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dc.contributor.authorClerici, Massimo
dc.contributor.authorDe Bartolomeis, Andrea
dc.contributor.authorDe Filippis, Sergio
dc.contributor.authorDucci, Giuseppe
dc.contributor.authormaremmani, Icro
dc.contributor.authorMartinotti, Giovanni
dc.contributor.authorSchifano, Fabrizio
dc.date.accessioned2019-02-21T10:09:19Z
dc.date.available2019-02-21T10:09:19Z
dc.date.issued2018-11-13
dc.identifier.citationClerici , M , De Bartolomeis , A , De Filippis , S , Ducci , G , maremmani , I , Martinotti , G & Schifano , F 2018 , ' Patterns of management of patients with dual disorder (psychosis) in Italy: a survey of psychiatrists and other physicians focusing on clinical practice ' , Frontiers in Psychiatry , vol. 9 , 575 , pp. 1-12 . https://doi.org/10.3389/fpsyt.2018.00575
dc.identifier.issn1664-0640
dc.identifier.otherPURE: 15530261
dc.identifier.otherPURE UUID: 2e475c78-07f2-4a90-bf4a-5c15d7155496
dc.identifier.urihttp://hdl.handle.net/2299/21130
dc.description© 2018 Clerici, de Bartolomeis, De Filippis, Ducci, Maremmani, Martinotti and Schifano. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).
dc.description.abstractPatients with severe psychotic disorders such as schizophrenia, schizoaffective and bipolar disorders frequently suffer from concomitant substance use disorders (SUDs) – Dual Disorder (DD) patients. In order to better understand current practices for management of patients with psychotic episodes and concomitant SUD in Italy, we carried out a survey of psychiatrists on current routine practice among prescribers. These aspects can help to identify at-risk patients, improve current prescribing practices, and favor early intervention. An ad hoc survey of 17 questions was administered to psychiatrists via electronic polling and on-line distribution; 448 completed questionnaires were collected. Comorbid substance abuse was most frequently diagnosed within the context of anxiety disorder (46%), followed by bipolar disorder (25%), and schizophrenia/schizoaffective disorder (12%). The vast majority of respondents felt that patient management was becoming more complex due to substance abuse. The areas reported to be most affected in patients with SUD were functioning, interpersonal relations, and impulsivity, while sensory perception disorders, ideation, agitation, and impulsivity were the most frequently reported symptoms. In the acute setting, haloperidol was used as the first-line agent of choice followed by aripiprazole and olanzapine. In the maintenance phase, aripiprazole was the dominantly used first-line agent, followed by olanzapine. Almost half of respondents used long-acting agents, while about one-third did not. Among those prescribing long-acting agents, efficacy, control of impulsivity, and control of specific symptoms were cited as motivators, while in the maintenance phase, better adherence and tolerability were mainly cited. From the responses to the present survey, it is clear that the respondents are aware of the problem of SUD in psychotic patients. While treatment be optimized in terms of the choice and formulation of antipsychotics, greater emphasis should be placed on efficacy, tolerability and the negative metabolic consequences of some antipsychotics. When considering the ideal antipsychotic, long-acting agents were considered to be superior in reducing relapse, even if current treatment guidelines often give preference to oral formulations.en
dc.format.extent12
dc.language.isoeng
dc.relation.ispartofFrontiers in Psychiatry
dc.rightsOpen
dc.subjectschizophrenia
dc.subjectpsychosis
dc.subjectPsychotic Disorders
dc.subjectsubstance use disorder
dc.subjectsurvey
dc.subjectmanagement
dc.subjectdual disorder
dc.titlePatterns of management of patients with dual disorder (psychosis) in Italy: a survey of psychiatrists and other physicians focusing on clinical practiceen
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionDepartment of Pharmacy, Pharmacology and Postgraduate Medicine
dc.contributor.institutionPsychopharmacology, Drug Misuse and Novel Psychoactive Substances Unit
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionDepartment of Clinical and Pharmaceutical Sciences
dc.description.statusPeer reviewed
dc.relation.schoolSchool of Life and Medical Sciences
dc.description.versiontypeFinal Published version
dcterms.dateAccepted2018-11-13
rioxxterms.versionAM
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.3389/fpsyt.2018.00575
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeOpen


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