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Gobbicchi C, Verdolini N, Menculini G, Cirimbilli F, Gallucci D, Vieta E, Tortorella A. Searching for factors associated with the "Revolving Door phenomenon" in the psychiatric inpatient unit: A 5-year retrospective cohort study. Psychiatry Res 2021; 303:114080. [PMID: 34246004 DOI: 10.1016/j.psychres.2021.114080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 11/30/2022]
Abstract
The revolving door (RD) phenomenon refers to subjects who undergo frequent rehospitalizations in psychiatric units. The main aim of this study was to analyze clinical factors associated with RD in acute inpatient psychiatric ward. In a 5-year cohort study, subjects hospitalized three or more times in 12 months (revolving door subjects-RDS) were identified. A total of 1,324 subjects were hospitalized. RDS represented 6.3% (n = 84) of the entire sample with a total of 337 RD hospitalizations (revolving door hospitalizations-RDH) (16.7% of all admissions). RDS were younger, unmarried, with comorbid substance related disorders, with mood or psychotic disorders and affected by comorbid medical conditions. After controlling for age, sex and marital status, the most strongly associated variable with RDH was the comorbidity between mood and substance use disorders. Other associated factors were the presence of a comorbid medical condition and a longer length of stay. The commitment to community residential facilities and the treatment with a first generation long-acting antipsychotic were also associated with RDH. On the contrary, admissions to the psychiatric unit for manic/hypomanic episode or for self-directed harmful behavior were inversely associated with RDH. Attention should be given to these clinical variables in order to reduce RD.
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Affiliation(s)
- Chiara Gobbicchi
- Department of Psychiatry, University of Perugia, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132, Perugia, Italy; Department of Mental Health, AUSL Umbria 2, Terni, Viale D. Bramante 37, 05100 Terni (TR) Italy
| | - Norma Verdolini
- Department of Psychiatry, University of Perugia, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132, Perugia, Italy; Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Institute of Neuroscience, Barcelona, Catalonia, Spain
| | - Giulia Menculini
- Department of Psychiatry, University of Perugia, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132, Perugia, Italy
| | - Federica Cirimbilli
- Department of Psychiatry, University of Perugia, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132, Perugia, Italy
| | - Daniela Gallucci
- Department of Psychiatry, University of Perugia, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132, Perugia, Italy; AUSL Umbria 1, Via G. Guerra, Perugia, 21 Italy
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Institute of Neuroscience, Barcelona, Catalonia, Spain
| | - Alfonso Tortorella
- Department of Psychiatry, University of Perugia, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132, Perugia, Italy.
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Pauselli L, Galletti C, Verdolini N, Paolini E, Gallucci D, Balducci PM, Bernardini F, Kogan JH, Shim R, Moretti P, Compton MT. Predictors of Client Satisfaction with Outpatient Mental Health Clinic Services in Italy and New York. Community Ment Health J 2018; 54:562-570. [PMID: 29147978 DOI: 10.1007/s10597-017-0196-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 11/04/2017] [Indexed: 10/18/2022]
Abstract
The aim of this cross-sectional study was to assess factors associated with client satisfaction in two mental health outpatient settings in Italy and the US. Sociodemographic and clinical variables, hope, and personality characteristics were evaluated in 18-65-year-old patients who had been receiving services for at least 2 months in one of two outpatient clinics, in Italy and the US. Patients were administered: the Healthy Days Core Module, the Kessler Screening Scale for Psychological Distress, the Verona Service Satisfaction Survey, the Client Satisfaction Inventory, the Health Service OutPatient Experience questionnaire, the Herth Hope Index, and the NEO Five-Factor Inventory-3. Bivariate tests for differences between the two samples were conducted, a Satisfaction Composite z-score was computed, and a stepwise, backward elimination, multiple linear regression model-including the variables that were significantly associated with Satisfaction Composite Score in bivariate tests-was built. From July 1, 2015 to April 30, 2016, 184 patients (121 in Foligno, 63 in New York City) were enrolled in the study. Predictors of client satisfaction included: receiving services in New York City, being older, having lower educational attainment, having inner positive readiness and expectancy as well as interconnectedness with self and others, and high scores on the agreeableness personality domain. Interestingly, diagnosis and treatment characteristics did not influence satisfaction. Client satisfaction with outpatient mental health services is mainly influenced by sociodemographic characteristics and personality factors more than clinical variables or patterns of care. These findings could have implications regarding trends toward value-based payment models.
