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The Social Skill Training is structured as a cognitive-behavioral therapy for rehabilitation plans whereby the patient can develop and recover social skills.
To verify the effects of a literary workshop for increase assertiveness in patients with eating disorders.
Thirty-two patients consequently admitted to the Ward for Eating Disorders at the Private Clinic “Villa Maria Luigia” in the North of Italy were recruited in the study, and all of them agreed to take part in it. Of the 32 patients, 8 were randomly assigned to treatment and 24 to care as usual, being the difference between treatment and care as usual only represented by the literary workshop. The Rathus Assertiveness Schedule and Verbal Fluency Test (phonemic and semantic) was administered to all patients in the first and last week of hospitalization. The literary workshop consists in 16 weekly 45-minute group sessions. Issues of expressiveness through the use of writing are addressed during the sessions.
A significant improvement of semantic skills (t=-5.60; p< 0.01 vs. t=1.43; p=0.17), phonetic skills (t=-3.66; p< 0.01 vs. t=1.35; p=0.19) and assertiveness (t=4.47; p< 0.01 vs. t=0.94; p=0.93) was registered in the literary workshop group.
Effectiveness of the literary workshop in a rehabilitation program for patients suffering from eating disorders is suggested: improved communication and language skills might have a positive and significant impact on patients’ levels of assertiveness.
To evaluate psychiatric features in liver post transplant HIV recipients.
An observational study was conducted. Different psychiatric rating scales to evaluate cognitive status (MMSE), anxiety and depressive symptoms (HAM-A, HAM-D), social phobia (BSPS), quality of life (SF-36), sexual satisfaction (ISS), coping strategies (Brief Cope) and alcohol-drug abuse (LDQ) were submitted to a population of 11 HIV outpatients that underwent to OLT (19% of the Italian HIV transplant recipients). Scores were statistically related to socio-demographic and clinical data.
All patients were male, aged between 33 and 54 years. In the past 8 patients were drug abusers, three suffered from depression. At the moment of the evaluation 8 patients didn't suffer from any psychiatric disease while the three youngest patients presented a mild depressive status. BASIS-32 scores were related to HAM-D and to a history of drug abuse (p< 0.01). SF-36 was related to age (p< 0.05), HAM-D (p< 0.01), BSPS and BASIS 32 (p< 0.02).
Despite the higher risk for a HIV patient of developing an anxious or mood disorder, our population isn’t affected by psychiatric diseases; this is an encouraging data considering that post transplant period can be very stressful. This result may be due to a personality organization or a coping style strengthened by a long term disease such as HIV. Further studies are needed to investigate psychosocial outcome of OLT in HIV and to improve our knowledge of this controversial issue and guarantee a better take in care of these complex patients.
Common language is a mirror of culture and society. Death and mental illness are the human deepest and most ancient taboos, which both patients and professionals have to face in the medical world. Psychiatry has strong and circular connections with culture and society. The aim of this work was to collect and analyze expressions in colloquial language originally derived from psychiatric technical terminology.
A hundred and ten fifth-year medical students (M/F% = 42/58; mean age = 23.5 ± 3.1) attending their semester in psychiatry were asked to list as many expressions as possible of their everyday colloquial use which they thought referred to psychiatry. The terms were collected and analyzed critically.
A list of 150 espressions was drawn and then classified in the following categories: technical psychiatric terms; medical-neurological terms; psycoanalytic references; terms referring to abnormality and need for care; irrelevant terms. Though an overall good level of pertinence in the use of technical psychiatric terms was observed, these usually refer to common situations, both individual and happening to others. Often these locutions are used as jokes or offences.
Due to fears and prejudices evoked by psychiatric themes, an attempt on exorcising and taking distance leads to the use of psychiatric terms as potentially offensive and despising. This work suggests the need to work - especially in training settings - on filling the gap between common and medical languages and to analyze critically the contaminations as suggestive of very relevant cultural issues.
To construct and test the validity of a new psychometric questionnaire to assess psychological impact of facial lipoatrophy (ABCD-F), that is the most stigmatizing feature of HIV-related lipodystrophy.
Construction: The development went through Focus groups and Content Validity, Item reduction and Exploratory Factor Analysis.
