Predicting rehospitalisation in older inpatients with a psychotic disorder [2020]

The objective of this study was to predict rehospitalisation in a psychiatric clinic in older inpatients with a psychotic disorder.

In this prospective, observational study, all eligible inpatients aged 55 years and over with a primary psychotic disorder, admitted to a specialised ward for older psychotic patients in a large psychiatric inpatient clinic in the Netherlands, were asked to participate. Whether or not patients were rehospitalised and time to rehospitalisation were assessed 1 year after discharge from the ward. We recorded age, gender, living arrangement, psychiatric diagnosis, severity of psychotic symptoms, duration of index episode, age of onset of psychotic disorder, number of previous admissions, involuntary admission and use of depot medication at discharge. All patients underwent a neuropsychological assessment.

Of the 90 patients that were included, 32 (35.6%) had been readmitted within 1 year after discharge. None of the demographic or clinical variables predicted rehospitalisation or the time to rehospitalisation.

Factors that predict rehospitalisationin younger adult patients with schizophrenia may not predict rehospitalisationin older patients with a psychotic disorder, of which the majority suffered from schizophrenia. We expect that other factors than those investigated may be of greater importance to predict rehospitalisation, as for example social support and coping mechanisms.

Key points
None of the demographical and clincial variables in our study predicted rehospitalisation in older patients with a psychotic disorder.
Factors associated with rehospitalisation in younger adults with schizophrenia, may be different from factors that are associated with rehospitalisation in older adults with schizophrenia.
Multiple factors contribute to the risk of rehospitalisation and demographic and clinical characteristics alone may be of limited utility in identifying patients most likely to be rehospitalised.

Nicolien Kist, Julia F. van den Berg, Rob M. Kok
International Journal of Geriatric Psychiatry, Volume 35, Issue 10, October 2020