Abstract
Objectivesthis Italian observational study was aimed at collecting data of psychiatric patients with acute episodes entering General Hospital Psychiatric Wards (GHPWs). Information was focused on diagnosis (DSM-IV), reasons of hospitalisation, prescribed treatment, outcome of aggressive episodes, evolution of the acute episode.Methodsassessments were performed at admission and discharge. Used psychometric scales were the Brief Psychiatric Rating Scale (BPRS), the Modified Overt Aggression Scale (MOAS) and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30).Results864 adult patients were enrolled in 15 GHPWs: 728 (320 M; mean age 43.6 yrs) completed both admission and discharge visits. A severe psychotic episode with (19.1%) or without (47.7%) aggressive behaviour was the main reason of admission. Schizophrenia (42.8% at admission and 40.1% at discharge) and depression (12.9% at admission and 14.7% at discharge) were the predominant diagnoses. The mean hospital stay was 12 days. The mean (± SD) total score of MOAS at admission, day 7 and discharge was, respectively, 2.53 ± 5.1, 0.38 ± 2.2, and 0.21 ± 1.5. Forty-four (6.0%) patients had episodes of aggressiveness at admission and 8 (1.7%) at day 7. A progressive improvement in each domain/item vs. admission was observed for MOAS and BPRS, while NOSIE-30 did not change from day 4 onwards.The number of patients with al least one psychotic drug taken at admission, in the first 7 days of hospitalisation, and prescribed at discharge, was, respectively: 472 (64.8%), 686 (94.2%) and 676 (92.9%). The respective most frequently psychotic drugs were: BDZs (60.6%, 85.7%, 69.5%), typical anti-psychotics (48.3%, 57.0%, 49.6%), atypical anti-psychotics (35.6%, 41.8%, 39.8%) and antidepressants (40.9%, 48.8%, 43.2%). Rates of patients with one, two or > 2 psychotic drugs taken at admission and day 7, and prescribed at discharge, were, respectively: 24.8%, 8.2% and 13.5% in mono-therapy; 22.0%, 20.6% and 26.6% with two drugs, and 53.2%, 57.8% and 59.0% with > two drugs. Benzodiazepines were the most common drugs both at admission (60.0%) and during hospitalisation (85.7%), and 69.5% were prescribed at discharge.Conclusionpatients with psychiatric diseases in acute phase experienced a satisfactory outcome following intensified therapeutic interventions during hospitalisation.
Highlights
Despite an increasing amount of studies on the epidemiology of acute mental disorders and the availability of recently introduced pharmacological interventions in the management of such conditions, only few reports provide detailed information on the characteristics of psychiatric patients and treatments received both in the hospital setting and as routine clinical practice [1].In Italy, a law issued in 1978 stated that all admission of psychiatric patients had to take place in the General Hospital Psychiatric Wards (GHPWs), prohibiting the admission to Psychiatric Hospitals
Patients previously enrolled in this study and newly admitted to GHPWs were excluded from participation; any new admission was recorded in the case report form
A total of 864 patients were enrolled in 15 GHPWs and 728 of them (320 males and 408 females) resulted to be evaluable
Summary
Despite an increasing amount of studies on the epidemiology of acute mental disorders and the availability of recently introduced pharmacological interventions in the management of such conditions, only few reports provide detailed information on the characteristics of psychiatric patients and treatments received both in the hospital setting and as routine clinical practice [1].In Italy, a law issued in 1978 stated that all admission of psychiatric patients had to take place in the General Hospital Psychiatric Wards (GHPWs), prohibiting the admission to Psychiatric Hospitals. Despite an increasing amount of studies on the epidemiology of acute mental disorders and the availability of recently introduced pharmacological interventions in the management of such conditions, only few reports provide detailed information on the characteristics of psychiatric patients and treatments received both in the hospital setting and as routine clinical practice [1]. Most of reports refer to studies performed in local settings [2,3,4], which may differ between them in terms of methods of admission, patients' demographics and sociocultural background, and interventions. Patients remain in GHPWs only during the acute phase. At discharge, they usually receive therapeutic prescriptions and are no more followed by GHPWs structures, but they are followed by territorial services, which are not part of General Hospitals.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
