Psychol Med Monogr Suppl. 1991;19:1-54.
Community-based psychiatry has attracted a wide interest in the last 20 years. However, the evidence in the literature on monitoring and evaluating community psychiatric services for a long period of time is scanty. The aim of this monograph is to present the results of a number of evaluative studies, covering a ten-year period, conducted in South-Verona, an area of 75,000 inhabitants in Northern Italy, where a new community-based system of care, the South-Verona Community Psychiatric Service (CPS), has operated since 1978. This system, which is based on the provisions of the Italian psychiatric reform, is alternative to the old hospital-centred system of care, and provides care and support to all types of patients, without back-up from the mental hospital, where only a few old long-stay in-patients continue to reside. In the first part of the monograph, trends in the provision of psychiatric care in the period 1979-1988 are presented, using the South-Verona Psychiatric Case Register (PCR). Both one-day and one-year prevalence figures and incidence rates are lower than in other register areas outside Italy, partly because of the smaller number of specialized out-patient services available in South-Verona and partly because of less use of in-patient care in our area. Moreover, there is a tendency in Italy to care for elderly patients in geriatric institutions outside the psychiatric system. Most of the patients seen in any year are treated without in-patient care. This applies to all diagnostic groups, except affective psychosis. Rates of compulsory admission dropped dramatically after the reform. The total number of admissions to all in-patient psychiatric facilities (including private hospitals) in 1988 is only 8.4% lower than that found in 1977 (one year prior to the reform), while the mean number of occupied beds in 1988 was 47% lower than in 1977. In South-Verona point-prevalence of long-stay in-patients has slowly decreased over the years and there is a negligible build-up of new long-stay in-patients. The South-Verona CPS is now taking care of most psychiatric patients who, before the reform, would have been admitted to the mental hospital and become long-stay. These patients, who may be defined as long-term patients in the community, have consistently accumulated since 1981 and are making high use of psychiatric community services.(ABSTRACT TRUNCATED AT 400 WORDS)
在过去20年中，社区精神病学引起了广泛关注。然而，长期监测和评估社区精神科服务的文献证据却很少。这本专著的目的是呈现一系列评估研究的结果，这些研究涵盖了十年时间，是在意大利北部一个有75000居民的南维罗纳地区进行的。自1978年以来，一个新的基于社区的护理系统——南维罗纳社区精神科服务（CPS）在该地区运行。这个系统基于意大利精神病学改革的规定，是旧的以医院为中心的护理系统的替代方案，为所有类型的患者提供护理和支持，无需精神病院的后备支持，目前只有少数长期住院患者仍住在那里。在专著的第一部分，利用南维罗纳精神病病例登记册（PCR）呈现了1979 - 1988年期间精神科护理的提供趋势。一日患病率和一年患病率以及发病率均低于意大利以外的其他登记地区，部分原因是南维罗纳可用的专科门诊服务较少，部分原因是我们地区对住院护理的使用较少。此外，在意大利有一种趋势，即在精神病系统之外的老年机构中照顾老年患者。每年见到的大多数患者都无需住院治疗。这适用于所有诊断类别，情感性精神病除外。改革后强制入院率大幅下降。1988年所有住院精神科设施（包括私立医院）的入院总数仅比1977年（改革前一年）低8.4%，而1988年占用床位的平均数比1977年低47%。多年来，南维罗纳长期住院患者的点患病率逐渐下降，新的长期住院患者积累量可忽略不计。南维罗纳CPS现在照顾着大多数精神病患者，这些患者在改革前会被收治到精神病院并成为长期住院患者。这些患者可被定义为社区中的长期患者，自1981年以来一直在持续积累，并大量使用社区精神科服务。（摘要截选至400字）
