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Patient-controlled hospital admission for patients with severe mental disorders: study protocol for a nationwide prospective multicentre study
  1. Christoffer Torgaard Thomsen1,2,
  2. Michael Eriksen Benros2,
  3. Lene Halling Hastrup2,3,
  4. Per Kragh Andersen4,
  5. Domenico Giacco5,
  6. Merete Nordentoft2
  1. 1Mental Health Centre Frederiksberg, Copenhagen University Hospital, Copenhagen, Denmark
  2. 2Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
  3. 3Psychiatric Research Unit, Region Zealand, Slagelse, Denmark
  4. 4Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
  5. 5Unit for Social and Community Psychiatry (World Health Organisation, Collaborating Centre for Mental Health Services Development), Queen Mary, University of London, London, UK
  1. Correspondence to Christoffer Torgaard Thomsen; christoffer.torgaard.thomsen{at}


Introduction Patient-controlled hospital admission for individuals with severe mental disorders is a novel approach in mental healthcare. Patients can admit themselves to a hospital unit for a short stay without being assessed by a psychiatrist or contacting the emergency department. Previous studies assessing the outcomes of patient-controlled hospital admission found trends towards reduction in the use of coercive measures and length of hospital stay; however, these studies have methodological shortcomings and small sample sizes. Larger studies are needed to estimate the effect of patient-controlled hospital admission on the use of coercion and of healthcare services.

Design and methods We aim to recruit at least 315 patients who are offered a contract for patient-controlled hospital admissions in eight different hospitals in Denmark. Patients will be followed-up for at least 1 year to compare the use of coercive measures and of healthcare services, the use of medications and suicidal behaviour. Descriptive statistics will be used to investigate hospitalisations, global assessment of functioning (GAF) and patient satisfaction with treatment. To minimise selection bias, we will match individuals using patient-controlled hospital admission and controls with a 1:5 ratio via a propensity score based on the following factors: sex, age group, primary diagnosis, substance abuse as secondary diagnosis, coercion, number of psychiatric bed days, psychiatric history, urbanity and suicidal behaviour. Additionally, a historical control study will be undertaken in which patients serve as their own control group prior to index date.

Ethics and dissemination The study has been approved by The Danish Health and Medicines Authority ( 3-3013-934/1/) and by The Danish Data Protection Agency ( 2012-58-0004). The study was categorised as a register study by The Danish Health Research Ethics Committee and therefore no further approval was needed ( H-2-2014-FSP70). Findings will be disseminated through scientific publications, presentations and in a PhD thesis.


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