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4. 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

5. The influence of illness-related variables, personal resources and context-related factors on real-life functioning of people with schizophrenia

Author

Galderisi, S, Rossi, A, Rocca, P, Bertolino, A, Mucci, A, Bucci, P, Rucci, P, Gibertoni, D, Aguglia, E, Amore, M, Bellomo, A, Biondi, M, Brugnoli, R, Dell'Osso, L, De Ronchi, D, Di Emidio, G, Di Giannantonio, M, Fagiolini, A, Marchesi, C, Monteleone, P, Oldani, L, Pinna, G, S, Pinna, F, Roncone, R, Sacchetti, E, Santonastaso, P, Siracusano, A, Vita, A, Zeppegno, P, Maj, M, Chieffi, M, De Simone, S, De Riso, F, Giugliano, R, Piegari, G, Vignapiano, A, Caforio, G, Mancini, M, Colagiorgio, L, Porcelli, S, Salfi, R, Bianchini, O, Galluzzo, A, Barlati, S, Carpiniello, B, Fatteri, F, Di Santa Sofia, S, Cannavò, D, Minutolo, G, Signorelli, M, Martinotti, G, Di Iorio, G, Acciavatti, T, Pallanti, S, Faravelli, C, Altamura, M, Stella, E, Marasco, D, Calcagno, P, Respino, M, Marozzi, V, Riccardi, I, Collazzoni, A, Stratta, P, Giusti, L, Ussorio, D, Delauretis, I, Serati, M, Caldiroli, A, Palazzo, C, Iasevoli, Fz, Gramaglia, C, Gili, S, Gattoni, E, Tenconi, E, Giannunzio, V, Monaco, F, De Panfilis, C, Camerlengo, A, Ossola, P, Landi, P, Rutigliano, G, Pergentini, I, Mauri, M, Di Fabio, F, Torti, C, Buzzanca, A, Comparelli, A, De Carolis, A, Corigliano, V, DI LORENZO, G, Niolu, C, Troisi, A, Corrivetti, Aa, G, Pinto, Diasco, Aa, F, Goracci, A, Bolognesi, S, Borghini, E, Montemagni, C, Frieri, T, Birindelli, N, Galderisi, S., Rossi, A., Rocca, P., Bertolino, A., Mucci, A., Bucci, P., Rucci, P., Gibertoni, D., Aguglia, E., Amore, M., Bellomo, A., Biondi, M., Brugnoli, R., Dell'Osso, L., De Ronchi, D., Di Emidio, G., Di Giannantonio, M., Fagiolini, A., Marchesi, C., Monteleone, P., Oldani, L., Pinna, F., Roncone, R., Sacchetti, E., Santonastaso, P., Siracusano, A., Vita, A., Zeppegno, P., Maj, M., Chieffi, M., De Simone, S., De Riso, F., Giugliano, R., Piegari, G., Vignapiano, A., Caforio, G., Mancini, M., Colagiorgio, L., Porcelli, S., Salfi, R., Bianchini, O., Galluzzo, A., Barlati, S., Carpiniello, B., Fatteri, F., Di Santa Sofia, S. L., Cannavo, D., Minutolo, G., Signorelli, M., Martinotti, G., Di