Frequent Visits to a French Psychiatric Emergency Service: Diagnostic Variability in Psychotic Disorders

Objective: This study examined characteristics of frequent visitors to a psychiatric emergency service in a French public teaching hospital over six years. Diagnostic variability of psychotic disorders was documented. Methods: A retrospective review of the service's administrative and medical databases identified 1,285 patients with more than one visit during the period who were given at least one diagnosis of a psychotic disorder. A total of 317 patients with six or more visits (frequent visitors) were compared with 968 patients with between two and five visits (occasional visitors). Results: Frequent visitors were significantly more likely to be single and homeless and to have diagnostic variability, substance use disorders, and personality disorders. A total of 177 patients experienced diagnostic variability, which was found mainly in three diagnostic categories: schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features. Conclusions: Future studies should further examine the link between increased use of emergency services and diagnostic variability. (Psychiatric Services 62:966-970, 2011)