Factors associated with the revolving door phenomenon in patients with schizophrenia: results from an acute psychiatric hospital in Romania
BackgroundThe revolving door phenomenon refers to patients with frequent hospital admissions and emerged after deinstitutionalization reforms have been implemented. Schizophrenia is a severe and debilitating mental disorder and has frequently been identified as one of the most prevalent disorders am...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1496750/full |
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| author | Vlad Dionisie Vlad Dionisie Maria Gabriela Puiu Maria Gabriela Puiu Mihnea Costin Manea Mihnea Costin Manea Emanuel Moisa Ana Maria Dumitru Leila Ibadula Aliss Madalina Mares Aliss Madalina Mares Corina Ioana Varlam Mirela Manea Mirela Manea |
| author_facet | Vlad Dionisie Vlad Dionisie Maria Gabriela Puiu Maria Gabriela Puiu Mihnea Costin Manea Mihnea Costin Manea Emanuel Moisa Ana Maria Dumitru Leila Ibadula Aliss Madalina Mares Aliss Madalina Mares Corina Ioana Varlam Mirela Manea Mirela Manea |
| author_sort | Vlad Dionisie |
| collection | DOAJ |
| description | BackgroundThe revolving door phenomenon refers to patients with frequent hospital admissions and emerged after deinstitutionalization reforms have been implemented. Schizophrenia is a severe and debilitating mental disorder and has frequently been identified as one of the most prevalent disorders among revolving door patients. Therefore, this research aimed to identify socio-demographic and clinical factors associated with the revolving door phenomenon in patients with schizophrenia.MethodsWe conducted an observational and retrospective cohort study and collected data from the medical records of individuals admitted to the largest psychiatric hospital in Romania during a 2-year period. Patients with three or more admissions during a 12-month period were identified as revolving door.ResultsOf the total of 635 patients included in this study, 108 met the criteria for revolving door. Patients had a mean age of 44.55±12.83 years and most of them were single (81.7%) and receiving a disability pension (68.7%) and had an illness duration of more than 5 years (81.9%). Male gender (p=0.000), younger age (p<0.05), presence of psychiatric comorbidity (p<0.05), substance use disorder (p=0.000) and alcohol use disorder (p<0.01) were associated with the revolving door patients. A binary linear logistic regression revealed that male gender (OR=1.92, 95%CI:1.21-3.08), shorter hospitalization (OR=0.982, 95%CI:0.964-1.000), substance use disorder (OR=2.47, 95%CI:1.16-5.26), verbal (OR=1.44, 95%CI:1.05-1.98) and physical (OR=1.331, 95%CI:1.017-1.744) aggression were predictive factors for frequent use of inpatient services.ConclusionsThe results may facilitate development of future reform policies aimed at reducing the revolving door phenomenon, including implementing transitional care interventions between hospital and community services. |
| format | Article |
| id | doaj-art-c657fcd3acbf438a940f4d1f3f847152 |
| institution | Kabale University |
| issn | 1664-0640 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj-art-c657fcd3acbf438a940f4d1f3f8471522025-01-24T07:13:40ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-01-011510.3389/fpsyt.2024.14967501496750Factors associated with the revolving door phenomenon in patients with schizophrenia: results from an acute psychiatric hospital in RomaniaVlad Dionisie0Vlad Dionisie1Maria Gabriela Puiu2Maria Gabriela Puiu3Mihnea Costin Manea4Mihnea Costin Manea5Emanuel Moisa6Ana Maria Dumitru7Leila Ibadula8Aliss Madalina Mares9Aliss Madalina Mares10Corina Ioana Varlam11Mirela Manea12Mirela Manea13Department of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Adult Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, Bucharest, RomaniaDepartment of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Adult Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, Bucharest, RomaniaDepartment of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Adult Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, Bucharest, RomaniaDepartment of Anaesthesia and Intensive Care Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaReteaua Medicala Victoria, Bucharest, RomaniaDepartment of Adult Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, Bucharest, RomaniaDepartment of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Adult Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, Bucharest, RomaniaDepartment of Adult Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, Bucharest, RomaniaDepartment of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Adult Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, Bucharest, RomaniaBackgroundThe revolving door phenomenon refers to patients with frequent hospital admissions and emerged after deinstitutionalization reforms have been implemented. Schizophrenia is a severe and debilitating mental disorder and has frequently been identified as one of the most prevalent disorders among revolving door patients. Therefore, this research aimed to identify socio-demographic and clinical factors associated with the revolving door phenomenon in patients with schizophrenia.MethodsWe conducted an observational and retrospective cohort study and collected data from the medical records of individuals admitted to the largest psychiatric hospital in Romania during a 2-year period. Patients with three or more admissions during a 12-month period were identified as revolving door.ResultsOf the total of 635 patients included in this study, 108 met the criteria for revolving door. Patients had a mean age of 44.55±12.83 years and most of them were single (81.7%) and receiving a disability pension (68.7%) and had an illness duration of more than 5 years (81.9%). Male gender (p=0.000), younger age (p<0.05), presence of psychiatric comorbidity (p<0.05), substance use disorder (p=0.000) and alcohol use disorder (p<0.01) were associated with the revolving door patients. A binary linear logistic regression revealed that male gender (OR=1.92, 95%CI:1.21-3.08), shorter hospitalization (OR=0.982, 95%CI:0.964-1.000), substance use disorder (OR=2.47, 95%CI:1.16-5.26), verbal (OR=1.44, 95%CI:1.05-1.98) and physical (OR=1.331, 95%CI:1.017-1.744) aggression were predictive factors for frequent use of inpatient services.ConclusionsThe results may facilitate development of future reform policies aimed at reducing the revolving door phenomenon, including implementing transitional care interventions between hospital and community services.https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1496750/fullschizophreniarevolving doorfrequent hospitalizationinpatient mental health servicesubstance use disorderaggression |
| spellingShingle | Vlad Dionisie Vlad Dionisie Maria Gabriela Puiu Maria Gabriela Puiu Mihnea Costin Manea Mihnea Costin Manea Emanuel Moisa Ana Maria Dumitru Leila Ibadula Aliss Madalina Mares Aliss Madalina Mares Corina Ioana Varlam Mirela Manea Mirela Manea Factors associated with the revolving door phenomenon in patients with schizophrenia: results from an acute psychiatric hospital in Romania Frontiers in Psychiatry schizophrenia revolving door frequent hospitalization inpatient mental health service substance use disorder aggression |
| title | Factors associated with the revolving door phenomenon in patients with schizophrenia: results from an acute psychiatric hospital in Romania |
| title_full | Factors associated with the revolving door phenomenon in patients with schizophrenia: results from an acute psychiatric hospital in Romania |
| title_fullStr | Factors associated with the revolving door phenomenon in patients with schizophrenia: results from an acute psychiatric hospital in Romania |
| title_full_unstemmed | Factors associated with the revolving door phenomenon in patients with schizophrenia: results from an acute psychiatric hospital in Romania |
| title_short | Factors associated with the revolving door phenomenon in patients with schizophrenia: results from an acute psychiatric hospital in Romania |
| title_sort | factors associated with the revolving door phenomenon in patients with schizophrenia results from an acute psychiatric hospital in romania |
| topic | schizophrenia revolving door frequent hospitalization inpatient mental health service substance use disorder aggression |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1496750/full |
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