The clinical and radiographic features of three adult siblings with mental deficiency and dwarfism due to the Dyggve-Melchior-Clausen syndrome are documented. The consanguinity of the unaffected parents is further evidence to support the concept of autosomal recessive inheritance of this disorder. The fact that this is the fifth reported kindred of Lebanese extraction emphasise3 the geographic predilection of the abnormal genes.
Objectives: To describe the main features of the younger group of patients hospitalized (January 1 st and December 31 st) in the Acute Psychiatry Unit of a General Hospital in Bologna (Northern Italy), comparing their socio-demographic and clinical characteristics and their needs with those of the adult patients admitted. Methods: Retrospective consultation of case-histories concerning 111 subjects (60.4% men) randomly selected. Chi-square and independent sample T-test used to compare 33 cases (≤21 years) and 78 controls (35-49 years). Results: Young-cases had a higher prevalence of parental separation (31% vs 2.7%; p< 0.001) and were more frequently adopted (18.8% vs 0%; p=0.01). Psychomotor agitation or etero/self-aggressiveness (36.4%) and personality disorders (12.1%) were the most prevalent causes of hospitalization among the younger group, whereas psychosis (32.1%), mood disorders (19.2%) and alcohol-substances dependence (11.5%) were more common in controls (p< 0.001). Presence of unfavorable life-events was twofold higher in cases than in controls (p=0.074). In particular, quarrels with family (40%) or friends (20%) and substance abuse (13.3%) occurred especially in young individuals. In adults, mournings/separations and rejection therapy were more frequent (p=0.017). Hospitalization's features (type, length, number of laboratory and instrumental exams) were not significantly different among the two groups, except for frequency and number of interviews and childpsychiatrists and educators' care provided that prevailed in cases. Conclusions: The young population admitted in our acute psychiatric ward has a complex sociorelational and clinical situation requiring a multi-professional management. The frequent need of care in emergent/urgent situation highlights the importance of further studies on this issue.
Objectives: To evaluate the features of Frequent-Attenders (FAs) admitted to an Acute Psychiatric Unit of a general hospital in Bologna, Northern Italy. Methods: Persons admitted between January 2008-June 2009 (N=110) were randomly selected thanks to the Hospital Information System. All participants' admissions in the indexed period were recorded, the case-history of the first admission was reviewed gathering socio-demographic and clinical information. The International Classification of Disease (ICD-10) was used for diagnosis. FAs were defined for 3 or more admissions within 18 months (Botha et al. 2009). Results: Almost one out of three patients was a FA (N=34; 30.9%). The mean number of admission for each subject being 5.6±3.4 for an average length of stay of 56.2±62.1 days. In comparison to single users, FAs were more frequently men (67.6% vs. 46.1%; p=0.029), unemployed (79.4% vs. 29.2%; p< 0.001) and living in social-health facilities (29.4% vs. 9.5%; p< 0.024). FAs and common users were not different concerning compulsory/voluntary admission. Schizophrenia and other Psychotic Disorders were predominant among FAs (44.1%), followed by Substance Use and Personality Disorders (14.7%), but no differences were detectable between cases and controls in terms of discharge diagnoses. Conversely, the prevalence of concomitant organic diseases was higher in FAs (50% vs. 27.6%; p=0.020).Finally, the results of the Logistic Regression Model estimating Odds Ratios and 95% Confidence Intervals suggested that FAs had a lower insight/compliance (2.15; 2.50-29.66; p=0.001). Conclusions: FAs have a higher mental-social disability. A targeted treatment might reduce the frequency of hospitalization.
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