Clinical features and therapeutic management of patients admitted to Italian acute hospital psychiatric units: the PERSEO (psychiatric emergency study and epidemiology) survey

Andrea Ballerini¹ , Roberto M Boccalon² , Giancarlo Boncompagni³ , Massimo Casacchia⁴ , Francesco Margari⁵ , Lina Minervini⁶ , Roberto Righi⁷ , Federico Russo⁸ , Andrea Salteri⁹ , Sonia Frediani¹⁰ , Andrea Rossi¹⁰ , Marco Scatigna¹⁰ and the PERSEO study group¹¹

¹Servizio Psichiatrico Diagnosi e Cura, Santa Maria Nuova Hospital, Firenze, Italy

²Servizio Psichiatrico Diagnosi e Cura, Sant' Anna Hospital, Ferrara, Italy

³Servizio Psichiatrico Diagnosi e Cura, S. Orsola Malpighi Hospital, Bologna, Italy

⁴Clinica Psichiatrica, San Salvatore Hospital, L'Aquila, Italy

⁵Istituto di Clinica Psichiatrica, Policlinico Consorziale Hospital, Bari, Italy

⁶Dipartimento di Salute Mentale, Azienda USL 16 Hospital, Padova, Italy

⁷Servizio Psichiatrico Diagnosi e Cura, Hospital of Adria, Rovigo, Italy

⁸Servizio Psichiatrico Diagnosi e Cura, Nuovo Regina Margherita Hospital, Roma, Italy

⁹Servizio Psichiatrico Diagnosi e Cura, Vimercate Civil Hospital, Milano, Italy

¹⁰Medical Department, Eli Lilly Italia, Firenze, Italy

¹¹See Appendix for details of participating groups

author email corresponding author email

Annals of General Psychiatry 2007, 6:29doi:10.1186/1744-859X-6-29


Published:	5 November 2007

Abstract

Background

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). 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.

Methods

A total of 62 SPDCs distributed throughout Italy participated in the study and 2521 patients were enrolled over the 5-month study period.

Results

Almost 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.

Conclusion

Results confirm the widespread use of antipsychotics and the increasing trend in atypical drugs prescription, in both psychiatric in- and outpatients.