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Thomas H. McGlashan, MD; Robert K. Heinssen, PhD

Arch Gen Psychiatry. 1988;45(4):363-368.

Abstract
• The prognosis of self-discharged inpatients has seldom been studied, especially by diagnosis, and is frequently assumed to be poor. This study evaluated the long-term (15year average) outcome of inpatients discharged with medical advice (WMA), against medical advice (AMA), or by transfer for patients with schizophrenia (N =113), schizoaffective disorder (N= 46), borderline personality disorder (N = 63), and unipolar affective disorder (N = 33) from a follow-up study. Results showed that outcome among discharge cohorts varied considerably depending on diagnostic category. Within each diagnostic cohort, outcome of transferred patients was poorest. The outcome of AMA-discharged patients was poorer than the outcome of patients discharged with medical advice only in the unipolar cohort, except that AMA discharge in schizoaffective patients correlated significantly with suicide.

Author Affiliations
From the Chestnut Lodge Research Institute, Rockville, Md.

Footnotes
Accepted for publication Nov 5, 1987.

Reprint requests to Chestnut Lodge Research Institute, 500 W Montgomery Ave, Rockville, MD 20850 (Dr McGlashan).

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