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Migration is a complex phenomenon and mental illness among immigrants remains a major matter of concern in Italy and worldwide. 243 medical and pharmacy records of patients admitted to University of Foggia hospital between 2004 and 2018 were retrospectively screened and included in the study. Socio-demographic data and clinical characteristics of inpatients were compared in those with and without first-episode of mental illness (FEMI). Subjects (140 men, 103 women; aged 34.4 ± 10.2 years) represented 6.66 ± 3.73% of all hospitalizations in 15 years. Nearly half of them (48.5%) had emigrated from other European countries. 30.8% were diagnosed with a DSM-IV TR unspecified psychosis. 103 patients (42.3%) were in first-lifetime episodes of mental illness. Factors significantly associated with FEMI were: younger age, sex (men), immigrating from Africa, poor language proficiency, lower amount of prescribed psychotropics. Mental health among immigrants is of major concern in Italy. Our findings report on factors possibly associated to the onset of mental illness among immigrant psychiatric inpatients.

Introduction: Approximately 10% of patients with psychotic disorders receive the diagnosis “Psychotic disorder not otherwise specified” (PNOS). However, there is a lack of knowledge about the clinical presentations captured by this diagnosis in the mental health services. Therefore, we examined the symptom profiles of participants with PNOS compared to participants with bipolar disorder (BD) and schizophrenia spectrum disorder (SZ) diagnoses.Methods: We here included 1,221 participants from the Thematically Organized Psychosis-study at Oslo University Hospital; 792 with SZ, 283 with BD, and 146 with PNOS, assessed with SCID-I for DSM-IV. The participants with PNOS were categorized into subgroups based on SCID information. The GAF, PANSS, Alcohol Use Disorders Identification Test (AUDIT), and Drug Use Disorders Identification Test (DUDIT) were used to assess function, clinical symptoms, and substance use.Results: In the PNOS group, 44% did not meet the criteria for any specific psychotic disorder, 35.5% had contradictory information making a specific diagnosis difficult, and 20.5% had inadequate information to make a specific diagnosis. The most frequent reason for a PNOS diagnosis was difficulty ruling out a substance-induced psychotic disorder (n = 41, 28%). Participants with PNOS were younger and more often first-episode than participants with BD and SZ. They were intermediate between BD and SZ for GAF scores (BD>PNOS>SZ) and PANSS scores (BD

17th World-Psychiatric-Association (WPA) World Congress of Psychiatry -- OCT 08-12, 2017 -- Berlin, GERMANY, WOS: 000468130500010, PubMed: 30911237, Introduction: Unspecified psychosis, defined with the F29 code in the International Classification of Diseases (ICD) 10th version is commonly used if there is inadequate information to make the diagnosis of a specific psychotic disorder. There is a lack of data about the prevalence, incidence, diagnostic validity and stability of this diagnosis. Therefore, we aimed to evaluate the prevalence and diagnostic consistency of unspecified psychosis in the outpatient unit. Methods: Patients diagnosed with the ICD-10 F29 code at the first visit and interviewed at least three times between January 2012-2016 in the Psychiatry Outpatient Clinic were included (n= 138). Hospital records were reviewed retrospectively and data were analyzed with SPSS 19th version. Results: Mean duration of follow-up was 22.8 +/- 14.7 months. The diagnoses at the final follow-up were unspecified psychosis (43%), bipolar disorders (18%), schizophrenia (11%), major depression (7%), and anxiety disorders (4%). No significant difference was found between the follow-up diagnoses in terms of age, duration of follow-up, gender, educational status and marital status. Conclusion: The diagnostic stability of unspecified psychosis is low compared to other psychotic disorders. Follow-up studies with larger sample sizes are required to elucidate the the low diagnostic stability of unspecified psychosis., World Psychiat Assoc

Background and aim: Lack of cultural adaptation may risk or worsen mental illness among immigrants, and interfere with assessment and treatment. Language proficiency (LP) seems essential for access to foreign environments, and the limited research concerning its effects on mental health care encouraged this preliminary study. Methods: We reviewed clinical records of all immigrant psychiatric patients hospitalized at the University of Foggia in 2004–09 ( N = 85), and compared characteristics of patients with adequate versus inadequate LP. Results: Subjects (44 men, 41 women; aged 35.7±10.0 years) represented 3.62±0.94% of all hospitalizations in six years. (2004–09). Most (60.0%) had emigrated from other European countries. Many were diagnosed with a DSM-IV unspecified psychosis (40.0%) or adjustment disorder (18.8%), and 45.9% were in first-lifetime episodes. Average comprehension and spoken LP was considered adequate in 62.4% and inadequate in 37.6%. In multivariate modelling, adequate LP was more prevalent among women, emigration from another European country, receiving more psychotropic drugs at hospitalization, and having entered Italy legally. Conclusion: Findings support an expected importance of LP among immigrant psychiatric inpatients, and encourage language assessment and training as part of the comprehensive support of such patients, especially men.

Diagnostic shifts have been prospectively examined in the short term, but the long-term stability of diagnoses has rarely been evaluated. The authors examined diagnostic shifts over a 10-year follow-up period.A cohort of 470 first-admission patients with psychotic disorders was systematically assessed at baseline and at 6-month, 2-year, and 10-year follow-ups. Longitudinal best-estimate consensus diagnoses were formulated after each assessment.At baseline, the diagnostic distribution was 29.6% schizophrenia spectrum disorders, 21.1% bipolar disorder with psychotic features, 17.0% major depression with psychotic features, 2.4% substance-induced psychosis, and 27.9% other psychoses. At year 10, the distribution changed to 49.8%, 24.0%, 11.1%, 7.0%, and 8.1%, respectively. Overall, diagnoses were changed for 50.7% of study participants at some point during the study. Most participants who were initially diagnosed with schizophrenia or bipolar disorder retained the diagnosis at year 10 (89.2% and 77.8%, respectively). However, 32.0% of participants (N=98) originally given a non-schizophrenia diagnosis had gradually shifted to a schizophrenia diagnosis by year 10. The second largest shift was to bipolar disorder (10.7% of those not given this diagnosis at baseline). Changes in the clinical picture explained many diagnostic shifts. In particular, poorer functioning and greater negative and psychotic symptom ratings predicted a subsequent shift to schizophrenia. Better functioning and lower negative and depressive symptom ratings predicted the shift to bipolar disorder.First-admission patients with psychotic disorders run the risk of being misclassified at early stages in the illness course, including more than 2 years after first hospitalization. Diagnosis should be reassessed at all follow-up points.

Context: Studies on acute psychosis in patients from India report good outcome. A small proportion of these patients may suffer relapses or other develop major psychiatric disorders later. Aim: The aim of this study was to examine the diagnostic stability of acute psychosis in patients from India. Materials and Methods: The records of patients who presented with the first episode of acute and transient psychotic disorder ( n =57) over 1 year (2004) were analyzed, and the follow-up data at the end of 1 and 2 years were recorded. Results: The mean age of the sample was 30.72 years. The mean duration of illness episode was 18.15±17.10 days. The follow-up data were available for 77.2% ( n =44) and 75.4% ( n =43) of the sample at the end of first and second years. Relapse was recorded in 47.4 and 54.4% at the end of first and second years, respectively. Conclusion: The diagnosis changed into other disorders such as bipolar disorder, schizophrenia, and unspecified psychosis, while a majority retained the initial diagnosis of acute psychosis. The findings suggest that acute psychosis is a relatively stable condition. A small percentage of these patients may go on to develop schizophrenia or bipolar disorder.