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Although cancer-associated fibroblasts (CAF) are key determinants in the malignant progression of cancer, their functional contribution to this process is still unclear. Analysis of the mutual interplay between prostate carcinoma cells and CAFs revealed a mandatory role of carcinoma-derived interleukin-6 in fibroblast activation. In turn, activated fibroblasts through secretion of metalloproteinases elicit in cancer cells a clear epithelial-mesenchymal transition (EMT), as well as enhancement of tumor growth and development of spontaneous metastases. CAF-induced EMT leads prostate carcinoma cells to enhance expression of stem cell markers, as well as the ability to form prostaspheres and to self-renew. Hence, the paracrine interplay between CAFs and cancer cells leads to an EMT-driven gain of cancer stem cell properties associated with aggressiveness and metastatic spread. Cancer Res; 70(17); 6945–56. ©2010 AACR.

Supplementary Figures 1-5 from Reciprocal Activation of Prostate Cancer Cells and Cancer-Associated Fibroblasts Stimulates Epithelial-Mesenchymal Transition and Cancer Stemness

BackgroundETV4 is one of the ETS proteins overexpressed in prostate cancer (PC) as a result of recurrent chromosomal translocations. In human prostate cell lines, ETV4 promotes migration, invasion, and proliferation; however, its role in PC has been unclear. In this study, we have explored the effects of ETV4 expression in the prostate in a novel transgenic mouse model.MethodsWe have created a mouse model with prostate-specific expression of ETV4 (ETV4 mice). By histochemical and molecular analysis, we have investigated in these engineered mice the expression of p21, p27, and p53. The implications of our in vivo findings have been further investigated in human cells lines by chromatin-immunoprecipitation (ChIP) and luciferase assays.ResultsETV4 mice, from two independent transgenic lines, have increased cell proliferation in their prostate and two-thirds of them, by the age of 10 months, developed mouse prostatic intraepithelial neoplasia (mPIN). In these mice,cdkn1aand its p21 protein product were reduced compared to controls; p27 protein was also reduced. By ChIP assay in human prostate cell lines, we show that ETV4 binds to a specific site (-704/-696 bp upstream of the transcription start) in theCDKN1Apromoter that was proven, by luciferase assay, to be functionally competent. ETV4 further controlsCDKN1Aexpression by downregulating p53 protein: this reduction of p53 was confirmed in vivo in ETV4 mice.ConclusionsETV4 overexpression results in the development of mPIN but not in progression to cancer. ETV4 increases prostate cell proliferation through multiple mechanisms, including downregulation ofCDKN1Aand its p21 protein product: this in turn is mediated through direct binding of ETV4 to theCDKN1Apromoter and through the ETV4-mediated decrease of p53. This multi-faceted role of ETV4 in prostate cancer makes it a potential target for novel therapeutic approaches that could be explored in this ETV4 transgenic model.

Simple Summary Metastatic melanoma is one of the most aggressive and lethal malignancies with a poor prognosis. Several data underline the crucial role of amoeboid motility in the dissemination of metastatic melanoma cells. Thus, targeting this phenomenon could represent a promising strategy to prevent metastasis formation and improve metastatic melanoma patient’s survival. With this aim, we investigated the effect of Claisened Hexafluoro, a chemical analogue of Honokiol, on human metastatic melanoma cells. We demonstrated that Claisened Hexafluoro, by deregulating the mitochondrial activity, inhibits amoeboid motility and impairs many steps of the dissemination process, finally decreasing the in vivo metastatic spreading. Collectively, these data suggest possible future applications of Claisened Hexafluoro for the treatment of metastatic melanoma. Abstract Metastatic melanoma is characterized by poor prognosis and a low free-survival rate. Thanks to their high plasticity, melanoma cells are able to migrate exploiting different cell motility strategies, such as the rounded/amoeboid-type motility and the elongated/mesenchymal-type motility. In particular, the amoeboid motility strongly contributes to the dissemination of highly invasive melanoma cells and no treatment targeting this process is currently available for clinical application. Here, we tested Claisened Hexafluoro as a novel inhibitor of the amoeboid motility. Reported data demonstrate that Claisened Hexafluoro specifically inhibits melanoma cells moving through amoeboid motility by deregulating mitochondrial activity and activating the AMPK signaling. Moreover, Claisened Hexafluoro is able to interfere with the adhesion abilities and the stemness features of melanoma cells, thus decreasing the in vivo metastatic process. This evidence may contribute to pave the way for future possible therapeutic applications of Claisened Hexafluoro to counteract metastatic melanoma dissemination.

