Background
Methods
Setting
Participants
Design of the study
Study of courses
Study of symptoms and functioning
Statistical analysis
Results and discussion
Course
Time of observation
First consultation
Age at T0
CMHC interventions
Day center programs
Hospitalization
Total | Males | Females | P-value Mann–Whitney | ||||
---|---|---|---|---|---|---|---|
Mean (S.D.) | Median (IR) | Mean (S.D.) | Median (IR) | Mean (S.D.) | Median (IR) | ||
Age at T0 | 37.5 (14.42) | 34 (22) | 34.0 (13.14) | 31 (17) | 41.5 (14.73) | 39 (22) | < 0.0001 |
Years of observation | 12.9 (7.56) | 13 (10) | 12.9 (7.72) | 13 (12) | 12.9 (7.39) | 13 (10) | 0.760 |
Total number of admissions | 4.8 (11.26) | 2 (4) | 5.7 (13.26) | 2 (5) | 3.8 (8.40) | 1 (4) | < 0.0001 |
Length of admissions (days) | 213.3 (720.44) | 31 (95) | 246.4 (792.55) | 39 (112) | 176.3 (628.88) | 25 (87) | < 0.0001 |
Admissions for acute crisis (number) | 3.8 (8.37) | 2 (3) | 4.4 (9.54) | 2 (3) | 3.0 (6.76) | 1 (3) | < 0.0001 |
Admissions for acute crisis (length/days) | 63.9 (145.01) | 24 (66) | 76.7 (176.79) | 28 (69) | 49.7 (96.29) | 21 (55.5) | < 0.0001 |
Rehabilitation -residential programs (number) | 1.0 (3.96) | 0 (1) | 1.2 (4.87) | 0 (1) | 0.8 (2.57) | 0 (0) | 0.030 |
Rehabilitation-residential programs (length/days) | 149.6 (660.54) | 0 (2) | 170.3 (715.53) | 0 (20) | 126.5 (592.88) | 0 (0) | 0.005 |
Total Hospitalization Index - THI | 15.7 (39.84) | 2.8 (10.2) | 17.9 (41.91) | 3.3 (13.8) | 13.3 (37.29) | 2.3 (8.35) | < 0.0001 |
Acute Hospitalization Index - AHI | 6.1 (13.49) | 2.2 (6.2) | 7.2 (15.73) | 2.6 (7.2) | 4.9 (10.34) | 1.9 (5.45) | < 0.0001 |
Rehabilitation-residential Index - RRI | 9.8 (35.48) | 0 (0.4) | 10.8 (36.35) | 0 (2) | 8.6 (34.47) | 0 (0) | 0.029 |
Discharges and deaths
Symptoms and Functioning
Total | Males | Females | P-value Mann–Whitney | ||||
---|---|---|---|---|---|---|---|
Mean (S.D.) | Median (IR) | Mean (S.D.) | Median (IR) | Mean (S.D.) | Median (IR) | ||
Age at T0 | 33.1(11.54) | 31(16) | 30.7 (10.48) | 29 (13) | 36.3(12.14) | 35 (16) | < 0.0001 |
Years of observation | 13.4 (7.36) | 13 (10) | 13.5 (7.57) | 13 (11) | 13.3 (7.08) | 13 (9) | 0.892 |
Total number of admissions | 7.5 (14.86) | 3 (6) | 7.9 (16.88) | 4 (7) | 6.1 (11.28) | 3 (5) | 0.015 |
Length of admissions (days) | 300.0 (731.57) | 64 (178) | 313.1 (744.65) | 68 (216) | 282.1 (713.98) | 58 (148) | 0.071 |
Admissions for acute crisis (number) | 5.3 (10.79) | 2 (4) | 5.9 (11.78) | 3 (5) | 4.5 (9.22) | 2 (3) | 0.003 |
Admissions for acute crisis (length/days) | 88.3 (182.18) | 43 (80) | 99.9 (213.57) | 47 (83) | 72.5 (126.03) | 35 (68) | <0.004 |
Rehabilitation -residential programs (number) | 1.8 (5.43) | 0 (2) | 2.0 (6.53) | 0 (2) | 1.5 (3.39) | 0 (1.5) | 0.499 |
Rehabilitation-residential programs (length/days) | 212.4 (630.88) | 0 (87) | 214.2 (614.98) | 0 (100) | 209.8 (652.82) | 0 (75) | 0.465 |
