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Cluster studies identified a subgroup of patients with psychosis whose premorbid adjustment deteriorates before the onset, which may reflect variation in genetic influence. However, other studies reported a complex relationship between distinctive patterns of cannabis use and cognitive and premorbid impairment that is worthy of consideration. We examined whether: (1) premorbid social functioning (PSF) and premorbid academic functioning (PAF) in childhood and adolescence and current intellectual quotient (IQ) define different clusters in 802 first-episode of psychosis (FEP) patients; resulting clusters vary in (2) polygenic risk scores (PRSs) for schizophrenia (SCZ_PRS), bipolar disorder (BD_PRS), major depression (MD_PRS), and IQ (IQ_PRS), and (3) patterns of cannabis use, compared to 1,263 population-based controls. Four transdiagnostic clusters emerged (BIC = 2268.5): (1) high-cognitive-functioning (n = 205), with the highest IQ (Mean = 106.1, 95% CI: 104.3, 107.9) and PAF, but low PSF. (2) Low-cognitive-functioning (n = 223), with the lowest IQ (Mean = 73.9, 95% CI: 72.2, 75.7) and PAF, but normal PSF. (3) Intermediate (n = 224) (Mean_IQ = 80.8, 95% CI: 79.1, 82.5) with low-improving PAF and PSF. 4) Deteriorating (n = 150) (Mean_IQ = 80.6, 95% CI: 78.5, 82.7), with normal-deteriorating PAF and PSF. The PRSs explained 7.9% of between-group membership. FEP had higher SCZ_PRS than controls [F(4,1319) = 20.4, P

Objective: Stereotyped beliefs about schizophrenia are well-established in the society and relatively common among healthcare professionals and students. The aim of this study was to investigate the opinions about the causes, treatment, and outcome of schizophrenia among healthcare students. Method: Undergraduate nursing and psychology students completed selected items of the Opinion on Mental Illness Questionnaire after reading a clinical vignette of undiagnosed schizophrenia. Results: Students who labelled the description as schizophrenia were more pessimistic regarding full recovery from the disorder. Those who acknowledged greater relevance to biogenetic risk factors were more convinced of the efficacy of medications. Respondents’ opinions on the efficacy of psychological interventions were more positive among psychology students than among nursing students. Conclusions: The study confirmed the associations of schizophrenia labelling with prognostic pessimism and beliefs about the efficacy of pharmacological treatment among future healthcare professionals. Students’ opinions were less influenced by differences between academic degree programs. Information about current recovery rate and comprehensive care for schizophrenia may support future healthcare professionals in the relationship and the clinical management of PWS.

Objectives This study aimed at investigating the relationship between perceived public stigma towards people with schizophrenia (PWS) and their family members in a large sample of medical and psychology students. We hypothesised that: a) schizophrenia labelling would be related to greater perceived public stigma; b) contact with PWS would be related with lower perceived stigma; c) perceived public stigma would be similar between medical and psychology students and would be higher among students attending the clinical stage compared to their pre-clinical colleagues. Methods Participants were 592 students attending either the pre-clinical or clinical stage of coursework in Medicine and Psychology, at the University of Palermo (Italy) (Tab. I). Study measures included a short socio-demographic questionnaire, the Devaluation of Consumers Scale (DCS), and the Devaluation Consumers Families Scale (DCFS). Results Students who identified schizophrenia in an unlabelled clinical description expressed greater perceived public stigma towards PWS (t = -2.895, p = 0.004) and their family members (t = -2.389, p = 0.017). A trend-level association was found between previous contact with PWS and lower perceived public stigma (t = 1.903, p = 0.058), which became significant for those students who had a more extensive contact (Mann-Whitney z = 2.063, p = 0.039). Compared to medical students, psychology students perceived greater public stigma towards PWS. No difference was observed between students at different stages of their academic coursework (Tab. II). In a multivariate linear regression model, schizophrenia labelling and degree course predicted perceived public stigma towards severe mental disorders. Conclusions This study replicated previous findings on the relationship between public stigma towards PWS, schizophrenia labelling, and contact with PWS. Perception of public stigma was similar among pre-clinical and clinical students and greater among psychology students. The findings suggest the importance of promoting a critical awareness of negative stereotypes towards schizophrenia among healthcare students, since the beginning of their coursework. In addition to correct information about schizophrenia, anti-stigma intervention should include contact with PWS who live in the community.

si descrivono i dati relativi ad un campioni di pazienti affetti da disturbo psicotico all'esordio, come parte del progetto SGAP (Sicilian Genetic and Psychosis. tra i fattori di rischio implicati nell'insorgenza del disturbo si prende in esame il ruolo del consumo di cannabis mettendo a confronto i pazienti con un gruppo di cntrollo costituito da soggetti non psicotici. Emerge come l'età media di insorgenza del disturbo psicotico è stata più precoce per coloro che avevano fumato cannabis nel corso della vita (24.2 anni vs. 31.6 anni) mentre non è stata riscontrata nessuna differenza in relazione all'uso recente di cannabis.

