32 results on '"Clerici, Massimo"'
Search Results
2. Gender differences in clinical and biochemical parameters among patients hospitalized for schizophrenia: towards precision medicine.
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Esposito CM, De Cagna F, Caldiroli A, Capuzzi E, Ceresa A, Di Paolo M, Auxilia AM, Capellazzi M, Tagliabue I, Cirella L, Clerici M, Brondino N, Barkin JL, Politi P, and Buoli M
- Subjects
- Humans, Male, Female, Adult, Middle Aged, Sex Factors, Comorbidity, Sex Characteristics, Italy epidemiology, Substance-Related Disorders epidemiology, Substance-Related Disorders blood, Age of Onset, Young Adult, Schizophrenia blood, Schizophrenia epidemiology, Precision Medicine, Hospitalization statistics & numerical data
- Abstract
Background: The scientific literature shows some gender differences in the clinical course of schizophrenia. The aim of this study is to identify gender differences in clinical and biochemical parameters in subjects affected by schizophrenia. This would allow for the implementation of individualized treatment strategies., Methods: We examined a large set of clinical and biochemical parameters. Data were obtained from clinical charts and blood analyses from a sample of 555 schizophrenia patients consecutively admitted for exacerbation of symptoms to the inpatient clinic of Fondazione IRCCS Policlinico (Milan) or ASST Monza in Italy from 2008 to 2021. Univariate analyses, binary logistic regression, and a final logistic regression model were performed with gender as dependent variable., Results: The final logistic regression models showed that male patients (compared to females) were more prone to lifetime substance use disorders (p = 0.010). However, they also had higher GAF (global functioning) mean scores (p < 0.001) at the time of hospitalization. Univariate analyses showed that male patients (with respect to females) had an earlier age at onset (p < 0.001), a more frequent family history of multiple psychiatric disorders (p = 0.045), were more often smokers (p < 0.001), had a more frequent comorbidity with at least one psychiatric disorder (p = 0.001), and less often suffered from hypothyroidism (p = 0.011). In addition, men had higher levels of albumin (p < 0.001) and bilirubin (t = 2.139, p = 0.033), but lower levels of total cholesterol (t = 3.755, p < 0.001)., Conclusions: Our analyses indicate a less severe clinical profile in female patients. This is evident especially in the early years of the disorder, as suggested by less comorbidity with psychiatric disorders or later age at onset; this is consistent with the related literature. In contrast, female patients seem to be more vulnerable to metabolic alterations as demonstrated by more frequent hypercholesterolemia and thyroid dysfunction. Further studies are needed to confirm these results in the framework of precision medicine., (© 2023. The Author(s).)
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- 2024
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3. Novel pharmacotherapy targeting the positive symptoms of schizophrenia.
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Capuzzi E, Caldiroli A, Quitadamo C, Butturini F, Surace T, Clerici M, and Buoli M
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- Humans, Female, Schizophrenia drug therapy, Antipsychotic Agents therapeutic use
- Abstract
Introduction: The severity of positive symptoms in schizophrenia is associated with poor prognosis. About one-third of schizophrenia patients partially respond to treatment with available antipsychotics. The purpose of the present manuscript is to provide an updated overview of novel pharmacotherapy targeting positive symptoms in schizophrenia., Areas Covered: A comprehensive research on the main database sources (PubMed, PsychINFO, Isi Web of Knowledge, MEDLINE, and EMBASE) was performed to obtain original articles published till 31
st January 2023 about new pharmacological strategies for the treatment of positive symptoms in schizophrenia., Expert Opinion: The most promising compounds include: lamotrigine, pro-cognitive-compounds (donepezil - in the short term, idazoxan and piracetam) and drugs acting partially or totally outside the Central Nervous System (CNS) (anti-inflammatory drugs: celecoxib, methotrexate; cardiovascular compounds: L-theanine, mononitrate isosorbide, propentofylline, sodium nitroprusside; metabolic regulators: diazoxide, allopurinol; others: bexarotene, raloxifene [in women]). The effectiveness of the latter compounds indicates that other biological systems, such as immunity or metabolism can be object of future research to identify pharmacological targets for positive symptoms of schizophrenia. Mirtazapine could be useful for treating negative symptoms without increasing the risk of a worsening of delusions/hallucinations. Nevertheless, the lack of replication of studies prevents to draw definitive conclusions and future studies are needed to confirm the findings presented in this overview.- Published
- 2023
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4. Ecological monitoring of physical activity, emotions and daily life activities in schizophrenia: the DiAPAson study.
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Zarbo C, Rota M, Calza S, Crouter SE, Ekelund U, Barlati S, Bussi R, Clerici M, Placenti R, Paulillo G, Pogliaghi S, Rocchetti M, Ruggeri M, Starace F, Zanolini S, Zamparini M, and de Girolamo G
- Subjects
- Humans, Cohort Studies, Emotions, Exercise, Outpatients, Schizophrenia diagnosis
- Abstract
Background: Schizophrenia spectrum disorders (SSD) compromise psychosocial functioning, including daily time use, emotional expression and physical activity (PA)., Objective: We performed a cohort study aimed at investigating: (1) the differences in PA, daily activities and emotions between patients with SSD and healthy controls (HC); (2) the strength of the association between these variables and clinical features among patients with SSD., Methods: Ninety-nine patients with SSD (53 residential patients, 46 outpatients) and 111 matched HC were assessed for several clinical variables, and levels of functioning by means of standardised clinical measures. Self-reported daily activities and emotions were assessed with a smartphone application for ecological momentary assessment (EMA), and PA levels were assessed with a wearable accelerometer for 7 consecutive days.FindingsPatients with SSD, especially those living in residential facilities, spent more time being sedentary, and self-reported more sedentary and self-care activities, experiencing higher levels of negative emotions compared with HC. Moreover, higher functioning levels among patients were associated with more time spent in moderate-to-vigorous activity., Conclusions: Sedentary behaviour and negative emotions are particularly critical among patients with SSD and are associated with more impaired clinical outcomes., Clinical Implications: Mobile-EMA and wearable sensors are useful for monitoring the daily life of patients with SSD and the level of PA. This population needs to be targeted with specific rehabilitative programmes aimed at improving their commitment to structured daily activities., Competing Interests: Competing interests: No, there are no competing interests., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. Published by BMJ.)