Iorio, G., Acciavatti, T., Pallanti, S., Faravelli, C., Altamura, M., Stella, E., Marasco, D., Calcagno, P., Respino, M., Marozzi, V., Riccardi, I., Collazzoni, A., Stratta, P., Giusti, L., Ussorio, D., Delauretis, I., Serati, M., Caldiroli, A., Palazzo, C., Iasevoli, F., Gramaglia, C., Gili, S., Gattoni, E., Tenconi, E., Giannunzio, V., Monaco, F., De Panfilis, C., Camerlengo, A., Ossola, P., Landi, P., Rutigliano, G., Pergentini, I., Mauri, M., Di Fabio, F., Torti, C., Buzzanca, A., Comparelli, A., De Carolis, A., Corigliano, V., Di Lorenzo, G., Niolu, C., Troisi, A., Corrivetti, G., Pinto, G., Diasco, F., Goracci, A., Bolognesi, S., Borghini, E., Montemagni, C., Frieri, T., Birindelli, N., Galderisi, Silvana, Rossi, Alessandro, Rocca, Paola, Bertolino, Alessandro, Mucci, Armida, Bucci, Paola, Rucci, Paola, Gibertoni, Dino, Aguglia, Eugenio, Amore, Mario, Bellomo, Antonello, Biondi, Massimo, Brugnoli, Roberto, Dell'Osso, Liliana, De Ronchi, Diana, Di Emidio, Gabriella, Di Giannantonio, Massimo, Fagiolini, Andrea, Marchesi, Carlo, Monteleone, Palmiero, Oldani, Lucio, Pinna, Federica, Roncone, Rita, Sacchetti, Emilio, Santonastaso, Paolo, Siracusano, Alberto, Vita, Antonio, Zeppegno, Patrizia, Maj, Mario, Chieffi, Marcello, De Simone, Stefania, De Riso, Francesco, Giugliano, Rosa, Piegari, Giuseppe, Vignapiano, Annarita, Caforio, Grazia, Mancini, Marina, Colagiorgio, Lucia, Porcelli, Stefano, Salfi, Raffaele, Bianchini, Oriana, Galluzzo, Alessandro, Barlati, Stefano, Carpiniello, Bernardo, Fatteri, Francesca, Di Santa Sofia, Silvia Lostia, Cannavò, Dario, Minutolo, Giuseppe, Signorelli, Maria, Martinotti, Giovanni, Di Iorio, Giuseppe, Acciavatti, Tiziano, Pallanti, Stefano, Faravelli, Carlo, Altamura, Mario, Stella, Eleonora, Marasco, Daniele, Calcagno, Pietro, Respino, Matteo, Marozzi, Valentina, Riccardi, Ilaria, Collazzoni, Alberto, Stratta, Paolo, Giusti, Laura, Ussorio, Donatella, Delauretis, Ida, Serati, Marta, Caldiroli, Alice, Palazzo, Carlotta, Iasevoli, Felice, Gramaglia, Carla, Gili, Sabrina, Gattoni, Eleonora, Tenconi, Elena, Giannunzio, Valeria, Monaco, Francesco, De Panfilis, Chiara, Camerlengo, Annalisa, Ossola, Paolo, Landi, Paola, Rutigliano, Grazia, Pergentini, Irene, Mauri, Mauro, Di Fabio, Fabio, Torti, Chiara, Buzzanca, Antonino, Comparelli, Anna, De Carolis, Antonella, Corigliano, Valentina, Di Lorenzo, Giorgio, Niolu, Cinzia, Troisi, Alfonso, Corrivetti, Giulio, Pinto, Gaetano, Diasco, Ferdinando, Goracci, Arianna, Bolognesi, Simone, Borghini, Elisa, Montemagni, Cristiana, Frieri, Tiziana, and Birindelli, Nadia