Psychotic patients with a lifetime history of cannabis use generally show better cognitive functioning than other psychotic patients. Some authors suggest that cannabis-using patients may have been less cognitively impaired and less socially withdrawn in their premorbid life. Using a dataset comprising 948 patients with first-episode psychosis (FEP) and 1313 population controls across 6 countries, we examined the extent to which IQ and both early academic (Academic Factor [AF]) and social adjustment (Social Factor [SF]) are related to the lifetime frequency of cannabis use in both patients and controls. We expected a higher IQ and a better premorbid social adjustment in psychotic patients who had ever used cannabis compared to patients without any history of use. We did not expect such differences in controls. In both patients and controls, IQ was 3 points higher among occasional-users than in never-users (mean difference [Mdiff] = 2.9, 95% CI = [1.2, 4.7]). Both cases and control daily-users had lower AF compared to occasional (Mdiff = -0.3, 95% CI = [-0.5; -0.2]) and never-users (Mdiff = -0.4, 95% CI = [-0.6; -0.2]). Finally, patient occasional (Mdiff = 0.3, 95% CI = [0.1; 0.5]) and daily-users (Mdiff = 0.4, 95% CI = [0.2; 0.6]) had better SF than their never-using counterparts. This difference was not present in controls (Fgroup*frequency(2, 2205) = 4.995, P = .007). Our findings suggest that the better premorbid social functioning of FEP with a history of cannabis use may have contributed to their likelihood to begin using cannabis, exposing them to its reported risk-increasing effects for Psychotic Disorders. © The Author(s) 2019. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.All rights reserved. For permissions, please email: journals.permissions@oup.com.

Objectives This study aimed to assess the psychometric properties of the Italian versions of the Devaluation of Consumers Scale (DCS) and the Devaluation of Consumer Families Scale (DCFS), twoshort-scales examining public stigma towards people with mental disorders and their relatives. Methods The scales were administered to 117 individuals with a clinical diagnosis of affective or non-affective psychoses (ICD 10 criteria F20-29, F30-33). Translation procedures were carried out according to accepted standards. Internal reliability was assessed using Cronbach’s alpha coefficient. Convergent validity was evaluated in terms of correlation with the Global Functioning Scale (GAF) and with the Questionnaire on Users’ Opinions (QUO). Known-group validity was assessed comparing patients at first-episode of psychosis and patients with a history of psychosis of at least 3 years (long-term psychosis).Results The overall Cronbach’s alpha value was 0.85 for DCS and 0.81for DCFS; subscales’ alpha values ranged from 0.80 to 0.55 for DCS, and from 0.68 to 0.55 for DCFS. Negative correlations were found between the Italian DCS and the DCFS total score and the QUO affective problems (DCS -0.33; DCFS -0.235) and social distance subscales (DCS -0.290; DCFS -0.356). Moreover, the GAF positively correlated with some of the DCS and DCFS subscales. Patients with long-term psychosis had higher scores in most DCS and DCFS subscales. Conclusion The Italian translation of DCF and DCFS showed good internal consistency, known-group validity, and convergent validity. These psychometric properties support their application in routine clinical practice in Italy as well as their use in international studies.

Objective: This study aimed at describing the coping strategies used by patients of small burns (

Summary Objectives: Cannabis is the most widely used illicit drug globally and its use has been linked to an increased risk for psychotic disorders. An association between cannabis consumption and psychotic symptoms was consistently reported by several studies. This case-control study aimed to widen the current findings about the impact of cannabis exposure on the risk of psychosis, by investigating the pattern of cannabis consumption in a sample of first-episode of psychosis (FEP) patients compared to healthy controls. Material and methods: 68 individuals who presented for the first time to mental health services of Palermo (Italy) with an ICD-10 diagnosis of psychotic disorders and 74 healthy were enrolled as part of the Sicilian Genetics and Psychosis study. Psychopathological assessment and diagnosis were carried out by the Schedule for Clinical Assessment in Neuropsychiatry (SCAN). Socio-demographic data were collected by the modified version of the Medical Research Council (MRC) socio-demographic scale. All participants were interviewed using the Cannabis Experience Questionnaire – Modified Version to obtain a detailed assessment of lifetime patterns of cannabis and other illicit drug consumption. Logistic regression was applied to investigate the relationships between various aspects of cannabis use (lifetime use, age at first use, duration, and frequency of use) and case-control status while controlling for potential confounders. Results: Patients started cannabis consumption about 3 years earlier than the control group (t = 3.1, p = 0.002) and were 8 times more likely to having started using cannabis before 15 years (adjusted OR = 8.0, 95% CI 2.4-27) than controls. Furthermore cases were more likely to smoke more frequently than controls (adjusted OR = 4.4, 95% CI 1.08-18). We did not find a difference in duration of cannabis use between cases and controls. Conclusions: The findings suggest that cannabis exposure, and especially daily cannabis consumption, is associated with the risk for psychosis; however, the retrospective study design does not allow drawing firm conclusions about causality.

