Hamish Innes1, James Lewsey2, Daniel J Smith2. 1. Glasgow Caledonian University, School of Health and Life Sciences, Glasgow, UK. Electronic address: hamish.innes@gcu.ac.uk. 2. University of Glasgow, Institute of Health and Wellbeing; Glasgow, UK.
Abstract
BACKGROUND: Our current knowledge about predictors of admission and re-admission to hospital as a result of major depressive disorder (MDD) is limited. Here we present a descriptive analysis of factors which are associated with MDD hospitalisations within a large population cohort. METHODS: We linked participants of the Scottish Health Survey (SHS) to historical and prospective hospital admission data. We combined information from the SHS baseline interview and historical hospitalisations to define a range of exposure variables. The main outcomes of interest were: (1) first time admission for MDD occurring after the SHS interview; and (2) readmission for MDD. We used Cox regression to determine the association between each predictor and each outcome, after adjusting for age, gender and deprivation quintile. RESULTS: 52,990 adult SHS participants were included. During a median follow-up of 4.5 years per participant, we observed 530 first-time admissions for MDD. A relatively wide range of factors - encompassing social, individual health status, and lifestyle-related exposures - were associated with this outcome (p<0.05). Among the 530 participants exhibiting a de novo admission for MDD during follow-up, 118 were later re-admitted. Only older age (over 70) and a prior non-depression related psychiatric admission were associated with readmission for MDD. LIMTATIONS: MDD was defined using records of International Classification of Disease hospital discharge codes rather than formal diagnostic assessments. CONCLUSION: These findings have implications for mental health service organisation and delivery and should stimulate future research on predictive factors for admission and readmission in MDD.
BACKGROUND: Our current knowledge about predictors of admission and re-admission to hospital as a result of major depressive disorder (MDD) is limited. Here we present a descriptive analysis of factors which are associated with MDD hospitalisations within a large population cohort. METHODS: We linked participants of the Scottish Health Survey (SHS) to historical and prospective hospital admission data. We combined information from the SHS baseline interview and historical hospitalisations to define a range of exposure variables. The main outcomes of interest were: (1) first time admission for MDD occurring after the SHS interview; and (2) readmission for MDD. We used Cox regression to determine the association between each predictor and each outcome, after adjusting for age, gender and deprivation quintile. RESULTS: 52,990 adult SHS participants were included. During a median follow-up of 4.5 years per participant, we observed 530 first-time admissions for MDD. A relatively wide range of factors - encompassing social, individual health status, and lifestyle-related exposures - were associated with this outcome (p<0.05). Among the 530 participants exhibiting a de novo admission for MDD during follow-up, 118 were later re-admitted. Only older age (over 70) and a prior non-depression related psychiatric admission were associated with readmission for MDD. LIMTATIONS: MDD was defined using records of International Classification of Disease hospital discharge codes rather than formal diagnostic assessments. CONCLUSION: These findings have implications for mental health service organisation and delivery and should stimulate future research on predictive factors for admission and readmission in MDD.
Authors: J McLauchlan; H Innes; J F Dillon; G Foster; E Holtham; S McDonald; B Wilkes; S J Hutchinson; W L Irving Journal: Int J Epidemiol Date: 2017-10-01 Impact factor: 9.685