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1. Factors associated with first- versus second-generation long-acting antipsychotics prescribed under ordinary clinical practice in Italy.

Author

Giovanni Ostuzzi, Maria Angela Mazzi, Samira Terlizzi, Federico Bertolini, Andrea Aguglia, Francesco Bartoli, Paola Bortolaso, Camilla Callegari, Mariarita Caroleo, Giuseppe Carrà, Mariangela Corbo, Armando D'Agostino, Chiara Gastaldon, Claudio Lucii, Fabio Magliocco, Giovanni Martinotti, Michela Nosé, Edoardo Giuseppe Ostinelli, Davide Papola, Marco Piero Piccinelli, Alberto Piccoli, Marianna Purgato, Tommaso Tabacchi, Giulia Turrini, Mirella Ruggeri, Corrado Barbui, and STAR Network Investigators

Subjects
Medicine, Science
Abstract

BACKGROUND:For many years, long-acting intramuscular (LAI) antipsychotics have been prescribed predominantly to chronic and severe patients, as a last resort when other treatments failed. Recently, a broader and earlier use of LAIs, particularly second-generation LAIs, has been emphasized. To date, few studies attempted to frame how this change in prescribing took place in real-world practice. Therefore, this study aimed to describe the clinical features of patients prescribed with LAIs, and to explore possible prescribing differences between first- and second-generations LAIs under ordinary clinical practice in Italy. METHODS:The STAR Network "Depot" Study is an observational, longitudinal, multicenter study involving 35 centers in Italy. In the cross-sectional phase, patients prescribed with LAIs were consecutively recruited and assessed over a period of 12 months. Descriptive statistics and multivariable logistic regression analyses were employed. RESULTS:Of the 451 recruited patients, 61% were males. The level of social and working functioning was heterogeneous, as was the severity of disease. Seventy-two per cent of the patients had a diagnosis of the schizophrenia spectrum. Seventy per cent were prescribed with second-generation antipsychotic (SGA) LAIs (mostly paliperidone, aripiprazole and risperidone). Compared to first-generation antipsychotic (FGA) LAIs, patients prescribed with SGA LAIs were more often younger; employed; with a diagnosis of the schizophrenia spectrum or bipolar disorder; with higher levels of affective symptoms; with fewer LAI prescriptions in the past. DISCUSSION:LAIs' prescribing practices appear to be more flexible as compared to the past, although this change is mostly restricted to SGA LAIs.

Published
2018
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3. Comparing 1-year effectiveness and acceptability of once-monthly paliperidone palmitate and aripiprazole monohydrate for schizophrenia spectrum disorders: Findings from the STAR Network Depot Study

