Search

[Background and hypothesis] Evidence suggests that childhood maltreatment (ie, childhood abuse and childhood neglect) affects educational attainment and cognition. However, the association between childhood maltreatment and Intelligence Quotient (IQ) seems stronger among controls compared to people with psychosis. We hypothesised that: the association between childhood maltreatment and poor cognition would be stronger among community controls than among people with first-episode of psychosis (FEP); compared to abuse, neglect would show stronger associations with educational attainment and cognition; the association between childhood maltreatment and IQ would be partially accounted for by other risk factors; and the association between childhood maltreatment, educational attainment, and IQ would be stronger among patients with affective psychoses compared to those with nonaffective psychoses., [Study Design] 829 patients with FEP and 1283 community controls from 16 EU-GEI sites were assessed for child maltreatment, education attainment, and IQ., [Study Results] In both the FEP and control group, childhood maltreatment was associated with lower educational attainment. The association between childhood maltreatment and lower IQ was robust to adjustment for confounders only among controls. Whereas childhood neglect was consistently associated with lower attainment and IQ in both groups, childhood abuse was associated with IQ only in controls. Among both patients with affective and nonaffective psychoses, negative associations between childhood maltreatment and educational attainment were observed, but the crude association with IQ was only evident in affective psychoses., [Conclusions] Our findings underscore the role of childhood maltreatment in shaping academic outcomes and cognition of people with FEP as well as controls., The EU-GEI Study is funded by grant agreement HEALTH-F2-2010-241909 (Project EU-GEI) from the European Community’s Seventh Framework Programme, and Grant 2012/0417-0 from the São Paulo Research Foundation. B.P.F. Rutten is funded by a VIDI award (no. 91.718.336) from the Netherlands Scientific Organization. H. L. Fisher, C. Gayer-Anderson, and C. Morgan are supported by the Economic and Social Research Council (ESRC) Centre for Society and Mental Health at King’s College London [ES/S012567/1]. C. Arango has received support by the Spanish Ministry of Science and Innovation. Instituto de Salud Carlos III (SAM16PE07CP1, PI16/02012, PI19/024), co-financed by ERDF Funds from the European Commission, “A way of making Europe”, CIBERSAM. Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), European Union Structural Funds. European Union Seventh Framework Program under grant agreements, FP7- HEALTH-2013-2.2.1-2-603196 (Project PSYSCAN) and FP7- HEALTH-2013-2.2.1-2-602478 (Project METSY); and European Union H2020 Program under the Innovative Medicines Initiative 2 Joint Undertaking (grant agreement No 115916, Project PRISM, and grant agreement No 777394, Project AIMS-2-TRIALS), Fundación Familia Alonso and Fundación Alicia Koplowitz. J.B. Kirkbride is supported by the NIHR University College London Hospital Biomedical Research Centre.

Funder: FP7 Ideas: European Research Council; doi: http://dx.doi.org/10.13039/100011199; Grant(s): HEALTH-F2-2010-241909, Purpose: The EUropean Network of National Schizophrenia Networks Studying Gene–Environment Interactions (EU-GEI) study contains an unparalleled wealth of comprehensive data that allows for testing hypotheses about (1) variations in incidence within and between countries, including by urbanicity and minority ethnic groups; and (2) the role of multiple environmental and genetic risk factors, and their interactions, in the development of psychotic disorders. Methods: Between 2010 and 2015, we identified 2774 incident cases of psychotic disorders during 12.9 million person-years at risk, across 17 sites in 6 countries (UK, The Netherlands, France, Spain, Italy, and Brazil). Of the 2774 incident cases, 1130 cases were assessed in detail and form the case sample for case–control analyses. Across all sites, 1497 controls were recruited and assessed. We collected data on an extensive range of exposures and outcomes, including demographic, clinical (e.g. premorbid adjustment), social (e.g. childhood and adult adversity, cannabis use, migration, discrimination), cognitive (e.g. IQ, facial affect processing, attributional biases), and biological (DNA via blood sample/cheek swab). We describe the methodology of the study and some descriptive results, including representativeness of the cohort. Conclusions: This resource constitutes the largest and most extensive incidence and case–control study of psychosis ever conducted.

