Original scientific paper

https://doi.org/10.24869/psyd.2018.207

ASSOCIATIONS BETWEEN FUNCTIONAL MILESTONES AND PSYCHIATRIC ADMISSIONS IN AN URBAN AREA: UTILITY OF A CLUSTER-ANALYTICAL APPROACH

Cristiana Montemagni ; Department of Neuroscience, University of Turin, Struttura Semplice di Coordinamento a Valenza Dipartimentale (SSD), Department of Neuroscience and Mental Health A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
Tiziana Frieri ; Department of Neuroscience, University of Turin, Struttura Semplice di Coordinamento a Valenza Dipartimentale (SSD), Department of Neuroscience and Mental Health A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
Vincenzo Villari ; Department of Neuroscience and Mental Health, SC Psychiatry SPDC, A.O.U. Città della Salute e della Scienza, Turin, Italy
Paola Rocca orcid.org/0000-0002-6414-3559 ; Department of Neuroscience, University of Turin, Struttura Semplice di Coordinamento a Valenza Dipartimentale (SSD), Department of Neuroscience and Mental Health A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy

Abstract

Background: The purpose of the study was to identify homogenous subgroups, based upon achievement of two functional
milestones (marriage and employment) and Global Assessment of Functioning (GAF) score in a sample of 848 acute patients
admitted to the Psychiatric Emergency Service (PES) of the Città della Salute e della Scienza di Torino, during a 24-months period.
Subjects and methods: A two-step cluster-analysis, using GAF total score and the achievements in the two milestones as input
data was performed. In order to examine whether the identified subgroups differed in external variables that were not included in the
clustering process, and consequently to validate the found functional profiles, chi-square tests for categorical variables and analyses
of variance (ANOVA) for continuous variables were performed.
Results: Five clusters were found. Employed patients (Clusters 4 and 5) had more years of education, less illness chronicity
(shorter duration of illness and lower proportion of previous voluntary hospitalizations), lower use of mental health resources in the
last year yet higher treatment adherence, larger network size, and higher ordinary discharge. Married inpatients (Clusters 3 and 5)
had lower frequencies of substance abuse.
Conclusions: The remarkably high rate of unemployment in this inpatients’ sample, and the evidence of associations between
unemployment and poorer functioning, argue for further research and development of evidence-based supported employment
programs, that put forth diligent effort in helping people obtain work quickly and sustain; they may also help to reduce health care
service use among that clientele.

Keywords

functional milestones; cluster analysis; marriage; Global Assessment of Functioning; severe mental illnesses

Hrčak ID:

202201

URI

https://hrcak.srce.hr/202201

Publication date:

26.6.2018.

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