Differenti studi hanno riscontrato nei pazienti con diagnosi di disturbo psicotico una diffusa compromissione delle funzioni esecutive, in particolare della Working Memory, e una tendenza a prendere decisioni rapidamente dovuta ad errori nel processamento di raccolta delle informazioni presenti nel contesto (Jumping To Conclusion, JTC). Obiettivo del presente studio é quello indagare la presenza di una possibile correlazione tra Working Memory e Jumping To Conclusions in un campione di pazienti al primo episodio psicotico. Per il presente studio sono stati valutati 41 pazienti all’esordio psicotico (58,5% M), di età media 29,63 (DS=10,285) e 89 controlli sani (47,2% M), di età media 33,31 (DS=12,817). I dati hanno mostrato che il Jumping To Conclusions è presente in 45 degli 89 soggetti del gruppo di controllo (51,1%) e in 31 dei 38 individui del gruppo dei casi (81,6%). Dalle percentuali ricavate, si nota come il gruppo dei casi fosse più propenso a “saltare alle conclusioni” rispetto ai controlli (χ2=10,28; p=0,001). Per quanto riguarda i compiti di Working Memory, i pazienti psicotici hanno ottenuto punteggi peggiori rispetto ai controlli. Infine, le analisi di correlazione svolte all’interno del gruppo dei casi rilevano la presenza di una correlazione significativamente positiva tra il punteggio ottenuto al Beads Task e tutti i compiti di Working Memory: Digit Span (rho=0,28; p=0,003), Digit Symbol (rho=0,27; p=0,002), Arithmetic (rho=0,26; p=0,003) e Block Design (rho=0,29; p=0,001). I risultati esposti sembrano inoltre supportare, in accordo con la letteratura, l’ipotesi di una possibile correlazione tra alterazioni a carico della Working Memory e deficit di raccolta dati Jumping To Conclusions.

Objective: Only few studies have investigated social and personality characteristics of members of Italian organized criminal groups: Mafia, Camorra, ‘Ndrangheta, and Sacra Corona Unita. This study aimed to explore the most relevant social and clinical features of Mafia criminals and their psychopathic traits. Method: The Psychopathy Check List-Revised (PCL-R) and a socio-demographic questionnaire were administered to 30 condemned for Mafia crimes and imprisoned in the “Pagliarelli” district prison of Palermo (Italy). The results were investigated applying the methods of Network Theory. Results: The study identified two communities, which were statistically different in terms of history of juvenile delinquency, levels of education, and antisocial and deviant behaviours score at PCL-R. Conclusions: The onset of antisocial behaviour and educational achievement might be relevant variables in understanding mafia offences, as well as antisocial behaviours in general. Moreover, methodologies of Network Theory may be used to characterize real-world complex systems of sociological and clinical dates.

Background: Cannabis is one of the most commonly used drugs among young people across Europe (EMCDDA data 2014), Moreover, it is one of the most abused illicit drugs among patients suffering from schizophrenia (Linszen et al., 1994) and, particularly, in patients at their first episode of psychosis (Donoghue et al., 2011). Furthermore, 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 to European samples with expected differences in pattern of cannabis use (i.e. age at first use, frequency of use) Methods: Cannabis is one of the most commonly used drugs among young people across Europe (EMCDDA data 2014), Moreover, it is one of the most abused illicit drugs among patients suffering from schizophrenia (Linszen et al., 1994) and, particularly, in patients at their first episode of psychosis (Donoghue et al., 2011). Furthermore, 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 to European samples with expected differences in pattern of cannabis use (i.e. age at first use, frequency of use) Results: In the total sample, N = 935, comparing FEP who were cannabis users with never users, we found a significant difference in mean AOP (cannabis users: 28.30 (9.05) vs. non-users: 34.94 (12.5), t = -9.32, Po0.001). Moreover, 58% of cannabis users started at age ≤16 years old, with mean age of onset of Psychotic Disorder (25.47, sd = 7.03), compared with those who started later (M = 25.47, sd = 10.05) (t = -9.42, Po0.001). When the sample was split in NE and SE groups, we found that NE sample the mean AOP in cannabis users was 28.12 (±8.42) and 34.18 (±12.68) non-users (t = -4.65, Po0.001). In SE sample the mean AOP in cannabis users is 29.02 (±9.62) and in never users is 35.55 (±11.61) (t = -5.75, Po0.001). All predictors are statistically significant (in NE sample age first use β = .31, t = 5.16, P = .000, frequency β = -1.80, t = -2.93, Po0.001; in SE sample age first use β = 0.41, t = 6.67, P = .000, frequency β = -2.87, t = -4.66, Po0.001). In SE, the percentage of variance explained in a regression model is 31% (R2adj = .30) vs 16% (R2adj = .15) of NE. Discussion: Our results support the association between cannabis use and younger AOP in both samples, but were not observed significant difference across Europe. Linear regression model on predictors (age of first use, frequency of use) analyzed in the NE and the SE clinical samples confirmed relationship of causality with dependent variable (AOP), with a higher percentage of explained variance in sample of SE than NE.

