The Revolving Door Phenomenon: Psychiatric Hospitalization and Risk of Readmission Among Drug-Addicted Patients

Background. Substance use may influence the onset and course of psychiatric diseases. The "Revolving door" (RD) phenomenon, which indicates repeated hospitalizations of the same patients, has become a public health. Objectives. The aim of this study was detecting the risk factors associated to hospital readmission to psychiatric wards of drug-addicted patients. Methods. The study considered all the admissions performed between 2006 and 2015 in Abruzzo, Italy. Only the hospital discharge registry having code 304 (drug dependence) as diagnosis was taken into account. In addition, only the patients with a psychiatric DRG were included. Results. 325 patients performed 558 psychiatric admissions during the study period (1089 person-years). The analyses of the discharge registry showed "Psychoses" as the main DRG (73.2%). An amount of 119 patients experienced a second psychiatric admission. Psychiatric readmissions were independently predicted by Schizofrenia (HR=2.061) and Anxiety disorders (HR=0.326). Conclusions. Psychiatric hospitalization and readmission are frequent among drug-addicted patients. The subsequent RD phenomenon has become a public health issue, both for health and economic sides.