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. 2022 Oct 14:13:959399.
doi: 10.3389/fpsyt.2022.959399. eCollection 2022.

Changes of consultation-liaison psychiatry practice in Italian general hospitals: A comparative 20-year multicenter study

Luigi Zerbinati  1   2 , Laura Palagini  1   2 , Matteo Balestrieri  3 , Martino Belvederi Murri  1   2 , Rosangela Caruso  1   2 , Armando D'Agostino  4   5 , Maria Ferrara  1   2 , Silvia Ferrari  6   7 , Antonino Minervino  8 , Paolo Milia  8 , Maria Giulia Nanni  2   9 , Stefano Pini  9 , Pierluigi Politi  10 , Matteo Porcellana  11 , Matteo Rocchetti  10 , Ines Taddei  12 , Tommaso Toffanin  1   2 , Luigi Grassi  1   2 ; Italian Society of Consultation-Liaison Psychiatry; Jessica Bellucci  1   2 , Emilio Bergamelli  3 , Victor Attilio Campagna  3 , Melissa Cherubini  1   2 , Federica Folesani  4   5 , Marta Gancitano  4   5 , Francesca Giannetti  6 , Gianluca Giovanna  7 , Benedetta Gullotta  4   5 , Lucia Massa  8 , Giulia Montardi  1   2
Affiliations

Changes of consultation-liaison psychiatry practice in Italian general hospitals: A comparative 20-year multicenter study

Luigi Zerbinati et al. Front Psychiatry. .

Abstract

Introduction: Conducted under the auspices of the Italian Society of Consultation Liaison Psychiatry (SIPC) the aim of this study was to describe the characteristics of Consultation Liaison Psychiatry (CLP) activity in Italy (SIPC-2-2018) over the past 20 years by comparing with data from the first Italian nation-wide study (SIPC-1-1998).

Methods: We collected data on CLP visits of 3,943 patients from 10 Italian hospitals over a period of 1 year. Data were compared with those from the SIPC-1 1998 study (4,183 participants). Patients were assessed with the same ad hoc 60-item Patient Registration Form recording information from five different areas: Sociodemographic, hospitalization-related, consultation-related, interventions and outcome.

Results: Compared with participants from the previous study, SIPC-2-2018 participants were significantly older (d = 0.54) and hospitalized for a longer duration (d = 0.20). The current study detected an increase in the proportion of referrals from surgical wards and for individuals affected by onco-hematologic diseases. Depressive disorders still represented the most frequent psychiatric diagnosis, followed by adjustment and stress disorders and delirium/dementia. Also, CLP psychiatrists prescribed more often antidepressants (Φ = 0.13), antipsychotics (Φ = 0.09), mood stabilizers (Φ = 0.24), and less often benzodiazepines (Φ = 0.07).

Conclusion: CLP workload has increased considerably in the past 20 years in Italy, with changes in patient demographic and clinical characteristics. A trend toward increase in medication-based patient management was observed. These findings suggest that the psychiatric needs of patients admitted to the general hospital are more frequently addressed by referring physicians, although Italian CLP services still deserve better organization and autonomy.

Keywords: Consultation-Liaison (C-L) psychiatry; Italy; hospital psychiatry; liaison psychiatry; medical psychiatry.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Percentage of somatic (A) and psychiatric (B) diagnoses of referred patients.
FIGURE 2
FIGURE 2
Distribution of referrals according to the ward.
See this image and copyright information in PMC

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