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Psychiatric Symptom Severity and Length of Stay on an Intensive Rehabilitation Unit

Received February 1, 1999; revised August 12, 1999; accepted August 24, 1999. From the Beth Israel Medical Center/Albert Einstein School of Medicine, New York, NY. Address reprint requests to Dr. Galynker, 6 Karpas, Department of Psychiatry, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003.

The purpose of this study was to evaluate the role of psychiatric symptoms in the medical and surgical rehabilitation of patients on an intensive rehabilitation unit and to examine whether psychiatric symptom severity contributes to length of hospital stay (LOS). Forty-four patients (21 men and 23 women) were assessed at admission and before discharge with the Functional Independence Measure (FIM). Subjects were evaluated with the Mini-Mental State Exam (MMSE), the Hamilton Rating Scale for Depression (Ham-D), Positive and Negative Symptom Scale, (PANSS), and Scale for the Assessment of Negative Symptoms (SANS). Thirty-six percent of subjects were cognitively impaired (MMSE<25), 14% had significant depressive symptoms (Ham-D>12), and 52% had significant negative symptomatology (PANSS-N>15). A regression analysis yielded a model of three predictive factors. Gender, the PANSS General subscale, and the SANS Attention subscale accounted for 42.4% of LOS variance. These results indicate that psychiatric symptoms are common in medical rehabilitation inpatients and, together with demographic factors, are associated with increased LOS.

Key Words: Symptoms/Dimensions • Rehabilitation • Length of Stay

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