The Amsterdam Studies of Acute Psychiatry - II (ASAP-II): a comparative study of psychiatric intensive care units in the Netherlands.
BACKGROUND
The number of patients in whom mental illness progresses to stages in which acute, and often forced treatment is warranted, is on the increase across Europe. As a consequence, more patients are involuntarily admitted to Psychiatric Intensive Care Units (PICU). From several studies and reports it has become evident that important dissimilarities exist between PICU's. The current study seeks to describe organisational as well as clinical and patient related factors across ten PICU's in and outside the Amsterdam region, adjusted for or stratified by level of urbanization.


METHODS
This paper describes the design of the Amsterdam Studies of Acute Psychiatry II (ASAP-II). This study is a prospective observational cohort study comparing PICU's in and outside the Amsterdam region on various patient characteristics, treatment aspects and recovery related variables. Dissimilarities were measured by means of collecting standardized forms which were filled out in the framework of care as usual, by means of questionnaires filled out by mental health care professionals and by means of extracting data from patient files for every consecutive patient admitted at participating PICU's during a specific time period. Urbanization levels for every PICU were calculated conform procedures as proposed by the Dutch Central Bureau for Statistics (CBS).


CONCLUSIONS
The current study may provide a deeper understanding of the differences between psychiatric intensive care units that can be used to promote best practice and benchmarking procedures, and thus improve the standard of care.
Koppelmans
Vincent
V
Arkin Mental Health Care, Amsterdam, The Netherlands. v.koppelmans@erasmusmc.nl
Schoevers
Robert
R
van Wijk
Cecile Gijsbers
CG
Mulder
Wijnand
W
Hornbach
Annett
A
Barkhof
Emile
E
Klaassen
André
A
van Egmond
Marieke
M
van Venrooij
Janine
J
Bijpost
Yan
Y
Nusselder
Hans
H
van Herrewaarden
Marjan
M
Maksimovic
Igor
I
Achilles
Alexander
A
Dekker
Jack
J
D000208:Acute Disease; D002391:Catchment Area, Health / Q000706:statistics & numerical data*; D015331:Cohort Studies; D003625:Data Collection; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005568:Forms and Records Control / Q000379:methods*; D006778:Hospitals, Psychiatric / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000517:prevention & control; D009426:Netherlands; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011570:Psychiatry / Q000458:organization & administration*; D036301:Qualitative Research; D012107:Research Design; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000145:classification* / Q000706:statistics & numerical data