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For patients with psychiatric conditions, data shows that both illness severity and instability are key factors in predicting their future risk of hospitalisation.

Doctor talking to patient © Shutterstock

The research team, led by clinical psychiatrist and University of Oxford senior research fellow Maxime Taquet, found that patients who experienced severe illness and instability within two months of seeing their clinician had a significantly higher risk of psychiatric hospitalisation within six months.

Patients ranking in the top half for clinical severity and instability had a 45 per cent increased risk of hospitalisation.

The research, conducted using data from 36,000 US patients collated by behavioural health data analytics company Holmusk, also found that this association remained consistent across a wide range of diagnoses, including major depressive disorder, bipolar disorder, schizophrenia, post-traumatic stress disorder, and others. The association was seen in both adults and children, and both men and women.

Dr Taquet said:

“This research has implications for many areas of mental illness and health. In clinical practice, providers might use severity and instability to aid in making decisions, such as which patients might benefit from intensive interventions. Hospitals and health systems might use this information in planning provision of care, such as predicting need for psychiatric hospital beds.

“Finally, these results are important in research and might be used to accelerate the development of new interventions that aim to prevent hospitalisation or to help in recruitment of specific patient cohorts based on their hospitalisation risk.”

Co-author Dr Rashmi Patel, Senior Clinical Lecturer and NIHR Advanced Fellow at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London, said: “Traditional measurement of illness severity focuses around using numerical scores to estimate how severely unwell a patient is at a given time. However, severity of illness isn’t fixed or static. People experiencing a mental disorder can experience fluctuations in their symptoms or severity of illness and a numerical score estimated at a single point in time may not accurately reflect the nature of an individual’s illness or its likely progression subsequently.

“Measuring clinical instability in addition to clinical severity could help to better predict outcomes and guide the initial care of people presenting with symptoms of a mental disorder.”

The data was collected using Holmusk’s NeuroBlu database.

Nawal Roy, Founder and CEO of Holmusk, said: “Our vision in creating the NeuroBlu Database was to provide the gold standard for behavioural health real-world data. Findings like these validate that this vision is being realised. Even more importantly, they underscore the importance of developing standardised measures across behavioural health care in order to improve patient care and outcomes.”

In addition to his role at University of Oxford, Dr Taquet has a consultancy contract to conduct research at Holmusk.

The full study is available in the Lancet Psychiatry