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Aggravating stress and functional level as predictors of length of psychiatric hospitalization.

Diagnosis in general and diagnosisrelated groups (DRGs) in particular are poor predictors of hospital length of stay for psychiatric patients (1 ,2). Variables such as sex and age (1-4) or stage ofillness (5) are correlated with length of stay, but they do not by themselves dramatically improve prediction of resource use. Mezzich and associates (6) have shown that measures of aggravating stress, as recorded on axis IV of DSM-III (7), and current functional level, as assessed with the axis V scale, are significantly correlated with the decision to hospitalize a psychiatric patient. Our own work suggests that aggravating stress and premorbid functional level are important predictors oflength ofstay (1,3,4). This paper explores the relationship between length of stay and data derived from axis IV and axis V of DSM-III. We hypothesize that the ratio of aggravating stress