What drives the higher incidence of psychosis in London compared to Palermo?

Background: Incidence of psychosis seems to be lower in Italy than in other European countries (Tansella et al. 1991; Lasalvia et al. 2012, Tarricone et al. 2012); however there are no studies comparing the incidence of psychotic disorder in Northern and Southern Europe. Methods: Incidence and socio-demographic data on all psychotic patients presenting for the first time to the mental health services of Palermo were collected over a period of three years. Palermo incidence rates were compared to South London rates obtained from the AESOP study (Kirkbride et al 2006). South London rates were reanalyzed excluding people aged 16-17 years and substance related psychoses. Second generation migra…

Il recovery dalla disabilità. Manuale di riabilitazione psichiatrica

The influence of risk factors on the onset and outcome of psychosis: What we learned from the GAP study

The GAP multidisciplinary study carried out in South London, recruited 410 first episode of psychosis patients and 370 controls; the aim was to elucidate the multiple genetic and environmental factors influencing the onset and outcome of psychosis. The study demonstrated the risk increasing effect of adversity in childhood (especially parental loss, abuse, and bullying) on onset of psychosis especially positive symptoms. Adverse life events more proximal to onset, being from an ethnic minority, and cannabis use also played important roles; indeed, one quarter of new cases of psychosis could be attributed to use of high potency cannabis. The “jumping to conclusions” bias appeared to mediate …

Low incidence of psychosis in Italy: confirmation from the first epidemiological study in Sicily

Purpose: The incidence of psychotic disorders varies in different geographical areas. As there have been no reports from Southern Italy, this study aimed to determine the incidence rate of first-episode psychosis in Palermo, Sicily. Methods: All patients, aged 18–65 years, presenting with a first episode of psychosis (FEP) (ICD-10 F20–29, F30–33) to mental health services in Palermo, were recorded over a 3-year period. Incidence rates of psychotic disorders and their 95% confidence intervals (95% CI) were estimated. Poisson regression was applied to estimate the differences in incidence rate ratio (IRR) by age, sex and migrant status. Results: Two hundred and four FEP participants were iden…

Cumulative social disadvantage and psychosis: findings from a southern Italy case-control study

Aim: There are consistent evidence suggesting that psychotic disorders are associated to social disadvantage and isolation in adulthood, and research suggested that they these are not simply a consequence of the functional impairment related to onset of the disease (Stilo et al., 2013; Morgan et al., 2008). To date only a few studies have investigated the impact of social risk factors on psychosis in Italy. This study aimed to replicate existing findings in a case-control sample from Southern Italy. Methods: 134 individuals presenting for the first time to mental health services of Palermo (Italy) with an ICD 10 diagnosis of psychosis and 175 population controls from Palermo (Italy) were en…

Genetic and psychosocial stressors have independent effects on the level of subclinical psychosis: findings from the multinational EU-GEI study.

the Spanish Ministry of Science and Innovation. Instituto de Salud Carlos III (SAM16PE07CP1, PI16/02012, PI19/024), co-financed by ERDF Funds from the European Commission, ‘A way of making Europe’, CIBERSAM. Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), European Union Structural Funds. European Union Seventh Framework Program under grant agreements FP7-4-HEALTH-2009-2.2.1-2-241909 (Project EU-GEI) and FP7-HEALTH-2013-2.2.1-2-603196 (Project PSYSCAN); and European Union H2020 Program under the Innovative Medicines Initiative 2 Joint Undertaking (grant agreement No 115916, Project PRISM, and grant agreement No 777394, Project AIMS-2-TRIALS) (...)

FUNCTIONAL CONNECTIVITY OF THE CEREBELLUM INPATHOLOGICAL GAMBLER

Cannabis consumption and the risk of psychosis

Summary Objectives: Cannabis is the most widely used illicit drug globally and its use has been linked to an increased risk for psychotic disorders. An association between cannabis consumption and psychotic symptoms was consistently reported by several studies. This case-control study aimed to widen the current findings about the impact of cannabis exposure on the risk of psychosis, by investigating the pattern of cannabis consumption in a sample of first-episode of psychosis (FEP) patients compared to healthy controls. Material and methods: 68 individuals who presented for the first time to mental health services of Palermo (Italy) with an ICD-10 diagnosis of psychotic disorders and 74 hea…

P.0170 Distinct polygenic risk scores in clusters of psychotic subjects with different premorbid trajectories and current IQ

Perceived stigma in patients affected by psychosis: Is there an impact on relapse?

