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1. The influence of autistic symptoms on social and non-social cognition and on real-life functioning in people with schizophrenia: Evidence from the Italian Network for Research on Psychoses multicenter study

Author

Vita, A., Barlati, S., Deste, G., Rocca, P., Rossi, A., Bertolino, A., Aguglia, E., Amore, M., Bellomo, A., Biondi, M., Carpiniello, B., Collantoni, E., Cuomo, A., D'Ambrosio, E., dell' Osso, L., di Giannantonio, M., Giordano, G. M., Marchesi, C., Monteleone, P., Montemagni, C., Oldani, L., Pompili, M., Roncone, R., Rossi, R., Siracusano, A., Zeppegno, P., Nibbio, G., Galderisi, S., Maj, M., Ceraso, A., Galluzzo, A., Lisoni, J., Di Palo, P., Papalino, M., Romano, R., Pinna, F., Lai, A., di Santa Sofia, S. L., Bucci, P., Piegari, G., Brando, F., Giuliani, L., Signorelli, M. S., Poli, L. F., Martinotti, G., Pettorruso, M., Montemitro, C., Altamura, M., Malerba, S., Padalino, F., Amerio, A., Cal-Cagno, P., Zampogna, D., Giusti, L., Salza, A., Mammarella, S., Pacitti, F., Socci, V., Talevi, D., Gramaglia, C., Feggi, A., Jona, A., Favaro, A., Tenconi, E., Meneguzzo, P., Ossola, P., Tonna, M., Gerra, M. L., Carmassi, C., Gesi, C., Carpita, B., Corrivetti, G., Cascino, G., del Buono, G., Di Fabio, F., Buzzanca, A., Girardi, N., Brugnoli, R., Comparelli, A., Corigliano, V., Fagiolini, A., Bolognesi, S., Goracci, A., Di Lorenzo, G., Niolu, C., Ribolsi, M., Brasso, C., Riccardi, C., Del Favero, E., Vita, A., Barlati, S., Deste, G., Rocca, P., Rossi, A., Bertolino, A., Aguglia, E., Amore, M., Bellomo, A., Biondi, M., Carpiniello, B., Collantoni, E., Cuomo, A., D'Ambrosio, E., dell' Osso, L., di Giannantonio, M., Giordano, G. M., Marchesi, C., Monteleone, P., Montemagni, C., Oldani, L., Pompili, M., Roncone, R., Rossi, R., Siracusano, A., Zeppegno, P., Nibbio, G., Galderisi, S., Maj, M., Ceraso, A., Galluzzo, A., Lisoni, J., Di Palo, P., Papalino, M., Romano, R., Pinna, F., Lai, A., di Santa Sofia, S. L., Bucci, P., Piegari, G., Brando, F., Giuliani, L., Signorelli, M. S., Poli, L. F., Martinotti, G., Pettorruso, M., Montemitro, C., Altamura, M., Malerba, S., Padalino, F., Amerio, A., Cal-Cagno, P., Zampogna, D., Giusti, L., Salza, A., Mammarella, S., Pacitti, F., Socci, V., Talevi, D., Gramaglia, C., Feggi, A., Jona, A., Favaro, A., Tenconi, E., Meneguzzo, P., Ossola, P., Tonna, M., Gerra, M. L., Carmassi, C., Gesi, C., Carpita, B., Corrivetti, G., Cascino, G., del Buono, G., Di Fabio, F., Buzzanca, A., Girardi, N., Brugnoli, R., Comparelli, A., Corigliano, V., Fagiolini, A., Bolognesi, S., Goracci, A., Di Lorenzo, G., Niolu, C., Ribolsi, M., Brasso, C., Riccardi, C., and Del Favero, E.

Subjects
schizophrenia, autism spectrum disorders, cognition, psychosocial functioning, social cognition, Adult, Male, Social Cognition, Interpersonal Relation, autism spectrum disorders, cognition, psychosocial functioning, schizophrenia, social cognition, Disease, Autism spectrum disorders, Cognition, Psychosocial functioning, Schizophrenia, Social cognition, Psychotic Disorder, behavioral disciplines and activities, 03 medical and health sciences, Interpersonal relationship, 0302 clinical medicine, mental disorders, Medicine, Humans, Interpersonal Relations, Autism spectrum disorder, Autistic Disorder, business.industry, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, Multicenter study, Settore MED/25, Italy, Psychotic Disorders, Autism, Female, Verbal memory, business, 030217 neurology & neurosurgery, Research Article, Clinical psychology, Human
Abstract

Background Autism spectrum disorders (ASDs) and schizophrenia spectrum disorders (SSDs), although conceptualized as separate entities, may share some clinical and neurobiological features. ASD symptoms may have a relevant role in determining a more severe clinical presentation of schizophrenic disorder but their relationships with cognitive aspects and functional outcomes of the disease remain to be addressed in large samples of individuals. Aims To investigate the clinical, cognitive, and functional correlates of ASD symptoms in a large sample of people diagnosed with schizophrenia. Methods The severity of ASD symptoms was measured with the PANSS Autism Severity Scale (PAUSS) in 921 individuals recruited for the Italian Network for Research on Psychoses multicenter study. Based on the PAUSS scores, three groups of subjects were compared on a wide array of cognitive and functional measures. Results Subjects with more severe ASD symptoms showed a poorer performance in the processing speed (p = 0.010), attention (p = 0.011), verbal memory (p = 0.035), and social cognition (p = 0.001) domains, and an overall lower global cognitive composite score (p = 0.010). Subjects with more severe ASD symptoms also showed poorer functional capacity (p = 0.004), real-world interpersonal relationships (p p Conclusions These findings strengthen the notion that ASD symptoms may have a relevant impact on different aspects of the disease, crucial to the life of people with schizophrenia. Prominent ASD symptoms may characterize a specific subpopulation of individuals with SSD.

Published
2020

2. Factors Associated With Real-Life Functioning in Persons With Schizophrenia in a 4-Year Follow-up Study of the Italian Network for Research on Psychoses

Author

Mucci, A., Galderisi, S., Gibertoni, D., Rossi, A., Rocca, P., Bertolino, A., Aguglia, E., Amore, M., Bellomo, A., Biondi, M., Blasi, G., Brasso, C., Bucci, P., Carpiniello, B., Cuomo, A., Dell'Osso, L., Giordano, G. M., Marchesi, C., Monteleone, P., Niolu, C., Oldani, L., Pettorruso, M., Pompili, M., Roncone, R., Rossi, R., Tenconi, E., Vita, A., Zeppegno, P., Maj, M., Piegari, G., Aiello, C., Brando, F., Giuliani, L., Palumbo, D., Coccia, C., Papalino, M., Calia, V., Romano, R., Barlati, S., Deste, G., Valsecchi, P., Pinna, F., Lai, A., Lostia di Santa Sofia, S., Salvina Signorelli, M., Fusar Poli, L., Surace, T., Martinotti, G., Montemitro, C., Fraticelli, S., Altamura, M., Angelini, E., Elia, A., Calcagno, P., Belvederi Murri, M., Cattedra, S., Pacitti, F., Talevi, D., Socci, V., Giusti, L., Salza, A., Mammarella, S., de Bartolomeis, A., Favaro, A., Collantoni, E., Meneguzzo, P., Tonna, M., Ossola, P., Gerra, M. L., Gramaglia, C., Binda, V., Gambaro, E., Carmassi, C., Carpita, B., Cremone, I. M., Corrivetti, G., Cascino, G., Del Buono, G., Brugnoli, R., Comparelli, A., Corigliano, V., Buzzanca, A., Gerardi, N., Frascarelli, M., Fagiolini, A., Goracci, A., Bolognesi, S., Siracusano, A., Di Lorenzo, G., Ribolsi, M., Montemagni, C., Riccardi, C., Del Favero, E., Mucci, A., Galderisi, S., Gibertoni, D., Rossi, A., Rocca, P., Bertolino, A., Aguglia, E., Amore, M., Bellomo, A., Biondi, M., Blasi, G., Brasso, C., Bucci, P., Carpiniello, B., Cuomo, A., Dell'Osso, L., Giordano, G. M., Marchesi, C., Monteleone, P., Niolu, C., Oldani, L., Pettorruso, M., Pompili, M., Roncone, R., Rossi, R., Tenconi, E., Vita, A., Zeppegno, P., Maj, M., Mucci A., Galderisi S., Gibertoni D., Rossi A., Rocca P., Bertolino A., Aguglia E., Amore M., Bellomo A., Biondi M., Blasi G., Brasso C., Bucci P., Carpiniello B., Cuomo A., Dell'Osso L., Giordano G.M., Marchesi C., Monteleone P., Niolu C., Oldani L., Pettorruso M., Pompili M., Roncone R., Rossi R., Tenconi E., Vita A., Zeppegno P., and Maj M.

Subjects
Adult, Hospitals, Psychiatric, Male, Mental Health Services, Social Cognition, Apathy, Psychological intervention, Relapse prevention, schizophrenia, functioning, psychopatology, Structural equation modeling, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Cognitive Dysfunction, Female, Follow-Up Studies, Independent Living, Italy, Middle Aged, Psychotic Disorders, Schizophrenia, Functional Status, Original Investigation, business.industry, Mental health, Hospitals, Cognitive training, 030227 psychiatry, Psychiatry and Mental health, Settore MED/25, schizophrenia, real-life functioning, SEM, Psychiatric, Work Skills, business, Psychosocial, 030217 neurology & neurosurgery, Psychopathology, Clinical psychology
Abstract

Importance: The goal of schizophrenia treatment has shifted from symptom reduction and relapse prevention to functional recovery; however, recovery rates remain low. Prospective identification of variables associated with real-life functioning domains is essential for personalized and integrated treatment programs. Objective: To assess whether baseline illness-related variables, personal resources, and context-related factors are associated with work skills, interpersonal relationships, and everyday life skills at 4-year follow-up. Design, Setting, and Participants: This multicenter prospective cohort study was conducted across 24 Italian university psychiatric clinics or mental health departments in which 921 patients enrolled in a cross-sectional study were contacted after 4 years for reassessment. Recruitment of community-dwelling, clinically stable persons with schizophrenia was conducted from March 2016 to December 2017, and data were analyzed from January to May 2020. Main Outcomes and Measures: Psychopathology, social and nonsocial cognition, functional capacity, personal resources, and context-related factors were assessed, with real-life functioning as the main outcome. Structural equation modeling, multiple regression analyses, and latent change score modeling were used to identify variables that were associated with real-life functioning domains at follow-up and with changes from baseline in these domains. Results: In total, 618 participants (427 male [69.1%]; mean [SD] age, 45.1 [10.5] years) were included. Five baseline variables were directly associated with real-life functioning at follow-up: neurocognition with everyday life (β, 0.274; 95% CI, 0.207-0.341; P

Published
2021

3. Prevalence of antipsychotic-induced extrapyramidal symptoms and their association with neurocognition and social cognition in outpatients with schizophrenia in the 'real-life'

Author

Monteleone, P., Cascino, G., Monteleone, A. M., Rocca, P., Rossi, A., Bertolino, A., Aguglia, E., Amore, M., Collantoni, E., Corrivetti, G., Cuomo, A., Bellomo, A., D'Ambrosio, E., Dell'Osso, L., Frascarelli, M., Giordano, G. M., Giuliani, L., Marchesi, C., Montemagni, C., Oldani, L., Pinna, F., Pompili, M., Roncone, R., Rossi, R., Siracusano, A., Vita, A., Zeppegno, P., Galderisi, S., Maj, M., Del Buono, G., Marciello, F., Di Palo, P., Sangiuliano, M., Di Gioia, C., Barlati, S., Deste, G., Turrina, C., Carpiniello, B., Marras, L., Muscas, M., Bucci, P., Piegari, G., Brando, F., Aiello, C., Poli, L. F., Saitta, G., Surace, T., Altamura, M., Malerba, S., Padalino, F., Calcagno, P., Murri, M. B., Escelsior, A., Giusti, L., Bianchini, V., Salza, A., Pacitti, F., Socci, V., Lucaselli, A., De Bartolomeis, A., Gramaglia, C., Feggi, A., Jona, A., Favaro, A., Tenconi, E., Meneguzzo, P., Ossola, P., Tonna, M., Gerra, M. L., Carmassi, C., Cremone, I. M., Carpita, B., Biondi, M., Di Fabio, F., Accinni, T., Brugnoli, R., Comparelli, A., Corigliano, V., Fagiolini, A., Bolognesi, S., Goracci, A., Di Lorenzo, G., Ribolsi, M., Niolu, C., Brasso, C., Riccardi, C., Del Favero, E., Monteleone, P., Cascino, G., Monteleone, A. M., Rocca, P., Rossi, A., Bertolino, A., Aguglia, E., Amore, M., Collantoni, E., Corrivetti, G., Cuomo, A., Bellomo, A., D'Ambrosio, E., Dell'Osso, L., Frascarelli, M., Giordano, G. M., Giuliani, L., Marchesi, C., Montemagni, C., Oldani, L., Pinna, F., Pompili, M., Roncone, R., Rossi, R., Siracusano, A., Vita, A., Zeppegno, P., Galderisi, S., and Maj, M.

