Are patients improving during and after a psychiatric hospitalisation? Continuity of care outcomes of compulsory and voluntary admissions to an Italian psychiatric ward
Background: To compare the characteristics of compulsory admissions (CAs) and voluntary admissions (VAs) in a General Hospital Psychiatric Unit (GHPU), and to assess whether CA and VA patients’ outcomes improved during hospitalisation and follow-up in mental health services (MHS) based on community...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2021-08-01
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| Series: | Journal of Public Health Research |
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| Online Access: | https://www.jphres.org/index.php/jphres/article/view/2382 |
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| author | Giulio Castelpietra Silvia Guadagno Livia Pischiutta Davide Tossut Elisa Maso Umberto Albert Matteo Balestrieri |
| author_facet | Giulio Castelpietra Silvia Guadagno Livia Pischiutta Davide Tossut Elisa Maso Umberto Albert Matteo Balestrieri |
| author_sort | Giulio Castelpietra |
| collection | DOAJ |
| description | Background: To compare the characteristics of compulsory admissions (CAs) and voluntary admissions (VAs) in a General Hospital Psychiatric Unit (GHPU), and to assess whether CA and VA patients’ outcomes improved during hospitalisation and follow-up in mental health services (MHS) based on community continuity of care.
Design and Method: Observational longitudinal study comparing 19 CAs and 83 VAs consecutively admitted to GHPU of Udine, Italy, and followed up for six months by MHS. Five psychometric scales assessed psychosocial and clinical characteristics for each patient at admission (T0), discharge (T1) and follow-up (T2). Statistical analyses were performed using: multivariate logistic regression for comparing CA and VA; Friedman χ2 and Mann-Whitney tests for outcomes’ improvement.
Results: Being hospitalised for a psychotic crisis was the most significant predictor of CA (OR = 5.07). An outcomes’ improvement was observed from T0 to T1 in almost all psychometric tests, while from T1 to T2 only for PSP-A (useful social activities), CGI-S (severity of illness) and CGI-EI (drug’s efficacy related to side effects). CA was associated to lower performances in all scales at T0, in GAF and CGI-S at T1, while no difference with VA was observed at T2.
Conclusion: CA and VA patients improved to a same extent during hospitalisation and follow-up, particularly in relation to social functioning. This fosters the hypothesis that community-based MHS using a longitudinal continuity of care model might achieve recovery in a long-term perspective. Future research may benefit by considering patients’ subjective experiences and assessing long-term improvement in those who received person-centred interventions. |
| first_indexed | 2024-04-11T02:51:53Z |
| format | Article |
| id | doaj.art-59036f2811344ac687f471dca56ee7d0 |
| institution | Directory Open Access Journal |
| issn | 2279-9028 2279-9036 |
| language | English |
| last_indexed | 2024-04-11T02:51:53Z |
| publishDate | 2021-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Public Health Research |
| spelling | doaj.art-59036f2811344ac687f471dca56ee7d02023-01-02T16:17:31ZengSAGE PublishingJournal of Public Health Research2279-90282279-90362021-08-0110.4081/jphr.2021.2382Are patients improving during and after a psychiatric hospitalisation? Continuity of care outcomes of compulsory and voluntary admissions to an Italian psychiatric wardGiulio Castelpietra0Silvia Guadagno1Livia Pischiutta2Davide Tossut3Elisa Maso4Umberto Albert5Matteo Balestrieri6Outpatient and Inpatient Care Service, Central Health Directorate, Friuli Venezia Giulia Region, TriesteUdine Nord Community Mental Health Centre, Mental Health Department, Friuli Centrale Healthcare Agency, UdineDepartment of Medicine, Surgery and Health Sciences, University of TriesteWelfare Area, Giuliano Isontina Healthcare Agency, Palmanova (UD)Psychiatric Unit, Mental Health Department, Friuli Centrale Healthcare Agency, UdineDepartment of Medicine, Surgery and Health Sciences, University of TriesteUnit of Psychiatry, Deaprtment of Medicine (DAME), University of UdineBackground: To compare the characteristics of compulsory admissions (CAs) and voluntary admissions (VAs) in a General Hospital Psychiatric Unit (GHPU), and to assess whether CA and VA patients’ outcomes improved during hospitalisation and follow-up in mental health services (MHS) based on community continuity of care. Design and Method: Observational longitudinal study comparing 19 CAs and 83 VAs consecutively admitted to GHPU of Udine, Italy, and followed up for six months by MHS. Five psychometric scales assessed psychosocial and clinical characteristics for each patient at admission (T0), discharge (T1) and follow-up (T2). Statistical analyses were performed using: multivariate logistic regression for comparing CA and VA; Friedman χ2 and Mann-Whitney tests for outcomes’ improvement. Results: Being hospitalised for a psychotic crisis was the most significant predictor of CA (OR = 5.07). An outcomes’ improvement was observed from T0 to T1 in almost all psychometric tests, while from T1 to T2 only for PSP-A (useful social activities), CGI-S (severity of illness) and CGI-EI (drug’s efficacy related to side effects). CA was associated to lower performances in all scales at T0, in GAF and CGI-S at T1, while no difference with VA was observed at T2. Conclusion: CA and VA patients improved to a same extent during hospitalisation and follow-up, particularly in relation to social functioning. This fosters the hypothesis that community-based MHS using a longitudinal continuity of care model might achieve recovery in a long-term perspective. Future research may benefit by considering patients’ subjective experiences and assessing long-term improvement in those who received person-centred interventions.https://www.jphres.org/index.php/jphres/article/view/2382Compulsory admissionVoluntary admissionMental health serviceOutcomeContinuity of care |
| spellingShingle | Giulio Castelpietra Silvia Guadagno Livia Pischiutta Davide Tossut Elisa Maso Umberto Albert Matteo Balestrieri Are patients improving during and after a psychiatric hospitalisation? Continuity of care outcomes of compulsory and voluntary admissions to an Italian psychiatric ward Journal of Public Health Research Compulsory admission Voluntary admission Mental health service Outcome Continuity of care |
| title | Are patients improving during and after a psychiatric hospitalisation? Continuity of care outcomes of compulsory and voluntary admissions to an Italian psychiatric ward |
| title_full | Are patients improving during and after a psychiatric hospitalisation? Continuity of care outcomes of compulsory and voluntary admissions to an Italian psychiatric ward |
| title_fullStr | Are patients improving during and after a psychiatric hospitalisation? Continuity of care outcomes of compulsory and voluntary admissions to an Italian psychiatric ward |
| title_full_unstemmed | Are patients improving during and after a psychiatric hospitalisation? Continuity of care outcomes of compulsory and voluntary admissions to an Italian psychiatric ward |
| title_short | Are patients improving during and after a psychiatric hospitalisation? Continuity of care outcomes of compulsory and voluntary admissions to an Italian psychiatric ward |
| title_sort | are patients improving during and after a psychiatric hospitalisation continuity of care outcomes of compulsory and voluntary admissions to an italian psychiatric ward |
| topic | Compulsory admission Voluntary admission Mental health service Outcome Continuity of care |
| url | https://www.jphres.org/index.php/jphres/article/view/2382 |
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