1. The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study
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Andrea, Aguglia, Laura, Fusar-Poli, Andrea, Amerio, Valeria, Placenti, Carmen, Concerto, Giovanni, Martinotti, Giuseppe, Carrà, Francesco, Bartoli, Armando, D’Agostino, Gianluca, Serafini, Mario, Amore, Eugenio, Aguglia, Giovanni, Ostuzzi, Corrado, Barbui, e STAR Network Investigators, Michela, Nose’, Marianna, Purgato, Giulia, Turrini, Maria Angela Mazzi, Davide, Papola, Chiara, Gastaldon, Samira, Terlizzi, Federico, Bertolini, Alberto Piccoli (Verona), Mirella Ruggeri (Verona), Pasquale De Fazio (Catanzaro), Fabio Magliocco (Catanzaro), Mariarita Caroleo (Catanzaro), Gaetano Raffaele (Catanzaro), Armando D’Agostino (Milano), Edoardo Giuseppe Ostinelli (Milano), Margherita Chirico (Milano), Simone Cavallotti (Milano), Claudio Lucii (Siena), Simone Bolognesi (Siena), Sara Debolini (Siena), Elisa Pierantozzi (Siena), Francesco Fargnoli (Siena), Maria Del Zanna (Siena), Alessandra Giannini (Siena), Livia Luccarelli (Siena), Alberto De Capua (Siena), Pasqua Maria Annese (Siena), Massimiliano Cerretini (Siena), Fiorella Tozzi (Siena), Nadia Magnani (Grosseto), Giuseppe Cardamone (Grosseto), Francesco Bardicchia (Grosseto), Edvige Facchi (Grosseto), Federica Soscia (Grosseto), Spyridon Zotos (Ferrara), Bruno Biancosino (Ferrara), Filippo Zonta (Treviso), Francesco Pompei (Treviso), Callegari, Camilla, Daniele, Zizolfi, Ielmini, Marta, Caselli, Ivano, Edoardo Giana (Varese), Aldo Buzzi (Varese), Marcello Diurni (Varese), Anna Milano (Varese), Emanuele Sani (Varese), Roberta Calzolari (Varese), Paola Bortolaso (Varese Verbano), Marco Piccinelli (Varese Verbano), Sara Cazzamalli (Varese Verbano), Gabrio Alberini (Varese Verbano), Silvia Piantanida (Varese Verbano), Chiara Costantini (Varese Verbano), Chiara Paronelli (Varese Verbano), Angela Di Caro (Varese Verbano), Valentina Moretti (Reggio Emilia), Mauro Gozzi (Reggio Emilia), Chiara D’Ippolito (Reggio Emilia), Silva Veronica Barbanti (Reggio Emilia), Papalini Alessandro (Reggio Emilia), Mariangela Corbo (Chieti), Giovanni Martinotti (Chieti), Ornella Campese (Chieti), Federica Fiori (Chieti), Marco Lorusso (Chieti), Lucia Di Capro (Chieti), Daniela Viceconte (Chieti), Valerio Mancini (Chieti), Francesco Suraniti (Catania), Maria Salvina Signorelli (Catania), Eugenio Rossi (Bologna), Pasqualino Lupoli (Bologna), Marco Menchetti (Bologna), Laura Terzi (Bologna), Marianna Boso (Pavia), Paolo Risaro (Pavia), Giuseppe De Paoli (Pavia), Cristina Catania (Pavia), Ilaria Tarricone (Bologna), Valentina Caretto (Bologna), Viviana Storbini (Bologna), Roberta Emiliani (Bologna), Beatrice Balzarro (Bologna), Giuseppe Carrà (Monza), Francesco Bartoli (Monza), Tommaso Tabacchi (Monza), Roberto Nava (Monza), Adele Bono (Monza), Milena Provenzi (Monza), Giulia Brambilla (Monza), Flora Aspesi (Monza), Trotta, (Monza), Martina Tremolada (Monza), Gloria Castagna (Monza), Mattia Bava (Monza), Enrica Verrengia (Monza), Sara Lucchi (Monza), Maria Ginevra Oriani (Ancona), Michela Barchiesi (Ancona), Monica Pacetti (Forlì), Andrea Aguglia (Genova), Laura Rosa Magni (Brescia), Giuseppe Rossi (Brescia), Rossella Beneduce (Brescia), Giovanni Battista Tura (Brescia), Laura Laffranchini (Brescia), Daniele Mastromo (Milano), Farida Ferrato (Milano), Francesco Restaino (Milano), Emiliano Monzani (Milano), Matteo Porcellana (Milano), Ivan Limosani (Milano), Lucio Ghio (Genova), Maurizio Ferro (Genova), Vincenzo Fricchione Parise (Avellino), Giovanni Balletta (Avellino), Lelio Addeo (Avellino), Elisa De Vivo (Avellino), Rossella Di Benedetto (Avellino), Federica Pinna (Cagliari), Bernardo Carpiniello (Cagliari), Mariangela Spano (Treviso), Marzio Giacomin (Treviso), Damiano Pecile (Mantova), Chiara Mattei (Fermo), Elisabetta Pascolo Fabrici (Trieste), Sofia Panarello (Trieste), Giulia Peresson (Trieste), Claudio Vitucci (Trieste), Tommaso Bonavigo (Trieste), Monica Pacetti (Forli‘), Giovanni Perini (Verona), Filippo Boschello (Verona), Stefania Strizzolo (Vicenza), Francesco Gardellin (Vicenza), Massimo di Giannantonio (Chieti), Daniele Moretti (Savona), Carlo Fizzotti (Savona), Edoardo Cossetta (Savona), Luana Di Gregorio (Trento), Francesca Sozzi (Trento), Giancarlo Boncompagni (Bologna), Daniele La Barbera (Palermo), Giuseppe Colli (Palermo), Sabrina Laurenzi (Civitanova Marche), Carmela Calandra (Catania), Maria Luca, (Catania)., Aguglia, A, Fusar-Poli, L, Amerio, A, Placenti, V, Concerto, C, Martinotti, G, Carra, G, Bartoli, F, D'Agostino, A, Serafini, G, Amore, M, Aguglia, E, Ostuzzi, G, Barbui, C, Aguglia, Andrea, Fusar-Poli, Laura, Amerio, Andrea, Placenti, Valeria, Concerto, Carmen, Martinotti, Giovanni, Carrà, Giuseppe, Bartoli, Francesco, D'Agostino, Armando, Serafini, Gianluca, Amore, Mario, Aguglia, Eugenio, Ostuzzi, Giovanni, Barbui, Corrado, and LA BARBERA, DANIELE
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Psychiatry ,psychotic symptom ,therapeutic alliance ,RC435-571 ,drug ,antipsychotic ,Psychiatry and Mental health ,antipsychotics ,adherence ,attitude ,long-acting injectable ,psychotic symptoms ,Original Research - Abstract
Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent predictors of symptoms changes over time.Methods: The STAR Network “Depot Study” was a naturalistic, multicenter, observational, prospective study that enrolled people initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centers were assessed at three time points: baseline, 6-month, and 12-month follow-up. Psychopathological symptoms, attitude toward medication and treatment adherence were measured using the Brief Psychiatric Rating Scale (BPRS), the Drug Attitude Inventory (DAI-10) and the Kemp's 7-point scale, respectively. Linear mixed-effects models were used to evaluate whether attitude toward medication and treatment adherence independently predicted symptoms changes over time. Analyses were conducted on the overall sample and then stratified according to the baseline severity (BPRS < 41 or BPRS ≥ 41).Results: We included 461 participants of which 276 were males. The majority of participants had received a primary diagnosis of a schizophrenia spectrum disorder (71.80%) and initiated a treatment with a second-generation LAI (69.63%). BPRS, DAI-10, and Kemp's scale scores improved over time. Six linear regressions—conducted considering the outcome and predictors at baseline, 6-month, and 12-month follow-up independently—showed that both DAI-10 and Kemp's scale negatively associated with BPRS scores at the three considered time points. Linear mixed-effects models conducted on the overall sample did not show any significant association between attitude toward medication or treatment adherence and changes in psychiatric symptoms over time. However, after stratification according to baseline severity, we found that both DAI-10 and Kemp's scale negatively predicted changes in BPRS scores at 12-month follow-up regardless of baseline severity. The association at 6-month follow-up was confirmed only in the group with moderate or severe symptoms at baseline.Conclusion: Our findings corroborate the importance of improving the quality of relationship between clinicians and patients. Shared decision making and thorough discussions about benefits and side effects may improve the outcome in patients with severe mental disorders.
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- 2021