Subjects
Adult, Male, Social Cognition, Extrapyramidal symptoms, Chlorpromazine, medicine.medical_treatment, Antipsychotic, 03 medical and health sciences, 0302 clinical medicine, Cognition, Basal Ganglia Diseases, Social cognition, Prevalence, Medicine, Antipsychotics, Humans, Extrapyramidal symptom, Neurocognition, Biological Psychiatry, Pharmacology, business.industry, Parkinsonism, Middle Aged, medicine.disease, Risperidone, 030227 psychiatry, Settore MED/25, Schizophrenia, Female, Schizophrenic Psychology, medicine.symptom, business, Neurocognitive, Antipsychotic Agents, Psychopathology, Clinical psychology
Abstract

First generation antipsychotics (FGAs) are more likely to induce extrapyramidal side-effects (EPS) than second generation antipsychotics (SGAs), and EPS have been shown associated to cognitive deficits in schizophrenia. So far, no study has explored the relationships between EPS and social cognition (SC) in people with schizophrenia. Therefore, we assessed the prevalence of EPS in a large sample of drug-treated community-dwelling persons with schizophrenia and explored their relationships with patients' neurocognitive and SC abilities. 875 patients underwent EPS, psychopathological, neurocognitive and SC assessments by means of standardized measures. Relationships between EPS, psychopathology and neurocognitive and SC measures were investigated by correlation tests. Moreover, a partial correlation network was computed by means of a network analysis. 256 patients were treated with FGAs alone or in combination with SGA and 619 with SGAs. EPS were significantly more frequent in FGA-treated group than in the SGA-treated one. Patients with EPS disclosed a more severe psychopathology and were more impaired in neurocognitive and SC measures compared to those without EPS. Disorganization, expressive deficit, and duration of illness were significantly associated to both neurocognitive and SC measures while EPS were associated to neurocognitive measures only. The network analysis showed that parkinsonism was the sole EPS directly connected to both psychopathological and neurocognitive indices whereas no direct connection emerged between EPS and SC measures. Present findings confirm that EPS are still present in the era of SGAs and contribute, together with other clinical variables, to the neurocognitive but not to the SC impairment of patients with schizophrenia.

Published
2021

4. Traumatic experiences and type 2 diabetes mellitus

Author

Saya, A, Proietti, L, Lisi, G, Ribolsi, M, Uccioli, L, Niolu, C, and Siracusano, A

Subjects
Male, Adult Survivors of Child Abuse, Resilience, Psychological, Checklist, Logistic Models, Settore MED/25, Adult Survivors of Child Adverse Events, Diabetes Mellitus, Type 2, Case-Control Studies, Surveys and Questionnaires, Humans, Female, Life Style, Stress, Psychological, Aged
Abstract

Type 2 diabetes mellitus (T2DM) is a complex and demanding chronic condition resulting from the body's inability to adequately produce and or effectively utilize insulin. A wide variety of lifestyle factors are of great importance to the development of T2DM, such as sedentary lifestyle, obesity, physical inactivity, smoking and alcohol consumption. An emerging body of literature suggests that stress and traumatic experiences have a role in the aetiology of T2DM.We recruited a sample of 52 patients with a diagnosis of T2DM and a control group of 48 subjects. Using the Traumatic Experience Checklist (TEC), the Childhood Experience of Care and Abuse Questionnaire (CECA-Q), and the Connor-Davidson Resilience Scale (CD-RISC 25), we investigated the presence of history of traumatic experiences and of childhood experience of neglect and abuse.We found that patients with a diagnosis of T2DM have a higher number of traumatic experiences in their personal history, when compared to the control group.Traumatic experiences or sustained stress exposure may contribute to the onset of T2DM. Neuro-inflammatory and psychoanalytic factors will be discussed to explain such association.We conclude that factors that determine high levels of resiliency can have a protective effect against the development of T2DM while stress and the consequent inflammation can contribute to the development of depression and T2DM. These biological features are analyzed in the psychoanalytical context of theories from Freud, Mahler, and Kohut.

Published
2020

5. Diagnostic and therapeutic challenges in neuroleptic malignant syndrome: a severe medical case

Author

Brogna, P, Colasuonno, R, Di Michele, F, Paterniti, Am, Talamo, A, Ribolsi, M, Jannini, Tb, Siracusano, A, and Niolu, C

Subjects
Adult, Settore MED/25, Humans, Neuroleptic Malignant Syndrome, Female, Severity of Illness Index
Abstract

Neuroleptic malignant syndrome (NMS) is a rare, idiosyncratic medical emergency usually associated with the use of dopamine antagonists, commonly typical antipsychotic drugs. However, it has been observed that it can occur with atypical antipsychotics as well. NMS is characterized by altered consciousness, fever, rigidity, autonomic instability and high creatine phosphokinase (CPK) blood levels. Here, we report a case of a 44-year-old female patient with history of a treatment-resistant bipolar disorder. She was admitted to our psychiatric ward for severe psychomotor agitation and treated with a therapy based on typical and atypical antipsychotics. During the course of the hospitalization she developed NMS. In this case, the diagnosis was delayed due to the slow and insidious symptom presentation, therefore requiring a differential diagnosis. Autoimmune NMDA receptor encephalitis, catatonic syndrome and malignant catatonia have been excluded. The patient met all the DSM-5 criteria for NMS: exposure to dopamine-blocking agent, severe muscle rigidity, fever, diaphoresis, dysphagia, altered level of consciousness, mutism, tremors, tachycardia, high or labile blood pressure, leukocytosis, high creatine phosphokinase. Since robust evidence-based protocols are lacking, here we discuss the relevance of this case in order to highlight the hurdles of a prompt diagnosis, clinical management of associated complications and treatment possibilities for such emergency.

Published
2020

6. The association between insight and depressive symptoms in schizophrenia: Undirected and Bayesian network analyses

Author

Amore, M., Murri, M. B., Calcagno, P., Rocca, P., Rossi, A., Aguglia, E., Bellomo, A., Blasi, G., Carpiniello, B., Cuomo, A., Dell'Osso, L., Di Giannantonio, M., Giordano, G. M., Marchesi, C., Monteleone, P., Montemagni, C., Oldani, L., Pompili, M., Roncone, R., Rossi, R., Siracusano, A., Vita, A., Zeppegno, P., Corso, A., Arzani, C., Galderisi, S., Maj, M., Petrilli, G., Respino, M., Papalino, M., Falsetti, A., Calia, V. M., Barlati, S., Deste, G., Turrina, C., Pinna, F., Lai, A., Di Santa Sofia, S. L., Signorelli, M. S., Petralia, A., Pettorruso, M., Barone, G., Salone, A., Piegari, G., Aiello, C., Brando, F., Giuliani, L., Altamura, M., Carnevale, R., Padalino, F., Giusti, L., Salza, A., Ussorio, D., Pizziconi, G., Santarelli, V., Pacitti, F., De Bartolomeis, A., Gambaro, E., Gattoni, E., Gramaglia, C., De Panfilis, C., Ossola, P., Tonna, M., Carmassi, C., Carpita, B., Cremone, I., Comparelli, A., Corigliano, V., Brugnoli, R., Corrivetti, G., Cascino, G., Del Buono, G., Fagiolini, A., Bolognesi, S., Goracci, A., Di Lorenzo, G., Niolu, C., Ribolsi, M., Bellino, S., Bozzatello, P., Brasso, C., Amore, M., Murri, M. B., Calcagno, P., Rocca, P., Rossi, A., Aguglia, E., Bellomo, A., Blasi, G., Carpiniello, B., Cuomo, A., Dell'Osso, L., di Giannantonio, M., Giordano, G. M., Marchesi, C., Monteleone, P., Montemagni, C., Oldani, L., Pompili, M., Roncone, R., Rossi, R., Siracusano, A., Vita, A., Zeppegno, P., Corso, A., Arzani, C., Galderisi, S., and Maj, M.

Subjects
Adult, Male, media_common.quotation_subject, Social Stigma, Hostility, NO, Suicidal Ideation, Extrapyramidal symptoms, Demoralization, depression, insight, sadness, schizophrenia, self-esteem, Sadness, Self-esteem, medicine, Humans, Suicidal ideation, media_common, Depression, Insight, Schizophrenia, Bayes Theorem, Cross-Sectional Studies, Diagnostic and Statistical Manual of Mental Disorders, Female, Middle Aged, Self Concept, Social Class, Guilt, Schizophrenic Psychology, Positive and Negative Syndrome Scale, Sadne, medicine.disease, Psychiatry and Mental health, Settore MED/25, medicine.symptom, Psychology, Neurocognitive, Research Article, Clinical psychology, Diagnosis of schizophrenia
Abstract

Background. Greater levels of insight may be linked with depressive symptoms among patients with schizophrenia, however, it would be useful to characterize this association at symptom-level, in order to inform research on interventions. Methods. Data on depressive symptoms (Calgary Depression Scale for Schizophrenia) and insight (G12 item from the Positive and Negative Syndrome Scale) were obtained from 921 community-dwelling, clinically-stable individuals with a DSM-IV diagnosis of schizophrenia, recruited in a nationwide multicenter study. Network analysis was used to explore the most relevant connections between insight and depressive symptoms, including potential confounders in the model (neurocognitive and social-cognitive functioning, positive, negative and disorganization symptoms, extrapyramidal symptoms, hostility, internalized stigma, and perceived discrimination). Bayesian network analysis was used to estimate a directed acyclic graph (DAG) while investigating the most likely direction of the putative causal association between insight and depression. Results. After adjusting for confounders, better levels of insight were associated with greater self-depreciation, pathological guilt, morning depression and suicidal ideation. No difference in global network structure was detected for socioeconomic status, service engagement or illness severity. The DAG confirmed the presence of an association between greater insight and self-depreciation, suggesting the more probable causal direction was from insight to depressive symptoms. Conclusions. In schizophrenia, better levels of insight may cause self-depreciation and, possibly, other depressive symptoms. Person-centered and narrative psychotherapeutic approaches may be particularly fit to improve patient insight without dampening self-esteem., Highlights Better insight seems associated with depressive symptoms in schizophrenia.Network analyses were used to explore this association in a large sample.Insight was associated with self-depreciation, guilt, and suicidal ideation.Although cross-sectional, data suggest causal direction from insight to depression.

Published
2020

7. Familial aggregation of MATRICS Consensus Cognitive Battery scores in a large sample o outpatients with schizophrenia and their unaffected relatives

Author

Mucci A., Galderisi S., Green M. F., Nuechterlein K., Rucci P., Gibertoni D., Rossi A., Rocca P., Bertolino A., Bucci P., Hellemann G., Spisto M., Palumbo D., Aguglia E., Amodeo G., Amore M., Bellomo A., Brugnoli R., Carpiniello B., Dell'osso L., Di Fabio F., Di Giannantonio M., Di Lorenzo G., Marchesi C., Monteleone P., Montemagni C., Oldani L., Romano R., Roncone R., Stratta P., Tenconi E., Vita A., Zeppegno P., Maj M., Piegari G., Vignapiano A., Caputo F., Plescia G., Montefusco V., Mancini M., Attrotto M. T., Paladini V., Atti A. R., Barlati S., Galluzzo A., Mussoni C., Pinna F., Sanna L., Primavera D., Signorelli M. S., Minutolo G., Cannavo D., Acciavatti T., Santacroce R., Corbo M., Altamura M., La Montagna M., Carnevale R., Pizziconi G., Rossi R., Santarelli V., Giusti L., Malavolta M., Salza A., Murri M. B., Calcagno P., Bugliani M., Serati M., Orsenigo G., Gramaglia C., Gattoni E., Cattaneo C., Campagnola N., Ferronato L., Piovan C., Tonna M., Bettini E., Ossola P., Gesi C., Landi P., Rutigliano G., Biondi M., Girardi P., Buzzanca A., Zocconali M., Comparelli A., Mancinelli I., Niolu C., Ribolsi M., Siracusano A., Corrivetti G., Bartoli L., Diasco F., Bolognesi S., Goracci A., Fagiolini A., Bellino S., Cardillo S., Bracale N., Mucci, A., Galderisi, S., Green, M. F., Nuechterlein, K., Rucci, P., Gibertoni, D., Rossi, A., Rocca, P., Bertolino, A., Bucci, P., Hellemann, G., Spisto, M., Palumbo, D., Aguglia, E., Amodeo, G., Amore, M., Bellomo, A., Brugnoli, R., Carpiniello, B., Dell'Osso, L., Di Fabio, F., Di Giannantonio, M., Di Lorenzo, G., Marchesi, C., Monteleone, P., Montemagni, C., Oldani, L., Romano, R., Roncone, R., Stratta, P., Tenconi, E., Vita, A., Zeppegno, P., Maj, M., Piegari, G., Vignapiano, A., Caputo, F., Plescia, G., Montefusco, V., Mancini, M., Attrotto, M. T., Paladini, V., Atti, A. R., Barlati, S., Galluzzo, A., Mussoni, C., Pinna, F., Sanna, L., Primavera, D., Signorelli, M. S., Minutolo, G., Cannavo, D., Acciavatti, T., Santacroce, R., Corbo, M., Altamura, M., La Montagna, M., Carnevale, R., Pizziconi, G., Rossi, R., Santarelli, V., Giusti, L., Malavolta, M., Salza, A., Murri, M. B., Calcagno, P., Bugliani, M., Serati, M., Orsenigo, G., Gramaglia, C., Gattoni, E., Cattaneo, C., Campagnola, N., Ferronato, L., Piovan, C., Tonna, M., Bettini, E., Ossola, P., Gesi, C., Landi, P., Rutigliano, G., Biondi, M., Girardi, P., Buzzanca, A., Zocconali, M., Comparelli, A., Mancinelli, I., Niolu, C., Ribolsi, M., Siracusano, A., Corrivetti, G., Bartoli, L., Diasco, F., Bolognesi, S., Goracci, A., Fagiolini, A., Bellino, S., Cardillo, S., Bracale, N., and di Giannantonio, M.

