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Severe and persistent mental illness: a useful definition for prioritizing community-based mental health service interventions

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Abstract

Objective

There is a lack of consensus on the identification of seriously mentally ill patients (SMI). This study investigates the external and predictive validity of an operationalized definition for the severity and persistency of mental illness applied to a sample of service users attending a community mental health service.

Method

The definition is based on the fulfilment of dysfunction (GAF ≤ 50) and illness duration (≥2 yrs) criteria. The study was conducted with a two-year longitudinal design. External and predictive validity of the SMI definition were assessed against the diagnosis of psychosis.

Results

Our data show evidence for an overall high predictive and external validity of the SMI definition and high sensitivity in predicting those with high burden of mental illness.

Conclusions

In order to identify people with high levels of psychiatric burden, the SMI working definition seems to be more useful than that simply based on diagnostic criteria.

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Notes

  1. Schizophrenia and functional psychoses includes the following ICD-10 codes: F20, F21, F22, F23, F24, F25, F28, F29, F84; Severe affective disorders includes the following ICD-10 codes: F30, F31, F32.2, F33.3.

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Acknowledgements

We are grateful to the patients who participated in the study and to the staff of the South-Verona Community Psychiatric Service for their kind collaboration in the project. This study was supported by a grant of Ministero dell’Istruzione, dell’Università e della Ricerca Scientifica (MIUR), Roma (fondi 60%) to prof. Mirella Ruggeri.

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Authors and Affiliations

  1. Dept. of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Ospedale Policlinico, Verona, Italy

    Alberto Parabiaghi MD, Chiara Bonetto Dr. Stat, Mirella Ruggeri PhD & Antonio Lasalvia PhD

  2. Dip.to di Medicina e Sanità Pubblica Sezione di Psichiatria e di Psicologia Clinica, Università di Verona, Policlinico GB Rossi, Piazzale L.A. Scuro, 10, 37134, Verona, Italy

    Alberto Parabiaghi MD

  3. Section of Community Psychiatry (PRiSM) Health Service Research Dept., Institute of Psychiatry, King’s College London, London, England

    Morven Leese PhD

Authors
  1. Alberto Parabiaghi MD
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  2. Chiara Bonetto Dr. Stat
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  3. Mirella Ruggeri PhD
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  4. Antonio Lasalvia PhD
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  5. Morven Leese PhD
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Correspondence to Alberto Parabiaghi MD.

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Parabiaghi, A., Bonetto, C., Ruggeri, M. et al. Severe and persistent mental illness: a useful definition for prioritizing community-based mental health service interventions. Soc Psychiat Epidemiol 41, 457–463 (2006). https://doi.org/10.1007/s00127-006-0048-0

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  • DOI: https://doi.org/10.1007/s00127-006-0048-0

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