bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assistenza psichiatrica e monitoraggio dei servizi. Il Registro dei casi di Caltagirone 1987–1990
Authors: Interlandi Gaetano , Sotera Maria Grazia 
Published: October 2011

RiassuntoSono descritte, con la stessa metodologia impiegata in altre 4 aree italiane sedi di Registro Psichiatrico dei Casi (RPC), le caratteristiche della catchment-aerea, del RPC, della struttura e dei principi del Dipartimento di Psichiatria di Caltagirone. II monitoraggio della domanda su 4 anni evidenzia che i tassi di prevalenza annua (763/100000 residenti adulti) e un giorno (223/100000 residenti adulti) hanno valori inferiori ai RPC europei. I tassi di incidenza (281/100000 residenti adulti) indicano un afflusso di nuovi casi appartenenti a tutte le categorie diagnostiche. II RPC di Caltagirone monitora l'attività svolta in strutture e servizi a differente gradiente assistenziale: residenziale ospedaliera, residenziale non ospedaliera, semiresidenziale, ambulatoriale, domiciliare, ecc. II rapporto tra prevalenza annua non ospedaliera e ospedaliera è nel 1990 di 4,4 a 1. II tasso di lungoassistiti è di 122/100000 residenti adulti, con una tendenza ad un accumulo per quelli che vivono nel territorio, mentre vi è un calo di quelli che sono in Comunità. II costo del Dipartimento, che è andato riducendosi dal 1987 al 1990, è in buona parte da addebitare alle giornate di assistenza in Comunità.Parole chiaveservizi psichiatrici territoriali, registri psichiatrici dei casi, utilizzazione dei servizi.SummaryThe principles, structure, Psychiatric Case Register (PCR) and catchment-area of the Community Psychiatric Service of Caltagirone are described, using the same methodology employed in 4 other Italian PCRs. The monitoring of the demand over 4 years shows that the year prevalence (763'100000 adult inhabitants) and day prevalence (248'100000 adult inhabitants) rates are lower than those of other European PCRs. Incidence rate (248'100000 adult inhabitants) shows that new patients belong to all diagnostic categories. The PCR records data of the activities made in multiple structures and services, offering different degrees of care: residential in and outside the hospital, semiresidential, care in outpatient clinics, domiciliary care, etc. The ratio between non-hospitalized and hospitalized users is 4.3 to 1. The rate of long-term patients is 122'100000 adult inhabitants; the rate of long-term patients living in the community is increasing over the years, whereas the similar rate of patients living in the sheltered apartments is decreasing. The costs of the Service (which have decrease from 1987 to 1990) have to be attributed mainly to the costs of the treatment in sheltered apartments.
Assistenza psichiatrica e monitoraggio dei servizi. Il Registro dei casi di Legnano 1987-1990
Authors: Mastroeni Antonino , Colombo Maria Grazia 
Published: October 2011

RiassuntoSono descritte, con la stessa metodologia impiegata in altre aree italiane sedi di Registro Psichiatrico dei Casi (RPC), le caratteristiche della catchment-area, del RPC, della struttura e dei principi dell'Unità Operativa di Psichiatria di Legnano. II monitoraggio della domanda su 4 anni evidenzia che i tassi di prevalenza annua (530/100000 residenti adulti) e un giorno (226/100000 residenti adulti) hanno valori inferiori ai RCP europei. I tassi di incidenza (152/100000 residenti adulti) sono diminuiti nel corso dei 4 anni considerati, mostrando la difficoltà dei servizi ad accogliere nuovi utenti. II rapporto tra prevalenza annua non ospedaliera ed ospedaliera è, mediamente, di 3,8 a 1. II tasso dei lungoassistiti è di 195/100000 residenti adulti, con un accumulo di quelli che vivono nel territorio, ma non di quelli che sono in Comunita. II costo dei servizi psichiatrici di Legnano è diminuito nella componente ospedaliera e semiresidenziale, mentre è aumentato in quella territoriale.Parole chiaveservizi psichiatrici territoriali, registri psichiatrici dei casi, utilizzazione dei servizi.SummaryThe principles, structure. Psychiatric Case Register (PCR) and catchment-area of the Community Psychiatric Service of Legnano are described, using the same methodology employed in 4 other Italian PCRs. The monitoring of the demand over 4 years shows that the mean year prevalence (530/100000 adult inhabitants) rates are lower than those of other European PCRs. Incidence rate (152/100000 adult inhabitants) have diminished, showing a difficulty of the psychiatric services in accepting new patients. The ratio between non-hospidalized and hospidalized users is 3.8 to 1. The rate of long-term patients is 195/100000 adult inhabitants; the rate of long-term patients living in the community is increasing over the years, whereas the similar rate of patients living in the community is increasing over the years, whereas the similar rate of patients living in the scheltered apartments is stable. The costs of the hospital-based and the semiresidential agencies decreased, while the cost of the community agencies increased.
Assistenza psichiatrica e monitoraggio dei servizi. Il Registro dei casi di Portogruaro 1987-1990
Authors: De Salvia Domenico , Rocco Diego 
Published: October 2011

