REPEATED VISITS IN THE PES

Chaput YJA, Lebel MJ. Demographic and clinical profiles of patients who make multiple visits to psychiatric emergency services. Psychiatr Serv. 2007;58:335-341.

Using data from patients who visited a psychiatric emergency service (PES) in Montreal from 1985 to 2000, researchers determined that most visits to the PES were made by frequent users who had distinctive profiles.

During the study period, 14,825 patients made 29,569 visits to the PES. A total of 10,571 patients (71%) made single visits (36% of all visits), 2046 patients (14%) made 2 visits (4092 visits; 14% of all visits), 1916 patients (13%) made 3 to 10 visits (8826 visits; 30% of all visits), and 292 patients (2%) made 11 or more visits (6080 visits; 21% of all visits). Of all visits, 64% were between 8 am and 7:59 pm. Persons from younger groups (44 years or younger) were overrepresented, especially in the group with 11 or more visits.

Patients with multiple visits were significantly more likely to have schizophrenia. The more PES visits that patients had, the more likely they were to have a comorbid psychiatric diagnosis and the more likely they were to be economically impaired.

Schizophrenia, conduct disorder, and mania were cited as the reason for the PES visit 50% more often in the group with 11 or more visits than in the single-visit group. However, substance use disorder was cited as the primary diagnosis for 21% of visits by all other groups (1 visit, 2 visits, and 3 to 10 visits), and affective disorder was listed as the primary diagnosis for more than 20% of visits by all groups.