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IntroductionThe admission experience survey (AES) is a reliable tool for measuring perceived coercion in mental hospital admission. We developed the Italian AES through translation back-translation and administered it to acutely hospitalized psychiatric patients.Objectives/AimsTo verify psychometric characteristics of the Italian AES. To Examine the AES factor structure.Methodsn = 156 acutely hospitalized patients (48% women, 69% voluntary) were recruited in two university hospitals in Rome (Umberto I Policlinic, Sant’Andrea Hospital) and were administered the Italian AES. We conducted a principal component analysis (PCA) with equamax rotation.ResultsSocio-demographic and clinical characteristics of the sample are reported in Table 1. The Italian AES had good internal consistency (Cronbach's alpha = 0.90); Guttmann split-half reliability coefficient was 0.90. AES total score significantly differed between voluntary and involuntary patients (5.08 ± 4.1 vs. 8.1 ± 4.9, P < 0.05). PCA disclosed a three-factor solution explaining 59.3 of the variance. Significant correlations emerged between AES total score and clinical variables (Table 2). Pearson's correlation coefficient disclosed a significant correlation between perceived coercion and psychiatric symptoms severity (BPRS total score).ConclusionsThe Italian version of AES and proposed new factor structure proved reliable.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionDespite the potential theoretical and clinical relevance of psychopathological dimensions in Obsessive-Compulsive Disorder (OCD), few studies to date have investigated their possible association with obsession subtypes.Objectives/AimsWe aimed to examine whether, in OCD patients, anger and other psychopathological dimensions are associated with specific obsession subtypes.MethodsWe consecutively recruited 57 first-visit DSM-V OCD patients (females = 66.7%; age range = 18–63 years) at the Psychiatric Outpatient Clinic of our University Hospital. These patients were affected by severe OCD, as shown by a median (1st quartile–3rd quartile) Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score of 27.0 (23.0–32.5). We used the point-biserial coefficient (rpbi) to measure the correlation between psychopathological dimensions, as assessed with the Scale for the Rapid Assessment of Psychopathology (SVARAD), and obsession subtypes, as evaluated with the Y-BOCS.ResultsWe found significant correlations (P-values < 0.05) between: anger/aggressiveness dimension and aggressive, contamination, and sexual obsessions; apprehension/fear dimension and contamination, religious, and somatic obsessions; sadness/demoralization dimension and contamination and somatic obsessions; obsessiveness/iterativity dimension and all obsession subtypes; impulsivity dimension and aggressive and sexual obsessions; somatic concern/somatization dimension and contamination and somatic obsessions. We also found, by using the Mann-Whitney U-test, that OCD patients with comorbid Obsessive-Compulsive Personality Disorder–but not Schizotypal or Histrionic ones–showed higher levels (P < 0.05) of obsessiveness/iterativity and anger/aggressiveness than OCD patients without the personality disorder.ConclusionsAnger and other psychopathological dimensions seem to be linked with specific obsession subtypes in OCD patients, suggesting an association between these dimensions and OCD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Introduction The vulnerability-stress model assumes that psychotic symptoms emerge from the interaction between stress, basic symptoms and information processing deficits. Despite the large amount of data on first episode psychosis, this particular topic has been investigated to a minor extent in patients readmitted to acute psychiatric wards. Objectives To assess the association between basic symptoms and subjective stress, life events, and executive functions. Aims To identify the factors associated to basic symptoms during relapses. Methods Patients affected by schizophrenia, schizoaffective and bipolar disorder according to DSM-IV TR were recruited from the acute psychiatric wards of two University Hospitals in Rome. They were evaluated through: a) Frankfurt Complaint Questionnaire (FCQ); b) Stress-related Vulnerability Scale (SVS); c) Paykel Interview for Recent Life Events (IRLE); d) Wisconsin Card Sorting Test (WCST). Results Forty-nine patients were enrolled (65% women; mean age 42.7 ± 10.5 years; education 12.4 ± 3.2 years; disease duration 17.6 ± 11.4; 63% affected by bipolar disorder). Basic symptoms were positively associated to SVS total score (rho = 0.66, p Conclusions Preliminary results of this study show that basic symptoms are positively associated to perceived stress and marital life events, while negatively associated to executive functions, during psychotic relapses.

