IntroductionDiscrimination towards people with schizophrenia (PWS) by healthcare professionals is responsible of underdiagnosis and undertreatment of these patients. Negative attitudes toward PSW in health care professionals tend to be present since their university studies and are related to their knowledge and experience about the disease.Objectives and aimsTo assess opinion towards PSW in medical, nursing and psychology students and to investigate the relation with their knowledge of schizophrenia and its causes.MethodsThe study involved 133 medical, 200 nursing and 296 psychology undergraduate students. The opinion on mental illness questionnaire, the Devaluation Consumers Scale, and the Devaluation of Consumer Families Scale were administered to the sample. ANOVA and ANCOVA were used to test differences between groups and the relation between causal explanation of schizophrenia and discrimination towards PWS.ResultsPsychology students were more aware than the other student of public stigma towards PWS and their families (F 12.57, P < 0.001; F 32.69, P < 0.001) and expressed a more positive view on treatments’ effectiveness (F 30.74, P < 0.001). Psychology (OR 0.48, 95% CI 0.26–0.88) and nursing (OR 0.29, 95% CI 0.15–0.55) students were more likely to identify psychological and social risk factors as more frequent causes of schizophrenia (vs. biogenetics) and these, in turn, were related to a better opinion towards social equality of PWS.ConclusionsThese preliminary findings underline the relevance of biopsychosocial model of schizophrenia within stigma-reduction programs for health science students.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The incidence of psychotic disorders varies in different geographical areas. As there have been no reports from Southern Italy, this study aimed to determine the incidence rate of first-episode psychosis in Palermo, Sicily.All patients, aged 18-65 years, presenting with a first episode of psychosis (FEP) (ICD-10 F20-29, F30-33) to mental health services in Palermo, were recorded over a 3-year period. Incidence rates of psychotic disorders and their 95% confidence intervals (95% CI) were estimated. Poisson regression was applied to estimate the differences in incidence rate ratio (IRR) by age, sex and migrant status.Two hundred and four FEP participants were identified during the 3 years; 183 (89.7%, males n = 112) participants were native Italians and 21 were migrants (10.3%, males n = 14). The crude incidence of all psychoses was 15.9 (95% CI 13.7-18.1). As predicted, the risk of schizophrenia F20 was higher in males compared to females (adjusted IRR = 1.99, 95% CI 1.36-2.88) and in migrants compared to native Italians (adjusted IRR = 4.02, 95% CI 2.39-6.75).This study, the first from Sicily, confirms previous findings from Northern Italy that the risk of schizophrenia and other psychoses is much lower in Italian cities than those reported from cities in Northern Europe; the reasons for this disparity may provide important clues to the aetiology of psychosis.

IntroductionA number of authors have hypothesized that psychotic patients who consume cannabis constitute a differentiated subgroup of patients that have better cognitive and social skills, necessary to engage in illegal drug consumption, than non-using patients.ObjectivesGiven that the prevalence, and patterns, of cannabis use are culturally driven, we wanted to study first-episode psychosis (FEP) cannabis-using and non-using patients coming from different European countries as part of the EUGEI-STUDY.AimsWe tested the hypothesis of better premorbid social adjustment in cannabis-using FEP patients, by comparing them to FEP non cannabis users and to their respective healthy controls.MethodsA total of 1745 people (746 cases; 999 controls) completed the assessment for premorbid adjustment [Premorbid Adjustment Scale (PAS)] and cannabis use (CEQ-Revised). We first extracted the Premorbid Social Adjustment Factor (PSA) from PAS and then performedlinear mixed models with PSA as dependent variable and cannabis lifetime (Yes/No) and subject status (Cases/Controls) as independent variables. We then considered “Country” as random intercept.ResultsAcross all countries, PSA scores were better in patients who had smoked cannabis in their lifetime than patients who had not (P = 0.009). The difference in PSA score between cannabis users and non-users was significantly greater in cases than controls (P = 0.038). The relationship between PSA, cannabis lifetime (Yes/No) and subject status among nations (random intercept) is shown on Fig. 1.ConclusionsCannabis-using psychotic patients show better premorbid social adjustment than non-using patients, across 5 European countries.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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