Author

Francesco Bartoli, A, Daniele Cavaleri, A, Tommaso Callovini, A, Ilaria Riboldi, A, Cristina Crocamo, A, Armando D’Agostino, B, Giovanni Martinotti, C, Federico Bertolini, D, Giovanni Ostuzzi, D, Corrado Barbui, D, Giuseppe Carr`a, A, STAR Network Depot Investigators, Corrado, Barbui, Federico, Bertolini, Filippo, Boschello, Chiara, Gastaldon, Maria Angela Mazzi, Michela, Nos´e, Giovanni, Ostuzzi, Davide, Papola, Giovanni, Perini, Alberto, Piccoli, Michela, Pievani, Marianna, Purgato, Mirella, Ruggeri, Federico, Tedeschi, Samira, Terlizzi, and Giulia Turrini (Verona), Mariarita, Caroleo, Pasquale De Fazio, Fabio, Magliocco, and Gaetano Raffaele (Catanzaro), Simone, Cavallotti, Margherita, Chirico, Armando, D’Agostino, Farida, Ferrato, Ivan, Limosani, Daniele, Mastromo, Emiliano, Monzani, Edoardo Giuseppe Ostinelli, Matteo, Porcellana, and Francesco Restaino (Milano), Pasqua Maria Annese, Simone, Bolognesi, Massimiliano, Cerretini, Alberto De Capua, Sara, Debolini, Maria Del Zanna, Francesco, Fargnoli, Alessandra, Giannini, Livia, Luccarelli, Claudio, Lucii, Elisa, Pierantozzi, and Fiorella Tozzi (Siena), Francesco, Bardicchia, Giuseppe, Cardamone, Edvige, Facchi, Nadia, Magnani, and Federica Soscia (Grosseto), Bruno Biancosino, and Spyridon Zotos (Ferrara), Marzio, Giacomin, Francesco, Pompei, Mariangela, Spano, and Filippo Zonta (Treviso), Buzzi, ALDO EMANUELE, Callegari, Camilla, Roberta, Calzolari, Caselli, Ivano, Marcello, Diurni, Edoardo Luigi Giana, Ielmini, Marta, Anna, Milano, Emanuele, Sani, and Daniele Zizolfi (Varese), Gabrio, Alberini, Paola, Bortolaso, Sara, Cazzamalli, Chiara, Costantini, Angela Di Caro, Chiara, Paronelli, Silvia, Piantanida, and Marco Piccinelli (Varese Verbano), Papalini, Alessandro, Silva Veronica Barbanti, Chiara, D’Ippolito, Mauro, Gozzi, and Valentina Moretti (Reggio Emilia), Ornella, Campese, Mariangela, Corbo, Lucia Di Capro, Massimo di Giannantonio, Federica, Fiori, Marco, Lorusso, Valerio, Mancini, Giovanni, Martinotti, and Daniela Viceconte (Chieti), Carmela, Calandra, Maria, Luca, Maria Salvina Signorelli, and Francesco Suraniti (Catania), Beatrice, Balzarro, Giancarlo, Boncompagni, Valentina, Caretto, Roberta, Emiliani, Pasqualino, Lupoli, Marco, Menchetti, Eugenio, Rossi, Viviana, Storbini, Ilaria, Tarricone, and Laura Terzi (Bologna), Marianna, Boso, Cristina, Catania, Giuseppe De Paoli, and Paolo Risaro (Pavia), Flora, Aspesi, Francesco, Bartoli, Mattia, Bava, Adele, Bono, Giulia, Brambilla, Giuseppe, Carr`a, Gloria, Castagna, Sara, Lucchi, Roberto, Nava, Milena, Provenzi, Tommaso, Tabacchi, Martina, Tremolada, and Enrica Verrengia (Monza), Michela Barchiesi and Maria Ginevra Oriani (Ancona), Monica Pacetti (Forlì), Andrea, Aguglia, Maurizio, Ferro, and Lucio Ghio (Genova), Rossella, Beneduce, Laura, Laffranchini, Laura Rosa Magni, Giuseppe, Rossi, and