Main clinical features in patients at their first psychiatric admission to Italian acute hospital psychiatric wards. The PERSEO study.
BACKGROUND
Few data are available on subjects presenting to acute wards for the first time with psychotic symptoms. The aims of this paper are (i) to describe the epidemiological and clinical characteristics of patients at their first psychiatric admission (FPA), including socio-demographic features, risk factors, life habits, modalities of onset, psychiatric diagnoses and treatments before admission; (ii) to assess the aggressive behavior and the clinical management of FPA patients in Italian acute hospital psychiatric wards, called SPDCs (Servizio Psichiatrico Diagnosi e Cura = psychiatric service for diagnosis and management).


METHODS
Cross-sectional observational multi-center study involving 62 Italian SPDCs (PERSEO--Psychiatric EmeRgency Study and EpidemiOlogy).


RESULTS
253 FPA aged < or = 40 were identified among 2521 patients admitted to Italian SPDCs over the 5-month study period. About half of FPA patients showed an aggressive behavior as defined by a Modified Overt Aggression Scale (MOAS) score greater than 0 Vs 46% of non-FPA patients (p = 0.3651). The most common was verbal aggression, while about 20% of FPA patients actually engaged in physical aggression against other people. 74% of FPA patients had no diagnosis at admission, while 40% had received a previous psychopharmacological treatment, mainly benzodiazepines and antidepressants. During SPDC stay, diagnosis was established in 96% of FPA patients and a pharmacological therapy was prescribed to 95% of them, mainly benzodiazepines, antipsychotics and mood stabilizers.


CONCLUSIONS
Subjects presenting at their first psychiatric ward admission have often not undergone previous adequate psychiatric assessment and diagnostic procedures. The first hospital admission allows diagnosis and psychopharmacological treatment to be established. In our population, aggressive behaviors were rather frequent, although most commonly verbal. Psychiatric symptoms, as evaluated by psychiatrists and patients, improved significantly from admission to discharge both for FPA and non-FPA patients.
Ballerini
Andrea
A
Servizio Psichiatrico Diagnosi e Cura, Santa Maria Nuova Hospital, Firenze, Italy. ballerini.ciardi@libero.it <ballerini.ciardi@libero.it>
Boccalon
Roberto M
RM
Boncompagni
Giancarlo
G
Casacchia
Massimo
M
Margari
Francesco
F
Minervini
Lina
L
Righi
Roberto
R
Russo
Federico
F
Salteri
Andrea
A
Frediani
Sonia
S
Rossi
Andrea
A
Scatigna
Marco
M
D000328:Adult; D000374:Aggression; D003430:Cross-Sectional Studies; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D012307:Risk Factors