Introduction The World Health Organization (WHO) considers stigma of mental illness as a crucial problem (WHO, 2001). Stigma contributes to the onset (Morgan et al., 2010) and the outcome of people affected by schizophrenia (Himan, 2015). Objectives To evaluate the perception of patients affected by psychotic disorders of being stigmatized by the community. Aims To compare the perception of stigma among subgroups of patients at different stage of their disorder. Methods Thirty-five patients affected by a first-episode of psychosis (FEP) and 96 patients affected by chronic psychosis were recruited. The Devaluation of Consumers Scale (DCS) and the Devaluation of Consumer Families Scale (DCFS) were administered to assess the perceived public stigma (Struening et al., 2001). The Positive And Negative Schizophrenic Symptoms Scale (PANSS) (Kay et al., 1987) and the Global Assessment of Functioning (GAF) (Goldman et al., 1992) were administered to assess psychotic symptoms and global level of functioning.Results Patients affected by chronic psychosis perceived higher devaluation against mental disorders than patients with a recent onset of psychosis (Mann–Whitney’s U = 910.500, P = 0.017). DCS and DCFS correlated with increased voluntary admissions (Rho = 0.355, P = 0.002; Rho = 0.257, P = 0.029) and DCS with increased compulsory admissions (Rho = 0.349, P = 0.003). Only among chronic patients, DCS factor 2 was related to global level of functioning (Rho = 0.217, P = 0.041). Conclusions Patients affected by chronic psychotic disorders perceived a more pessimistic attitude of the community towards their participation in social and community life and this is related to increased admissions and disability. Disclosure of interest The authors have not supplied their declaration of competing interest.

Aim: There are consistent evidence suggesting that psychotic disorders are associated to social disadvantage and isolation in adulthood, and research suggested that they these are not simply a consequence of the functional impairment related to onset of the disease (Stilo et al., 2013; Morgan et al., 2008). To date only a few studies have investigated the impact of social risk factors on psychosis in Italy. This study aimed to replicate existing findings in a case-control sample from Southern Italy. Methods: 134 individuals presenting for the first time to mental health services of Palermo (Italy) with an ICD 10 diagnosis of psychosis and 175 population controls from Palermo (Italy) were enrolled, as part of the Sicilian Genetics and Psychosis study. Information about current social indicators were collected by the modified version of the Medical Research Council (MRC) socio-demographic scale. Results: Cases and controls were different in terms of gender, age, family history for psychotic disorders, and education achievement. Unemployment, no relationship, and lack of close confidants were independently associated with psychotic disorders, and these associations were still significant after adjusting for confounders. However, in contrast with previous studies from Northern Europe, cases were more likely to live with their parents or other relatives, rather than alone. A cumulative index of social disadvantage was computed using unemployment, no relationship, and lack of close confidants (range 0-3). Controlling for gender, age, education level and family history of psychosis, there was evidence of an effect of increased risk for psychosis for individuals exposed to ≥ 2markers of social disadvantage. Conclusion: Unemployment, being single, and lack of close friends were significantly related with psychosis, while living alone was not. Moreover, in contrast with previous studies that found evidence of dose-response effect, in this sample individuals exposed to more than 2 markers of social disadvantage showed a five-fold increase in the odds for psychosis, suggesting the possibility of a threshold effect.

Cognitive difficulties are prevalent in people with diagnosis of schizophrenia and are associated with poor long-term functioning. In particular, memory, selective, divided and sustained attention and executive functions are altered by this disease. We used a Virtual Reality environment (developed via the NeuroVr2.0 software) for the rehabilitation of shifting, sustained attention and action planning functions using tasks reminiscent of daily life tasks. Test and retest showed significant differences in the assessed cognitive dimensions.

Recent years have seen considerable progress in epidemiological and molecular genetic research into environmental and genetic factors in schizophrenia, but methodological uncertainties remain with regard to validating environmental exposures, and the population risk conferred by individual molecular genetic variants is small. There are now also a limited number of studies that have investigated molecular genetic candidate gene-environment interactions (G × E), however, so far, thorough replication of findings is rare and G × E research still faces several conceptual and methodological challenges. In this article, we aim to review these recent developments and illustrate how integrated, large-scale investigations may overcome contemporary challenges in G × E research, drawing on the example of a large, international, multi-center study into the identification and translational application of G × E in schizophrenia. While such investigations are now well underway, new challenges emerge for G × E research from late-breaking evidence that genetic variation and environmental exposures are, to a significant degree, shared across a range of psychiatric disorders, with potential overlap in phenotype. © 2014 The Author.

Cognitive dysfunction is a core feature of schizophrenia. Patients with schizophrenia shown perform poorly on tasks that require vigilance or sustained attention. Patients with more pronounced attention deficits are least likely to acquire skills in psychosocial programs as the attention problems makes it difficult for them to process the information given in groups, and they may not be able to sustain attention for the session duration. The study aimed to develop a Virtual Reality cognitive training to improve the selective, divide and sustained attention. Specifically, we developed, via the NeuroVr 2.0 software, three different virtual environments with the hierarchical sequences of tasks. The study included two clinical samples of patients suffering from schizophrenia disorder: experimental group (9 patients) treated with pharmacological therapy and Virtual Reality cognitive training (10 weekly individual sessions); control group (6 patients) received pharmacological therapy and Integrated Psychological Treatment. Before and after training

