Use of psychiatric hospitals and social integration of patients with psychiatric disorders: a prospective cohort study in five European countries

Purpose Long lengths of stay (LoS) in psychiatric hospitals or repeated admission may affect the social integration of patients with psychiatric disorders. So far, however, studies have been inconclusive. This study aimed to analyse whether long LoS or repeated admissions in psychiatric wards were associated in different ways with changes in the social integration of patients. Methods Within a prospective cohort study, data were collected on 2181 patients with a main ICD-10 diagnosis of psychotic, affective, or anxiety disorder, hospitalised in the UK, Italy, Germany, Poland, and Belgium in 2015. Social integration was measured at baseline and 1 year after admission using the SIX index, which includes four dimensions: employment, housing, family situation, and friendship. Regression models were performed to test the association between LoS, the number of admissions, and the change in social integration over the study period, controlling for patients’ characteristics (trial registration ISRCTN40256812). Results A longer LoS was significantly associated with a decrease in social integration ( β = − 0.23, 95%CI − 0.32 to − 0.14, p = 0.03), particularly regarding employment (OR = 2.21, 95%CI 1.18–3.24, p = 0.02), housing (OR = 3.45, 95%CI 1.74–5.16, p