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Abstract

Objectives:

This report characterizes pathways to first psychiatric admission and describes their relationship to patients’ sociodemographic and clinical features.

Methods:

Eighty-four patients consecutively admitted for the first time in 2009–2010 to a Lisbon district psychiatric department were interviewed. Associations between pathways and clinical and sociodemographic variables were explored through univariate and multivariate analysis.

Results:

Most patients (N=49, 58%) went directly to the psychiatric emergency department and were admitted, without contacting any other care providers. This pathway was significantly associated with male gender, involuntary admission, referral by a family member, fewer people per room in the household, and lower probability of previous contact with mental health services.

Conclusions:

The most striking feature was the high prevalence of direct access to the psychiatric emergency department with subsequent admission. Use of this direct pathway suggests that these patients were bypassing care filters, with negative consequences. Specific sociodemographic variables, but not diagnosis, were associated with filter bypass.

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Go to Psychiatric Services
Go to Psychiatric Services

Cover: The Violoncellist, by Lilla Cabot Perry, 1906. Private collection.

Psychiatric Services
Pages: 888 - 891
PubMed: 25873023

History

Received: 19 April 2014
Revision received: 13 October 2014
Accepted: 24 November 2014
Published online: 15 April 2015
Published in print: August 01, 2015

Authors

Details

José Ramos, M.D.
Dr. Ramos is with the Department of Psychiatry, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal (e-mail: [email protected]). Dr. Santos, Dr. Jorge, and Dr. Maia are with the Department of Psychiatry, Hospital Prof. Doutor Fernando Fonseca, Lisbon. Dr. Cardoso is with the Chronic Diseases Research Center and Department of Mental Health, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon.
Júlio Santos, M.D.
Dr. Ramos is with the Department of Psychiatry, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal (e-mail: [email protected]). Dr. Santos, Dr. Jorge, and Dr. Maia are with the Department of Psychiatry, Hospital Prof. Doutor Fernando Fonseca, Lisbon. Dr. Cardoso is with the Chronic Diseases Research Center and Department of Mental Health, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon.
Susana Jorge, M.D.
Dr. Ramos is with the Department of Psychiatry, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal (e-mail: [email protected]). Dr. Santos, Dr. Jorge, and Dr. Maia are with the Department of Psychiatry, Hospital Prof. Doutor Fernando Fonseca, Lisbon. Dr. Cardoso is with the Chronic Diseases Research Center and Department of Mental Health, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon.
Teresa Maia, M.D., Ph.D.
Dr. Ramos is with the Department of Psychiatry, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal (e-mail: [email protected]). Dr. Santos, Dr. Jorge, and Dr. Maia are with the Department of Psychiatry, Hospital Prof. Doutor Fernando Fonseca, Lisbon. Dr. Cardoso is with the Chronic Diseases Research Center and Department of Mental Health, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon.
Graça Cardoso, M.D., Ph.D.
Dr. Ramos is with the Department of Psychiatry, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal (e-mail: [email protected]). Dr. Santos, Dr. Jorge, and Dr. Maia are with the Department of Psychiatry, Hospital Prof. Doutor Fernando Fonseca, Lisbon. Dr. Cardoso is with the Chronic Diseases Research Center and Department of Mental Health, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon.

Funding Information

The authors report no financial relationships with commercial interests.

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