Aim: We aimed to characterize youth hospitalization trends in a psychiatric inpatient unit from a large, public university hospital with a broad catchment area in Milan, Italy. Methods: Hospitalization data of patients with an age at admission ≤ 35 were retrospectively retrieved over a time span of 15 years. The sample was comprised of 1982 admissions to a psychiatric ward, aggregated into ICD-10 diagnostic clusters and then analysed. We investigated the epidemiological trends with a focus on age at admission, gender, nationality and hospitalization rates, length of stay and "revolving door" readmissions within a year. Results: Hospitalization rates increased for eating Disorders and decreased for nonaffective psychotic disorders; median length of stay generally decreased; hospitalization rates for foreign youth increased, in particular for those diagnosed with nonaffective psychotic disorders, personality disorders, and substance-related and addictive disorders. The revolving door phenomenon was also associated with nonaffective psychoses and neurodevelopmental disorders, while found to increase for eating disorders. Conclusions: Hospitalization patterns reflect the general increase of foreign youth in the suburban tissue of a large metropolitan area like Milan. However, our data might underestimate the constant growth of mental health problems in foreign youth due to a generally lower access to services. Novel pharmacological treatments and early intervention programs might explain the decrease of hospitalization duration and hospitalization rate for youth with non-affective psychoses. The observed increase in hospitalization for young patients with eating disorders sustains the development of adequate policies tailored towards specialty wards. K E Y W O R D S hospitalization trends, psychiatric services, psychosis, revolving door, youth inpatient care 1 | INTRODUCTION Most findings associated with the course of psychiatric disorders suggest that early identification and treatment leads to improved outcome (Brimblecombe et al., 2017). The clinical relevance of early intervention programs has gained increasing attention over the past few decades, in full agreement with current understanding of primary and secondary prevention in psychiatric disorders. Prospective patients' awareness of mental health and associated problems is influenced by several features that shape their access to mental health

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Aims Certain bacteria can produce gamma aminobutyric acid (GABA) from glutamate in the human intestinal tract, leading to the possibility of altering GABA levels through diet. To this end, we assessed the ability of seven commercially available probiotic supplements to produce GABA. Method and results Probiotic strains were compared for GABA production in pure culture. The bacteria were inoculated at a concentration of 107 CFU ml−1 in 10 ml MRS supplemented with monosodium glutamate (1% w/v), both with and without oligofructose-enriched inulin (OFI) (1% w/v). Two strains with the highest production of GABA were further assessed for 48 h in pH-controlled anaerobic batch cultures inoculated with faecal bacteria. Liquid chromatography-mass spectrometry (LC–MS) was used for quantification of GABA and microbiota composition was determined through 16S rRNA gene sequencing. Levilactobacillus brevis LB01 (CGMCC 16921) and Lactiplantibacillus plantarum 299v (DSM 9843) were the most efficient producers of GABA. High GABA levels (28.32 mmol l−1 ± 0.29) were produced by the probiotic strain L. brevis LB01 at pH 5.4–5.6. This was significantly higher than the levels of GABA produced by L. plantarum (4.8 mmol l−1 ± 6.8) and a negative control (2.9 mM ± 3.1). The addition of OFI did not further stimulate GABA production under the conditions tested. The ability of these strains to produce GABA in-vitro was further evaluated in a faecal microbiota environment. Once again, L.brevis LB01 produced the highest levels of GABA (40.24 mmol l−1 ± 20.98). Conclusions L. brevis LB01 was found to be the most efficient probiotic strain, of those tested, for GABA production.