title: Main clinical features in patients at their first psychiatric admission to Italian acute hospital psychiatric wards. The PERSEO study.
abstract: 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.
authors.affiliation: Servizio Psichiatrico Diagnosi e Cura, Santa Maria Nuova Hospital, Firenze, Italy. ballerini.ciardi@libero.it <ballerini.ciardi@libero.it>
authors.forename: Andrea
authors.initials: A
authors.lastname: Ballerini
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Boccalon
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Boncompagni
authors.forename: Massimo
authors.initials: M
authors.lastname: Casacchia
authors.forename: Francesco
authors.initials: F
authors.lastname: Margari
authors.forename: Lina
authors.initials: L
authors.lastname: Minervini
authors.forename: Roberto
authors.initials: R
authors.lastname: Righi
authors.forename: Federico
authors.initials: F
authors.lastname: Russo
authors.forename: Andrea
authors.initials: A
authors.lastname: Salteri
authors.forename: Sonia
authors.initials: S
authors.lastname: Frediani
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.forename: Marco
authors.initials: M
authors.lastname: Scatigna
mesh_terms: 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