J Korean Neuropsychiatr Assoc.  2019 Aug;58(3):238-244. 10.4306/jknpa.2019.58.3.238.

Factors Affecting Admission Type in Patients with Schizophrenia Spectrum

• Park YJ
• Ko MS
• Kim KE
• Jho KH
• Nam HJ

• KMID: 2456604
• DOI: http://doi.org/10.4306/jknpa.2019.58.3.238

Abstract

OBJECTIVES
This study examined the admission type and its related factors among patients with psychotic disorders defined based on the revised mental health welfare law.
METHODS
This study was conducted on a total of 100 patients diagnosed on the schizophrenia spectrum and other psychotic disorders. The admission type and sociodemographic characteristics were examined. Social support, psychopathology, excitement, insight, and social functioning were evaluated using the Social Support Scale, Positive and Negative Syndrome Scale (PANSS), PANSS excitement component, Brief Psychiatric Rating Scale, Global Assessment Functioning Scale, Strauss-Carpenter scale, Korean version of the Scale to Assess Unawareness of Mental Disorder, and Korean version of Beck Cognitive Insight Scale.
RESULTS
The severity of psychotic symptoms, excitement, social functioning, and insight were significantly different between involuntary and voluntary admissions (p<0.05). Excitement and insight were found to be factors affecting the admission type (p<0.05).
CONCLUSION
Excitement and insight were factors mainly accounting for the admission type in patients with psychotic disorder. This study could be helpful in improving clinical decision-making and community mental health care.

Keyword

Mental health welfare law; Admission type; Psychotic symptom; Insight

MeSH Terms

Brief Psychiatric Rating Scale
Clinical Decision-Making
Humans
Jurisprudence
Mental Disorders
Mental Health
Patient Admission
Psychopathology
Psychotic Disorders
Schizophrenia Spectrum and Other Psychotic Disorders
Schizophrenia*

Reference

1. Law.go.kr [homepage on the Internet]. Sejong: National Law Information Center;updated 2015 Nov 19. cited 2019 Jun 4. Available from: http://www.law.go.kr/법령/정신보건법/(13323,20150518).

2. Montemagni C, Badà A, Castagna F, Frieri T, Rocca G, Scalese M, et al. Predictors of compulsory admission in schizophrenia-spectrum patients: excitement, insight, emotion perception. Prog Neuropsychopharmacol Biol Psychiatry. 2011; 35:137–145.

3. Chung YI, Lee YM. Medicoethical aspect of involuntary and compulsory admission. J Korean Neuropsychiatr Assoc. 2012; 51:107–112.

4. Law.go.kr [homepage on the Internet]. Sejong: National Law Information Center;updated 2019 Jun 12. cited 2019 Jun 12. Available from: http://www.law.go.kr/법령/정신건강증진및정신질환자복지서비스지원에관한법률/(15907,20181211).

5. Yoon JS, Kim CY, Ahn JH. Critique of mental health welfare law in Korea: focusing on involuntary hospitalization criteria. J Korean Neuropsychiatr Assoc. 2018; 57:145–156.

6. Mohw.go.kr [homepage on the Internet]. Sejong: Ministry of Health and Welfare;updated 2017 Jul 5. cited 2019 May 20. Available from: http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=340430.

7. Caballero JL, Martínez DC, Farré ML, Amor MM, González MB, Fresnedo AG, et al. P.1.k.009 Epidemiology of involuntary hospitalization of schizophrenic patients attended at home. Eur Neuropsychopharmacol. 2014; 24:S346.

8. De Jong MH, Oorschot M, Kamperman AM, Brussaard PE, Knijff EM, Van de Sande R, et al. Crucial factors preceding compulsory psychiatric admission: a qualitative patient-record study. BMC Psychiatry. 2017; 17:350.

9. Abbey A, Abramis DJ, Caplan RD. Effects of different sources of social support and social conflict on emotional well-being. Basic Appl Soc Psychol. 1985; 6:111–129.

10. You SE, Kwon JH. The effects of perfectionism, social support, stress, and coping style on depression in the middle-aged woman. Korean J Clin Psychol. 1997; 16:67–84.

11. Kim CY, editor. Psychiatric assessment instruments. Seoul: Hanampc;2001. p. 44.

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

13. Montoya A, Valladares A, Lizán L, San L, Escobar R, Paz S. Validation of the excited component of the positive and negative syndrome scale (PANSS-EC) in a naturalistic sample of 278 patients with acute psychosis and agitation in a psychiatric emergency room. Health Qual Life Outcomes. 2011; 9:18.

14. Overall JE, Gorham DR. The brief psychiatric rating scale. Psychological Reports. 1962; 10:799–812.

15. Endicott J, Spitzer RL, Fleiss JL, Cohen J. The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry. 1976; 33:766–771.

16. Amador XF, Strauss DH, Yale SA, Flaum MM, Endicott J, Gorman JM. Assessment of insight in psychosis. Am J Psychiatry. 1993; 150:873–879.

17. Song JY, Kim KT, Lee SK, Kim YH, Noh JH, Kim JW, et al. Reliability and validity of the Korean version of the scale to assessment unawareness of mental disorder (SUMD-K). J Korean Neuropsychiatr Assoc. 2006; 45:307–315.

18. Beck AT, Baruch E, Balter JM, Steer RA, Warman DM. A new instrument for measuring insight: the Beck Cognitive Insight Scale. Schizophr Res. 2004; 68:319–329.

19. Kim YL, Yoon T, Kim MS. Cognitive insight in schizophrenic patients. Korean J Clin Psycol. 2006; 25:1011–1027.

20. Sohn JH, Ahn SH, Sung SJ, Ryu JM, Park JE, Cho MJ. Efficacy of case management for the community dwelling schizophrenia patients: a 36-month prospective follow-up study. J Korean Neuropsychiatr Assoc. 2015; 54:578–586.

21. Hustoft K, Larsen TK, Brønnick K, Joa I, Johannessen JO, Ruud T. Voluntary or involuntary acute psychiatric hospitalization in Norway: a 24h follow up study. Int J Law Psychiatry. 2018; 56:27–34.

22. Jung DH, Song JY, Yum TH, Yoon DJ, Bahn GH, Kim JW. Insight and psychopathology in schizophrenics. J Korean Neuropsychiatr Assoc. 1998; 37:1013–1021.

23. McEvoy JP, Applebaum PS, Apperson LJ, Geller JL, Freter S. Why must some schizophrenic patients be involuntarily committed? The role of insight. Compr Psychiatry. 1989; 30:13–17.

24. Bindman J, Reid Y, Szmukler G, Tiller J, Thornicroft G, Leese M. Perceived coercion at admission to psychiatric hospital and engagement with follow-up--a cohort study. Soc Psychiatry Psychiatr Epidemiol. 2005; 40:160–166.

25. Uh D, Lee MS, Han C, Paik JW, Kim SH. Relationship of insight with cognitive function, psychopathology and psychosocial factors in patients with schizophrenia. Korean J Schizophr Res. 2015; 18:79–85.

26. Kim SW. Psychosocial intervention for patients with schizophrenia. J Korean Neuropsychiatr Assoc. 2018; 57:235–243.