multiple-dose study in stable schizophrenia subjects washed out of their current antipsychotic medications (n= 47) and healthy Japanese subjects (n= 30). Ten subjects per cohort were enrolled and randomized to either TAK-063 or placebo (8 active and 2 placebo). Schizophrenia subjects were dosed once daily (QD) 3, 10, 20, 30, and 100 mg, and healthy Japanese subjects were dosed 3, 10, and 20 mg TAK-063 or placebo QD in the fed state using tablets for 7 days. Safety assessments were recorded throughout; serial plasma and urine samples were collected on days 1 and 7, with predose plasma samples on days 4, 5, and 6. Results: TAK-063 was safe and generally well tolerated in both groups. There were no serious adverse events (AEs). Most AEs were of mild or moderate intensity. Somnolence, the most frequent AE in both treatment groups, was especially prevalent in schizophrenia subjects following 100 mg QD. Extrapyramidal syndrome (EPS), mainly dystonia, was observed in 14 schizophrenia subjects and 1 healthy Japanese subject treated with TAK-063. EPS was also observed in 1 schizophrenia subject in the placebo group. No clinically significant changes in the physical examination, clinical laboratory tests, or ECGs were observed. Blood pressure and pulse rate parameters were consistent with treatment-emergent AEs of orthostatic tachycardia and orthostatic hypotension and were similar between placebo and treatment groups. In the two groups, PK was broadly similar; in addition to TAK-063, a metabolite (M-I) was also quantified and exhibited a similar profile to TAK-063. TAK-063 was absorbed with a median Tmax of 1.5 to 4 hours. Cmax and AUC24 values of TAK-063 and M-I increased in a dose-related manner up to 30 mg in schizophrenia subjects and up to 20 mg in Japanese subjects, with modest accumulation upon repeat dosing. At doses of 30 to 100 mg, the increase in exposure was less than dose proportional. Renal clearance was a minor elimination route (o0.1% of dose). Discussion: TAK-063 was safe and well tolerated in schizophrenia and healthy Japanese subjects at all doses tested; somnolence was the most commonly observed AE. At equivalent doses, reports of EPS were higher in subjects with schizophrenia than in healthy Japanese subjects, despite similar PK between groups. At doses of 30 to 100 mg, the increase in exposure was less than dose proportional, likely due to solubility-limited oral bioavailability.

A large body of literature has demonstrated that people affected by psychotic disorders show deficits in working memory, in Emotion Recognition (ER) and in data-gathering to reach a decision (Jumping To Conclusions – JTC). To investigate a possible correlation between working memory, JTC and ER in FEP. 41 patients and 89 healthy controls completed assessments of working memory using WAIS shortened version, JTC using the 60:40 Beads Task and ER using Degraded Facial Affect Recognition Task. According to the literature, cases had poorer performance in working memory tasks (Digit Span: μ7,72 [ds=2,98] vs μ10,14 [ds=3,10], U=865,00, p=0,00; Digit Symbol: μ5,36 [ds=2,43] vs μ10,05 [ds=3,10], U=455,50, p=0,00; Arithmetic: μ5,46 [ds=2,76] vs μ8,74 [ds=3,24], U=865,50, p=0,00; Block Design: μ4,82 [ds=2,72] vs μ7,60 [ds=3,18], U=912,00, p=0,00), in Beads Task (81,6% vs 51,1%, χ2=10,27, p=0,001, μ2,53 [ds=3,57] vs μ4,23 [ds=4,77], U=1171,00, p=0,006) and in DFAR (total errors: μ21,62 [ds=7,43] vs μ16,58 [ds=8,69], U=554,50, p=0,002). Furthermore working memory tasks in cases group correlated significantly with JTC (Digit Span: rrho=0,276, p=0,003; Digit Symbol: rrho=0,275, p=0,002; Arithmetic: rrho=0,265, p=0,003; Block Design: rrho=0,292, p=0,001), but only Digit Span with ER (rrho=-0,239; p=0,021). In addition, we found that JTC and ER were significantly associated (rrho=-0,281; p=0,004). Data show that working memory impairments, JTC style and dysfunctions in the facial emotions recognition are phenomena strongly correlated in the group of patients. Preliminary results suggest the importance of early rehabilitation as the impairments detected may lead to difficulties in social and relational adaptation in psychotic patients.

Introduction A growing body of literature suggests that people affected by psychotic disorders are more likely to be unemployed, tend to live alone, have a poor social network, and are not able to establish long-term relationships (Morgan et al., 2008). Aims To investigate social disadvantage in a sample of first-episode of psychosis patients and geographically matched controls. Methods The study sample consists of 52 healthy controls and 37 FEP who were assessed using the MRC Sociodemographic Schedules. Results Preliminary results suggest that, consistently with the literature, cases are more exposed than controls to social disadvantage. They tend to reach a lower education degree (OR 6.66; CI 95%, 1.67–26.50, p 0.005) and to have an underpaid job 5 years before the onset (OR 2.84; CI 95%, 1.08–7.45, p 0.03). Furthermore, cases are more likely to live longer with their parents rather than independently (OR 3.33; CI 95%, 1.25–8.86, p 0.01) and are more exposed to house overcrowding (OR 3.92; CI 95%, 1.03–14.93, p 0.05). It was also found that an higher percentage of cases have never been in a stable relationship in the previous 5 years (OR 2.61; CI 95%, 1.08–6.27, p 0.03). Conclusions In line with the previous literature, we found that lower educational and occupational status and poor relationship status are associated to risk for psychosis. However, in contrast with North European cases, Italian FEP are more likely to live with their family rather than alone and, therefore, to be exposed to house overcrowding.

Results: Preliminary results suggest that, consistently with the literature, cases are more exposed than controls to social disadvantage. They tend to reach a lower education degree (OR 6.66; CI 95%, 1.67-26.50, p 0.005) and to have an underpaid job 5 years before the onset (OR 2.84; CI 95%, 1.08-7.45, p 0.03). Furthermore, cases are more likely to live longer with their parents rather than independently (OR 3.33; CI 95%, 1.258.86, p 0.01) and are more exposed to house overcrowding (OR 3.92; CI 95%, 1.03-14.93, p 0.05). It was also found that an higher percentage of cases have never been in a stable relationship in the previous 5 years (OR 2.61; CI 95%, 1.08-6.27, p 0.03).