Drug treatment refusal,diagnosis, and length of hospitalization in involuntary psychiatric patients

A retrospective study of 664 involuntary psychotic inpatients who were discharged in a 27-month period indicated that 18% refused antipsychotic drug treatment. Statistical differences between refusers and consenters were found in diagnosis, length of hospitalization, and dosage of antipsychotic medications prescribed at the time of discharge. Compared with consenters, refusers were more often diagnosed as having bipolar or schizoaffective disorder while a majority of consenting patients were diagnosed as having schizophrenia. The variance in length of stay was explained by diagnosis alone. Refusers were receiving antipsychotic medication at discharge of one-half the average daily dosage of consenters. Both refusal status and diagnosis were found to contribute statistically to the variance in antipsychotic drug dosage.