J Korean Neuropsychiatr Assoc.  2015 Feb;54(1):76-83. 10.4306/jknpa.2015.54.1.76.

A Study on Factors Related to Long-term Hospitalization in Patients with Chronic Schizophrenia

• Jang OJ
• Lee BD
• Chung YI

• KMID: 2344001
• DOI: http://doi.org/10.4306/jknpa.2015.54.1.76

Abstract

OBJECTIVES
The purpose of this study is to investigate the factors related to long-term hospitalization of schizophrenia.
METHODS
The subjects were inpatients with schizophrenia who were constantly hospitalized for more than 12 months and their caregivers. They were compared with schizophrenia with no previous experience of sustained hospitalization for more than 12 months and their caregivers. Demographic and clinical data, Korea version of the Positive and Negative Symptom Scale, functional disability and family burden scale were analyzed.
RESULTS
In this study long-term hospitalization of schizophrenia was influenced by the following measures. First, primary caregivers variables such as parents/non-parents and cohabitation with patients, second, negative symptom severity of passive/apathetic social withdrawal and lack of spontaneity and flow of conversation, and third, functional disability of go to hospital/take a dose regularly and using public transportation/facilities were associated with long-term hospitalization. And they were significant in logistic regression analysis.
CONCLUSION
The above results suggest that long-term hospitalization of schizophrenic patients in Korea might be affected by caregiver's factor, negative symptoms, and functional disability.

Keyword

Schizophrenia; Long-term hospitalization; Caregiver's factor; Negative symptom; Functional disability

MeSH Terms

Caregivers
Hospitalization*
Humans
Inpatients
Korea
Logistic Models
Schizophrenia*

Reference

1. Mattes JA. The optimal length of hospitalization for psychiatric patients: a review of the literature. Hosp Community Psychiatry. 1982; 33:824–828.

2. Thornicroft G, Bebbington P, Leff J. Outcomes for long-term patients one year after discharge from a psychiatric hospital. Psychiatr Serv. 2005; 56:1416–1422.

3. Caton CL, Gralnick A. A review of issues surrounding length of psychiatric hospitalization. Hosp Community Psychiatry. 1987; 38:858–863.

4. Kiesler CA, Simpkins C, Morton T. Predicting length of hospital stay for psychiatric inpatients. Hosp Community Psychiatry. 1990; 41:149–154.

5. McGorry PD, Killackey E, Yung AR. Early intervention in psychotic disorders: detection and treatment of the first episode and the critical early stages. Med J Aust. 2007; 187:7 Suppl. S8–S10.

6. Korea Ministry of Health and Welfare. Mental health act. Sejong: Korea Ministry of Health and Welfare;2008.

7. Korea Policy Materials of Parliamentary Audit. Restriction measures for long-term hospitalization of psychiatric institution. Seoul: National Assembly Research Service;2013.

8. Suh TW. Length of stay of psychiatric inpatients by sociodemographic and clinical characteristics, and type of facilities. J Korean Neuropsychiatr Assoc. 2002; 41:1174–1184.

9. Kim S, Kim YS. Assessment of continuing hospitalization judgement guideline in mental health review board. J Korean Neuropsychiatr Assoc. 2011; 50:441–449.

10. Lee YM, Kim JH, Lee HY, Jeong YK, Lim KY, Lee JH, et al. Length of stay in the mental health facilities in Korea. J Korean Neuropsychiatr Assoc. 1998; 37:83–94.

11. Cho SJ, Lee BJ, Cho MJ, Kim YI, Suh T, Jung IK. Length of stay of psychiatric patient and its correlate in mental health-related facilities. J Korean Neuropsychiatr Assoc. 2006; 45:372–381.

12. Suh T, Lee YM, Hong JP, Cho SJ, Lee JY, Lee SY, et al. Influencing Factors on Length of Stay of Psychiatric Patients in Mental Health-related Facilities. J Korean Neuropsychiatr Assoc. 2003; 42:761–770.

13. Chang G, Brenner L, Bryant K. Factors predicting inpatient length of stay in a CMHC. Hosp Community Psychiatry. 1991; 42:853–855.

