18 research outputs found
Views of Mental Health Professionals on Positive Changes in Service Practices and Staff-User Relationships After One Year of Covid-19 Pandemic in Italy
Abstract This study explored views of mental health services (MHS) professionals regarding positive changes in service practices and organizations,
and staff-user relationships after one year of COVID19 in Italy. Professionals from a community-oriented MHS completed online the Questionnaire on MHS Transformations during the COVID-19 pandemic, a 30-item tool developed by a participatory approach and validated. Of the 184 participants, 91.8% felt it was ââtrue/definitely trueââ that during the pandemic they had informed users on procedures to reduce contagion risks, and 82.1% stated that they had increased telephone contact with users. Sixty-nine percent of professionals reported that staff revised treatment plans according to new needs of care and 78.6% stated that they had been able to mediate between user needs and safe working procedures. Moreover, 79.4% of respondents stated that they had rediscovered the importance of gestures and habits, and 65% that they had gained strength among colleagues to face fear. Fifty-four percent of participants admitted that they had discovered unexpected personal resources in users. Overall, 59.6% of participants stated that they found some positives in the COVID-19 experience. Perceived positive changes was greater among professionals from community facilities vs. those from hospital and residential facilities. In community-oriented MHS, the pandemic offered an opportunity to change practices and rethink the meaning of relationships between people. This data may be useful in generating a more balanced understanding of COVID-19âs impact on MHS and for MHS planning in the pandemic era
Offâlabel long acting injectable antipsychotics in realâworld clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study
Introduction: Information on the offâlabel use of LongâActing Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with onâ vs offâlabel LAIs and predictors of offâlabel Firstâ or SecondâGeneration Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice. Method: In a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on offâ or onâlabel prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the offâlabel group. Results: SGA LAIs were more commonly prescribed in everyday practice, without significant differences in their onâ and offâlabel use. Approximately 1 in 4 patients received an offâlabel prescription. In the offâlabel group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale. Conclusion: Our study is the first to identify predictors of FGA vs SGA choice in patients treated with offâlabel LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use coâmorbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns
Comparing Long-Acting Antipsychotic Discontinuation Rates Under Ordinary Clinical Circumstances: A Survival Analysis from an Observational, Pragmatic Study
Background: Recent guidelines suggested a wider use of long-acting injectable antipsychotics (LAI) than previously, but naturalistic data on the consequences of LAI use in terms of discontinuation rates and associated factors are still sparse, making it hard for clinicians to be informed on plausible treatment courses. Objective: Our objective was to assess, under real-world clinical circumstances, LAI discontinuation rates over a period of 12 months after a first prescription, reasons for discontinuation, and associated factors. Methods: The STAR Network âDepot Studyâ was a naturalistic, multicentre, observational prospective study that enrolled subjects initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centres were assessed at baseline and at 6 and 12 months of follow-up. Psychopathology, drug attitude and treatment adherence were measured using the Brief Psychiatric Rating Scale, the Drug Attitude Inventory and the Kemp scale, respectively. Results: The study followed 394 participants for 12 months. The overall discontinuation rate at 12 months was 39.3% (95% confidence interval [CI] 34.4â44.3), with paliperidone LAI being the least discontinued LAI (33.9%; 95% CI 25.3â43.5) and olanzapine LAI the most discontinued (62.5%; 95% CI 35.4â84.8). The most frequent reason for discontinuation was onset of adverse events (32.9%; 95% CI 25.6â40.9) followed by participant refusal of the medication (20.6%; 95% CI 14.6â27.9). Medication adherence at baseline was negatively associated with discontinuation risk (hazard ratio [HR] 0.853; 95% CI 0.742â0.981; p = 0.026), whereas being prescribed olanzapine LAI was associated with increased discontinuation risk compared with being prescribed paliperidone LAI (HR 2.156; 95% CI 1.003â4.634; p = 0.049). Conclusions: Clinicians should be aware that LAI discontinuation is a frequent occurrence. LAI choice should be carefully discussed with the patient, taking into account individual characteristics and possible obstacles related to the practicalities of each formulation
Counselling in transexualsm: a fundamental step for a better quality of life
520-22 june 2013nonemixedSANDRI F; BRETTI L; PASCOLO-FABRICI E; FIORINDO F; BERTOSSI cSandri, F; Bretti, L; PASCOLO-FABRICI, Elisabetta; Fiorindo, F; Bertossi, C
GENDER DIFFERENCES AND CLINICAL EVIDENCE: BODY SHAPE PERCEPTION AND PHYSICAL APPEARANCE STEREOTYPES IN OBESE PEOPLE
The Unregulated Psychoactive Compound: âBenzo Furyâ
Introduction: The âlegal highâ âBenzo Furyâ [1-(benzofuran-5-yl)propan-2-amine (5-APB) and 1-(benzofuran-6-yl)propan-2-amine (6-APB)] is an unregulated psychoactive compound which has similar effects as known controlled drugs like amphetamines and ecstasy (with hallucinogenic and stimulant properties). It is known to pose significant health risks, such as causing anxiety, sinus tachycardia, hypertension, and QT prolongation. Furthermore, it is easily obtained from the internet. Methods: A systematic review based on PubMed and Medline literature was conducted. Deaths involving âBenzo Furyâ (implicated in death and/or identified at post mortem toxicology) in the UK from 1997-2012 were identified from the national programme on Substance Abuse Deaths (np-SAD) database. The programme periodically receives information regarding drugrelated deaths in the UK submitted voluntarily by Coroners, the Northern Ireland Statistics and Research Agency, and the Scottish Crime and Drug Enforcement Agency. The general characteristics of these fatalities were analysed. Results: Ten cases were found with âBenzo Furyâ identified at post mortem and it was directly implicated in eight of these deaths. In nine cases, âBenzo Furyâ was found in combination with other psychoactive substances. All deaths occurred between 2011-12; the median age at death was 24 years; the majority were male (8/10); and where ethnicity was known, all were white. Conclusions: Our findings indicate a need for a Public Health education campaign on the risks of âBenzo Furyâ consumption, especially targeting young users and drugs education workers. Further research into the toxicity of âBenzo Furyâ and the risks associated with its consumption is also needed.Peer reviewe