General practitioner referral to specialist psychiatric services: a comparison of practices in north- and south-Verona.

Specialist psychiatric services run by the Italian National Health Service are mainly hospital-based in North-Verona and community-based in South-Verona. Ninety-two GPs from both areas participated in a one-day survey of their provision of psychiatric care, and this paper focuses on socio-demographic and clinical variables associated with specialist psychiatric referral. The one-day prevalence figure for GP referral to specialist psychiatric services was 7.3% (17.6/10,000): the figures did not differ between the sexes or between the two areas. Whereas in North-Verona 49% of the patients referred were sent to the two local hospital-based public services and 51% to other agencies (mainly to private psychiatrists), in South-Verona 71% of referrals were to the community-based public service. Log-linear analysis showed that past psychiatric history, psychological presenting complaint, social problems and GPs' psychiatric diagnosis exerted positive joint main effects on GP referral to specialist psychiatric services, and that diagnosed organic illness had a negative effect in this regard. In the presence of a psychological complaint, a psychiatric diagnosis proved to be quite unimportant, so that those without a psychiatric diagnosis were just as likely to be referred as those with one. However, in the absence of a psychological complaint a GP diagnosis of depression greatly increased the risk of referral. Though the type of psychiatric service proved not to be an important determinant of GP referral to specialist psychiatric services it influenced the GPs' choice of referral agency.

Psychotropic drug prescription in Italy. A survey in general practice.

A survey of psychotropic drug prescription was conducted in Verona using information obtained from 92 GPs. A total of 2559 patients consulted their GPs on the day of the study and 14.2% of them received a prescription for a psychotropic drug. Benzodiazepines were the most frequently prescribed: 72.8% and 70.4% of all psychotropic prescriptions in women and men respectively. The prevalence of prescription was higher in women than in men (15.8% vs 11.2%) and the difference was statistically significant (P less than 0.001). Subjects aged 45-64 had the highest chance of receiving prescriptions for psychotropics. Occupational status seems related to psychotropic drug prescription only in women. A strong association was found between psychotropic drug prescription and conspicuous psychiatric morbidity. This association was independent of sex, age, and occupational status. An interactive effect between social problems and sex on psychotropic drug prescription was found. The perception by the GP of a social problem increases the risk that a psychotropic will be prescribed about twice in women, but not in men.

Psychotropic drug prescription in general practice in Italy: a two-week prevalence study.

A study on psychotropic drug monitoring was carried out in Verona over a 2-week period using information obtained during consultation with 3 GPs. Psychotropic drugs accounted for 23.4% and 24.3% of all prescriptions in men and women respectively. Benzodiazepines were the most frequently prescribed: 76% and 72% of all psychotropic prescriptions respectively in women and in men. No significant association between psychotropic drug prescription and age, sex, marital status and occupation was found in the present survey. In men only, those patients with higher educational level were more likely to receive a prescription for psychotropic drugs than those with a lower educational level. About 70% of men and 60.4% of women diagnosed by the GP as having a psychiatric problem were prescribed a psychotropic drug. However, the probability of a psychotropic being prescribed, when a psychiatric problem is identified by the GP, was significantly higher (p less than 0.05) in men than in women: odds ratio 39.37 and 16.33 respectively. Psychotropic drugs were prescribed in 35% of men and in about 48% of women in which a social problem was identified by the GP. Women were about 5 times more likely to receive a prescription than men: odds ratio 12 and 2.75 respectively. A significant influence of physical ill-health and educational level on psychotropic prescription emerged: both effects were independent of sex, psychiatric morbidity and social problems. Using a logistic regression analysis, an interactive effect between sex and conspicuous psychiatric morbidity and between sex and social problems was also found.

Urban-rural differences in psychotropic drug prescribing in northern Italy.

Urban-rural differences in psychotropic drug prescribing were examined by comparing data from general practices in two contrasting areas of northern Italy. Patients attending the urban doctors were 1.5 times more likely to be prescribed a psychotropic drug than their rural counterparts. We also explored urban-rural differences in factors influencing psychotropic prescribing. Such influences were more numerous and complex in the urban than the rural setting.

Somaclonal variation versus chemically induced mutagenesis in tomato (Lycopersicon esculentum L.).

A comparison was made of the type and frequency of mutational events found in the progeny of tomato plants regenerated after one passage in vitro with those induced by chemical mutagenesis with ethyl methane sulphonate. Several mutants were recovered in the progeny of regenerated and mutagenized plants of two cultivars of tomato. They can be grouped into the following categories: seedling lethality, male sterility, resistance to Verticillium, short stature, change in number of lateral shoots or in leaf shape. The results indicate that the two sources of variability differ in their effect, changing the spectrum and frequency of the mutants as well as, at least in some cases, their pattern of segregation.