정신과 입원환자의 병원이탈에 대한 고찰

A Study of Elopement of Psychiatric Inpatients

This study was a survey o f all available hospital records pertaining to the 300 elopers of psychiatric inpatients admitted at Naju National Mental Hospital during the years between 1991 -1993. The findings were compared with randomly selected control group o f 300 inpatients who were admitted during the same period. This study was designed to evaluate the demographic data and clinical characteristics, motivations, and results of elopement in these patients. Results were as follows ： 1) During 3 years, 308 of 4670 inpatients (6.5%) committed elopement. 2) Most of them were involuntarily admitted young male patients and they were likely to be unmarried, unemployed, and high-school graduated compared to control group. Their socioeconomic status were relatively low. 3) While the control group was mainly diagnosed as undifferentiated schizophrenia, most of elopers was diagnosed as paranoid schizophrenia. 4) Clinically, elopers had chronic course of illness, frequent and long-term hospitalization, and previous history of elopement than control group. 5) Patients in open wards showed more frequent elopement behavior than those in closed wards. They were likely to elope during the strolling. Many attempted to elope on Thursday when the family members visited them. 6) Most of the elopers were safely returned to the hospital and the management was simple interview without restraint. Many of families were not unconcerned about the patient s elopement. 7) Elopement group were characterized by their severe psychotic symptoms(hallucination, delusion). poor relationship with treatment teams, and cold familial concerns. It was suggested that the patient’s intrapsychic factor(42.8%) was the most important factor in determining the elopement.