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

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.

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.

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).

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.

No significant relationships.

To create an image of therapeutic options available for the first episode psychsis and the way these options influence the evolution of patients.

The present study is part of a larger follow-up study on a number of 121 patients with a diagnostic of first episode psychosis admitted in the Timisoara Psychiatric Clinic and The Day Clinic in the Timisoara Mental Health Center between 2003-2006 and prospectively monitored from the moment of their first contact with psychiatric services.

The average calculated duration of prodrome period and average Duration of Untreated Psychosis (DUP) are similar to the results indicated by most other studies. The results of statistical tests show that: the longest the prodrome, the worse the improvement of illness during course; a longer prodrome is correlated with a higher number of relapses during the patient's illness course and a longer Duration of Untreated Psychosis is likely to lead to an increased severity of illness. Patients’ adherence to treatment is influenced both by the traits of the first psychotic episode and the way the patients perceive the side effects and the general utility of the administered medication.

Psychiatrists have to dedicate more time and interest to establishing a therapeutic alliance with their patients with first episode psychosis; an individualized strategy is required to establish the adequate means and ways of intervention before initiating any type of therapy.