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Introduction: Psychiatric rehabilitation activities (PRA) aim at restoring community functioning and improving well-being and quality of life of patients, guiding them towards independence and taking responsibility for their own existence. PRA suitable to psychiatry emergency settings are crucial as they prepare effective postdischarge therapeutic programs. Our psychiatry emergency unit designed rapid group PRA based on a combination of personcentred, evidence-based interventions. Objectives: The aim of our study is to assess several aspects of our PRA: participation rate, degree of participants' satisfaction, perceived utility, and the quality of climate within the group. Methods: Self-report questionnaires were administered in our psychiatry emergency unit to acute patients during their hospitalization. Patients underwent our PRA, a structured weekly program based on a combination of cognitive-behavioural interventions such as Psycho-education, Cognitive Remediation and Social Skills Training. Results: From April to December 2018, 195 self-report questionnaires were administered. 88.5% of participants described PRA as very useful to their recovery process, 87% considered themselves very satisfied with the climate within the group and 86.1% of the sample was very satisfied with the quality of time spent on PRA. Conclusions: Monitoring our group program resulted in a positive feedback on PRA, with high rates of perceived efficacy and satisfaction. High acceptability makes this intervention a promising approach able to promote awareness and recovery in acute patients. The therapeutic effects of PRA possibly unfold through the enhanced ability to cope with stress and to manage personal vulnerabilities, along with an improvement of cognitive functions. [ABSTRACT FROM AUTHOR]

Background: Athanasios Koukopoulos proposed the primacy of mania hypothesis (PoM) in a 2006 book chapter and later, in two peer-reviewed papers with Nassir Ghaemi and other collaborators. This hypothesis supports that in bipolar disorder, mania leads to depression, while depression does not lead to mania., Objective: To identify evidence in literature that supports or falsifies this hypothesis., Method: We searched the medical literature (PubMed, Embase, PsycINFO, and the Cochrane Library) for peer-reviewed papers on the primacy of mania, the default mode function of the brain in normal people and in bipolar disorder patients, and on illusion superiority until 6 June, 2016. Papers resulting from searches were considered for appropriateness to our objective. We adopted the PRISMA method for our review. The search for consistency with PoM was filtered through the neurobiological results of superiority illusion studies., Results: Out of a grand total of 139 records, 59 were included in our analysis. Of these, 36 were of uncertain value as to the primacy of mania hypothesis, 22 favoured it, and 1 was contrary, but the latter pooled patients in their manic and depressive phases, so to invalidate possible conclusions about its consistency with regard to PoM. All considered studies were not focused on PoM or superiority illusion, hence most of their results were, as expected, unrelated to the circuitry involved in superiority illusion. A considerable amount of evidence is consistent with the hypothesis, although indirectly so., Limitations: Only few studies compared manic with depressive phases, with the majority including patients in euthymia., Conclusion: It is possible that humans have a natural tendency for elation/optimism and positive self-consideration, that are more akin to mania; the depressive state could be a consequence of frustrated or unsustainable mania. This would be consistent with PoM.