Giovanni Battista Tura (Brescia), Lelio, Addeo, Giovanni, Balletta, Elisa De Vivo, Rossella Di Benedetto, and Vincenzo Fricchione Parise (Avellino), Bernardo Carpiniello and Federica Pinna (Cagliari), Damiano Pecile (Mantova), Chiara Mattei (Fermo), Tommaso, Bonavigo, Elisabetta Pascolo Fabrici, Sofia, Panarello, Giulia, Peresson, and Claudio Vitucci (Trieste), Francesco Gardellin, and Stefania Strizzolo (Vicenza), Edoardo, Cossetta, Carlo, Fizzotti, and Daniele Moretti (Savona), Luana Di Gregorio and Francesca Sozzi (Trento), Giuseppe Colli and Daniele La Barbera (Palermo), and Sabrina Laurenzi (Civitanova, Marche)., Bartoli, F, Cavaleri, D, Callovini, T, Riboldi, I, Crocamo, C, D'Agostino, A, Martinotti, G, Bertolini, F, Ostuzzi, G, Barbui, C, Carra, G, and Bartoli, F., Cavaleri, D., Callovini, T., Riboldi, I., Crocamo, C., D'Agostino, A., Martinotti, G., Bertolini, F., Ostuzzi, G., Barbui, C., Carrà, G., Boschello, F., Gastaldon, C., Mazzi, M.A., Nosé, M., Papola, D., Perini, G., Piccoli, A., Pievani, M., Purgato, M., Ruggeri, M., Tedeschi, F., Terlizzi, S., Turrini, G., Caroleo, M., De Fazio, P., Magliocco, F., Raffaele, G., Chirico, M., Ferrato, F., Limosani, I., Mastromo, D., Monzani, E., Ostinelli, E.G., Porcellana, M., Restaino, F., Annese, P.M., Bolognesi, S., Cerretini, M., De Capua, A., Debolini, S., Del Zanna, M., Fargnoli, F., Giannini, A., Luccarelli, L., Lucii, C., Pierantozzi, E., Tozzi, F., Bardicchia, F., Cardamone, G., Facchi, E., Magnani, N., Soscia, F., Biancosino, B., Zotos, S., Giacomin, M., Pompei, F., Spano, M., Zonta, F., Buzzi, A., Callegari, C., Calzolari, R., Caselli, I., Diurni, M., Giana, E.L., Ielmini, M., Milano, A., Poloni, N., Sani, E., Zizolfi, D., Alberini, G., Bortolaso, P., Cazzamalli, S., Costantini, C., Di Caro, A., Paronelli, C., Piantanida, S., Piccinelli, M., Alessandro, P., Barbanti, S.V., D'Ippolito, C., Gozzi, M., Moretti, V., Corbo, M., Di Capro, L., di Giannantonio, M., Fiori, F., Lorusso, M., Mancini, V., Viceconte, D., Calandra, C., Luca, M., Signorelli, M.S., Suraniti, F., Balzarro, B., Boncompagni, G., Caretto, V., Emiliani, R., Lupoli, P., Menchetti, M., Rossi, E., Storbini, V., Tarricone, I., Terzi, L., Boso, M., Catania, C., De Paoli, G., Risaro, P., Aspesi, F., Bava, M., Bono, A., Brambilla, G., Castagna, G., Lucchi, S., Nava, R., Provenzi, M., Tabacchi, T., Tremolada, M., Verrengia, E., Barchiesi, M., Oriani, M.G., Aguglia, A., Ferro, M., Ghio, L., Beneduce, R., Laffranchini, L., Magni, L.R., Rossi, G., Tura, G.B., Addeo, L., Balletta, G., De Vivo, E., Di Benedetto, R., Parise, V.F., Carpiniello, B., Pinna, F., Pecile, D., Mattei, C., Bonavigo, T., Fabrici, E.P., Panarello, S., Peresson, G., Vitucci, C., Pacetti, M., Gardellin, F., Strizzolo, S., Cossetta, E., Fizzotti, C., Moretti, D., Di Gregorio, L., Sozzi, F., Colli, G., La Barbera, D., Laurenzi, S.

