Predictors of Rehospitalization for Depressed Adolescents Admitted to Acute Psychiatric Treatment

J Clin Psychiatry. 2017 May;78(5):592-598. doi: 10.4088/JCP.15m10326.


Objective: Presently, little is known about what factors predict adolescent psychiatric rehospitalization. Thus, the present study tested whether a battery of demographic and clinical characteristics predicted readmission within 6 months of discharge.

Methods: Participants were 165 adolescents (112 females) aged 13-19 years (mean = 15.61, SD = 1.48) admitted to an acute residential treatment program between November 25, 2013, and November 18, 2014. Patients met diagnostic criteria (DSM-IV-TR) for current major depressive disorder or dysthymia. At admission, participants completed a battery of clinical interviews and questionnaires assessing demographics, early life stress, comorbid diagnoses, psychiatric symptoms, suicidality, self-injury, and risky behavior engagement. At discharge, psychiatric symptoms were reassessed. Readmission to the same residential service was monitored over a 6-month period following discharge.

Results: Overall, 12.1% of adolescents were rehospitalized. We conducted a series of Cox regression survival analyses to test demographic and clinical predictors of patients' time to readmission. More frequent self-injurious behaviors in the month prior to hospitalization was significantly associated with a more rapid time to rehospitalization (β = 0.05, SE = .02, Wald₁ = 4.35, P = .037, OR = 1.05, 95% CI = 1.003-1.10).

Conclusions: It is critical to more effectively manage self-injury during the treatment of depressed adolescents, as this is the strongest predictor of later rehospitalization.

MeSH terms

  • Adolescent
  • Case Management
  • Combined Modality Therapy
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / psychology
  • Depressive Disorder / therapy*
  • Female
  • Humans
  • Interview, Psychological
  • Likelihood Functions
  • Male
  • Massachusetts
  • Patient Readmission / statistics & numerical data*
  • Psychometrics / statistics & numerical data
  • Residential Treatment*
  • Risk Assessment / statistics & numerical data
  • Self-Injurious Behavior / diagnosis
  • Self-Injurious Behavior / epidemiology
  • Self-Injurious Behavior / psychology
  • Self-Injurious Behavior / therapy
  • Surveys and Questionnaires