OBJECTIVE: A subpopulation of chronically mentally ill patients,
sometimes referred to as "revolving door" patients, are frequently
readmitted to psychiatric units. This study examined the relationships
among demographic features, diagnostic characteristics, and frequency of
hospitalization of patients from four state hospitals. METHOD: Two
semistructured, standardized instruments, the Schedule for Affective
Disorders and Schizophrenia and a life events history, were administered to
135 inpatients who met the Research Diagnostic Criteria for schizophrenia
(N = 56), schizoaffective disorder (N = 33), unipolar major depressive
disorder (N = 23), and bipolar disorder (N = 23). Criminal history was
assessed by arrest records. The main outcome measure was the number of
hospitalizations. RESULTS: Chi-square and trend test analyses indicated
that substance abuse and noncompliance with medication regimens were
significantly associated with higher frequencies of hospitalization. A
multiple regression model, which included alcohol/drug problems, medication
noncompliance, and six sociodemographic and diagnostic variables (age,
gender, race, marital status, years of education, and diagnosis) accounted
for a significant proportion of the ability to predict frequency of
hospitalization. Half of this predictability was due to the relationship of
substance abuse and medication noncompliance with number of
hospitalizations. CONCLUSIONS: Alcohol/drug problems and noncompliance with
medication were the most important factors related to frequency of
hospitalization. Preventing these behaviors through patient education may
reduce rehospitalization rates.Abstract Teaser