Subjects
Long-acting injectable antipsychotic, Paliperidone palmitate 1-month, Aripiprazole, Aripiprazole monohydrate, Long-acting injectable antipsychotics, Psychiatry and Mental health, Paliperidone Palmitate, Schizophrenia, Humans, Prospective Studies, Settore MED/25 - Psichiatria, Biological Psychiatry, Antipsychotic Agents
Abstract

In this prospective study, we assessed the effectiveness and acceptability of paliperidone palmitate 1-month (PP1M) and aripiprazole monohydrate (AM) over 1-year follow-up. We included 195 subjects (117 treated with PP1M and 78 with AM) with schizophrenia spectrum disorders from real-world settings. We estimated no differences in hospitalization (Odds Ratio=1.59; p = 0.12), symptoms improvement (p = 0.90 adjusted for baseline severity), and discontinuation (Hazard Ratio=0.72; p = 0.20) at study endpoint. Although current evidence suggests the possible superiority of AM over PP1M, our findings showed comparable effectiveness between these drugs. Additional studies in real-world settings with direct comparisons between these two LAIs are needed.

Published
2022

4. The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

Author

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

Subjects
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.

Published
2021

5. Association between depression and neuropathy in people with type 2 diabetes: a meta-analysis

Author

Cristina Crocamo, Tommaso Tabacchi, Giuseppe Carrà, Davide La Tegola, Daniele Carretta, Massimo Clerici, Pierluigi Gamba, and Francesco Bartoli

Subjects
medicine.medical_specialty, business.industry, 030209 endocrinology & metabolism, Publication bias, Odds ratio, Type 2 diabetes, medicine.disease, Confidence interval, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, Meta-analysis, Internal medicine, Diabetes mellitus, medicine, 030212 general & internal medicine, Geriatrics and Gerontology, business, Association (psychology), Psychiatry, Depression (differential diagnoses)
Abstract

Objective Depression and neuropathy are frequent complications of type 2 diabetes. The current meta-analysis aimed to estimate the association between depression and neuropathy in subjects with type 2 diabetes. Methods We systematically searched electronic databases for articles published up to February 2015, providing data on the association between depression and neuropathy in individuals with type 2 diabetes. No language restrictions were applied. The meta-analysis generated random-effect odds ratios with 95% confidence intervals (95% CI). Risk of publication bias and heterogeneity were estimated using the Egger test and I2 index, respectively. Leave-one-out analysis was performed. Data were analysed using stata. Results Thirteen studies were included in the meta-analysis. Data on the association between depression and neuropathy were available for 3898 individuals with type 2 diabetes. Pooled analysis showed an association between depression and neuropathy, with an odds ratio of 2.01 (95% CI: 1.60–2.54; p 65 years) showed a slightly higher estimate for the association. Conclusions We found an association between depression and neuropathy among people with type 2 diabetes. Because of the cross-sectional nature of included studies, the relationship between these two conditions might be bidirectional. Further research exploring factors that might moderate or mediate this association is needed. Targeted interventions for comorbid depression and neuropathy should be implemented in clinical practice. Copyright © 2015 John Wiley & Sons, Ltd.

Published
2016
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6. Adjunctive second-generation antipsychotics for specific symptom domains of schizophrenia resistant to clozapine: A meta-analysis

Author

Cristina Crocamo, Giovanni Esposito, Enrica Verrengia, Massimo Clerici, Francesco Bartoli, Giuseppe Carrà, Tommaso Tabacchi, Carmen Di Brita, Bartoli, F, Crocamo, C, DI BRITA, C, Esposito, G, Tabacchi, T, Verrengia, E, Clerici, M, and Carrà, G

Subjects
medicine.medical_specialty, Drug Resistance, Placebo, law.invention, Antipsychotic, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, Humans, Meta-analysi, Clozapine, Biological Psychiatry, Randomized Controlled Trials as Topic, business.industry, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, Tolerability, Strictly standardized mean difference, Schizophrenia, Meta-analysis, Drug Therapy, Combination, Schizophrenic Psychology, Biological psychiatry, business, 030217 neurology & neurosurgery, medicine.drug, Antipsychotic Agents
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; I2 = 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.

Published
2018

7. Area-Level Deprivation and Adverse Consequences in People With Substance Use Disorders: Findings From the Psychiatric and Addictive Dual Disorder in Italy (PADDI) Study

Author

Paola Borrelli, Giuseppe Carrà, Ioana Popa, Cristina Montomoli, Francesco Bartoli, Massimo Clerici, Cristina Crocamo, Tommaso Tabacchi, Carra', G, Crocamo, C, Borrelli, P, Tabacchi, T, Bartoli, F, Popa, I, Montomoli, C, and Clerici, M

