A follow-up on patients with severe mental disorders in Sardinia after two changes in regional policies: poor resources still correlate with poor outcomes

BMC Psychiatry

Dinesh Bhugra¹  Giuseppina Trincas⁵  Davide Massidda⁵  Maria Francesca Moro⁵  Emanuele Pisanu⁵  Mirra Pintus⁵  Gisa Mellino⁵  Elisa Pintus⁵  Anna Pisano⁴  Roberto Pirastu²  Francesco Tuligi⁶  Federica Sancassiani⁵  Matthias C Angermeyer³  Mauro Giovanni Carta⁵ 

[1] HSPRD Institute of Psychiatry (KCL) London, London, UK;Department of Mental Health (DSM)- of Carbonia-Iglesias, Carbonia, Italy;Centre for Public Mental Health, Gösing am Wagram, Austria;Department of Mental Health (DSM)- of Cagliari, Cagliari, Italy;Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, via Ospedale, 117 Cagliari, Italy;Department of Mental Health (DSM)- of Lanusei, Lanusei, Italy

关键词: Resources;    Social functioning;    Follow-up;    Psychosis;    Mental health;    Quality of care;   

Others  :  1123863
DOI  :  10.1186/1471-244X-13-333

 received in 2013-06-27, accepted in 2013-12-02,  发布年份 2013

【 摘 要 】

Background

This survey followed a cohort of patients with chronic psychosis recruited from five catchment areas (DSMs) of the Sardinian community mental health services. The objective was to examine whether the amount of resources in the different sites may be a determinant of the outcomes.

Methods

Naturalistic follow-up study on 309 consecutive users with diagnosis of schizophrenic disorder, schizoaffective disorder, bipolar affective disorder with psychotic symptoms (DSM-IV TR) of five Sardinian community mental health services. Mental state and clinical symptoms along with functioning were assessed using semi-structured clinical interviews (ANTAS), Clinical Global Impression Severity Scale (CGI-S), Global Assessment of Functioning Scale (GAF) and Health of the Nation Outcome Scales (HONOS). Assessments were conducted at the beginning of the study and after one year.

Results

The proportion of professionals working in all DSMs participating in the study was found lower than the national Italian standard (0.7 vs 1.0 per 1,500 inhabitants). Follow-up revealed significant differences between DSMs in the improvement of the Honos scores (F = 5.932, p = 0.000). These differences correlate with the improvement of resources in terms of number of professionals during, and one year prior, to the trial.

Conclusions

The study shows that mental health services provided in the public sector in Sardinia are still very resource-poor, at least in terms of human resources. Our findings suggest that mental health service resources influence outcomes as regards the social functioning of users. We urge policy makers to take these observations into account when planning future services.

【 授权许可】

   
2013 Carta et al.; licensee BioMed Central Ltd.

【 图 表 】

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