Subjects
Attention, MCCB Italian standardization, reasoning and problem solving, social cognition, verbal learning, working memory, Proband, Adult, Male, Consensus, Psychometrics, Context (language use), social cognition, Verbal learning, working memory, 03 medical and health sciences, Attention, MCCB Italian standardization, reasoning and problem solving, verbal learning, Aged, Cognition, Cognitive Dysfunction, Family, Female, Humans, Middle Aged, Outpatients, Psychiatric Status Rating Scales, Schizophrenia, Schizophrenic Psychology, 0302 clinical medicine, Social cognition, medicine, Applied Psychology, Psychiatry and Mental Health, Family aggregation, medicine.disease, 030227 psychiatry, Settore MED/25, Psychology, MATRICS, Neurocognitive, 030217 neurology & neurosurgery, Clinical psychology
Abstract

BackgroundThe increased use of the MATRICS Consensus Cognitive Battery (MCCB) to investigate cognitive dysfunctions in schizophrenia fostered interest in its sensitivity in the context of family studies. As various measures of the same cognitive domains may have different power to distinguish between unaffected relatives of patients and controls, the relative sensitivity of MCCB tests for relative–control differences has to be established. We compared MCCB scores of 852 outpatients with schizophrenia (SCZ) with those of 342 unaffected relatives (REL) and a normative Italian sample of 774 healthy subjects (HCS). We examined familial aggregation of cognitive impairment by investigating within-family prediction of MCCB scores based on probands’ scores.MethodsMultivariate analysis of variance was used to analyze group differences in adjusted MCCB scores. Weighted least-squares analysis was used to investigate whether probands’ MCCB scores predicted REL neurocognitive performance.ResultsSCZ were significantly impaired on all MCCB domains. REL had intermediate scores between SCZ and HCS, showing a similar pattern of impairment, except for social cognition. Proband's scores significantly predicted REL MCCB scores on all domains except for visual learning.ConclusionsIn a large sample of stable patients with schizophrenia, living in the community, and in their unaffected relatives, MCCB demonstrated sensitivity to cognitive deficits in both groups. Our findings of significant within-family prediction of MCCB scores might reflect disease-related genetic or environmental factors.

Published
2018

8. The complex relationship between self-reported 'personal recovery' and clinical recovery in schizophrenia

Author

Rossi, A, Amore, M, Galderisi, S, Rocca, P, Bertolino, A, Aguglia, E, Amodeo, G, Bellomo, A, Bucci, P, Buzzanca, A, Carpiniello, B, Comparelli, A, Dell'Osso, L, Giannantonio, M, Mancini, M, Marchesi, C, Monteleone, P, Montemagni, C, Oldani, L, Roncone, R, Siracusano, A, Stratta, P, Tenconi, E, Vignapiano, A, Vita, A, Zeppegno, P, Maj, M, Rossetti, M, Rossi, R, Santarelli, V, Giusti, L, Malavolta, M, Salza, A, Palumbo, D, Patriarca, S, Chieffi, M, Attrotto, M, Colagiorgio, L, Andriola, I, Atti, A, Barlati, S, Deste, G, Galluzzo, A, Pinna, F, Deriu, L., Sanna, L, Signorelli, M., Minutolo, G, Cannavò, D, Martinotti, G, Acciavatti, T, Corbo, M, Altamura, M, Carnevale, R, Malerba, S, Murri, M, Calcagno, P, Bugliani, M, Serati, M, Bartolomeis, A, Gramaglia, C, Gattoni, E, Gambaro, E, Collantoni, E, Cremonese, C, Rossi, E, Ossola, P, Tonna, M, Panfilis, C, Rutigliano, G, Gesi, C, Carmassi, C, Biondi, M, Girardi, P, Brugnoli, R, Fabio, F, Pietro, S, Girardi, N, Niolu, C, Lorenzo, G, Ribolsi, M, Corrivetti, G, Pinto, G, Longobardi, N, Fagiolini, A, Goracci, A, Bolognesi, S, Bellino, S, Villari, V, Bracale, N, Rossi, A., Amore, M., Galderisi, S., Rocca, P., Bertolino, A., Aguglia, E., Amodeo, G., Bellomo, A., Bucci, P., Buzzanca, A., Carpiniello, B., Comparelli, A., Dell'Osso, L., Giannantonio, M. D., Mancini, M., Marchesi, C., Monteleone, P., Montemagni, C., Oldani, L., Roncone, R., Siracusano, A., Stratta, P., Tenconi, E., Vignapiano, A., Vita, A., Zeppegno, P., Maj, M., Rossetti, M. C., Rossi, R., Santarelli, V., Giusti, L., Malavolta, M., Salza, A., Palumbo, D., Patriarca, S., Chieffi, M., Attrotto, M. T., Colagiorgio, L., Andriola, I., Atti, A. R., Barlati, S., Deste, G., Galluzzo, A., Pinna, F., Deriu, L., Sanna, L., Signorelli, M. S., Minutolo, G., Cannavo, D., Martinotti, G., Acciavatti, T., Corbo, M., Altamura, M., Carnevale, R., Malerba, S., Murri, M. B., Calcagno, P., Bugliani, M., Serati, M., Bartolomeis, A., Gramaglia, C., Gattoni, E., Gambaro, E., Collantoni, E., Cremonese, C., Rossi, E., Ossola, P., Tonna, M., Panfilis, C. D., Rutigliano, G., Gesi, C., Carmassi, C., Biondi, M., Girardi, P., Brugnoli, R., Fabio, F. D., Pietro, S. D., Girardi, N., Niolu, C., Lorenzo, G. D., Ribolsi, M., Corrivetti, G., Pinto, G., Longobardi, N., Fagiolini, A., Goracci, A., Bolognesi, S., Bellino, S., Villari, V., and Bracale, N.

Subjects
Adult, Male, Schizophrenia, Personal recovery, Clinical recovery, Insight, Recovery styles, Cluster analysis, Clinical recovery, Coping (psychology), Cross-sectional study, Recovery style, 03 medical and health sciences, Diagnostic Self Evaluation, 0302 clinical medicine, Cluster analysis, Recovery styles, Insight, Personal recovery, Schizophrenia, Cluster Analysis, Cross-Sectional Studies, Female, Humans, Psychiatric Status Rating Scales, Self Report, Recovery of Function, Schizophrenic Psychology, Cluster analysi, Self report, Settore MED/25 - Psichiatria, Biological Psychiatry, 030227 psychiatry, Psychiatry and Mental Health, Psychiatric status rating scales, Biological psychiatry, Psychology, 030217 neurology & neurosurgery, Clinical psychology
Abstract

Self-reported 'personal recovery' and clinical recovery in schizophrenia (SRPR and CR. respectively) reflect different perspectives in schizophrenia outcome, not necessarily concordant with each other and usually representing the consumer's or the therapist's point of view. By means of a cluster analysis on SRPR related variables, we identified three dusters. The first and third cluster included subjects with the best and the poorest clinical outcome respectively. The second cluster was characterized by better insight, higher levels of depression and stigma, lowest self-esteem and personal strength, and highest emotional coping. The first duster showed positive features of recovery, while the third duster showed negative features. The second cluster, with the most positive insight, showed a more complex pattern, a some-what 'paradoxical' mixture of positive and negative personal and clinical features of recovery. The present results suggest the need for a characterization of persons with schizophrenia along SRPR and CR dimensions to design individualized and integrated treatment programs aimed to improve insight and coping strategies, reduce stigma and shape recovery styles. (C) 2017 Elsevier B.V. All rights reserved.

Published
2018

9. Prevalence and correlates of QTc prolongation in Italian psychiatric care: cross-sectional multicentre study

Author

Nosè, M., Bighelli, I., Castellazzi, M., Martinotti, G., Carrà, G., Lucii, C., Ostuzzi, G., Sozzi, F., Barbui, C., Acciavatti, T., Adamo, A., Aguglia, A., Albanese, C., Baccaglini, S., Bardicchia, F., Barone, R., Barone, Y., Bartoli, F., Bergamini, C., Bertolini, F., Bolognesi, S., Bordone, A., Bortolaso, P., Bugliani, M., Calandra, C., Calò, S., Cardamone, G., Caroleo, M., Carra, E., Carretta, D., Chiocchi, L., Clerici, M., Corbo, M., Corsi, E., Costanzo, R., Costoloni, G., D'Arienzo, F., Debolini, S., De Capua, A., Di Napoli, W. A., Dinelli, M., Facchi, E., Fargnoli, F., Fiori, F., Franchi, A., Gardellin, F., Gazzoletti, E., Ghio, L., Giacomin, M., Gregis, M., Iovieno, N., Koukouna, D., Lax, A., Lintas, C., Luca, A., Luca, M., Lussetti, M., Madrucci, M., Magnani, N., Magni, L., Manca, E., Martorelli, C., Mattafirri, R., Percudani, M., Perini, G., Petrosemolo, P., Pezzullo, M., Piantanida, S., Pinna, F., Prato, K., Prestia, D., Quattrone, D., Reggianini, C., Restaino, F., Ribolsi, M., Rinosi, G., Rizzo, C., Rizzo, R., Roggi, M., Rossi, G., Rossi, S., Ruberto, S., Santoro, R., Santi, M., Signorelli, M. S., Soscia, F., Staffa, P., Stilo, M., Strizzolo, S., Suraniti, F., Tavian, N., Tortelli, L., Tosoni, F., Valdagno, M., Zanobini, V., Nosè, M, Bighelli, I, Castellazzi, M, Martinotti, G, Carra', G, Lucii, C, Ostuzzi, G, Sozzi, F, Barbui, C, Acciavatti, T, Adamo, A, Aguglia, A, Albanese, C, Baccaglini, S, Bardicchia, F, Barone, R, Barone, Y, Bartoli, F, Bergamini, C, Bertolini, F, Bolognesi, S, Bordone, A, Bortolaso, P, Bugliani, M, Calandra, C, Calò, S, Cardamone, G, Caroleo, M, Carra, E, Carretta, D, Chiocchi, L, Clerici, M, Corbo, M, Corsi, E, Costanzo, R, Costoloni, G, D'Arienzo, F, Debolini, S, De Capua, A, Di Napoli, W, Dinelli, M, Facchi, E, Fargnoli, F, Fiori, F, Franchi, A, Gardellin, F, Gazzoletti, E, Ghio, L, Giacomin, M, Gregis, M, Iovieno, N, Koukouna, D, Lax, A, Lintas, C, Luca, A, Luca, M, Lussetti, M, Madrucci, M, Magnani, N, Magni, L, Manca, E, Martorelli, C, Mattafirri, R, Percudani, M, Perini, G, Petrosemolo, P, Pezzullo, M, Piantanida, S, Pinna, F, Prato, K, Prestia, D, Quattrone, D, Reggianini, C, Restaino, F, Ribolsi, M, Rinosi, G, Rizzo, C, Rizzo, R, Roggi, M, Rossi, G, Rossi, S, Ruberto, S, Santoro, R, Santi, M, Signorelli, M, Soscia, F, Staffa, P, Stilo, M, Strizzolo, S, Suraniti, F, Tavian, N, Tortelli, L, Tosoni, F, Valdagno, M, and Zanobini, V

Subjects
Adult, Male, medicine.medical_specialty, Psychotropic drugs, Epidemiology, medicine.medical_treatment, Long QT syndrome, Antidepressant, Drug overdose, Adverse effect, QT interval, Antipsychotic, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, Risk Factors, Psychotropic drug, medicine, Prevalence, Humans, cardiovascular diseases, Psychiatry, Settore MED/25 - Psichiatria, Polypharmacy, business.industry, Environmental and Occupational Health, Public Health, Environmental and Occupational Health, Public Health, Psychiatry and Mental Health, Original Articles, medicine.disease, 030227 psychiatry, Substance abuse, Long QT Syndrome, Cross-Sectional Studies, Italy, Aripiprazole, Female, business, adverse effect, antipsychotic, psychotropic drugs, Antipsychotic Agents, 030217 neurology & neurosurgery, medicine.drug
Abstract

Aims.In recent years several warnings have been issued by regulatory authorities on the risk of electrocardiogram abnormalities in individuals exposed to psychotropic drugs. As a consequence of these warnings, monitoring of the QT interval corrected for heart rate (QTc) has become increasingly common. This study was conducted to measure the frequency of QTc prolongation in unselected psychiatric patients, and to document the associated factors using a cross-sectional approach.Method.The study was carried out in 35 Italian psychiatric services that are part of the STAR (Servizi Territoriali Associati per la Ricerca) Network, a research group established to produce scientific knowledge by collecting data under ordinary circumstances. During a three-month period, a consecutive unselected series of both in- and out-patients were enrolled if they performed an ECG during the recruitment period and were receiving psychotropic drugs on the day ECG was recorded.Results.During the recruitment period a total of 2411 patients were included in the study. The prevalence of QTc prolongation ranged from 14.7% (men) and 18.6% (women) for the cut-off of 450 ms, to 1.26% (men) and 1.01% (women) for the cut-off of 500 ms. In the multivariate model conducted in the whole sample of patients exposed to psychotropic drugs, female sex, age, heart rate, alcohol and/or substance abuse, cardiovascular diseases and cardiovascular drug treatment, and drug overdose were significantly associated with QTc prolongation. In patients exposed to antipsychotic drugs, polypharmacy was positively associated with QTc prolongation, whereas use of aripiprazole decreased the risk. In patients exposed to antidepressant drugs, use of citalopram, citalopram dose and use of haloperidol in addition to antidepressant drugs, were all positively associated with QTc prolongation.Conclusions.The confirmation of a link between antipsychotic polypharmacy and QTc prolongation supports the current guidelines that recommend avoiding the concurrent use of two or more antipsychotic drugs, and the confirmation of a link between citalopram and QTc prolongation supports the need for routine QTc monitoring. The relatively low proportion of patients with QTc prolongation not only suggests compliance with current safety warnings issued by regulatory authorities, but also casts some doubts on the clinical relevance of QTc prolongation related to some psychotropic drugs.

Published
2016

10. Antipsychotic dose mediates the association between polypharmacy and corrected QT interval

Author

Barbui, Corrado, Bighelli, Irene, Carrà, Giuseppe, Castellazzi, Mariasole, Lucii, Claudio, Martinotti, Giovanni, Nosè, Michela, Ostuzzi, Giovanni, Acciavatti, T., Adamo, A., Aguglia, A., Albanese, C., Baccaglini, S., Bardicchia, F., Barone, R., Barone, Y., Bartoli, F., Bergamini, C., Bertolini, F., Bolognesi, S., Bordone, A., Bortolaso, P., Bugliani, M., Calandra, C., Calò, S., Cardamone, G., Caroleo, M., Carra, E., Car-Retta, D., Chiocchi, L., Cinosi, E., Clerici, M., Corbo, M., Corsi, E., Costanzo, R., Costoloni, G., D'Arienzo, F., Debolini, S., De Capua, A., Di Napoli, W. A., Dinelli, M., Facchi, E., Fargnoli, F., Fiori, F., Franchi, A., Gardellin, F., Gastaldon, C., Gazzoletti, E., Ghio, L., Giacomin, M., Gregis, M., Iovieno, N., Koukouna, D., Lax, A., Lintas, C., Luca, A., Luca, M., Lussetti, M., Madrucci, M., Magnani, N., Magni, L., Manca, E., Martorelli, C., Mattafirri, R., Paladini, C., Papola, D., Percudani, M., Perini, G., Petrosemolo, P., Pezzullo, M., Piantanida, S., Pinna, F., Prato, K., Prestia, D., Quattrone, D., Reggianini, C., Restaino, F., Ribolsi, M., Rinosi, G., Rizzo, C., Rizzo, R., Roggi, M., Rossi, G., Rossi, S., Ruberto, S., Santi, M., Santoro, R., Sepede, G., Signorelli, M. S., Soscia, F., Sozzi, F., Staffa, P., Stilo, M., Strizzolo, S., Suraniti, F., Tavian, N., Tortelli, L., Tosoni, F., Valdagno, M., Zanobini, V., Barbui, C, Bighelli, I, Carrà, G, Castellazzi, M, Lucii, C, Martinotti, G, Nosè, M, Ostuzzi, G, Acciavatti, T, Adamo, A, Aguglia, A, Albanese, C, Baccaglini, S, Bardicchia, F, Barone, R, Barone, Y, Bartoli, F, Bergamini, C, Bertolini, F, Bolognesi, S, Bordone, A, Bortolaso, P, Bugliani, M, Calandra, C, Calò, S, Cardamone, G, Caroleo, M, Carra, E, Carretta, D, Chiocchi, L, Cinosi, E, Clerici, M, Corbo, M, Corsi, E, Costanzo, R, Costoloni, G, D'Arienzo, F, Debolini, S, De Capua, A, Di Napoli, W, Dinelli, M, Facchi, E, Fargnoli, F, Fiori, F, Franchi, A, Gardellin, F, Gastaldon, C, Gazzoletti, E, Ghio, L, Giacomin, M, Gregis, M, Iovieno, N, Koukouna, D, Lax, A, Lintas, C, Luca, A, Luca, M, Lussetti, M, Madrucci, M, Magnani, N, Magni, L, Manca, E, Martorelli, C, Mattafirri, R, Paladini, C, Papola, D, Percudani, M, Perini, G, Petrosemolo, P, Pezzullo, M, Piantanida, S, Pinna, F, Prato, K, Prestia, D, Quattrone, D, Reggianini, C, Restaino, F, Ribolsi, M, Rinosi, G, Rizzo, C, Rizzo, R, Roggi, M, Rossi, G, Rossi, S, Ruberto, S, Santi, M, Santoro, R, Sepede, G, Signorelli, M, Soscia, F, Sozzi, F, Staffa, P, Stilo, M, Strizzolo, S, Suraniti, F, Tavian, N, Tortelli, L, Tosoni, F, Valdagno, M, and Zanobini, V

Subjects
Male, Genetics and Molecular Biology (all), medicine.medical_treatment, Aripiprazole, lcsh:Medicine, Pharmacology, Cardiovascular Medicine, dose-dependent risk, Biochemistry, Electrocardiography, 0302 clinical medicine, Heart Rate, Medicine and Health Sciences, 80 and over, Antipsychotics, lcsh:Science, Aged, 80 and over, Multidisciplinary, Pharmaceutics, Medicine (all), Mental Disorders, Confounding, Drug Information, Drugs, Middle Aged, Long QT Syndrome, Bioassays and Physiological Analysis, Italy, Cardiovascular Diseases, Cardiology, Female, QT interval corrected for heart rate, Adult, Aged, Antipsychotic Agents, Cross-Sectional Studies, Dose-Response Relationship, Drug, Haloperidol, Humans, Young Adult, Polypharmacy, Agricultural and Biological Sciences (all), medicine.drug, Research Article, medicine.medical_specialty, Patients, QTc lenghtening, therapy risk, Long QT syndrome, antipsychotic drugs, Research and Analysis Methods, polypharmacy, QT interval, 03 medical and health sciences, Dose Prediction Methods, Drug Therapy, Internal medicine, Dose-Response Relationship, Drug, Biochemistry, Genetics and Molecular Biology (all), Heart rate, medicine, Antipsychotic, Inpatients, business.industry, lcsh:R, Electrophysiological Techniques, medicine.disease, 030227 psychiatry, Health Care, Defined daily dose, Settore MED/25, lcsh:Q, Cardiac Electrophysiology, business, 030217 neurology & neurosurgery
Abstract

Antipsychotic (AP) drugs have the potential to cause prolongation of the QT interval corrected for heart rate (QTc). As this risk is dose-dependent, it may be associated with the number of AP drugs concurrently prescribed, which is known to be associated with increased cumulative equivalent AP dosage. This study analysed whether AP dose mediates the relationship between polypharmacy and QTc interval. We used data from a cross-sectional survey that investigated the prevalence of QTc lengthening among people with psychiatric illnesses in Italy. AP polypharmacy was tested for evidence of association with AP dose and QTc interval using the Baron and Kenny mediational model. A total of 725 patients were included in this analysis. Of these, 186 (26%) were treated with two or more AP drugs (AP polypharmacy). The mean cumulative AP dose was significantly higher in those receiving AP polypharmacy (prescribed daily dose/defined daily dose = 2.93, standard deviation 1.31) than monotherapy (prescribed daily dose/defined daily dose = 0.82, standard deviation 0.77) (z = -12.62, p < 0.001). Similarly, the mean QTc interval was significantly longer in those receiving AP polypharmacy (mean = 420.86 milliseconds, standard deviation 27.16) than monotherapy (mean = 413.42 milliseconds, standard deviation 31.54) (z = -2.70, p = 0.006). The Baron and Kenny mediational analysis showed that, after adjustment for confounding variables, AP dose mediates the association between polypharmacy and QTc interval. The present study found that AP polypharmacy is associated with QTc interval, and this effect is mediated by AP dose. Given the high prevalence of AP polypharmacy in real-world clinical practice, clinicians should consider not only the myriad risk factors for QTc prolongation in their patients, but also that adding a second AP drug may further increase risk as compared with monotherapy.

Published
2016

11. First-generation antipsychotics and QTc: any role for mediating variables?

Author

Carrà, G., Crocamo, Cristina, Bartoli, F., Lax, A., Tremolada, Martina, Lucii, C., Martinotti, G., Nosè, M., Bighelli, I., Ostuzzi, G., Castellazzi, M., Clerici, M., Barbui, C., Acciavatti, T., Adamo, A., Aguglia, A., Albanese, C., Baccaglini, S., Bardicchia, F., Barone, R., Barone, Y., Bergamini, C., Bertolini, F., Bolognesi, S., Bordone, A., Bortolaso, P., Bugliani, M., Calandra, C., Calò, S., Cardamone, G., Caroleo, M., Carra, E., Carretta, D., Chiocchi, L., Cinosi, E., Corbo, M., Corsi, E., Costanzo, R., Costoloni, G., D’Arienzo, F., Debolini, S., De Capua, A., Di Napoli, W. A., Dinelli, M., Facchi, E., Fargnoli, F., Fiori, F., Franchi, A., Gardellin, F., Gastaldon, C., Gazzoletti, E., Ghio, L., Giacomin, M., Gregis, M., Iovieno, N., Koukouna, D., Lintas, C., Luca, A., Luca, M., Lussetti, M., Madrucci, M., Magnani, N., Magni, L., Manca, E., Martorelli, C., Mattafirri, R., Paladini, C., Papola, D., Percudani, M., Perini, G., Petrosemolo, P., Pezzullo, M., Piantanida, S., Pinna, F., Prato, K., Prestia, D., Quattrone, D., Reggianini, C., Restaino, F., Ribolsi, M., Rinosi, G., Rizzo, C., Rizzo, R., Roggi, M., Rossi, G., Rossi, S., Ruberto, S., Santi, M., Santoro, R., Sepede, G., Signorelli, M. S., Soscia, F., Sozzi, F., Staffa, P., Stilo, M., Strizzolo, S., Suraniti, F., Tavian, N., Tortelli, L., Tosoni, F., Valdagno, M., Zanobini, V., Carra', G, Crocamo, C, Bartoli, F, Lax, A, Tremolada, M, Lucii, C, Martinotti, G, Nosè, M, Bighelli, I, Ostuzzi, G, Castellazzi, M, Clerici, M, and Barbui, C

Subjects
Adult, Male, QT prolongation, alcohol, antipsychotic agents, drug therapy combination, risk factors, Antipsychotic Agents, Cross-Sectional Studies, Electrocardiography, Female, Heart Rate, Humans, Italy, Long QT Syndrome, Mental Disorders, Middle Aged, Pharmacology (medical), Settore MED/25 - Psichiatria, Neurology, Neurology (clinical), Psychiatry and Mental Health, antipsychotic agent, risk factor
Abstract

Objective: Corrected QT (QTc) interval prolongation is often associated with use of first-generation antipsychotics (FGAs). However, other factors require appropriate consideration, including age and gender, the role of other known medications associated with QTc prolongation, and severe comorbid conditions, such as co-occurring alcohol abuse/dependence. We aimed to study potential mediating roles of different, related, candidate variables on QTc. Methods: We capitalized on data from a large (N = 2366), cross-sectional, national survey, the STAR Network QTc study, using a representative sample of people taking FGAs, and recruited from mental health services across Italy. Results: About one-third of the sample was treated with FGAs, and almost one-tenth of the subjects took a different, additional, drug known to cause QTc prolongation. Our findings confirmed that there is an impact from FGAs, age, gender, alcohol misuse, and concurrent risky drugs on QTc. However, comorbid alcohol abuse/dependence and concurrent risky drugs did not mediate the effect of FGAs on QTc. Conclusions: Our findings showed that FGAs, concurrent risky drugs, and alcohol use disorders prolonged QTc. FGAs had a direct effect on QTc, confirming the need for clinicians to monitor a risk that could lead to sudden unexplained death. Copyright © 2016 John Wiley & Sons, Ltd.

