Providing care to individuals with complex mental health needs can be stressful. However, little research has focused on the emotional, cognitive, and physical consequences of providing mental health care. The aim of this study is to assess burnout (BO), compassion fatigue (CF) and compassion satisfaction (CS) among staff at the four community-based mental health services (CMHS) of Verona, Italy. All staff were asked to complete anonymously the Professional Quality of Life Scale, the General Health Questionnaire, and a socio-demographic questionnaire. In total 260 staff participated (a response rate of 84%). Psychiatrists and social workers were the professionals with the highest levels of BO and CF. Workers with psychological distress reported both higher BO and CF scores, and lower levels of CS. A significant increase in the BO and CF scores was also detected for each extra year spent working in a CMHS. A higher level of CF was associated with female and having been experienced one negative life event in the previous year. These findings are useful for health managers and team leaders to identify factors affecting the professional quality of life of mental healthcare staff, and can provide a rationale for detecting staff at risk for developing negative work-related outcomes.
Background. Most mortality studies of psychiatric patients published to date have been conducted in hospital-based systems of care. This paper describes a study of the causes of death and associated risk factors among psychiatric patients who were followed up over a 20-year period in an area where psychiatric care is entirely provided by community-based psychiatric services.Method. All subjects in contact with the South Verona Community-based Mental Health Service (CMHS) over a 20-year period with an ICD-10 psychiatric diagnosis were included. Of these 6956 patients, 938 died during the study period. Standardized mortality ratios (SMRs) and Poisson multiple regressions were used to assess the excess of mortality in the sample compared with the general population.Results. The overall SMR of the psychiatric patients was 1.88. Mortality was significantly high among out-patients [SMR 1.71, 95 % confidence interval (CI) 1.6-1.8], and higher still following the first admission (SMR 2.61, 95 % CI 2.4-2.9). The SMR for infectious diseases was higher among younger patients and extremely high in patients with diagnoses of drug addiction (216.40, 95 % CI 142.5-328.6) and personality disorders (20.87, 95 % CI 5.2-83.4).Conclusions. This study found that psychiatric patients in contact with a CMHS have an almost twofold higher mortality rate than the general population. These findings demonstrate that, since the closure of long-stay psychiatric hospitals, the physical health care of people with mental health problems is often neglected and clearly requires greater attention by health-care policymakers, services and professionals.
Psychiatric patients showed different patterns of site-specific cancer mortality when compared with the general population. The 20-fold higher risk of dying from hematological neoplasms needs further investigation. Chronic use of phenothiazines could be involved in the relative protection from stomach and prostate cancer found in psychiatric patients.
For the first time the hospital discharge card regional survey of all public acute inpatient psychiatric facilities in Veneto Region were used. The innovative aspect of this study was the attempt to investigate the relationship between length of stay and other indexes, characterizing not only the inpatient facilities, but also the resident population structure in each area. The information about factors that influence length of stay can be useful to inform service planning and resource allocation.
Aims – The Diagnostic Interview for Psychoses (DIP) is a comprehensive interview schedule for psychotic disorders, linked to the OPCRIT diagnostic algorithm, bridging the gap between fully structured, lay-administered schedules and semistructured, psychiatrist-administered interviews. Here we describe the validity, reliability and applications of the Italian version of the DIP. Methods – The interview was translated into Italian and its content validity tested by back translation. Sixty patients, drawn from among those who contacted the South-Verona Community Mental Health Service, were included in the study. Each patient was first assessed independently by two raters, one of whom conducted the interview, while the other assumed the role of observer. Subsequently (median: 89 days), 44 of these patients were re-interviewed by a third rater, who made an independent assessment. Diagnostic validity was assessed in 18 cases, interviewed with the DIP and using the SCAN as ‘gold standard. Results – The mean duration of the interview was 37 minutes for the inter-rater interviews and 39 minutes for the retest interviews. Good to excellent inter-rater reliability was demonstrated for both ICD-10 and DSM-IV diagnoses, while in the test-retest reliability pairwise agreement was high for half of the items. Diagnostic validity was good, with twelve out of the 18 DIP-OPCRIT diagnoses (67%) matching the SCAN diagnosis. Conclusions – Overall, the results support the reliability and validity of the Italian translation of the DIP. The Italian version will be useful both in routine practice to establish standard reference diagnoses of psychosis and in the research field, where it can be used by academic researchers in clinical trials and epidemiological studies.
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