pediatric psychiatry unit between 1/1/2015 and 12/31/2015. The primary outcome measure was rehospitalization to the same psychiatric hospital unit within one year of first discharge. Trauma was defined as having a history of Post-Traumatic Stress Disorder, Reactive Attachment Disorder, or a filed Suspected Abuse and Neglect of a Child report by the end of first hospitalization. Ongoing bullying was identified by medical record review.

RESULTS: History of trauma (Odds Ratio (OR) = 3.2, 95% Confidence Interval (CI) = 1.8-5.6, p < 0.0001) and ongoing bullying (OR = 2.2, CI = 1.2-3.9, p = 0.009) were significantly associated with increased rates of rehospitalizations. We controlled for the following covariates: Patient Health Questionnaire-9 Modified (PHQ-9M) score, gender, age, relative age, initial length of stay, disrupted family system, and sexual orientation/identity.

CONCLUSION: History of trauma or ongoing bullying are important risk factors for pediatric psychiatric rehospitalization.

Copyright © 2018 Elsevier Inc. All rights reserved.

Language: en

Keywords

Bullying; Pediatric psychiatric rehospitalization; Trauma; Youth