Our Psychiatry Institute has a long-standing tradition of providing training in the importance of relational and emotional skills and helping relationships. Here we describe techniques that are routinely used on our psychiatric ward (Maggiore della Carita Hospital, Novara, Italy) to promote early rehabilitation of acute psychiatric inpatients. We focus on the Cinema group, which is typical of our approach to informal, therapeutic group activity. Targeting social and relational issues as adjunct to treatment as usual is useful in acute settings and can begin at an early stage of hospitalization. Our intervention is designed to improve patients’ coping strategies, relational and communication skills, and overall quality of life.

Mood disorders represent a major cause of hospitalization in psychiatric ward. We focused on sex differences, therapies and rehospitalization rates/length of stay in inpatients with mood disorders. Rehospitalization is often observed in patients with mental disorders, with rates up to 80%. Socio-demographic features, clinical features and treatment type influence the length of stay. The objective of this study was to assess how the literature findings match everyday clinical practice in an acute psychiatric ward. We performed a retrospective observational study extracting data from our medical records from 1st July 2012 to 1st July 2014. 85 patients were eligible for the study; the overall number of admittances to the ward was 103. We have not found any difference in the rates of Bipolar Disorder between males and females, we failed to find an higher frequency of Depressive disorders in females. In our sample the rates of early readmission is 17.5%. Patients with an involuntary admission included exclusively those with a manic or hypomanic episode; patients with depressive episodes were more likely to have committed a suicide attempt.

In this manuscript, we show the involvement of the uPA/uPAR system in the regulation of aerobic glycolysis of melanoma cells. uPAR over-expression in human melanoma cells controls an invasive and glycolytic phenotype in normoxic conditions. uPAR down-regulation by siRNA or its uncoupling from integrins, and hence from integrin-linked tyrosine kinase receptors (IL-TKRs), by an antagonist peptide induced a striking inhibition of the PI3K/AKT/mTOR/HIF1α pathway, resulting into impairment of glucose uptake, decrease of several glycolytic enzymes and of PKM2, a checkpoint that controls metabolism of cancer cells. Further, binding of uPA to uPAR regulates expression of molecules that govern cell invasion, including extracellular matrix metallo-proteinases inducer (EMPPRIN) and enolase, a glycolytyc enzyme that also serves as a plasminogen receptor, thus providing a common denominator between tumor metabolism and phenotypic invasive features. Such effects depend on the α5β1-integrin-mediated uPAR connection with EGFR in melanoma cells with engagement of the PI3K-mTOR-HIFα pathway. HIF-1α trans-activates genes whose products mediate tumor invasion and glycolysis, thus providing the common denominator between melanoma metabolism and its invasive features. These findings unveil a unrecognized interaction between the invasion-related uPAR and IL-TKRs in the control of glycolysis and disclose a new pharmacological target (i.e., uPAR/IL-TKRs axis) for the therapy of melanoma.

Introduction The use of movies in medical (particularly psychiatric) education has been often limited to portraits of mental illness and psychiatrists. The Psychiatric Institute of the Università del Piemonte Orientale has a longstanding tradition of working with/on movies according to a method developed by Eugenio Torre, using dynamic images as educational incitements. Our aim is to describe the preliminary results on the impact of this intervention in medical students. Methods The cinemeducation project lasted 6 months, and included 12 meetings. Forty randomly selected participants were assessed with: Attitudes Towards Psychiatry Scale (ATP-30), Social Distance Scale (SDS), Interpersonal Reactivity Index (IRI), and Toronto Alexithymia Scale (TAS), both at baseline and after 6 months, when the workshop was concluded. Results A significant increase was found in the ATP-30 score, and a reduction of the SDS and IRI-Personal Distress scale scores. Conclusions Informal feedback from participants was strongly positive. Preliminary results from the assessment of participants are encouraging. Students’ attitudes towards psychiatry and ability to tolerate anxiety when experiencing others’ distress improved, while stigma decreased. The evocative power of movie dynamic images, developed in the group and integrated with the help of the group leader, can enrich students’ knowledge, both from a cognitive and emotional standpoint.