BackgroundThe Community Assessment of Psychic Experiences (CAPE) is a 42-item self-report questionnaire that has been developed and validated to measure the dimensions of psychosis in the general population. The CAPE has a three-factor structure with dimensions of positive, negative and depression. Assessing the cross-national equivalence of a questionnaire is an essential prerequisite before pooling data from different countries. In this study, our aim was to investigate the measurement invariance of the CAPE across different countries.MethodsData were drawn from the European Union Gene-Environment Interaction (EU-GEI) study. Participants (incident cases of psychotic disorder, controls and siblings of cases) were recruited in Brazil, France, Italy, the Netherlands, Spain and UK. To analyse the measurement invariance across these samples, we tested configural invariance (i.e. identical structures of the factors), metric invariance (i.e. equivalence of the factor loadings) and scalar invariance (i.e. equivalence of the thresholds) of the three CAPE dimensions using multigroup categorical confirmatory factor analysis methods.ResultsThe configural invariance model fits well, providing evidence for identical factorial structure across countries. In comparison with the configural model invariance, the fit indices were very similar in the metric and scalar invariance models, indicating that factor loadings and thresholds did not differ across the six countries.ConclusionWe found that, across six countries, the CAPE showed equivalent factorial structure, factor loadings and thresholds. Thus, differences observed in scores between individuals from different countries should be considered as reflecting different levels of psychosis.

Diagnostic categories do not completely reflect the heterogeneous expression of psychosis. Using data from the EU-GEI study, we evaluated the impact of schizophrenia polygenic risk score (SZ-PRS) and patterns of cannabis use on the transdiagnostic expression of psychosis. We analysed first-episode psychosis patients (FEP) and controls, generating transdiagnostic dimensions of psychotic symptoms and experiences using item response bi-factor modelling. Linear regression was used to test the associations between these dimensions and SZ-PRS, as well as the combined effect of SZ-PRS and cannabis use on the dimensions of positive psychotic symptoms and experiences. We found associations between SZ-PRS and (1) both negative (B = 0.18; 95%CI 0.03–0.33) and positive (B = 0.19; 95%CI 0.03–0.35) symptom dimensions in 617 FEP patients, regardless of their categorical diagnosis; and (2) all the psychotic experience dimensions in 979 controls. We did not observe associations between SZ-PRS and the general and affective dimensions in FEP. Daily and current cannabis use were associated with the positive dimensions in FEP (B = 0.31; 95%CI 0.11–0.52) and in controls (B = 0.26; 95%CI 0.06–0.46), over and above SZ-PRS. We provide evidence that genetic liability to schizophrenia and cannabis use map onto transdiagnostic symptom dimensions, supporting the validity and utility of the dimensional representation of psychosis. In our sample, genetic liability to schizophrenia correlated with more severe psychosis presentation, and cannabis use conferred risk to positive symptomatology beyond the genetic risk. Our findings support the hypothesis that psychotic experiences in the general population have similar genetic substrates as clinical disorders.

BACKGROUND: The 'jumping to conclusions' (JTC) bias is associated with both psychosis and general cognition but their relationship is unclear. In this study, we set out to clarify the relationship between the JTC bias, IQ, psychosis and polygenic liability to schizophrenia and IQ.; METHODS: A total of 817 first episode psychosis patients and 1294 population-based controls completed assessments of general intelligence (IQ), and JTC, and provided blood or saliva samples from which we extracted DNA and computed polygenic risk scores for IQ and schizophrenia.; RESULTS: The estimated proportion of the total effect of case/control differences on JTC mediated by IQ was 79%. Schizophrenia polygenic risk score was non-significantly associated with a higher number of beads drawn (B = 0.47, 95% CI -0.21 to 1.16, p = 0.17); whereas IQ PRS (B = 0.51, 95% CI 0.25-0.76, p < 0.001) significantly predicted the number of beads drawn, and was thus associated with reduced JTC bias. The JTC was more strongly associated with the higher level of psychotic-like experiences (PLEs) in controls, including after controlling for IQ (B = -1.7, 95% CI -2.8 to -0.5, p = 0.006), but did not relate to delusions in patients.; CONCLUSIONS: Our findings suggest that the JTC reasoning bias in psychosis might not be a specific cognitive deficit but rather a manifestation or consequence, of general cognitive impairment. Whereas, in the general population, the JTC bias is related to PLEs, independent of IQ. The work has the potential to inform interventions targeting cognitive biases in early psychosis.

