Involuntary admissions in Italy: the impact of seasonality

Aguglia, Andrea; Moncalvo, Marta; Solia, Francesca; Maina, Giuseppe

doi:10.1080/13651501.2016.1214736

Cited by 35 publications

(34 citation statements)

References 54 publications

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“…However, a peak of cases of violence in spring (potentially leading to restraint) in the acute psychiatric wards in South-Trøndelag has been reported [33] as well as a peak of restraint in spring in Italy [34]. For mania, it is also established that there is an increase in spring [35], but we could not find any reports on seasonal variation in activity of non-affective psychoses.…”

Section: Non-patient Factorscontrasting

confidence: 45%

Use of mechanical and pharmacological restraint over an eight-year period and its relation to clinical factors

Reitan

Helvik

Iversen

2017

Nordic Journal of Psychiatry

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Background: Use of restraint and finding the balance between security and ethics is a continuous dilemma in clinical psychiatry. In daily clinic and in planning health-care service, knowledge on the characteristics of restraint situations is necessary to optimize its use and avoid abuse. Methods: We describe characteristics in the use of pharmacological and mechanical restraint in psychiatric acute wards in a hospital in Middle Norway over an eight-year period. Data on all cases of mechanical and pharmacological restraint from 2004 to 2011 were retrospectively collected from handwritten protocols. Complementary information on the patients was obtained from the hospital patient administrative system. Results: Restraint in acute wards was used on 13 persons per 100,000 inhabitants annually. The percentage of admitted patients exposed to restraint was 1.7%, with a mean of 4.5 cases per exposed patient. Frequency per 100 admitted patients varied from 3.7 (in 2007) to 10 (in 2009). The majority of restraint cases concerned male patients under 50 years and with substance-abuse, psychotic, or affective disorders. Significantly more coercive means were used during daytime compared to night and morning. There was a significant increase in pharmacological coercion during spring and mechanical coercion during summer. Conclusions: Restraint was used on 1.7% of admitted patients, representing 13 per 100,000 inhabitants per year. Use of restraint was higher during certain periods of the day and was associated with the patient's diagnosis, age, gender, and legal status of hospitalization. There was a marked variation over the years.

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Section: Non-patient Factorscontrasting

confidence: 45%

Use of mechanical and pharmacological restraint over an eight-year period and its relation to clinical factors

Reitan

Helvik

Iversen

2017

Nordic Journal of Psychiatry

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“…The major limitation of our study is its register-based nature which implies a substantial poverty of available variables for inpatients, among which include; sociocultural and educational parameters, medical comorbidities, treatment regimen. The lack of a relevant hospitalization-related parameter such as the voluntary or involuntary type of admission, further limits the possibility of comparing our findings with other recent studies within a shared socio-cultural domain (Aguglia, Moncalvo, Solia, & Maina, 2016). Another limitation intrinsic to the nature of the study is the eminently clinical origin of diagnoses, the vast majority of which were unlikely to be supported by certified diagnostic instruments, making them highly heterogeneous.…”

Section: Limitationsmentioning

confidence: 81%

The reMAP project: A retrospective, 15‐year register study on inpatient care for youth with mental disorders