14. Huntley DA, Cho DW, Christman J, Csernansky JG. Predicting length of stay in an acute psychiatric hospital. Psychiatr Serv. 1998; 49:1049–1053.

15. Lave JR, Frank RG. Effect of the structure of hospital payment on length of stay. Health Serv Res. 1990; 25:327–347.

16. Goodpastor WA, Hare BK. Factors associated with multiple readmissions to an urban public psychiatric hospital. Hosp Community Psychiatry. 1991; 42:85–87.

17. Suh SK, Kim Y, Park JI, Lee MS, Jang HS, Lee SY, et al. [Medical care utilization status and associated factors with extended hospitalization of psychiatric patients in Korea]. J Prev Med Public Health. 2009; 42:416–423.

18. Choi JK, Jang HS, Lee MS, Hong JP, Park JI. psychosocial correlates of length of stay of institutionalized patients with mental illness. J Korean Neuropsychiatr Assoc. 2013; 52:98–107.

19. Creed F, Tomenson B, Anthony P, Tramner M. Predicting length of stay in psychiatry. Psychol Med. 1997; 27:961–966.

20. Korea National Statistical Office. Statistics of health insurance review and assessment service. Deajeon: Statistics Korea;2012.

21. Munich RL, Gabbard GO. Hospital psychiatry. In : Tasman A, Riba MB, editors. Review of psychiatry. Vol. 11. Washington, DC: American Psychiatric Press;1992. p. 501–534.

22. Malik P, Kohl C, Holzner B, Kemmler G. Distress in primary caregivers and patients listed for liver transplantation. Psychiatry Res. 2014; 215:159–162.

23. California Deparment of Public Health. Primary caregiver's responsibilities. Sacramento: California Department of Public Health;2012.

24. Yi JS, Ahn YM, Shin HK, An SK, Joo YH, Kim SH, et al. Reliability and validity of the Korean Version of the Positive and Negative Syndrome Scale. J Korean Neuropsychiatr Assoc. 2001; 40:1090–1105.

25. Korea Ministry of Health and Welfare. Disability grade determination guideline. Sejong: Korea Ministry of Health and Welfare;2012.

26. Kim CK, Seo JM, Kim SS, Cho JS, Ha JS, Kim JO, et al. Development of the Korean Version of the Social Adjustment Scale in the schizophrenics: a study on the reliability and validity. J Korean Neuropsychiatr Assoc. 1999; 38:1351–1364.

27. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987; 13:261–276.

28. Chung IW, Chi KH, Son JW, Shin CJ. Influetial factors of the cohabitation intention of the mentally-ill patient's family. J Korean Assoc Soc Psychiatry. 2002; 7:3–9.

29. Kwang DH, Kim CH, Byun WT. The Objective and subjective family burden of schizophrenic patient. J Korean Neuropsychiatr Assoc. 1995; 34:193–203.

30. Lee HY, Lee YM, Cheng YG, Kim BH. A study for reclassification of mentally ill patients and development standard of mental health institutions. Sejong: Korea Ministry of Health and Welfare;1994.

31. Kirkpatrick B, Fenton WS, Carpenter WT Jr, Marder SR. The NIMHMATRICS consensus statement on negative symptoms. Schizophr Bull. 2006; 32:214–219.

32. Kring AM, Gur RE, Blanchard JJ, Horan WP, Reise SP. The Clinical Assessment Interview for Negative Symptoms (CAINS): final development and validation. Am J Psychiatry. 2013; 170:165–172.

33. Tiihonen J, Haukka J, Taylor M, Haddad PM, Patel MX, Korhonen P. A nationwide cohort study of oral and depot antipsychotics after first hospitalization for schizophrenia. Am J Psychiatry. 2011; 168:603–609.

34. Kim CK, Kim JW, Seo JM, Lee GZ, Kim GJ, Byun WT. Family Burden of Schizophrenics in the Primary Caregivers and Siblings. J Korean Neuropsychiatr Assoc. 2000; 39:113–127.