Sociodemographic and Clinical Correlates Associated with the Frequent Service Users in an Italian Psychiatric Emergency Department.

BACKGROUND

The aim of the present study is to identify the main sociodemographic and clinical correlates associated with frequent service users (FSUs) in an Italian psychiatric emergency department.

METHODS

This study is an observational and prospective clinical investigation. All subjects (N = 549) consecutively admitted to the Psychiatric Inpatient Unit of the IRCCS Ospedale Policlinico San Martino ((Genoa, Italy) were recruited over a period of 18 months.

RESULTS

On average, FSUs were more likely to be single (75.0% vs. 64.0, = 0.001), younger (38.79 years ± 14.68 vs. 45.94 years ± 16.94, = 0.028), with an earlier onset (20.15 years ± 7.22 vs. 29.33 years ± 15.96, < 0.001), and longer length of hospitalisation (13.65 days ± 12.40 vs. 9.89 ± 10.15, = 0.006) compared to non-FSUs. While bipolar disorder was the most common primary diagnosis in both FSUs and non-FSUs, cluster B personality disorder was particularly elevated in FSUs (30.3% vs. 10.4%, < 0.001). Furthermore, FSUs were more prone to substance use disorder (63.6% vs. 40.0%, < 0.001), particularly cannabis (45.5% vs. 15.3%, < 0.001), cocaine (33.3% vs. 10.4%, < 0.001), and heroin (19.7% vs. 5.8%, < 0.001), and were more likely to have non-suicidal self-injuries (21.2% vs. 6.8%, < 0.001). FSUs were significantly more likely to be discharged against medical advice (18.2% vs. 5.6%, < 0.001) or to have at least one escape attempt from the psychiatric ward (12.1% vs. 0.8%, < 0.001).

CONCLUSIONS

Specific clinical and social profiles of patients who repeatedly utilised the services of a psychiatric emergency department have been identified. Our findings can be used to develop suitable structures to support and reintegrate FSUs into society and work life.