Calabrese L V, Micciolo R, Tansella M
Department of Medical Psychology, University of Verona, Italy.
Soc Sci Med. 1990;31(7):815-22. doi: 10.1016/0277-9536(90)90176-s.
A comprehensive and well-integrated community-based system of psychiatric services has been developed in South-Verona since the Italian psychiatric reform. Using the South-Verona Psychiatric Case Register, we identified chronic psychiatric patients in the community over a 6-year period after the reform. Six first-contact sociodemographic variables (sex, age, marital status, living situation, education, occupational status) and two clinical variables (ICD-9 diagnosis and past history of state psychiatric hospital admission) were studied for these patients. Four full cohort-years of post-reform chronic patients were followed for a 2-year period to determine their subsequent patterns of care. Logistic analysis was used to examine the interaction of cohort-year with outcome and the above sociodemographic and clinical variables studied individually and in combination. We found that 36.4% of post-reform chronic patients in the community remained in long-term contact with psychiatric services for 2 years after they were first identified. Logistic analysis revealed that none of the sociodemographic and clinical variables studied individually or in combination were predictive of the probability of remaining in long-term contact with community psychiatric services.
自意大利精神病学改革以来，南维罗纳已建立起一个全面且整合良好的社区精神病服务体系。利用南维罗纳精神病病例登记册，我们确定了改革后6年期间社区内的慢性精神病患者。对这些患者研究了六个首次接触时的社会人口统计学变量（性别、年龄、婚姻状况、生活状况、教育程度、职业状况）和两个临床变量（国际疾病分类第九版诊断和过去入住国立精神病医院的病史）。对改革后慢性患者的四个完整队列年份进行了为期2年的随访，以确定他们随后的护理模式。采用逻辑分析来检验队列年份与结果以及上述单独和综合研究的社会人口统计学和临床变量之间的相互作用。我们发现，社区中改革后慢性患者中有36.4%在首次被确定后的2年里一直与精神病服务保持长期接触。逻辑分析显示，单独或综合研究的社会人口统计学和临床变量均无法预测与社区精神病服务保持长期接触的可能性。
