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Psychiatr Serv. 2007 Apr;58(4):561-5.

Predicting hospitalization versus discharge of suicidal patients presenting to a psychiatric emergency service.

Author information

1
Affective Disorders Program, Silver Hill Hospital, 208 Valley Rd., New Canaan, CT 06840, USA. jfgoldberg@yahoo.com

Abstract

OBJECTIVE:

Suicidal ideation frequently prompts visits to psychiatric emergency departments, and more information is needed about factors that mediate clinicians' decisions to hospitalize or discharge patients with suicidal ideation.

METHODS:

The authors reviewed records for 257 patients presenting with suicidal ideation to a psychiatric emergency service. Demographic and clinical correlates of hospitalization were examined by backward stepwise binary logistic regression.

RESULTS:

Hospitalization occurred for 70% of suicidal persons and was significantly associated with psychosis, a history of attempted suicide, and a suicidal plan. With potential confounding factors controlled, these variables correctly classified 80% of hospitalization decisions.

CONCLUSIONS:

Psychosis, past suicide attempts, and the presence of a suicide plan robustly predicted the decision to hospitalize suicidal persons seen in psychiatric emergency services. Diagnosis, pharmacotherapy, having a psychiatrist, and insurance subtype were unrelated to hospitalization decisions, suggesting that psychiatric emergency department staff perceive few alternatives to hospitalization when psychosis and suicide plans accompany suicidal ideation.

PMID:
17412862
DOI:
10.1176/ps.2007.58.4.561
[Indexed for MEDLINE]

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