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- 2023
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5. Two-Injection Start Regimen of Long-Acting Aripiprazole in 133 Patients With Schizophrenia.
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Cuomo A, Aguglia E, Biagini S, Carano A, Clerici M, D'Agostino A, De Filippis S, De Giorgi S, Goracci A, Libri C, Lombardi F, Lupi M, Maina G, Martinotti G, Nigro P, Pettorruso M, Ricci V, Rossi E, Russo F, and Fagiolini A
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- Humans, Aripiprazole, Retrospective Studies, Drug Administration Schedule, Delayed-Action Preparations therapeutic use, Schizophrenia drug therapy, Antipsychotic Agents
- Abstract
Purpose/background: Based on a population-pharmacokinetic model, the European Medicines Agency has recently approved a simplified starting strategy of aripiprazole once a month (AOM), injectable and long-acting antipsychotic, with two 400 mg injections and a single oral 20 mg dose of aripiprazole, administered on the same day, instead of 1 injection and 14 daily administrations of concurrent oral aripiprazole. However, to our knowledge, no previous study has reported the safety and tolerability of this regimen in real-world patients., Methods/procedures: We retrospectively reviewed medical records of 133 patients who received the newly approved 2-injection start regimen as part of their standard care in 10 Italian clinical centers., Findings/results: Adverse effects were mild or moderate, with no clinically evident difference from the adverse effects observed in previous trials where AOM was started with a single injection followed by 14 days of orally administered aripiprazole. None of the patients who started AOM after the 2-injection start regimen experienced severe adverse effects or severe adverse effects., Implications/conclusions: The coadministration of 2 injections of 400 mg aripiprazole and 20 mg oral aripiprazole was not associated with safety concerns beyond those reported after a single injection followed by 14 days of orally administered aripiprazole. Our results should be interpreted with caution, due to the limited sample size and to the retrospective design of the study., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2023
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6. Monocyte count in schizophrenia and related disorders: a systematic review and meta-analysis.
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Mazza MG, Capellazzi M, Lucchi S, Tagliabue I, Rossetti A, and Clerici M
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- Adult, Biomarkers blood, Case-Control Studies, Female, Genetic Heterogeneity, Humans, Male, Microglia immunology, Mononuclear Phagocyte System immunology, Psychotic Disorders diagnosis, Psychotic Disorders epidemiology, Psychotic Disorders physiopathology, Schizophrenia diagnosis, Schizophrenia epidemiology, Schizophrenia physiopathology, Sensitivity and Specificity, Leukocytes, Mononuclear cytology, Microglia metabolism, Psychotic Disorders blood, Schizophrenia blood
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Objective: Increasing evidence suggests that immunological and inflammatory dysfunctions may play an important role in predisposition, onset, and progression of schizophrenia and related psychosis. The activation of cells of the mononuclear phagocyte system, especially microglia and monocytes, has been reported in schizophrenia. We carried out this systematic review and meta-analysis to investigate if there are significant differences in monocyte count comparing healthy controls with people suffering from schizophrenia and related disorders., Methods: We searched main electronic databases; nine records met all our criteria and were included in the meta-analysis. Meta-analyses based on random effects models have been carried out generating pooled standardised mean differences (SMDs) of monocyte count in peripheral blood between schizophrenia and related psychosis and healthy controls. Heterogeneity was estimated. Relevant sensitivity and subgroup analyses were conducted., Results: Patients showed higher monocyte count as compared with healthy control (SMD = 0.393; p = 0.001). Heterogeneity across studies was from moderate to high (I2 = 65.952%); sensitivity analysis leaving out two studies responsible for most of the heterogeneity showed a slightly higher SMD. Subgroup analyses confirmed this result, showing no significant differences in the effect size across different study characteristics., Conclusions: Monocyte count can be considered an indirect marker of microglia activation in the central nervous system. Thus, the observed higher monocyte count in patients could be considered as a possible peripheral marker of microglia's activation in schizophrenia disorder.
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- 2020
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7. Neutrophil-lymphocyte, monocyte-lymphocyte and platelet-lymphocyte ratio in schizoaffective disorder compared to schizophrenia.
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Mazza MG, Capellazzi M, Tagliabue I, Lucchi S, Rossetti A, and Clerici M
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- Adult, Blood Cell Count, Cross-Sectional Studies, Female, Humans, Male, Young Adult, Blood Platelets, Lymphocytes, Monocytes, Neutrophils, Psychotic Disorders blood, Schizophrenia blood
- Published
- 2019
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8. Adjunctive second-generation antipsychotics for specific symptom domains of schizophrenia resistant to clozapine: A meta-analysis.
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Bartoli F, Crocamo C, Di Brita C, Esposito G, Tabacchi TI, Verrengia E, Clerici M, and Carrà G
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- Drug Resistance, Drug Therapy, Combination, Humans, Randomized Controlled Trials as Topic, Schizophrenic Psychology, Antipsychotic Agents therapeutic use, Clozapine therapeutic use, Schizophrenia drug therapy
- Abstract
A fair amount of subjects with schizophrenia do not respond to clozapine and are defined 'ultra-resistant'. In this systematic review and meta-analysis, we tested the efficacy of adjunctive second-generation antipsychotics (SGAs) for main symptom domains (positive, negative, and depressive symptoms) in individuals with clozapine-resistant schizophrenia. We searched main electronic databases till December 2017. We included twelve double-blind, randomized, placebo-controlled trials (RCTs), evaluating the efficacy of SGAs for clozapine non/partial responders. We did not find any difference between SGAs and placebo (standardized mean difference, SMD = -0.21; p = 0.170; I
2 = 68.0%) in improving positive symptoms. The effect size varied according to RCT duration (p = 0.025) and assessment methods (p = 0.016). Low-moderate effects of SGAs on both negative (SMD = -0.38; p = 0.005; I2 = 62.7%) and depressive symptoms (SMD = -0.35; p = 0.003; I2 = 4.9%), were estimated. In sum, our meta-analysis highlights the lack of efficacy of SGAs as add-on treatment for positive symptoms in clozapine-resistant schizophrenia. A small benefit of SGAs was estimated for both negative and depressive symptoms. Further RCTs are needed to establish efficacy and tolerability of SGAs or other augmentation strategies for different symptoms of clozapine-resistant schizophrenia., (Copyright © 2018 Elsevier Ltd. All rights reserved.)- Published
- 2019
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9. Executive control in schizophrenia: a preliminary study on the moderating role of COMT Val158Met for comorbid alcohol and substance use disorders.