Subjects
Adult, Male, medicine.medical_specialty, Health (social science), Adolescent, Substance-Related Disorders, media_common.quotation_subject, Medicine (miscellaneous), Poison control, Substance use disorder, Suicide prevention, hepatiti, Occupational safety and health, socioeconomic status, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Risk Factors, Poverty Areas, Injury prevention, medicine, Humans, 030212 general & internal medicine, Psychiatry, Socioeconomic status, media_common, Aged, business.industry, Addiction, Public Health, Environmental and Occupational Health, Human factors and ergonomics, Middle Aged, medicine.disease, Hepatitis B, Hepatitis C, 030227 psychiatry, Substance abuse, Psychiatry and Mental health, Cross-Sectional Studies, Logistic Models, Italy, Socioeconomic Factors, Female, Crime, prison, Drug Overdose, overdose, business
Abstract

Background: Environmental factors may operate with individual ones to influence the risk of substance use. Research has focused on severe adverse consequences influenced by contextual variables. However, the literature on community level factors influencing substance use behaviors is relatively limited across Europe so far. Objective: We capitalized on data from a National survey, exploring individual and contextual characteristics, to study adverse consequences among people with substance use disorders. Methods: The impact of area-level deprivation on nonfatal overdose, hepatitis C or B infections, and major involvement with the criminal justice system, was explored. Logistic regression models with cluster-robust errors, modeling subject-level and area-level effects, were used. Results: Living in deprived and intermediate areas, as compared with affluent ones, was associated with greater likelihood of both nonfatal overdose and jail sentences longer than 6 months, though not of active viral hepatitis. Conclusions: Area-level deprivation may play an important role in determining adverse consequences in people with substance use disorders, also after controlling for individual-level characteristics. More research is needed to understand the aspects of social and physical environments that matter for drug outcomes before effective policy and research interventions can be developed.

Published
2017

8. Engagement in the Overdose RIsk InfOrmatioN (ORION) e-health tool for opioid overdose prevention and self-efficacy : a preliminary study

Author

Cristina Crocamo, Norbert Scherbaum, Julia Neufeind, Gerald Michael Humphris, Francesco Bartoli, Giuseppe Carrà, Alex Baldacchino, Tommaso Tabacchi, Carrà, G, Crocamo, C, Humphris, G, Tabacchi, T, Bartoli, F, Neufeind, J, Scherbaum, N, Baldacchino, A, University of St Andrews. School of Medicine, University of St Andrews. WHO Collaborating Centre for International Child & Adolescent Health Policy, University of St Andrews. Health Psychology, University of St Andrews. St Andrews Sustainability Institute, University of St Andrews. Population and Behavioural Science Division, and University of St Andrews. Centre for Minorities Research (CMR)

Subjects
Male, Denmark, Medizin, 030508 substance abuse, 0302 clinical medicine, RA0421, Risk Factors, RA0421 Public health. Hygiene. Preventive Medicine, Germany, Systematic risk, Medicine, 030212 general & internal medicine, Applied Psychology, Communication, General Medicine, Middle Aged, Self Efficacy, Telemedicine, Computer Science Applications, Treatment Outcome, Italy, Scale (social sciences), Female, Medical emergency, Smartphone, overdose, 0305 other medical science, self-efficacy, Adult, medicine.medical_specialty, Social Psychology, Adolescent, NDAS, Dysfunctional family, Drug overdose, Risk Assessment, 03 medical and health sciences, Young Adult, SDG 3 - Good Health and Well-being, Patient Education as Topic, Humans, Psychiatry, Estimation, Self-efficacy, business.industry, Public health, Opioid overdose, medicine.disease, Opioid-Related Disorders, T Technology, United Kingdom, Human-Computer Interaction, e-Health, opioid, Drug Overdose, business
Abstract

Increasing awareness of, and information about, overdose risk is an appropriate approach in risk reduction. e-Health technology in substance use disorders is an opportunity to support behavioral changes related to public health concerns. The present study aimed to evaluate the short-term impact of an innovative e-health psychoeducational software, the Overdose RIsk InfOrmatioN (ORION) tool. The ORION programme provided relevant information to opioid-dependent individuals about the risk of suffering a drug overdose as a result of high risky and dysfunctional behaviors. Seven aggregate risk factors were identified through a systematic review and their outputs included in a risk estimation model. We recruited 194 opioid-dependent treatment-seeking individuals from the United Kingdom, Germany, Italy, and Denmark. All participants were given at study entry, and after their use of the software, the General Self-Efficacy (GSE) Scale. We found comparable pre- and post-ORION administration mean GSE scores (SD), 28.49 (5.50) and 28.32 (5.90), respectively (p = 0.297). However, there was an inverse correlation between the number of risk factors and reported levels of self-efficacy (p

