P-1318 - Determinants of the « revolving door » syndrom in tunisian population of patients with schizophrenia

Revolving Door Syndrome usually corresponds to what might be called “hospital multiple readmissions phenomenon”. Beyond consequences to the patients and their families, frequent re-readmissions also heavily increase healthcare cost and cause burn out among medical and paramedical staff. The objective of this study was to find the characteristics of Tunisian patients with “revolving door” syndrome. The purpose of this study was to identify factors associated to short-term readmissions in a sample of Tunisian patients with schizophrenia. The authors conducted a retrospective study on 50 patients with schizophrenia or schizo-affective disorders from November to february 2009 in Razi Hospital's “Psychiatry C” service. Patients included in the study had been hospitalized at least 4 times. The patients were analyzed for socio-demographic characteristics, total readmissions and the number of admissions in the last year. Their medication adherence was evaluated by MARS (Medication Adherence Rating Scale) and their insight was evaluated by the Q8 scale. The sample was composed of 50 patients with schizophrenia or schizo-affective disorders according to DSM-IV, more than 18 years of age, which have been hospitalized more than 4 times. The sample was composed of 80% men. 74% of the sample was single and 66% were living with their parents. 88% were unemployed. 54% of patients were bad observers and 88% had lack of insight. The authors found that the typical Tunisian revolving door patient is a single man, living at his parent's, unemployed and with a lack of observation skills and insight.