Are Patients Improving during and after a Psychiatric Hospitalisation? Continuity of Care Outcomes of Compulsory and Voluntary Admissions to an Italian Psychiatric Ward
Open accessAbstract
Background: To compare the characteristics of compulsory admissions (CAs) and voluntary admissions (VAs) in a General Hospital Psychiatric Unit (GHPU), and to assess whether CA and VA patients’ outcomes improved during hospitalisation and followup in mental health services (MHS) based on community continuity of care. Design and methods: Observational longitudinal study comparing 19 CAs and 83 VAs consecutively admitted to GHPU of Udine, Italy, and followed-up for six-months by MHS. Five psychometric scales assessed psychosocial and clinical characteristics for each patient at admission (T0), discharge (T1) and follow-up (T2). Statistical analyses were performed using: multivariate logistic regression for comparing CA and VA; Friedman χ2 and Mann-Whitney tests for outcomes’ improvement. Results: Being hospitalised for a psychotic crisis was the most significant predictor of CA (OR = 5.07). An outcomes’ improvement was observed from T0 to T1 in almost all psychometric tests, while from T1 to T2 only for PSP-A (useful social activities), CGI-S (severity of illness) and CGI-EI (drug's efficacy related to side effects). CA was associated to lower performances in all scales at T0, in GAF and CGI-S at T1, while no difference with VA was observed at T2. Conclusions: CA and VA patients improved to a same extent during hospitalisation and follow-up, particularly in relation to social functioning. This fosters the hypothesis that communitybased MHS using a longitudinal continuity of care model might achieve recovery in a long-term perspective. Future research may benefit by considering patients’ subjective experiences and assessing long-term improvement in those who received personcentred interventions.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Some studies found no difference in the clinical effects of involuntary admission.
“In general, these studies found either no difference in the clinical effects of involuntary admission (27,40–45) or greater improvements in clinical symptoms and functioning than for voluntary patients (46,47).”
From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [41]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Vos, T., Lim, S. S., Abbafati, C., Abbas, K. M., Abbasi, M., Abbasifard, M., Abbasi-Kangevari, M., Abbastabar, H., Abd-Allah, F., Abdelalim, A., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30925-9 · Cited by 19,358 · see citing works
An Introduction to Statistical Learning
James, G., Witten, D., Hastie, T., & Tibshirani, R. (2013) · Springer Texts in Statistics · doi:10.1007/978-1-4614-7138-7 · Cited by 12,106 · see citing works
The clinical global impressions scale: applying a research tool in clinical practice.
Busner, J., & Targum, S. D. (2007) · PubMed Central · Cited by 1,952 · see citing works
Morosini, P. L., Magliano, L., Brambilla, L., Ugolini, S., & Pioli, R. (2000) · PubMed · Cited by 1,168 · see citing works
Morosini, P. L., Magliano, L., Brambilla, L., Ugolini, S., & Pioli, R. (2000) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2000.101004323.x · Cited by 1,097 · see citing works
Epidemiology of involuntary placement of mentally ill people across the European Union
Salize, H. J., & Dreßing, H. R. (2004) · The British Journal of Psychiatry · doi:10.1192/bjp.184.2.163 · Cited by 384 · see citing works
Continuity of care for chronic mental patients: a conceptual analysis
Bachrach, L. L. (1981) · American Journal of Psychiatry · doi:10.1176/ajp.138.11.1449 · Cited by 272 · see citing works
Sheridan Rains, L., Zenina, T., Dias, M. C., Jones, R., Jeffreys, S., Branthonne-Foster, S., Lloyd-Evans, B., & Johnson, S. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30090-2 · Cited by 230 · see citing works
Walker, S., Mackay, E., Barnett, P., Sheridan Rains, L., Leverton, M., Dalton-Locke, C., Trevillion, K., Lloyd-Evans, B., & Johnson, S. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30406-7 · Cited by 221 · see citing works
Involuntary vs. voluntary hospital admission: A systematic literature review on outcome diversity
Kallert, T. W., Glöckner, M., & Schützwohl, M. (2008) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-007-0777-4 · Cited by 204 · see citing works
The Groningen Social Disabilities Schedule
Wiersma, D., deJong, A., & Ormel, J. (1988) · International Journal of Rehabilitation Research · doi:10.1097/00004356-198809000-00001 · Cited by 166 · see citing works
Symptomatic and functional remission in patients with first-episode psychosis
Verma, S., Subramaniam, M., Abdin, E., Poon, L. Y., & Chong, S. A. (2012) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2012.01883.x · Cited by 149 · cited 3× · see citing works
“PSP Median (range) 45 (5-65) 25 (15-45) <0.”
