Frequent visits to a French psychiatric emergency service: diagnostic variability in psychotic disorders.

ABSTRACT

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.