Background: Jumping to conclusions (JTC) is a reasoning and data gathering bias that results in the tendency to require less evidence and make hasty decisions. Preliminary work on reasoning bias focused primarily on the association with delusions, although jumping to conclusions has also been found in non-deluded schizophrenia (SZ) patients. Literature to date has shown JTC as a well-established bias in psychosis even at First Episode Psychosis (FEP), after remission, and in individuals with at risk mental state. Furthermore, JTC has been found to be associated with proneness to psychotic-like experiences in the general population. In teresting findings showed also an association with lower cognitive functioning in psychotic patients, and some degree of stability of JTC over the course of illness. Overall, findings to date could suggest a shared genetic liability between the occurrence of JTC and psychosis. The present study aims to investigate in a sample of FEP and healthy controls: 1) environment, cognitive, and clinical factors associated with JTC bias 2) whether the addition of SZ Polygenic Risk Score (PRS) explains any further variance in the model. Methods: We analyzed data on JTC (Beads task 60:40) in a sample of 503 FEP and 959 population controls for which genetic information was available, recruited as part as the EU-GEI study across UK, Netherlands, France, Spain, Italy and Brazil. In the first step, logistic regressions have been performed to predict JTC respectively in cases and controls considering as covariates: age, gender, level of education, IQ, country, frequency of cannabis use, population density, positive symptoms, and 20 principal components (PCs) for population stratification. In the second step, we estimated a model adding SZ PRS to the aforementioned terms. Results: Individuals coming from Brazil were about 6 times more likely to jump to conclusions in case group (OR=6.69; CI 95%=2.23-20.06; p=0.001) and around 5 times among controls (OR=4.76; CI 95%=2.28-9.93; p

BACKGROUND: The value of the nosological distinction between non-affective and affective psychosis has frequently been challenged. We aimed to investigate the transdiagnostic dimensional structure and associated characteristics of psychopathology at First Episode Psychosis (FEP). Regardless of diagnostic categories, we expected that positive symptoms occurred more frequently in ethnic minority groups and in more densely populated environments, and that negative symptoms were associated with indices of neurodevelopmental impairment. METHOD: This study included 2182 FEP individuals recruited across six countries, as part of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study. Symptom ratings were analysed using multidimensional item response modelling in Mplus to estimate five theory-based models of psychosis. We used multiple regression models to examine demographic and context factors associated with symptom dimensions. RESULTS: A bifactor model, composed of one general factor and five specific dimensions of positive, negative, disorganization, manic and depressive symptoms, best-represented associations among ratings of psychotic symptoms. Positive symptoms were more common in ethnic minority groups. Urbanicity was associated with a higher score on the general factor. Men presented with more negative and less depressive symptoms than women. Early age-at-first-contact with psychiatric services was associated with higher scores on negative, disorganized, and manic symptom dimensions. CONCLUSIONS: Our results suggest that the bifactor model of psychopathology holds across diagnostic categories of non-affective and affective psychosis at FEP, and demographic and context determinants map onto general and specific symptom dimensions. These findings have implications for tailoring symptom-specific treatments and inform research into the mood-psychosis spectrum.