Total Hospitalization Index THI | 22.1 (46.94) | 5.2 (16.7) | 21.8 (41.57) | 5.6 (19.4) | 22.5 (53.46) | 4.9(13.6) | 0.159 |
Acute Hospitalization Index AHI | 7.3 (13.0) | 3.6 (7.0) | 7.9 (13.72) | 3.9 (7.8) | 6.5 (11.92) | 3.1 (6.3) | 0.013 |
Rehabilitation-residential Index RRI | 14.9 (39.72) | 0 (7.4) | 14.3 (34.92) | 0 (9) | 15.8 (45.52) | 0 (6.2) | 0.415 |
Symptoms
Scale | Total | Males | Females | P-value Mann–Whitney | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Mean | S.D. | Median | IR | Mean | S.D. | Median | IR | Mean | S.D. | Median | IR | ||
Total BPRS
|
58.3
|
20.98
|
56
|
30
|
59.7
|
21.66
|
58
|
34
|
56.4
|
19.89
|
54
|
27
| 0.031 |
BPRS Anxiety-Depression | 14.6 | 6.08 | 14 | 9 | 14.4 | 6.29 | 13 | 10 | 14.9 | 5.79 | 14 | 8 | 0.075 |
BPRS Positive Symptoms | 13.9 | 6.41 | 13 | 10 | 14.4 | 6.65 | 14 | 10 | 13.1 | 6.01 | 13 | 9 | 0.011 |
BPRS Negative Symptoms | 16.9 | 7.45 | 16 | 10 | 17.5 | 7.45 | 16 | 11 | 16.1 | 7.38 | 15 | 10 | 0.003 |
BPRS Mania/Disorganization | 13.0 | 6.13 | 11 | 9 | 13.5 | 6.32 | 12 | 10 | 12.3 | 5.80 | 11 | 7 | 0.007 |
Total PSP/FPS
|
55.0
|
22.47
|
54.5
|
32
|
52.1
|
22.53
|
50
|
33
|
58.9
|
21.82
|
58
|
28
| <0.0001 |
Work/Social utility | 2.1 | 1.55 | 2 | 3.5 | 2.3 | 1.56 | 2.5 | 3 | 1.9 | 1.50 | 2 | 2.5 | 0.001 |
Personal relationships | 1.9 | 1.33 | 2 | 2 | 2.1 | 1.29 | 2 | 2 | 1.7 | 1.35 | 2 | 3 | <0.0001 |
Personal and Health care | 1.6 | 1.33 | 1.5 | 3 | 1.7 | 1.35 | 2 | 3 | 1.4 | 1.26 | 1 | 2.5 | <0.0001 |
Bother/Aggressiveness | 0.6 | 1.11 | 0 | 1 | 0.7 | 1.19 | 0 | 1 .5 | 0.5 | 0.98 | 0 | 0.75 | 0.024 |
Functioning
-
The sample, consisting of all the overt cases of a whole population living in a geographic area;
-
The length of the observation period, which is mandatory to assess trends in a disease so variable among individuals and for single individuals over time;
-
The observation of patients in real life, without artifacts of institutionalization;
-
The study of individual cases’ course, in addition to the study of the entire sample;
-
A stable model of care, minimizing “external” variability factors;
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The study of present conditions for both symptoms and personal and social functioning.
-
The difficulty of translating individual variability in comparable data;
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The inability to reconstruct in all cases the different therapeutic paths including drug therapies and treatment programs: this forced us to postpone the study of these variables to a next phase, in more limited samples;
-
The incompleteness of some data, particularly: the causes of death, the day-centers data and several years of CMHC data, which were recorded and computerized, but unfortunately became inaccessible after moving from an information system to another.