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Carrà G, Nicolini G, Crocamo C, Lax A, Amidani F, Bartoli F, Castellano F, Chiorazzi A, Gamba G, Papagno C, and Clerici M
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- Adult, Cognition physiology, Comorbidity, Cross-Sectional Studies, Diagnosis, Dual (Psychiatry) methods, Female, Humans, Male, Middle Aged, Polymorphism, Genetic genetics, Random Allocation, Schizophrenia diagnosis, Schizophrenic Psychology, Substance-Related Disorders diagnosis, Substance-Related Disorders psychology, Catechol O-Methyltransferase genetics, Executive Function physiology, Methionine genetics, Schizophrenia genetics, Substance-Related Disorders genetics, Valine genetics
- Abstract
Background: A functional polymorphism in the catechol-O-methyltransferase (COMT) gene (Val158Met) appears to influence cognition in people with alcohol/substance use disorders (AUD/SUD) and in those with psychosis., Methods: To explore the potential moderating effect of these factors, a cross-sectional study was conducted, randomly recruiting subjects with DSM-IV diagnosis of schizophrenia. AUD/SUD was rigorously assessed, as well as COMT Val158Met polymorphism. Executive control functioning was measured using the Intra-Extra Dimensional Set Shift (IED). The effect of a possible interaction between comorbid AUD/SUD and COMT Val158Met polymorphism on IED scores was explored., Results: Subjects with schizophrenia, comorbid AUD/SUD, and MetMet carriers for SNP rs4680 of the COMT gene showed worse performance on IED completed stages scores, as compared with individuals with ValVal genotype. However, among subjects without AUD/SUD, those with the MetMet variant performed better than people carrying ValVal genotype., Conclusions: This study is the first to date examining the impact of COMT on cognition in a highly representative sample of people with schizophrenia and comorbid AUD/SUD. Differential moderating effects of COMT Val/Met genotype variations may similarly influence executive functions in people with schizophrenia and comorbid AUD/SUD.
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- 2017
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10. Long-Acting Injectable Antipsychotics in Schizophrenia: Literature Review and Practical Perspective, with a Focus on Aripiprazole Once-Monthly.
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Biagi E, Capuzzi E, Colmegna F, Mascarini A, Brambilla G, Ornaghi A, Santambrogio J, and Clerici M
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- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Recurrence, Administration, Oral, Antipsychotic Agents therapeutic use, Aripiprazole therapeutic use, Delayed-Action Preparations therapeutic use, Injections, Schizophrenia drug therapy
- Abstract
Introduction: Prevention of relapse is a major challenge in schizophrenia, a disease characterized by poor adherence to antipsychotic medication leading to multiple rehospitalizations and a substantial burden-of-care., Methods: We narratively review published clinical data from the development of long-acting injectable (LAI) formulations of antipsychotic drugs and examine the comparative effectiveness of oral versus LAIs in schizophrenia, with a focus on the second-generation LAI antipsychotic aripiprazole. Evidence is presented from studies with naturalistic/pragmatic as well as explanatory trial designs, supported by the clinical experience of the authors., Results: LAI formulations of antipsychotic drugs offer advantages over oral medications and there is good evidence for their use as a first-choice treatment and in younger patients. Key phase III studies have shown aripiprazole once-monthly 400 mg (AOM 400) to be effective and well tolerated, with high rates of adherence and low rates of impending relapse. In a recent randomized trial with a "naturalistic" study design more representative of routine clinical practice, AOM 400 was well tolerated and had significantly greater effectiveness than paliperidone LAI overall and in younger patients aged ≤35 years., Conclusion: Results across the "full spectrum" of efficacy in traditional clinical trials as well as those encompassing the concept of effectiveness in a more naturalistic setting of real-life clinical practice support the use of AOM 400 as a valid long-term treatment option in schizophrenia overall, as well as earlier in the treatment course, and not solely in situations of poor adherence or when oral antipsychotics have failed.
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- 2017
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11. Second-generation antipsychotics and adiponectin levels in schizophrenia: A comparative meta-analysis.
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Bartoli F, Crocamo C, Clerici M, and Carrà G
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- Humans, Observational Studies as Topic, Adiponectin blood, Antipsychotic Agents therapeutic use, Psychotic Disorders blood, Psychotic Disorders drug therapy, Schizophrenia blood, Schizophrenia drug therapy
- Abstract
People with schizophrenia treated with second-generation antipsychotics (SGAs) have lower plasma adiponectin levels, as compared with general population, that may lead to metabolic abnormalities. However, the contribution of different SGAs on adiponectin dysregulation is still unclear. The objective of this systematic review and meta-analysis was to estimate differences in adiponectin levels among people with schizophrenia treated with different SGAs. We systematically searched for observational studies published up to March 2015 in main electronic databases. Different SGAs were included if data on adiponectin were available from at least three different samples involving as a minimum five participants per treatment arm. Standardized mean differences with relevant 95% confidence intervals were generated. I(2) was used to test heterogeneity among studies. Eight studies were included with data suitable for carrying out four different comparisons: Clozapine vs. Olanzapine (including n=877 individuals with schizophrenia); Clozapine vs. Risperidone (n=660); Olanzapine vs. Risperidone (n=738); Quetiapine vs. Risperidone (n=186). There were no differences on adiponectin levels between people taking Clozapine and those taking Olanzapine (p=0.86), but high heterogeneity was detected (I(2)=82%). Both individuals taking Clozapine (p<0.001; I(2)=0%) and those taking Olanzapine (p=0.02; I(2)=9%), but not subjects treated with Quetiapine (p=0.47; I(2)=0%), had adiponectin levels significantly lower than people taking Risperidone. Our findings are consistent with previous evidence showing greater metabolic abnormalities attributable to Clozapine and Olanzapine, as compared with other SGAs. Although mechanisms whereby both these SGAs influence adiponectin remain unexplained, its reduction might mediate relevant abnormalities. Prospective evaluations of long-term effects of different SGAs on adiponectin are needed., (Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.)