Introduction Psychiatric management of inpatients with suicidal behavior involves psychiatrists and psychiatric nurses. Specific precautions should be adopted: observation on a one to one basis with the cooperation of qualified nurses and accommodating the patient in a room close to the infirmary is usually recommended. An ongoing assessment of suicidal risk is warranted to check the response to treatment over time. Aim To compare the severity of depressive symptoms in depressed inpatients admitted after an attempted suicide and in depressed inpatients admitted for any other reason; to assess the severity of attempted suicide and the management of suicidal risk in the clinical setting. Material and method We divided the sample in two subgroups: patients with a diagnosis of depression admitted for a current suicide attempt and depressed patients without a current suicide attempt. Socio-demographic and clinical features were gathered; assessment included the Montgomery-Asberg Depression Rating Scale (MADRS) and the Nurses’ Global Assessment of Suicide Risk (NGASR). Results 46 patients were recruited in a 1-year period and were eligible for our study: 20 had been admitted to the hospital after attempting suicide, while the other 26 had not attempted suicide and were admitted for other reasons related to their depression. The multivariate analysis yielded a statistically significant correlation between the use of antidepressants and current suicide attempt. The occurrence of suicidal attempt was not significantly related to the severity of depressive symptoms. In the current suicide attempters subgroup, NGASR suicide risk levels at discharge were significantly lower than those measured at admission. Current suicide attempters had a higher number of suicide attempts in their clinical history, compared to the other group. Conclusion We found no significant correlation among psychiatric diagnosis, severity of depressive symptoms and current suicide attempt. Antidepressant therapy was found to play the role of protective factor for suicide attempts. History of suicide attempts was one of the major predictor for reattempted suicide. A more thorough understanding of the complex phenomenon of suicide and of the reasons underlying suicidal behaviors is warranted.

This work describes the effectiveness of HDAC-inhibitor (S)-2 towards colorectal cancer (CRC) HCT116 cells in vitro by inducing cell cycle arrest and apoptosis, and in vivo by contrasting tumour growth in mice xenografts. Among the multifaceted drug-induced events described herein, an interesting link has emerged between the oncoprotein histone deacetylase HDAC1 and the oncogenic Cancerous Inhibitor of Protein Phosphatase 2A (CIP2A) which is overexpressed in several cancers including CRCs. HDAC1 inhibition by (S)-2 or specific siRNAs downregulates CIP2A transcription in three different CRC cell lines, thus restoring the oncosuppressor phosphatase PP2A activity that is reduced in most cancers. Once re-activated, PP2A dephosphorylates pGSK-3β(ser9) which phosphorylates β-catenin that remains within the cytosol where it undergoes degradation. The decreased amount/activity of β-catenin transcription factor prompts cell growth arrest by diminishing c-Myc and cyclin D1 expression and abrogating the prosurvival Wnt/β-catenin signaling pathway. These results are the first evidence that the inhibition of HDAC1 by (S)-2 downregulates CIP2A transcription and unleashes PP2A activity, thus inducing growth arrest and apoptosis in CRC cells.

It is widely acknowledged that 16% to 34% of suicide attempters repeat a suicide behavior within 1-2 years after the first, “index”, attempt, and that a previous nonfatal suicide attempt is found in up to 40% of suicide deaths (Scoliers, Portzky, van Heeringen & Audenaert, 2009). Suicide attempt is defined as “a self inflicted, potentially injurious behavior with a nonfatal outcome for which there is evidence (either explicit or implicit) of intent to die; a suicide attempt may result in no injuries, or death” (Silverman, Berman Sanddal & O’carroll, 2007).

Introduction Half of cases of Prostate cancer (PC) carry a chromosomal translocation involving one of the genes of the ETS family (ERG, ETV1, ETV4, ETV5, FLI1). Each translocation results in the deregulated expression of an ETS protein in the prostate that, likely, plays a direct role in PC pathogenesis. We have showed that in prostate cell lines ETV4 overexpression increases migration and invasion, and also proliferation, cell cycle progression, anchorage-independent growth, tumor growth in xenograft model. Here we have investigated the effects of ETV4 expression in mouse prostate. Material and Methods The truncated form of ETV4, present in patients, has been cloned under the control a modified rat probasin gene promoter that drives prostate specific expression. By using this construct we have obtained two different transgenic mouse lines with ETV4 specific prostate expression (ETV4-FVB mice). The tissues of these mice have been analyzed by H&E staining and immunohistochemistry. Result and discussion 6 months-old (mo) ETV4-FVB mice did not present prostate lesions, whereas low grade prostatic intraepithelial neoplasia (LGPIN) lesions have been found in about half of 10 mo mice (10 of 18 line C, 4 of 11 line E) and in none of control mice. Since Pten loss is common in PC and it is often associated with ETS translocations, we have investigated the interaction of ETV4 expression with Pten loss by crossing our FVB-ETV4 mice with PTEN+/- mice. Analyzing the progeny of this cross at 7 months of age we found LGPIN in 33% of FVB-ETV4 mice and in 50% of Pten+/- mice, whereas we found multifocal high grade PIN (HGPIN) lesions in all Pten+/-,ETV4 mice (n=9). In addition, at least one LGPIN was found in all 2 months-old Pten+/-,ETV4. Thus, Pten+/-,ETV4 developed early neoplastic lesions whose number and severity increased with age: in fact, HGPIN progressed to locally invasive adenocarcinoma in 12.5% of 7 mo mice and in 50% 10 mo mice. Conclusion These results suggest that ETV4 over-expression is sufficient to initiate neoplastic transformation and cooperates with Pten loss in promoting prostate cancer progression. Thus, also in vivo, ETV4 induces most and perhaps all of the features that make a tumor. Now we are investigating the molecular mechanisms through which ETV4 cooperates with Pten loss to promote cancer progression. These mouse models, in addition to provide insight into PC biology, will be useful to test the effectiveness of experimental therapeutic approaches.