Validation: ABCD-F questionnaire was administered together with ABCD and MOS HIV questionnaires. The Cronbach's Alfa was used to test internal consistency, while convergent validity and divergent validity were analyzed by the correlations with MOS, ABCD items and BMI and CD4 counts respectively.
42 HIV+ people participated to focus groups. In the EFA the 17 Items were aggregated around psychological distress and role functioning domains.
ABCD-F showed high internal consistency (Chronbach's alpha = 0.95). Both convergent and divergent validity were confirmed. ABCD-F scores were highly correlated to Physical Health Summary (B 0.59; 95% [CI] 0.35; 0.84; p< 0.0001), Mental Health Summary (B-1.54; 95% [CI] 1.15; 1.93; p< 0.0001), and weakly correlated to CD4 count (B-0.02; 95% [CI] -0.01; 0.06; p=0.54) and HIV viral load (B-0.004; 95% [CI] -2.69; 2.69; p=1.00).
ABCD-F is a valid and reliable questionnaire to assess psychological impact of facial lipoatrophy (FLA).
ABCD-F may result as a useful tool both in clinical and research settings: it's able to identify people experiencing greater psychological impact due to FLA. It may become an objective instrument to evaluate priority and efficacy of plastic surgery to treat lipodystrophy. In research setting may be used to compare different populations or different treatments of FLA.
To test the presence of significant correlations between psychopathological symptoms in patients with dementia and the stress perceived by the primary caregiver.
Primary caregivers of patients with a DSM-IV diagnosis of dementia admitted to the neuro-psycho-geriatric-rehabilitation ward of the private hospital “Villa Maria Luigia”, Parma - Italy, between May and November 2008 were asked to take part in the study. The NPI scale (UCLA Neuropsychiatric Inventory - Commings J.L. et al., 1994) and a socio-demographic data collection schedule were administered to the primary caregiver willing to be involved in the study.
Only 30 of the 40 eligible subjects agreed to take part to the study (75%). 35 significant correlations (according to Spearman's Correlation Index) were found. Those most highly significant (p< 0.001) were between stress perception and the following NPI symptom categories: delirium, hallucination, agitation, euphoria, apathy, disinhibition, aberrant physical activity and sleep disorders.
The psychopathological symptoms found to contribute mostly to distress of caregivers were those most showy and disruptive of behaviour; other symptoms, such as anxiety, depression, irritability and eating disorders are better tolerated as considered normal consequences of ageism. Interventions addressed to caregivers should provide them with detailed and structured coping instruments. Clear, therefore, the need for all health professionals, to structure an intervention aimed at caregivers characterized by two different phases:
1. To provide more tools to recognize those disorders which don’t emotionally involve them;
2. To give detailed, structured information useful to cope with these disorders in everyday life.
Drop-out from treatment for Eating Disorders is increasing (Campbell; 2007), and it is a risk factor for relapse and more chronic and severe course of the illness (Fassino et al.; 2009). Drop-out can be caused by interaction of concurrent, individual, familiar ad environmental factors (Sly; 2009).
Aim of the study
To examine possible risk factors of drop-out from inpatient treatment for eating disorders.
Materials and methods
The sample included 41 patients who voluntarily left the treatment before completion (’droppers’) and 88 patients who completed it (’completers’), in the period between 1st January 2006 and 31st December 2009 at Villa Maria Luigia Hospital (Monticelli Terme, PR, Italy). Patients were administered 2 self-report questionnaires and 3 psychometric tests: Eating Disorders Questionnaire, Predisposing, bringing on and maintaining risk factors for eating disorders, EDI-II, BUT, SCL-90.
Droppers appear to be more aggressive (p = 0.022), get worse scholastic results (p = 0.016) and have less friendships and less social interaction (p = 0.021). Parental break-up (p = 0.015), moving house (p = 0.006), father's death (p = 0.005), abortition (p = 0.040), father's alcohol abuse (p = 0.011) and a mother who suffers of eating disorder (p = 0.008) are more frequent in droppers than completers. Catholic religion seems to be a protective factor from drop-out (p = 0.005).
Drop-out is a multifactor phenomenon; identification of risk factors can improve treatment strategies and outcome.
The use of standardized tools for assessment and monitoring of a rehabilitation program is strongly recommended, though not so often accomplished in clinical practice.
To describe the development and feasibility of a computerised method of assessment of rehabilitation activities based on psychometrics.