- Published
- 2015
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12. Schizoaffective disorder and metabolic syndrome: A meta-analytic comparison with schizophrenia and other non-affective psychoses.
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Bartoli F, Crocamo C, Caslini M, Clerici M, and Carrà G
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- Comorbidity, Humans, Metabolic Diseases epidemiology, Psychotic Disorders epidemiology, Schizophrenia epidemiology
- Abstract
People with psychotic disorders, including schizophrenia (SCZ), schizoaffective disorder (SD), or other non-affective psychoses (ONAP), have a higher risk of metabolic syndrome (MetS) than general population. However, previous meta-analyses failed to explore if people with SD are more likely to suffer from MetS than SCZ and ONAP. We carried out a systematic review and meta-analysis comparing rates of MetS in SD with those in SCZ or ONAP. We searched main electronic databases for relevant articles published up to January 2015, and for unpublished data, contacting corresponding authors, to minimize selective reporting bias. Odds ratios (ORs) based on random effects models, with 95% confidence intervals (CIs), and heterogeneity (I(2)), were estimated. We performed leave-one-out, quality-based, and subgroups analyses to check findings validity. Testing for publication bias, Egger's test estimates were reported. We included 7616 individuals (1632 with SD and 5984 with SCZ/ONAP) from 30 independent samples. SD, as compared with SCZ/ONAP, had a random-effect pooled OR (95%CI) for MetS of 1.41 (1.23-1.61; p < 0.001; I(2) = 5%). No risk of publication bias was found (p = 0.85). Leave-one-out, sensitivity, and subgroups analyses confirmed the association. To our knowledge, this is the first meta-analysis comparing MetS comorbidity between individuals with SD and those with SCZ or ONAP. SD subjects are more likely to suffer from MetS, with consistent findings across the studies included. However, the role of explanatory factors of this association, and the relative contribution of MetS subcomponents, deserve further research., (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Published
- 2015
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13. Plasma adiponectin levels in schizophrenia and role of second-generation antipsychotics: a meta-analysis.
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Bartoli F, Lax A, Crocamo C, Clerici M, and Carrà G
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- Humans, Adiponectin blood, Antipsychotic Agents adverse effects, Antipsychotic Agents therapeutic use, Schizophrenia blood, Schizophrenia drug therapy
- Abstract
Background: People with schizophrenia are more likely than general population to suffer from metabolic abnormalities, with second-generation antipsychotics (SGAs) increasing the risk. Low plasma adiponectin levels may lead to metabolic dysregulations but evidence in people with schizophrenia, especially for the role of SGAs, is still inconclusive., Objective: To compare plasma adiponectin levels between people with schizophrenia and healthy controls, and to estimate the relative effect of schizophrenia and SGAs on adiponectin., Methods: We performed a systematic review and meta-analysis of observational studies published up to 13 June 2014 in main electronic databases. Pooled standardized mean differences (SMDs) between index and control groups were generated. Appropriate subanalyses and additional subgroup analyses were carried out., Results: Data from 2735 individuals, 1013 with and 1722 without schizophrenia, respectively, were analysed. Schizophrenia was not associated with lower adiponectin levels (SMD of -0.28, 95%CI: -0.59, 0.04; p=0.09). However, individuals with schizophrenia taking SGAs had plasma levels significantly lower than controls (p=0.002), which was not the case of drug free/drug naïve subjects (p=0.52). As regards single antipsychotic drugs clozapine (p<0.001) and olanzapine (p=0.04)--but not risperidone (p=0.88)--were associated with adiponectin levels lower than controls., Conclusions: People with schizophrenia per se may not have levels of adiponectin lower than controls, though treatment with SGAs is associated with this metabolic abnormality. This bears clinical significance because of hypoadiponectinemia involvement in cardiovascular diseases, even if mechanisms whereby SGAs affect adiponectin remain unexplained. Longitudinal studies evaluating long-term effects of SGAs on adiponectin are needed., (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Published
- 2015
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14. Comorbid addiction and major mental illness in Europe: a narrative review.
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Carrà G, Bartoli F, Brambilla G, Crocamo C, and Clerici M
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- Community Mental Health Services organization & administration, Comorbidity, Diagnosis, Dual (Psychiatry), Europe epidemiology, European Union, Health Policy, Humans, Mental Disorders epidemiology, Mental Disorders therapy, Psychotic Disorders therapy, Schizophrenia therapy, Substance-Related Disorders rehabilitation, Psychotic Disorders epidemiology, Schizophrenia epidemiology, Substance-Related Disorders epidemiology
- Abstract
Background: Most evidence about comorbid addiction and major mental illness comes from the USA, since this literature remains relatively limited in many European countries. The purpose of this review was to examine prevalence, policies, and treatment systems of comorbid substance misuse and psychotic illness in Europe, illustrating differences and similarities with US findings., Methods: Based on computerized main databases searches, a narrative review was performed., Results: The availability of substances but also the social contexts in terms of individual and local issues are factors likely to explain different dual diagnosis prevalence rates in Europe as compared with the USA., Conclusions: Integrated models implemented following US example might perform differently within the context of well-established European Union (EU) community mental health services. Such programs would require additional resources and radical redesign of service delivery systems.
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- 2015
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15. Factors characterizing access and latency to first pharmacological treatment in Italian patients with schizophrenia, mood, and anxiety spectrum disorders.