Published
2016

12. Common variant at 16p11.2 conferring risk of psychosis

Author

Steinberg, S., de Jong, S., Sigurdsson, E., Murray, R., Corvin, A., Gill, M., Morris, D., O'Neill, F. A., Kendler, K., Riley, B., 2, Wellcome Trust Case Control Consortium, Craddock, N., Owen, M. J., Vassos, E., O'Donovan, M. C., Thorsteinsdottir, U., Kong, A., Ehrenreich, H., Carracedo, A., Golimbet, V., Andreassen, O. A., Børglum, A. D., Mors, O., Mortensen, P. B., Giegling, I., Werge, T., Ophoff, R. A., Nöthen, M. M., Rietschel, M., Cichon, S., Ruggeri, M., Tosato, S., Palotie, A., St Clair, D., Rujescu, D., Breuer, R., Collier, D. A., Stefansson, H., Stefansson, K., Donnelly, Peter, Barroso, Ines, Blackwell, Jenefer M, Bramon, Elvira, Brown, Matthew A, Casas, Juan P, Corvin, Aiden, Fraser, G., Deloukas, Panos, Duncanson, Audrey, Jankowski, Janusz, Markus, Hugh S, Mathew, Christopher G, Palmer, Colin N A, Plomin, Robert, Rautanen, Anna, Sawcer, Stephen J, Trembath, Richard C, Walker, N., Viswanathan, Ananth C, Wood, Nicholas W, Spencer, Chris C A, Band, Gavin, Bellenguez, Céline, Freeman, Colin, Hellenthal, Garrett, Giannoulatou, Eleni, Pirinen, Matti, Pearson, Richard, Melle, I., Strange, Amy, Su, Zhan, Vukcevic, Damjan, Langford, Cordelia, Hunt, Sarah E, Edkins, Sarah, Gwilliam, Rhian, Blackburn, Hannah, Djurovic, S., Bumpstead, Suzannah J, Dronov, Serge, Gillman, Matthew, Gray, Emma, Hammond, Naomi, Jayakumar, Alagurevathi, McCann, Owen T, Liddle, Jennifer, Potter, Simon C, Ravindrarajah, Radhi, Agartz, I., Ricketts, Michelle, Waller, Matthew, Weston, Paul, Widaa, Sara, Whittaker, Pamela, Tuulio-Henriksson, A., Mattheisen, M., Suvisaari, J., Lönnqvist, J., Paunio, T., Olsen, L., Hansen, T., Ingason, A., Pirinen, M., Strengman, E., GROUP, Hougaard, D. M., Costas, J., Orntoft, T., Didriksen, M., Hollegaard, M. V., Nordentoft, M., Abramova, L., Kaleda, V., Arrojo, M., Sanjuán, J., Arango, C., Etain, B., Demontis, D., Bellivier, F., Méary, A., Schürhoff, F., Szoke, A., Ribolsi, M., Magni, V., Siracusano, A., Sperling, S., Rossner, M., Christiansen, C., Jamain, S., Kiemeney, L. A., Franke, B., van den Berg, L. H., Veldink, J., Curran, S., Bolton, P., Poot, M., Staal, W., Rehnstrom, K., Kilpinen, H., Pietiläinen, O. P. H., Freitag, C. M., Meyer, J., Magnusson, P., Saemundsen, E., Martsenkovsky, I., Bikshaieva, I., Martsenkovska, I., Vashchenko, O., Raleva, M., Paketchieva, K., Lin, K., Stefanovski, B., Durmishi, N., Pejovic Milovancevic, M., Lecic Tosevski, D., Silagadze, T., Naneishvili, N., Mikeladze, N., Surguladze, S., Vincent, J. B., Farmer, A., Papiol, S., Mitchell, P. B., Wright, A., Schofield, P. R., Fullerton, J. M., Montgomery, G. W., Martin, N. G., Rubino, I. A., van Winkel, R., Kenis, G., De Hert, M., Huttenlocher, J., Réthelyi, J. M., Bitter, I., Terenius, L., Jönsson, E. G., Bakker, S., van Os, J., Jablensky, A., Leboyer, M., Bramon, E., Powell, J., deCODE Genet, IS-101 Reykjavik, Iceland Univ Calif Los Angeles, Ctr Neurobehav Genet, Los Angeles, CA USA Harvard Univ, Brigham & Womens Hosp, Sch Med, Channing Div Network Med, Boston, MA 02115 USA Univ Bonn, Inst Genom Math, Bonn, Germany Univ Bonn, Dept Genom, Life & Brain Ctr, Bonn, Germany CHUS, Galician Fdn Genom Med SERGAS, Santiago De Compostela, Spain Aarhus Univ, Dept Biomed, Aarhus, Denmark Aarhus Univ, iSEQ, Ctr Integrat Sequencing, Aarhus, Denmark Lundbeck Fdn Initiat Integrat Psychiat Res, iPSYCH, Aarhus, Denmark Fdn FondaMental, Creteil, France Hop Henri Mondor, INSERM, U955, F-94010 Creteil, France Univ Helsinki, Inst Mol Med Finland FIMM, Helsinki, Finland Inst Hlth & Welf, Publ Hlth Genom Unit, Helsinki, Finland Wellcome Trust Sanger Inst, Cambridge, England South London & Maudsley NHS Fdn Trust, NIHR Biomed Res Ctr Mental Hlth, Dept Neurosci, London, England Kings Coll London, London, England DFG Res Ctr Mol Physiol Brain CMPB, Gottingen, Germany Max Planck Inst Expt Med, Div Clin Neurosci, D-37075 Gottingen, Germany Univ Tubingen, Inst Human Genet, Dept Med Genet, Tubingen, Germany Natl Univ Hosp Reykjavik, Dept Psychiat, Reykjavik, Iceland Univ Iceland, Sch Med, Reykjavik, Iceland Kings Coll London, Inst Psychiat, Social Genet & Dev Psychiat Res Ctr, London, England Univ Munich, Dept Psychiat, Div Mol & Clin Neurobiol, D-80539 Munich, Germany Heidelberg Univ, Cent Inst Mental Hlth, Dept Genet Epidemiol Psychiat, Mannheim, Germany Univ Aberdeen, Dept Mental Hlth, Royal Cornhill Hosp, Aberdeen, Scotland Ravenscraig Hosp, Greenock, Scotland [Univ Oslo, Inst Clin Med, KG Jebsen Ctr Psychosis Res, Div Mental Hlth & Addict,Oslo Univ Hosp, Oslo, Norway Natl Inst Hlth & Welf, Dept Mental Hlth & Subst Abuse Serv, Helsinki, Finland Univ Helsinki, Dept Psychiat, SF-00180 Helsinki, Finland Univ Helsinki, Cent Hosp, Helsinki, Finland Natl Inst Hlth & Welf THL, Publ Hlth Genom Unit, Helsinki, Finland Univ Copenhagen, Mental Hlth Ctr Sct Hans, Inst Biol Psychiat, Roskilde, Denmark Univ Oxford, Wellcome Trust Ctr Human Genet, Oxford, England Univ Med Ctr Utrecht, Dept Med Genet, Utrecht, Netherlands Statens Serum Inst, Dept Clin Biochem Immunol & Genet, Sect Neonatal Screening & Hormones, DK-2300 Copenhagen, Denmark Aarhus Univ Hosp, Dept Mol Med, DK-8000 Aarhus, Denmark H Lundbeck & Co AS, Synapt Transmiss, Copenhagen, Denmark Copenhagen Univ Hosp, Psychiat Ctr Copenhagen, Copenhagen, Denmark Russian Acad Med Sci, Mental Hlth Res Ctr, Moscow 109801, Russia CHUS, Serv Psychiat, Santiago De Compostela, Spain Univ Valencia, Network Ctr Biomed Res Mental Hlth CIBERSAM, Unit Psychiat, Fac Med, Valencia, Spain Univ Complutense, Hosp Gen Univ Gregorio Maranon, IiSGM, CIBERSAM, E-28040 Madrid, Spain Hop H Mondor A Chenevier, AP HP, Creteil, France Univ Paris Est, Fac Med, Creteil, France Univ Roma Tor Vergata, Dept Neurosci, Sect Psychiat, Rome, Italy Max Planck Inst Expt Med, Dept Neurogenet, D-37075 Gottingen, Germany Nord Biosci, Herlev, Denmark Radboud Univ Nijmegen, Med Ctr, Dept Epidemiol & Biostat, NL-6525 ED Nijmegen, Netherlands Radboud Univ Nijmegen, Med Ctr, Dept Urol, NL-6525 ED Nijmegen, Netherlands Radboud Univ Nijmegen, Med Ctr, Dept Human Genet, NL-6525 ED Nijmegen, Netherlands Radboud Univ Nijmegen, Med Ctr, Dept Psychiat, Donders Inst Brain Cognit & Behav, NL-6525 ED Nijmegen, Netherlands Univ Med Ctr, Rudolf Magnus Inst Neurosci, Dept Neurol, Utrecht, Netherlands Kings Coll London, Inst Psychiat, Dept Child & Adolescent Psychiat, London, England Radboud Univ Nijmegen, Dept Cognit Neurosci, NL-6525 ED Nijmegen, Netherlands Goethe Univ Frankfurt, Dept Child & Adolescent Psychiat Psychosomat & Ps, D-60054 Frankfurt, Germany Univ Trier, Dept Neurobehav Genet, Trier, Germany Natl Univ Hosp Reykjavik, Dept Child & Adolescent Psychiat, Reykjavik, Iceland State Diagnost & Counseling Ctr, Kopavogur, Iceland Ukrainian Res Inst Social Forens Psychiat & Drug, Dept Child Adolescent Psychiat & Med Social Rehab, Kiev, Ukraine Univ Skopje, Dept Child & Adolescent Psychiat, Skopje, Macedonia Inst Mental Hlth, Belgrade, Serbia Univ Belgrade, Fac Med, Belgrade, Serbia Tbilisi State Med Univ TSMU, Dept Psychiat & Drug Addict, Tbilisi, Rep of Georgia Ilia State Univ, Social & Affect Neurosci Lab, Tbilisi, Rep of Georgia Ctr Addict & Mental Hlth CAMH, Mol Neuropsychiat & Dev Lab, Toronto, ON, Canada Prince Wales Hosp, Black Dog Inst, Randwick, NSW 2031, Australia Univ New S Wales, Sch Psychiat, Sydney, NSW, Australia Neurosci Res Australia, Sydney, NSW, Australia Univ New S Wales, Sch Med Sci, Sydney, NSW, Australia Queensland Inst Med Res, Brisbane, Qld 4006, Australia Catholic Univ Louvain, Univ Psychiat Ctr, Kortenberg, Belgium Maastricht Univ, European Grad Sch Neurosci EURON,Med Ctr, Sch Mental Hlth & Neurosci,Dept Psychiat & Psycho, South Limburg Mental Hlth Res & Teaching Network, Maastricht, Netherlands Semmelweis Univ, Dept Psychiat & Psychotherapy, H-1085 Budapest, Hungary Karolinska Hosp & Inst, HUBIN Project, Dept Clin Neurosci, Stockholm, Sweden Univ Med Ctr, Rudolf Magnus Inst Neurosci, Dept Psychiat, Utrecht, Netherlands Maastricht Univ, Dept Psychiat, Med Ctr, Maastricht, Netherlands Univ Western Australia, Graylands Hosp, CCRN, Perth, WA 6009, Australia UCL, Mental Hlth Sci Unit, London, England UCL, Inst Cognit Neurosci, London, England South London & Maudsley NHS Fdn Trust, NIHR Biomed Res Ctr Mental Hlth, Dept Psychosis Studies, London, England Trinity Coll Dublin, Sch Med, Neuropsychiat Genet Res Grp, Dublin, Ireland Queens Univ Belfast, Dept Psychiat, Belfast, Antrim, North Ireland Virginia Commonwealth Univ, Dept Human Genet, Richmond, VA USA Virginia Commonwealth Univ, Virginia Inst Psychiat & Behav Genet, Richmond, VA USA Virginia Commonwealth Univ, Dept Psychiat, Richmond, VA USA Cardiff Univ, Sch Med, Inst Psychol Med & Clin Neurosci, MRC Ctr Neuropsychiat Genet & Genom, Cardiff CF10 3AX, S Glam, Wales Univ Santiago de Compostela, Biomed Network Res Ctr Rare Dis CIBERER, Galician Fdn Genom Med, Genom Med Grp, Santiago De Compostela, Spain Aarhus Univ Hosp, Ctr Psychiat Res, Risskov, Denmark Aarhus Univ, Natl Ctr Register Based Res, Aarhus, Denmark German Ctr Neurodegenerat Disorders DZNE, Bonn, Germany Univ Bonn, Inst Human Genet, Bonn, Germany Inst Neurosci & Med INM 1, Julich, Germany Univ Verona, Sect Psychiat, I-37100 Verona, Italy Broad Inst MIT & Harvard, Program Med & Populat Genet & Genet Anal Platform, Cambridge, MA USA Univ Helsinki, Dept Med Genet, Helsinki, Finland Univ Cent Hosp, Helsinki, Finland Univ Halle Wittenberg, Dept Psychiat, D-06108 Halle, Germany Eli Lilly & Co Ltd, Erl Wood Manor, Windlesham, Surrey, England, Psychiatrie & Neuropsychologie, MUMC+: MA Psychiatrie (3), MUMC+: Hersen en Zenuw Centrum (3), and RS: MHeNs - R2 - Mental Health