Introduction Cardiac surgery with cardiopulmonary bypass represents a severe source of stress and has been reported to be associated to the development of Posttraumatic Stress Disorder (PTSD). This disorder leads to a significant disability that might greatly decrease the benefits of surgery. Research rarely focused on the role of attachment styles in the development of PTSD, and no studies addressed this issue in patients undergoing cardiac surgery. Objectives To assess the influence of attachment styles on the development of PTSD. Aims The identification of specific personological traits predictive of the development of PTSD. Methods Participants were recruited among patients scheduled for elective cardiac surgery with cardiopulmonary bypass and evaluated through a) Experiences in Close Relationships (ECR) b) Post-traumatic 10 Stress Symptom Inventory - Modified (PTSS-10) c) Perceived Stress Scale (PSS). Six months after surgery, participants were mailed the PTSS-10 and the PSS. Multiple logistic regression analysis was performed with PTSD as dependent variable, and attachment-related avoidance and anxiety, sex, age and perceived stress as independent variables. Results One hundred twenty-one patients (94% of candidates for elective cardiac surgery who met study inclusion criteria) underwent surgery; 61(59%) were assessed after 6 months. Fourteen subjects (19.7%) scored ≥35 on the PTSS-10 at followup and were considered as having a probable diagnosis of PTSD. Attachment related avoidance at baseline predicted the development of PTSD at follow-up (p Conclusions Subjects endorsing the avoidant attachment style are more likely to develop PTSD after cardiac surgery.

Introduction First-generation immigrants from developed countries appear to be particularly at risk of being diagnosed with a mental disorder after migration. Nevertheless, in Europe immigrated people appear less likely than their native counterparts to access community mental health care. Inequity in treatment may lead to enhanced severity of the disease and consequent emergency referrals. Aim The aim of this study was to explore demographic and clinical characteristics in immigrants patients compared to Italianborn patients admitted in a Psychiatric Intensive Care Unit (PICU) for an acute mental disorder. Methods One hundred first-generation immigrant patients were consecutively recruited and compared to 100 age-, genderand diagnosis-matched Italian-born patients. Subjects were diagnosed according to DSM-IV-TR and rated on the Clinical Global Impression - Severity Scale and the Global Assessment of Functioning. Medical history and demographic information were collected with a study-specific form and were abstracted from medical records. Results The majority of patients were admitted to the PICU for an acute psychotic or manic episode. There were no differences in socio-demographic characteristics, in clinical severity scores and global functioning scores between immigrant and Italian-born patients. Despite no differences in age or diagnosis, immigrant patients were significantly more likely to be at the first psychiatric contact (32% vs 15%; p=0.007). Conclusions Our results suggest a role of migration in the development of acute psychotic or manic episodes. Moreover, limited access for immigrants to community mental health services may lead to longer duration of untreated illness, increased disease severity and consequent emergency referrals.

ObjectivesTo asses competence to consent to treatment in involuntary committed patients (ICP) for a mental disorder, as compared to matched acute voluntary hospitalized patients (VHP). To evaluate the effect of psychopathology severity and cognitive dysfunction on decisional capacity.MethodsCases were recruited among ICP at the Umberto I Hospital, ‘Sapienza’ University of Rome; controls were age- and sex-matched VHP, in the same ward and time period. Subjects were diagnosed according to DSM-IV-TR criteria and further evaluated through a) MacArthur Competence Assessment Tool for Treatment (MacCAT-T) b) Brief Psychiatric Rating Scale-24 (BPRS) c) Raven's Colored Progressive Matrices (CPM) d) Mini Mental State Examination (MMSE).ResultsEighteen cases were enrolled (67% women), mean age was 25.1 ± 2.8 years. There were no differences between groups in: diagnostic distribution (40% schizophrenic spectrum disorders, 40% mood disorders, 20% other diagnosis), disease duration, MMSE. ICP had higher BPRS total scores (mean difference ± S.D.= 10.3 ± 19.4; [95% C.I.= 0.6 ÷ -20.0]), and performed worse than VHP in MacCAT-T comprehension (-1.0 ± 1.3; [95% C.I.= -1.6 ÷ -0.3]), appreciation (-1,7 ± 2.0; [95% C.I.= -3.0 ÷ -0.7]), reasoning (-2.1 ± 2.9; [95% C.I.= -3.6 ÷ -0.7]) and expression of a choice (-0.8 ± 1.0 [95% C.I.= -1.3 ÷ -0.3]). Competence to give informed consent was associated with psychopathological dimensions but not with MMSE and CPM scores, in the sample overall.ConclusionCompetence to consent to treatment was reduced in ICP compared to VHP. Involuntary commitment was not necessarily associated with incapability of making treatment decisions.