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Dell'Osso B, Cremaschi L, Palazzo C, Suardi N, Spagnolin G, Camuri G, Benatti B, Oldani L, Dobrea C, Arici C, Pace G, Tiseo A, Nahum ES, Castellano F, D'Urso N, Clerici M, Primavera D, Carpiniello B, and Altamura AC
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- Adolescent, Adult, Age of Onset, Anxiety Disorders diagnosis, Anxiety Disorders psychology, Early Diagnosis, Female, Humans, Italy, Male, Middle Aged, Mood Disorders diagnosis, Mood Disorders psychology, Predictive Value of Tests, Psychiatric Status Rating Scales, Referral and Consultation, Risk Factors, Schizophrenia diagnosis, Schizophrenic Psychology, Surveys and Questionnaires, Time Factors, Young Adult, Anxiety Disorders drug therapy, Mood Disorders drug therapy, Patient Acceptance of Health Care, Schizophrenia drug therapy, Time-to-Treatment
- Abstract
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.
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- 2015
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16. The association between expressed emotion, illness severity and subjective burden of care in relatives of patients with schizophrenia. Findings from an Italian population.
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Carrà G, Cazzullo CL, and Clerici M
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- Educational Status, Female, Humans, Italy, Male, Middle Aged, Randomized Controlled Trials as Topic statistics & numerical data, Schizophrenia diagnosis, Time Factors, Cost of Illness, Expressed Emotion, Family psychology, Hospitalization statistics & numerical data, Schizophrenia nursing
- Abstract
Background: An appropriate understanding of the association between high-Expressed Emotion (EE) in family members of people with schizophrenia, patients' and relatives' correlates is needed to improve adaptation of psychoeducational interventions in diverse cultures. The aim of this study was to test the hypothesis that relatives designated as high EE would report higher subjective burden of care, and would be associated with objective variables that indicate greater illness severity i.e. number of previous hospitalizations and duration of illness., Methods: We performed secondary analyses of baseline data from a randomized controlled trial conducted in Italy., Results: High-EE relatives reported more subjective burden of care in disturbed behaviours and adverse effects areas, but did not perceive more deficits in social role performances. As regards illness severity characteristics, neither the number of previous hospital admissions nor the duration of illness was associated with high-EE. However, patients' previous psychosocial functioning, as measured by educational attainments, seems to protect the relative from high-EE status., Conclusion: There is a need for cross-cultural comparisons of the subjective experience of distress and burden among high EE carers as a target for intervention, aimed at reducing family stress as much as improving patient outcomes.
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- 2012
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17. And how shall we deal with adaptation and implementation of NICE schizophrenia guidelines in Italy?
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Carrà G, Lusignani GS, Sciarini P, Barale F, Marinoni A, and Clerici M
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- Humans, Italy, Guideline Adherence, Mental Health Services standards, Practice Guidelines as Topic standards, Schizophrenia therapy
- Published
- 2008
18. Ecological monitoring of emotional intensity, variability, and instability in individuals with schizophrenia spectrum disorders: Results of a multicentre study.
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Zarbo, Cristina, Zamparini, Manuel, Patrono, Alessandra, Calini, Cosima, Harvey, Philip D., Casiraghi, Letizia, Clerici, Massimo, Malvezzi, Matteo, Rocchetti, Matteo, Starace, Fabrizio, and de Girolamo, Giovanni
- Subjects
SCHIZOPHRENIA ,ENVIRONMENTAL monitoring ,PEOPLE with schizophrenia ,EMOTIONAL state ,MENTAL health personnel ,EMOTIONAL experience ,WELL-being - Abstract
Background: Evaluating emotional experiences in the life of people with Schizophrenia Spectrum Disorder (SSD) is fundamental for developing interventions aimed at promoting well‐being in specific times and contexts. However, little is known about emotional variability in this population. In DiAPAson project, we evaluated between‐ and within‐person differences in emotional intensity, variability, and instability between people with SSD and healthy controls, and the association with psychiatric severity and levels of functioning. Methods: 102 individuals diagnosed with SSD (57 residential patients, 46 outpatients) and 112 healthy controls were thoroughly evaluated. Daily emotions were prospectively assessed with Experience Sampling Method eight times a day for a week. Statistical analyses included ANOVA, correlations, and generalized linear models. Results: Participants with SSD, and especially residential patients, had a higher intensity of negative emotions when compared to controls. Moreover, all people with SSD reported a greater between‐person‐variability of both positive and negative emotions and greater intra‐variability of negative emotions than healthy controls. In addition, the emotion variability in people with SSD does not follow a linear or quadratic trend but is more "chaotic" if compared to controls. Conclusions: Adequate assessments of positive and negative emotional experiences and their time course in people with SSD can assist mental health professionals with well‐being assessment, implementing targeted interventions through the identification of patterns, triggers, and potential predictors of emotional states. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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19. High Rate of Discontinuation during Long-Acting Injectable Antipsychotic Treatment in Patients with Psychotic Disorders.
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Auxilia, Anna Maria, Buoli, Massimiliano, Caldiroli, Alice, Carnevali, Greta Silvia, Tringali, Agnese, Nava, Roberto, Clerici, Massimo, and Capuzzi, Enrico
- Subjects
PSYCHOSES ,TERMINATION of treatment ,PATIENT compliance ,ANTIPSYCHOTIC agents ,INDIVIDUALIZED medicine - Abstract
Treatment discontinuation is a major challenge in routine clinical settings. Despite poor adherence to antipsychotic medication, long acting injectable (LAI) formulations are an underutilized option in psychotic disorders. Recently, an earlier and broader use of LAIs has been emphasized. However, few studies have evaluated the factors associated with LAI antipsychotic discontinuation in ordinary clinical practice. The main purpose of the present study was, therefore, to identify the factors associated with LAI discontinuation in a real-world setting. Patients in treatment with LAI antipsychotics were recruited. A Cox regression analysis was applied considering a 12-month follow-up period. Moreover, a Kaplan-Meier survival analysis was applied to compare the single treatment LAI antipsychotic groups in terms of time to discontinuation. Our analysis showed an LAI discontinuation rate at 12 months, corresponding to 28.8%, with olanzapine and aripiprazole having a longer time to discontinuation compared to zuclopenthixol. The results of the present study can help clinicians with their choice of LAI antipsychotic according to patients' characteristics and in a context of precision medicine. Increasing knowledge about factors affecting discontinuation of LAI antipsychotics can improve the prescribing practices of these compounds. Individualized approaches may ameliorate long-term patients' treatment adherence, thus preventing the long-term disability caused by psychotic disorders. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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20. Quality of residential facilities in Italy: satisfaction and quality of life of residents with schizophrenia spectrum disorders.