Ostinelli

Cavallotti²,

Fanti

et al. 2019

Early Intervention Psych

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Aim: We aimed to characterize youth hospitalization trends in a psychiatric inpatient unit from a large, public university hospital with a broad catchment area in Milan, Italy. Methods: Hospitalization data of patients with an age at admission ≤ 35 were retrospectively retrieved over a time span of 15 years. The sample was comprised of 1982 admissions to a psychiatric ward, aggregated into ICD-10 diagnostic clusters and then analysed. We investigated the epidemiological trends with a focus on age at admission, gender, nationality and hospitalization rates, length of stay and "revolving door" readmissions within a year. Results: Hospitalization rates increased for eating Disorders and decreased for nonaffective psychotic disorders; median length of stay generally decreased; hospitalization rates for foreign youth increased, in particular for those diagnosed with nonaffective psychotic disorders, personality disorders, and substance-related and addictive disorders. The revolving door phenomenon was also associated with nonaffective psychoses and neurodevelopmental disorders, while found to increase for eating disorders. Conclusions: Hospitalization patterns reflect the general increase of foreign youth in the suburban tissue of a large metropolitan area like Milan. However, our data might underestimate the constant growth of mental health problems in foreign youth due to a generally lower access to services. Novel pharmacological treatments and early intervention programs might explain the decrease of hospitalization duration and hospitalization rate for youth with non-affective psychoses. The observed increase in hospitalization for young patients with eating disorders sustains the development of adequate policies tailored towards specialty wards. K E Y W O R D S hospitalization trends, psychiatric services, psychosis, revolving door, youth inpatient care 1 | INTRODUCTION Most findings associated with the course of psychiatric disorders suggest that early identification and treatment leads to improved outcome (Brimblecombe et al., 2017). The clinical relevance of early intervention programs has gained increasing attention over the past few decades, in full agreement with current understanding of primary and secondary prevention in psychiatric disorders. Prospective patients' awareness of mental health and associated problems is influenced by several features that shape their access to mental health

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“…Studies exploring seasonal effects tend to treat months and years as separate units in time [ 3 , 7 , 8 , 27 ]. The observed long-term non-linear increase in daily number of trauma admissions in this study underpins that using months as the unit of analysis cannot automatically be recommended, as this will effectively imply turning continuous time into a categorical variable, potentially masking clinically valuable information.…”

Section: Discussionmentioning

confidence: 99%

“…In healthy Danish males, a three-week bright-light intervention during winter season enhanced the functional MRI neural response to risk-taking in a card gambling game [ 6 ]. A nationwide US material of Emergency Department admissions for suicide attempts and self-harm showed a pronounced peak from March to May [ 7 ], similar to the pattern of non-voluntary psychiatric admissions in Italy [ 8 ]. For bipolar disorder a close association exists between increase in daylight hours and both the onset of disease and subsequent hospital admissions [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Seasonality in trauma admissions – Are daylight and weather variables better predictors than general cyclic effects?

2018

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BackgroundTrauma is a leading global cause of death, and predicting the burden of trauma admissions is vital for good planning of trauma care. Seasonality in trauma admissions has been found in several studies. Seasonal fluctuations in daylight hours, temperature and weather affect social and cultural practices but also individual neuroendocrine rhythms that may ultimately modify behaviour and potentially predispose to trauma. The aim of the present study was to explore to what extent the observed seasonality in daily trauma admissions could be explained by changes in daylight and weather variables throughout the year.MethodsRetrospective registry study on trauma admissions in the 10-year period 2001–2010 at Oslo University Hospital, Ullevål, Norway, where the amount of daylight varies from less than 6 hours to almost 19 hours per day throughout the year. Daily number of admissions was analysed by fitting non-linear Poisson time series regression models, simultaneously adjusting for several layers of temporal patterns, including a non-linear long-term trend and both seasonal and weekly cyclic effects. Five daylight and weather variables were explored, including hours of daylight and amount of precipitation. Models were compared using Akaike’s Information Criterion (AIC).ResultsA regression model including daylight and weather variables significantly outperformed a traditional seasonality model in terms of AIC. A cyclic week effect was significant in all models.ConclusionDaylight and weather variables are better predictors of seasonality in daily trauma admissions than mere information on day-of-year.

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Involuntary admissions in Italy: the impact of seasonality

Cited by 35 publications

References 54 publications

Use of mechanical and pharmacological restraint over an eight-year period and its relation to clinical factors

Use of mechanical and pharmacological restraint over an eight-year period and its relation to clinical factors

The reMAP project: A retrospective, 15‐year register study on inpatient care for youth with mental disorders

Seasonality in trauma admissions – Are daylight and weather variables better predictors than general cyclic effects?

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