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Cited by 77Psychiatric care and mental health servicesMental Health Treatment and AccessChild and Adolescent Psychosocial and Emotional Development

Psychiatric readmission of children and adolescents: a systematic review and meta-analysis.

Edgcomb, Juliet Beni, Sorter, Michael, Lorberg, Boris, Zima, Bonnie T.·2020·Psychiatric Services
DOI 10.1176/appi.ps.201900234
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Abstract

Objective: To investigate predictors of psychiatric hospital readmission of children and adolescents, a systematic review and meta-analysis was conducted. Methods: Following PRISMA statement guidelines, a systematic literature search of articles published between 1997 and 2018 was conducted in PubMed/MEDLINE, Google Scholar, and PsycINFO for original peer-reviewed articles investigating predictors of psychiatric hospital readmission among youths (<18 years old). Effect sizes were extracted and combined by using random-effects meta-analysis. Covariates were investigated with meta-regression and subgroup analyses. Results: Thirty-three studies met inclusion criteria, containing information on 83,361 children and adolescents, of which raw counts of readmitted vs. non-readmitted youths were available for 76,219. Of these youths, 13.2% (N=10,076) were readmitted. The mean±SD study follow-up was 15.9±15.0 months, and time to readmission was 13.1±12.8 months. Readmission was associated with, but not limited to, suicidal ideation at index hospitalization (pooled odds ratio [ORpooled]=2.35, 95% confidence interval [CI]=1.64–3.37), psychotic disorders (ORpooled=1.87, 95% CI=1.53–2.28), prior hospitalization (ORpooled=2.51, 95% CI=1.76–3.57), and discharge to residential treatment (ORpooled=1.84, 95% CI=1.07–3.16). There was evidence of moderate study bias. Prior investigations were methodologically and substantively heterogeneous, particularly for measurement of family-level factors. Conclusions: Interventions to reduce child psychiatric readmissions should place priority on youths with indicators of high clinical severity, particularly with a history of suicidality, psychiatric comorbidity, prior hospitalization, and discharge to residential treatment. Standardization of methods to determine prevalence rates of readmissions and their predictors is needed to mitigate potential biases and inform a national strategy to reduce repeated child psychiatric hospital readmissions.

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Authors
Edgcomb, J. B., Sorter, M., Lorberg, B., & Zima, B. T.
Affiliations
Cincinnati Children's Hospital Medical Center (US)
ORCID
Venue
Psychiatric Services
Publisher
American Psychiatric Association Publishing
Published
2020-03-01
Volume
71
Issue
3
Pages
269-279
ISSN
  • 0022-1597 (ISSN-L)
  • 1075-2730
  • 1557-9700
DOI
10.1176/appi.ps.201900234
OpenAlex
W2995923749
Cited by
77
References
58
Citations by year
2026: 12 · 2025: 13 · 2024: 14 · 2023: 17 · 2022: 10 · 2021: 7 · 2020: 4
FWCI
0.83
Type
journal article
Language
en
Open access
closed
Locations
  • Psychiatric Services (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
psychiatric readmission, child and adolescent psychiatry, predictors of readmission, suicidal ideation, psychosis, prior hospitalization, psychiatric comorbidity, family factors, readmission prevention
MeSH terms
Adolescent, Mental Disorders, Child, Humans, Patient Readmission, Risk Factors, Comorbidity

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