Introduction The World Health Organization (WHO) considers stigma of mental illness as a crucial problem (WHO, 2001). Stigma contributes to the onset (Morgan et al., 2010) and the outcome of people affected by schizophrenia (Himan, 2015). Objectives To evaluate the perception of patients affected by psychotic disorders of being stigmatized by the community. Aims To compare the perception of stigma among subgroups of patients at different stage of their disorder. Methods Thirty-five patients affected by a first-episode of psychosis (FEP) and 96 patients affected by chronic psychosis were recruited. The Devaluation of Consumers Scale (DCS) and the Devaluation of Consumer Families Scale (DCFS)…

Premorbid social adjustment is better in cannabis-using than non-using psychotic patients across Europe

IntroductionA number of authors have hypothesized that psychotic patients who consume cannabis constitute a differentiated subgroup of patients that have better cognitive and social skills, necessary to engage in illegal drug consumption, than non-using patients.ObjectivesGiven that the prevalence, and patterns, of cannabis use are culturally driven, we wanted to study first-episode psychosis (FEP) cannabis-using and non-using patients coming from different European countries as part of the EUGEI-STUDY.AimsWe tested the hypothesis of better premorbid social adjustment in cannabis-using FEP patients, by comparing them to FEP non cannabis users and to their respective healthy controls.Methods…

Implementazione del Virtual Multiple Errand Test per la valutazione delle funzioni esecutive

23. Resting state functional magnetic resonance imaging analysis of the brain of pathological gamblers

Purpose Gambling disorder has been recently reclassified under the category “substance-related and addictive disorders”. Recent studies performed through functional MRI (fMRI) have shown that the perseverance of some behaviors can alter brain activation [1] , [2] . In this work we aim at investigating functional connectivity changes in pathological gamblers (PGs) in comparison to healthy controls (HCs) by means of resting state functional Magnetic Resonance Imaging (rs-fMRI). Methods and materials Thirteen HCs and fourteen PGs were recruited (all right handed males; drugs free; mean age 36 ± 10 yrs). All acquisitions were performed through a 1,5 T MRI scanner using a 8-channels phased-array…

Differences in cannabis-related experiences between patients with a first episode of psychosis and controls

BackgroundMany studies have reported that cannabis use increases the risk of a first episode of psychosis (FEP). However, only a few studies have investigated the nature of cannabis-related experiences in FEP patients, and none has examined whether these experiences are similar in FEP and general populations. The aim of this study was to explore differences in self-reported cannabis experiences between FEP and non-psychotic populations.MethodA total of 252 subjects, who met International Classification of Diseases (ICD)-10 criteria for FEP, and 217 controls who reported cannabis use were selected from the Genetics and Psychosis (GAP) study. The Medical Research Council Social Schedule and t…

Working Memory, Jumping to Conclusions and Emotion Recognition: a Possible Link in First Episode Psychosis (Fep)

Introduction A large body of literature has demonstrated that people affected by psychotic disorders show deficits in working memory, in Emotion Recognition (ER) and in data-gathering to reach a decision (Jumping To Conclusions – JTC). Aims To investigate a possible correlation between working memory, JTC and ER in FEP. Methods 41 patients and 89 healthy controls completed assessments of working memory using WAIS shortened version, JTC using the 60:40 Beads Task and ER using Degraded Facial Affect Recognition Task. Results According to the literature, cases had poorer performance in working memory tasks (Digit Span: μ7,72 [ds=2,98] vs μ10,14 [ds=3,10], U=865,00, p=0,00; Digit Symbol: μ5,36 …

Does age of first cannabis use and frequency of use influence age of first-episode psychosis (FEP)?

