Difficult patients in mental health care–who are they?

IntroductionDifficult patients are not something new and we can find innumerous definitions for this concept. However, they form a very heterogenous group and we need a less abstract definition focused more on the clinical reality and the difficulties experienced by patients and mental health profes...

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Bibliographic Details
Published in:European psychiatry 2023-03, Vol.66 (S1), p.S900-S900
Main Authors: Figueiredo, I. M., Soares, G., Lopes, C., Rodrigues, A. C., Falcão, A. L., Lourenço, A., Cargaleiro, I., Nascimento, M., Oliveira, C.
Format: Article
Language:English
Subjects:
Abstract
Cluster analysis
e-Poster Viewing
Hospitalization
Mental health
Patients
Somatoform disorders
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Summary:IntroductionDifficult patients are not something new and we can find innumerous definitions for this concept. However, they form a very heterogenous group and we need a less abstract definition focused more on the clinical reality and the difficulties experienced by patients and mental health professionals.ObjectivesOur goal was to find a more precise and clinical definition of the difficult patient based on quantitative measures using a statistical analysis of a series of hospitalizations.MethodsA cluster analysis of our hospital’s in-patient treatment from the last 5 years was made concerning the duration of the stay and the number of previous hospitalizations.ResultsA sample of 8576 inpatient treatment episodes was used. 52.4% were male and 47.6% female patients between the age of 15 and 103 years old. The length of the treatment varied from 0 to 1007 days and the number of previous hospitalizations from 0 to 109; excluding the outliers the means were, respectively, 21 days and 2 previous hospitalizations.The cluster analysis excluded 85 episodes and it found the presence of 3 clusters, being the number 1 the wider one (n=5861 episodes) and the other quite similar.The Cluster 1 was characterized by a smaller length of hospital stay and number of hospitalizations; the Cluster 2 was defined by the episodes with the highest number of previous hospitalizations (`x =8.77) and the Cluster C by the longest hospital stays (`x =58.09 days). With a Kruskal-Wallis test we found both variables statistically different between all clusters (p
ISSN:0924-9338
1778-3585
DOI:10.1192/j.eurpsy.2023.1907