The interaction between endothelial cells and pericytes is crucial for the stabilization of newly formed vessels in angiogenesis. The comprehension of the mechanisms regulating pericyte recruitment might open therapeutical perspectives on vascular-related pathologies. Sphingosine 1-phosphate (S1P) is a bioactive sphingolipid that derives from sphingomyelin catabolism and regulates biological functions in cell survival, proliferation, and differentiation. In this study, we aimed to identify the role of S1P axis in the intercellular communication between human mesenchymal progenitor mesoangioblasts (MAB) and endothelial cells (human microvascular endothelial cells (H-MVEC)) in the formation of capillary-like structures. We demonstrated that the S1P biosynthetic pathway brought about by sphingosine kinases (SK) SK1 and SK2 as well as spinster homolog 2 (SPNS2) transporter in H-MVEC is crucial for MAB migration measured by Boyden chambers and for the formation and stabilization of capillary-like structures in a 3D Matrigel culture. Moreover, the conditioned medium (CM) harvested from H-MVEC, where SK1, SK2, and SPNS2 were down-regulated, exerted a significantly diminished effect on MAB capillary morphogenesis and migration. Notably, we demonstrated that S1P1 and S1P3 receptors were positively involved in CM-induced capillary-like formation and migration, while S1P2 exerted a negative role on CM-induced migratory action of MAB. Finally, SK inhibition as well as MAB S1P1 and S1P3 down-regulation impaired H-MVEC-MAB cross-talk significantly reducing in vivo angiogenesis evaluated by Matrigel plug assay. These findings individuate novel targets for the employment of MAB in vascular-related pathologic conditions. • Down-regulation of SK1/2 in H-MVEC impaired vessel formation when cultured with MAB. • H-MVEC SPNS2 is critical for morphogenesis and migration induced by H-MVEC CM of MAB. • CM from SK1- and SK2-siRNA H-MVEC impaired morphogenesis and migration of MAB. • S1P1/3 were involved on CM-induced morphogenesis and migration of MAB. • Matrigel plug assay showed the role of S1P axis in MAB-endothelial cell interaction.

IntroductionThe effects of psychotropic drugs and alcohol acute intoxication are important risk factors for attempted suicide among individuals with and without substance use disorder (SUD).AimsThe first aim of this study is describing the socio-demographic features and clinical history of subjects who were acutely intoxicated when attempting suicide. The second aim is to compare their features with those of subjects without acute alcohol and substances intoxication at suicide attempt time.MethodsDeterminants of ER psychiatric consultations were studied prospectively during the period 2008–2014 at the “Maggiore della Carità” Hospital in Novara, Italy. For each patient, a data sheet was filled in by experienced psychiatrists, in order to gather demographic features, psychiatric history and present clinical issues like blood and urine dosage of amphetamine and methamphetamine, cannabinoid, cocaine and alcohol. Comparison of qualitative data was performed by means of the Chi2 test. Statistical significance was set at P ≤ 0.05.ResultsWe collected a sample of 495 suicide attempters who referred to our ER. Statistical analysis of demographic and clinical data is still ongoing.ConclusionsPreliminary results point out that acute alcohol and drugs intoxication at suicide attempt time is much more frequent in subjects without a SUD. Implications will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionStudies conducted on Italian samples suggested that 70% of self-harms referred to the emergency room (ER) were suicide attempts. Suicide attempts are associated with societal, relationship and individual risk factors, which vary with age and gender, occur in combination, and may change over time. We conducted a previous study on a sample of psychiatric consultations in ER from 2008 to 2011. We observed that female gender, a permanent job and being in the warmer months of the year were risk factors for suicide attempts.AimTo update knowledge about risk factors for attempted suicide analyzing a larger sample of ER psychiatric consultations.MethodsDeterminants of emergency room visits for psychiatric reasons were studied prospectively in a period of 8 years, from 2008 to 2015 at the “Maggiore della Carità” Hospital in Novara. The psychiatric assessment of patients was performed by experienced psychiatrists with a clinical interview. For each patient, a data sheet was filled in order to gather demographic and clinical features. Comparison of qualitative data was performed by means of the Chi2 test while differences between groups for continuous variables were assessed through a t-test. Statistical significance was set at P ≤ 0.05. A multivariate analysis was performed using logistic regression in order to assess the potential predictors of attempted suicide. Results are expressed as odds ratio (OR) with 95% confidence intervals (95% CI).ConclusionsWe have collected data from more than 500 psychiatric consultations for attempted suicide. Data collection and statistical analyses are still ongoing. Implications will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

