Are early post‐discharge physician contacts associated with 30‐day psychiatric re‐hospitalisation? A nationwide claims data based retrospective cohort study in Austria free of immortal time bias

Abstract Objectives Cost containment and quality of care considerations have increased research interest in the potential preventability of early re‐hospitalisations. Various registry‐based retrospective cohort studies on psychiatric re‐hospitalisation have focused on the role of early post‐discharge service contacts, but either did not consider their time‐dependent nature (‘immortal time bias’) or evaded the issue by analysing late re‐hospitalisations. The present study takes care of the immortal time bias in studying early psychiatric re‐hospitalisations. Methods In a retrospective cohort study using nationwide electronic claims data in Austria, 10,689 adults discharged from acute psychiatric inpatient wards were followed up for 30 days. Cox regression analyses were performed with post‐discharge psychiatric and general practitioner contacts as time‐dependent covariates and time to first psychiatric re‐hospitalisation as outcome. Results Post‐discharge ambulatory physician contacts were significantly associated with a decreased psychiatric re‐hospitalisation rate (hazard ratio 0.77 [95% CI 0.69; 0.87], p < 0.0001), with similarly strong contributions to this association by general practitioners and psychiatrists. Conclusions Despite avoiding the immortal time bias and controlling for several confounders, we suggest to be cautious with a causal interpretation of the identified association, since potentially relevant confounders, such as disease severity, were unavailable in our claims data base

Immersive Episodic Memory Assessment with 360\ub0 Videos: The Protocol and a Case Study

Episodic memory has been conceptualized as the memory for personal events with specific spatiotemporal components. The assessment of episodic memory is usually conducted by means of verbal recall tasks, in which the individual is required to repeat what (s)he remembers from a previously presented verbal material (either single words or a brief story). However, the need of a more ecological approach to memory assessment led researchers to investigate the potential use of 360\ub0 videos as a suitable tool to present real life scenes to be remembered. The present study presents the protocol of the assessment of episodic memory employing five 360\ub0 video that represent interpersonal, emotional experiences known to be altered in psychopathological conditions. Furthermore, a case study in which the assessment protocol is applied to a patient with Borderline Personality Disorder is described. The results of the case study seem to indicate that our 360\ub0 videos are able to detect anomalies in remembering the behaviors displayed, the connected emotion together with details regarding the \u201cwhere\u201d and \u201cwhen\u201d components of the episodic recall