Population-Based Examination of the Relationship Between Type of First Admission for Schizophrenia and Outcomes
Abstract
Objective This study examined the relationship between legal status at the time of the first psychiatric hospitalization and hospitalization outcomes in a population-based cohort.Methods All first and subsequent admissions for schizophrenia were extracted from the complete Israeli national registry of psychiatric admissions for the years 1978 to 1992, and the cohort (N=12,071) was followed through 1996 for additional admissions or death. Admissions were categorized as being voluntary, involuntary, or forensic. Multivariate analysis of covariance and binary logistic regression were conducted to predict hospitalization outcomes, controlling for age at first hospitalization and sex.Results Among males and females, a forensic first admission predicted a higher average number of days hospitalized per year and a longer length of first stay in a hospital. And among males, but not females, a forensic first admission predicted more admissions per illness year.Conclusions Findings suggest that a forensic first admission is a risk factor for a more severe course of illness; this measure thus appears to have prognostic value aside from age of onset.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Once a person was admitted as an involuntary patient they were more likely to be subject to use of coercive treatment modalities such as restraint and seclusion than people admitted on a voluntary basis.
“A similar cycle of coercive care provision may also be evident during admission, with the available literature indicating that once a person was admitted as an involuntary patient they were more likely to be subject to use of coercive treatment modalities such as restraint and seclusion than people admitted on a voluntary basis (34,76–88), and may be more likely to display aggressive behaviours (”
From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [76]
Cites
Gender differences in age at onset of Schizophrenia
Angermeyer, M. C., & K�hnz, L. (1988) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/bf00380979 · Cited by 311 · see citing works
The criminal careers of incident cases of schizophrenia
Wessely, S. C., Castle, D. J., Douglas, A. J., & Taylor, P. J. (1994) · Psychological Medicine · doi:10.1017/s0033291700027458 · Cited by 204 · see citing works
A population based elaboration of the role of age of onset on the course of schizophrenia
Rabinowitz, J., Levine, S. Z., & Häfner, H. (2006) · Schizophrenia Research · doi:10.1016/j.schres.2006.07.007 · Cited by 153 · see citing works
Self-citationCourse of Violence in Patients With Schizophrenia: Relationship to Clinical Symptoms
KRAKOWSKI, M. I., Czobor, P., & Chou, J. C.-Y. (1999) · Schizophrenia Bulletin · doi:10.1093/oxfordjournals.schbul.a033397 · Cited by 132 · see citing works
Weiser, M., Kanyas, K., Malaspina, D., Harvey, P. D., Glick, I., Goetz, D. M., Karni, O., Yakir, A., Turetsky, N., Fennig, S., et al. (2005) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2004.07.016 · Cited by 91 · see citing works
Involuntary First Admission of Patients With Schizophrenia as a Predictor of Future Admissions
Fennig, S., Rabinowitz, J., & Fennig, S. (1999) · Psychiatric Services · doi:10.1176/ps.50.8.1049 · Cited by 63 · see citing works
Hospitalization patterns in schizophrenia
Munk-Jørgensen, P., Bo Mortensen, P., & Machón, R. A. (1991) · Schizophrenia Research · doi:10.1016/0920-9964(91)90004-b · Cited by 61 · see citing works
Craw, J. A., & Compton, M. T. (2006) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-006-0122-7 · Cited by 60 · see citing works
Changes in diagnosis in a 9-year national longitudinal sample
Rabinowitz, J., Slyuzberg, M., Ritsner, M. S., Mark, M., Popper, M., & Ginath, Y. (1994) · Comprehensive Psychiatry · doi:10.1016/0010-440x(94)90276-3 · Cited by 59 · see citing works
Trends in involuntary psychiatric hospitalization in Israel 1991–2000
Bauer, A., Rosca, P., Grinshpoon, A., Khawaled, R., Mester, R., Yoffe, R., & Ponizovsky, A. M. (2006) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2006.02.002 · Cited by 41 · see citing works
Survey methods in community medicine: An introduction to epidemiological and evaluative studies
Abramson, J. H. (1979) · Medical Entomology and Zoology · Cited by 39 · see citing works
Reform in mental health services in Israel: The changing role of government, HMOs, and hospitals
Mark, M., Rabinowitz, J., Feldman, D., Gilboa, D., & Shemer, J. (1996) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/bf02108323 · Cited by 11 · see citing works
Differential use of admission status in a psychiatric emergency room.