- Author
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Martinelli, Alessandra, Killaspy, Helen, Zarbo, Cristina, Agosta, Sara, Casiraghi, Letizia, Zamparini, Manuel, Starace, Fabrizio, Rocchetti, Matteo, de Girolamo, Giovanni, Ruggeri, Mirella, DIAPASON consortium, Barlati, Stefano, Boero, Maria Elena, Cerveri, Giancarlo, Clerici, Massimo, D'Anna, Giulio, De Novellis, Antonio, Di Michele, Vittorio, Di Prisco, Pasquale, and Durbano, Federico
- Subjects
SCHIZOPHRENIA ,PSYCHOSOCIAL functioning ,QUALITY of life ,PEOPLE with schizophrenia ,SATISFACTION - Abstract
Background: Recovery and human rights promotion for people with Schizophrenia Spectrum Disorders (SSDs) is fundamental to provide good care in Residential Facilities (RFs). However, there is a concern about rehabilitation ethos in RFs. This study aimed to investigate the care quality of Italian RFs, the quality of life (QoL) and care experience of residents with SSD. Methods: Fourty-eight RFs were assessed using a quality assessment tool (QuIRC-SA) and 161 residents with SSD were enrolled. Seventeen RFs provided high intensity rehabilitation (SRP1), 15 medium intensity (SRP2), and 16 medium-low level support (SRP3). Staff-rated tools measured psychiatric symptoms and psychosocial functioning; user-rated tools assessed QoL and satisfaction with services. RFs comparisons were made using ANOVA and Chi-squared. Results: Over two-thirds patients (41.5 y.o., SD 9.7) were male. Seventy-six were recruited from SRP1 services, 48 from SRP2, and 27 from SRP3. The lowest QuIRC-SA scoring was Recovery Based Practice (45.8%), and the highest was promotion of Human Rights (58.4%). SRP2 had the lowest QuIRC-SA ratings and SRP3 the highest. Residents had similar psychopathology (p = 0.140) and functioning (p = 0.537). SRP3 residents were more employed (18.9%) than SRP1 (7.9%) or SRP2 (2.2%) ones, and had less severe negative symptoms (p = 0.016) and better QoL (p = 0.020) than SRP2 residents. There were no differences in the RF therapeutic milieu and their satisfaction with care. Conclusions: Residents of the lowest supported RFs in Italy had less severe negative symptoms, better QoL and more employment than others. The lowest ratings for Recovery Based Practice across all RFs suggest more work is needed to improve recovery. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
21. Family interventions for schizophrenia in Italy: randomized controlled trial
- Author
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Carrà, Giuseppe, Montomoli, Cristina, Clerici, Massimo, and Cazzullo, Carlo Lorenzo
- Published
- 2007
- Full Text
- View/download PDF
22. Neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio and platelet-lymphocyte ratio in non-affective psychosis: A meta-analysis and systematic review.
- Author
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Mazza, Mario Gennaro, Lucchi, Sara, Rossetti, Aurora, and Clerici, Massimo
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META-analysis ,PSYCHOSES ,MONOCYTES ,NEUTROPHILS ,LYMPHOCYTES ,SENSITIVITY analysis ,BLOOD platelets ,MONOCYTE lymphocyte ratio - Abstract
Objectives: Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) are inexpensive and reproducible biomarkers of inflammation. This is the first meta-analysis exploring the role of NLR, MLR and PLR in non-affective psychosis. Methods: Eight studies have been identified from the main electronic databases. Meta-analyses based on random-effects models have been carried out generating pooled standardised mean differences (SMDs) between non-affective psychotic patients and healthy controls (HCs). Results: Subjects with non-affective psychosis had a significant higher NLR and MLR as compared with HC (respectively SMD = 0.715; P < 0.001; I
2 =57.565% and SMD = 0.417; P = 0.001; I2 =65.754%), confirmed by heterogeneity-based sensitivity analysis. Subgroup analyses showed no differences in effect size across different study characteristics, including drug treatment status, diagnosis, and setting. Meta-regression showed that age influenced the relationship between non-affective psychosis and MLR. A trend of significance, not confirmed by heterogeneity-based sensitivity analysis, was observed in PLR with patients showing higher PLR than HC. Conclusions: Our meta-analysis supports the hypothesis that an inflammatory activation occurs in non-affective psychosis and inflammatory ratios, especially NLR and MLR, may be useful to detect this activation. [ABSTRACT FROM AUTHOR]- Published
- 2020
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23. Attitudes of Italian Psychiatrists Toward the Evaluation of Physical Comorbidities and Sexual Dysfunction in Patients With Schizophrenia. Implications for Clinical Practice.
- Author
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Monteleone, Palmiero, Amore, Mario, Cabassi, Aderville, Clerici, Massimo, Fagiolini, Andrea, Girardi, Paolo, Jannini, Emmanuele A., Maina, Giuseppe, Rossi, Alessandro, Vita, Antonio, and Siracusano, Alberto
- Subjects
PEOPLE with schizophrenia ,PEOPLE with mental illness ,COMORBIDITY ,MEDICAL care ,SEXUAL dysfunction ,MEDICAL personnel ,PSYCHIATRISTS - Abstract
Treatment guidelines for patients with schizophrenia recommend evaluating their risk of physical comorbidities, especially since these patients are known to have decreased life expectancy due to comorbidities. Therefore, to the authors' knowledge, this is the first national survey conducted to investigate how Italian psychiatrists deal with the risk of physical comorbidities and sexual dysfunction in patients with schizophrenia. A sample of 750 psychiatrists completed an ad hoc online survey investigating their decision making about performing blood tests, clinical and instrumental examinations, and scheduling follow-up appointments in relation to the different phases of the illness and possible pharmacological side effects. Compared to patients in therapeutic continuation, those diagnosed for the first time and those who received a therapeutic change were visited more frequently (every 15 to 17 days vs. every 40 days, respectively), and were more regularly prescribed blood tests and instrumental examinations (every 4.2 to 4.4 months vs. every 9 months, respectively). There was a high interest in the surveillance of cardiometabolic risk. In 54% of patients, prolactin testing was not requested before starting an antipsychotic. In terms of specialist referrals, only 5% of surveyed psychiatrists "never" sought for additional counseling. There was little attention given to sexual functioning assessment based on the survey results about patients' daily life and with regard to deciding to prescribe additional examinations. In fact, only up to 3% of psychiatrists reported assessing sexual functioning using specific psychometric tests. In summary, Italian psychiatrists describes themselves as careful healthcare providers for the physical illnesses of patients with schizophrenia but with several shortcomings. For instance, clinical attention toward patients' sexual and reproductive healthcare needs remains a challenge. Psychiatrists should take the lead for the integrated education, assessment, and care of medical needs of their patients with mental illness. Based on the results of this survey, the authors also believe that a future challenge for the management of patients with mental illness will be the classification of patients based on their risk of comorbidities, to help ensure optimal healthcare provision for those at greater risk of other illnesses. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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24. Patterns of Management of Patients With Dual Disorder (Psychosis) in Italy: A Survey of Psychiatrists and Other Physicians Focusing on Clinical Practice.
