Factors associated with readmission to adolescent psychiatric care.

OBJECTIVE: The aim of this study is to identify factors associated with readmission to adolescent psychiatric inpatient care, in the context of a relapsing major mental illness.
METHOD: Data were obtained from 71 patients admitted to an adolescent psychiatric inpatient unit over a 2-year period. Patients who were rehospitalized within 12 months of discharge were compared with patients who had only one admission during the study period with respect to diagnosis, age of first admission, history of child sexual abuse (CSA) and the events precipitating admission.
RESULTS: Medication non-adherence and a history of CSA were positively and independently associated with relapse readmission, while a trend emerged among readmitted patients toward younger age at first psychiatric hospitalization. A negative association was found between readmission and the experience of personal loss. Readmission was not related to DSM-IV axis I or axis II diagnosis, including substance abuse.
CONCLUSIONS: The association, in an adolescent sample, of medication non-adherence and relapse readmission is consistent with findings from numerous adult studies, as is the trend toward younger age of first admission. The relationship of a history of CSA to readmission has attracted little previous research and the finding of a positive association suggests that further investigation of a history of CSA in this context is warranted. The implications of these findings and suggestions for further research are discussed.