title: Factors characterizing access and latency to first pharmacological treatment in Italian patients with schizophrenia, mood, and anxiety spectrum disorders.
abstract: Latency to first pharmacological treatment [duration of untreated illness (DUI)] in psychiatric disorders can be measured in years, with differences across diagnostic areas and relevant consequences in terms of socio-occupational functioning and outcome. Within the psychopathological onset of a specific disorder, many factors influence access and latency to first pharmacotherapy and the present study aimed to investigate such factors, through an ad-hoc developed questionnaire, in a sample of 538 patients with diagnoses of schizophrenia-spectrum disorder (SZ), mood disorder (MD), and anxiety disorder (AD). Patients with SZs showed earlier ages at onset, first diagnosis and treatment, as well as shorter DUI compared with other patients (43.17 months vs. 58.64 and 80.43 months in MD and AD; F=3.813, P=0.02). Patients with MD and AD reported more frequently onset-related stressful events, benzodiazepines as first treatment, and autonomous help seeking compared with patients with SZs. In terms of first therapist, psychiatrist referral accounted for 43.6% of the cases, progressively decreasing from SZ to MD and AD (57.6, 41.8, and 38.3%, respectively). The opposite phenomenon was observed for nonpsychiatrist clinician referrals, whereas psychologist referrals remained constant. The present findings confirm the presence of a relevant DUI in a large sample of Italian patients with different psychiatric disorders (5 years, on average), pointing out specific differences, in terms of treatment access and latency, between psychotic and affective patients. Such aspects are relevant for detection of at-risk patients and implement early intervention programs.
authors.affiliation: aDepartment of Neuroscience, University of Milan, Department of Mental Health, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan bDepartment of Psychiatry, S. Gerardo Hospital, Monza cDepartment of Public Health, Clinical and Molecular Medicine, Section of Psychiatry and Psychiatric Clinic, University of Cagliari, Cagliari, Italy.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Dell'Osso
authors.forename: Laura
authors.initials: L
authors.lastname: Cremaschi
authors.forename: Carlotta
authors.initials: C
authors.lastname: Palazzo
authors.forename: Neva
authors.initials: N
authors.lastname: Suardi
authors.forename: Gregorio
authors.initials: G
authors.lastname: Spagnolin
authors.forename: Giulia
authors.initials: G
authors.lastname: Camuri
authors.forename: Beatrice
authors.initials: B
authors.lastname: Benatti
authors.forename: Lucio
authors.initials: L
authors.lastname: Oldani
authors.forename: Cristina
authors.initials: C
authors.lastname: Dobrea
authors.forename: Chiara
authors.initials: C
authors.lastname: Arici
authors.forename: Giovanna
authors.initials: G
authors.lastname: Pace
authors.forename: Alessandra
authors.initials: A
authors.lastname: Tiseo
authors.forename: Ester Sembira
authors.initials: ES
authors.lastname: Nahum
authors.forename: Filippo
authors.initials: F
authors.lastname: Castellano
authors.forename: Nazario
authors.initials: N
authors.lastname: D'Urso
authors.forename: Massimo
authors.initials: M
authors.lastname: Clerici
authors.forename: Diego
authors.initials: D
authors.lastname: Primavera
authors.forename: Bernardo
authors.initials: B
authors.lastname: Carpiniello
authors.forename: A Carlo
authors.initials: AC
authors.lastname: Altamura
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001008:Anxiety Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D010342:Patient Acceptance of Health Care; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012017:Referral and Consultation; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D061665:Time-to-Treatment; D055815:Young Adult