- Author
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Clerici, Massimo, de Bartolomeis, Andrea, De Filippis, Sergio, Ducci, Giuseppe, Maremmani, Icro, Martinotti, Giovanni, and Schifano, Fabrizio
- Abstract
Patients 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. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
25. Schizophrenia and psychosocial family intervention. A study on users' characteristics and one-year follow-up (Schizofrenia e intervento psicosociale sulle famiglie. Indagine sulle caratteristiche dell'utenza e follow-up ad un anno)
- Author
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CARRA', GIUSEPPE, CLERICI, MASSIMO, Cazzullo, CL, Carra', G, Clerici, M, and Cazzullo, C
- Subjects
schizophrenia ,schizofrenia ,family therapy, community psychiatry ,MED/25 - PSICHIATRIA ,intervento psicosociale familiare ,esito del trattamento - Abstract
Scopo - Valutare le caratteristiche sociodemografiche di un campione di 102 pazienti schizofrenici e dei loro familiari, i quali sono afferiti ad un servizio con programmi psicoeducativi diversificati. Individuare caratteristiche differenziali tra sottogruppi in funzione dell'adesione a diversi programmi di trattamento. Valutare longitudinalmente l'evoluzione psicosociale del paziente e la percezione del familiare ad un anno dal termine del trattamento. Disegno - Valutazione delle caratteristiche sociodemografiche di base di pazienti e familiari in funzione dell'adesione a 2 diversi gruppi psicoeducativi (informativo e di supporto) o della non-adesione {drop-out precoce) rispetto a un gruppo di controllo esterno di famiglie ‘non trattate’. Studio di follow-up ad 1 anno sulla situazione sia ‘oggettiva’ che ‘soggettiva’ di pazienti e familiari. Setting - Un'organizzazione privata con finalita sociali di psichiatri volontari, l'Associazione Ricerche sulla Schizofrenia di Milano. Principali misure utilizzate - Rilevazioni delle caratteristiche di pazienti e familiari, nei diversi livelli di trattamento, raccolte mediante cartelle standardizzate e confrontate con quelle dei gruppi di controllo. II Test t di Student a due code e stato usato per comparare alcuni dati sociodemografici. Le analisi del chi-square sono state usate per comparare i dati nominali. II test di Me Nemar e stato usato per seguire la significativita dei cambiamenti. Risultati - Alcune differenze preliminari nelle caratteristiche sociodemografiche devono essere confermate dall'ampliamento del campione, mentre vi sono differenze significative per differente decorso ed esito in un gruppo che segue un particolare tipo di intervento (gruppo informativo) sia per la performance oggettiva del paziente che per il benessere soggettivo della famiglia. Conclusioni - II trattamento psicoeducativo familiare mostra buone prospettive per famiglie interessate alia gestione della patologia schizofrenica e che sono in grado di formulare una richiesta di informazione e supporto. La valutazione longitudinale mostra interessanti modificazioni nei rapporti con il servizio pubblico e nello stato occupazionale soprattutto nei gruppo informativo. Questo ne dimostra l'importanza nella schizofrenia ‘acuta’, mentre un trattamento di sostegno conserva la sua utilita nelle condizioni croniche per ridurre il ‘carico’ dell'assistenza Aims - Evaluating socio-demographic characteristics of a sample of 102 schizophrenic patients and their relatives which got in touch with a facility with different psychoeducational treatments. Checking differential characteristics among subsamples according to the engaging to different treatment programs. Longitudinally evaluating both patient's psychosocial course and relative's perception 1 year after the end of such a treatment. Design - Assessment of patients and relatives sociodemographic characteristics, according to engaging in 2 different psychoeducative groups (informative and support) or not engaging (early drop-outs), matching Vs. an external control sample of «no-treated» families. One year follow-up study on patients and relatives both for «objective» and «subjective» conditions. Setting -A private social organization of voluntary psychiatrists, the Association for Research on Schizophrenia in Milan. Main outcome measures - Survey on characteristics of patients and relatives in different stage of treatment collected by standardized records and contrasted with those of comparison groups. Follow-up study by structured questionary. Student's two tailed t tests were used to compare some socio-demographic data. Chi-square analyses were used to compare nominal data. Mc Nemar test is used to follow significative changes. Results - Some preliminar differences in sociodemographic features, between different groups, are to be confirmed by increasing sample while there are interesting evidences for different course and outcome in a group following a particular kind of treatment (informative group) for both patient's objective performance and family subjective well-being. Conclusions - Psychoeducational family treatment shows good prospects for families interested to coping with schizophrenia and which are able to look for information and support. Longitudinal evaluation shows interesting changes in the relationship with public facilities and in the occupational status overall in the informative group. It proves its importance for «acute» schizophrenia, while a supportive treatment retains an usefulness in chronic ilnesses reducing the burden of care
- Published
- 1995
26. Comparative Italian-Hungarian Study of the psychosocial profiles of schizophrenic patients and their families
- Author
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Tényi T, Trixler, M, Hwerold, R, Bertrando, P, Cazzullo, CL, CLERICI, MASSIMO, Tényi, T, Trixler, M, Hwerold, R, Clerici, M, Bertrando, P, and Cazzullo, C
- Subjects
schizophrenia ,MED/25 - PSICHIATRIA ,family relations - Published
- 1995
27. Psychosocial profiles of a sample of schizophrenic patients and their families: the ARS experience
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CLERICI, MASSIMO, Bertrando, P, CARRA', GIUSEPPE, Doria, S, Cazzullo, CL, Clerici, M, Bertrando, P, Carra', G, Doria, S, and Cazzullo, C
- Subjects
schizophrenia ,MED/25 - PSICHIATRIA ,family therapy - Published
- 1993
28. Profili emotivi in famiglie di pazienti schizofrenici: studio italiano sull'emotività espressa
- Author
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Bertrando P, Beltz, J, Bressi, C, Farma, T, Invernizzi, G, Cazzullo, CL, CLERICI, MASSIMO, Bertrando, P, Beltz, J, Bressi, C, Clerici, M, Farma, T, Invernizzi, G, and Cazzullo, C
- Subjects
schizophrenia ,expressed emotion ,MED/25 - PSICHIATRIA ,family relations - Published
- 1991
29. The association between expressed emotion, illness severity and subjective burden of care in relatives of patients with schizophrenia. Findings from an Italian population.
