Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy.
Early Interv Psychiatry. 2020 Dec;14(6):705-713. doi: 10.1111/eip.12899. Epub 2019 Nov 25.
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.
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.
Hospitalization rates increased for eating Disorders and decreased for non-affective psychotic disorders; median length of stay generally decreased; hospitalization rates for foreign youth increased, in particular for those diagnosed with non-affective psychotic disorders, personality disorders, and substance-related and addictive disorders. The revolving door phenomenon was also associated with non-affective psychoses and neurodevelopmental disorders, while found to increase for eating disorders.
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.
我们旨在描述意大利米兰一家大型公立大学附属医院精神科住院部青年住院趋势的特征。
回顾性检索了 15 年间年龄≤35 岁的患者住院数据。该样本包括 1982 名入住精神科病房的患者，按 ICD-10 诊断分类汇总后进行分析。我们研究了流行病学趋势，重点关注入院年龄、性别、国籍和住院率、住院时间以及一年内“循环”再入院情况。
饮食障碍的住院率增加，非情感性精神病障碍的住院率下降；平均住院时间普遍缩短；外国青年的住院率增加，特别是非情感性精神病障碍、人格障碍、物质相关和成瘾障碍的患者。“循环”现象也与非情感性精神病和神经发育障碍有关，而饮食障碍的“循环”现象则有所增加。
住院模式反映了像米兰这样的大城市郊区外国青年人数的普遍增加。然而，由于服务利用率普遍较低，我们的数据可能低估了外国青年心理健康问题的不断增加。新型药物治疗和早期干预方案可能解释了非情感性精神病患者住院时间和住院率的下降。观察到饮食障碍青年患者住院率增加，支持制定针对专业病房的适当政策。
