Intensieve nazorg voorkomt BOPZ-heropname niet: EEN PROSPECTIEF COHORTONDERZOEK MET 5 JAAR FOLLOW-UP

Objective To explore the relationship between psychiatric care consumption after a compulsory admission and the probability of a repeat compulsory admission. Design Prospective cohort study with a 5year followup. Method Mental health care consumption was registered for 460 patients admitted compulsorily under the Dutch Psychiatric Care (Compulsory Admissions) Act by the Amsterdam Emergency Psychiatry service between 15 September 2004 and 14 September 2006, with sociodemographic and clinical data as independent variables. Results There was no repeat compulsory admission in 63% of the cohort. The odds ratio for repeat compulsory admission only decreased in the fourth year (odds ratio (OR) 0.64; 95% CI 0.450.92). Repeat compulsory admission was associated with high treatment continuity (χ² p ≤ 0.001) and a high level of care consumption during the followup period (χ² p ≤ 0.001). Compulsory admission was predicted on the basis of: high care consumption in the five years prior to inclusion (OR 2.61; 1.444.73), aged younger than 35 years at outset (OR 1.65; 1.082.52), living alone at the time of inclusion (OR 1.68; 1.222.33), and a history of compulsory admission (OR 1.56; 1.032.35). Conclusion Twothirds of the patients were not readmitted compulsorily. The probability of a repeat admission of this kind fell only after four years. Patients who underwent a repeat compulsory admission proved to be the ones who had been treated most intensively, yet this intense treatment did not prevent a higher probability of readmission. When not taking the quality and nature of care and social integration of patients into account, attempts to reduce treatment dropout on the one hand and more intense treatments on the other may not have an effect on reducing the probability of a repeat compulsory admission.