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      Exploring risk factors for re-hospitalization in a psychiatric inpatient setting: a retrospective naturalistic study

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          Abstract

          Background

          The reduction of multiple psychiatric hospitalizations is an important clinical challenge in mental health care. In fact, psychiatric re-hospitalization negatively affects the quality of life and the life expectancy of patients with psychiatric disorders. For these reasons, identifying predictors of re-hospitalization is important for better managing psychiatric patients. The first purpose of the present study was to examine the readmission rate in a large sample of inpatients with a psychiatric disorder. Second, we investigated the role of several demographical and clinical features impacting re-hospitalization. 

          Method

          This retrospective study enrolled 1001 adult inpatients (510 men and 491 women) consecutively admitted to the University Psychiatric Clinic, Sant'Andrea Hospital, Sapienza University of Rome between January 2018 and January 2022. To identify risk factors for psychiatric re-hospitalization, we divided the sample into 3 subgroups: the Zero-Re group which had no readmission after the index hospitalization, the One-Re group with patients re-admitted only once, and the Two-Re with at least two re-admissions. 

          Results

          The groups differed according to previous hospitalizations, a history of suicide attempts, age at onset, and length of stay. Furthermore, the results of the regression model demonstrated that the Two-Re group was more likely to have a history of suicide attempts and previous hospitalizations.

          Discussion

          These results indicate the importance of assessing risk factors in psychiatric hospitalized patients and implementing ad hoc prevention strategies for reducing subsequent re-hospitalizations.

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          Most cited references55

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          The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults.

          Research on suicide prevention and interventions requires a standard method for assessing both suicidal ideation and behavior to identify those at risk and to track treatment response. The Columbia-Suicide Severity Rating Scale (C-SSRS) was designed to quantify the severity of suicidal ideation and behavior. The authors examined the psychometric properties of the scale. The C-SSRS's validity relative to other measures of suicidal ideation and behavior and the internal consistency of its intensity of ideation subscale were analyzed in three multisite studies: a treatment study of adolescent suicide attempters (N=124); a medication efficacy trial with depressed adolescents (N=312); and a study of adults presenting to an emergency department for psychiatric reasons (N=237). The C-SSRS demonstrated good convergent and divergent validity with other multi-informant suicidal ideation and behavior scales and had high sensitivity and specificity for suicidal behavior classifications compared with another behavior scale and an independent suicide evaluation board. Both the ideation and behavior subscales were sensitive to change over time. The intensity of ideation subscale demonstrated moderate to strong internal consistency. In the adolescent suicide attempters study, worst-point lifetime suicidal ideation on the C-SSRS predicted suicide attempts during the study, whereas the Scale for Suicide Ideation did not. Participants with the two highest levels of ideation severity (intent or intent with plan) at baseline had higher odds for attempting suicide during the study. These findings suggest that the C-SSRS is suitable for assessment of suicidal ideation and behavior in clinical and research settings.
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            Rebuilding the tower of Babel: a revised nomenclature for the study of suicide and suicidal behaviors. Part 1: Background, rationale, and methodology.

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              Rebuilding the tower of Babel: a revised nomenclature for the study of suicide and suicidal behaviors. Part 2: Suicide-related ideations, communications, and behaviors.

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                Author and article information

                Contributors
                isabella.berardelli@uniroma1.it
                Salvatore.sarubbi@uniroma1.it
                elena.rogante@uniroma1.it
                denise.erbuto@gmail.com
                mariarosariacif@gmail.com
                karl_giuliani@alice.it
                gcalabro@ospedalesantandrea.it
                david.lester@stockton.edu
                marco.innamorati@unier.it
                Maurizio.pompili@uniroma1.it
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                22 December 2022
                22 December 2022
                2022
                : 22
                : 821
                Affiliations
                [1 ]GRID grid.7841.a, Department of Neurosciences, Faculty of Medicine and Psychology, Suicide Prevention Centre, , Mental Health and Sensory Organs, Sant’Andrea Hospital, Sapienza University of Rome, ; Via Di Grottarossa, 1035, 00189 Rome, Italy
                [2 ]GRID grid.7841.a, Department of Human Neurosciences, , Sapienza University of Rome, ; Viale Dell’Università, 30, 00185 Rome, Italy
                [3 ]GRID grid.7841.a, Psychiatry Residency Training Program, Faculty of Medicine and Psychology, , Sapienza University of Rome, Sant’Andrea Hospital, Psychiatry Unit, ; Via Di Grottarossa, 1035, 00189 Rome, Italy
                [4 ]GRID grid.262550.6, ISNI 0000 0001 2231 9854, Psychology Program, , Stockton University, ; Galloway, NJ USA
                [5 ]GRID grid.459490.5, ISNI 0000 0000 8789 9792, Department of Human Sciences, , European University of Rome, ; Via Degli Aldobrandeschi 190, 00163 Rome, Italy
                Article
                4472
                10.1186/s12888-022-04472-3
                9783999
                36550540
                94dda0d8-4e51-4d03-985f-03610f40199f
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 6 June 2022
                : 14 December 2022
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                Clinical Psychology & Psychiatry
                suicide risk,re-hospitalization,hospitalization,prevention strategies

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