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Incidence and predictive factors of non adherence to therapy in young adults attending a psycho social center in Milan: a retrospective observational “Real world” study

Published online by Cambridge University Press:  01 September 2022

S. Vanzetto ,
G. Cirnigliaro ,
E. Piccoli ,
S. Dagoberti ,
M. Vismara ,
B. Benatti ,
C. Viganò  and
B. Dell’Osso
S. Vanzetto*
Affiliation:
Luigi Sacco University Hospital, Psychiatry 2 Unit, ASST FBF-Sacco, University Of Milan, Milan, Italy
G. Cirnigliaro
Affiliation:
Luigi Sacco University Hospital, Psychiatry 2 Unit, ASST FBF-Sacco, University Of Milan, Milan, Italy
E. Piccoli
Affiliation:
Luigi Sacco University Hospital, Psychiatry 2 Unit, ASST FBF-Sacco, University Of Milan, Milan, Italy
S. Dagoberti
Affiliation:
“Luigi Sacco” Department of medicine and surgery, University Of Milan, Milan, Italy
M. Vismara
Affiliation:
Luigi Sacco University Hospital, Psychiatry 2 Unit, ASST FBF-Sacco, University Of Milan, Milan, Italy “Aldo Ravelli” Center for Nanotechnology and Neurostimulation”, University Of Milan, Milan, Italy
B. Benatti
Affiliation:
Luigi Sacco University Hospital, Psychiatry 2 Unit, ASST FBF-Sacco, University Of Milan, Milan, Italy “Aldo Ravelli” Center for Nanotechnology and Neurostimulation”, University Of Milan, Milan, Italy
C. Viganò
Affiliation:
Luigi Sacco University Hospital, Psychiatry 2 Unit, ASST FBF-Sacco, University Of Milan, Milan, Italy
B. Dell’Osso
Affiliation:
Luigi Sacco University Hospital, Psychiatry 2 Unit, ASST FBF-Sacco, University Of Milan, Milan, Italy “Aldo Ravelli” Center for Nanotechnology and Neurostimulation”, University Of Milan, Milan, Italy Department of Psychiatry and Behavioral Sciences, Stanford University, Milan, Italy “Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche”, University Of Milan, Milan, Italy
*
*Corresponding author.

Abstract

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Introduction

Non adherence to psychotropic drugs is associated with negative outcomes, including hospitalizations, aggressive behaviors, suicide attempts and increased premature mortality. It represents a psychiatric challenge, especially in young adults who show higher risk of non-adherence to treatment

Objectives

Firstly this study evaluates the incidence of non-adherence to therapy in 18-24 years patients from a Psycho-Social Center in Milan; and then to analyze the predictive factors of non-adherence.

Methods

In this retrospective “Real Life” observational study, 120 outpatients aged 18 to 24 years, from Psycho-social Center of L. Sacco University Hospital in Milan, were recruited in 2019. Non-adherence to treatment, according to the World Health Organization, was considered “a modality of assuming medications that does not correspond to healthcare professionals’ recommendations”. Statistical analysis were performed with chi-square, ANOVA and linear regression tests, setting significance to p<0.05.

Results

88 of 120 outpatients (73.3%) received an indication to psychopharmacological treatment. Of these, 23 (26.1%) did not show adherence to therapy. Results showed a positive association between non-adherence and increased hospitalizations (p <.01), oral antipsychotics (p<.05) and drop-out rates (p<.001). A significant correlation was also observed between non-adherence and Intellectual Disability (p<.05), Bipolar Disorder (p<.05), psychotic symptoms (p<.05), alterations in affectivity and mood (p<.005), alterations in sleep pattern (p<.05), school dropout (p<.05) and poor family support (p<.01).

Conclusions

This study confirms that non-adherence has a relevant incidence in young-adults psychiatric population, highlighting the importance of effective and structured assessment in clinical practice to identify predictive factors and risk profiles associated with this phenomenon.

Disclosure

No significant relationships.

Keywords

Adherence to treatmentPromotion of mental healthTerritorial psychiatryyoung adults
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S691
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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