Fiorillo, A., Rosa, C. D., VECCHIO, V. D., Jurjanz, L., Schnall, K., Onchev, G., Alexiev, S., Raboch, J., Kališová, L., Mastrogianni, A., et al. (2010) · European Psychiatry · doi:10.1016/j.eurpsy.2010.01.013 · Cited by 124 · see citing works
Tyler, N., Wright, N., & Waring, J. J. (2019) · BMC Health Services Research · doi:10.1186/s12913-019-4658-0 · Cited by 118 · see citing works
Juckel, G., Schaub, D., Fuchs, N., Naumann, U., Uhl, I., Witthaus, H., Hargarter, L., Bierhoff, H., & Brüne, M. (2008) · Schizophrenia Research · doi:10.1016/j.schres.2008.04.037 · Cited by 110 · see citing works
Bertelsen, M., Jeppesen, P., Petersen, L., Thorup, A. A. E., Øhlenschlæger, J., le Quach, P., Christensen, T. Ø., Krarup, G., Jørgensen, P., & Nordentoft, M. (2008) · Schizophrenia Research · doi:10.1016/j.schres.2008.09.018 · Cited by 106 · see citing works
Sayeed, A., Kundu, S., Banna, M. H. A., Christopher, E., Hasan, M. T., Begum, M. R., Chowdhury, S., & Khan, M. S. I. (2020) · Psychiatria Danubina · doi:10.24869/psyd.2020.491 · Cited by 89 · see citing works
Egger, S., Weniger, G., Müller, M., Bobes, J., Seifritz, E., & Vetter, S. (2019) · Health and Quality of Life Outcomes · doi:10.1186/s12955-019-1235-5 · Cited by 87 · see citing works
Forty years without mental hospitals in Italy
Barbui, C., Papola, D., & Saraceno, B. (2018) · International Journal of Mental Health Systems · doi:10.1186/s13033-018-0223-1 · Cited by 83 · see citing works
Balestrieri, M., Isola, M., Bonn, R., Tam, T., Vio, A., Linden, M., & Maso, E. (2012) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796012000480 · Cited by 62 · see citing works
Self-citationPatterns of mental health service utilisation in Italy and Spain
Salvador‐Carulla, L., Tibaldi, G., Johnson, S., Scala, E., Romero-López-Alberca, C., & Munizza, C. (2005) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-005-0860-y · Cited by 56 · see citing works
Nicaise, P., Giacco, D., Soltmann, B., Pfennig, A., Miglietta, E., Lasalvia, A., Welbel, M., Wciórka, J., Bird, V. J., Priebe, S., et al. (2020) · Health Policy · doi:10.1016/j.healthpol.2019.11.004 · Cited by 49 · see citing works
Forty years of the Law 180: the aspirations of a great reform, its successes and continuing need
Mezzina, R. (2018) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796018000070 · Cited by 47 · see citing works
Impact of social-psychiatric services and psychiatric clinics on involuntary admissions
Emons, B., Haussleiter, I. S., Kalthoff, J., Schramm, A., Hoffmann, K., Jendreyschak, J., Schaub, M., Armgart, C., Juckel, G., & Illės, F. (2013) · International Journal of Social Psychiatry · doi:10.1177/0020764013511794 · Cited by 42 · see citing works
Samalin, L., Llorca, P., Giordana, B., Milhiet, V., Yon, L., El‐Hage, W., Courtet, P., Hacques, E., Bedira, N., Filipovics, A., et al. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.02.023 · Cited by 42 · see citing works
Local psychiatric beds appear to decrease the use of involuntary admission: a case-registry study
Myklebust, L. H., Sørgaard, K. W., & Wynn, R. (2014) · BMC Health Services Research · doi:10.1186/1472-6963-14-64 · Cited by 39 · see citing works
Hegedüs, A., Kozel, B., Richter, D., & Behrens, J. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00969 · Cited by 39 · see citing works
Interventions for involuntary psychiatric inpatients: A systematic review
Giacco, D., Conneely, M., Masoud, T., Burn, E., & Priebe, S. (2018) · European psychiatry · doi:10.1016/j.eurpsy.2018.07.005 · Cited by 35 · see citing works
Should compulsory admission to hospital be part of suicide prevention strategies?