Introduction There are strong enough evidences of the fact that risk of psychosis is augmented by cannabis use. In a recent analysis, the strongest predictor of case-control status was daily-skunk use, i.e. the ORs for skunk users increase with the frequency of use5. We know also that FEP who smoked cannabis in their lifetime are less neuropsychologically impaired i.e. they have better premorbid and current IQ6. In this study we wanted to test what augments the probability to be everyday users, taking into account premorbid social and academic adjustment and cognition as predictors, along with age at first cannabis-use and % of THC in cannabis used. Methods The sample was made of 834 First Episode Psychosis (FEP) cannabis-using and non-using patients from different European countries and 1.061 healthy controls, as part of the EUGEI-STUDY. A logistic regression was computed, using frequency of cannabis use among those who reported to have used cannabis in their lifetime, as an outcome variable in order to estimate the risk to be an everyday-user (heavy user) or a less-than-everyday user (recreational user), taking into account a list of predictors: sociodemographics, age at first cannabis-use, % of THC, premorbid social factor (PSF), premorbid academic factor (PAF), extracted from the Premorbid Adjustment Scale (PAS) and the four scales of WAIS-brief version. Results The risk to be an everyday-smoker was higher for cases, in interaction with age at first use, i.e. while the risk of controls diminishes when age at first use increases, this is not true for cases, whose risk stay higher even when age at first use increases (OR=1.2, p=0.001, CI 95% 1.09, 1.45). THC absolute concentration >10% augmented almost 2 folds the risk to be an everyday-smoker (OR=1.8, p=0.001, CI 95% 1.29, 2.60). A lower premorbid academic adjustment (OR=0.8, p=0.040, CI 95% 0.68, 0.99) and higher premorbid social adjustment before 16 years (OR=1.6, p=0.019, CI 95% 1.08, 2.60) increased the risk to be a heavy cannabis user, along with having a lower education level and being unemployed (all p

Background: Several studies report that patients with psychosis who used cannabis have a better cognitive performance than those whodid not (Rabin et al. 2011). In a previous study we found out a higher premorbid IQ, and a better IQ in psychotic patients who smoked cannabis in their lifetime, and our findings were consistent with the idea that this association is due to a better premorbid functioning rather than to an ameliorative effect of cannabis use on cognitive performance (Ferraro et al., 2013). A number of authors have hypothesized that psychotic patients who consume cannabis constitute a differentiated subgroup of patients that have better cognitive and social skills, necessary to engage in illegal drug consumption, than non-using patients (Compton et al., 2011; Løberg et al., 2014; Arnold et al., 2015). Given that the prevalence, and patterns, of cannabis use are culturally driven, we wanted to test the hypothesis of a better premorbid functioning in First Episode Psychosis (FEP) cannabis-using and non-using patients coming from different European countries (England, Italy, Spain, France, the Netherlands) as part of the EUGEI-STUDY. Methods: 1.745 people (746 cases; 999 controls) completed the assessment for Intellectual Quotient (IQ) (WAIS-brief version) premorbid adjustment (Premorbid Adjustment Scale – PAS) and cannabis use (CEQ-Revised). We first performed a factor analysis on PAS components, by obtaining two main factors: “Premorbid Social Adjustment” (PSA) and “Premorbid Academic Adjustment” (PAA). We therefore performed linear mixed models with IQ, PSA, and PAA as dependent variables and cannabis lifetime (Yes/No), subject status (Cases/Controls), gender and age as independent variables. Results: Across all countries, IQ was higher in those patients who smoked cannabis in their lifetime compared to those who did not (P = 0.027). This IQ difference was only 3 points and was the same for cases and healthy controls (P = 0.949). Similarly, patients who had smoked cannabis in their lifetime showed better PSA scores than non users (P = 0.009). The difference in PSA score between cannabis-users and non-users was significantly greater in cases than controls (P = 0.038). Conversely, across all countries, PAA resulted worst in patients who smoked cannabis lifetime than patients who did not (Po0.001) and this PAA score difference was the same for cases and controls (P = 0.693). Discussion: Our cannabis-using FEP patients have higher IQ, better PSA and lower PAA than non user patients across 5 different European countries. Starting from these preliminary results, we can conclude that a better PSA is significantly associated with cannabis use in FEP patients. Nevertheless, in an exploratory analysis, a better IQ resulted related to a better PAA (o0.001) but not to PSA (P = 0.260); thus indicating an independent relationship of IQ and PSA with cannabis use. Further analysis are required in order to model these multivariate relationships.