Subjects
medicine.medical_specialty, media_common.quotation_subject, neurocognition, positive symptoms, Context (language use), avolition, Personal resource, Social cognition, Avolition, Disorganization, Engagement with mental health services, Internalized stigma, Neurocognition, Personal resources, Positive symptoms, Real-life functioning, Resilience, Schizophrenia, Psychiatry and Mental Health, Psychiatric Mental Health, medicine, real-life functioning, personal resources, Psychiatry, resilience, Settore MED/25 - Psichiatria, media_common, business.industry, Schizophrenia, avolition, disorganization, engagement with mental health services, internalized stigma, neurocognition, personal resources, positive symptoms, real-life functioning, resilience, disorganization, internalized stigma, engagement with mental health services, Social environment, Research Reports, medicine.disease, Mental health, Psychiatry and Mental health, Psychological resilience, Pshychiatric Mental Health, medicine.symptom, business, Positive symptom, Independent living, Engagement with mental health service
Abstract

In people suffering from schizophrenia, major areas of everyday life are impaired, including independent living, productive activities and social relationships. Enhanced understanding of factors that hinder real-life functioning is vital for treatments to translate into more positive outcomes. The goal of the present study was to identify predictors of real-life functioning in people with schizophrenia, and to assess their relative contribution. Based on previous literature and clinical experience, several factors were selected and grouped into three categories: illness-related variables, personal resources and context-related factors. Some of these variables were never investigated before in relationship with real-life functioning. In 921 patients with schizophrenia living in the community, we found that variables relevant to the disease, personal resources and social context explain 53.8% of real-life functioning variance in a structural equation model. Neurocognition exhibited the strongest, though indirect, association with real-life functioning. Positive symptoms and disorganization, as well as avolition, proved to have significant direct and indirect effects, while depression had no significant association and poor emotional expression was only indirectly and weakly related to real-life functioning. Availability of a disability pension and access to social and family incentives also showed a significant direct association with functioning. Social cognition, functional capacity, resilience, internalized stigma and engagement with mental health services served as mediators. The observed complex associations among investigated predictors, mediators and real-life functioning strongly suggest that integrated and personalized programs should be provided as standard treatment to people with schizophrenia. In people suffering from schizophrenia, major areas of everyday life are impaired, including independent living, productive activities and social relationships. Enhanced understanding of factors that hinder real-life functioning is vital for treatments to translate into more positive outcomes. The goal of the present study was to identify predictors of real-life functioning in people with schizophrenia, and to assess their relative contribution. Based on previous literature and clinical experience, several factors were selected and grouped into three categories: illness-related variables, personal resources and context-related factors. Some of these variables were never investigated before in relationship with real-life functioning. In 921 patients with schizophrenia living in the community, we found that variables relevant to the disease, personal resources and social context explain 53.8% of real-life functioning variance in a structural equation model. Neurocognition exhibited the strongest, though indirect, association with real-life functioning. Positive symptoms and disorganization, as well as avolition, proved to have significant direct and indirect effects, while depression had no significant association and poor emotional expression was only indirectly and weakly related to real-life functioning. Availability of a disability pension and access to social and family incentives also showed a significant direct association with functioning. Social cognition, functional capacity, resilience, internalized stigma and engagement with mental health services served as mediators. The observed complex associations among investigated predictors, mediators and real-life functioning strongly suggest that integrated and personalized programs should be provided as standard treatment to people with schizophrenia.

Published
2014

26. 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

27. Take a picture! The role of visual methods in understanding psychiatric patient's everyday life.

Author

Moretti V, Brunetti C, Candaten A, Cannavò D, Manfredi M, Maserati M, Piccinini A, Rinaldi M, Artioli G, Sarli L, and Ferri P

Subjects
Adult, Health Personnel, Humans, Italy, Qualitative Research, Mental Disorders, Psychiatry
Abstract

Background and Aim: Understanding the patient's experience of mental illness can foster better support for this population and greater partnership with healthcare professionals. This study aims to explore the application of visual methods in the psychiatric field and, in particular, the experience of people suffering from psychotic disorders because it is still an open question that has not been only partially empirically examined., Methods: This qualitative study was conducted using two visual methods (auto-photography and photo-elicitation) associated with the narrative that emerged from an unstructured interview, in a clinical setting of adult Mental Health in Italy, between October 2019 and February 2020. A total of 5 patients and 5 corresponding referring healthcare professionals were identified and enrolled.  Patients were asked to produce photographs following 4 thematic areas: "Fun", "Time", "Something indispensable", "Place where I feel good"., Results: A total of 85 photographs were produced. Visual methods have proved to be a useful technique in qualitative research in the area of adult psychiatry. From the interviews, it emerged that visual methods have allowed psychotic patients to use a new language to be able to communicate their emotions., Conclusions: The healthcare professionals involved also confirm the potential of this tool which, when combined with the traditional interview, is able to deepen the patient's knowledge by overcoming the verbal barriers that often make it difficult to reconstruct the individual experience of illness.

Published
2021
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28. New antipsychotic drugs for the treatment of agitation and psychosis in Alzheimer's disease: focus on brexpiprazole and pimavanserin.

Author

Caraci F, Santagati M, Caruso G, Cannavò D, Leggio GM, Salomone S, and Drago F

Subjects
Anxiety, Humans, Piperidines, Quinolones, Thiophenes, Urea analogs & derivatives, Alzheimer Disease complications, Alzheimer Disease drug therapy, Antipsychotic Agents therapeutic use, Psychotic Disorders drug therapy
Abstract