RiassuntoSono descritte, con la stessa metodologia impiegata in quattro altre aree italiane sedi di Registro Psichiatrico dei Casi (RPC), le caratteristiche della catchment-area, del RPC, della struttura e dei principi del Dipartimento di Psichiatria di Portogruaro. II monitoraggio della domanda su 4 anni evidenzia tassi di prevalenza un anno (1045/100000 residenti adulti), di prevalenza un giorno (332/100000 residenti adulti) e di incidenza (250/100000 residenti adulti) inferiori a quelli dei RPC europei. II RPC di Portogruaro monitora l'attività svolta in strutture e servizi a differente gradiente assistenziale (residenziale ospedaliera, residenziale non ospedaliera, semiresidenziale, ambulatoriale, socioambientale, domiciliare, ecc), secondo il principio della continuità dell'assistenza fornita ai pazienti. II rapporto tra prevalenza annua non ospedaliera ed ospedaliera è nel 1990 di 5,5 a 1. II tasso di lungoassistiti è di 161/100000 adulti. La spesa globale del Dipartimento è lievemente diminuita dal 1987 al 1990.Parole chiaveservizi psichiatrici territoriali, registri psichiatrici dei casi, utilizzazione dei servizi.SummaryThe principles, structure, Psychiatric Case Register (PCR) and catchment-area of the Community Psychiatric Service of Portogruaro are described, using the same methodology employed in 4 other Italian PCRs. The monitoring of the demand over 4 years shows one-year prevalence rates (1045/100000 adult inhabitants), one-day prevalence rates (332/100000 adult inhabitants) and incidence rates (250/100000 adult inhabitants) lower than those of other european PCRs. Portogruaro PCR records data of the activities made in a comprehensive psychiatric service, which has multiple structures and services, offering different degrees of care: residential in and outside the hospital, semiresidential, in outpatient clinics, domiciliary, etc. The 1990 ratio between non-hospitalized and hospitalized users is 5.5 to 1. The rate of long-term patients is 161/100000 adult inhabitants. The costs of the Community Psychiatric Service slightly decreased during 1987-90 period.
La morbilità psichiatrica nella medicina di base: aspetti concettuali e diagnostici
Authors: Piccinelli Marco , Ferraris Aloisia 
Published: October 2011

RiassuntoGli Autori affrontano alcuni aspetti concettuali e metodologici legati allo studio della morbilità psichiatrica nella medicina di base. Vengono discussi i concetti di «malattia» in generale e di «caso psichiatrico» in particolare, con le ripercussioni che tali definizioni possono avere sull'attività di ricerca. Sono presentati i risultati di alcuni studi che hanno utilizzato i modelli statistici basati sulla latent trait theory per indagare i disturbi emotivi di comune riscontro tra i pazienti del medico di base. È stato cosi possibile evidenziare che tali disturbi tendono a distribuirsi lungo un continuum in assenza di punti di interruzione o di rarità. I problemi diagnostici tuttora presenti nella medicina di base sono considerati alia luce delle difficoltà nell'applicazione delle tradizionali categorie diagnostiche e delle prospettive aperte dai recenti sistemi multiassiali di classificazione.Parole chiavemedicina di base, disturbi emotivi, diagnosi.SummaryThe Authors examine some conceptual and methodological issues involved in the study of psychiatric morbidity in primary care settings. The concept of «disease» in general and that of «psychiatric case» in particular are discussed together with the implications that such definitions may have in research activity. Some studies are reviewed which have employed statistical models based on latent trait theoryto investigate the emotional disorders commonly found among subjects who consult the general practitioner. It becomes apparent that these disorders tend to distribute along a continuum with no rarity points or interruptions. Diagnostic problems still present in primary care settings are considered paying attention to the difficulties in the application of traditional diagnostic categories and to the new perspectives disclosed by recent multiaxial systems of classification.
Classificazione, diagnosi ed ICD-10. III - Le sindromi affettive
Authors: Nicolaou Stylianos , de Girolamo Giovanni 
Published: October 2011

