Why do adolescents return to an acute psychiatric unit?

Objective: The aim of this paper is to determine potentially modifiable factors associated with the high proportion of patients who are readmitted to adolescent psychiatric units.

Method: The case notes of 112 adolescents admitted over 1 year to an acute adolescent psychiatry unit were reviewed. Socio-demographic and clinical variables were compared between those who were readmitted over a 12-month period post discharge and those who were not.

Results: The readmission rate over a 12-month period was 31%. Males were significantly more likely to be readmitted. No other statistically significant predictors of readmission were identified. There was a trend towards readmission for those with bipolar disorder and a trend away from readmission for those with adjustment disorders. A history of sexual abuse and cluster B personality traits were significantly related to a history of previous admission, but not with subsequent readmission.

Conclusions: Readmission is influenced by a number of factors, which may not be easily identified by a chart review. Prospective studies which follow-up adolescents for several years after discharge are needed.