Aims Psychiatric disorders represent highly impairing conditions, often underdiagnosed and undertreated, with a conspicuous duration of untreated illness (DUI). Given that social and cultural factors influence the DUI and assuming that progress in diagnosis and treatment determines a reduced latency to pharmacotherapy, we assessed and compared DUI and related variables in a large sample of psychiatric patients (n = 562) whose onset occurred within three different a priori-defined epochs. Methods Two temporal cut-offs were established - the year 1978, when Law 180 (redefining standards for mental care) was introduced in Italy, and the year 2000 - in order to divide patients into three subgroups: onset before 1978, onset 1978-2000 and onset after 2000. Results A significant difference in terms of age at onset, age at first diagnosis and age at first treatment was observed in patients with onset 1978-2000 and in those with onset after 2000. In addition, a significant reduction of the DUI was found across epochs (onset before 1978: 192.25 ± 184.52 months; onset 1978-2000: 77.00 ± 96.63 months; and onset after 2000: 19.00 ± 31.67 months; P < 0.001). Furthermore, the proportion of patients with onset-related stressful events, use of benzodiazepines and neurological referral was found to be significantly different between the three epochs (χ2 = 23.4, P < 0.001; χ2 = 9.92, P = 0.007; χ2 = 16.50, P = 0.011). Conclusions Present data indicate a progressive, statistically significant reduction of latency to treatment and other related changes across subsequent epochs of onset in patients with different psychiatric disorders. Future studies will assess specific changes within homogeneous diagnostic subgroups.

Reduced duration of untreated illness over time in patients with schizophrenia spectrum, mood and anxiety disorders / B. Dell'Osso, L. Oldani, G. Camuri, B. Benatti, B. Grancini, C. Arici, L. Cremaschi, M. Palazzo, G. Spagnolin, C. Dobrea, A.C. Altamura. - In: PSYCHIATRY AND CLINICAL NEUROSCIENCES. - ISSN 1323-1316. - 70:5(2016 May), pp. 202-210. [10.1111/pcn.12380]

Reduced duration of untreated illness over time in patients with schizophrenia spectrum, mood and anxiety disorders

B. Dell'Osso
Primo
;
L. Oldani
Secondo
;
G. Camuri;B. Benatti;C. Arici;L. Cremaschi;M. Palazzo;G. Spagnolin;C. Dobrea
Penultimo
;
A.C. Altamura
2016

Abstract

Aims Psychiatric disorders represent highly impairing conditions, often underdiagnosed and undertreated, with a conspicuous duration of untreated illness (DUI). Given that social and cultural factors influence the DUI and assuming that progress in diagnosis and treatment determines a reduced latency to pharmacotherapy, we assessed and compared DUI and related variables in a large sample of psychiatric patients (n = 562) whose onset occurred within three different a priori-defined epochs. Methods Two temporal cut-offs were established - the year 1978, when Law 180 (redefining standards for mental care) was introduced in Italy, and the year 2000 - in order to divide patients into three subgroups: onset before 1978, onset 1978-2000 and onset after 2000. Results A significant difference in terms of age at onset, age at first diagnosis and age at first treatment was observed in patients with onset 1978-2000 and in those with onset after 2000. In addition, a significant reduction of the DUI was found across epochs (onset before 1978: 192.25 ± 184.52 months; onset 1978-2000: 77.00 ± 96.63 months; and onset after 2000: 19.00 ± 31.67 months; P < 0.001). Furthermore, the proportion of patients with onset-related stressful events, use of benzodiazepines and neurological referral was found to be significantly different between the three epochs (χ2 = 23.4, P < 0.001; χ2 = 9.92, P = 0.007; χ2 = 16.50, P = 0.011). Conclusions Present data indicate a progressive, statistically significant reduction of latency to treatment and other related changes across subsequent epochs of onset in patients with different psychiatric disorders. Future studies will assess specific changes within homogeneous diagnostic subgroups.
affective disorders; anxiety and obsessive-compulsive disorders; epidemiology and mental health; schizophrenia; stigma and mental disorders; neurology (clinical); neurology; psychiatry and mental health; neuroscience (all)
Settore MED/25 - Psichiatria
mag-2016
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/437330
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