RiassuntoScopo - Presentare un breve profilo storico sui termini nosografici e sui principali modelli di classificazione dei disturbi affettivi descrivendo le caratteristiche più importanti della loro classificazione secondo l'ICD-10, le principali novita introdotte in essa rispetto all'ICD-9 ed infine alcune similarità e differenze tra la classificazione ICD-10 ed il DSM-III-R. Risultati - DalFanalisi della struttura della classificazione di questi disturbi nelFICD-10 emerge con chiarezza la difficoltà di arrivare ad una sistemazione nosografica esauriente sulla base delle conoscenze attuali. L'ICD-10, comunque, ha segnato un significativo progresso rispetto all'ICD-9, ed ha, al tempo stesso incorporato molti degli orientamenti riscontrabili nel DSM-III-R. Conclusioni - L'ICD-10 ha proposto un modello di classificazione che cerca di operare una sintesi tra tradizioni e scuole diverse, e di valorizzare nel contempo, per quanto possibile, i risultati emersi dalle ricerche di queste ultime 2 decadi.
The economic perspective in the care and treatment of patients with diagnosis of schizophrenia
Authors: Percudani Mauro , Knapp Martin 
Published: October 2011

RIASSUNTOScopo- Considerare le principali problematiche connesse all'assistenza ed al trattamento dei pazienti con diagnosi di schizofrenia alia luce della piu recente letteratura sugli aspetti economici di questa patologia.Metodo- È stata effettuata una analisi della letteratura relativa ai costi sociali della schizofrenia, all'analisi economica di diversi modelli di assistenza, alia valutazione dei costi dei trattamenti antipsicotici.Risultati- La schizofrenia è una patologia che genera ingenti costi sociali. I costi sanitari legati all'assistenza alia schizofrenia assorbono una percentuale significativa delle risorse dei sistemi sanitari dei principali paesi industrializzati. I costi indiretti, dovuti principalmente al mancato inserimento al lavoro dei pazienti, risultano superiori ai costi diretti di trattamento. Nei paesi ove l'assistenza centrata sul territorio è stata supportata da un reale sforzo organizzativo per la creazione di servizi territoriali e residenziali, è emerso che essa è meno costosa dell'assistenza centrata sull'ospedale psichiatrico e genera un miglior esito per pazienti e familiari. L'introduzione di nuovi farmaci antipsicotici e lo sviluppo di interventi di tipo psicosociale possono rappresentare strumenti che favoriscono nuove strategie di assistenza.Conclusion!- Utilizzare una prospettiva economica implica pensare a quale organizzazione, quali strumenti tecnologici, quali strategie permettono di investire con razionalita le risorse disponibili. Una riflessione su questi temi appare oggi ineludibile non solo per gli amministratori ed i decisori politici, ma anche per gli operatori dei servizi di salute mentale.
Pattern of patients recovered in psychiatric rehabilitation services: defining homogeneous groups. Multivariate analysis of a sample
Authors: Marinoni Alessandra , Carolei Adriana , Paglione Marcello , Pietrantonj Carlo Di , Foresti Giovanni , Cerri Mario , Croce Luigi , Marinato Giorgio , Lavoro Gruppo Di 
Published: October 2011