The software “SVAROSKI” was implemented by means of a relational ER (Entity-Relationship) model with a user interface managed by MS-Access. The rehabilitation activities were: Physical therapy; Locomotion, Occupational Therapy and Reality-Orientation Therapy. Patients were administered at the beginning and at the end of admission the following tests: MMSE, MODA, Barthel Index, Tinetti.
The software enables processing of test data with those obtained from rating scales at each session.
For each patient, two graphical reports are made available:
Punctual performance of each item divided by subject areas;
Overall pace of the three scales assessing rehabilitation (physical therapy was maintained for an evaluation board, partly qualitative, for the sake of the physiotherapist of the structure).
The software allows:
1) the rapid storage of the scores obtained from patients during the course of rehabilitation activities,
2) the real-time consultation of the development of therapeutic and rehabilitation,
3) the comparison of the iteration of several rehabilitation interventions on the patient.
SVAROSKY is a useful tool for analysis and monitoring of developments in the rehabilitation of the patient as a valid tool for the development of a synthesis report of the rehabilitation process.
HIV testing is not yet a routine procedure in most mental health settings although adults with severe mental illness (SMI) are disproportionately affected by HIV/AIDS.
We focused our attention to explore if the appropriate care of patients with SMI may include a routine HIV testing offering and thus contribute to diagnose HIV-infected persons earlier in the course of their infection.
We present three case histories related to primary HIV diagnosis in patients presenting with different psychiatric disorders, admitted to Modena teaching Hospital in the passed two years.
Psychiatric symptoms delayed HIV diagnosis in all of the three reported cases.
The case histories here presented suggest that HIV testing is appropriate in the care of people with SMI, avoiding delay in HIV diagnosis with an obvious clinical benefit for the patient. Further studies are needed to assess the prevalence of HIV in those patients. These will be able to validate psychiatric diseases within a specific HIV indicator diseases list and help identifying a segment of the population in which HIV test must be routinely offered as a public health strategy, to face the burden of undiagnosed HIV infection.
Cardiac surgery is being performed more frequently in octogenarians with huge pressure on health care resources. Quality of Life (QoL) improvement should be the primary goal in this high-risk patients.
This study evaluates the feasibility of QoL assessment in octogenarians after cardiac surgery.
QoL was assessed by three self-administered psychometric tests: modified Seattle Angina Questionnaire, SF-36, and Hospital Anxiety and Depression Scale. QoL was evaluated after a mean time of 5.5 years after operation in 86 patients, and before and 6 months after surgery in 21 patients.
Retrospective evaluation of QoL showed absence of physical limitation in 50% of patients, treatment satisfaction in 80%, symptoms-free conditions in 62%, poor or absent disease perception in 94%, satisfactory wellbeing and enjoyment of life in 78%. QoL six-month variance analysis showed significant improvement in 4 of 5 modified SAQ domains (except of Treatment Satisfaction), 6 of 8 SF-36 domains (except of Emotional Role Limitation and Vitality), and in both depression and anxiety HADS subscales. However, test's self-administration failed, always necessitating physician and relatives’ help. Moreover, several questions showed to be unfit for this subset of patients.
Despite the emerged limitations using these tests, cardiac surgery seems to improve QoL in octogenarians with cardiac disease. After 5 years the prevalence of physical disability, cardiac symptoms and functional limitation due to cardiac symptoms, are comparable to the overall octogenarian population. QoL improvement appears more evident 6 months after the operation. New suitable tests are required for old patients.
A recovery-oriented mental health service system should focus on empowering people with mental illness.
Aim of the study
To analyse the feasibility of setting up a web-radio run by 13 subjects suffering from mental disorders.
Materials and methods
The patients involved in the project attended a one-year preparatory course promoted by the Province of Reggio Emilia, before the factual setting up of “Radio TAB”. After six months, each patient was asked to fill in a qualitative questionnaire addressing motivation and personal competences; opinions on the preparatory course; the identity of the radio, objectives and values shared by participants, the satisfaction they obtained from the activities and their vision of the radio then and for the future.
• great motivation for joining the project and holding on to it
• the preparatory course was judged to be effective to acquire technical, communication and interpersonal skills;
• expectations and objectives of participants were consistent with the values underpinning the radio and the outcomes of the project, suggesting good internal cohesion;
• a well-defined vision of the radio as a result of the work emerged, which will hopefully lead to setting up an actual workplace in future.
