2Bakirkoy Prof. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery, Department of Psychiatry, Istanbul, Turkiye
3Istanbul University-Cerrahpasa, Institute of Forensic Sciences and Legal Medicine, Department of Psychiatry, Istanbul, Turkiye
Abstract
Objective: Schizophrenia is a chronic psychiatric disorder frequently complicated by nonadherence to oral antipsychotics. Long-acting injectable antipsychotics (LAIA) improve adherence and reduce relapse, yet their use differs across countries. This study examined the knowledge, attitudes, and prescribing practices of psychiatrists in Türkiye regarding LAIA treatments.
Method: A cross-sectional online survey was conducted between March 2024 and March 2025. The questionnaire, distributed to 1,255 psychiatrists, collected sociodemographic data, clinical workload, and responses to 13 attitude statements. A total of 157 psychiatrists completed the survey and met inclusion criteria. Descriptive statistics and chi-square analyses were performed to assess associations between attitudes and demographic or institutional characteristics.
Results: Participants had a mean age of 38 years; 72.6% were female. Most respondents (79.6%) reported routinely considering
LAIA therapy. Paliperidone (80.3%) and aripiprazole (47.8%) were the most frequently preferred agents. Positive attitudes were more common among psychiatrists with longer professional experience and those working in institutions with inpatient clinics. More experienced clinicians were significantly less likely to endorse misconceptions, such as the belief that LAIAs limit therapeutic relationships, are costlier than hospitalization, or represent an unpleasant treatment for patients. Attitudes varied across workplace settings: private sector psychiatrists more often expressed caution, particularly regarding first-episode psychosis.
Conclusion: Psychiatrists in Türkiye generally recognize the value of LAIAs beyond nonadherent cases, with professional experience and institutional context shaping prescribing patterns. While favorable attitudes predominate, misconceptions and systemic barriers persist. Targeted education, supportive policies, and shared decision-making strategies may promote wider,
evidence-based use of LAIAs in clinical practice.