Changes of consultation-liaison psychiatry practice in Italian general hospitals: A comparative 20-year multicenter study

Luigi Zerbinati; Laura Palagini; Matteo Balestrieri; Martino Belvederi Murri; Rosangela Caruso; Armando D'Agostino; Maria Ferrara; Silvia Ferrari; Antonino Minervino; Paolo Milia; Maria Giulia Nanni; Stefano Pini; Pierluigi Politi; Matteo Porcellana; Matteo Rocchetti; Ines Taddei; Tommaso Toffanin; Luigi Grassi; Italian Society of Consultation-Liaison Psychiatry; Jessica Bellucci; Emilio Bergamelli; Victor Attilio Campagna; Melissa Cherubini; Federica Folesani; Marta Gancitano; Francesca Giannetti; Gianluca Giovanna; Benedetta Gullotta; Lucia Massa; Giulia Montardi

doi:10.3389/fpsyt.2022.959399

Changes of consultation-liaison psychiatry practice in Italian general hospitals: A comparative 20-year multicenter study

Front Psychiatry. 2022 Oct 14:13:959399. doi: 10.3389/fpsyt.2022.959399. eCollection 2022.

Authors

Luigi Zerbinati^{1

2}, Laura Palagini^{1

2}, Matteo Balestrieri³, Martino Belvederi Murri^{1

2}, Rosangela Caruso^{1

2}, Armando D'Agostino^{4

5}, Maria Ferrara^{1

2}, Silvia Ferrari^{6

7}, Antonino Minervino⁸, Paolo Milia⁸, Maria Giulia Nanni^{2

9}, Stefano Pini⁹, Pierluigi Politi¹⁰, Matteo Porcellana¹¹, Matteo Rocchetti¹⁰, Ines Taddei¹², Tommaso Toffanin^{1

2}, Luigi Grassi^{1

2}; Italian Society of Consultation-Liaison Psychiatry; Jessica Bellucci^{1

2}, Emilio Bergamelli³, Victor Attilio Campagna³, Melissa Cherubini^{1

2}, Federica Folesani^{4

5}, Marta Gancitano^{4

5}, Francesca Giannetti⁶, Gianluca Giovanna⁷, Benedetta Gullotta^{4

5}, Lucia Massa⁸, Giulia Montardi^{1

2}

Affiliations

¹ Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.
² University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy.
³ Psychiatric Clinic, Department of Medicine, University of Udine, Udine, Italy.
⁴ Department of Health Sciences, Università Degli Studi di Milano, Milano, Italy.
⁵ Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy.
⁶ Section of Psychiatry, Department of Diagnostic-Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Modena, Italy.
⁷ Dipartimento ad Attività Integrata di Salute Mentale e Dipendenze Patologiche, USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
⁸ Italian Society of Psychosomatic Medicine, Parma, Italy.
⁹ Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Pisa, Italy.
¹⁰ Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
¹¹ Department of Mental Health and Addiction Services, Niguarda Hospital, Milan, Italy.
¹² Department of Psychiatric Sciences and Psychological Medicine, University La Sapienza, 3rd Psychiatric Clinic, Rome, Italy.

Abstract

Introduction: Conducted under the auspices of the Italian Society of Consultation Liaison Psychiatry (SIPC) the aim of this study was to describe the characteristics of Consultation Liaison Psychiatry (CLP) activity in Italy (SIPC-2-2018) over the past 20 years by comparing with data from the first Italian nation-wide study (SIPC-1-1998).

Methods: We collected data on CLP visits of 3,943 patients from 10 Italian hospitals over a period of 1 year. Data were compared with those from the SIPC-1 1998 study (4,183 participants). Patients were assessed with the same ad hoc 60-item Patient Registration Form recording information from five different areas: Sociodemographic, hospitalization-related, consultation-related, interventions and outcome.

Results: Compared with participants from the previous study, SIPC-2-2018 participants were significantly older (d = 0.54) and hospitalized for a longer duration (d = 0.20). The current study detected an increase in the proportion of referrals from surgical wards and for individuals affected by onco-hematologic diseases. Depressive disorders still represented the most frequent psychiatric diagnosis, followed by adjustment and stress disorders and delirium/dementia. Also, CLP psychiatrists prescribed more often antidepressants (Φ = 0.13), antipsychotics (Φ = 0.09), mood stabilizers (Φ = 0.24), and less often benzodiazepines (Φ = 0.07).

Conclusion: CLP workload has increased considerably in the past 20 years in Italy, with changes in patient demographic and clinical characteristics. A trend toward increase in medication-based patient management was observed. These findings suggest that the psychiatric needs of patients admitted to the general hospital are more frequently addressed by referring physicians, although Italian CLP services still deserve better organization and autonomy.

Keywords: Consultation-Liaison (C-L) psychiatry; Italy; hospital psychiatry; liaison psychiatry; medical psychiatry.

Copyright © 2022 Zerbinati, Palagini, Balestrieri, Belvederi Murri, Caruso, D’Agostino, Ferrara, Ferrari, Minervino, Milia, Nanni, Pini, Politi, Porcellana, Rocchetti, Taddei, Toffanin, Grassi and Italian Society of Consultation-Liaison Psychiatry.