The experience of “Radio TAB” could be a good example of empowerment strategies, encouraging individuals to autonomy, reintegration and sense of active citizenship.
Cardiovascular disorders are the first cause of death among over-80 year-old patients and cardio-surgery is sometimes the one therapeutic option. No scientific assessment of Quality of Life (QoL) or other psycho-socially relevant consequences has been carried out. Aim of the study was to quantify and describe QoL on over-80 patients after cardio-surgery.
Study 1 was a one-arm cohort study on 192 subjects who underwent cardio-surgery between years 2003 and 2005 and were interviewed by phone 5 to 7 years after by means of SF-36 and the Seattle Angina Questionnaire, matching these with socio-demographics and clinical pre/post operative variables. Study 2 was a pre-post study on 21 subjects who underwent cardio-surgery in 2009-2010, who were interviewed face-to-face before the interventions and 6 months after, including assessment of anxiety and depression via the HADS.
Study 1 patients reported satisfaction with treatment in 80%, freedom from cardiac symptoms in 62% and overall well-being in 78% of cases. Study 2 patients reported statistically significant improvement of QoL (SF-36 mean total score 57.1 vs. 73.5, p = .001), clinical conditions and anxiety-depressive symptoms (p = .001 both for HADS-anxiety and HADS-depression).
Assessment of QoL and anxiety-depressive symptoms should be included in routine evaluation of elderly surgical patients, though the present study also suggested the need for improvement of methodology of interview, being phone-calling and traditional self-assessment psychometric instruments particularly inappropriate for this patient population.
Clozapine was administered to 28 resistant schizophrenics at psychiatric services in Bologna. At 26 weeks 62% responded. Positive and negative symptoms improved, but decrease of negative symptoms partially depended upon improvement of positive and EPS. No cases of agranulocytosis were seen. Some drop-outs were related to difficulties with psychopathological improvement.
There is evidence that women with breast cancer can develop anxiety and depression, ultimately affecting patients’ compliance and quality of life.
Previous studies investigated psychological distress in women with breast cancer at different stages of the disease. However, few data are available about Italian women in the early steps of their clinical history.
To investigate psychological distress, anxiety and depressive symptoms in a sample of women with a recent diagnosis of breast cancer.
This cross-sectional study involved twenty-five women consecutively attending the oncology outpatient clinic for their first oncology evaluation after surgery. Anxious and depressive symptomatology was assessed through the Hospital Anxiety and Depression Scale (HADS) and Distress Thermometer (DT). Socio-demographic and clinical characteristics were also collected. Correlations were analyzed using Spearman's correlation coefficient.
The mean values (±SD) of the HADS Anxiety and Depression Subscales were 7.6 (±4.7) and 5.7 (±4.4) respectively. Five patients (24%) scored ≥10 at the HADS Anxiety subscale and 16% scored ≥10 at the HADS Depression subscale, suggesting the presence of clinically relevant symptomatology. DT mean score (±SD) was 5.36 (±3.5), with 48% of patients scoring ≥7, indicative of significant psychological distress. Multivariate analysis showed an inverse correlation between psychological distress severity and time after cancer diagnosis.
These preliminary findings show a prevalence of anxious and depressive symptoms in one out four women with breast cancer. Further prosecution of the study will help to identify women at risk for psychiatric comorbidities, suggesting the development of targeted interventions.
The Metabolic Syndrome (MetS) is defined as a cluster of cardiometabolic risk factors affecting the same subject, when three out of the following five criteria are present: abdominal obesity, hypertriglyceridemia, low HDL cholesterol, hypertension, impaired glucose tolerance (or diagnosis of Type 2 Diabetes). Recent studies on the association between the MetS, depression and anxiety have reported conflicting findings; yet, clinically they are very frequently present in the same patient.
To review findings supporting the opportunity of considering the presence of depressive/anxiety symtoms as the “sixth criterion” of the Metabolic Syndrome.
Systematic review. A Medline search of the literature conducted on September 12th, 2012 (key words: metabolic syndrome, anxiety, depression) provided 148 references. A further temporal-limit of the search, taking into account only papers published in the last five years, provided 90 references. Finally, 16 studies were retained eligible for the present study.
