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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

Background: In Italy since February 2020, the unexpected massive afflux of COVID-19 patients exposed healthcare professionals to high work-related stress, high time pressure and increased the risk of being infected. This is the first study that aimed to investigate the psychological impact of COVID-pandemic at the end of the peak, by identifying latent burnout profiles in a sample of front-line healthcare professionals that worked in Italy during the peak of the pandemic. Methods: A total of 589 subjects filled in an online ad-hoc questionnaire and the Italian version of Maslach Burnout Inventory - Human Services Survey. Results: A higher presence of burnout profile in healthcare professionals who worked in frontline during the peak of the COVID-19 pandemic was highlighted. Furthermore, those professionals showed significantly higher perceived stress levels, increase of worries, and sleep problems, they were more likely to underline the importance of team spirit and to consider asking for psychological support. A multiple regression analysis revealed that age, managing COVID-19 patients, perceived stress levels, adequacy of training, and considering to ask for psychological support significantly predicted latent burnout profiles. Moreover, perceived stress levels mediate the relationship between those profiles and managing COVID-19 patients. Conclusions: These findings highlight how stressful and damaging the pandemic has been, especially for people directly involved in the care of patients tested positive for COVID-19. Furthermore, it provides evidence for the importance of investing in wellness for healthcare professionals, in order to avoid shortage due to burnout and to guarantee optimal standards of care to all patients., Mediterranean Journal of Clinical Psychology, Vol 10, No 1 (2022)

Background: This study aimed to screen a wide range of emotional and behavioural variables emerging during the first COVID-19 pandemic-lockdown in a sample of parents and children, residents in the southern part of Italy, and explore which variables could predict children’s wellbeing. We hypothesised that difficulties in adapting routines to pandemic restrictions, parents’ emotional wellbeing, and attitude towards the pandemic could influence the children’s behavioural attitudes. Methods: 221 parents completed the survey and gave information about 246 children. Ad hoc questionnaires were created and then exploratory reduced in factors. Strengths and Difficulties Questionnaire (SDQ) for parents assessed positive and negative behavioural attitudes in children. Depression Anxiety Stress Scale (Italian DASS-21) scored depression, anxiety and stress in parents. Results: Children presented higher emotional distress (Mean difference (Mdiff)=0.6, 95% C.I. 0.2, 0.9, p=0.013) and better prosocial behaviour (Mdiff=0.5, 95% C.I. 0.1, 0.9, p=0.011) than the Italian normative sample. Parents were more depressed than expected in the general population (Mdiff=1.0, 95% C.I. 0.3, 1.6, p=0.005). Having developed a morbid attachment to an adult (B=0.37, 95% CI 0.05, 0.69, p=0.024), a higher parental depression (B=0.1, 95% CI 0.02, 0.18, p=0.014), and children’s suffering from nightmares (B=0.35, 95% CI 0.03, 0.67, p=0.032) explained the 31.9% of the total variance in children’s emotional distress. Children’s anxiety was related to parents’ fear of the pandemic effects (r=0.32, p=0.001) and avoiding communicative approach (r=0.24, p=0.011). Conclusion: The first lockdown determined emotional distress and regressive mechanisms in children in the contest of higher parental discomfort, fear of the infection and avoidant communication. Following parents’ indications, it could be helpful to provide families with informative and age-appropriate support., Mediterranean Journal of Clinical Psychology, Vol 9, No 2 (2021)

Background: The prevalence of Internet Gaming Disorder (IGD) in the Italian population of gamers is unknown. Several risk factors, including time spent playing (TSP), are proposed as an epiphenomenon of emotional dysregulation. Methods: The study estimated the prevalence of IGD in at-risk Italian online gamers, and the interplay between alexithymia and other risk factors. 5,979 responders were surveyed. IGDS-SF9 estimated pathological gaming. TAS-20 measured Difficult in Identifying (DIF) and Describing Feelings (DDF), and Externally Oriented Thinking (EOT). Results: 43% of participants had pathological IGD scores. Male gender (OR=1.2, 95% C.I.=1, 1.5, p=0.019), TSP (OR=7.6, 95% C.I.=5.5, 10.6, p0.001), DIF (OR=1.5, 95% C.I.=1.1, 2.1, p=0.003), boredom/loneliness feelings (OR=1.8, 95% C.I.=1.5, 2, p0.001), recent negative events (OR=1.1, 95% C.I.=1, 1.3, p=0.026), and a behavioral addiction (OR=2.1, 95% C.I.=1.2, 3.9, p=0.009) independently increased its risk. Conclusions: Almost one on two players joining online communities presented IGD. Some risk factors were crucial, including TSP, independently from emotional dysregulation., Mediterranean Journal of Clinical Psychology, Vol 8, No 3 (2020)

Introduction: Internet gaming disorder (IGD) is a new diagnosis in DSM 5 worth of research. New potentially addictive features are emerging in pay- and free-to-play videogames, involving different at-risk populations of gamers. However, few studies have examined whether and how different game-genres can contribute to the risk of IGD. Objectives: This study aimed to investigate how game-genres can predict IGD, accounting for alexithymia scores, time-related play- ing habits, and other predictors. Methods: Participants were gamers joining online communities, surveyed about which games they played more than 20 hours in their lifetime, time-variables, other stressors and alexithymia scores. A six-steps linear regression with IGD scores and a post hoc logistic regression (outcome: IGD>=21) were performed. Results: 5,979 subjects (88.7% males, 14-18 years), playing at different games (Figure-1). The game-genre explained the 1% of variation only. WoW and similar MMORPGs confirmed their potentiality in promoting IGD, regardless of alexithymia features (B=0.50, p=0.005). However, time-variables completely absorbed the WoW effect (B=0.01, p=0.951). LoL resulted addictive, even if considering time-variables and alexithymia (B=0.88, p0.001). None of the different game- genres was able to push the subject over the threshold of IGD, because other characteristics interacted as additive risk-factors. Conclusions: Alexithymia traits and time-related playing habits mostly moderated the effect of different games in increasing IGD risk. A videogame could engage people with specific characteristics that may, in turn, differentially predispose to IGD.

