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Factors characterizing access and latency to first pharmacological treatment in Italian patients with schizophrenia, mood, and anxiety spectrum disorders

Dell’Osso, Bernardoa; Cremaschi, Lauraa; Palazzo, Carlottaa; Suardi, Nevaa; Spagnolin, Gregorioa; Camuri, Giuliaa; Benatti, Beatricea; Oldani, Lucioa; Dobrea, Cristinaa; Arici, Chiaraa; Pace, Giovannaa; Tiseo, Alessandraa; Nahum, Ester Sembiraa; Castellano, Filippob; D’Urso, Nazariob; Clerici, Massimob; Primavera, Diegoc; Carpiniello, Bernardoc; Altamura, A. Carloa

International Clinical Psychopharmacology: January 2015 - Volume 30 - Issue 1 - p 29–35
doi: 10.1097/YIC.0000000000000049

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.

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

Correspondence to Bernardo Dell’Osso, MD, Department of Psychiatry, University of Milan, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy Tel: +39 2 55035994; fax: +39 2 55033140; e-mail:

Received March 13, 2014

Accepted July 3, 2014

© 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins