Strategie e modelli organizzativi per la gestione condivisa dalle Aziende Sanitarie dei servizi di supporto nelle Aziende sanitarie ed Ospedaliere

Objectives: The primary aim of this research was to evaluate the attention that Italian psychiatrists give to sleep disorders in their medical practice. The second was to study therapeutic choices to reduce sleep alterations with respect to primary psychiatric treatment. Method: The Italian Society of Psychopathology (SOPSI) and the Italian Association of Sleep Medicine (AIMS) have performed a cognitive investigation on 1,300 psychiatrists randomized for age, sex, seniority of service and geographic area. All the psy chiatrists answered a specific questionnaire prepared by SOPSI and AIMS. The 48 items (Figs. 1-48) of the questionnaire were selected and divided into five clusters with respect to the topics correlated to the sleep alterations in the most important and prevalent psychiatric disorders (schizophrenia, depressive disorder, anxiety disorders, bipolar disorder) and with respect to their pharmacological treatment. The survey was limited to the most important psychiatric diagnoses and to the main psychiatric pharmacological therapies to permit the best comparison between these findings and the relative data in the scientific literature. Results: Of the 1,330 psychiatrists, 1,246 answered the questionnaire (62% male, 38% female). No statistical differences were observed as far as concerns age; overall mean age was 45 years (male: 47 years; female: 43 years). The geographic area most represented was northern Italy (60%), 74% of the participants had qualified for the practice of psychia try in 1983 and in 1988 (Table I). Conclusions: This survey represents an interesting opportunity to establish how Italian psychia trists consider and treat sleep and psychiatric disorders. Results of the survey reveal excellent agreement of opinions among Italian psychiatrists. According to many participants sleep disorders represent the prodromal or residual symptoms of psychi atric disorders. Moreover, there is almost overall agreement in considering that the pharmacological control of sleep disorders can improve the outcome of psychiatric disorders and that the polysomnographic study is rarely used to assess psychiatric patients. Many opinions expressed by the psychiatrists, in the survey, are confirmed in the scientific literature.