MULTIPLE ADMISSIONS TO THE PSYCHIATRIC-HOSPITAL - A STUDY ABOUT THE SO-CALLED REVOLVING-DOOR PATIENTS

The graph of the frequency distribution of rehospitalization shows a constant exponential decline without demarking a particular population of so-called "revolving-door" patients. Patients with at least four admissions to a regional psychiatry hospital within a time span of two years are compared to a control group of the total clinic population. Multiple admission patients suffer significantly more often from diseases with an unfavourable prognosis, the illness has started earlier in their lives, and the course of illness is marked by unstable dynamic states with frequent crises of suicide. A demographic analysis shows the group under survey to be younger and less often married; participation in the world of labour has been lost more often, schizophrenics who have frequently stayed in hospitals even loose their former autonomy in housing. Guardianships are significantly more often installed, but they have not proved to be an efficient form of help. The therapeutic care of this problem patients is rather unsatisfactory. The offered ambulatory services are not claimed and in hospital the special treatment units fail to reach these patients. Lack of therapeutic continuity and compliance determines the course of treatment and complicates the-rapeutic strategies.