Rabinowitz, J., Slyuzberg, M., Salamon, I., & Dupler, S. (1995) · PubMed · Cited by 10 · see citing works
Forensic psychiatry in Israel: Some comparisons with England and Wales
Gordon, H., Kirchhoff, E., & Silfen, P. (1996) · Journal of Forensic Psychiatry · doi:10.1080/09585189608409919 · Cited by 7 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Pauselli, L., Verdolini, N., Bernardini, F., Compton, M. T., & Quartesan, R. (2017) · Psychiatric Quarterly · doi:10.1007/s11126-016-9440-4 · Cited by 49 · see citing works
Rodrigues, R., MacDougall, A. G., Zou, G., Lebenbaum, M., Kurdyak, P., Li, L.-H., Shariff, S., & Anderson, K. (2019) · Schizophrenia Research · doi:10.1016/j.schres.2019.01.043 · Cited by 40 · see citing works
Boyer, L., Zendjidjian, X. Y., Auquier, P., Lançon, C., Loundou, A., Parola, N., & Faugère, M. (2014) · Patient Preference and Adherence · doi:10.2147/ppa.s67641 · Cited by 30 · see citing works
Cocchi, A., Meneghelli, A., Erlicher, A., Pisano, A., Cascio, M. T., & Preti, A. (2013) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-013-0736-5 · Cited by 28 · see citing works
CORRELATES OF INVOLUNTARY ADMISSION: FINDINGS FROM AN ITALIAN INPATIENT PSYCHIATRIC UNIT
Balducci, P. M., Bernardini, F., Pauselli, L., Tortorella, A. A. V., & Compton, M. T. (2017) · Psychiatria Danubina · doi:10.24869/psyd.2017.490 · Cited by 27 · see citing works
Landgraf, S., Blumenauer, K., Osterheider, M., & Eisenbarth, H. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2013.09.009 · Cited by 18 · see citing works
The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review
Corderoy, A., Kisely, S., Zirnsak, T., & Ryan, C. J. (2025) · Psychiatry, Psychology and Law · doi:10.1080/13218719.2024.2346734 · Cited by 19 · see citing works
Factors influencing the length of stay in forensic psychiatric settings: a systematic review
Dima, A., Wazir, A., Clark-Castillo, R., Zakopoulos, I., Smith, S. M., & Gaughran, F. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-10863-x · Cited by 14 · see citing works
Voluntary admissions for patients with schizophrenia: A systematic review and meta-analysis
Yang, Y., Li, W., Lok, K.-I., Zhang, Q., Hong, L., Ungvari, G. S., Bressington, D. T., Cheung, T. C. C., & Xiang, Y. (2019) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2019.101902 · Cited by 11 · see citing works
Predicting the length of hospital stay of psychiatry patients using signal detection analysis
Badriah, F., Abe, T., Nabeshima, Y., Ikeda, K., Kuroda, K., & Hagihara, A. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2013.09.019 · Cited by 10 · see citing works
Krivoy, A., Fischel, T., Zahalka, H., Shoval, G., Weizman, A., & Valevski, A. (2012) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2012.03.006 · Cited by 6 · see citing works
Youngmann, R., Goldberger, N., Haklai, Z., Pugachova, I., & Neter, E. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.113958 · Cited by 4 · see citing works
Walsh, S. D., Blass, D. M., Bensimon-Braverman, M., Barak, L. T., & Delayahu, Y. (2014) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-014-9982-1 · Cited by 5 · see citing works
Factors Associated with Involuntary Hospitalization among Young People with Early Psychosis
Rodrigues, R. (2017) · Scholarship@Western (Western University)
Dima, A., Wazir, A., Clark-Castillo, R., Zakopoulos, I., Smith, S. M., & Gaughran, F. (2024) · Figshare · doi:10.6084/m9.figshare.25511898
Dima, A., Wazir, A., Clark-Castillo, R., Zakopoulos, I., Smith, S. M., & Gaughran, F. (2024) · Figshare · doi:10.6084/m9.figshare.26699672
Dima, A., Wazir, A., Clark-Castillo, R., Zakopoulos, I., Smith, S. M., & Gaughran, F. (2024) · Figshare · doi:10.6084/m9.figshare.26699669
Dima, A., Wazir, A., Clark-Castillo, R., Zakopoulos, I., Smith, S. M., & Gaughran, F. (2024) · Figshare · doi:10.6084/m9.figshare.25511807
Forensic mental health service use in early psychosis: A scoping review
Rodrigues, R., Wootten, J. C., Anderson, K. K., Stranges, S., Wilk, P., Freeman, M., & Zeegers, M. P. (2026) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-025-03038-4
- Authors
- Levine, S. Z.
- Affiliations
- Bar-Ilan University (IL)
- Corresponding author
- Levine, Stephen Z.
- ORCID
- Levine, Stephen Z.
- Venue
- Psychiatric Services
- Published
- 2008-12
- Volume
- 59
- Issue
- 12
- Pages
- 1470-1473
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2167270274
- Cited by
- 19
- References
- 14
- Citations by year
- 2026: 1 · 2024: 6 · 2021: 1 · 2019: 2 · 2017: 2 · 2016: 1 · 2014: 2 · 2013: 3 · 2012: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Keywords
- schizophrenia, involuntary admission, voluntary admission, length of hospital stay, hospitalization outcomes, clinical course, prognostic factors, sex differences
- MeSH terms
- Adult, Female, Humans, Israel, Length of Stay, Male, Mental Health Services, Patient Admission, Schizophrenia, Cohort Studies, Outcome Assessment, Health Care, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