Pathological gambling is an emerging and increasing phenomenon in Western counties. This work is aimed at reviewing the existing literature on this topic, paying special attention to its development, course and outcome in adolescence. We will explore epidemiological data, the instruments for the diagnostic and clinical assessment, the course and the outcome of the disorder, the comorbidity with other psychiatric syndromes and disorders. The main risk factors will be described at individual, social and community level. We provide an overview of the available pharmacological and psychological treatments and we report a clinical vignette in order to describe the psychological and psychopathological features of pathological gambling in adolescence., Mediterranean Journal of Clinical Psychology, Vol 6, No 1 (2018)

Objectives: The aim of this study was to evaluate the effect of alexithymia and defence mechanisms on the quality of life of patients affected by breast cancer at different stages of the disease. Methods A convenience sample of 110patients with breast cancer was involved in the study: 41 were receiving adjuvant chemotherapyafter surgery, 29 had disease-free survival in follow-up and 40 were receiving chemotherapy for metastatic disease. Quality of life, alexithymia and defence mechanisms were assessed using the following instruments: EORTC QLQ-C30-BR23, Toronto Alexithymia Scale (TAS-20) and Defense Mechanism Inventory (DMI). Results Compared to the other groups, patients receiving chemotherapy for metastatic disease reported poorer quality of life in several domains, more severe cancer-related and treatment-related symptoms and higher levels of alexithymia. When the effect of other potential predictors was taken into account, TAS-20 difficulty in identifying feelings was significantly related to all the EORTC functional subscale. Conclusion: This study underlined the relevance of difficulty in emotional processing and defence mechanisms in modulating psychological adjustment in women affected by breast cancer, suggesting that these might be potential targets of psychological intervention for this population.