Introduction: Online gaming is potentially harmful to a group, but not for the entire population, of online gamers. The prevalence varies by geographical areas, however, there are few Italian studies about risk factors for Internet Gaming Disorder (IGD) and its presence among non-occasional gamers. Objectives: This study aimed to describe the presence of IGD in internet gamers who participate in online communities, and how well-established risk-factors can predict it. Methods: Participants were surveyed about their playing habits and other relevant characteristics. IGDS-SF9 diagnosed IGD. TAS-20 measured alexithymia scores, i.e. Difficult in Identifying (DIF) and Describing Feelings (DDF), and Externally Oriented Thinking (EOT). Selected order of variables (via linear regression) and interactions were set in a logistic regression (outcome: IGD≥21). Results: The sample included 5,979 responders (88.7% males; 44% 14-18 years-hold). Alexithymia explained the 11.3% of the variance. IGD was present in the 43% of the subjects, the risk (70% prediction-rate) was increased by male gender (OR=1.2, 95% C.I. =1, 1.5, p=0.019), higher DIF z-scores (OR=1.5, 95% C.I.=1.1, 2.1, p=0.003), boredom/loneliness feelings (OR=1.8, 95% C.I.=1.5, 2, p

Introduction: Videogames have become more popular across females, although their widespread diffusion among males. How- ever, few studies have examined differences between female and male gamers and gender-specific risk factors for Internet Gaming Disorder (IGD). Objectives: The study aimed to describe males and females’ differ- ences in a sample of gamers, and to identify gender-specific risk- factors for IGD, accounting for alexithymia, playing habits, and other perceived stressors. Methods: Participants were gamers joining online communities, tested by IGDS-SF9 and TAS-20 for alexithymia. To explore isk-factors for IGD (outcome: IGD>=21), we set a binary logistic regression stratified by gender. Results: 5,305 males and 674 females differed in most of the descrip- tive characteristics (Figure-1) and game-genres preferences (Figure- 2). Higher DIF scores increased the risk of IGD in both males (OR=1.8 95% C.I. 1.6, 2) and females (OR=1.3 95% C.I. 1.1, 1.7) while higher EOT in males only (OR=1.2 95% C.I. 1.1, 1.3). Having another hobby apart from gaming was protective for males (OR=0.5, 95% C.I. 0.4, 0.6). Having started playing before their ten-years was a risk factor for females (OR=2.3 95% C.I. 1.2, 4.6). Loneliness and boredom feelings predicted IGD in males (OR=1.7 95% C.I. 1.5, 2) and, even more, in females (OR=2.7 95% C.I. 1.8, 4.2). Playing more than six hours/per day increased IGD-risk up to seven times in males (OR=7.3 95% C.I. 5.1, 10.3) and of almost sixteen times in females (OR=15.9 95% C.I. 5.4, 46.7) (Figure-3). Conclusions: Female gamers presented specific characteristics and a greater vulnerability to the increased time spent playing as a risk- factor for IGD

The work was supported by: Clinician Scientist Medical Research Council fellowship (project reference MR/M008436/1) to MDF; the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King’s College Hospital NHS Foundation Trust to DQ; DFG Heisenberg professorship (no. 389624707) to UR. National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health 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., Ferraro, L., Tripoli, G., La Cascia, C., Quigley, H., Quattrone, A., Jongsma, H.E., Del Peschio, S., Gatto, G., Gayer-Anderson, C., Jones, P.B., Kirkbride, J.B., La Barbera, D., Tarricone, I., Berardi, D., 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., Tortelli, A., Velthorst, E., De Haan, L., Rutten, B.P.F., Lynskey, M.T., Freeman, T.P., Sham, P.C., Cardno, A.G., Vassos, E., Van Os, J., Morgan, C., Reininghaus, U., Lewis, C.M., Murray, R.M., Di Forti, M.

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.

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.

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.

Purpose: several studies report that patients with psychosis who used cannabis in their lifetime have a better cognitive performance than those who did not and this association is most likely due to a better premorbid functioning. We aimed 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. Materials and Methods: 1.745 people (746 cases; 999 healthy controls) completed the assessment for Intellectual Quotient (IQ) (WAIS-brief version) premorbid adjustment (Premorbid Adjustment Scale – PAS) and cannabis use (CEQ-Revised). We first obtained two main factors from PAS: “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) and subject status (Cases/Controls) as independent variables. Results: across all countries, IQ was higher in cannabis users patients compared to non users (p=0.027). Conversely, PAA resulted worst in cannabis-users patients than non users (p

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.

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.

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.