First-admissions in Psychiatry: a cluster analysis of a sample of inpatients from 2019 to 2021
Introduction Only a few studies analyse the clinical and psychopathological characteristics of first-admitted inpatients regardless of diagnosis. Objectives Describing the psychopathological, demographic, and clinical characteristics of inpatients with acute symptomatology identifying groups with c...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2023-03-01
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| Series: | European Psychiatry |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933823019028/type/journal_article |
| _version_ | 1797616342688333824 |
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| author | E. La Spina M. Mastrangelo B. Montalbani I. Mancinelli A. Del Casale A. Comparelli M. Pompili |
| author_facet | E. La Spina M. Mastrangelo B. Montalbani I. Mancinelli A. Del Casale A. Comparelli M. Pompili |
| author_sort | E. La Spina |
| collection | DOAJ |
| description |
Introduction
Only a few studies analyse the clinical and psychopathological characteristics of first-admitted inpatients regardless of diagnosis.
Objectives
Describing the psychopathological, demographic, and clinical characteristics of inpatients with acute symptomatology identifying groups with common features using factors extracted from the Brief Psychiatric Rating Scale (BPRS).
Methods
We selected 103 (48 F) inpatients from the psychiatric ward of the Sant’Andrea Hospital in Rome from January 2019 to December 2021. We assessed psychopathological characteristics and suicide risk with BPRS, Global Assessment of Functioning, and Columbia-Suicide Severity Rating Scale and gathered the anamnestic and demographic data. We conducted descriptive analyses and factor analysis on BPRS items. Then we used the BPRS factors as variables to perform a cluster analysis.
Results
Major Depressive Disorder (MDD) was the most frequent diagnosis. We obtained five factors: “Psychotic dimensions” (FI); “Anxiety” (FII); “Hostility and lack of cooperation” (FIII); “Depression” (FIV); “Flattening of affectivity” (FV). We identified two clusters (cluster 1 n=31; cluster 2 n=72). Patients in cluster 1 reported higher average scores in FI and FIII while the average scores of cluster 2 patients in FII and FIV were higher than patients in cluster 1. We called cluster 1 “psychotic and hostile patients compulsory admitted with a low risk of suicide”. Cluster 2 patients are “affective patients with a high risk of suicide”. The two clusters share an average age of 38-39 yo and an average GAF score indicating severe impairment and inability to function in almost all areas. They differ in the psychiatric diagnosis represented: respectively, Schizophrenia Spectrum Disorder and Bipolar Disorder with low suicidal risk, MDD, and Personality Disorders with a high suicidal risk. 39% of patients in cluster 1 were involuntarily admitted.
Conclusions
The results of our study show that patients admitted for the first time usually are admitted for psychotic symptoms and a high risk of suicide. Psychotic patients more often show hostility and lack of cooperativeness which can explain the higher rate of involuntary admissions. Patients with predominant affective symptoms show a higher risk of suicide. Our analyses do not consider categorical diagnosis highlighting that exist transdiagnostic groups of patients with specific needs.
Disclosure of Interest
None Declared |
| first_indexed | 2024-03-11T07:39:41Z |
| format | Article |
| id | doaj.art-043e540d298646ceb89af290b86c6228 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:39:41Z |
| publishDate | 2023-03-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-043e540d298646ceb89af290b86c62282023-11-17T05:08:50ZengCambridge University PressEuropean Psychiatry0924-93381778-35852023-03-0166S898S89810.1192/j.eurpsy.2023.1902First-admissions in Psychiatry: a cluster analysis of a sample of inpatients from 2019 to 2021E. La Spina0M. Mastrangelo1B. Montalbani2I. Mancinelli3A. Del Casale4A. Comparelli5M. Pompili6Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of RomePsychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of RomePsychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of RomeDepartment of Psychiatry, Sant’Andrea Hospital of RomeDepartment of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University of Rome, Rome, ItalyDepartment of Psychiatry, Sant’Andrea Hospital of RomeDepartment of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy Introduction Only a few studies analyse the clinical and psychopathological characteristics of first-admitted inpatients regardless of diagnosis. Objectives Describing the psychopathological, demographic, and clinical characteristics of inpatients with acute symptomatology identifying groups with common features using factors extracted from the Brief Psychiatric Rating Scale (BPRS). Methods We selected 103 (48 F) inpatients from the psychiatric ward of the Sant’Andrea Hospital in Rome from January 2019 to December 2021. We assessed psychopathological characteristics and suicide risk with BPRS, Global Assessment of Functioning, and Columbia-Suicide Severity Rating Scale and gathered the anamnestic and demographic data. We conducted descriptive analyses and factor analysis on BPRS items. Then we used the BPRS factors as variables to perform a cluster analysis. Results Major Depressive Disorder (MDD) was the most frequent diagnosis. We obtained five factors: “Psychotic dimensions” (FI); “Anxiety” (FII); “Hostility and lack of cooperation” (FIII); “Depression” (FIV); “Flattening of affectivity” (FV). We identified two clusters (cluster 1 n=31; cluster 2 n=72). Patients in cluster 1 reported higher average scores in FI and FIII while the average scores of cluster 2 patients in FII and FIV were higher than patients in cluster 1. We called cluster 1 “psychotic and hostile patients compulsory admitted with a low risk of suicide”. Cluster 2 patients are “affective patients with a high risk of suicide”. The two clusters share an average age of 38-39 yo and an average GAF score indicating severe impairment and inability to function in almost all areas. They differ in the psychiatric diagnosis represented: respectively, Schizophrenia Spectrum Disorder and Bipolar Disorder with low suicidal risk, MDD, and Personality Disorders with a high suicidal risk. 39% of patients in cluster 1 were involuntarily admitted. Conclusions The results of our study show that patients admitted for the first time usually are admitted for psychotic symptoms and a high risk of suicide. Psychotic patients more often show hostility and lack of cooperativeness which can explain the higher rate of involuntary admissions. Patients with predominant affective symptoms show a higher risk of suicide. Our analyses do not consider categorical diagnosis highlighting that exist transdiagnostic groups of patients with specific needs. Disclosure of Interest None Declaredhttps://www.cambridge.org/core/product/identifier/S0924933823019028/type/journal_article |
| spellingShingle | E. La Spina M. Mastrangelo B. Montalbani I. Mancinelli A. Del Casale A. Comparelli M. Pompili First-admissions in Psychiatry: a cluster analysis of a sample of inpatients from 2019 to 2021 European Psychiatry |
| title | First-admissions in Psychiatry: a cluster analysis of a sample of inpatients from 2019 to 2021 |
| title_full | First-admissions in Psychiatry: a cluster analysis of a sample of inpatients from 2019 to 2021 |
| title_fullStr | First-admissions in Psychiatry: a cluster analysis of a sample of inpatients from 2019 to 2021 |
| title_full_unstemmed | First-admissions in Psychiatry: a cluster analysis of a sample of inpatients from 2019 to 2021 |
| title_short | First-admissions in Psychiatry: a cluster analysis of a sample of inpatients from 2019 to 2021 |
| title_sort | first admissions in psychiatry a cluster analysis of a sample of inpatients from 2019 to 2021 |
| url | https://www.cambridge.org/core/product/identifier/S0924933823019028/type/journal_article |
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