European Community Recent years have seen considerable progress in epidemiological and molecular genetic research into environmental and genetic factors in schizophrenia, but methodological uncertainties remain with regard to validating environmental exposures, and the population risk conferred by individual molecular genetic variants is small. There are now also a limited number of studies that have investigated molecular genetic candidate gene-environment interactions (G x E), however, so far, thorough replication of findings is rare and G x E research still faces several conceptual and methodological challenges. in this article, we aim to review these recent developments and illustrate how integrated, large-scale investigations may overcome contemporary challenges in G x E research, drawing on the example of a large, international, multi-center study into the identification and translational application of G x E in schizophrenia. While such investigations are now well underway, new challenges emerge for G x E research from late-breaking evidence that genetic variation and environmental exposures are, to a significant degree, shared across a range of psychiatric disorders, with potential overlap in phenotype. Maastricht Univ, Med Ctr, Dept Psychiat & Neuropsychol, Sch Mental Hlth & Neurosci,South Limburg Mental H, NL-6200 MD Maastricht, Netherlands Kings Coll London, Inst Psychiat, Dept Psychosis Studies, London WC2R 2LS, England Mondriaan Mental Hlth Trust, Maastricht, Heerlen, Netherlands Univ Groningen, Univ Med Ctr Groningen, Rob Giel Clin Res, Univ Ctr Psychiat, Groningen, Netherlands Kings Coll London, Inst Psychiat, Dept Hlth Serv & Populat Res, London WC2R 2LS, England Kings Coll London, Inst Psychiat, Dept Psychol, London WC2R 2LS, England Cardiff Univ, MRC, Ctr Neuropsychiat Genet, Cardiff CF10 3AX, S Glam, Wales Cent Inst Mental Hlth, Dept Psychiat & Psychotherapy, Mannheim, Germany Dokuz Eylul Univ, Sch Med, Dept Psychiat, Konak, Turkey Istanbul Univ, Istanbul Fac Med, Dept Psychiat, Psychot Disorders Res Unit, Istanbul, Turkey Ankara Univ, Sch Med, Dept Psychiat, Cebeci Hosp, TR-06100 Ankara, Turkey Ankara Univ, Brain Res Ctr, TR-06100 Ankara, Turkey Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA Middle E Tech Univ, Dept Psychol, TR-06531 Ankara, Turkey Diskapi YB Res & Training Hosp, Ankara, Turkey Turkish Federat Schizophrenia Assoc, Ankara, Turkey Ataturk Training & Res Hosp, Psychiat Clin, Ankara, Turkey Manisa Mental Hlth Hosp, Manisa, Turkey Istanbul Univ, Expt Med Res Inst, Dept Adv Neurol Sci, Istanbul Fac Med, Istanbul, Turkey Univ Complutense, IiSGM CIBERSAM, Dept Child & Adolescent Psychiat, Hosp Gen Univ Gregorio Maranon,Sch Med, E-28040 Madrid, Spain Univ Barcelona, Dept Psychiat, Hosp Clin, IDIBAPS,Ctr Invest Biomed Red Salud Mental CIBERS, Barcelona, Spain Univ Valencia, Sch Med, Dept Psychiat, Ctr Invest Biomed Red Salud Mental CIBERSAM, Valencia, Spain Univ Oviedo, Sch Med, Dept Med,Psychiat Area, Ctr Invest Biomed Red Salud Mental CIBERSAM, Oviedo, Spain Univ Santiago de Compostela, Dept Mental Hlth & Drug Addit Assistance, Hlth Serv Galicia,Psychiat Genet Grp IDIS, Hosp Clin,Ctr Invest Biomedica Red Salud Mental C, Santiago de Compostela 15706, Spain Hosp Virgen de la Luz, Serv Psiquiat, Dept Psychiat, Cuenca, Spain Hosp Univ Infanta Leonor Hosp Virgen Torre, Villa de Vallecas Mental Hlth Ctr, Villa de Vallecas Mental Hlth Dept, Madrid, Spain Hosp Univ Infanta Leonor Hosp Virgen Torre, Puente de Vallecas Mental Hlth Dept, Ctr Salud Mental Puente Vallecas, Madrid, Spain Hosp Clin Univ, Fdn Publ Galega Med Xenomica, Santiago de Compostela, Spain Univ Complutense, Sch Med, Hosp Gen Univ Gregorio Maranon, Dept Psychiat, E-28040 Madrid, Spain Hosp Psiquiatr Conxo, Santiago de Compostela, Spain Univ Amsterdam, Acad Med Ctr, Early Psychosis Sect, Dept Psychiat, NL-1105 AZ Amsterdam, Netherlands Vrije Univ Amsterdam, Dept Clin Psychol, Amsterdam, Netherlands EMGO Inst Hlth & Care Res, Amsterdam, Netherlands Parnassia Psychiat Inst, Dept Psychosis Res, the Hague, Netherlands Rivierduinen Psychiat Inst, Leiden, Netherlands Grp Hosp Mondor, AP HP, Creteil, France Hop Henri Mondor, INSERM, U955, Equipe 15, F-94010 Creteil, France Univ Paris Est, Fac Med, Creteil, France Fdn Fondamental, Creteil, France CMP B CHU, F-63003 Clermont Ferrand 1, France Univ Auvergne, EA 7280, Clermont Ferrand, France EPS Maison Blanche, Paris, France UPC KU Leuven, Dept Neurosci, UPC, Kortenberg, Belgium UPC, Dept Neurosci, Res Grp Psychiat, Leuven, Belgium Katholieke Univ Leuven, Univ Hosp Gasthuisberg, Dept Human Genet, Leuven, Belgium Assoc Sci Res Multiple Births, Ghent, Belgium Univ Ghent, Dept Neurol, Ghent Univ Hosp, B-9000 Ghent, Belgium Univ Athens, Sch Med, Eginit Hosp, Athens 11528, Greece Med Univ Vienna, Dept Psychiat & Psychotherapy, Vienna, Austria Psychiat Univ Clin Basel, Ctr Gender Res & Early Detect, Basel, Switzerland Psychiat Univ Clin Basel, Diagnost & Crisis Intervent Ctr, Basel, Switzerland Univ Cologne, Dept Psychiat & Psychotherapy, D-50931 Cologne, Germany Univ Hong Kong, Li Ka Shing Fac Med, Ctr Genom Sci, State Key Lab Brain & Cognit Sci, Hong Kong, Hong Kong, Peoples R China Univ Hong Kong, Li Ka Shing Fac Med, Dept Psychiat, Hong Kong, Hong Kong, Peoples R China Univ Hong Kong, Queen Mary Hosp, Li Ka Shing Fac Med, State Key Lab Brain & Cognit Sci, Hong Kong, Hong Kong, Peoples R China Univ Hong Kong, Queen Mary Hosp, Li Ka Shing Fac Med, Dept Psychiat, Hong Kong, Hong Kong, Peoples R China Univ Basque Country, Univ Deusto, Interuniv Chair Law & Human Genome Prov Govt Bisk, Bilbao, Bizkaia, Spain Univ Zaragoza, Zaragoza, Spain Univ Cambridge, Dept Psychiat, Cambridge, England UCL, Div Psychiat, London, England Royal Coll Surgeons Ireland, Beaumont Hosp, Educ & Res Ctr, Dept Psychiat, Dublin 9, Ireland Univ Munich, Dept Psychiat, Div Mol & Clin Neurobiol, Munich, Germany Univ Bologna, Alma Mater Studiorium, Psychiat Unit, Dept Med & Surg Sci, Bologna, Italy Univ Bologna, Alma Mater Studiorium, Genet Unit, Dept Med & Surg Sci, Bologna, Italy Local Hlth Trust, Dept Mental Hlth & Pathol Addict, Bologna, Italy Univ Palermo, Sect Psychiat, Dept Expt Biomed & Clin Neurosci, Palermo, Italy P Giaccone Gen Hosp, Unit Psychiat, Palermo, Italy Univ Melbourne, Ctr Youth Mental Hlth, Parkville, Vic 3052, Australia Univ Melbourne, Melbourne Neuropsychiat Ctr, Carlton, Vic, Australia Univ São Paulo, Fac Med, Dept Med Prevent, BR-01246903 São Paulo, Brazil Univ São Paulo, Nucleo Pesquina Saude Mental Populac, São Paulo, Brazil Univ São Paulo, Fac Med Ribeirao Preto, Dept Neurociencias & Ciencias Comportamento, BR-14049 Ribeirao Preto, Brazil Univ Verona, Sect Psychiat, Dept Publ Hlth & Community Med, I-37100 Verona, Italy Copenhagen Univ Hosp, Res Unit, Mental Hlth Ctr Copenhagen, Copenhagen, Denmark Univ Paris 05, Fac Med, Serv Hosp Univ, Hop St Anne, Paris, France Univ Autonoma Barcelona, Dept Psicol Clin & Salut, E-08193 Barcelona, Spain St Pere Claver Fundacio Sanitaria, Dept Salut Mental, Barcelona, Spain Univ N Carolina, Dept Psychol, Greensboro, NC 27412 USA CIBERSAM, Spanish Mental Hlth Res Network, Barcelona, Spain Universidade Federal de São Paulo, Dept Psychiat, PRISMA Early Intervent Program, São Paulo, Brazil Univ Belgrade, Sch Med, Beograd, Serbia Universidade Federal de São Paulo, Dept Psychiat, PRISMA Early Intervent Program, São Paulo, Brazil European Community: HEALTH-F2-2009-241909 Web of Science

