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Biomedical subjects

M Tansella

Publications and source records attributed to M Tansella.

At least 73 records · Page 4Linked to original sources
PubMed1990

Patterns of care for chronic patients after the Italian psychiatric reform. A longitudinal case register study.

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.

Aged↗
PubMed1990

The Interval General Health Questionnaire and its relationship with psychiatric disorder in community and general practice samples.

This paper contrasts the usual scoring of the GHQ-30 with scoring based upon a criterion approach applied to only 12 of the GHQ items that takes account of the 'diagnostic significance' of the chosen items. Repeat assessments with this shorter form of the questionnaire (the I-GHQ), coupled with procedures to assess change, can be used to provide summary measures of symptom course in those research situations where available interview time precludes the use of more formal assessment methods.

Adolescent↗
PubMed1989

The demand for extramural psychiatric intervention in a community-based service.

Using a psychiatric case register, patients who had extramural contacts with the South-Verona Community Psychiatric Service in 1983 (N = 549) were selected for this study and followed-up for 3 years, from the date of their first 1983 contact. Out of the total number of extramural contacts made in 3 years (N = 12,429) 16% were unplanned (drop-in) contacts. A linear-logistic model was used to investigate the joint effects of sociodemographic and clinical variables on the frequency of unplanned extramural contacts. The model to fit the data was complex, confirming that many interactions among the variables considered in the study significantly affect the probability of using the community services on an urgent or unplanned basis.

Aged↗
PubMed1989

Mobility of schizophrenic patients, non-psychotic patients and the general population in a case register area.

This preliminary study attempts to evaluate the effect of a community psychiatric service on residential mobility by comparing a cohort of schizophrenic patients over a 5-year period with that of non-psychotic and general population control groups in South Verona, a case register area in Northern Italy. No significant differences were found between the groups for different types of movement (within South Verona/outside catchment area of South Verona/outside City of Verona), except for movements within South Verona between the schizophrenic group and neurotic group. The former tended to move less than the latter. The sociodemographic factors associated with movements of the general population in Verona were being male and single, whereas place of birth was less important. The results showed that in the two patient groups as well as in the general population in South Verona, the percentages of those who moved outside the case-register area ranged between 1.5%-4.4% over a one-year period, and between 7.3%-13.8% over a five-year period, indicating a relatively consistent denominator for the Case Register.

Adult↗
PubMed1989

Seasonal variation in suicide: is there a sex difference?

Seasonal variation in suicide in Italy for the years 1969-81 has been assessed in males and females by means of harmonic analysis. Cyclical fluctuations in the number of suicides, reasonably consistent over the 13 years of the study, have been observed in both sexes. Seasonal harmonics accounted for 65.3 and 48.4% of the variance in male and female suicides respectively. While in males the only important seasonal harmonic was the first (one cycle per year), in females there was an important first harmonic and a second harmonic (two cycles per year). In both sexes the peak of the first harmonic occurred in May, while in females the subsidiary peak occurred in October-November.

Cross-Sectional Studies↗
PubMed1989

The spectrum of psychiatric morbidity in a defined geographical area.

The concept of 'the pathway to psychiatric care' as described by Goldberg & Huxley (1980) using a scheme of five 'levels' and four 'filters', has provided a useful framework in investigating referral processes in places where health services are organized in a way similar to the British National Health Service. Previous estimates of psychiatric morbidity at each of the levels of this model have been calculated, based upon data obtained from diverse geographical areas and over different time frames. The value of these estimates for service planning is therefore limited by the heterogeneity of the data sources. This paper provides data related to all five levels based upon the same geographical area (South-Verona, Italy) and within the same time frame (one week in 1987). The importance of studying the full spectrum of psychiatric morbidity at all levels in the same area is discussed. In particular, it is shown that the assessment of morbidity in the primary medical care setting (levels 2 and 3) and data about filters 2 and 3 can provide useful information for the evaluation of specialist services (levels 4 and 5) as well as for understanding changes in the provision of specialist care.

Adult↗
PubMed1989

Use of mental health services in south Verona and Groningen. A comparative case-register study.

