Hospital admission as first-contact with a community-based psychiatric service. A 2 year study in South-Verona.

The aim of this study was to understand the decision to hospitalize at the first contact, rather than utilize the other services of a community-based system of care. Using the South Verona Psychiatric Case Register, 46 first-contact patients admitted to hospital were compared to all other in-patients (n = 187) over a 2-year span with respect to socio-demographic characteristics, diagnosis (ICD-9) and symptoms (on the Present State Examination Syndrome Check List). Results suggested that first-contact hospitalized patients have significantly more neurotic depressive features. Alternatives to admission were investigated in only about one-third of depressive neurosis patients, compared to two-thirds of patients with other affective disorder diagnoses. In contrast, for patients with psychoses, admission is a second choice (except for patients with organic psychoses).