SummaryObjective– To provide a multidimensional description about the pattern of patients recovered in some Psychiatric Rehabilitation Sevices, as emerging from identification of similar groups regarded the total severity.Design and Setting– A cross-sectional survey has been conducted on patients recovered in 4 Northern-Italy Psychiatric Rehabilitation Services. A statistical bottom-up analysis (Principal Components and Cluster Analysis) has been performed.Main outcome measures– Any patient has been evaluated using a questionnaire with well-known rating scales (BPRS-psychiatric rating, Katx index and IADL index, IDS index of comorbidity) together with informations on sex, age, social and economic state, psychiatic history, therapeutic devices and staff involvement.Results– We analyzed 455 patients. 267 (58.7%) male and the mean age is 58.517.9. After statistical analysis, 4 clusters of patients has been found: the first group (106 patients) is younger, descrided as not seriuosly compromised, mostly with psychotic problems; the second (96 patients, most of them woman with diagnosis of demetia) is much older, with serious problems of indipendency and comorbidity. The third (82 patients) and fourth (171 patients) group show intermediate patterns. The level of care requested by these groups has been provided.Conclusions– Our results show the usefulness of sophisticated statistical methods to describe patients recovered in psychiatric rehabilitation services. Moreover, our findings could be useful as good proposal to the people involved in this field, planning an active intervention in this area.
Problems of patients with schizophrenic disorders and of their families
Authors: Lanzara Dino , Cosentino Ugo , Maglio Anna Maria Lo , Lora Antonio , Nicolo Anna , Rossini Maria Stella 
Published: October 2011

SummaryObjective— To evaluate psychopathological symptoms, disabilities and family burden in schizophrenic patients and to analyse predictors of family burden and relatives' satisfaction.Design— Descriptive study of 203 patients with an ICD 10 — F2 diagnosis (schizophrenia and related disorders) in contact with the Desio Department of Mental Health on 31stDecember 1994.Setting— The Desio Department of Mental Health.Main outcome measures— The patients have been evaluated in three areas: disability (by ADC-DAS), psychiatric symptoms (by 24 items BPRS) and family burden (by Family Problems questionnaire). The outpatient, hospital and residential care contacts of the patients have been collected for six months by our service information system. For each area (DAS, BPRS and FP) a principal component analysis and a rotation of the significant components have been performed. Eleven factors, derived from three scales, have been retained as explanatory variables. Finally, a multiple regression analysis has been performed to assess the influence of explanatory variables on the set of response variables regarding family burden and relatives' satisfaction.Results— One third of patients suffer of moderate-severe positive symptoms, while negative symptoms are less frequent.
Evaluating the closure or downsizing of psychiatric hospitals: social or clinical event?
Authors: Lesage Alain D. 
Published: October 2011

SummaryObjectives – The evaluation matrix recently proposed by Tansella and Thornicroft suggests that the field of social and epidemiological psychiatry has focussed more on the individual/patient level of mental health care services than the system level. Moreover, phenomena such as deinstitutionalisation have been examined more as clinical events than as social ones. The aims here are to deepen our understanding of deinstitutionalisation, particularly as regards the downsizing/closure and role of psychiatric hospitals. Methods – I begin by reviewing the manifest and latent functions of psychiatric hospitals. This is followed by a discussion of how these functions must be met by any comprehensive community-oriented system of mental health care for severely mentally ill patients. Also, in order to reframe the downsizing/closure of psychiatric hospitals as a social event for the field of social psychiatry and psychiatric epidemiology, I posit that the process of deinstitutionalisation is driven today by the same forces that were present at the outset of the movement. Results – I review four recent series of studies addressing primarily the outcomes, but also other aspects, of the downsizing/closure of psychiatric hospitals, with a view to illustrating the methods used, the results obtained and the blind angles missed in this research. Conclusions – Lessons are drawn on how to fill certain vacant cells of the matrix.
Mental disorder and homicide: a review of epidemiological research
Authors: Woodward Mark , Nursten Jean , Williams Paul , Badger Doug 
Published: October 2011

