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To examine factors associated with prolonged length of stay (LOS) on an inpatient, acute geropsychiatry service, the authors reviewed electronic medical records and social work files for patients discharged during a 12-month period. There was no significant correlation between LOS and age, medical comorbidity, or the presence of dementia, depression, or psychosis. Patients transferred to adult homes or nursing homes stayed twice as long as patients who returned to their own homes (84 vs. 41 days; P= 0.002). Discharge disposition (rather than clinical factors) is associated with prolonged LOS in geropsychiatry and should be the focus of efforts to shorten hospital stays., (Copyright © 1994. Published by Elsevier Inc. All rights reserved.)

Guidelines are set forth for judges and others who must make decisions in custody disputes that include allegations of child sexual abuse. The focus is on the protection of the child and the model highlights the role of mental health professionals, prescribing separate therapists for child and parent where possible. Allegations of sexual abuse are seen as an indicator of emotional risk for the child, even in cases where the allegations are untrue.