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Objectives: Working Alliance (WA) is important in the care of patients with Schizophrenia Spectrum Disorders (SSD). This study aims to determine which sociodemographic and clinical factors are associated with WA, as assessed by patients and staff members in Residential Facilities (RFs), and may predict WA dyads' discrepancies. Methods: Three hundred and three SSD patients and 165 healthcare workers were recruited from 98 RFs and characterized for sociodemographic features. WA was rated by the Working Alliance Inventory (WAI) for patients (WAIP) and staff members (WAI- T). SSD patients were assessed for the severity of psychopathology and psychosocial functioning. Results: Pearson's correlation revealed a positive correlation (ρ = .314; p < .001) between WAI- P and WAI- T ratings. Linear regression showed that patients with higher education reported lower WAI- P ratings (β = -.50, p = .044), while not being engaged in work or study was associated with lower WAI- T scores (β = -4.17, p = .015). A shorter lifetime hospitalization was associated with higher WAI- P ratings (β = 5.90, p = .008), while higher psychopathology severity negatively predicted WAI- T (β = -.10, p = .002) and WAI- P ratings (β = -.19, p < .001). Better functioning level positively foresaw WAI- T (β = .14, p < .001) and WAI- P ratings (β = .12, p < .001). Regarding discrepancies, staff members' age was associated with higher dyads discrepancy in Total scale and Agreement subscale scores, which were also associated with more severe negative symptoms, while patients' age was negatively correlated to Relationship subscale discrepancy. Conclusions: This study provides insight into the factors that influence WA in SSD patients and health workers in RFs. The findings address interventions to improve WA and ultimately patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Evaluating emotional experiences in the life of people with Schizophrenia Spectrum Disorder (SSD) is fundamental for developing interventions aimed at promoting well‐being in specific times and contexts. However, little is known about emotional variability in this population. In DiAPAson project, we evaluated between‐ and within‐person differences in emotional intensity, variability, and instability between people with SSD and healthy controls, and the association with psychiatric severity and levels of functioning. Methods: 102 individuals diagnosed with SSD (57 residential patients, 46 outpatients) and 112 healthy controls were thoroughly evaluated. Daily emotions were prospectively assessed with Experience Sampling Method eight times a day for a week. Statistical analyses included ANOVA, correlations, and generalized linear models. Results: Participants with SSD, and especially residential patients, had a higher intensity of negative emotions when compared to controls. Moreover, all people with SSD reported a greater between‐person‐variability of both positive and negative emotions and greater intra‐variability of negative emotions than healthy controls. In addition, the emotion variability in people with SSD does not follow a linear or quadratic trend but is more "chaotic" if compared to controls. Conclusions: Adequate assessments of positive and negative emotional experiences and their time course in people with SSD can assist mental health professionals with well‐being assessment, implementing targeted interventions through the identification of patterns, triggers, and potential predictors of emotional states. [ABSTRACT FROM AUTHOR]

Aim: To estimate the treated incidence of individuals with first‐episode psychosis (FEP) who contacted the Emilia‐Romagna public mental healthcare system (Italy); to examine the variability of incidence and user characteristics across centres and years. Methods: We computed the raw treated incidence in 2013–2019, based on FEP users aged 18–35, seen within or outside the regional program for FEP. We modelled FEP incidence across 10 catchment areas and 7 years using Bayesian Poisson and Negative Binomial Generalized Linear Models of varying complexity. We explored associations between user characteristics, study centre and year comparing variables and socioclinical clusters of subjects. Results: Thousand three hundred and eighteen individuals were treated for FEP (raw incidence: 25.3 / 100.000 inhabitant year, IQR: 15.3). A Negative Binomial location‐scale model with area, population density and year as predictors found that incidence and its variability changed across centres (Bologna: 36.55; 95% CrI: 30.39–43.86; Imola: 3.07; 95% CrI: 1.61–4.99) but did not follow linear temporal trends or density. Centers were associated with different user age, gender, migrant status, occupation, living conditions and cluster distribution. Year was associated negatively with HoNOS score (R = −0.09, p <.001), duration of untreated psychosis (R = −0.12, p <.001) and referral type. Conclusions: The Emilia‐Romagna region presents a relatively high but variable incidence of FEP across areas, but not in time. More granular information on social, ethnic and cultural factors may increase the level of explanation and prediction of FEP incidence and characteristics, shedding light on social and healthcare factors influencing FEP. [ABSTRACT FROM AUTHOR]

Aim: To report on the development of an early intervention service in Modena, Italy, with information relevant to the first 4 years of implementation. Methods: The 2‐year service was offered to people aged 18‐35 with psychotic manifestations, within 2 years from psychosis onset/or naïve to antipsychotics, by teams placed within community mental health Centres, according to a "specialist within generalist" model. Treatment included pharmacological consultation, psychoeducation and social inclusion programs. Health of the Nation Outcome Scale was administered at baseline and every 6 months. Results: One hundred cases accepted the treatment from 1 March 2013 to 31 December 2016. Of these, 71% were male with a median age of 23. Ninety percent were diagnosed with non‐affective psychosis, yielding an estimated treated incidence of 19.1/105. General practitioners (GPs)represented the most frequent referrers to the program (38%), followed by referrals from acute general and psychiatric hospital units (22%) and self‐referrals (14%). Meaningful clinical improvement was observed, 6 months after enrolment. Conclusions: An early intervention service for psychosis was successfully implemented within existing community outpatient services. GPs represented the main referrals, providing some validation of the "specialist within generalist" model of care. A promising clinical improvement and trend of reduction in duration of untreated psychosis was found, supporting the variety of early detection efforts in the community. The high median age and lack of information about pathways to care underline possible barriers to access for younger patients. These findings will inform refinement of treatments and service models for the Region. [ABSTRACT FROM AUTHOR]

Abstract: Despite the call by the scientific community for a systematic monitoring of physical health in people with psychiatric illnesses, national and international audits have reported poor quality of cardiovascular risk assessments and management in this vulnerable population. Available evidence indicates that in people affected by mental illness, life expectancy is reduced by 10–20 years, mainly due to cardiovascular accidents and metabolic syndrome (MetS)‐related diseases. The primary aim of the present study was to evaluate the accuracy of cardiovascular risk monitoring in an outpatient sample of patients taking second‐generation antipsychotics. The sample consisted of 200 patients consecutively recruited from two community mental health centres. A clinical chart review was performed on the following laboratory tests: total cholesterol, high‐ and low‐density lipoprotein, serum triglycerides, fasting blood glucose, γ‐glutamyl transpeptidase. Blood pressure and waist circumference were measured. A complete cardiovascular risk assessment was available only in 60 patients out of 200 (33.3%). The only variable associated with laboratory tests for MetS was receiving three or more psychotropic medications, which increased fourfold the probability of metabolic screening. In the subsample of patients with full screening, the prevalence of MetS was 33.3%. Our findings suggest that mental health professionals working in community mental health services should incorporate a more systematic assessment of physical health in their practice, and intervene proactively to reduce the significant cardiovascular burden carried by people with several mental illness. [ABSTRACT FROM AUTHOR]