TY - JOUR T1 - Use of psychiatric hospitals and social integration of patients with psychiatric disorders: a prospective cohort study in five European countries JF - Social Psychiatry and Psychiatric Epidemiology Y1 - 2020 A1 - Pierre Smith A1 - Pablo Nicaise A1 - Giacco Domenico A1 - Victoria Jane Bird A1 - Michael Bauer A1 - Mirella Ruggeri A1 - Marta Welbel A1 - Andrea Pfennig A1 - Antonio Lasalvia A1 - Jacek Moskalewicz A1 - Stefan Priebe A1 - Lorant, Vincent KW - Employment KW - Hospital readmissions KW - Length of hospital stay KW - Mental illness KW - social integration AB -

Purpose : Long lengths of stay (LoS) in psychiatric hospitals or repeated admission may afect the social integration of patients with psychiatric disorders. So far, however, studies have been inconclusive. This study aimed to analyse whether long LoS or repeated admissions in psychiatric wards were associated in diferent ways with changes in the social integration of patients.

Methods  : Within a prospective cohort study, data were collected on 2181 patients with a main ICD-10 diagnosis of psychotic, afective, or anxiety disorder, hospitalised in the UK, Italy, Germany, Poland, and Belgium in 2015. Social integration was measured at baseline and 1 year after admission using the SIX index, which includes four dimensions: employment, housing, family situation, and friendship. Regression models were performed to test the association between LoS, the number of admissions, and the change in social integration over the study period, controlling for patients’ characteristics (trial registration ISRCTN40256812).

Results : A longer LoS was signifcantly associated with a decrease in social integration (β=−0.23, 95%CI −0.32 to −0.14, p=0.03), particularly regarding employment (OR=2.21, 95%CI 1.18–3.24, p=0.02), housing (OR=3.45, 95%CI 1.74–5.16, p<0.001), and family situation (OR=1.94, 95%CI 1.10–2.78, p=0.04). In contrast, repeated admissions were only associated with a decrease in friendship contacts (OR=1.15, 95CI% 1.08–1.22, p=0.03).

Conclusions : Results suggest that a longer hospital LoS is more strongly associated with a decrease in patients’ social integration than repeated admissions. Special attention should be paid to helping patients to fnd and retain housing and employment while hospitalised for long periods

VL - 55 CP - 11 M3 - 10.1007/s00127-020-01881-1 ER -