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Affiliation(s)
- Luca Pauselli
- Department of Medicine, Section of Psychiatry, University of Perugia, Perugia, Italy. .,Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY, USA. .,New York State Psychiatric Institute (NYSPI), 1051 Riverside Drive, Box 100, New York, NY, 10032, USA.
| | - Chiara Galletti
- Department of Medicine, Section of Psychiatry, University of Perugia, Perugia, Italy
| | - Norma Verdolini
- Department of Medicine, Section of Psychiatry, University of Perugia, Perugia, Italy.,Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Enrico Paolini
- Department of Medicine, Section of Psychiatry, University of Perugia, Perugia, Italy
| | - Daniela Gallucci
- Department of Medicine, Section of Psychiatry, University of Perugia, Perugia, Italy
| | | | - Francesco Bernardini
- Department of Psychiatry, Erasme Hospital, Université Libre de Bruxelles, Anderlecht, Belgium
| | - Jerome H Kogan
- Department of Psychiatry, Lenox Hill Hospital, New York, NY, USA
| | - Ruth Shim
- Department of Psychiatry and Behavioral Sciences, UC Davis Health System, Sacramento, CA, USA
| | - Patrizia Moretti
- Department of Medicine, Section of Psychiatry, University of Perugia, Perugia, Italy
| | - Michael T Compton
- Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY, USA
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Alberti P, Bianchi P, Pasini M, Rivadossi F, Gallucci D, Pasini GF. [Solitary ulcer of the rectum]. MINERVA CHIR 1994; 49:653-8. [PMID: 7991171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The authors review their five-year experience of solitary rectal ulcers. A revision of the most recent literature enables them to outline the characteristics of the disease with reference to its epidemiology, anatomopathology and clinical features. The discussion focuses on the problem of treatment which must be based on a thorough and in-depth knowledge of pathogenetic mechanisms. The paper outlines two theories, the hamortomatous one and the so-called mechanical theory involving the hinge valve, which are referred to by most researchers. The question of treatment is then discussed illustrating the possibility of resorting to surgical-type treatment which appears to be the most suitable for the definitive resolution of the problem. But since, at least in the light of the authors' personal experience; the majority of patients belong to an age group in which other pathologies are often present, the medical treatment option appears to be more rational. The re-education of the alvus achieved using suggestions not only of a dietary type but also regarding the behaviour and correct position to assume during defecation appears, at least theoretically, sufficient to obtain a marked improvement. The local application of therapeutical AIDS, if necessary strengthened by the action of drugs taken systemically, brings considerable further benefit to the patient who cannot and/or does not which to undergo surgery.
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Affiliation(s)
- P Alberti
- Regione Lombardia-USSL n. 39, Comunità Montana di Valle Sabbia
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Alberti P, Gallucci D, Rivadossi F, Bianchi P, Pasini GF. [Primary stones of the common bile duct]. MINERVA CHIR 1993; 48:73-7. [PMID: 8464559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Primary stones can probably form, although rarely, in the common bile duct. The authors report a series of six cases which they considered as primary common duct stone disease and, in order to get more precise information on this problem, they review the literature on the subject. This disease would be caused by the presence of a lithogenic bile which, with a chronic obstruction of the Vater's ampulla, could let lithiasic particles accumulate in the common bile duct. On the basis of this hypothesis and in order to perform a correct procedure that allows easy drainage of the bile to the intestine to the chronic use of litholytic drugs.
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Affiliation(s)
- P Alberti
- Comunità Montana di Valle Sabbia, USSL n. 39, Regione Lombardia
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Alberti P, Antoci G, Rivadossi F, Gallucci D, Bianchi P, Pasini M, Pasini GF. [Mondor syndrome. Etiopathogenesis and case report]. Minerva Ginecol 1992; 44:541-4. [PMID: 1461559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The Authors observed and report a case of Mondor's syndrome in a male. In the attempt to identify the real origin in this peculiar thrombophlebitis they reviewed the recent literature. It is apparently impossible to drawn definitive conclusions from the different studies on this subject. Anyway Mondor's syndrome looks suitable for inclusion in the group of jumping thrombophlebitis. Therefore the real cause of the venous accident should be a pathologic situation next to the venous branch where the thrombophlebitis has broken out.
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Affiliation(s)
- P Alberti
- Comunità Montana di Valle Sabbia, USSL 39, Regione Lombardia
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Alberti P, Pasini M, Rivadossi F, Gallucci D, Pasini GF. [Tumors of the small intestine. Case reports and comments]. MINERVA CHIR 1992; 47:1149-53. [PMID: 1508367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Tumours of the small intestine are extremely rare and have a particularly severe prognosis. The impossibility of making an early diagnosis due to the scarcity of precise symptoms during the early stages of the disease and the lack of safe instrumental tests limits the results of treatment which is essentially surgical. In order to contribute to the study of the disease and improve its prognosis, the authors report the cases which they have observed and review the literature.
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Affiliation(s)
- P Alberti
- Ospedale di Gavardo, Divisione di Chirurgia, Brescia
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Alberti P, Pasini M, Gallucci D, Rivadossi F, Pasini GF. [Carcinoid tumor of the appendix]. Riv Eur Sci Med Farmacol 1991; 13:251-5. [PMID: 1819854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The authors after briefly outlining the epidemiological and clinical characteristics of the appendiceal carcinoid, report a case observed by them. They discuss the problem concerning the prognosis of this particular tumoral form, and the prognosis which could be more severe than people generally think.
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Affiliation(s)
- P Alberti
- Divisione di Chirurgia, Ospedale Gavardo (BS)
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