Il capitolo descrive Il progetto “Interventi Psicologici e Riabilitativi nei Reparti ad alta Criticità” Nato da una collaborazione tra l’Azienda Ospedaliera Universitaria Policlinico “Paolo Giaccone” dell’Università degli Studi di Palermo e l’Assessorato della Salute della Regione Sicilia, si è inscritto nel Progetto Obiettivo di Piano Sanitario Nazionale (intesa Stato Regione del 20/04/2011) con l’obiettivo di rispondere all’esigenza di ascolto e sostegno che molte persone sperimentano attraversando momenti critici, in grado di mettere a dura prova la loro qualità di vita. Avvalendosi di una equipe di psicologi che, nel primo anno ha annoverato tre unità, affiancate da un Tecnico della Riabilitazione Psichiatrica e che si è arricchita di ulteriori sei unità nella seconda annualità, ha operato in seno ai diversi reparti del Policlinico, con l’obiettivo di offrire interventi di prevenzione e presa in carico del disagio psicologico. Oltre al tempo ed al numero di interventi effettuati tra il gennaio 2013 e l'ottobre 2014 si esaminano gli obiettivi raggiunti e quelli da raggiungere. I punti di forza del progetto possono essere, in sintesi riassunti come segue: 1. L’attivazione del progetto è stata in grado di stimolare una sensibilizzazione importante in molte delle Unità Operative coinvolte nella fase di pubblicizzazione, facendo sorgere la richiesta di una presenza mensile per il monitoraggio degli utenti di alcune di esse (ad es. Malattie Infettive, Ambulatorio di Terapia del Dolore ed Audiologia). 2. I pazienti inviati in consulenza erano in effetti portatori di un disagio psicologico cui è stato prestato ascolto. 3. Gli interventi effettuati si sono dimostrati benefici in termini di outcome sintomatologico.

Introduction: A growing body of literature suggests that people affected by psychotic disorders are more likely to be unemployed, tend to live alone, have a poor social network, and are not able to establish long-term relationships (Morgan et al., 2008). Aims: To investigate social disadvantage in a sample of first-episode of psychosis patients and geographically matched controls. Methods: The study sample consists of 52 healthy controls and 37 FEP who were assessed using the MRC Sociodemographic Schedules. Results: Preliminary results suggest that, consistently with the literature, cases are more exposed than controls to social disadvantage. They tend to reach a lower education degree (OR 6.66; CI 95%, 1.67-26.50, p 0.005) and to have an underpaid job 5 years before the onset (OR 2.84; CI 95%, 1.08-7.45, p 0.03). Furthermore, cases are more likely to live longer with their parents rather than independently (OR 3.33; CI 95%, 1.25- 8.86, p 0.01) and are more exposed to house overcrowding (OR 3.92; CI 95%, 1.03-14.93, p 0.05). It was also found that an higher percentage of cases have never been in a stable relationship in the previous 5 years (OR 2.61; CI 95%, 1.08-6.27, p 0.03). Conclusions: In line with the previous literature, we found that lower educational and occupational status and poor relationship status are associated to risk for psychosis. However, in contrast with North European cases, Italian FEP are more likely to live with their family rather than alone and, therefore, to be exposed to house overcrowding. Morgan C, Kirkbride J, Hutchinson G, Craig T, Morgan K, Dazzan P, Boydell J, Doody GA, Jones PB, Murray RM, Leff J, Fearon P. Cumulative social disadvantage, ethnicity and first-episode psychosis: a case-control study. Psychol Med. 2008; 38(12):1701-15.

Introduction: Cannabis is one of the most common substances used by patients with a first episode of psychosis. The aim of the study was to investigate the most frequent effects of cannabis use, their relationship with psychotic symptoms and characteristics of the consumption. Methods: 116 first episode psychosis were recruited, 50% of which (n=58) used cannabis lifetime. We investigated the characteristics of the consumption and the effects of cannabis using the Cannabis Experience Questionnaire-mv (CEQmv) and the psychotic symptoms using the Positive and Negative Symptoms Scale (PANSS). Results: The effects more often experienced by cannabis users were slowed down thinking and feeling to be able to understand the world better. Feeling fearful was associated with interruption of consumption (U= 287,500, p=0.046). Hearing voices was associated with more than 50 times lifetime cannabis use (U=223,00, p=0.043). In addition, we found correlations between feeling fearful and like going crazy after cannabis use and positive and general PANSS. Conclusions: Those who have experienced more psychotic-like effects of cannabis present stronger positive symptoms. In addition, awareness of negative effects involves the interruption of consumption. These evidences underline the importance of primary and secondary prevention regarding the effects of cannabis use among people at high risk for psychotic disorders.

