title: Changing trends in hospitalization rates associated with psychosis: Spain, 1980-2009.
abstract: OBJECTIVE
  To analyze the prevalence of hospitalization attributable to psychosis in Spain over the last three decades.
  
  
  METHODS
  Longitudinal analysis (1980-2009) of age-adjusted hospital discharges rates associated with psychosis (ICD9 290-8) in all Spanish hospitals.
  
  
  METHODS
  Spanish Hospital Morbidity Survey.
  
  
  RESULTS
  The hospitalization rate associated with psychotic episodes had been gradually increasing since 1980 until 2004; an abrupt turnaround observed in 2004 marks the beginning of a steady decline in the rate. The turning point described is not observed for each of the psychotic diagnoses separately analyzed. However, it is clearly seen when data are grouped in diagnosis-related groups (organic-psychosis, functional psychosis and substance-induced psychosis) since the time course of the diseases within the major diagnostic groups are interrelated as evidenced by shared turning points which collectively display a common time course pattern. Main hospital indicators and antipsychotic drug prescriptions were analyzed for any possible turning point in mid-2000s. Psychiatric hospital beds and length of stays remained stable by 2004; the hospitalizations associated with non-psychotic psychiatric pathologies show no turning point in 2004. However, an abrupt change on antipsychotic drug prescriptions is precisely observed in 2004.
  
  
  CONCLUSIONS
  After decades of linear growth, hospitalizations for psychotic patients begin to decline in 2004, coinciding with the start of last generation atypical antipsychotic drug consumption in Spain. Some of the psychotic diagnostic rates evolve in an interrelated manner which calls into question the diagnosis and nosological boundaries between some of these pathologies.
authors.affiliation: Department of Medicine, University of Valencia, Av. Blasco Ibáñez, 15, 46010, Valencia, Spain. alvaromedel@yahoo.es.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Medel-Herrero
authors.affiliation: Health Technology Assessment Agency, Institute of Health Carlos III, Madrid, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Amate
authors.affiliation: Hospital Clínico San Carlos Health Research Institute (IdISSC), Biomedical Research Foundation-HCSC, Madrid, Spain.
authors.forename: Z
authors.initials: Z
authors.lastname: Saz-Parkinson
authors.affiliation: Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Gómez-Beneyto
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use; D003953:Diagnosis-Related Groups; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011618:Psychotic Disorders / Q000628:therapy*; D013030:Spain
chemical_list: D014150:Antipsychotic Agents
keywords: Antipsychotic agents; Diagnosis-related groups; Hospitalization; Psychosis