Studies of patients signing out against medical advice (AMA) from a
psychiatric service have been retrospective and inconsistent or
contradictory in their findings. The authors report findings from a
prospective study in which data from a brief structured interview of
patients at the time of admission were used to predict subsequent AMA
behavior. They achieved 80% accuracy. Critical variables centered around
the nature of the "treatment contract" as perceived by the patient: AMA
patients never intended to stay in the hospital for more than a few
days.Abstract Teaser