Objective This systematic review and meta‐analysis aimed to examine: the pooled prevalence of symptomatic behaviours and mental health deterioration amongst individuals with eating disorders (EDs) and obesity during the COVID‐19 confinement. Moreover, we examined changes in EDs and distress before and during the confinement, and the association between psychosocial factors and EDs symptoms. Method A systematic search was carried out in biomedical databases from January 2020 to January 2021. Both cross‐sectional and longitudinal studies that used quantitative measures of ED symptoms and psychological distress during and after the COVID‐19 confinement were included. Results A total of 26 studies met inclusion criteria (n = 3399, 85.7% female). The pooled prevalence of symptomatic deterioration in EDs was 65% (95% CI[48,81], k = 10). The pooled prevalence of increased weight in obesity was 52% (95% CI[25,78], k = 4). More than half of the participants experienced depression and anxiety. Moreover, at least 75% of the individuals with EDs reported shape and eating concerns, and increased thinking about exercising. However, the pooled analyses of longitudinal studies showed no significant differences from pre‐pandemic levels to the first lockdown phase in Body Mass Index and ED symptoms, whereas only few studies suggested increased distress, particularly among individuals with anorexia nervosa. Conclusions The majority of individuals with EDs and obesity reported symptomatic worsening during the lockdown. However, further longitudinal studies are needed to identify vulnerable groups, as well as the long‐term consequences of COVID‐19., Key points Sixty‐five percent of the individuals with Eating Disorders experienced symptom deterioration during the COVID‐19 confinementFifty‐two percent of the individuals with obesity reported weight increaseMore than half of the participants experienced depression and anxietyHowever, the few studies that examined changes in symptoms before and during the confinement showed inconsistent findingsHigh‐quality longitudinal studies are needed to identify vulnerable groups, as well as the long‐term impact of COVID‐19

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.

Our work is aimed at exploring the recent literature data on web sites, forums, and blogs, which promote eating disorders as normal life styles and their implication in the changes of the psychopatology of such disorders. We also want to understand whether new technologies have an impact in the course of the disorders or, on the other hand, whether they can also represent an instrument for searching help or information about them. The search strategy included a search of PsycINFO, Medline, and Ovid databases to identify research reports about pro-ana sites and their implication on the course of anorexia using the following key words: pro-ana, thinspiration, anorexia-web, online help eating disorders, anorexia nation.

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.

Premorbid functioning and cognitive measures may reflect gradients of developmental impairment across diagnostic categories in psychosis. In this study, we sought to examine the associations of current cognition and premorbid adjustment with symptom dimensions in a large first episode psychosis (FEP) sample. We used data from the international EU-GEI study. Bifactor modelling of the Operational Criteria in Studies of Psychotic Illness (OPCRIT) ratings provided general and specific symptom dimension scores. Premorbid Adjustment Scale estimated premorbid social (PSF) and academic adjustment (PAF), and WAIS-brief version measured IQ. A MANCOVA model examined the relationship between symptom dimensions and PSF, PAF, and IQ, having age, sex, country, self-ascribed ethnicity and frequency of cannabis use as confounders. In 785 patients, better PSF was associated with fewer negative (B=-0.12, 95% C.I. -0.18, -0.06, p

The work was supported by Guarantors of Brain post-doctoral clinical fellowship to DQ; Clinician Scientist Medical Research Council fellowship (project reference MR/M008436/1) to MDF; Heisenberg professorship from the German Research Founda- tion (grant no. 389624707) to UR; the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The EU-GEI Project is funded by the European Community’s Seventh Framework Programme under grant agreement No. HEALTH-F2-2010-241909 (Project EU-GEI). The Brazilian study was funded by the São Paulo Research Foundation under grant number 2012/0417-0., Quattrone D., Reininghaus U., Richards A.L., Tripoli G., Ferraro L., Quattrone A., Marino P., Rodriguez V., Spinazzola E., Gayer-Anderson C., Jongsma H.E., Jones P.B., La Cascia C., La Barbera D., Tarricone I., Bonora E., Tosato S., Lasalvia A., Szöke A., Arango C., Bernardo M., Bobes J., Del Ben C.M., Menezes P.R., Llorca P.-M., Santos J.L., Sanjuán J., Arrojo M., Tortelli A., Velthorst E., Berendsen S., de Haan L., Rutten B.P.F., Lynskey M.T., Freeman T.P., Kirkbride J.B., Sham P.C., O’Donovan M.C., Cardno A.G., Vassos E., van Os J., Morgan C., Murray R.M., Lewis C.M., Di Forti M., Hubbard K., Beards S., Stilo S.A., Parellada M., Fraguas D., Castro M.R., Andreu-Bernabeu Á., López G., Matteis M., González E., Durán-Cutilla M., Díaz-Caneja C.M., Cuadrado P., Rodríguez Solano J.J., Carracedo A., Costas J., Sánchez E., Amoretti S., Lorente-Rovira E., Garcia-Portilla P., Jiménez-López E., Franke N., van Dam D., Termorshuizen F., van der Ven E., Messchaart E., Leboyer M., Schürhoff F., Jamain S., Baudin G., Ferchiou A., Pignon B., Richard J.-R., Charpeaud T., Tronche A.-M., Frijda F., Marrazzo G., Sideli L., Sartorio C., Seminerio F., Loureiro C.M., Shuhama R., Ruggeri M., Bonetto C., Cristofalo D., Berardi D., Seri M., D’Andrea G.