Subjects
Oncology, Male, association, Bipolar disorder, cross-disorder, schizophrenia, 1p11.2, Bipolar Disorder, International Cooperation, Genome-wide association study, Disease, 0302 clinical medicine, Risk Factors, Epidemiology, Odds Ratio, Medicine, genetics [Schizophrenia], Oligonucleotide Array Sequence Analysis, Genetics, Aged, 80 and over, bipolar disorder, 0303 health sciences, Middle Aged, 16p11.2, 3. Good health, Europe, Psychiatry and Mental health, genetics [Chromosomes, Human, Pair 16], epidemiology [Bipolar Disorder], Urological cancers Radboud Institute for Health Sciences [Radboudumc 15], genetics [Polymorphism, Single Nucleotide], Female, Adult, medicine.medical_specialty, Psychosis, Genotype, complications [Bipolar Disorder], epidemiology [Schizophrenia], Polymorphism, Single Nucleotide, Article, 03 medical and health sciences, Cellular and Molecular Neuroscience, Young Adult, complications [Schizophrenia], Internal medicine, mental disorders, Humans, Genetic Predisposition to Disease, ddc:610, Molecular Biology, Settore MED/25 - Psichiatria, 030304 developmental biology, Aged, Chromosome Aberrations, Neurodevelopmental disorders Donders Center for Medical Neuroscience [Radboudumc 7], business.industry, Gene Expression Profiling, Odds ratio, medicine.disease, Schizophrenia, Autism, business, Body mass index, genetics [Bipolar Disorder], 030217 neurology & neurosurgery, Chromosomes, Human, Pair 16, Genome-Wide Association Study
Abstract

To access publisher's full text version of this article. Please click on the hyperlink in Additional Links field. Epidemiological and genetic data support the notion that schizophrenia and bipolar disorder share genetic risk factors. In our previous genome-wide association study, meta-analysis and follow-up (totaling as many as 18 206 cases and 42 536 controls), we identified four loci showing genome-wide significant association with schizophrenia. Here we consider a mixed schizophrenia and bipolar disorder (psychosis) phenotype (addition of 7469 bipolar disorder cases, 1535 schizophrenia cases, 333 other psychosis cases, 808 unaffected family members and 46 160 controls). Combined analysis reveals a novel variant at 16p11.2 showing genome-wide significant association (rs4583255[T]; odds ratio=1.08; P=6.6 × 10(-11)). The new variant is located within a 593-kb region that substantially increases risk of psychosis when duplicated. In line with the association of the duplication with reduced body mass index (BMI), rs4583255[T] is also associated with lower BMI (P=0.0039 in the public GIANT consortium data set; P=0.00047 in 22 651 additional Icelanders). National Institute of Mental Health N01 MH900001 MH074027 1U24MH081810 R01 MH078075 Eli Lilly and Company Pritzker Neuropsychiatric Disorders Research Fund L.L.C. Massachusetts General Hospital in Boston, MA (NIMH) 2N01MH080001-001 Wellcome Trust 076113 085475 075491/Z/04 085475/B/08/Z 085475/Z/08/Z Medical Research Council G0601030 Anthony P Monaco, PI, University of Oxford National Genome Research Network of the German Federal Ministry of Education and Research (BMBF) 01GS08144 01GS08147 Centre of Excellence for Complex Disease Genetics of the Academy of Finland 213506 129680 Biocentrum Helsinki Foundation Research Program for Molecular Medicine, Faculty of Medicine, University of Helsinki Stanley Medical Research Institute Danish Council for Strategic Research 2101-07-0059 H Lundbeck A/S; the Research Council of Norway 163070/V50 Danish Medical Research Council South-East Norway Health Authority 2004-123 Medical Research Council Ministerio de Sanidad y Consumo, Spain PI081522 Xunta de Galicia 08CSA005208PR Swedish Research Council Wellcome Trust Case Control Consortium 2 Max Planck Society; Saarland University T6 03 10 00-45 Netherlands Foundation for Brain Research (Hersenstichting) 2008(1).34 2006-037761 PIAP-GA-2008-218251 HEALTH-F2-2009-223423 HEALTH-F4-2009-242257 info:eu-repo/grantAgreement/EC/FP7/218251

Published
2014

13. A between-subjects test of the lower-identification/ higher-priming paradox

Author

Rubino, I, DI LORENZO, G, Magni, V, Ribolsi, M, Mancini, V, Saya, A, Pezzarossa, B, Siracusano, A, and Suslow, T

Subjects
Adult, Male, Emotions, Humans, Linear Models, Subliminal Stimulation, Awareness, Sensory Thresholds, Repetition Priming, Judgment, Facial Expression, Pattern Recognition, Visual, Cues, Middle Aged, Perceptual Masking, Individuality, Female, Pattern Recognition, Visual, Settore MED/25 - Psichiatria
Published
2013

14. PLATELET ACTIVATING FACTOR AND DISTINCT CHEMOKINES ARE ELEVATED IN MUCOSAL BIOPSIES OF EROSIVE COMPARED TO NON-EROSIVE REFLUX DISEASE PATIENTS AND CONTROLS

Author

Altomare, A., Ma, J., Guarino, M.P.L., Cheng, L., Rieder, F., Ribolsi, M., Fiocchi, C., Biancani, P., Harnett, K., and Cicala, M.

Subjects
Adult, Male, Biopsy, Enzyme-Linked Immunosorbent Assay, Middle Aged, Real-Time Polymerase Chain Reaction, Article, Gastroesophageal Reflux, Humans, Female, Chemokines, Platelet Activating Factor, Esophagitis, Peptic, Aged
Abstract

A distinction between symptomatic non-erosive reflux disease (NERD) and erosive esophagitis (EE) patients is supported by the presence of inflammatory response in the mucosa of EE patients, leading to a damage of mucosal integrity. To explore the underlying mechanism of this difference, we assessed inflammatory mediators in mucosal biopsies from EE and NERD patients and compared them with controls.Nineteen NERD patients, 15 EE patients, and 16 healthy subjects underwent endoscopy after a 3-week washout from PPI or H(2) antagonists. Biopsies obtained from the distal esophagus were examined by quantitative real-time polymerase chain reaction (qPCR) and multiplex enzyme-linked immunosorbent assay for selected chemokines and lyso-PAF acetyltransferase (LysoPAF-AT), the enzyme responsible for production of platelet-activating factor (PAF).Expression of LysoPAF-AT and multiple chemokines was significantly increased in mucosal biopsies derived from EE patients, when compared with NERD patients and healthy controls. Upregulated chemokines included interleukin 8, eotaxin-1, -2, and -3, macrophage inflammatory protein-1α (MIP-1α), and monocyte chemoattractant protein-1 (MCP-1). LysoPAF-AT and the chemokine profile in NERD patients were comparable with healthy controls.Levels of selected cytokines and Lyso-PAF AT were significantly higher in the esophageal mucosa of EE patients compared with NERD and control patients. This difference may explain the distinct inflammatory response occurring in EE patients' mucosa. In contrast, as no significant differences existed between the levels of all mediators in NERD and control subjects, an inflammatory response does not appear to play a major role in the pathogenesis of the abnormalities found in NERD patients.

Published
2012

15. Relationship between baseline impedance levels and esophageal mucosal integrity in children with erosive and non-erosive reflux disease

Author

Borrelli, O., Salvatore, S., Mancini, V., Ribolsi, M., Gentile, Massimo, Bizzarri, B., Cicala, M., Lindley, K. J., and De'Angelis, G. L.

Subjects
baseline impedance, Male, gastro-esophageal reflux disease, Mucous Membrane, Adolescent, Biopsy, non-erosive reflux disease, multichannel intraluminal impedance test, children, erosive reflux disease, intercellular space diameter, Esophagus, Microscopy, Electron, Transmission, Child, Preschool, Electric Impedance, Gastroesophageal Reflux, Humans, Female, Esophagoscopy, Child, Extracellular Space
Abstract

Baseline impedance measurement has been reported to be related to esophageal acid exposure and hypothesized to be a marker of microscopic changes of the esophageal mucosa. Aims of the study were to establish whether any relationship existed between the magnitude of intercellular space diameter (ISD) of esophageal mucosa and baseline impedance levels in children with gastro-esophageal reflux disease (GERD), and to compare baseline impedance levels between children with non erosive (NERD) and erosive (ERD) reflux disease.Fifteen children (median age: 11.2 years) with NERD, and 11 with ERD (median age: 9.6 years) were prospectively studied. All patients underwent upper endoscopy. Biopsies were taken 2-3cm above the Z-line, and ISD was measured using transmission electron microscopy. All patients underwent impedance pH-monitoring, and baseline impedance levels were assessed in the most distal impedance channel.Mean (±SD) ISD did not differ between NERD (1.0±0.3μm) and ERD (1.1 ± 0.3 μm, ns). Considering all patients together, no correlation was found between distal baseline impedance and ISD (r: -0.15; ns). Conversely, negative correlations were found between distal baseline impedance and acid exposure time (r: -0.76; P0.001), long-lasting reflux episodes (r: -0.78; P0.001), acid reflux episodes (r: -0.62; P0.001), and acid clearance time (r: -0.79; P0.001). Distal baseline impedance was significantly lower in ERD [1455 (947-2338) Ω] than in NERD children [3065 (2253-3771) Ω; P0.01]. In children with GERD baseline impedance levels are not useful in predicting reflux-induced ultrastructural changes in the esophageal mucosa, despite their ability to discriminate between NERD and ERD.

Published
2012

16. Neural correlates of local contextual processing deficits in schizophrenic patients

Author

Fogelson, N, Ribolsi, M, Fernandez-Del-Olmo, M, Rubino, Ia, Romeo, D, Koch, G, and Peled, A

Subjects
Adult, Cerebral Cortex, Male, Brain Mapping, Schizophrenia, Photic Stimulation, Evoked Potentials, Visual, Humans, Electroencephalography, Visual Perception, Female, Reaction Time, NO, Visual, Evoked Potentials, Settore MED/25 - Psichiatria
Abstract

Deficits in processing contextual information are one of the main features of cognitive dysfunction in schizophrenia, but the neurophysiologic substrate underlying this dysfunction is poorly understood. We used ERPs to investigate local contextual processing in schizophrenic patients. Local context was defined as the occurrence of a short predictive series of stimuli occurring before delivery of a target event. Response times of predicted targets were faster in controls compared to patients. Schizophrenia patients failed to generate the P3b latency shift between predicted and random targets that was observed in controls and demonstrated a prominent reduction of the peak of an early latency context dependent positivity. The current study provides evidence of contextual processing deficits in schizophrenia patients by demonstrating alteration in the behavioral and neural correlates of local contextual processing.

