More men than women admitted to psychiatric hospitals for depression and anxiety
By Ashwin, UK Correspondent
Oct 5, 2004, 16:12

A study in the October issue of the British Journal of Psychiatry has found that, contrary to belief, and the findings of population morbidity surveys, psychiatric admissions are more common for men than for women, and for depression and anxiety than for psychosis.

This study was carried out by researchers at the University of Bristol and the South West Public Health Authority using the Department of Health's national Hospital Episode Statistics data on admissions to NHS hospitals in England between April 1999 and March 2000. The aim was to investigate admission rates of patients aged 16-64 by region, age, gender and diagnosis.

Although the number of in-patient psychiatric beds in England has fallen dramatically over the past 40 years, hospitalisation still accounts for about 75% of NHS spending on mental health. The assessment and reporting of national patterns of psychiatric hospital admissions is important for strategic service development and planning.

It was found that there were 102,980 admissions to psychiatric hospitals in England during the study period. The mental illness specialty of psychiatry accounted for 97.3% of all admissions. Rates for old age psychiatry were 0.9%, forensic psychiatry 0.8%, mental handicap 0.6%, child and adolescent psychiatry 0.4% and psychotherapy 0.04%.

The overall annual admission rate for England was 3.2 per 1000 population. Rates were highest in the North West region (3.8 per 1000) and lowest in the Eastern region (2.7 per 1000), a difference of about 30%.

Overall, the admission rates were higher for males (3.3 per 1000) than females (3.0 per 1000). The gender ratio was narrowest in the older age groups.

Depression and anxiety together were the most common reason for admission (29.6%). Schizophrenia and related psychoses accounted for 26%, substance misuse 19.1% and others 12.2%.

The proportion of admissions for schizophrenia and related psychoses was higher than for depression and anxiety in London only (34.5% v. 21.7%). The proportion of admissions for substance misuse was highest in the North West region, and for organic disorders in the Northern and Yorkshire region.

Although the London region had the second lowest admission rate, it had the highest proportion of long-stay patients. Length of stay was greatest for schizophrenia, almost twice that for depression and anxiety.

The authors comment that the findings of the study may point to variations in service delivery or availability. The impact on patient outcomes is uncertain.

Thompson A, Shaw M, Harrison G, Verne J, Ho D and Gunnell D (2004) Patterns of hospital admission for adult psychiatric illness in England: analysis of Hospital Episode Statistics data, British Journal of Psychiatry, 185, 334-341.

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