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Multiple adverse outcomes following first discharge from inpatient psychiatric care: A national cohort study

The Lancet Psychiatry Jun 26, 2019

Walter F, et al. - Given a higher risk among discharged psychiatric inpatients for serious adverse outcomes, researchers sought to comprehensively examine their multiple risks in a cohort of individuals born in Denmark in 1967-2000 who were alive and living in Denmark on their 15th birthday, and who had been discharged from their initial inpatient psychiatric episode at age 15 years or older. The Danish Civil Registration System yielded 62,922 individuals for inclusion in the cohort. Comparators (n=1,573,050) were 25 individuals without a history of psychiatric admission matched to each individual in the discharged cohort. Absolute and relative risks of all-cause mortality, suicide, accidental death, homicide victimization, homicide perpetration, non-fatal self-harm, violent criminality, and hospitalization following violence, until December 31, 2015 were determined by performing survival analysis techniques. A higher risk for a range of serious fatal and non-fatal adverse outcomes was seen in patients discharged from inpatient psychiatric care vs the rest of the population. In the discharged cohort, the cumulative incidence within 10 years of first discharge of death, self-harm, committing a violent crime, or hospitalization due to interpersonal violence was 32.0%. Patients diagnosed with a psychoactive substance use disorder at first discharge had the highest absolute risk of at least one adverse outcome occurring within this timeframe.

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