BackgroundMental disorders are considered a risk factor for suicide: for example, the lifetime risk of suicide is estimated to be 4%–8% in people with mood disorders. The literature suggests that a history of suicide attempts is significantly related to electrodermal hyporeactivity and that patients with violent suicide attempters exhibit faster habituation of the electrodermal response to repeated neutral tones than patients with non-violent attempts. The impact of depressive symptoms on suicidal ideation may be moderated by resilience. Resilience refers to the ability to maintain o regain mental health despite experiencing adversity. In bipolar and depressive disorders, resilience may influence severity of episodes, frequency of relapse and response to treatment.AimThe objective of our study was to assess the possible correlation among attempted suicide, resilience and dermal reactivity in a sample of depressed patients.MethodsWe recruited patients with depressive disorders and bipolar depression; data about socio-demographic, clinical features, severity of attempted suicide and suicidal risk were gathered. Patients filled in the Resilience Scale for Adult (RSA). Moreover, for each patient we performed the Edor test in order to assess dermal reactivity.ResultsData collection is still ongoing. We expect to find lower levels of resilience in those patients who are hyporeactive and attempted suicide. Moreover, we hypothesize that suicide attempts in the group of hyporeactive patients would be characterized by planning and greater severity. Clinical implications will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionAccording to Durkheim's theory, suicide attempts increase during periods of rapid economic changes and decrease again when stability is achieved, due to the social integration in the community guaranteed by occupational status. Since 2009 in Europe, it was observed an increase in the suicide rates, in line with the increase of unemployment. Although unemployment is considered a risk factor for suicide, it was observed a noticeable increase in suicide rates among Italian employed men during the last years, probably related to the specific economic scenario and to emerging difficulties in keeping an income to adequately maintain one's own family standard of living.AimTo study attempted suicides with a specific focus and attention on the current Italian economic scenario.MethodsDeterminants of emergency room visits for psychiatric reasons in patients aged > 16 years were studied prospectively from 2008 to 2015 at the AOU Maggiore della Carità Hospital, Novara, Italy. Each patient was assessed by an experienced psychiatrist with a clinical interview and socio-demographic and clinical features were gathered. Statistical significance was set at P ≤ 0.05.ResultsPreliminary results suggest an increase in suicide attempts according to the rise of the unemployment rate in Novara. Although in absolute figures most attempters are unemployed, it seems that suicide attempts are more frequent in the group of employed subjects, which includes also people under redundancy fund. This subgroup may be considered halfway between employed and unemployed attempters.ConclusionsData collection and statistical analyses are still ongoing. Implications for clinical practice will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

