Monitoring community psychiatric services in Italy: differences between patients who leave care and those who stay in treatment

Br J Psychiatry. 2002 Mar:180:254-9. doi: 10.1192/bjp.180.3.254.

Abstract

Background: Continuity of care has been monitored rarely in Italian community mental health centres.

Aims: To estimate the long-term probability of leaving care in first-contact patients attending an out-patient service, and to identify patients most likely to drop out.

Method: All patients who had a first contact with the community mental health centre of Magenta during a 1-year recruitment period were followed up for 24 months. Patients who failed to return after the last out-patient visit were regarded as 'drop-outs'.

Results: During the 1-year recruitment period 330 subjects were at their first contact. The 1-year incidence of first-contact patients was nearly 33 per 10 000 inhabitants. At follow-up, 46% of patients had dropped out. In comparison with patients with psychoses, subjects suffering from neurotic (P =0.004) and personality disorders (P=0.029) were more likely to drop out.

Conclusions: In the Italian system of community psychiatric care nearly half of the patients are no longer in contact after 2 years. Those who stay in treatment are more likely to suffer from psychosis, suggesting a commitment of Italian out-patient facilities to tackling the needs of patients with more severe disorders.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • Community Mental Health Services / statistics & numerical data*
  • Continuity of Patient Care / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Italy
  • Male
  • Mental Disorders / therapy*
  • Middle Aged
  • Multivariate Analysis
  • Patient Dropouts / statistics & numerical data*
  • Regression Analysis