Psychiatric reforms in Italy have been the subject of many publications since 1978, when these reforms became law. One such publication is the article by Hinterhuber et al. entitled "Status and Development of Psychiatric Care in Italy" appearing in this edition of Der Nervenarzt [17]. In it, a number of unsolved issues are pointed out, concentrating on some of the main problems encountered by any country going through a process of major institutional change. Some additional points are helpful to a discussion of Italian psychiatric methods and their implications for reorganizing psychiatric practice elsewhere in Europe. Making use of certain "key concepts," we review these questions [2].