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Sex perspective on mandatory admission in acute psychotic patients
Published online by Cambridge University Press: 27 August 2024
Abstract
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Introduction
Psychotic disorders are strongly linked to a higher risk of mandatory hospitalization, often affecting men more, though some studies report the opposite. Recent investigations also show a higher rate of involuntary admissions in younger individuals. Knowledge in this area is still limited despite extensive research.
Objectives
Analyze whether there is an association between sex and age with involuntary admissions of individuals with psychotic disorders.
Methods
Retrospectively, 254 people with psychotic disorders admitted between 2018-2023 to the adult psychiatric inpatient unit at Hospital Universitari Germans Trias i Pujol were selected, collecting their nature of admission, sex, age, and discharge diagnosis. Comparisons between voluntary and involuntary admissions, with respect to sex and age variables, were conducted using independent sample t-tests, Mann-Whitney U tests, Fisher’s exact test, and chi-square tests. A logistic regression model was used to identify variables significantly associated with mandatory admission.
Results
Table 2:
Table 3:
In both the male and female groups, there were no statistically significant differences in terms of the mean age at admission (p = 0.162) or the nature of admission (p = 0.586) (Table 1). When analyzing the voluntary nature of admission based on age and sex, statistically significant differences were only found in the female group (p = 0.01), resulting in a 9.18 year age difference among those admitted voluntarily (Table 2). The model that best predicted the probability of involuntary admission in individuals with psychotic disorders included the sex variable (OR = 4.88) and the interaction between sex and age (OR = 0.97) (Table 3).Table 1:
Differences between sex regarding voluntariness of patients with psychotic disorders.
| Male | Female | p value | |
|---|---|---|---|
| N (%) | 122 (48%) | 132 (52%) | |
| Age, m (SD) | 38.39 (16.64) | 44.15 (18.44) | 0.162 |
| Admissions, N (%) | |||
| Voluntary | 38 (31.1%) | 37 (28.0%) | 0.586 |
| Involuntary | 84 (68.9%) | 95 (72.0%) |
Analysis of voluntariness by sex and age.
| Age, m (SD) | Voluntary | Involuntary | p value |
|---|---|---|---|
| Male | 37.45 (16.38) | 38.81 (16.84) | 0.677 |
| Female | 50.76 (18.19) | 41.58 (17.98) | 0.01* |
| Total | 44.01 (18.44) | 40.28 (17.46) | 0.127 |
Predictors of involuntariness in psychotic patients: Logistic regression model (ENTER METHOD).
| Predictor | -2log likelihood | Nagelkerke R2 | x2 (df*) | OR* (95% CI*) | p value |
|---|---|---|---|---|---|
| 301.22 | 0.039 | 0.03 (1) | |||
| Age | 1.01 (0.98; 1.03) | 0.674 | |||
| Sex | 4.88 (1.15; 20.72) | 0.032* | |||
| Age x Sex Interaction | 0.97 (0.94; 0.99) | 0.046* |
Conclusions
Young women with psychotic disorders face a higher risk of involuntary admissions, emphasizing the need for gender-specific strategies to improve care of these patients.
Disclosure of Interest
None Declared
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- Abstract
- Information
- European Psychiatry , Volume 67 , Special Issue S1: Abstracts of the 32nd European Congress of Psychiatry , April 2024 , pp. S812 - S813
- Creative Commons
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.- Copyright
- © The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
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