Of 16 papers, 3 reported absolutely no association between MetS, depression and anxiety; 5 reported a significant correlation. As far as depression is concerned, 5 papers reported a correlation with MetS, 1 reported no correlation between MetS and the Major Depressive Disorder. As far as anxiety is concerned, 4 papers reported a significant correlation with MetS, 2 reported no correlation. The most reproducible finding was the correlation between anxious/depressive symptoms and the MetS (especially large waist circumference), when affecting women.
The presence of depression and/or anxiety could be considered the sixth criterion to diagnose the MetS in females with large waist circumference.
Multidimensional geriatric assessment is a functional, psychosocial and medical evaluation of an elderly patient. Such an approach improves function and survival in frail older patients, mostly in an outpatient setting. New RCTs suggest that the application of a multidisciplinary approach to the elderly should be applied to all the patients admitted to acute care hospitals. A model of integrated geriatric care is proposed, starting in the emergency room (ER) in an acute care hospital. The project will be developed over a 3 year period. A nurse case manager will work in the ER, evaluating all the patients aged over 75. She will provide the ER physician with information on functional and psychosocial status of the patient using standardized tests, and will contact primary care physician and the social workers to gather further information. In case of hospitalization, the case manager will evaluate possible occurring complications during the hospital stay and the outcome. Given the huge amount of hospitalizations among the geriatric patients, it is mandatory that the physicians are familiar with the fundaments of geriatric culture and principles of geriatric assessment and management. This issue will be addressed through a formative plan designed for physicians and nurses. End point of the pilot study is to reduce complications of hospitalization, improve patients function at hospital discharge, decrease nursing home admissions, reduce hospital inappropriate admissions and readmissions, reduce the mean length of hospital stay and health care system costs.
Project supported by grant RF-2009-1511459 Ministero della Salute assigned to Dr Alessandra Colantoni
The recent economic recession and the subsequent strategy of austerity have deceased the amount of resources devoted to health care. They may also have contributed to the deterioration of the population health.
To assess the impact on mental health of the economic recession in the district of Sassuolo (Modena), by collecting and analyzing opinions of local Occupational Physicians.
METHODS Qualitative survey, by focus groups, conducted in Sassuolo (Modena), industrial center of ceramics, involving 8 Occupational Physicians active in the area. Rough descriptions analyzed independently by GU and GM using MAXQDA, with the independent supervision of a third researcher (SF), according to the principles of the General Grounded Theory. The second focus groupwas intendened as respondent validationof the first, yet it gathered further data, up to theortical saturation.
Two focus groups, about one hour long, attended by 8 Occupational Physicians, 7 during the first focus group, 4 during the second (of these, 3 attending both focus groups). The coding process yielded 261 segments, divided into four main areas: “changes in contemporary world” (16 coded segments), “social area” (82 coded segments), “medical area” (94 coded segments), “working area” (69 coded segments).
The impact of the economic crisis on health produced mainly negative consequences, locally, consistently with national data. Psychiatrists should work together with Occupational Physicians to develop targeted interventions, addressing social, political and medical needs. A more structured liaisonbetween Psychiatry and Occupational Medicine is an interesting and useful tool for future action and advocacy.
There has been an increased interest on the role of urban security and fear of crime on mental health of the general population, but there are not studies about this among patients with minor psychiatric disorders.
Assess patients’ fear of crime and perceived urban insecurity.
1) evaluate the association between perceived urban insecurity and crime, and minor psychiatric disorders;
2) identify subgroups of patients with high levels of perceived urban insecurity and fear of crime.
A sample of 24 patients with depressive or anxiety disorders attending outpatient services was collected. Patients consenting to the study underwent a battery of psychometric instruments. This study is part of a national multicentric study that enrolled 426 subjects.
The sample was mainly composed by females (83%), cohabiting (58%), employed (54%). Patients were more frequently diagnosed with dysthymia (54%) had an average GAF score of 73 (SD=8,44), an average GHQ-12 of 17.33 (SD =3,95). 41% reported high level of insecurity or fear and 58% stated that their worries were increased compared to 10 years earlier. Reported reasons for this were mostly ‘decrease of social security’ and ‘loss of values’. 12.5% of the sample reported of having been victim of a theft or vandalism.
The results of this study are not only useful to understand the role of fear of crime in the onset and relapses of minor psychiatric disorders, but they can also help to plan psychiatrists’ and Public Health's interventions in order to prevent them.
