Department of Neuroscience, Ophthalmology and Genetic, Psychiatry section, University of Genoa, Italy.
Early Interv Psychiatry. 2012 Aug;6(3):341-6. doi: 10.1111/j.1751-7893.2012.00340.x. Epub 2012 Feb 6.
To carry out an in-depth survey into the method of providing early intervention in schizophrenia in Italy and to evaluate the process of development of early psychosis clinical services following the pilot programme 'Programma 2000' and the publishing of Italian National Guidelines.
Topic-specific national and international clinical and research programmes, alongside national guidelines, were taken into consideration in order to create an ad hoc questionnaire. A telephone survey using this questionnaire was carried out. A randomized sample of 152 mental health centres (MHCs) were involved, equal to 21.5% of all Italian MHCs.
The process of nationwide diffusion of early psychosis clinical services in Italy is frustratingly slow. Italian MHCs, including a specialized service for early interventions in schizophrenia, are estimated at being between 20% and 30%. Most services adopt a generalist approach and more frequently follow guidelines drawn up within the centres than Italian National Guidelines, involve few patients and provide a high variability of treatment options. The distribution of these services in Italy is not homogenous and influenced by demographic factors.
Our data are consistent with worldwide literature showing a slow and variable implementation of early psychosis services in all nations. The main efforts to make these services diffused should be addressed to favour the process of localized adaptation to the guidelines, to demand possible and realistic implementation of the standard method, to stimulate policy endorsement and resources' allocation, and to particularly support the rural and the poorer zones.
深入调查意大利为精神分裂症提供早期干预的方法，并评估在“2000 计划”试点项目和意大利国家指南发布后，早期精神病临床服务的发展过程。
为创建专门的问卷，考虑了特定主题的国家和国际临床及研究计划以及国家指南。使用该问卷进行了电话调查。随机抽取了 152 个心理健康中心（MHC）作为样本，占意大利 MHC 的 21.5%。
意大利早期精神病临床服务的全国推广进程令人沮丧地缓慢。意大利 MHC，包括专门针对精神分裂症早期干预的服务，估计在 20%到 30%之间。大多数服务采用通才方法，更频繁地遵循中心制定的指南，而不是意大利国家指南，涉及的患者较少，并提供高度多样化的治疗选择。这些服务在意大利的分布不均匀，受人口因素影响。
我们的数据与全球文献一致，表明所有国家的早期精神病服务的实施都缓慢且存在差异。为了使这些服务得到普及，应主要努力促进指南的本地化适应过程，要求可能和现实地实施标准方法，鼓励政策支持和资源分配，并特别支持农村和贫困地区。
