Rehospitalization risk of former voluntary and involuntary patients with schizophrenia
Abstract
Background The aim of the study was to examine the differences between former involuntary and voluntary patients with a schizophrenic disorder with regard to time to and frequency of rehospitalization.Methods In this prospective observational study, 374 patients with a diagnosis of schizophrenia or schizoaffective disorder were included. At the time of inclusion, 290 (77.5 %) were hospitalized voluntarily and 84 (22.5 %) involuntarily. Follow-up assessments were conducted half-yearly over a 2-year period with measures of PANSS, GAF, sociodemographic data and cognitive functioning. These data served as covariates for adjustment in statistical models that included a Cox regression model, a random-effect logit model and a random-effect tobit model.Results After adjustment for other relevant covariates, the Cox regression showed that involuntary treatment is a significant risk factor of subsequent rehospitalization (HR = 1.53; CI = 1.06, 2.19; p = 0.02). The involuntary group had higher half-year incidence rates of rehospitalization, and in case of rehospitalization the duration of hospital stay was longer.Conclusions Involuntary hospitalization seems to be associated with a higher risk of rehospitalization and longer subsequent hospital stays in patients with schizophrenia and schizoaffective disorders. Further studies are needed to examine in detail the processes and interventions that are suitable for interrupting circles of repeated hospitalizations, especially in former involuntary patients.
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Involuntary treatment was generally associated with longer length of stay than was voluntary care.
“Involuntary treatment was generally associated with longer length of stay than was voluntary care (58,68,89,117–120), with the exception of one study (121).”
From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [68]
Other factors such as logistical and bureaucratic issues or bed availability may also affect length of stay for involuntary patients.
“This may be in part because involuntary treatment is often used for people with more severe illness or with conditions such as psychosis that take a greater period of time to resolve (89,118,119), although other factors such as logistical and bureaucratic issues or bed availability may also affect length of stay for involuntary patients (64,68,120).”
From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [68]
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- Authors
- Pfiffner, C., Steinert, T., Kilian, R., Becker, T., Frasch, K., Eschweiler, G., Längle, G., Croissant, D., Schepp, W., Weiser, P., & Jaeger, S.
- Affiliations
- Universität Ulm (DE)
- University of Tübingen (DE)
- Zentrum für Psychiatrie Südwürttemberg (DE)
- Kreiskliniken Reutlingen (DE)
- Johannes Gutenberg University Mainz (DE)
- Corresponding author
- Jaeger, Susanne
- ORCID
- Venue
- Social Psychiatry and Psychiatric Epidemiology
- Published
- 2014-05-08
- Volume
- 49
- Issue
- 11
- Pages
- 1719-1727
- ISSN
- 0933-7954 (ISSN-L)
- 1433-9285
- OpenAlex
- W1966899840
- Cited by
- 30
- References
- 45
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2022: 5 · 2021: 1 · 2020: 3 · 2019: 7 · 2018: 4 · 2017: 4 · 2016: 2 · 2014: 1
- FWCI
- 2.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Social Psychiatry and Psychiatric Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- AstraZeneca
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- schizophrenia, schizoaffective disorder, involuntary admission, voluntary hospitalization, hospital readmission, risk factors, length of hospital stay, psychiatric inpatient care
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Patient Readmission, Prospective Studies, Psychotic Disorders, Risk Factors, Schizophrenia, Incidence
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