Clinical outcome and length of stay in an Italian Psychiatric Emergency Service

Abstract

The aims of the present study were to analyze outcome and to evaluate diagnosis-specific pattern of improvement during a brief hospitalization in a Psychiatric Emergency Service (PES) in a catchment area in Turin, Italy. A sample of 848 acute patients, consecutively hospitalized between January 2007 and December 2008 in the PES of the San Giovanni Battista Hospital, with diagnoses of non-affective psychosis-affective psychosis, depressive disorder and mania-and personality disorder (DSM-IV-TR) was recruited. All patients were assessed with the Brief Psychiatric Rating Scale (BPRS). One-way analysis of variance was used to measure patients' individual reliable and clinically significant change speed between BPRS assessments, in which change speed was referred to the division of the gap between admission and discharge scores over the number of days of length of stay (LOS). The overall sample showed a significant improvement of BPRS total score and each domain during a brief hospitalization (mean LOS 10.5days), with a different pattern between the diagnostic groups. A significant difference in change speed of BPRS resulted in the whole sample and in each diagnostic groups; patients with mania showed a significantly faster improvement. A brief hospitalization in our service was shown to be highly effective. A different and diagnosis-specific patients' individual reliable and clinically significant change speed was observed, with a significantly faster improvement in patients with mania.