Abstract
Introduction
Psychiatric intensive care units (PICUs) provide intensive and short-term management in a secure environment, for mentally disordered patients with acute and severe behavioural disturbance. It previously has been demonstrated that patients admitted into PICUs are predominantly male (Bowers et al., 2008; Pereira et al., 2006). We investigated the gender differences in patients admitted into a seven-bedded PICU within a county psychiatric hospital that serves a population of around 380,000 in south Northamptonshire.
Method
Data were collected retrospectively on all admissions to the PICU over a two-year period between January 2009 and January 2011, using a standardized data collection tool. For each case, information was obtained shortly after admission through clinical records on gender, ethnicity, age, source of referral, reason for referral, diagnoses, legal status and previous psychiatric admissions details. Information regarding the reason for referral was based on the referrer’s account. The χ 2 test was used to examine relationships between variables.
Results
There were a total 206 admissions into the PICU during the study period. Of these admissions, 142 (69%) were male and 64 (31%) were female. Statistically significant differences between male and female cases were found in the following variables:
Admission pathway (p = .036): females were more likely to be admitted from an open ward (55%), whereas males were more likely to be admitted directly from the community (54%).
Reason for referral (p = .022): males were more likely than females to be referred to PICU for aggression (64% vs 58%).
Secondary diagnosis (p < .001): males were more likely than females to have misused substances (64% vs 27%).
There were no statistically significant differences between the two genders in terms of ethnicity, primary diagnosis, previous PICU usage, legal status and whether it was their first psychiatric admission.
Discussion
These findings are in line with previously published studies showing that the majority of patients admitted to PICUs are male (Bowers et al., 2008; Pereira et al., 2006). Although aggression management was the main reason for referral to PICU for both genders, male patients were more likely to be admitted for this reason. This may, in part, be explained by the remarkable difference between the two genders in our sample in the prevalence of substance misuse. Substance misuse has been shown to be an independent risk factor for aggression in schizophrenic patients (Lindqvist & Allebeck, 1989; Richardson et al., 1985). Further research is required in order to identify the reasons underlying the revealed differences. Future studies should quantify aggressive behaviour and take into consideration socio-economic factors that were not covered in this study.