Wang, D., & Colucci, E. (2017) · BJPsych Bulletin · doi:10.1192/pb.bp.116.055699 · Cited by 34 · see citing works
Boyer, L., Richieri, R. M., Guedj, É., Faget, C., Loundou, A., Llorca, P., Auquier, P., & Lançon, C. (2013) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2013.04.008 · Cited by 31 · see citing works
Factors associated with involuntary admissions: a register-based cross-sectional multicenter study
Maina, G., Rosso, G., Carezana, C., Mehanović, E., Risso, F., Villari, V., Gariglio, L., & Cardano, M. (2021) · Annals of General Psychiatry · doi:10.1186/s12991-020-00323-1 · Cited by 30 · see citing works
Validation aspects of the health of the nation outcome scales
Lovaglio, P. G., & Monzani, E. (2011) · International Journal of Mental Health Systems · doi:10.1186/1752-4458-5-20 · Cited by 29 · see citing works
Disorders of Functions and Disorders of Capacity in Relation To Sick Leave in Mental Disorders
Baron, S., & Linden, M. (2009) · International Journal of Social Psychiatry · doi:10.1177/0020764008091660 · Cited by 28 · see citing works
Castelpietra, G., Colli, C., Tossut, D., Furlan, M., Balestrieri, M., Starace, F., Beghi, M., Barbone, F., Perulli, A., & Salvador‐Carulla, L. (2020) · Health Policy and Technology · doi:10.1016/j.hlpt.2020.12.002 · Cited by 28 · see citing works
Self-citationCORRELATES OF INVOLUNTARY ADMISSION: FINDINGS FROM AN ITALIAN INPATIENT PSYCHIATRIC UNIT
Balducci, P. M., Bernardini, F., Pauselli, L., Tortorella, A. A. V., & Compton, M. T. (2017) · Psychiatria Danubina · doi:10.24869/psyd.2017.490 · Cited by 27 · see citing works
Silva, M., Antunes, A., Loureiro, A., Azeredo-Lopes, S., Saraceno, B., Caldas-de-Almeida, J., & Cardoso, G. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113420 · Cited by 24 · see citing works
Donisi, V., Tedeschi, F., Salazzari, D., & Amaddeo, F. (2014) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796014000663 · Cited by 22 · see citing works
Egger, S., Weniger, G., Prinz, S., Vetter, S., & Müller, M. (2015) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.12296 · Cited by 17 · see citing works
Clinical outcome and length of stay in an Italian Psychiatric Emergency Service
Frieri, T., Montemagni, C., Rocca, G., Rocca, P., & Villari, V. (2012) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-012-0607-5 · Cited by 16 · see citing works
Consistency of the Health of the Nation Outcome Scales (HoNOS) at inpatient-to-community transition
Luo, W., Harvey, R. J., Tran, T., Phung, D., Venkatesh, S., & Connor, J. P. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-010732 · Cited by 16 · see citing works
Fontecedro, E., Furlan, M., Tossut, D., Pascolo‐Fabrici, E., Balestrieri, M., Salvador‐Carulla, L., D’Avanzo, B., & Castelpietra, G. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17145017 · Cited by 14 · see citing works
Self-citationCastelpietra, G., Balestrieri, M., & Bovenzi, M. (2019) · International Journal of Psychiatry in Clinical Practice · doi:10.1080/13651501.2019.1611864 · Cited by 12 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 4
- [14]Castelpietra G. [Non-recours a la contention dans les services de sante mentale: le dispositif de Friuli Venezia Giulia].[Article in French]. Information Psychiatrique 2017; 93: 569- 73.
- [23]Guadagno S Balestrieri M Albert U. Social and clinical determinants of compulsory and voluntary admissions within the framework of an Italian community mental health system. Psychiatria Danubina 2020; 32: s491- 5. 33212454
- [34]Balestrieri M Lenzi J Lestani A. One-year changes in capacity and participation in patients with schizophrenia or bipolar I disorder treated in community-based mental health services in Italy. J Psychopathol 2016; 22: 221- 8.
- [39]Ielmini M Caselli I Poloni N. Compulsory versus voluntary admission in psychiatry: an observational study. Minerva Psichiatrica 2018; 59: 129- 34.
Cited by
Sorted by citations
The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review
Corderoy, A., Kisely, S., Zirnsak, T., & Ryan, C. J. (2025) · Psychiatry, Psychology and Law · doi:10.1080/13218719.2024.2346734 · Cited by 19 · see citing works
Involuntary psychiatric treatment during the COVID-19 pandemic. An international qualitative study
Carbone, A., & Knapp, M. R. J. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1200888 · Cited by 6 · see citing works
- Authors
- Castelpietra, G., Guadagno, S., Pischiutta, L., Tossut, D., Maso, E., Albert, U., & Balestrieri, M.
- Affiliations
- University of Udine (IT)
- Azienda sanitaria universitaria Friuli Centrale (IT)
- Welfare Area, Giuliano Isontina Healthcare Agency, Palmanova (UD)
- University of Trieste (IT)
- Corresponding author
- Castelpietra, Giulio
- Venue
- Journal of Public Health Research
- Publisher
- SAGE Publications
- Published
- 2022-01-31
- Volume
- 11
- Issue
- 1
- ISSN
- 2279-9036 (ISSN-L)
- PMC
- PMC8847955
- OpenAlex
- W3192755718
- Cited by
- 2
- References
- 43
- Citations by year
- 2024: 1 · 2023: 1
- FWCI
- 0.34
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Public Health Research (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion, cc-by-nc)
- Journal of Public Health Research (submittedVersion)
- Institutional Research Information System (University of Udine) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › Historical Psychiatry and Medical Practices
- Keywords
- compulsory psychiatric admission, general hospital psychiatric unit, continuity of care, community mental health services, psychotic crisis, social functioning, disease severity, treatment outcomes, follow-up outcomes, person-centred care
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
