title: Monitoring community psychiatric services in Italy: differences between patients who leave care and those who stay in treatment.
abstract: BACKGROUND
  Continuity of care has been monitored rarely in Italian community mental health centres.
  
  
  OBJECTIVE
  To estimate the long-term probability of leaving care in first-contact patients attending an out-patient service, and to identify patients most likely to drop out.
  
  
  METHODS
  All patients who had a first contact with the community mental health centre of Magenta during a 1-year recruitment period were followed up for 24 months. Patients who failed to return after the last out-patient visit were regarded as 'drop-outs'.
  
  
  RESULTS
  During the 1-year recruitment period 330 subjects were at their first contact. The 1-year incidence of first-contact patients was nearly 33 per 10 000 inhabitants. At follow-up, 46% of patients had dropped out. In comparison with patients with psychoses, subjects suffering from neurotic (P =0.004) and personality disorders (P=0.029) were more likely to drop out.
  
  
  CONCLUSIONS
  In the Italian system of community psychiatric care nearly half of the patients are no longer in contact after 2 years. Those who stay in treatment are more likely to suffer from psychosis, suggesting a commitment of Italian out-patient facilities to tackling the needs of patients with more severe disorders.
authors.affiliation: Department of Psychiatry, Hospital of Legnano, and Laboratory of Epidemiology and Social Psychiatry, 'Mario Negri' Institute for Pharmacological Research, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Percudani
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Belloni
authors.forename: Agostino
authors.initials: A
authors.lastname: Contini
authors.forename: Corrado
authors.initials: C
authors.lastname: Barbui
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D015999:Multivariate Analysis; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D012044:Regression Analysis