Compulsory and voluntary admissions in comparison: A 9-year long observational study

Stefano Draghetti, Siegfried Alberti, Gianluca Borgiani, Fabio Panariello, Diana De Ronchi and Anna Rita Atti

International Journal of Social Psychiatry, 2022, vol. 68, issue 8, 1716-1726

Abstract: Background: Few studies, so far, have been specifically designed to highlight the features related to Compulsory Admissions (CA) and Voluntary Admissions (VA) in Italian psychiatric emergency wards. Aims: The main purpose of this observational study was to compare the sociodemographic and clinical characteristics of VA and CA and to explore possible predictors of re-admissions. Methods: During a 6-month Index Period (February, the 1st–July, the 31st 2008) all psychiatric admissions were documented and then followed-up through all available informatic systems for the next 9 years. Results: Out of 390 hospitalizations, 101 (25.9%) were compulsory (CA rate was 2.79 per 10,000 inhabitants per year, mean duration of hospitalizations of 7.33 ± 7.84 days). Diagnoses were recorded for the 325 patients who had been hospitalized during index period: schizophrenic psychoses ([ p  = .042], in particular schizophrenia [ p  = .027]), manic episode ( p  = .044), and delusional disorders ( p  = .009) were associated with CA; conversely, the diagnosis of unipolar major depression ( p  = .005) and personality disorders ( p  = .048) were significantly more frequent in VA. The 325 admitted patients were followed up for 1,801 person-years. No significant differences were found in terms of drop-outs, transferring, and discharge rates, and mortality rates due to both natural causes and suicides. Factors associated with at least one compulsory readmission were younger age and having had a previous CA ( p  = .011); conversely having been engaged with psychiatric services for over 1 year prior to index hospitalization was protective for a subsequent CA ( p  = .013). Conclusions: After a 40-year old political reform, the current study shows that, in a context of integrated outpatient and inpatient services, engagement with outpatient care may be protective for compulsory rehospitalization.

Keywords: Compulsory admission; voluntary treatment; involuntary hospitalization; mental act; readmission (search for similar items in EconPapers)
Date: 2022
References: Add references at CitEc
Citations:

Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/00207640211057731 (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:sae:socpsy:v:68:y:2022:i:8:p:1716-1726

DOI: 10.1177/00207640211057731

Access Statistics for this article

More articles in International Journal of Social Psychiatry
Bibliographic data for series maintained by SAGE Publications ().