General hospital psychiatry in Italy: an update

The turning point in the history of consultation–liaison psychiatry (CLP) in Italy was undoubtedly the passing of the famous Reform Law 180 in 1978, with its dramatic consequences on both the clinical and health organizational levels of psychiatry. This has brought psychiatry back to medicine and to the general hospital CL Cazzullo, M Comazzi, GP Guaraldi, M Rigatelli and A Verdecchia, General hospital psychiatry in Italy: on the hospitalization of psychiatric patients and consultation–liaison psychiatry after Law 180/1978, Gen Hosp Psychiatry 6 (1984), pp. 261–265. Abstract | View Record in Scopus | Cited By in Scopus (8)[1] and [2].The development of CLP in Italy since then has been slow and variable across the country. During the 1980s, a few specific and integrated CLP services were established in university-based hospitals (e.g., Milan, Modena, and Padua), which led the way for the implementation of other centers in the country (e.g., Naples and Ferrara). These were some of the centers that were involved as research sites in ECLW studies . During the 1990s, Italian CLP then gradually started to move out of the general hospital toward community primary care, with the establishment of specific CLP services for GPs (e.g., Verona, Bologna, and Reggio Emilia) and the development of relevant research projects .As such services increased, a shift occurred from on-demand urgent psychiatric referrals to planned, excellent integrated activities. This has been a major achievement; some of these services include Ferrara for psycho-oncology, Modena and Udine for transplant units, Bari for gastroenterology, and Milan and Genova for psychogeriatrics. Integrated and formalized clinical experiences such as these have stimulated research activities in the same fields—locally, nationally, and internationally .