The main aim of this study is to assess the prevalence of early readmissions to inpatient care in Hospital Bahagia Ulu Kinta and the associated socio-demographic and clinical factors. Methods: This is an observational study for all patients with readmissions within 3 months from the last discharge, dated from 1 January 2013 to 31 December 2013. Related socio-demographic and clinical details are obtained from the medical records and compared between the patients who were readmitted within the first month after discharge to those who were readmitted later in the second and third month. Results: Total of 149 records of patients who were readmitted within 3 months of last discharge were analyzed. Majority of them were from the same state of Perak (83.9%), male (74.5%), single (71.1%), unemployed (85.9%), taken care by family (75.2%), achieved secondary education level (59.7%) with mean age of 37.89 years (SD 11.53). They were discharged for a mean of 32.52 days (SD 26.48) before readmission with a mean duration of 72.98 days in the previous admission, and mean previous admissions of 10.17 times. 69.8% of the patients were treated for psychotic disorders and the main reason for readmission was relapse (84.6%). Up to 34.2% of the patients reported to have substance abuse while 25.5% had medical co-morbidities. Most of the patients (63.8%) were not compliant to the treatment from the last discharge. Socioeconomic and clinical factors did not show statistical significance when the readmissions within the first month after discharge were compared to those who were admitted later at the second and third month. Conclusions: Due to limitations, further studies need to be done to identify risk factors associated with readmissions and adequate measures need to be taken to prevent these readmissions. ASEAN Journal of Psychiatry, Vol. 18 (1): January – June 2017: XX XX.

Objective: According to Malaysian law, defendants found not guilty by reason of insanity may be admitted to a psychiatric hospital and discharge is subject to the state ruler’s assent. The objective of this study is to examine the clinical, socio-demographic and forensic factors that influence inpatient duration of insanity acquittees in a Malaysian mental institution. Methods: This is a cross-sectional study of one hundred and twelve insanity acquittee inpatients in Hospital Bahagia Ulu Kinta from January 2007 to February 2007. Patients with a clinical diagnosis of schizophrenia, major depressive disorder and bipolar disorder were assessed using the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAMD) and Young Mania Rating Scale (YMRS) respectively. Other relevant socio-demographic, clinical and forensic factors were also assessed. Results: The inpatient duration varied widely from three months to forty-seven years with a median of seven years. Seventy five percent of patients were in remission. According to the multiple linear regression model, the strongest predictor of a longer duration of hospital stay for insanity acquittees was older age (p<0.001) followed by murder as the index offence (p=0.005). Good family support predicted a shorter inpatient duration. This model explains 56% of the variance in the inpatient duration. Conclusion: Social factors such as family support may be increasingly important in determining the discharge process of insanity acquittees besides clinical rehabilitation. Issues such as stigma of violent forensic patients and the role of community forensic rehabilitation services need to be further explored.