E. Orlandi, R. Covezzi, P. Boselli, G.P. Guaraldi - Vol. 5, Marzo1999, num.1
Testo Immagini Bibliografia Summary Riassunto Indice
Dall’esordio della patologia
al ricovero psichiatrico: indagine su soggetti ricoverati per disturbi dell’alimentazione
From onset of disease to psychiatric hospitalisation:
an investigation on in-patients with eating disorders
Objective: since patients with eating disorders are first hospitalised at a variable time interval after onset of their disorder, we aimed at determining antecedents of hospitalisation, such as doctor referral and reason for seeking hospitalisation, as well as outcome after hospital discharge.
Method: we investigated all records of patients who were admitted between the 1st of January, 1990 and the 31st of August, 1996 and discharged from the Psychiatric Clinic of the University of Modena with a diagnosis of anorexia nervosa (AN), bulimia nervosa (BN) or other eating disorders. We recorded sex, age, weight, diagnosis, onset-hospitalisation interval, reason for hospital admission, modality of discharge, and source of referral.
Results: all 45 patients who accounted for the 64 admissions during the above period were female; 23 (51%) were diagnosed as affected by AN, 14 (31%) by BN, and the remaining 8 (18%) by anorexia-bulimia (A-B). Mean age at onset was 17.5 for patients with AN, 17.1 for patients with BN, and 17.7 for patients with A-B. Onset-hospitalisation interval did not differ significantly among the three patient subgroups (4.3 years for AN, 4.5 years for BN, and 3.4 years for A-B). Fifteen out of 64 admissions were prompted by a suicide attempt. In 51% of cases, hospital stay ended through mutual doctor-patient agreement, whereas 48.5% of discharges were due to patient’s decision and were not approved by the medical staff. 57.82% of patients were referred for hospitalisation by a psychiatrist (53.13% working in a public hospital, 4.69% in private practice), 7.81% by other medical specialists, and 31.25% were referred by staff of emergency units.
Conclusions: our data show that there is a lag of about 4 years between onset of an eating disorder and psychiatric hospitalisation, and furthermore, that a considerable proportion of our sample reached clinical observation due to attempted suicide. This supports that a greater involvement of public health institutions is needed, comprising public information, to help patients affected by eating disorders to start treatment at the soonest. Finally, it is confirmed that patients with eating disorders are problematic and in danger, as well as difficult to support, as already stated in literature; hence the need for studying new strategies to limit these phenomena.