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The COVID-19 pandemic has had a significant impact on the quality of life (QoL), daily lifestyle, and mental health of people suffering from a mental disorder. This study aimed to investigate the effects of the prolongation of the COVID-19 emergency on QoL and lifestyles in a sample of 100 outpatients at the Psychiatry Unit in Palermo University Hospital, Italy. QoL was measured through the 12-item Short Form Survey and the COV19-Impact on Quality of Life. Lifestyle changes during the pandemic were measured through the lifestyle change questionnaire. The majority of participants reported a great impact of COVID-19 on the QoL, and almost half reported worsened lifestyles. Worsened lifestyles were predictive of both poor mental and physical health related QoL. These results suggest that people with mental illness need interventions targeting lifestyles, and the mental health service in Italy should adjust to the ongoing pandemic, developing virtual treatments.

This study was funded by the Medical Research Council, the European Community’s Seventh Framework Program grant [agreement HEALTH-F2-2009-241909 (Project EU-GEI)], São Paulo Research Foundation (grant 2012/0417-0), the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King’s College London, the NIHR BRC at University College London and the Wellcome Trust (grant 101272/Z/12/Z)., Tripoli, G., Quattrone, D., Ferraro, L., Gayer-Anderson, C., Rodriguez, V., La Cascia, C., La Barbera, D., Sartorio, C., Seminerio, F., Tarricone, I., Berardi, D., Szöke, A., Arango, C., Tortelli, A., Llorca, P.-M., De Haan, L., Velthorst, E., Bobes, J., Bernardo, M., Sanjuán, J., Santos, J.L., Arrojo, M., Del-Ben, C.M., Menezes, P.R., Selten, J.-P., Jones, P.B., Jongsma, H.E., Kirkbride, J.B., Lasalvia, A., Tosato, S., Richards, A., O'donovan, M., Rutten, B.P.F., Os, J.V., Morgan, C., Sham, P.C., Murray, R.M., Murray, G.K., Di Forti, M.

Background: Circuits is a computerized cognitive remediation program for individuals with schizophrenia. this study aimed to evaluate the feasibility of the italian version of circuits. MethODs: Feasibility was measured through ad-hoc questionnaires in a non-clinical sample (N.=30; target-score 70%; study 1); in patients with schizophrenia (N.=5; target-score 60%; study 2) and cr therapists (N.=3; target-score 60%; study 2). study 3 was a pilot study investigating: 1) enrolment, compliance, and retention rates; 2) satisfaction; 3) potential post-treatment and follow-up improvements in patients with schizophrenia (N.=20). these results were used to estimate sample size and feasibility for a future trial. resULts: all non-clinical participants rated high feasibility of circuits (83.3-100% scores). all patients (60-100% high-scores) and cr therapists (66-100% high-scores) evaluated circuits feasible. high rates of retention in treatment (74.5%) and satisfaction (85-100%) in patients were showed. Post-treatment assessment revealed an improvement in all cognitive measures. a sample size of 32 was calculated for each arm of the trial, at the desired power of 80%, to recruit for 18 months. cONcLUsiONs: results showed the feasibility of the italian version of circuits, they will inform a controlled future trial and implementation study of this therapy approach in the italian mental health system.

Importance: Psychotic disorders contribute significantly to the global disease burden, yet the latest international incidence study of psychotic disorders was conducted in the 1980s. Objectives: To estimate the incidence of psychotic disorders using comparable methods across 17 catchment areas in 6 countries and to examine the variance between catchment areas by putative environmental risk factors. Design, Setting, and Participants: An international multisite incidence study (the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions) was conducted from May 1, 2010, to April 1, 2015, among 2774 individuals from England (2 catchment areas), France (3 catchment areas), Italy (3 catchment areas), the Netherlands (2 catchment areas), Spain (6 catchment areas), and Brazil (1 catchment area) with a first episode of nonorganic psychotic disorders (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] codes F20-F33) confirmed by the Operational Criteria Checklist. Denominator populations were estimated using official national statistics. Exposures: Age, sex, and racial/ethnic minority status were treated as a priori confounders. Latitude, population density, percentage unemployment, owner-occupied housing, and single-person households were treated as catchment area-level exposures. Main Outcomes and Measures: Incidence of nonorganic psychotic disorders (ICD-10 codes F20-F33), nonaffective psychoses (ICD-10 codes F20-F29), and affective psychoses (ICD-10 codes F30-F33) confirmed by the Operational Criteria Checklist. Results: A total of 2774 patients (1196 women and 1578 men; median age, 30.5 years [interquartile range, 23.0-41.0 years]) with incident cases of psychotic disorders were identified during 12.9 million person-years at risk (crude incidence, 21.4 per 100 000 person-years; 95% CI, 19.4-23.4 per 100 000 person-years). A total of 2183 patients (78.7%) had nonaffective psychotic disorders. After direct standardization for age, sex, and racial/ethnic minority status, an 8-fold variation was seen in the incidence of all psychotic disorders, from 6.0 (95% CI, 3.5-8.6) per 100 000 person-years in Santiago, Spain, to 46.1 (95% CI, 37.3-55.0) per 100 000 person-years in Paris, France. Rates were elevated in racial/ethnic minority groups (incidence rate ratio, 1.6; 95% CI, 1.5-1.7), were highest for men 18 to 24 years of age, and were lower in catchment areas with more owner-occupied homes (incidence rate ratio, 0.8; 95% CI, 0.7-0.8). Similar patterns were observed for nonaffective psychoses; a lower incidence of affective psychoses was associated with higher area-level unemployment (incidence rate ratio, 0.3; 95% CI, 0.2-0.5). Conclusions and Relevance: This study confirmed marked heterogeneity in risk for psychotic disorders by person and place, including higher rates in younger men, racial/ethnic minorities, and areas characterized by a lower percentage of owner-occupied houses., The European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) Project is funded by grant agreement HEALTH-F2-2010-241909 (Project EU-GEI) from the European Community’s Seventh Framework Programme. The Brazilian study was funded by grant 2012/0417-0 from the São Paulo Research Foundation. Dr Kirkbride is funded by the Wellcome Trust and grant 101272/Z/13/Z from the Royal Society. Ms Jongsma and Dr Jones are funded by the National Institute of Health Research Collaboration of Leadership in Applied Health Research and Care East of England.

