Discharge Against Medical Active from Psychiatric Ward

Premature discharge is known as a cause of relapse of psychiatric disorder and readmission. Health supervisors and researchers are eager to keep this kind of discharge minimal. Current study was done to evaluate the frequency of Discharge Against Medical Advice (AMA) from psychiatric ward and correlated variables. In this case-control retrospective study, the chart of 908 admissions in psychiatry ward of Baqiatallah hospital between 1997 and 2003 were studied. Random sampling was done. Patients were divided to patients discharged AMA and those discharged with Medical Advice. Demographic and mental health related variables were registered and compared in two groups. 31 subjects (3.4%) were discharged Against Medical Advice and 877 (96.6%) with Medical Advice. Discharge AMA was significantly correlated with psychotic disorders and depressive disorders, but not with personality disorder, anxiety disorder and bipolar disorders. Age, being soldier, socioeconomic status, military duty, familial history of mental health disorder in relatives, history of suicide, using drugs and cigarette was not significantly correlated with discharge AMA. Over 3% of subjects who admit to Baqyiatallah hospital are discharged against medical advice. Patients with depressive or psychotic disorders are at higher risk for discharge with AMA. With respect to decrease the frequency of discharge against medical advice, it seems t be essential to give instruction to some groups of patients such as those with depressive or psychotic disorders. Further studies are recommended.