Primary Care Psychiatry in Italy

Berardi, Domenico; Ferrannini, Luigi; Menchetti, Marco; Vaggi, Marco

doi:10.1097/nmd.0000000000000145

Cited by 15 publications

(17 citation statements)

References 18 publications

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“…However, despite the fact that, in UK, GPs often have the primary responsibility for treatment of PWS and for referral when their condition becomes more complicated, the need of extending GPs' training in mental illness to improve support for PWS managed by primary care has been recently outlined (The Schizophrenia Commission, 2012). In Italy, one of the countries with the longest experience of community care, the importance of integrating primary care and mental health services has only recently been acknowledged (Berardi et al, 2014). In the absence of specific national government health policies, only two Regions have implemented explicit policies of integration between mental health services and primary care in Italy (Berardi et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…In Italy, one of the countries with the longest experience of community care, the importance of integrating primary care and mental health services has only recently been acknowledged (Berardi et al, 2014). In the absence of specific national government health policies, only two Regions have implemented explicit policies of integration between mental health services and primary care in Italy (Berardi et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

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General practitioners’ beliefs about people with schizophrenia and whether they should be subject to discriminatory treatment when in medical hospital: The mediating role of dangerousness perception.

Magliano¹,

Punzo²,

Strino³

et al. 2017

American Journal of Orthopsychiatry

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This study explored the relationships between General Practitioners' (GPs) beliefs about People With Schizophrenia (PWS) and GPs' recommendations regarding restrictions for such people when in medical (nonpsychiatric) hospital, and whether these relationships were mediated by dangerousness perception. Three-hundred twenty-two randomly selected ….. GPs completed a questionnaire measuring beliefs about PWS. Structural EquationModel (SEM) was used to explore the effects of these beliefs on the GPs' views about the need for restrictive rules in hospital. Thirty-one percent of GPs firmly believed that, in medical wards, PWS should be supervised and 18% that they should be separated from other patients. SEM revealed that belief in such differential treatment was positively related to a belief that PWS need medication for the rest of their lives, and to perceptions of others' need for social distance, and of dangerousness. Dangerousness was, in turn, positively related to the belief that PWS need medication for their lives, and to a perception of the need for social distance, but negatively related to perceived capacity to report health problems. Analyses of indirect effects showed that the relationships of belief in discriminatory treatment with belief in medication for life and with perceived social distance were mediated by perceived dangerousness. GPs' attitudes about PWS appear closely with their beliefs on discriminatory behaviours in hospital, and the mediating role of dangerousness perceptions. Providing GPs with education about schizophrenia treatments and prognosis, and countering stereotypes about dangerousness, could be helpful to reduce GPs beliefs in the need for discriminatory treatment of PWS.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

General practitioners’ beliefs about people with schizophrenia and whether they should be subject to discriminatory treatment when in medical hospital: The mediating role of dangerousness perception.

Magliano¹,

Punzo²,

Strino³

et al. 2017

American Journal of Orthopsychiatry

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“…Recruitment took place in the context of an established regional psychiatric consultation—liaison program (PCLP) between the mental health and primary care departments in four study centers. PCPs identified and preselected individuals aged 65–85 based on three concomitant criteria: clinically depressed, physical condition compatible with exercising, and sedentary.…”

Section: Methodsmentioning

confidence: 99%

“…The SEEDS study was a multicenter, single-blind, randomized trial that examined the effectiveness of PE as an adjunct to ADs for the treatment of individuals in primary care with LLMD. 13 Recruitment took place in the context of an established regional psychiatric consultation-liaison program (PCLP) between the mental health and primary care departments 14,15 in four study centers. PCPs identified and preselected individuals aged 65-85 based on three concomitant criteria: clinically depressed, physical condition compatible with exercising, and sedentary.…”

Section: Seeds Studymentioning

confidence: 99%

Physical Exercise for Late‐Life Depression: Customizing an Intervention for Primary Care

Zanetidou¹,

Murri

Menchetti

et al. 2016

J American Geriatrics Society

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OBJECTIVES:To identify which individual-and contextrelated factors influence the translation into clinical practice of interventions based on physical exercise (PE) as an adjunct to antidepressants (AD) for the treatment of latelife major depression (LLMD). DESIGN: Secondary analysis of a randomized controlled trial. SETTING: Primary care with psychiatric consultation-liaison programs (PCLPs)-organizational protocols that regulate the clinical management of individuals with psychiatric disorders. PARTICIPANTS: Individuals aged 65 and older with major depression according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (N = 121). INTERVENTION: Participants with LLMD were randomized to AD (sertraline) or AD plus PE (AD + PE). MEASUREMENTS: Participant characteristics that were associated with greater effectiveness of AD + PE (moderators) were identified, and effect sizes were calculated from success rate differences. Whether the characteristics of the study setting influenced participant flow and attendance at exercise sessions was then explored, and primary care physicians (PCPs) were surveyed regarding their opinions on PE as a treatment for LLMD. RESULTS:The following participant characteristics were associated with greater likelihood of achieving remission from depression with AD + PE than with AD alone: aged 75 and older (effect size 0.32), polypharmacy (0.35), greater aerobic capacity (0.48), displaying psychomotor slowing (0.49), and less-severe anxiety (0.30). The longer the PCLP had been established at a particular center, the more individuals were recruited at that center. After participating in the study, PCPs expressed positive views on AD + PE as a treatment for LLMD and were more likely to use this as a therapeutic strategy. CONCLUSIONS: The combination of PE and sertraline could improve the management of LLMD, especially when customized for individuals with specific clinical features. Liaison programs might influence the implementation of similar interventions in primary care, and PCPs viewed them positively. J Am Geriatr Soc 65: 348-355, 2017.

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“…Berardi et al, 2014 report on the pilot experiences of collaboration between primary care and psychiatry in Bologna and Verona in the 1990s, which would then give rise to a number of programs throughout the peninsula. Berardi et al, 2014 report on the pilot experiences of collaboration between primary care and psychiatry in Bologna and Verona in the 1990s, which would then give rise to a number of programs throughout the peninsula.…”

mentioning

confidence: 99%