Violent Behavior Prior to Admission Is Not a Factor in Further Prolonged Length of Stay: A Retrospective Cohort Study in a Japanese Psychiatric Hospital
Background: This study assessed the hypothesis that violent behavior prior to admission prolongs psychiatric hospitalization and evaluated the likelihood of hospital discharge to a community care setting based on demographic and clinical factors, with an emphasis on violent behavior.Methods: We retr...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-07-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2021.600456/full |
| _version_ | 1819027970893807616 |
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| author | Hidetoshi Kinoshita Hidetoshi Kinoshita Noriomi Kuroki Takayuki Okada |
| author_facet | Hidetoshi Kinoshita Hidetoshi Kinoshita Noriomi Kuroki Takayuki Okada |
| author_sort | Hidetoshi Kinoshita |
| collection | DOAJ |
| description | Background: This study assessed the hypothesis that violent behavior prior to admission prolongs psychiatric hospitalization and evaluated the likelihood of hospital discharge to a community care setting based on demographic and clinical factors, with an emphasis on violent behavior.Methods: We retrospectively selected 362 patients who were involuntarily admitted to a psychiatric hospital in Japan from December 1, 2015 to November 30, 2017, stayed longer than planned, and underwent review by a multidisciplinary team. We assessed (a) education and marital status and history of substance abuse, (b) the presence/absence and type of violent behavior that led to hospital admission, and (c) the discharge criteria. We divided the subjects into groups according to whether they had demonstrated violent behavior prior to admission and compared demographic and clinical variables between the groups using bivariate analysis. We also analyzed data using the Cox proportional hazard model, defining discharge to the community as the outcome. Age, sex, and variables that were significant at a level of P < 0.05 based on Cox univariate analysis were included in the multivariate models using the forced entry method.Results: The Violent group included 94 patients (26%). There were no significant between-group differences in age, sex, educational background, marital history, career history, or the history of substance abuse. However, hospitalization was significantly longer in the Non-violent group. The Cox proportional multivariate hazard ratios revealed that violent behavior prior to admission resulted in a higher probability of hospital discharge.Conclusion: Violent behavior prior to admission did not significantly contribute to prolonged hospitalization in patients who deviated from the treatment plan and had exceeded the planned hospitalization duration. Our findings recommend caution when using violence and impulsiveness observed during the acute stage to predict the difficulty of long-term treatment. |
| first_indexed | 2024-12-21T05:50:56Z |
| format | Article |
| id | doaj.art-a744fa844e90408f898ba1c43b9eb573 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-21T05:50:56Z |
| publishDate | 2021-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-a744fa844e90408f898ba1c43b9eb5732022-12-21T19:13:59ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402021-07-011210.3389/fpsyt.2021.600456600456Violent Behavior Prior to Admission Is Not a Factor in Further Prolonged Length of Stay: A Retrospective Cohort Study in a Japanese Psychiatric HospitalHidetoshi Kinoshita0Hidetoshi Kinoshita1Noriomi Kuroki2Takayuki Okada3Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, JapanForensic Mental Health Unit, Department of Psychiatry and Behavioral Sciences, Division of Cognitive and Behavioral Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, JapanDepartment of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, JapanForensic Mental Health Unit, Department of Psychiatry and Behavioral Sciences, Division of Cognitive and Behavioral Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, JapanBackground: This study assessed the hypothesis that violent behavior prior to admission prolongs psychiatric hospitalization and evaluated the likelihood of hospital discharge to a community care setting based on demographic and clinical factors, with an emphasis on violent behavior.Methods: We retrospectively selected 362 patients who were involuntarily admitted to a psychiatric hospital in Japan from December 1, 2015 to November 30, 2017, stayed longer than planned, and underwent review by a multidisciplinary team. We assessed (a) education and marital status and history of substance abuse, (b) the presence/absence and type of violent behavior that led to hospital admission, and (c) the discharge criteria. We divided the subjects into groups according to whether they had demonstrated violent behavior prior to admission and compared demographic and clinical variables between the groups using bivariate analysis. We also analyzed data using the Cox proportional hazard model, defining discharge to the community as the outcome. Age, sex, and variables that were significant at a level of P < 0.05 based on Cox univariate analysis were included in the multivariate models using the forced entry method.Results: The Violent group included 94 patients (26%). There were no significant between-group differences in age, sex, educational background, marital history, career history, or the history of substance abuse. However, hospitalization was significantly longer in the Non-violent group. The Cox proportional multivariate hazard ratios revealed that violent behavior prior to admission resulted in a higher probability of hospital discharge.Conclusion: Violent behavior prior to admission did not significantly contribute to prolonged hospitalization in patients who deviated from the treatment plan and had exceeded the planned hospitalization duration. Our findings recommend caution when using violence and impulsiveness observed during the acute stage to predict the difficulty of long-term treatment.https://www.frontiersin.org/articles/10.3389/fpsyt.2021.600456/fulllength of staydeinstitutionalizationgeneral psychiatryAsiaJapanviolent behavior |
| spellingShingle | Hidetoshi Kinoshita Hidetoshi Kinoshita Noriomi Kuroki Takayuki Okada Violent Behavior Prior to Admission Is Not a Factor in Further Prolonged Length of Stay: A Retrospective Cohort Study in a Japanese Psychiatric Hospital Frontiers in Psychiatry length of stay deinstitutionalization general psychiatry Asia Japan violent behavior |
| title | Violent Behavior Prior to Admission Is Not a Factor in Further Prolonged Length of Stay: A Retrospective Cohort Study in a Japanese Psychiatric Hospital |
| title_full | Violent Behavior Prior to Admission Is Not a Factor in Further Prolonged Length of Stay: A Retrospective Cohort Study in a Japanese Psychiatric Hospital |
| title_fullStr | Violent Behavior Prior to Admission Is Not a Factor in Further Prolonged Length of Stay: A Retrospective Cohort Study in a Japanese Psychiatric Hospital |
| title_full_unstemmed | Violent Behavior Prior to Admission Is Not a Factor in Further Prolonged Length of Stay: A Retrospective Cohort Study in a Japanese Psychiatric Hospital |
| title_short | Violent Behavior Prior to Admission Is Not a Factor in Further Prolonged Length of Stay: A Retrospective Cohort Study in a Japanese Psychiatric Hospital |
| title_sort | violent behavior prior to admission is not a factor in further prolonged length of stay a retrospective cohort study in a japanese psychiatric hospital |
| topic | length of stay deinstitutionalization general psychiatry Asia Japan violent behavior |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2021.600456/full |
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