Published
2011

17. Interplay Among Psychopathologic Variables, Personal Resources, Context-Related Factors, and Real-life Functioning in Individuals With Schizophrenia: A Network Analysis

Author

Galderisi, Silvana, Rucci, Paola, Kirkpatrick, Brian, Mucci, Armida, Gibertoni, Dino, Della Rocca, Paola, Rossi, Alessandro, Bertolino, Alessandro, Strauss, Gregory P., Aguglia, Eugenio, Bellomo, Antonello, Murri, Martino Belvederi, Bucci, Paola, Carpiniello, Bernardo, Comparelli, Anna, Cuomo, Alessandro, De Berardis, Domenico, Dell'Osso, Liliana, Di Fabio, Fabio, Gelao, Barbara, Marchesi, Carlo, Monteleone, Palmiero, Montemagni, Cristiana, Orsenigo, Giulia, Pacitti, Francesca, Roncone, Rita, Santonastaso, Paolo, Siracusano, Alberto, Vignapiano, Annarita, Vita, Antonio, Zeppegno, Patrizia, Maj, Mario, Italian Network for Research on Psychoses, Aiello, Carmen, Molle, Debora, Nicita, Alessia, Patriarca, Sara, Pietrafesa, Daria, Longo, Luisa, Falsetti, Andrea, Barone, Marina, Galluzzo, Alessandro, Barlati, Stefano, Deste, Giacomo, Pinna, Federica, Primavera, Diego, Sanna, Lucia, Signorelli, Maria, Minutolo, Giuseppe, Cannavò, Dario, Corbo, Mariangela, Baroni, Gaia, Montemitro, Chiara, Altamura, Mario, La Montagna, Maddalena, Carnevale, Raffaella, Amore, Mario, Calcagno, Pietro, Bugliani, Michele, Parnanzone, Serena, Rossi, Rodolfo, Serrone, Dario, Giusti, Laura, Malavolta, Maurizio, Salza, Anna, Caldiroli, Alice, Mandolini, Gianmario, De Carlo, Vera, de Bartolomeis, Andrea, Gramaglia, Carla, Marangon, Debora, Prosperini, Pierluigi, Pierluigi, Elena, Meneguzzo, Paolo, Giannunzio, Valeria, Tonna, Matteo, Ossola, Paolo, Lidia Gerra, Maria, Gesi, Camilla, Mirko Cremone, Ivan, Carpita, Barbara, Brugnoli, Roberto, Del Casale, Antonio, Corigliano, Valentina, Biondi, Massimo, Zocconali, Monica, Buzzanca, Antonino, Corrivetti, Giulio, Pinto, Gaetano, Diasco, Ferdinando, Fagiolini, Andrea, Goracci, Arianna, Bolognesi, Simone, Niolu, Cinzia, Di Lorenzo, Giorgio, Ribolsi, Michele, Mancini, Irene, Brasso, Claudio, Bozzatello, Paola, Galderisi, Silvana, Rucci, Paola, Kirkpatrick, Brian, Mucci, Armida, Gibertoni, Dino, Rocca, Paola, Rossi, Alessandro, Bertolino, Alessandro, Strauss, Gregory P., Aguglia, Eugenio, Bellomo, Antonello, Murri, Martino Belvederi, Bucci, Paola, Carpiniello, Bernardo, Comparelli, Anna, Cuomo, Alessandro, De Berardis, Domenico, Dell'Osso, Liliana, Di Fabio, Fabio, Gelao, Barbara, Marchesi, Carlo, Monteleone, Palmiero, Montemagni, Cristiana, Orsenigo, Giulia, Pacitti, Francesca, Roncone, Rita, Santonastaso, Paolo, Siracusano, Alberto, Vignapiano, Annarita, Vita, Antonio, Zeppegno, Patrizia, Maj, Mario, Aiello, C., Molle, D., Nicita, A., Patriarca, Paola, Pietrafesa, D., Longo, L., Falsetti, A., Barone, M., Galluzzo, A., Barlati, S., Deste, G., Pinna, F., Primavera, D., Sanna, L., Signorelli, M., Minutolo, G., Cannavò, D., Corbo, M., Baroni, G., Montemitro, C., Altamura, M., La Montagna, M., Carnevale, R., Amore, M., Calcagno, P., Bugliani, M., Parnanzone, S., Rossi, R., Serrone, D., Giusti, L., Malavolta, M., Salza, A., Caldiroli, A., Mandolini, G., De Carlo, V., de Bartolomeis, A., Gramaglia, C., Marangon, D., Prosperini, P., Pierluigi, E., Meneguzzo, P., Giannunzio, V., Tonna, M., Ossola, P., Gerra, M. L., Gesi, C., Cremone, I. M., Carpita, B., Brugnoli, R., Del Casale, A., Corigliano, V., Biondi, M., Zocconali, M., Buzzanca, A., Corrivetti, G., Pinto, G., Diasco, F., Fagiolini, A., Goracci, A., Bolognesi, S., Niolu, C., Di Lorenzo, G., Ribolsi, M., Mancini, I., Brasso, C., Bozzatello, P., Strauss, Gregory P, Galderisi, S., Rucci, P., Kirkpatrick, B., Mucci, A., Gibertoni, D., Rocca, P., Rossi, A., Bertolino, A., Strauss, G. P., Aguglia, E., Bellomo, A., Murri, M. B., Bucci, P., Carpiniello, B., Comparelli, A., Cuomo, A., De Berardis, D., Dell'Osso, L., Di Fabio, F., Gelao, B., Marchesi, C., Monteleone, P., Montemagni, C., Orsenigo, G., Pacitti, F., Roncone, R., Santonastaso, P., Siracusano, A., Vignapiano, A., Vita, A., Zeppegno, P., Maj, M., Patriarca, S., and Cannavo, D.

Subjects
Hospitals, Psychiatric, Male, Network Meta-Analysis, Social Environment, Hospitals, University, 0302 clinical medicine, Activities of Daily Living, Everyday life, Correlation of Data, Original Investigation, Psychopathology, Cognition, Middle Aged, Network Meta-Analysi, Hospitals, Psychiatry and Mental Health, Psychiatric Department, Social competence, Female, Schizophrenic Psychology, medicine.symptom, Psychology, Psychosocial, Social Adjustment, Clinical psychology, Human, Antipsychotic Agents, Adult, Psychiatric Department, Hospital, NO, 03 medical and health sciences, Hospital, Social cognition, medicine, Humans, Settore MED/25 - Psichiatria, Avolition, Cross-Sectional Studie, University, Mental health, Cross-Sectional Studies, Schizophrenia, Socioeconomic Factors, 030227 psychiatry, Antipsychotic Agent, Question How are real-life functioning, psychopathologic variables, cognition, personal resources, and sociodemographic variables connected to each other in community-dwelling individuals with schizophrenia? Findings In this network analysis of 740 individuals with schizophrenia, functional capacity and everyday life skills were the most central and interconnected nodes, while positive symptoms were the least interconnected nodes. Real-life functioning was connected with several variables belonging to different domains. Meaning The high centrality of functional capacity and everyday life skills suggests that improving the ability to perform tasks relevant to everyday life is critical for any therapeutic intervention in schizophrenia, and the pattern of network node connections supports the implementation of personalized interventions for individuals with schizophrenia, Psychiatric, Work Skills, 030217 neurology & neurosurgery
Abstract

Importance Enhanced understanding of factors associated with symptomatic and functional recovery is instrumental to designing personalized treatment plans for people with schizophrenia. To date, this is the first study using network analysis to investigate the associations among cognitive, psychopathologic, and psychosocial variables in a large sample of community-dwelling individuals with schizophrenia. Objective To assess the interplay among psychopathologic variables, cognitive dysfunctions, functional capacity, personal resources, perceived stigma, and real-life functioning in individuals with schizophrenia, using a data-driven approach. Design, Setting, and Participants This multicenter, cross-sectional study involved 26 university psychiatric clinics and/or mental health departments. A total of 921 community-dwelling individuals with a DSM-IV diagnosis of schizophrenia who were stabilized on antipsychotic treatment were recruited from those consecutively presenting to the outpatient units of the sites between March 1, 2012, and September 30, 2013. Statistical analysis was conducted between July 1 and September 30, 2017. Main Outcomes and Measures Measures covered psychopathologic variables, neurocognition, social cognition, functional capacity, real-life functioning, resilience, perceived stigma, incentives, and service engagement. Results Of 740 patients (221 women and 519 men; mean [SD] age, 40.0 [10.9] years) with complete data on the 27 study measures, 163 (22.0%) were remitted (with a score of mild or better on 8 core symptoms). The network analysis showed that functional capacity and everyday life skills were the most central and highly interconnected nodes in the network. Psychopathologic variables split in 2 domains, with positive symptoms being one of the most peripheral and least connected nodes. Functional capacity bridged cognition with everyday life skills; the everyday life skills node was connected to disorganization and expressive deficits. Interpersonal relationships and work skills were connected to avolition; the interpersonal relationships node was also linked to social competence, and the work skills node was linked to social incentives and engagement with mental health services. A case-dropping bootstrap procedure showed centrality indices correlations of 0.75 or greater between the original and randomly defined samples up to 481 of 740 case-dropping (65.0%). No difference in the network structure was found between men and women. Conclusions and Relevance The high centrality of functional capacity and everyday life skills in the network suggests that improving the ability to perform tasks relevant to everyday life is critical for any therapeutic intervention in schizophrenia. The pattern of network node connections supports the implementation of personalized interventions.

Published
2018

18. Premorbid academic and social functioning in patients with schizophrenia and its associations with negative symptoms and cognition

Author

Bucci, P., Galderisi, S., Mucci, A., Rossi, A., Rocca, P., Bertolino, A., Aguglia, E., Amore, M., Andriola, I., Bellomo, A., Biondi, M., Cuomo, A., Dell'Osso, L., Favaro, A., Gambi, F., Giordano, G. M., Girardi, P., Marchesi, C., Monteleone, P., Montemagni, C., Niolu, C., Oldani, L., Pacitti, F., Pinna, F., Roncone, R., Vita, A., Zeppegno, P., Maj, M., Patriarca, Sara, Pietrafesa, Daria, Aiello, Carmen, Longo, Luisa, Barone, Marina, Romano, Raffaella, Atti, Anna Rita, Barlati, Stefano, Deste, Giacomo, Valsecchi, Paolo, Carpiniello, Bernardo, Tusconi, Massimo, Puddu, Laura, Signorelli, Maria Salvina, Cannavò, Dario, Minutolo, Giuseppe, Corbo, Mariangela, Montemitro, Chiara, Baroni, Gaia, Altamura, Mario, La Montagna, Maddalena, Carnevale, Raffaella, Murri, Martino Belvederi, Calcagno, Pietro, Bugliani, Michele, Pizziconi, Giulia, Logozzo, Francesca, Rossi, Rodolfo, Giusti, Laura, Salza, Anna, Malavolta, Maurizio, Orsenigo, Giulia, Grassi, Silvia, De Bartolomeis, Andrea, Gramaglia, Carla, Gattoni, Eleonora, Gambaro, Eleonora, Tenconi, Elena, Ferronato, Luisa, Collantoni, Enrico, Tonna, Matteo, Ossola, Paolo, Gerra, Maria Lidia, Carmassi, Claudia, Cremone, Ivan Mirko, Carpita, Barbara, Buzzanca, Antonio, Girardi, Nicoletta, Frascarelli, Marianna, Del Casale, Antonio, Comparelli, Anna, Corigliano, Valentina, Siracusano, Alberto, Di Lorenzo, Giorgio, Ribolsi, Michele, Corrivetti, Giulio, Bartoli, Luca, Del Buono, Gianfranco, Fagiolini, Andrea, Bolognesi, Simone, Goracci, Arianna, Mancini, Irene, Bava, Irene, Cardillo, Simona, Bucci P., Galderisi S., Mucci A., Rossi A., Rocca P., Bertolino A., Aguglia E., Amore M., Andriola I., Bellomo A., Biondi M., Cuomo A., dell'Osso L., Favaro A., Gambi F., Giordano G.M., Girardi P., Marchesi C., Monteleone P., Montemagni C., Niolu C., Oldani L., Pacitti F., Pinna F., Roncone R., Vita A., Zeppegno P., Maj M., Patriarca S., Pietrafesa D., Aiello C., Longo L., Barone M., Romano R., Atti A.R., Barlati S., Deste G., Valsecchi P., Carpiniello B., Tusconi M., Puddu L., Signorelli M.S., Cannavo D., Minutolo G., Corbo M., Montemitro C., Baroni G., Altamura M., La Montagna M., Carnevale R., Murri M.B., Calcagno P., Bugliani M., Pizziconi G., Logozzo F., Rossi R., Giusti L., Salza A., Malavolta M., Orsenigo G., Grassi S., De Bartolomeis A., Gramaglia C., Gattoni E., Gambaro E., Tenconi E., Ferronato L., Collantoni E., Tonna M., Ossola P., Gerra M.L., Carmassi C., Cremone I.M., Carpita B., Buzzanca A., Girardi N., Frascarelli M., Del Casale A., Comparelli A., Corigliano V., Siracusano A., Di Lorenzo G., Ribolsi M., Corrivetti G., Bartoli L., Del Buono G., Fagiolini A., Bolognesi S., Goracci A., Mancini I., Bava I., Cardillo S., Bucci, P., Galderisi, S., Mucci, A., Rossi, A., Rocca, P., Bertolino, A., Aguglia, E., Amore, M., Andriola, I., Bellomo, A., Biondi, Maria, Cuomo, Anna, Dell'Osso, L., Favaro, A., Gambi, F., Giordano, G. M., Girardi, P., Marchesi, C., Monteleone, P., Montemagni, C., Niolu, C., Oldani, L., Pacitti, F., Pinna, F., Roncone, R., DE VITA, Anna, Zeppegno, P., Maj, M., Patriarca, Sara, Pietrafesa, Daria, Aiello, Carmen, Longo, Luisa, Barone, Marina, Romano, Raffaella, Atti, Anna Rita, Barlati, Stefano, Deste, Giacomo, Valsecchi, Paolo, Carpiniello, Bernardo, Tusconi, Massimo, Puddu, Laura, Signorelli, Maria Salvina, Cannavò, Dario, Minutolo, Giuseppe, Corbo, Mariangela, Montemitro, Chiara, Baroni, Gaia, Altamura, Mario, La Montagna, Maddalena, Carnevale, Raffaella, Murri, Martino Belvederi, Calcagno, Pietro, Bugliani, Michele, Pizziconi, Giulia, Logozzo, Francesca, Rossi, Rodolfo, Giusti, Laura, Salza, Anna, Malavolta, Maurizio, Orsenigo, Giulia, Grassi, Silvia, De Bartolomeis, Andrea, Gramaglia, Carla, Gattoni, Eleonora, Gambaro, Eleonora, Tenconi, Elena, Ferronato, Luisa, Collantoni, Enrico, Tonna, Matteo, Ossola, Paolo, Gerra, Maria Lidia, Carmassi, Claudia, Cremone, Ivan Mirko, Carpita, Barbara, Buzzanca, Antonio, Girardi, Nicoletta, Frascarelli, Marianna, Del Casale, Antonio, Comparelli, Anna, Corigliano, Valentina, Siracusano, Alberto, Di Lorenzo, Giorgio, Ribolsi, Michele, Corrivetti, Giulio, Bartoli, Luca, Del Buono, Gianfranco, Fagiolini, Andrea, Bolognesi, Simone, Goracci, Arianna, Mancini, Irene, Bava, Irene, Cardillo, Simona, Biondi, M., Cuomo, A., Vita, A., and Casale, Antonio