Behavioral and psychological symptoms of dementia are symptoms of disturbed perception, mood, behavior, and thought content that occurred frequently. These symptoms, which include apathy, depression, anxiety, psychosis, agitation, and aggression, can serve as predictors of and early clinical diagnostic markers for Alzheimer's disease (AD) and are common precipitants of institutional care. Agitation and psychosis are associated with accelerated disease progression and increased tau phosphorylation in patients with AD. Current guidelines recommend the use of second-generation antipsychotics for the treatment of agitation and psychosis in AD, but only after first-line non-pharmacological interventions and for no longer than 12 weeks because long-term use of these drugs is associated with an increased risk of mortality and an increased frequency of cerebrovascular events. Therefore, new antipsychotic drugs with improved efficacy and safety are needed as an alternative to current antipsychotic drugs. In this report, we discuss some of the most relevant advances in the field of agitation and psychosis in AD and focus on the recent positive clinical evidence observed with two new antipsychotics drugs: brexpiprazole and pimavanserin. Brexpiprazole is a receptor partial agonist (D2, D3, 5-HT1A), receptor antagonist (5-HT2A/B, α1B/α2C) according to the neuroscience-based nomenclature. Two recent phase III clinical trials have shown that brexpiprazole 2 mg/day is effective for the treatment of agitation in patients with AD and has an improved tolerability and safety profile compared with currently available second-generation antipsychotics. Pimavanserin is a receptor antagonist (5-HT2A, 5-HT2C) that has been given market authorization for psychosis occurring in Parkinson's disease. Recent phase II studies suggest that this drug is effective in AD patients with more severe psychosis, although further long-term studies are needed to better define the efficacy and long-term safety profile of pimavanserin for the treatment of psychosis in AD., Competing Interests: No competing interests were disclosed.No competing interests were disclosed.No competing interests were disclosed., (Copyright: © 2020 Caraci F et al.)

Published
2020
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29. Insight and recovery in schizophrenic patients.

Author

Cannavò D, Minutolo G, Battaglia E, and Aguglia E

Subjects
Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Remission Induction, Treatment Outcome, Young Adult, Antipsychotic Agents therapeutic use, Comprehension, Schizophrenia drug therapy, Schizophrenic Psychology
Abstract

Objective: To investigate the correlation between insight and recovery in schizophrenic patients according to criteria for both symptomatic and functional remission., Methods: Seventy patients affected by paranoid schizophrenia were recruited and treated with olanzapine, risperidone, aripiprazole, haloperidol and ziprasidone; visits were scheduled at baseline, 12 and 36 months. We administered PANSS (Positive and Negative Syndrome Scale), GAF (Global Assessment of Functioning), SF-36 (Short Form 36 Health Survey), PGWBI (Psychological General Well-Being index) and SAI (Schedule for the Assessment of Insight)., Results: After 1 year, 50% of the subjects obtained symptom remission and 25.5% had adequate social functioning for 2 years or more. Only 12% of subjects met full recovery criteria for 2 years or longer. The recovery group also showed an improvement in insight levels, especially patients treated with second-generation antipsychotics (SGA). Recovery was predicted by female sex, higher age, SGA treatment, pre-morbid social adaptation and low level of negative symptoms at baseline., Conclusions: Only a small proportion of schizophrenic patients achieved recovery, therefore greater patient's insight could have prognostic validity in terms of treatment outcome. More sensitive instruments and a larger sample are necessary to confirm these results.

Published
2016
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30. Effects of antipsychotic drugs on insight in schizophrenia.

Author

Bianchini O, Porcelli S, Nespeca C, Cannavò D, Trappoli A, Aguglia E, De Ronchi D, and Serretti A

Subjects
Adult, Antipsychotic Agents pharmacology, Aripiprazole, Benzodiazepines pharmacology, Benzodiazepines therapeutic use, Female, Haloperidol therapeutic use, Humans, Male, Middle Aged, Olanzapine, Piperazines pharmacology, Piperazines therapeutic use, Psychotic Disorders psychology, Quinolones pharmacology, Quinolones therapeutic use, Thiazoles pharmacology, Thiazoles therapeutic use, Antipsychotic Agents therapeutic use, Awareness drug effects, Psychotic Disorders drug therapy, Schizophrenia drug therapy, Schizophrenic Psychology
Abstract

Lack of insight is predominant in schizophrenia though the causes are still unclear. The present study was carried on to investigate the effect of three Second Generation Antipsychotics (SGAs) and Haloperidol on insight and the associations among different clusters of symptoms and insight. Fifty-five patients have been recruited at the moment of pharmacological switch needed for psychotic exacerbation, from other antipsychotic drugs to Olanzapine, Aripiprazole, Ziprasidone and Haloperidol. Patients have been followed for 6 months and evaluated at baseline, after 3 months and after 6 months. Regarding the insight improvement, all SGAs resulted more effective than Haloperidol, while no difference was detected among different SGAs. Concerning psychopathology, all SGAs showed a better efficacy than Haloperidol, positive symptoms apart. All SGAs showed a similar efficacy on all domains, except for negative symptoms which resulted less responsive to ziprasidone and haloperidol. An association between improvement of insight and psychopathology was detected. Furthermore, insight appears to be related to psychopathology severity, particularly to negative symptoms. However, the observed different effectiveness of Ziprasidone on negative symptoms and insight suggests that these psychopathological features may be not strictly related and, thus, they may be sustained by different psychopathological processes., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Published
2014
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31. Pramipexole induced psychosis in a patient with restless legs syndrome.