A comparison was made of the utilization of mental health services in a psychiatric case register area in Italy (south Verona) and one in the Netherlands (Groningen). All residents living in these areas who contacted a mental health service in 1982 were traced and followed for a period of one year. The year prevalence rates differed considerably (110/10,000 in south Verona and 329/10,000 in Groningen). Rates of single consulters were similar in both areas, while those of chronic inpatients were more than 11 times higher in Groningen than in south Verona. After excluding both single consulters and chronic inpatients, when comparing service consumption according to fixed classes of scores, the category of highest service use accounted for 60% of care provided in Groningen as compared with less than 30% in south Verona. The proportion of total service consumption due to inpatient care was about the same in both areas, but brief admissions were more common in south Verona. Moreover, when service use was considered as a relative construct, about 10% of patients in both areas could be called high users. Finally, long-term patients were more prevalent in Groningen (26%) than in south Verona (13%).

Adolescent↗
PubMed1987

Suicide and the Italian psychiatric reform: an appraisal of two data collection systems.

The reliability of Italian suicide data derived from returns made by the Police and Carabinieri was examined by comparing regional suicide data from that source with those based on medically certified cause of death for the years 1973-1980. Rates of medically certified suicide were found to be higher than those derived from the Police/Carabinieri returns, a difference which increased steadily over the years of study. The between-region within-year correlations (between the suicide rates derived from the two sources) were very high, but tended to decrease with time. The between-year within-region correlations were +0.700 or above for 12 of the 19 Italian regions and between +0.500 and +0.700 for a further 3. The correlation between the rates of suicide derived from the two sources was poor for the remaining 4 regions. A previous analysis of the influence on suicide of the Italian psychiatric reform used Police/Carabinieri data (Williams et al. 1986): this was repeated excluding data from these 4 regions, and the previous results were confirmed. Indeed, the negative correlation between suicide and the provision of general hospital psychiatric beds was stronger than that previously reported.

Community Mental Health Services↗
PubMed1987

The time for suicide.

Analysis of 25,987 suicides occurring in Italy during the years 1974-1983 demonstrated a clear diurnal variation, death by suicide being most prevalent between 6 a.m. and 4 p.m. Reasons and implications are discussed with reference to earlier work on this topic.

Circadian Rhythm↗
PubMed1987

Long-stay and long-term psychiatric patients in an area with a community-based system of care. A register follow-up study.

In South-Verona, where a community-based system of care consonant with the provisions of the Italian psychiatric reform has been operating since 1978, case-register data show that Long-stay inpatient rates are decreasing, while rates of patients treated long-term outside the mental hospital (i.e. those in "continuous care for one year, receiving treatment in the community by the various out-patient and day-patient facilities and in some cases short spells of inpatient care") show a recent increasing trend. Long-stay inpatients on 31.12.1982 have been compared with long-term community patients on the same date. The two cohorts were similar in terms of basic sociodemographic variables and contained a similar proportion of psychotic patients. However, while 88% of the long-stay inpatients were still long-stay after two years, only 45% of the long-term patients in the community remained in long-term treatment over the same period. Using a log-linear model, diagnosis was found to be the variable with the highest association in the long-term cohort with subsequent pattern of use of mental health services.

Adolescent↗
PubMed1986

Psychotropic drug use in Italy: national trends and regional differences.

Psychotropic drug sales data for Italy were examined for the years 1975-84. The principal findings were of more-or-less consistent annual increases in sales of antidepressants, minor tranquillizers and, to a lesser extent, of neuroleptics. These trends are interpreted in the context of the characteristics of the Italian National Health Service (NHS), and in relation to findings from psychotropic drug utilization studies in other Western countries. Regional differences in psychotropic drug sales for 1983/4 were also examined. Marked differences were found and, in general, levels of use were higher in North/Central Italy than in the South. Factors influencing regional differences were explored using regression analysis. Regional NHS expenditure (excluding that on drugs) was found to influence strongly the sales of all categories of psychotropic drug, whereas there was also a marked urban greater than rural difference in the sales of tranquillizers.

Antidepressive Agents↗