The association between childhood adversity (CA) and psychosis has been extensively investigated in recent years. An increasing body of research has also focused on the mediating or moderating role of biological and psychological mechanisms, as well as other risk factors that might account for the link between CA and psychosis. We conducted a systematic search of the PsychINFO, Embase, Ovid, and Web of Science databases for original articles investigating the role of genetic vulnerabilities, environmental factors, psychological and psychopathological mechanisms in the association between CA and psychosis up to August 2019. We included studies with individuals at different stages of the psychosis continuum, from subclinical psychotic experiences to diagnosed disorders. From the 28 944 records identified, a total of 121 studies were included in this review. Only 26% of the studies identified met the criteria for methodological robustness. Overall, the current evidence suggests that CA may be associated with psychosis largely independently of genetic vulnerabilities. More consistent and robust evidence supports interaction between early and recent adversities, as well as the mediating role of attachment and mood symptoms, which is suggestive of an affective pathway between CA and psychosis across the continuum from subclinical experiences to diagnosable disorder. This review highlighted numerous methodological issues with the existing literature, including selection bias, heterogeneity of measurement instruments utilised, and lack of control for potential confounders. Future research should address these limitations to more accurately estimate mediation and moderation effects on the CA-psychosis association to inform the development of preventive interventions.

Background: Accumulating evidence suggests that stigmatisation toward people with schizophrenia (PWS) is common among healthcare professionals and represents a major barrier to care. Aim: The study aimed at comparing the opinions about PWS among Italian medical students at different stages of education. Methods: Study participants were 234 medical students, attending either the first three-years pre-clinical or the following three-years clinical stage. Participants read an unlabelled case-vignette of schizophrenia and completed the Opinions on Mental Illness Questionnaire. Results: A greater proportion of students at the clinical stage identified schizophrenia in the clinical description, compared to their younger colleagues They were also more optimist about the efficacy of drug and psychological treatments and sceptical regarding the possibility of PWS to establish their own family. Conclusion: This study suggests that medical training may benefit from providing information about recovery from schizophrenia and contact with PWS in the community.

The GAP multidisciplinary study carried out in South London, recruited 410 first episode of psychosis patients and 370 controls; the aim was to elucidate the multiple genetic and environmental factors influencing the onset and outcome of psychosis. The study demonstrated the risk increasing effect of adversity in childhood (especially parental loss, abuse, and bullying) on onset of psychosis especially positive symptoms. Adverse life events more proximal to onset, being from an ethnic minority, and cannabis use also played important roles; indeed, one quarter of new cases of psychosis could be attributed to use of high potency cannabis. The “jumping to conclusions” bias appeared to mediate the effect of lower IQ on vulnerability to psychosis. We confirmed that environmental factors operate on the background of polygenic risk, and that genetic and environment act together to push individuals over the threshold for manifesting the clinical disorder. The study demonstrated how biological pathways involved in the stress response (HPA axis and immune system) provide important mechanisms linking social risk factors to the development of psychotic symptoms. Further evidence implicating an immune/inflammatory component to psychosis came from our finding of complement dysregulation in FEP. Patients also showed an upregulation of the antimicrobial alpha-defensins, as well as differences in expression patterns of genes involved in NF-κB signaling and Cytokine Production. Being of African origin not only increased risk of onset but also of a more difficult course of illness. The malign effect of childhood adversity predicted a poorer outcome as did continued use of high potency cannabis.

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.

This study investigated the psychometric properties of the Dissociative Symptoms Scale (DSS) among Italian adults from outpatient and community samples. The DSS is a self-report measure of clinically relevant dissociation in adults. An Italian translation of the DSS was administered with measures of lifetime traumatic experiences, psychoform dissociation, and somatoform dissociation to 175 psychiatric outpatients and 423 individuals from the community. The DSS scores for outpatient and community adults were significantly different and showed good internal reliability, good convergent and construct validity, and a four-factor structure (depersonalization and derealization, gaps in awareness and memory, sensory misperceptions, and cognitive and behavioral reexperiencing) that was consistent with findings from previous research. Therefore, our results support previous research showing that the DSS can be used as a screening measure to assess clinically relevant dissociative experiences.