QUALYOP Project 2: Monitoring the dismantling of Italian psychiatric hospitals. Psychotropic drug use in 1072 inpatients

Objective - This study describes the use of psychotropic drugs in a sample of eight Italian psychiatric hospitals. Methods - A cross-sectional approach was used to collect information about sociodemographic and clinical characteristics of the inpatient population, and about medications prescribed. Prescribing behaviour in the hospitals wa s compared using three indicators: the number of patients taking psychotrop ic drugs, the use of high doses of neuroleptics and the use of multiple neu roleptics. Results - More than a thousand patients were resident in the eight hospital s on the census day, 56% of them males. Half the population had an ICD-X di agnosis of schizophrenia, one third of mental retardation. Sixty-nine perce nt of the sample was on neuroleptic therapy, nearly 47% on benzodiazepines and 4% on antidepressants. Twenty percent of the sample did not take any ps ychotropic drug on the census day. After adjustment for sociodemographic an d clinical variables, setting-related variables resulted as determinants of psychotropic drug use. Conclusions - These data call for continuing education in psychopharmacolog y towards a more rational use of drugs; longitudinal audits of clinical pra ctice should be implemented to guide clinicians toward a more rational use of psychotropic drugs. Copyright (C) 1999 John Wiley & Sons, Ltd.