title: The five-year evolution of a mixed psychiatric and somatic care unit: a European experience.
abstract: BACKGROUND
  There are virtually no reported experiences of mixed medical/psychiatry inpatient units in Europe. Such a program was created in Geneva, Switzerland, in 1999.
  
  
  OBJECTIVE
  The authors retrospectively analyzed clinical data from its first 5 years of operation.
  
  
  METHODS
  These data represent 1,380 hospitalizations. A descriptive analysis was carried out on all collected data for each year of activity.
  
  
  RESULTS
  The severity of physical disorders increased with time. The number of medical comorbidities, length of hospital stay, and compulsory admissions increased. The proportion of mood disorders decreased, whereas the proportion of psychotic and adjustment disorders increased.
  
  
  CONCLUSIONS
  Patients with comorbid medical and psychiatric disorders are often refused admission to both medical and psychiatric wards. Once they are admitted, they are often released prematurely or transferred to another ward too quickly because of behavioral management difficulties. Physicians who refer patients to the unit recognize the complex nature of these cases and refer them because the unit is capable of offering acute psychiatric and medical treatments and provides an environment that encourages patient cooperation and treatment adherence.
authors.affiliation: Dept. of Psychiatry, Division of Adult Psychiatry, HUG, 2 Chemin du Petit-Bel-Air, Bâtiment Voirons, 1225, Geneva, Switzerland.
authors.forename: Christel
authors.initials: C
authors.lastname: Alberque
authors.forename: Marianne
authors.initials: M
authors.lastname: Gex-Fabry
authors.forename: Barbara
authors.initials: B
authors.lastname: Whitaker-Clinch
authors.forename: Ariel
authors.initials: A
authors.lastname: Eytan
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006778:Hospitals, Psychiatric / Q000458:organization & administration*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013557:Switzerland / Q000453:epidemiology