Studying the pathways followed by psychiatric patients is important to plan both mental health services organization and training programmes for doctors and psychiatrists.
Detecting the main pathways-to-care followed by patients.
Finding the reasons why patients look for psychiatric help and the main responses given to patients’ problems by psychiatric services. Evaluating the delays occurring along the pathways.
The study has been done on 420 Italian patients. In one month, patients with a new episode of disease have been included. Each of them has been administered a questionnaire collecting socio-demographical, medical infos and data concerning health workers, timing and delays along the pathways. Diagnosis done using ICD-10 and an Intervention Detection Schedule filled for each patient.
The Carpi’s sample consists of 43 patients. The 58% has seen the General Practitioner (GP) in the first place, the 19% the hospital doctor (HD), the 16% the psychiatric worker. Nation-widely, most patients have firstly referred to the psychiatrist (34%). In Carpi, the 44% has received a diagnosis of “Neurotic, stress-related and somatoform disorders”. The 93% has been treated with psychotropic medications. The longest pathway has occurred for behavioural syndromes associated with physiological disturbances and physical factors, the shortest for affective disorders.
GP, HD and direct access are the 3 main pathways followed by patients. The importance of the GP is confirmed, so as the necessity for training of sanitary workers within the psychiatric field. A greater cooperation between general practice and mental health services should be pursued
A group of intercompany job is constituted from the DSMs of the ASLs of Biella (BI), Novara (NO), VCO, Vercelli (VC) and of the Psychiatric Clinic of the AOU of Novara (NO) finalized to the definition of relief runs for the patients with Eating Disorders (ED). Currently they result active 2 ambulatory devoted to the ED near NO and VCO. In the AOU NO a collaboration is active with the dietology and a daily DH with activity of group for patient with different diagnoses. To Borgosesia (VC) a project of promotion and prevention it is active in the secondary (course of formation for teachers, job with the students) schools. In the DSM NO it is active a program of food education in the schools. Patients affections from ED currently in load: AOU NO 47 (2 AN Purging, 5 AN Restrictive, 2 BED, 20 Bulimia, 18 EDNOS); DSM NO 15 (7 AN, 5 Bulimia, 3 EDNOS); DSM VCO 27 (10 AN, 5 Bulimia, 12 EDNOS); DSM VC 21 (5 AN Purging, 1 AN Restrictive, 6 Bulimia, 9 EDNOS); DSM Arona (NO) 13 (4 AN, 9 Bulimia); DSM BI 20 (8 AN, 8 Bulimia, 4 EDNOS). In the last two years the followings have been effected refuges in Therapeutics Community specific (CT) for ED: 3 near the CT to Moncrivello (VC) and 1 near the CT to Cuasso al Monte (VA). Besides the structures of the DSM they are present associations of relatives and volunteers (informative counter).
In Italy, 6 months of abstinence from alcohol/substances are required before OLT, evidence for this recommendation remaining controversial. No standard approach linking abstinence duration at the index psychiatric pre-OLT evaluation to referral to Community Services is followed.
To report data of the Modena Consultation-Liaison Psychiatric Service (MCLPS) for pre-OLT patients with Substance Use Disorders (SUDs), and to evaluate patients' concordance with referrals.
Case-control study. Data source: database of MCLPS. Psychiatric evaluations pre-OLT from 01/01/2008 to 31/12/2013 were extracted. Patients were controls if they had a SUD and abstinent for more than 6 months; cases if they had a SUD with less than 6 months of abstinence. Chi-squared analysis was performed with STATA 13.0.
515 consultations were requested for 309 pre-OLT patients, 36.3% (N=112) of patients had a current or past SUD. Controls were 80 (71.3%), while cases – who had stopped use less than 6 months before the consultation, or were still using- were 20 (17.9%). 52.5% of controls (N=42) and 85.0% of cases (N=17) were referred to community services (Chi 5.71; p=0.02). 70.0% of cases (N=14) and 33.6% of controls (N=27) were seen at least twice (Chi 7.22; p=0.01). 16.7% (N=2) of cases and 23.5 % (N=4) of controls referred to community services reported concordance with Consultant's recommendation at re-assessment, a non-significant difference with cases (Chi 0.00; p=1.00).
Consistently with previously research in this field, no difference of concordance with recommendations emerged between patients with SUD with different duration of abstinence.