Published
2017

9. NEUROACTIVE STEROID LEVELS AND PSYCHIATRIC AND ANDROLOGICAL FEATURES IN POST-FINASTERIDE PATIENTS

Author

Daniele Santi, Maria Letizia Fusco, Silvia Giatti, Roberto Cosimo Melcangi, Roberto Spezzano, Manuela Simoni, Maria Grimoldi, Guido Cavaletti, Giuseppe Carrà, Donatella Caruso, Silvia Diviccaro, Tommaso Tabacchi, Melcangi, R, Santi, D, Spezzano, R, Grimoldi, M, Tabacchi, T, Fusco, M, Diviccaro, S, Giatti, S, Carrà, G, Caruso, D, Simoni, M, and Cavaletti, G

Subjects
Male, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Severity of Illness Index, Biochemistry, chemistry.chemical_compound, 5-alpha Reductase Inhibitors, 0302 clinical medicine, Endocrinology, Erectile Dysfunction, Testosterone, Longitudinal Studies, Prospective Studies, Progesterone, Pudendal Neuralgia, Incidence, Finasteride, Diagnostic and Statistical Manual of Mental Disorders, Italy, Pregnenolone, Dihydrotestosterone, Molecular Medicine, Drug Monitoring, 5α-reductase, erectile dysfunction, major depressive disorder, pregnenolone, progesterone, testosterone, medicine.drug, Adult, medicine.medical_specialty, Neuroactive steroid, Dehydroepiandrosterone, 030209 endocrinology & metabolism, Major depressive disorder, Young Adult, 03 medical and health sciences, Evoked Potentials, Somatosensory, Internal medicine, medicine, Humans, Psychiatry, Molecular Biology, Psychiatric Status Rating Scales, Depressive Disorder, Major, business.industry, Alopecia, 5α-Reductase, Cell Biology, medicine.disease, Pudendal Nerve, Hair loss, Erectile dysfunction, chemistry, Case-Control Studies, business, 030217 neurology & neurosurgery
Abstract

Recent reports show that, in patients treated with finasteride for male pattern hair loss, persistent side effects including sexual side effects, depression, anxiety and cognitive complaints may occur. We here explored the psychiatric and andrological features of patients affected by post-finasteride syndrome (PFS) and verified whether the cerebrospinal fluid (CSF) and plasma levels of neuroactive steroids (i.e., important regulators of nervous function) are modified. We found that eight out of sixteen PFS male patients considered suffered from a DSM-IV major depressive disorder (MDD). In addition, all PFS patients showed erectile dysfunction (ED); in particular, ten patients showed a severe and six a mild-moderate ED. We also reported abnormal somatosensory evoked potentials of the pudendal nerve in PFS patients with severe ED, the first objective evidence of a neuropathy involving peripheral neurogenic control of erection. Testicular volume by ultrasonography was normal in PFS patients. Data obtained on neuroactive steroid levels also indicate interesting features. Indeed, decreased levels of pregnenolone, progesterone and its metabolite (i.e., dihydroprogesterone), dihydrotestosterone and 17beta-estradiol and increased levels of dehydroepiandrosterone, testosterone and 5alpha-androstane-3alpha,17beta-diol were observed in CSF of PFS patients. Neuroactive steroid levels were also altered in plasma of PFS patients, however these changes did not reflect exactly what occurs in CSF. Finally, finasteride did not only affect, as expected, the levels of 5alpha-reduced metabolites of progesterone and testosterone, but also the further metabolites and precursors suggesting that this drug has broad consequence on neuroactive steroid levels of PFS patients.

Published
2017

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