- Author
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Carr…, Giuseppe, Cazzullo, Carlo, and Clerici, Massimo
- Subjects
SCHIZOPHRENIA ,DEPERSONALIZATION ,ECHOLALIA ,SCHIZOTYPAL personality disorder ,HOSPITAL care - Abstract
Background: An appropriate understanding of the association between high-Expressed Emotion (EE) in familymembers of people with schizophrenia, patients' and relatives' correlates is needed to improve adaptation ofpsychoeducational interventions in diverse cultures. The aim of this study was to test the hypothesis that relativesdesignated as high EE would report higher subjective burden of care, and would be associated with objectivevariables that indicate greater illness severity i.e. number of previous hospitalizations and duration of illness.Methods: We performed secondary analyses of baseline data from a randomized controlled trial conducted in Italy.Results: High-EE relatives reported more subjective burden of care in disturbed behaviours and adverse effectsareas, but did not perceive more deficits in social role performances. As regards illness severity characteristics,neither the number of previous hospital admissions nor the duration of illness was associated with high-EE.However, patients' previous psychosocial functioning, as measured by educational attainments, seems to protectthe relative from high-EE status.Conclusion: There is a need for cross-cultural comparisons of the subjective experience of distress and burdenamong high EE carers as a target for intervention, aimed at reducing family stress as much as improving patientoutcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
30. Expressed emotion and Milan systemic intervention: a pilot study on families of people with a diagnosis of schizophrenia.
- Author
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Bertrando, Paolo, Cecchin, Gianfranco, Clerici, Massimo, Beltz, Jutta, Milesi, Alessandra, and Cazzullo, Carlo L.
- Subjects
EMOTIONS ,PSYCHOLOGY ,SCHIZOPHRENIA ,PSYCHOSES ,SCHIZOTYPAL personality disorder ,PATHOLOGICAL psychology ,DIAGNOSIS ,DEPERSONALIZATION ,PSYCHIATRY - Abstract
This article presents the results of a pilot study carried out on families of people with a diagnosis of schizophrenia (high-frequency users of psychiatric services) using a standardized version of systemic family intervention based on the Milan Approach (‘Circular Interview’). We used expressed emotion (EE) to compare and assess two homogeneous samples of families, a treatment group (n = 10) and a control group (n = 8). We found that families participating in circular interviews showed a reduction in criticism, while 30% of their members with a diagnosis of schizophrenia relapsed. Families not receiving treatment showed no changes in EE levels, while 62.5% of their members with a diagnosis of schizophrenia relapsed. Although the difference in relapse rates is not statistically significant, these results justify further studies on the use of nondirective systemic intervention with families of people with a diagnosis of schizophrenia. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
31. Modelli d'intervento psicoeducativi ed informativi in familiari di pazienti schizofrenici. I. Esperienze ed orientamenti attuali
- Author
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CLERICI, MASSIMO, Bertrando, P, Bressi, C, Albertini, E, Donatini, L, Cazzullo, CL, Clerici, M, Bertrando, P, Bressi, C, Albertini, E, Donatini, L, and Cazzullo, C
- Subjects
schizophrenia ,MED/25 - PSICHIATRIA ,family therapy - Published
- 1989
32. Acute variations of cytokine levels after antipsychotic treatment in drug-naïve subjects with a first-episode psychosis: A meta-analysis.
- Author
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Capuzzi, Enrico, Bartoli, Francesco, Crocamo, Cristina, Clerici, Massimo, and Carrà, Giuseppe
- Subjects
- *
PSYCHOSES , *PSYCHIATRIC treatment , *ANTIPSYCHOTIC agents , *CYTOKINES , *IMMUNOLOGIC diseases , *IMMUNOMODULATORS , *META-analysis - Abstract
Schizophrenia is likely to be associated with immunological abnormalities. However, antipsychotics may induce immunomodulatory effects, by influencing plasma cytokines. In order to distinguish these influences, we carried out a systematic review and meta-analysis exploring the acute effect of antipsychotics on candidate cytokines plasma levels (IL-1β, IL-2, IL-6, IL-17, IFN-γ, TNF-α) among drug-naïve subjects with first episode psychosis. We searched main Electronic Databases, identifying eight studies meeting our inclusion criteria. Plasma cytokines values were used to estimate standardized mean differences. Heterogeneity across studies was evaluated using the I 2 index and controlled in relevant sensitivity analyses. IL-2 (p = 0.023) and IL-6 (p = 0.012) levels showed a significant decrease after four weeks of antipsychotic treatment. Relevant sensitivity analysis confirmed these findings. IL-1β had high between-study heterogeneity. However, leaving out one study, a significant decrease after treatment was found. IL-6 and IL-2, and possibly IL-1β, could be considered state markers, decreasing after antipsychotic treatment, whilst TNF-α, IL-17, and IFN-γ might be considered trait markers. Options for novel treatments in FEP, involving cytokine-modulating agents, should be further studied. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
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