title: Forty years of a psychiatric day hospital.
abstract: BACKGROUND
  Day hospitals in psychiatry are a major alternative to inpatient care today, acting as key components of community and social psychiatry.
  
  
  OBJECTIVE
  To study trends in the use of psychiatric day hospitals over the last decades of the 20th century and the first decade of the 21st century, focusing on patient age, sex, and diagnostic group, using data from Centro Hospitalar São João, Porto, Portugal.
  
  
  METHODS
  Data corresponding to years 1970 to 2009 were collected from patient files. Patients were classified into seven diagnostic groups considering their primary diagnoses only.
  
  
  RESULTS
  Mean age upon admission rose from 32.7±12.1 years in the second half of the 1970s to 43.5±12.2 years in 2005-2009 (p for trend < 0.001). Most patients were female (63.2%), however their proportion decreased from nearly 70% in the 1970s to 60% in the first decade of the 21st century. In males, until the late 1980s, neurotic disorders (E) were the most common diagnosis, accounting for more than one third of admissions. In the subsequent years, this proportion decreased, and the number of admissions for schizophrenia (C) exceeded 50% in 2004- 2009. In females, until the late 1980s, affective disorders (D) and neurotic disorders (E), similarly distributed, accounted for most admissions. From the 1990s on, the proportion of neurotic disorders (E) substantially decreased, and affective disorders (D) came to represent more than 50% of all admissions.
  
  
  CONCLUSIONS
  Mean age upon admission rose with time, as did the percentage of female admissions, even though the latter tendency weakened in the last 10 years assessed. There was also an increase in the proportion of patients with schizophrenia.
authors.affiliation: Department of Clinical Neurosciences and Mental Health, Porto Medical School, Porto, Portugal.
authors.forename: Rosário
authors.initials: R
authors.lastname: Curral
authors.affiliation: Centro Hospitalar São João, Porto, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Lopes
authors.affiliation: Department of Clinical Neurosciences and Mental Health, Porto Medical School, Porto, Portugal.
authors.forename: Celeste
authors.initials: C
authors.lastname: Silveira
authors.affiliation: Centro Hospitalar São João, Porto, Portugal.
authors.forename: Andreia
authors.initials: A
authors.lastname: Norton
authors.affiliation: Centro Hospitalar São João, Porto, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Domingues
authors.affiliation: Department of Health Information and Decision Sciences, Porto Medical School, Porto, Portugal.
authors.forename: Fernando
authors.initials: F
authors.lastname: Lopes
authors.affiliation: Department of Epidemiology, Porto Medical School, Porto, Portugal.
authors.forename: Elisabete
authors.initials: E
authors.lastname: Ramos
authors.affiliation: Centro Hospitalar São João, Porto, Portugal.
authors.forename: António
authors.initials: A
authors.lastname: Roma-Torres