A Choice-Based Conjoint Analysis of the Psychiatrist Decision-Making Process Used in Determining When to Discharge Adults with Major Depressive Disorder Hospitalized for Active Suicidal Ideation with Intent

Abstract

To ascertain the relative importance of attributes considered when deciding to discharge patients hospitalized with major depressive disorder (MDD) and active suicidal ideation with intent, a choice-based conjoint analysis was conducted via online survey among US-based psychiatrists actively managing such patients. Potential attributes and attribute levels were identified. Attribute importance in decision to discharge and the discharge time frame were assessed. One hundred psychiatrists completed the survey. The relative importance of attributes were current MDD severity (relative importance weight [out of 100] 24.8 [95% confidence interval, 23.3–26.3]), clinician assessment of current suicidal ideation (20.8 [18.5–23.0]), previous history of suicide attempts (16.7 [15.9–17.6]), psychosocial support at discharge (13.0 [11.7–14.4]), postdischarge outpatient follow-up (9.8 [8.8–10.8]), current length of hospital stay (9.2 [8.1–10.3]), and suicidal ideation at admission (5.7 [4.8–6.6]). Thus, current clinical symptoms were considered the most important attributes by psychiatrists when discharging patients initially hospitalized with MDD and active suicidal ideation with intent.