Subjects
Male, avolition, Severity of Illness Index, cognitive functioning, 0302 clinical medicine, Cognition, Academic Performance, Medicine, Psychopathology, Depression, primary negative symptoms, Middle Aged, Psychiatric Status Rating Scale, avolition, cognitive functioning, poor emotion expression, premorbid adjustment, primary negative symptoms, poor emotion expression, premorbid adjustment, Psychiatry and Mental Health, Memory, Short-Term, Schizophrenia, Female, Schizophrenic Psychology, medicine.symptom, Psychosocial, Social Adjustment, Clinical psychology, Human, Adult, primary negative symptom, 03 medical and health sciences, Cognition Disorder, Memory, Social cognition, Humans, Cognitive Dysfunction, Cognitive skill, Social Behavior, Aged, Cognition Disorders, Motivation, Psychiatric Status Rating Scales, Settore MED/25 - Psichiatria, Avolition, business.industry, medicine.disease, 030227 psychiatry, Short-Term, business, Neurocognitive, 030217 neurology & neurosurgery
Abstract

Objective The study aimed to explore premorbid academic and social functioning in patients with schizophrenia, and its associations with the severity of negative symptoms and neurocognitive impairment. Method Premorbid adjustment (PA) in patients with schizophrenia was compared to early adjustment in unaffected first-degree relatives and healthy controls. Its associations with psychopathology, cognition, and real-life functioning were investigated. The associations of PA with primary negative symptoms and their two factors were explored. Results We found an impairment of academic and social PA in patients (P ≤ 0.000001) and an impairment of academic aspects of early adjustment in relatives (P ≤ 0.01). Patients with poor PA showed greater severity of negative symptoms (limited to avolition after excluding the effect of depression/parkinsonism), working memory, social cognition, and real-life functioning (P ≤ 0.01 to ≤0.000001). Worse academic and social PA were associated with greater severity of psychopathology, cognitive impairment, and real-life functioning impairment (P ≤ 0.000001). Regression analyses showed that worse PA in the academic domain was mainly associated to the impairment of working memory, whereas worse PA in the social domain to avolition (P ≤ 0.000001). Conclusion Our findings suggest that poor early adjustment may represent a marker of vulnerability to schizophrenia and highlight the need for preventive/early interventions based on psychosocial and/or cognitive programs.

Published
2018

19. Perceptual Pseudoneglect in Schizophrenia: Candidate Endophenotype and the Role of the Right Parietal Cortex

Author

Giuseppe Rociola, Bianca Pezzarossa, Valentina Magni, Alberto Siracusano, Cinzia Niolu, Michele Ribolsi, Giorgio Di Lorenzo, Giulia Lisi, Massimiliano Oliveri, Anna Saya, Giacomo Koch, Ivo Alex Rubino, Ribolsi, M, Lisi, G, Di Lorenzo, G, Koch, G, Oliveri, M, Magni, V, Pezzarossa, B, Saya, A, Rociola, G, Rubino, IA, Niolu, C, and Siracusano, A

Subjects
Adult, Male, medicine.medical_specialty, Endophenotypes, Bisection, medicine.medical_treatment, Posterior parietal cortex, Audiology, Functional Laterality, Lateralization of brain function, NO, Perceptual Disorders, Young Adult, schizophrenia, brain stimulation, Parietal Lobe, medicine, Humans, Family, Depressive Disorder, Schizophrenia, Case-Control Studies, Schizophrenic Psychology, Space Perception, Middle Aged, Female, Settore MED/25 - Psichiatria, Settore M-PSI/02 - Psicobiologia E Psicologia Fisiologica, Transcranial direct-current stimulation, Parietal lobe, Regular Article, medicine.disease, Psychiatry and Mental health, Endophenotype, Laterality, Psychology, Cognitive psychology
Abstract

Several contributions have reported an altered expression of pseudoneglect in psychiatric disorders, highlighting the existence of an anomalous brain lateralization in affected subjects. Surprisingly, no studies have yet investigated pseudoneglect in first-degree relatives (FdR) of psychiatric patients. We investigated performance on “paper and pencil” line bisection (LB) tasks in 68 schizophrenic patients (SCZ), 42 unaffected FdR, 41 unipolar depressive patients (UP), and 103 healthy subjects (HS). A subgroup of 20 SCZ and 16 HS underwent computerized LB and mental number line bisection (MNL) tasks requiring judgment of prebisected lines and numerical intervals. Moreover, we evaluated, in a subgroup of 15 SCZ, performance on LB and MNL before and after parietal transcranial direct current stimulation (tDCS). In comparison to HS and UP, SCZ showed a systematic rightward bias on LB, partially corrected by selective right posterior parietal tDCS. Interestingly, even FdR showed a lack of pseudoneglect on LB, expressing a mean error lying in the middle between those of HS and SCZ. On the other hand, our results showed no significant difference between the performance of SCZ and HS on MNL. Both groups showed a comparable leftward bias that could not be significantly altered after left or right parietal tDCS. These findings confirm the existence of reduced lateralization in SCZ, suggesting specific impaired functioning of the right parietal lobule. Notably, we report a lack of pseudoneglect not only in SCZ but also in FdR, raising the hypothesis that an inverted laterality pattern may be considered a concrete marker of schizotypal traits.

Published
2012

20. Genetic variants of the NMDA receptor influence cortical excitability and plasticity in humans

Author

Alberto Siracusano, Elena Marasco, Giorgio Bernardi, Diego Centonze, Hajime Kusayanagi, Michele Ribolsi, Francesco Mori, Vilma Mantovani, Mori, F, Ribolsi, M, Kusayanagi, H, Siracusano, A, Mantovani, V, Marasco, E, Bernardi, G, and Centonze, D

Subjects
Adult, Male, Genotype, Genetic Variation, Polymorphism, Single Nucleotide, Carrier Proteins, Humans, Action Potentials, Nerve Tissue Proteins, Alleles, Middle Aged, Neuronal Plasticity, Transcranial Magnetic Stimulation, Receptors, N-Methyl-D-Aspartate, Long-Term Potentiation, Synaptic Transmission, Female, Physiology, Nonsynaptic plasticity, glutamate, Plasticity, Biology, Neurotransmission, Receptors, transcranial magnetic stimulation, Polymorphism, Receptor, Long-term depression, synaptic plasticity, General Neuroscience, Glutamate receptor, Single Nucleotide, Synaptic plasticity, NMDA receptor, Settore MED/26 - Neurologia, Neuroscience, N-Methyl-D-Aspartate
Abstract

N-methyl-d-aspartate (NMDA) receptors play crucial roles in glutamate-mediated synaptic transmission and plasticity and are involved in a variety of brain functions. Specific single nucleotide polymorphisms (SNPs) in the genes encoding NMDA receptor subunits have been associated with some neuropsychiatric disorders involving altered glutamate transmission, but how these polymorphisms impact on synaptic function in humans is unknown. Here, the role of NMDA receptors in the control of cortical excitability and plasticity was explored by comparing the response to single, paired, and repetitive transcranial magnetic stimulations of the motor cortex in 77 healthy subjects carrying specific allelic variants of the NR1 subunit gene (GRIN1 rs4880213 and rs6293) or of the NR2B subunit gene (GRIN2B rs7301328, rs3764028, and rs1805247). Our results showed that individuals homozygous for the T allele in the rs4880213 GRIN1 SNP had reduced intracortical inhibition, as expected for enhanced glutamatergic excitation in these subjects. Furthermore, individuals carrying the G allele in the rs1805247 GRIN2B SNP show greater intracortical facilitation and greater long-term potentiation-like cortical plasticity after intermittent θ-burst stimulation. Our results provide novel insights into the function of NMDA receptors in the human brain and might contribute to the clarification of the synaptic bases of severe neuropsychiatric disorders associated with defective glutamate transmission.

Published
2011

21. Pathways to mental health care in Italy: Results from a multicenter study

Author

Simona Gotelli, Francesco Bardicchia, Alice Mulè, Giancarlo Cerveri, Silvia Ferrari, Dario Filippo, S Piras, Andrea Fiorillo, Gaia Sampogna, Valeria Del Vecchio, Michele Ribolsi, Maria Salvina Signorelli, Claudia Palumbo, Corrado De Rosa, Norman Sartorius, Massimiliano Piselli, Mario Luciano, Salvatore Calò, Umberto Volpe, Pasquale De Fazio, Volpe, U, Fiorillo, A, Luciano, M, Del Vecchio, V, Palumbo, C, Calò, S, Piras, S, Signorelli, M, Filippo, D, Piselli, M, De Fazio, P, Gotelli, S, Bardicchia, F, Cerveri, G, Ferrari, S, Mulè, A, Ribolsi, M, Sampogna, G, De Rosa, C, and Sartorius, N.

Subjects
Male, Mental Health Services, medicine.medical_specialty, Time Factors, Mental health system, Primary care, Pathways to care, community mental health service, general practitioners, mental health systems, primary care, psychiatric care in Italy, Community Mental Health Services, Critical Pathways, Female, Humans, Italy, Mental Disorders, Middle Aged, Patient Acceptance of Health Care, pathways to care, psychiatry, General practitioner, Psychiatric care in Italy, Nursing, General practitioners, Health care, Medicine, Settore MED/25 - Psichiatria, business.industry, Critical pathways, Mental health systems, Community mental health service, Mental health, Psychiatry and Mental health, Multicenter study, Family medicine, Psychiatry and Mental Health, Mental health care, business
Abstract

Background and aims:In Italy, the reform of the mental health system in 1978 should have drastically changed the provision of care and pathways of patients seeking to obtain it. The aim of this article is to examine the current pathways to psychiatric care in Italy.Methods:We used a method developed in the World Health Organization international collaborative studies to investigate pathways to care in 15 Italian mental health centers. We recruited 420 patients with a psychiatric illness and explored the care pathways they took to reach to psychiatric services and the delays from the onset of illness to reaching psychiatric care.Results:The majority of patients (33.8%) had direct access to mental health care, whereas the others arrived to a specialist in psychiatry through general hospitals (20.3%), general practitioners (33.0%) or private practitioners (9.8%). The main diagnosis for referral was neurotic disorder (36.6%), followed by affective disorder (35.4%) and psychotic disorder (11.5%). The delay from onset of illness to psychiatric care was greater for patients with psychotic disorders than for those with affective and neurotic disorders. The most frequently prescribed treatments were pharmacotherapy (56%), psychological support (8%), and psychotherapy (7.0%); 15% of the patients received no treatment.Conclusions:Our multicenter study shows that although general practitioners and hospital doctors are still the main referral point for mental health care, a greater proportion of patients are first seen in private settings or directly reach mental health centers, compared to previous surveys conducted in Italy. However, a stronger collaboration of psychiatrists with general practitioners and psychologists is still needed.

Published
2014

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