SummaryObjective– This paper reviews 28 studies on the epidemiology of homicide committed by mentally disordered people, taken from recent international academic literature.Methods– The studies included were identified as part of a wider systematic review of the epidemiology of offending combined with mental disorder. The main databases searched were Embase, Medline, HealthStar, Psyclit, Mental Health Abstracts, Applied Social Sciences Index and Abstracts, and Criminology Penology and Police Science Abstracts. A comprehensive search was made for studies published since 1990, supplemented with key studies from the 1980s identified through citation tracing and personal contacts.Results– A summary is given in tabular form of the content and quality of each study. There is then discussion of the studies in eight categories: descriptive studies, studies of trends, comparative studies amongst homicide offenders, amongst prisoners and including general populations, studies of homicide of relatives, follow-up studies, and studies of recidivism.Conclusions– There is an association of homicide with mental disorder, most particularly with certain manifestations of schizophrenia, antisocial personality disorder and drug or alcohol abuse. However, the quality of epidemiological research in this area is not adequate to answer key questions, and prediction of potential for homicide remains elusive. Further research is needed.
Needs for care in psychiatric patients: a systematic review. I. General concepts and assessment measures. Needs for services
Authors: Lasalvia Antonio , Stefani Benedetta , Ruggeri Mirella 
Published: October 2011

SummaryObjective– In Italy, mental health care is in phase of reorganisation. In this frame the measurement of users' needs may be a useftil tool in planning individualised mental health service interventions and in their evaluation. Aims of the present study are (I) to highlight the basic concepts of 'needs for care' and give a brief description of the main needs assessment tools specifically developed for psychiatric patients; (II) to review studies assessing needs for mental health services in the general population; (III) to discuss the role played by the assessment of needs in planning mental health care.Methods– Studies published in the international literature from January 1980 to June 1999 were reviewed. The studies were located through a computerised search of the databases MEDLINE and PsycLit; in addition, the reference lists of the studies located through the computerised search and the content of main international psychiatric journals were manually scanned in order to avoid possible omissions. Studies assessing needs for services and studies assessing needs on individual level were separately reviewed. Both groups of studies, in turn, were divided in studies assessing needs for mental health care in the general population and in psychiatric patients.Results– Although most studies on needs for services used indirect methodologies and employed quite heterogeneous experimental design, they provide at large overlapping results. In the general population, about 60%- 70% of patients with anxiety, depression and other neurotic disorders and 30%-40% of psychotic patients do not receive any specialist mental health care, suggesting that the majority of subjects suffering from a psychiatric disorder do not receive the mental health care they need.Conclusions– Unmet needs for services show a higher frequency in patients with neurotic and depressive disorders, indicating a shortage in services delivery that should be taken into account both by psychiatrists and mental health planners. Moreover, the finding that a large number of patients suffering from psychotic disorders do not receive any kind of mental health care is of particular relevance for planning mental health services, since these subjects are usually the most problematic and difficult to treat.
Hospitalisation for schizophrenia in acute psychiatric wards of the Lazio region: a 4-year follow-up study
Authors: Gaddini Andrea , Franco Francesco , Lallo Domenico Di , Biscaglia Lilia 
Published: October 2011

SUMMARYAim– To determine the rates of psychiatric hospitalisation and to evaluate the predictors of readmissions in a cohort of 887 schizophrenic patients at their “first” psychiatric admission.Methods– Data were collected using the hospital dis-charge database of the Lazio region, Italy. The cohort included patients admitted to a psychiatric ward in 1999, with a main diagnosis of schizophrenia and no prior psychiatric hospitalisation during the 5 years preceding the index admission. Psychiatric read-missions were considered up to year 2004. Kaplan-Meier survival curves and logistic procedures were performed to estimate the cumulative readmission incidence and ORs of readmissions for potential confounders.Results– During the 4-year follow-up, 44.3% of the patients were readmitted at least once. An active treatment among community psychiatric facilities at the time of index admission predicted a higher readmission risk. However, for those who experienced their first admission in a private ward read-mission risk was consistently higher, whether or not having had such a treatment.Conclusions– Risk of readmission in a psychiatric ward appears to be related to the level of integration with mental health community facilities, while length of stay is strongly affected by service system variables. Possible uses of medical information systems in this field are described.Declaration of Interest: none.