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The Five-Year Evolution of a Mixed Psychiatric and Somatic Care Unit: A European Experience

Received July 20, 2007; revised October 8, 2007; accepted October 18, 2007. From the Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, Geneva, Switzerland; and the Department of Community Medicine and Primary Care, University Hospitals of Geneva, Geneva Switzerland. Send correspondence and reprint requests to Ariel Eytan, M.D., Dept. of Psychiatry, Division of Adult Psychiatry, HUG, 2 Chemin du Petit-Bel-Air, Bâtiment Voirons, 1225, Geneva, Switzerland. e-mail: Ariel.Eytan{at}hcuge.ch
© 2009 The Academy of Psychosomatic Medicine

BACKGROUND: There are virtually no reported experiences of mixed medical/psychiatry inpatient units in Europe. Such a program was created in Geneva, Switzerland, in 1999. OBJECTIVE: The authors retrospectively analyzed clinical data from its first 5 years of operation. METHOD: These data represent 1,380 hospitalizations. A descriptive analysis was carried out on all collected data for each year of activity. RESULTS: The severity of physical disorders increased with time. The number of medical comorbidities, length of hospital stay, and compulsory admissions increased. The proportion of mood disorders decreased, whereas the proportion of psychotic and adjustment disorders increased. CONCLUSION: Patients with comorbid medical and psychiatric disorders are often refused admission to both medical and psychiatric wards. Once they are admitted, they are often released prematurely or transferred to another ward too quickly because of behavioral management difficulties. Physicians who refer patients to the unit recognize the complex nature of these cases and refer them because the unit is capable of offering acute psychiatric and medical treatments and provides an environment that encourages patient cooperation and treatment adherence.

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