Objective - The aim of our research is to evaluate the prevalence of psychiatric illnesses by means of data collected at the Florence municipality community mental health services encompassing all hospital and extramural activities, providing the same kind of information given by Psychiatric Case Register (PCR) covered areas. Design - It has been carried out a one week prevalence assessment through a cross-sectional analysis of clinical records gathered by psychiatric services of the submitted area. Population studied - The inquiry has considered the area of USL (Administative Local Authority of National Health Service) 10/A, 10/B, 10/C and 10/D, which constituite togheter with USL 10/E, the Florence municipality area. Results - Total and specific rates for diagnostic categories, sex and age reveal a large variability among the four considered USLs confirmed by standardized rates: the 10/A and 10/B USLs, that include the historic centre of Florence, present the highest standardized rates (10/A 207/100.000, 10/B 189/100.000), especially for the most severe disorders (Schizophrenia: 10/A 110/100.000, 10/B 87/100.000; Major Affective Disorders: 10/A 32/100.000, 10/B 38/100.000; Organic Psichosys: 10/A 6/100.000, 10/B 9/100.000). Conclusion - In the present study, the prevalence rate for all diagnoses for the whole area considered, is about 150.6/100.000, quite close to the estimate calculated in Verona-Sud (200/100.000). As to the different rates among USLs we have to bear in mind the development of the delivery care system, and the available clinical settings (on day hospital and residentials activities for long-term patients).

A discussion of epidemiologic researches for the evaluation of psychiatric care is presented. With regard to the Italian context the author stresses the importance of analytical studies over the descriptive ones. The main design options for the evaluation of quality of care are then considered in the psychiatric framework.

Aim — The aim of this paper is to present the results of a citation analysis concerned with the impact on the international literature of Italian researchers in psychiaty and psychology and of sub-fields, within these two disciplines, in 1995-1999 compared to 1985-1989. Method — We used a database prepared by the Institute for Scientific Information (ISI) that included all papers, with at least one Italian author, working in Italy, which appeared in two periods (1995-1999 and 1985-1989) in psychiatric or psychological journals listed in Current Contents. A citation analysis concerning the following years, up to 1999, was performed. Results — In 1995-1999 the most cited researchers were those involved in clinical psychology, psychiatry and psychopharmacology research. Neuropsychology, which dominated the period 1985-1989, underwent a clearcut decline. Conclusions — Citation analysis, concerning relatively short periods of time (five years), appears to be a very helpful tool for monitoring the development of scientific research in specific disciplines and the trend of the scientific production of researchers.

Objective — Advocacy in the mental health services field is gaining importance since the traditional role of mental health hospitals is changing, particularly in North America and in Western Europe. This review will define advocacy, its goals and fundamental principles. It will then delineate the skills and strategies needed for any intervention on behalf of a patient or a group of patients. It will also deal with the issues and approaches most frequently raised and used, and finally, with the limits of advocacy. Method — The method used for this review was mainly a recension of the literature concerning advocacy throughout North America and Europe, having in view to see emerging the principal stakes and concerns related to this process. Results — Advocacy has a significant impact patients' awareness of their rights and their capacity to exercise them. It also prevents potential abuse of patients. On the other hand, some patients have an increased opportunity to cease treatment, and this could lead to serious medical consequences. There is also the possibility of retaliation from staff, as a result of being involved with an advocate. The combination of high quality care and effective advocacy is the best guarantee that a mental health patient will get the care he wants and needs with human dignity.

Objective – To verify if the foreign population resident in the Canton Ticino, differs in the use of public psychiatric services and in the type of mental disorder presented, with respect to the Swiss population. Design – Research completed on subjects Swiss and foreign, over 19 years old, and resident in the Canton Ticino, who during 1995 spent at least one day admitted at the psychiatric hospital or had at least one contact with the out—patient services. Setting – Public psychiatric services of the Canton's sociopsychiatric organisation. Main outcome measures – For the Swiss, Italian and other non-Italian foreigners, the standardised annual rates of in- and outpatient prevalence and first admission and first outpatient contact were calculated, both totals and per diagnostic categories (ICD-10). Results – The group of non-Italian foreigners presents higher total standardised annual rates of in-patient prevalence and first admission and above all, of first admission, with respect to the Swiss and Italian groups; furthermore, with respect to the other two groups it presents higher first admission rates for the schizophrenic syndromes (F2) in men and for mental disorders due to psychoactive substances (Fl) in women. Whereas for first outpatient contacts the other foreigners present higher rates in neurotic syndromes (F4) in men, and affective syndromes (F3) in women. Conclusions – The results seem to confirm the presence of higher levels of mental disorder in non—Italian foreigners, above all for certain nationalities, with respect to Swiss and Italians. It is possible that the presence of a substantial offer of psychiatric services from the private sector may have caused an underestimation of the actual rate of mental disorder above all in the Swiss group and to a minor extent in that of the Italians.

Objective — The aim of the study was to present the results of a citation analysis concerned with the impact of Italian researchers and institutions in psychiatry and psychology upon the international scientific community. Method — The analysis has been performed using a database of the Institute for Scientific Information (ISI). All scientific papers which were published between 1981 and 1998 in psychiatric and psychological journals included in the Science Citation Index (SCI) and the Social Sciences Citation Index (SSCI) were considered. The most cited Italian papers, authors and institutions are reported, as well the most frequently utilised journals. Results — Publications concerned with neuropsychology, psychopharmacology and biological psychiatry were the most cited. This prevalence also affected theranking of the most cited authors, even though, in this case, research groups in disciplines such as clinicalpsychology and epidemiological psychiatry appeared to be strong. The four most productive Italian Universities were characterized by the presence of both a School of Medicine and a School of Psychology. The Journal of Neurology, Neurosurgery and Psychiatry and Psychopharmacology were the most frequent vehicles of scientific communication. Conclusions — The results entail important implications for Italian research in psychology and psychiatry. On a general level, these analyses appear to be helpful for monitoring scientific production by granting agencies and for comparing different individual researchers. On a more specific level the analysis has identified the leading trends in research of Italian psychiatry and psychology.