Compulsory admission is associated with an increased risk of readmission in patients with schizophrenia: a 7-year, population-based, retrospective cohort study
Abstract
Purpose The aim of this study was to assess the risk of psychiatric readmission in patients with schizophrenia, compare it between patients prescribed compulsory admission and those consenting to voluntary admission, and determine risk factors for psychiatric readmission.Methods This 7-year (2007-2013), population-based, cohort study retrospectively compared data of 2038 schizophrenic inpatients who initially underwent compulsory admission (the CA group) and of 8152 matched controls with schizophrenia who initially underwent voluntary admission (the VA group).Results During the study period, there were 1204 and 3806 readmissions in the CA and VA groups, respectively. Compared with the VA group, the CA group was associated with a greater risk of psychiatric readmission [adjusted hazard ratio (AHR) = 1.765; 95% confidence interval (CI) 1.389-2.243; P < 0.001]. Stratified analyses showed that the CA group was associated with a higher risk of subsequent compulsory (AHR = 1.307; 95% CI 1.029-1.661; P < 0.001) and voluntary (AHR = 1.801; 95% CI 1.417-2.289; P < 0.001) readmissions compared to the VA group. Sensitivity analyses, after excluding data from the first year of observation, also provided significant findings with respect to compulsory and voluntary readmissions. Kaplan-Meier curves revealed that cumulative survival rates of psychiatric readmissions, compulsory and voluntary readmissions were significantly lower in the CA group than in the VA group among patients with schizophrenia (log-rank test, P < 0.001).Conclusions CA was associated with higher subsequent psychiatric readmissions, compulsory, and voluntary readmissions. Clinicians would need to focus on patients undergoing CAs to reduce readmissions.
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Some studies found that following an involuntary admission people were more likely to be re-hospitalised than following voluntary admissions, over a wide range of time-periods.
“Some studies found that following an involuntary admission people were more likely to be re-hospitalised than following voluntary admissions, over a wide range of time-periods (58–68).”
From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [63]
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- Authors
- Lin, C.-E., Chung, C.-H., Chen, L.-F., Chen, P.-C., Cheng, H.-Y., & Chien, W.-C.
- Affiliations
- Tzu Chi University (TW)
- Tri-Service General Hospital (TW)
- Hualien Armed Forces General Hospital (TW)
- Taipei Tzu Chi Hospital (TW)
- Corresponding author
- Chien, Wu-Chien
- Venue
- Social Psychiatry and Psychiatric Epidemiology
- Published
- 2018-09-24
- Volume
- 54
- Issue
- 2
- Pages
- 243-253
- ISSN
- 0933-7954 (ISSN-L)
- 1433-9285
- OpenAlex
- W2892832477
- Cited by
- 18
- References
- 25
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 2
- FWCI
- 1.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Social Psychiatry and Psychiatric Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan (TCRD-TPE-107-03)
- Tri-Service General Hospital (TSGH-C107-004)
- 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
- involuntary admission, voluntary admission, psychiatric readmission, schizophrenia, involuntary psychiatric admission, risk factors for readmission
- MeSH terms
- Adult, Aged, Female, Humans, Inpatients, Male, Middle Aged, Patient Admission, Patient Readmission, Retrospective Studies, Risk Factors, Schizophrenia, Proportional Hazards Models, Case-Control Studies
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