Background: Despite the great progress achieved by treatment approaches for Gambling Disorder (GD) the relevance of studying efficacious therapies still remains high. This pilot study aims at the evaluation of the efficacy of a standardized protocol based on Functional theory for GD. Functional Therapy (FT) is an integrated body-mind therapy.Methods: Twenty-eight pathological gamblers completed the FT protocol consisted in 16 sessions, two times a week for a total duration of two months, in an individual setting. No one of the patients was taking any psychopharmacological therapy. Psychological assessment both at baseline (T0) and at the end of the treament (T1) includes the South Oaks Gambling Screen, the PG-Yale-Brown Obsessive-Compulsive Scale (PG-YBOCS), State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory II version (BDI-II), the Barrat Impulsiveness Scale 11th version (BIS-11) and the Measurement of Psychological Stress (MSP).Results: a significant reduction of GD (gambling frequency, duration, money inserted, and expenditure) in pathological gamblers was revealed together with a significant reduction of depression, anxiety, impulsivity and perceived stress.Conclusions: the structured FT program for GD highlights a strong improvement in gambling behavior, in reducing impulsivity, depression, anxiety and perceived stress, thus obtaining a good compliance and a few dropout.

Background Jumping to conclusions (JTC) is a well-established reasoning and data gathering bias found in patients with psychosis even at illness onset (First Episode Psychosis, FEP). Preliminary work in this field focused primarily on the association with delusions, although jumping to conclusions has also been found in non-deluded schizophrenia patients after remission, and in individual with at risk mental state. Moreover, psychotic patients tend to show impairments in social cognition, struggling in identifying, processing and interpreting social clues. Deficits in facial emotion recognition (FER) – a key component of the construct – represent a well-replicated finding in schizophrenia. Furthermore, deficits in global facial affect recognition have been found in FEP with the same severity as at further stages, especially for anger recognition. The present study aims to measure JTC and FER bias in a sample of FEP recruited across 5 European countries, compared with healthy controls. Methods Data on JTC (Beads task 60:40), FER (Degraded Facial Recognition task – DFAR) and socio-demographics have been analysed in a sample of 643 FEP and 1019 population controls recruited as part as the EU-GEI study across UK, Netherlands, France, Spain, and Italy. IQ scores were used to exclude cases and controls with current IQ

Background: Patients presenting to psychiatric services with their first episode of psychosis (FEP) report higher rates of previous cannabis use than the general population (Donoghue et al., 2011; Myles, Myles and Large, 2016). Evidence suggested that 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 different countries, once having taken into account different patterns of cannabis use (i.e. frequency of use and age at first use). Methods: We analysed data on patterns of lifetime cannabis use and AOP from FEP=1,149 (61.7% males) from 5 European countries and Brazil part of the European network of national schizophrenia networks studying European Gene-Environment-Interaction (EUGEI) study. Patients met ICD-10 criteria for psychosis, ascertained by using OPCRIT (McGuffin et al., 1991). The CEQmv (Di Forti et al., 2009) further modified for the EUGEI study, was used to collect data on lifetime frequency of cannabis use (never used/ used at least once but less than daily/ everyday use) and age at first use in years (then dichotomized according to mean age at first use ≤15 years or ≥16 years). We used two ANOVAs: age of onset was used as the outcome variable and frequency of cannabis use and age of first use were respectively entered as independent predictors, along with country, gender and self-ascribed ethnicity. Results: 63.3% of our sample used cannabis at least once in lifetime. Among those who used cannabis in their lifetime, mean age at first use was 16.8 years (sd=4.6) and median age was 16 years, 42.3% tried first time cannabis at 15 years or before, 57.7% at 16 years or older. Patients who smoked cannabis on a recreational basis (mean age 29.0; contrast=5.8, CI 95% 4.3, 7.2, p