Background: Cannabis is one of the most commonly used drugs among young people across Europe (EMCDDA data 2014), Moreover, it is one of the most abused illicit drugs among patients suffering from schizophrenia (Linszen et al., 1994) and, particularly, in patients at their first episode of psychosis (Donoghue et al., 2011). Furthermore, patients suffering from psychosis with a history of cannabis use have an earlier age of onset of psychosis (AOP) than those who never used it (Di Forti et al., 2013). We aim to investigate if the reported association between use of cannabis and AOP is consistent across to European samples with expected differences in pattern of cannabis use (i.e. age at first…

Devaluation towards people with schizophrenia in Italian medical, nursing, and psychology students

IntroductionDiscrimination towards people with schizophrenia (PWS) by healthcare professionals is responsible of underdiagnosis and undertreatment of these patients. Negative attitudes toward PSW in health care professionals tend to be present since their university studies and are related to their knowledge and experience about the disease.Objectives and aimsTo assess opinion towards PSW in medical, nursing and psychology students and to investigate the relation with their knowledge of schizophrenia and its causes.MethodsThe study involved 133 medical, 200 nursing and 296 psychology undergraduate students. The opinion on mental illness questionnaire, the Devaluation Consumers Scale, and th…

Predictors of early dropout in treatment for gambling disorder: The role of personality disorders and clinical syndromes

Several treatment options for gambling disorder (GD) have been tested in recent years; however dropout levels still remain high. This study aims to evaluate whether the presence of psychiatric comorbidities predicts treatment outcome according to Millon's evolutionary theory, following a six-month therapy for GD. The role of severity, duration of the disorder, typology of gambling (mainly online or offline) and pharmacological treatment were also analysed. The recruitment included 194 pathological gamblers (PGs) to be compared with 78 healthy controls (HCs). Psychological assessment included the South Oaks Gambling Screen and the Millon Clinical Multiaxial Inventory-III. The "treatment fail…

Resting state functional magnetic resonance imaging analysis of the brain of pathological gamblers

Purpose . Gambling disorder has been recently reclassified under the category ‘‘substance-related and addictive disorders”. Recent studies performed through functional MRI (fMRI) have shown that the perseverance of some behaviors can alter brain activation [1,2]. In this work we aim at investigating functional connectivity changes in pathological gamblers (PGs) in comparison to healthy controls (HCs) by means of resting state functional Magnetic Resonance Imaging (rs-fMRI). Methods and materials. Thirteen HCs and fourteen PGs were recruited (all right handed males; drugs free; mean age 36 ± 10 yrs). All acquisitions were performed through a 1,5 T MRI scanner using a 8-channels phased-array …

Cognitive assessment of OCD patients: Neuro VR vs neuropsychological test

This study aimed to evaluate the reliability and validity of the Neuro- Virtual Reality as tool for the neuropsychological assessment in OCD patients. We used the neuropsychological battery and a virtual version of the Multiple Errand Test (V-MET), developed using the NeuroVR software, in order to evaluate the executive functions, the ability to plan ahead on complex problem solving tasks in daily life in 30 obsessive compulsive disorder (OCD) patients and 30 healthy controls. The results showed the presence of difficulties of OCD patients: lower levels of divided attention and higher levels of errors; higher mean rank of inefficiencies, interpretation failures and rule breaks and longer ti…

IL TRATTAMENTO INTEGRATO DELLA SCHIZOFRENIA. UN MANUALE PER LA GESTIONE CLINICA

Le prospettive per pazienti con schizofrenia sono oggi decisamente migliori di quanto precedentemente si pensava. L’idea tradizionale era che questa malattia fosse inevitabilmente grave, ricorrente, invalidante e cronica. Tuttavia, è diventato chiaro che con un buon trattamento una percentuale di pazienti può ristabilirsi completamente e molti altri possono vivere una vita gratificante, a condizione di aderire alle indicazioni dei medici. Inoltre, sebbene si affermi spesso che l’eziologia della schizofrenia è sconosciuta, abbiamo appreso molte cose riguardo ai fattori genetici e ambientali che contribuiscono al suo sviluppo. Purtroppo, la percezione sociale della malattia rimane molto negat…