No abstract

There is a well-established tradition in standardized evaluation of the symptomatology and the social performance of psychiatric patients (Wing et al. 1974; WHO, 1983b; Platt, 1983) together with instruments for describing the pattern of contacts with services, like Psychiatric Case Registers (Wing & Hailey, 1972; ten Horn et al. 1986). Interest in a systematic assessment procedure for recording which action should be taken by services in the presence of a problem is more recent. Instruments for these evaluations are still experimental.

The Italian psychiatric reform has attracted much interest and controversy around the world. While quantitative evidence on its implementation has already been provided (Tansella et al. 1987; de Girolamo, 1989), studies of the effects of the reform on patients are lacking.

No abstract

The aim of this study was to understand the decision to hospitalize at the first contact, rather than utilize the other services of a community-based system of care. Using the South Verona Psychiatric Case Register, 46 first-contact patients admitted to hospital were compared to all other in-patients (n = 187) over a 2-year span with respect to socio-demographic characteristics, diagnosis (ICD-9) and symptoms (on the Present State Examination Syndrome Check List). Results suggested that first-contact hospitalized patients have significantly more neurotic depressive features. Alternatives to admission were investigated in only about one-third of depressive neurosis patients, compared to two-thirds of patients with other affective disorder diagnoses. In contrast, for patients with psychoses, admission is a second choice (except for patients with organic psychoses).