Abstract
BackgroundThe PERSEO study (psychiatric emergency study and epidemiology) is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management). The aims of this paper are: (i) to describe the epidemiological and clinical characteristics of patients, including sociodemographic features, risk factors, life habits and psychiatric diagnoses; and (ii) to assess the clinical management, subjective wellbeing and attitudes toward medications.MethodsA total of 62 SPDCs distributed throughout Italy participated in the study and 2521 patients were enrolled over the 5-month study period.ResultsAlmost half of patients (46%) showed an aggressive behaviour at admission to ward, but they engaged more commonly in verbal aggression (38%), than in aggression toward other people (20%). A total of 78% of patients had a psychiatric diagnosis at admission, most frequently schizophrenia (36%), followed by depression (16%) and personality disorders (14%), and no relevant changes in the diagnoses pattern were observed during hospital stay. Benzodiazepines were the most commonly prescribed drugs, regardless of diagnosis, at all time points. Overall, up to 83% of patients were treated with neuroleptic drugs and up to 27% received more than one neuroleptic either during hospital stay or at discharge. Atypical and conventional antipsychotics were equally prescribed for schizophrenia (59 vs 65% during stay and 59 vs 60% at discharge), while atypical drugs were preferred in schizoaffective psychoses (72 vs 49% during stay and 70 vs 46% at discharge) and depression (41 vs 32% during stay and 44 vs 25% at discharge). Atypical neuroleptics were slightly preferred to conventional ones at hospital discharge (52 vs 44%). Polypharmacy was in general widely used. Patient attitudes toward medications were on average positive and self-reported compliance increased during hospital stay.ConclusionResults confirm the widespread use of antipsychotics and the increasing trend in atypical drugs prescription, in both psychiatric in- and outpatients.
Highlights
The PERSEO study is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management)
In Italy, since 1978, the law prescribes that psychiatric patients can only be admitted to hospitals through these specific emergency structures, called SPDCs (Servizio Psichiatrico Diagnosi e Cura, i.e. psychiatric service for diagnosis and management)
Psychiatric symptoms were evaluated by the 24 items Brief Psychiatric Rating Scale (BPRS) [5] and the Brief Symptoms Inventory (BSI) [6]
Summary
The PERSEO study (psychiatric emergency study and epidemiology) is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management). In Italy, since 1978, the law prescribes that psychiatric patients can only be admitted to hospitals through these specific emergency structures, called SPDCs (Servizio Psichiatrico Diagnosi e Cura, i.e. psychiatric service for diagnosis and management). The implementation of this mental health reform law shifted the focus of care from mental hospitals to community services. Since their institution, patients remain in SPDCs only during the acute phase of their illness. SPDCs should be the perfect setting for studying psychiatric patients at their hospital presentation, bed shortages, emphasis on acuity and a continuous emergency situation render it rather difficult to implement clinical research and epidemiology programs
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