The characteristics and outcomes of hospitalised and outpatient-treated first-onset schizophrenia patients: a 5-year register linkage study
| Autor: | Sami Pirkola, Helinä Hakko, Unto Häkkinen, O Saarento, Jaana Suvisaari, Marjo Kiviniemi, Matti Isohanni |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Hospitals Psychiatric Male Pediatrics medicine.medical_specialty Future studies Adolescent Young Adult Recurrence Ambulatory Care medicine Humans Psychiatric hospital Age of Onset Finland Aged Retirement Suicide mortality business.industry Mortality rate Outcome measures General Medicine Middle Aged medicine.disease Disability pension Hospitalization Hospital treatment Schizophrenia Female business Follow-Up Studies |
| Zdroj: | International Journal of Clinical Practice. 67:1105-1112 |
| ISSN: | 1368-5031 |
| DOI: | 10.1111/ijcp.12226 |
| Popis: | Summary Aim We compared the course and outcome of schizophrenia in two groups: (i) hospitalised patients (HP) (n = 5980) who were identified based on their first hospital admission for schizophrenia and (ii) outpatient-treated patients (OTP) who received disability pension because of schizophrenia but who had no hospital admissions for schizophrenia or other psychotic disorder before having been granted a disability pension for schizophrenia (n = 1220). Outcomes were compared using data on mortality, psychiatric hospital utilisation, relapse rate and occupational functioning. Methods A nationwide register-based 5-year follow-up study of all first-onset schizophrenia cases between 1998 and 2003 in Finland. The data were linked with the register information of hospital admissions, disability pensions and National Causes of Death Registers. Results When outcome of treatment was evaluated using mortality rate, relapses, hospital treatment and involuntary admissions as outcome measures, results indicated that OTP group had got along better with their illnesses than HP group. The mortality rates, number of psychiatric treatment days and relapse rate during the 5-year follow up were significantly lower in OTP group. Within the OTP group, there was a notable subgroup of never HP (n = 737, 60.4%), who did not require any psychiatric hospitalisation during the 5-year follow up. Conclusions Patients first identified as outpatients had better outcomes than patients first identified following a hospitalisation. Future studies are required to establish whether outpatient treatment is associated with more favourable prognosis, even after fully adjusting for severity of initial symptoms. The higher suicide mortality of hospital-treated patients suggests that hospital treatment of first-onset patients does not protect from suicide. |
| Databáze: | OpenAIRE |
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