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J Clin Psychiatry. 2017 May;78(5):592-598. doi: 10.4088/JCP.15m10326.

Predictors of Rehospitalization for Depressed Adolescents Admitted to Acute Psychiatric Treatment.

Author information

1
Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands.
2
Division of Child and Adolescent Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.
3
Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA.
4
McLean Hospital, 115 Mill St, Mailstop 331, de Marneffe Bldg, Room 240, Belmont, MA 02478. rauerbach@mclean.harvard.edu.

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.

PMID:
27529444
PMCID:
PMC5313382
DOI:
10.4088/JCP.15m10326
[Indexed for MEDLINE]
Free PMC Article

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