Author

Signorelli MS, Battaglia E, Costanzo MC, and Cannavò D

Subjects
Humans, Male, Middle Aged, Pramipexole, Benzothiazoles adverse effects, Dopamine Agonists adverse effects, Psychoses, Substance-Induced etiology, Restless Legs Syndrome drug therapy
Abstract

In the last few years, dopamine agonists (DA) have been used as first-line treatment for restless legs syndrome (RLS), a disabling sensorimotor disorder. Only recently have they reported some possible iatrogenic side effects, as shown below. The following case presents a RLS patient who developed hallucinatory and delusional symptoms with paranoid ideation after pramipexole assumption; these symptoms gradually decreased after pramipexole suspension and treatment by an oral antipsychotic therapy (quetiapine XR). Correlation between DAs assumption and psychotic symptoms is still not clear. The development of these side effects might be related to many risk factors such as genetic susceptibility, premorbid personality and psychosocial stressor; in order to minimise the risk of iatrogenic psychosis it could be useful to assess patients' vulnerability factors selecting an alternative medication regime.

Published
2013
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32. [The aggression in SPDC: an observational study. Preliminary data].

Author

Minutolo G, Cannavò D, Petralia A, Gandolfo L, Palermo F, and Aguglia E

Subjects
Adult, Algorithms, Borderline Personality Disorder psychology, Depression, Depressive Disorder psychology, Female, Hostility, Humans, Inpatients statistics & numerical data, Male, Mental Disorders epidemiology, Middle Aged, Psychometrics, Risk Assessment, Risk Factors, Sampling Studies, Schizophrenia diagnosis, Schizophrenic Psychology, Sex Distribution, Sex Factors, Sicily epidemiology, Substance-Related Disorders psychology, Violence psychology, Aggression psychology, Hospitals, Psychiatric, Inpatients psychology, Mental Disorders diagnosis, Mental Disorders psychology
Abstract

Aim: In the different psychiatric disorders the aggression often leads to uncontrolled events, taking aspects of impulsiveness and irrationality. Our research proposes the assessment of socio-demographic and clinical characteristics of patients with a psychiatric disorder, who presented an aggressive event., Methods: The observational study was conducted on a sample of 50 patients (34 men and 16 women), hospitalized following the manifestation of an aggressive event. For each patient was provided an assessment of socio-demographic and clinical variables and a psychometric investigation through: the OAS, for the analysis of aggressive episodes; the BDHI, for the hostile behavior and attitudes; the BIS-11, for the impulsiveness and the BPRS for the psychopathological aspects., Results: Among the socio-demographic features investigated, the highest correlation with aggressive behavior was related to the concomitant substance abuse, type of admission to psychiatric hospital and the male gender. The OAS has shown a greater propensity to directed-aggression in males with schizophrenia, and self-directed in females with major depression. The BPRS has shown a positive correlation between hetero-directed aggressive behavior and positive symptomatology, and between the self-directed and depression, risk of suicide, feelings of guilt and somatic concerns. The BDHI has indicated greater suspicion in women's group., Discussion: The hypothesis that aggression is otherwise related to specific socio-demographic and clinical characteristics was confirmed by our study. The data suggest that early identification and assessment of potential risk factors involved in the genesis of aggressive episodes would allow the clinician to implement a better strategy for prevention and intervention.

Published
2010

33. Infrared properties of chemical-vapor deposition polycrystalline diamond windows.

Author

Dore P, Nucara A, Cannavò D, De Marzi G, Calvani P, Marcelli A, Sussmann RS, Whitehead AJ, Dodge CN, Krehan AJ, and Peters HJ

Abstract

Low-resolution transmittance and reflectance spectra of high-quality chemical-vapor deposition (CVD) diamond windows were measured in the infrared in the 2.5-500-mum wavelength range (20-4000 cm(-1)). High-resolution measurements on a window with nearly parallel surfaces show well defined interference fringes at low frequencies. By standard procedures the optical constants n and k of CVD diamond were determined, for the first time to the author's knowledge, in the far-infrared region. It is shown that a window with a large wedge angle, close to 1 degrees , does not produce appreciable interference fringes. Modeling of these results confirms that interference fringes can be avoided by use of properly wedged CVD diamond windows. This result is of considerable relevance to the use of CVD diamond windows in spectroscopic applications for which fringe suppression is a major requirement.

Published
1998
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