• Aalia Akhtar Hayat, Muhammad Munir Ahmed, and Fareed Aslam Minhas.
• Institute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi. aaliah_hayat@hotmail.com
• J Coll Physicians Surg Pak. 2013 May 1; 23 (5): 342-6.

ObjectiveTo determine the frequency of patients leaving against medical advice (LAMA) in an inpatient psychiatric facility in Rawalpindi, Pakistan.Study DesignDescriptive cross-sectional study.Place And Duration Of StudyInstitute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi, from August 2010 to February 2011.MethodologyPatients who got admitted during study period irrespective of duration of illness and mode of admission were recruited through non-probability consecutive sampling and followed till discharge to determine their mode of leaving hospital. A thirteen-item proforma was developed and information was obtained on demographic, socioeconomic, patient related and disease related variables. Descriptive statistics were calculated on SPSS 14.ResultsThe total number (n) of participants was 246. Among the participants, 96 (39%) left against medical advice (LAMA) whereas 150 (61%) left on regular discharge on physician's advice. Frequency of patients who left against medical advice was found to be more in males (63.5%), younger age groups (21 - 30 years), lesser educated (more than half were under matric) and with the ICD-10 diagnosis of substance abuse (23.9%). About half of patients who LAMA had a prior history of psychiatric illness and a significant number (37.5%) had a history of previous psychiatric admission.ConclusionLeaving against medical advice is a frequent problem in psychiatric inpatients and is a matter of great concern for the treating doctors.

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