TY  - JOUR
PY  - 2022//
TI  - Compulsory and voluntary admissions in comparison: A 9-year long observational study
JO  - International journal of social psychiatry
A1  - Draghetti, Stefano
A1  - Alberti, Siegfried
A1  - Borgiani, Gianluca
A1  - Panariello, Fabio
A1  - De Ronchi, Diana
A1  - Atti, Anna Rita
SP  - 1716
EP  - 1726
VL  - 68
IS  - 8
N2  - BACKGROUND: Few studies, so far, have been specifically designed to highlight the features related to Compulsory Admissions (CA) and Voluntary Admissions (VA) in Italian psychiatric emergency wards.  AIMS: The main purpose of this observational study was to compare the sociodemographic and clinical characteristics of VA and CA and to explore possible predictors of re-admissions.  METHODS: During a 6-month Index Period (February, the 1st-July, the 31st 2008) all psychiatric admissions were documented and then followed-up through all available informatic systems for the next 9 years.  RESULTS: Out of 390 hospitalizations, 101 (25.9%) were compulsory (CA rate was 2.79 per 10,000 inhabitants per year, mean duration of hospitalizations of 7.33 ± 7.84 days). Diagnoses were recorded for the 325 patients who had been hospitalized during index period: schizophrenic psychoses ([p = .042], in particular schizophrenia [p = .027]), manic episode (p = .044), and delusional disorders (p = .009) were associated with CA; conversely, the diagnosis of unipolar major depression (p = .005) and personality disorders (p = .048) were significantly more frequent in VA. The 325 admitted patients were followed up for 1,801 person-years. No significant differences were found in terms of drop-outs, transferring, and discharge rates, and mortality rates due to both natural causes and suicides. Factors associated with at least one compulsory readmission were younger age and having had a previous CA (p = .011); conversely having been engaged with psychiatric services for over 1 year prior to index hospitalization was protective for a subsequent CA (p = .013).  CONCLUSIONS: After a 40-year old political reform, the current study shows that, in a context of integrated outpatient and inpatient services, engagement with outpatient care may be protective for compulsory rehospitalization.<p /> <p>Language: en</p>
LA  - en
SN  - 0020-7640
UR  - http://dx.doi.org/10.1177/00207640211057731
ID  - ref1
ER  -