scholarly journals O8.6. RISK OF HOMELESSNESS AFTER DISCHARGE FROM PSYCHIATRIC WARDS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S20-S20
Author(s):  
Sandra Nilsson ◽  
Thomas Munk Laursen ◽  
Carsten Hjorthøj ◽  
Merete Nordentoft
Keyword(s):  
Mental Illness ◽  
Substance Use ◽  
High Risk ◽  
Substance Use Disorders ◽  
Depressive Disorders ◽  
Important Predictor ◽  
Prior History ◽  
Men And Women ◽  
History Of ◽  
One Year

Abstract Background Homelessness is an increasing societal problem in most high-income countries and often linked to mental illness and substance use disorders. However, there are few high-quality studies examining the risk of homelessness following discharge from in-patient psychiatric treatment. such information might be used as documentation for the need of structural changes to prevent homelessness in people with severe mental illness. We aimed to analyse the absolute and relative risk of homelessness following discharge from psychiatric wards in Denmark in the period from 2001 to 2015 and to identify high-risk diagnostic groups. Methods We did a nationwide, register-based cohort study including people aged 18+ years discharged from psychiatric wards in Denmark between 1 January 2001 and 31 December 2015. We analysed associations between psychiatric diagnoses and the risk of homelessness using survival analysis. Results A total of 126,848 psychiatric in-patients were included accounting for 94,835 person-years. The incidence of homelessness one year following discharge was 28.18 (95% CI 26.69–29.75) and 9.27 (95% CI 8.45–10.16) per 1000 person-years at risk in men and women, respectively. The one-year cumulative probability of first homelessness after discharge from psychiatric wards with a schizophrenia disorder was 1.54% (95% CI 1.25–1.88) in males and 0.60% (95% CI 0.40–0.87) in females. Substance use disorders increased the risk of homelessness after discharge with adjusted incidence rate ratios of 6.60 (95% CI 5.19–8.40) (men) and 13.06 (95% CI 9.31–18.33) (women), compared with depressive disorders. Schizophrenia increased the risk of homelessness after discharge by 1.91 (95% CI 1.29–2.83) and by 2.53 (95% CI 1.41–4.54) in men and women, respectively, also compared with depressive disorders. Prior history of homelessness was an important predictor for homelessness following discharge. Discussion The first year following discharge from psychiatric wards is a high-risk period of homelessness, especially when having a substance use disorder or a prior history of homeless shelter contact. Schizophrenia was also an important predictor of homelessness. Improved efforts to prevent homelessness are needed.

A whole-of-population study of the prevalence and patterns of criminal offending in people with schizophrenia and other mental illness

2012 ◽  
Vol 43 (9) ◽  
pp. 1869-1880 ◽  
Author(s):  
V. A. Morgan ◽  
F. Morgan ◽  
G. Valuri ◽  
A. Ferrante ◽  
D. Castle ◽  
...  
Keyword(s):  
Mental Illness ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Psychiatric Illness ◽  
Diagnostic Category ◽  
Epidemiological Studies ◽  
Case Register ◽  
People With Mental Illness ◽  
Increased Risk ◽  
History Of

BackgroundLarge epidemiological studies are needed to better understand the prevalence and profile of offending by people with mental illness. This study used a whole-of-population design to examine the prevalence, type and pattern of offending across all psychiatric diagnoses, including schizophrenia, compared to the general population.MethodWe used whole-of-population longitudinal record-linked data for a cohort of all Western Australians born 1955–1969 to determine arrest history over the period 1985–1996 and to ascertain recorded history of psychiatric illness. Of the cohort, 116 656 had been arrested and 40 478 were on the psychiatric case register.ResultsThe period prevalence of arrest for people with any psychiatric illness was 32.1%. The highest arrest prevalence, by diagnostic category, was for substance use disorders (59.4%); the prevalence for schizophrenia was 38.7%. Co-morbid substance use disorders significantly increased risk of arrest in people with schizophrenia. The prevalence of mental illness among offenders was 11.1%: 6.5% of offenders had substance use disorders and 1.7% had schizophrenia. For the majority of offenders with a psychiatric illness, first arrest preceded first contact with mental health services; for schizophrenia only, this proportion was increasing over time. The mean percentage annual change in the number of arrests during 1985–1996 rose significantly for offenders with a psychiatric illness other than schizophrenia and dropped significantly for those with no mental illness. Compared to non-psychiatric offenders, offenders with schizophrenia were more likely to offend alone, to offend in open places and to target strangers.ConclusionsOur findings open the way to an informed approach to the management of offenders with mental illness.

High Risk of One-year Stroke Recurrence in Patients with Younger Age and Prior History of Ischemic Stroke

2019 ◽  
Vol 16 (3) ◽  
pp. 250-257 ◽  
Author(s):  
Jiann-Der Lee ◽  
Ya-Han Hu ◽  
Meng Lee ◽  
Yen-Chu Huang ◽  
Ya-Wen Kuo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ischemic Stroke ◽  
Multivariate Logistic Regression Analysis ◽  
Stroke Recurrence ◽  
Prior History ◽  
Multivariate Logistic Regression ◽  
Cart Analysis ◽  
Younger Age ◽  
History Of ◽  
One Year

Background and Purpose: Recurrent ischemic strokes increase the risk of disability and mortality. The role of conventional risk factors in recurrent strokes may change due to increased awareness of prevention strategies. The aim of this study was to explore the potential risk factors besides conventional ones which may help to affect the advances in future preventive concepts associated with one-year stroke recurrence (OSR). Methods: We analyzed 6,632 adult patients with ischemic stroke. Differences in clinical characteristics between patients with and without OSR were analyzed using multivariate logistic regression and classification and regression tree (CART) analyses. Results: Among the study population, 525 patients (7.9%) had OSR. Multivariate logistic regression analysis revealed that male sex (OR 1.243, 95% CI 1.025 – 1.506), age (OR 1.015, 95% CI 1.007 - 1.023), and a prior history of ischemic stroke (OR 1.331, 95% CI 1.096 – 1.615) were major factors associated with OSR. CART analysis further identified age and a prior history of ischemic stroke were important factors for OSR when classified the patients into three subgroups (with risks of OSR of 8.8%, 3.8%, and 12.5% for patients aged > 57.5 years, ≤ 57.5 years/with no prior history of ischemic stroke, and ≤ 57.5 years/with a prior history of ischemic stroke, respectively). Conclusions: Male sex, age, and a prior history of ischemic stroke could increase the risk of OSR by multivariate logistic regression analysis, and CART analysis further demonstrated that patients with a younger age (≤ 57.5 years) and a prior history of ischemic stroke had the highest risk of OSR.

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