Table of Contents Table of Contents
Previous Page  164 / 916 Next Page
Show Menu
Previous Page 164 / 916 Next Page
Page Background


25th European Congress of Psychiatry / European Psychiatry 41S (2017) S106–S169

R.M. Jeppesen

, T. Christensen

External researcher, Department of psychiatry- Aarhus University

Hospital Risskov Skovagervej 2 DK-8240 Risskov, Aarhus N, Denmark

Corresponding author.


The Danish psychiatric system has gone through

several structural changes in the last four decades. The deinstitu-

tionalization of the mental healthcare system was implemented in

Denmark in the late 1970s with the intention of increasing outpa-

tient treatment. One of the aims in the reorganization was to treat

the patient in the local environment rather than during long-term



This study focuses on the changes in the utilization of

hospital facilities for patients diagnosed with schizophrenia.


The aims of this study were to analyze the development

of admission/readmission, bed days and occupancy rates over four

decades (1970–2012) inDenmark in schizophrenia treatment using

admission statistics for in-patients only.


Using register data from secondary healthcare treat-

ment of patients diagnosed with schizophrenia in Denmark

1970–2012, we analyzed the development in the use of hospital



Our major findingwas a 220% increase between 1970 and

2012 in the total number of hospital admissions due to schizophre-

nia each year, while at the same time the number of annual

schizophrenia bed days was reduced by 76%. Furthermore, the

readmission rate within a year after discharge with a diagnosis

of schizophrenia reached 70% in 2012 compared to 51% in 1970.

Finally, the total bed occupancy continued to rise over the four

decades and has exceeded 100% in several years since 1999.


The findings indicate that the reorganization of the

Danish mental healthcare system has created a problem of “revolv-

ing door” schizophrenia patients’ who since the 1970s have been

increasingly hospitalized but for shorter periods.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Pathways to care and patterns of care

in first episode psychosis patients

treated in community based-mental

health services. A 5-years follow-up

from the PICOS

E. Miglietta

1 ,

, A. Lasalvia


, C. Comacchio


, D. Cristofalo



C. Bonetto


, S. Tosato


, K. De Santi


, G. Zanatta


, S. Petterlini



S. Zoppei


, G. Dimitri


, C. Cremonese


, L. Ramon


, M. Ruggeri



University of Verona, Department of Neurosciences, Biomedicine

and Movement Sciences, Section of Psychiatry, Verona, Italy


Psychiatric Clinic, Department of Neuroscience, University of Padua,

Italy, Padua, Italy


NHS Local Health Authority Portogruaro, Department of Mental

Health, Portogruaro, Italy

Corresponding author.


International treatment guidelines recommend that

key elements to reduce the burden of psychosis are the early iden-

tification of people and the adoption of specific evidence based



To investigate the pathway to care and patterns of

interventions provided by community based-mental health ser-

vices (CMHS) to a cohort of first-episode psychosis (FEP) patients

over 5-years period, exploring in which degree guidelines are met

in routine clinical practice.


Study conducted in the context of the Psychosis Incident

Cohort Outcome Study (PICOS), a multisite naturalistic research

conducted in the Veneto Region (Italy) on FEP patients in a 4.6

million inhabitants catchment area. A comprehensive set of stan-

dardized measures was used, including

ad hoc

schedules to collect

information on referrals to psychiatric services and on pharma-

cological and psycho-social treatments according to a multiwave

follow-up design (1-, 2- and 5 years).


Three hundred and ninety-seven FEP patients were

assessed at BL, 286 at 1 year, 233 at 2 years and 205 at 5 years. 47.4%

of patients were helped to seek care by a relative and more than

one half entered the treatment route through an emergency access.

Regarding the interventions received, 96% of patients had been pre-

scribed neuroleptics and atypical were the most prescribed class

(66.9%). Only half received a psychosocial intervention during the

first year and this percentage progressively decreased at each FU.


Findings highlight discrepancies between interven-

tions provided by CMHS and the best treatment options

recommended by guidelines, suggesting the need to implement

specific initiatives aiming to close the gap between research and

clinical practice.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


The relation between

socio-environmental factors and

intellectual disability: Unraveling the


E. Rondini

, M. Bertelli , D. Scuticchio

Fondazione San Sebastiano, CREA Centro di Ricerca e Ambulatori,

Florence, Italy

Corresponding author.

Background and aim

The current literature indicates that people

with intellectual disabilities (ID) present quantitative and qualita-

tive peculiarities of various socio-environmental factors than the

general population. Although the identification of such peculiari-

tieswould have very important implications for the development of

preventive, rehabilitative and inclusive procedures, valuable data

are still lacking. The aim of the present paper was to assess the

significance of the relationship between socio-environmental vari-

ables in person with ID, with particular reference to individual

history and life contexts.


A consecutively recruited sample of 112 participants

with ID attending residential or clinic/rehabilitative services across

Italy was evaluated by the administration of ISTORIA (Histori-

ographical organized interview for adult intellectual retard), a

semi-structured questionnaire designed to investigate clinical and

personal history of the person. A considerable percentage of the

samples have co-occurent psychiatric disorder. Scores obtained

were statistically processed through frequency analysis and cal-

culation of correlation indexes.


Significant correlations were found between the family,

the educational/professional environments, and the inclusion in

society. Further associations concerned social relationships within

and outside the family, the changes of living accommodation, and

the level of environmental stimulation received.


Both findings from previous research and the ones

of this work confirm the importance of investigating the mech-

anisms involved in the acquisition of social skills by persons

with ID, through family dynamics and participation in commu-

nity life, as protective factor against the worsening of disabilities

and potentially of psychopathological vulnerability that affects this


Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.