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Introduction:
Discharge against Medical Advice (DAM) is a process during which the patient leaves the hospital without completing the course of treatment and with the consent of the doctor. This study investigated the frequency and causes of discharge against medical advice and its related factors in Ghods Psychiatric Hospital in Sanandaj during 2017.
Method:
This is a descriptive-analytical study. The study population was all patients admitted to Qhods Hospital during 2017. Demographic and hospital related information and reasons for discharge were collected and completed with a pre-designed checklist. Finally, the data were statistically analyzed using SPSS software version 20 and Chi-square test.
 
Results:
The rate of discharge against Medical Advice   was 5.7%, 69.3% of the subjects were male, 55.3% were married, 51.5% were in the age range of 27 to 52 years,. 77.2% of hospitalizations were emergency, 63.4% of hospitalizations were the first time and mainly on holidays , evening and night shifts.
 Sex didn’t have a significant relation with the type of discharge(p=0.538). Day and shift of hospitalization(p=0.001), (p=0.002), age(p=0.001), number  of previous hospitalizations(p=0.0001)., ward(p=0.0001).and marital status(p=0.022).  had a significant relation with the type of discharge.
Personal couses(80.2%) was the main reason for discharge and the patientchr('39')s insistence (36.6%) was the most personal reason for discharge against medical advice.The most discharge occur in first 10 day of admition.
Conclusion:
In general, the rate of discharge against medical advice in Qhods Psychiatric Hospital is lower than other similar psychiatric and non-psychiatric studies in Iran, but higher than the global statistics.The patientchr('39')s insistence was the main reason for discharge and The most discharge occur in first 10 day of admition .According to this results, it seems that more focus on patient education during hospitalization, especially in the first days plays a major role in reducing discharge against medical advice and consequently reduce the complications   in health care system.