Introduzione: La gestione del paziente oncologico in corso di trattamento radioterapico non può prescindere da un’attenta valutazione delle variabili soggettive legate all’emotività e al vissuto interno del paziente, essendo tali aspetti implicati nella compliance al trattamento (Neilson et al., 2010). Questo lavoro si pone un duplice obiettivo: indagare la presenza di ansia, depressione e qualità della vita in un gruppo di pazienti oncologici non omogeneo per patologia, stadio della malattia e trattamento; valutare in che termini l’introduzione di un intervento psicologico possa avere delle ricadute sul benessere psico-fisico dei pazienti. Metodologia: Il campione è costituito da 50 pazienti suddivisi, con modalità random, in un gruppo sperimentale e uno di controllo. Strumenti: Toronto Alexithymia Scale (TAS-20, Taylor GJ,1992), EORTC QLQ-C30-BR23 (Fayers PM et al 1998), HADS (The Hospital Anxiety and Depression Scale, Zigmond e Snaith 1983), Scheda “Credenze e aspettative nei confronti del trattamento”. Per il gruppo sperimentale è previsto uno spazio di ascolto e condivisione dei vissuti legati al trattamento mediante compilazione e lettura di un diario. Risultati: si attende di riscontrare una riduzione dei livelli di ansia e di depressione, un miglioramento della qualità della vita e una maggiore compliance al trattamento nei pazienti del gruppo sperimentale. Conclusioni: Interventi di tipo psicologico costituirebbero un valido aiuto per i pazienti nel fronteggiare paure e angosce legate alla malattia e per migliorare la loro qualità della vita. La ricerca-intervento è ancora in corso di sperimentazione per cui i risultati definitivi saranno discussi in sede congressuale. Bibliografia: Fayers PM., Aaronson NK., Bjordal K., Groenvold M., Curran D., Bottomley A. (2001), EORTC QLQ-C30 Scoring Manual (3rd edition), EORTC Quality of Life Group, Brussels. Neilson KA., Pollard AC., Boonzaier AM., Corry J., Castle DJ., Mead KR., Gray MC., Smith DI., Trauer T., Couper JW. Psychological distress (depression and anxiety) in people with head and neck cancers. Med J Aust. 2010 Sep 6;193(5 Suppl):S48-51. Taylor GJ, Bagby RM., Parker JDA. (1992), “Toronto Alexitymia Scale” in Caretti Vi., La Barbera D., “Alessitimia, Valutazione e Trattamento”, Astrolabio, Roma, 2005.

Una buona capacità di insight pare costituire un fattore predittivo di minore espressività psicopatologica nei pazienti affetti da psicosi. In questo lavoro intendiamo analizzare le relazioni tra grado di insight e gravità dei sintomi psicotici utilizzando i punteggi totali e parziali ottenuti alla Positive and Negative Syndrome Scale (PANSS) in un gruppo di pazienti affetti da psicosi all'esordio nell'ambito del progetto SGAP "Sicilian Genetic and Psychosis" svolto in collaborazione con il GAP Study dell'Institute of Psychiatry, King's College of London.

Introduzione: Un consistente numero di studi suggerisce un’elevata prevalenza di eventi traumatici nella storia di soggetti con disturbi psicotici (Shevlin et al, 2008). Piu’ che l’impatto di un singolo evento di vita stressante, l’esposizione cumulativa ad esperienze traumatiche sembra incrementare il rischio di psicosi (van Winkel et al, 2008). Scopo dello studio e’ valutare la prevalenza di tali eventi in soggetti al primo episodio psicotico a confronto con controlli sani e la possibile correlazione con la sintomatologia psicotica e l’età di esordio. Metodologia: In atto sono stati reclutati 74 soggetti al primo episodio psicotico (51 m, 23 f; em=26.39, ds=9.36) e 27 controlli sani (18 m, 9 f; em=25.93, ds=7.65). Sono state somministrate le seguenti interviste: CECA-Q (Bifulco et al, 2005) per la valutazione retrospettiva degli eventi avversi infantili; List of Threatening Experiences (Brugha et al, 1985) per la valutazione degli eventi di vita stressanti durante il corso di vita e la PANSS (Kay et al, 1987) per la valutazione della sintomatologia psicotica. Risultati e Conclusioni: I risultati preliminari mostrano una maggiore prevalenza nel gruppo dei primi episodi psicotici di almeno un evento di vita stressante nell’arco della vita (p

