Behaviors as risk factors for rehospitalization: implications for predicting and preventing admissions among the seriously mentally ill.

This case-control study investigated the extent to which aberrant behaviors, in contrast to more traditional clinical factors (such as symptoms and alcohol abuse), place individuals with schizophrenia at increased risk for rehospitalization. One hundred and one recidivists (cases) were matched to 101 non-recidivists (controls) on gender, race, and time since index hospitalization. Key informants, usually family members, were interviewed to assess behaviors during a 2-week period. After controlling for possible confounding variables, we found that each aberrant behavior increased the risk for rehospitalization, but highly disruptive or dangerous behaviors (such as threatening others, acting very bizarrely, or attempting suicide) conveyed a markedly high degree of risk (adjusted odds ratio = 83.9). It is possible that service providers may be able to avert the fiscal and emotional cost of hospitalization by collaborating more closely with family members to identify these behaviors and intervene before hospitalization becomes unavoidable.