BackgroundHistory of previous suicide attempts is one of the most important risk factors for a subsequent completed suicide. Suicide reattempters (SR) has been long associated with demographic and clinical risk factors for suicide, such as unemployment and psychiatric disorders, however a recent review of the literature has not supported a specific age and gender profile of SR, but rather underscored that, as far as diagnosis is concerned, SR were more likely to have a personality disorder. According to literature, 16%–34% of the subjects repeat a suicide attempt within the first 2 years after the previous one.AimThe purpose of our study was evaluating clinical and socio-demographic characteristics and the outcome of psychiatric consultation among subjects referring to an emergency room for recommitting a suicide attempt.MethodsWe considered a sample of SR aged > 16 years. We extracted data from the database including all patients requiring psychiatric evaluation in the emergency room, and eventually compared the features of SR and patients with a single suicide attempt. For each patient, we gathered socio-demographic features, psychiatric history and current clinical issues, suicidal intent and suicidal behaviors.ResultsData collection and statistical analyses are still ongoing. Preliminary results show that, compared to patients with a single suicide attempt, SR were more frequent female, unmarried, employed, with a low level of instruction; they had a psychiatric disease (axis I – anxiety disorder, somatoform disorder; axis II – histrionic personality disorder); they are under the care of mental health services and under psychopharmacological treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Purpose Suicide attempts are extremely prevalent and associated with many risk factors that vary with age and gender, occur in combination, and may change over time. The aim of the present study was to describe gender differences among psychiatric ER users at the AOU Maggiore della Carita Hospital in Novara for attempted suicide with regard to intentions and methods of attempting. Methods Determinants of ER psychiatric consultations were studied prospectively during the period 2008-2014 at the 'Maggiore” Hospital in Novara. Comparison of qualitative data was performed by means of the ×2 test. Statistical significance was set at p≤0.05. Results We have already gathered data from more than 2000 ER psychiatric consultations. Preliminary results suggest that suicide attempts are more common in females than in males, although through the years there seems to be a trend towards increase of attempts even in males. Surprisingly, suicide attempts are found to be more common in employed subjects than in unemployed ones. Reasons for self-harming are associated with relational problems rather than psychiatric symptoms. Drugs poisoning seems to be the preferred suicide method. Conclusions The results described above should be considered as preliminary, as data collection and statistical analyses are still ongoing. Anyway, the possible correlation between employment and suicide attempt, and the growing frequency of attempts in males seem to be particularly interesting. Implications will be discussed.

Introduction Our Psychiatry Ward (SC Psichiatria, Maggiore della Carita Hospital, Novara) has a longstanding tradition in the training of clinicians (psychiatrists, but also non-psychiatrists) about the importance of the approach in helping relationships. This tradition reflects itself in the organization of the assistance to the acute psychiatric inpatients admitted to the Ward. In addition to treatment as usual, patients have the opportunity of being involved in several group activities. The activities are proposed to them, with an approach that varies according to the patient's lifetime diagnosis, current conditions, relational difficulties, etc. In other words, different activities may be proposed to different patients, in different ways. Aims To describe the integrated treatment approach we use in our Psychiatry Ward. Methods Group activities are guided by a group leader who is supported by one or two assistants whose role is to facilitate discussion. Activities include: Newspaper Reading (everyday in the morning, 1 hour); Music Listening Group (once a week; 1 hour); Cinema Group (once a week; 2 hours and a half); Fairytale Group (on alternating days in the evening, 1 hour). Results More details will be supplied regarding the theoretical background for the group, the group features/implementation, and its specific objectives. Conclusions All the group activities integrate themselves in an early rehabilitation project tailored to each patients' characteristics and needs. Briefly, their main objectives include: 1) to help patients endorse their cognitive, emotional and relational skills; 2) to offer support to the crisis they are experiencing, which led them to admission to the Ward.

Introduction Our Psychiatry Ward offers several group activities to both inpatients and outpatients. Among these, the Editorial Group involves only outpatients (who had been previously admitted to the Psychiatry Ward as inpatients) in fair psychopathological compensation, carefully selected for this long-term rehabilitation approach. Aims To describe the Editorial Group activity. Methods The Editorial Group meets once a week at the Psychiatry Ward. It involves patients, nurses and a group leader who is a Psychiatrist. The psychiatrists' and nurses' role is to facilitate the group process and the exploration of the topics discussed. Members are encouraged to discuss their opinions about tales, movies and books; to share poems, paintings, photographs. The aim of this process is to eventually develop a Ward magazine which is published quarterly. Results Members' commitment is extended beyond the weekly meeting hour of the group; indeed, we have observed that patients in their free time spontaneously decide to spend time collecting material to share and drawing up the articles, which are assigned according to patients' aptitudes and preferences. A continued commitment to share daily life experiences and to express creativity, helps patients get involved in the Group, and eventually leads to something concrete and valuable to share with others, also beyond the Group. Both the leader and the other equipe members help patients listening to each others' opinions, ideas and personal experiences. Conclusions The Editorial Group helps patients improving emotional and relational skills, and stimulates cognitive resources. Moreover, it enhances creativity, promotes collaboration and stimulates curiosity.