Introduzione: la durata di psicosi non trattata (DUP) nei pazienti affetti da psicosi all’esordio rappresenta un fattore predittivo dell’outcome e del decorso del disturbo (Perkins, 2005). La relazione tra consumo di cannabis e DUP è ancora controversa. In questo lavoro viene analizzato il rapporto tra DUP ed età di esordio, consumo di cannabis, funzionamento cognitivo, livello di istruzione e stato di occupazione in un gruppo di pazienti affetti da psicosi all’esordio reclutati nell’ambito dello studio SGAP (Sicilian Genetic and Psychosis) svolto in collaborazione con l’Institute of Psychiatry, King's College of London. Metodologia: sono stati reclutati 74 pazienti di età compresa tra 18 e 65 anni ai quali è stata somministrata una batteria di test composta da: Nottingham Onset Schedule (NOS-DUP), Positive and Negative Syndrome Scale (PANSS) , Social Data Schedule, Cannabis Experience Questionnaire (CEQ), WAIS-R. Risultati: il campione, ancora in fase di reclutamento, è costituito da 74 pazienti (M=68,9%), età media 26,39 (DS=9,36). La durata media di psicosi non trattata è di 40,4 settimane, il 39,5%, dei pazienti ha fatto uso di cannabis nel periodo immediatamente precedente il ricovero. Nel nostro campione i pazienti che fanno uso di cannabis hanno una DUP più breve (p=0,023) e afferiscono ai servizi di salute mentale in età più precoce (p=0,064) rispetto ai non consumatori. Inoltre vi è una correlazione inversa tra DUP e QI (p=0,05). Non sono al momento emerse correlazioni significative tra DUP e severità dei sintomi, valutati attraverso la PANSS. Conclusioni: i nostri risultati, in linea con i dati di letteratura, supportano l’associazione tra consumo di cannabis ed esordio precoce dei sintomi psicotici. Inoltre il consumo di cannabis si associa ad una minore durata della DUP ma quest’ultimo dato sembra meritevole di ulteriori indagini.

Introduzione: Numerosi studi hanno evidenziato l’associazione tra traumi infantili e psicosi (Morgan, Fisher, 2007). Sebbene inizialmente fosse enfatizzato il ruolo dell’abuso sessuale, recentemente l’associazione con l’abuso fisico e’ stata riportata come piu’ forte (Fisher et al, 2010; Rubino et al, 2009). Scopi dello studio sono valutare la prevalenza di eventi avversi infantili in un campione di soggetti al primo episodio psicotico e la sua relazione con la psicopatologia e le funzioni cognitive. Metodologia: Sono stati reclutati 74 soggetti al primo episodio psicotico (51 m, 23 f; em=26.39, ds=9.36). Sono state somministrate le seguenti interviste e test: CECA-Q (Bifulco et al, 2005) per la valutazione retrospettiva degli eventi avversi infantili; PANSS (Kay et al, 1987) per la valutazione della sintomatologia psicotica; WAIS-R (Wechsler, 1981) per la valutazione delle funzioni cognitive. Risultati: I risultati preliminari mostrano un’associazione tra la presenza di gravi eventi avversi infantili e la sottoscala di psicopatologia generale della PANSS (p

Alcuni studi in letteratura supportano l’associazione tra consumo di cannabis, età di esordio ed espressività psicopatologica nei pazienti al primo episodio psicotico (Orlandi, 2001). Questo lavoro si propone di analizzare la gravità della sintomatologia psicotica in relazione al consumo di cannabis, confrontando due campioni di pazienti all'esordio psicotico (FEP) reclutati a Palermo e a Londra.