In the field of the early psychosis two main approaches attempt to develop rating tools, one investigating the basic symptoms domain, and the other the attenuated psychotic symptoms. To explore the relationship between basic symptoms (BSs) and other symptom domains in different phases of the psychotic illness 32 at ultra-high risk (UHR), 49 first episode schizophrenia (FES), 42 multiple episode schizophrenia (MES), and 28 generalized anxiety disorder (GAD) patients were enrolled. Participants were assessed using the SIPS/SOPS and the FCQ scales. Analyses of covariance taking into account socio-demographic and clinical variables significantly different between groups were applied to compare FCQ and SOPS scores. Finally FCQ and SOPS principal component analysis was carried out in the schizophrenia spectrum group. SOPS scores were higher in the UHR, FES and MES groups compared to the GAD control group. Concordantly, FES and MES groups had a higher number of basic symptoms in comparison with the GAD group, whereas UHR did not differ from the control group. The largest number of correlations between BSs and psychotic symptoms was found in the GAD group. According to the principal component analysis (PCA) five factors were extracted, with the BSs loading on a unique factor. Our findings imply that the boundary between psychotic and non-psychotic conditions cannot be outlined on the basis of the presence/absence of basic and psychotic symptoms.

Insight may vary across psychosis risk syndrome (PRS), first-episode schizophrenia (FES), or multiepisode schizophrenia (MES). We aimed to compare insight domains (awareness, relabeling, and compliance) in PRS, FES, and MES groups and to correlate scores with psychopathological measures. Insight was assessed in 48 (14 PRS, 16 FES, and 18 MES) patients using the Schedule for the Assessment of Insight-Expanded Version. We conducted psychopathological assessment through the Brief Psychiatric Rating Scale (BPRS). In the whole group, the BPRS psychosis factor correlated with all insight domains. In the MES group, the more severe the anxiety/depression, the higher the insight score in the symptom relabeling domain. Insight did not differ significantly between the PRS, FES, and MES groups. Our results suggest that, across different phases of the illness, lack of insight behaves like a trait and is modulated by positive symptom severity. Anxiety and depression may be associated with increased insight in patients with chronic schizophrenia.

Background. Schizophrenia is preceded by basic symptoms which may persist after long time and include subjective cognitive impairment. Furthermore, it is characterised by cognitive deficits that may deteriorate with the progression of illness. To examine the relationship between neurocognition and basic symptoms along the course of schizophrenia, we compared the cognitive performance and the basic symptoms of one population with first episode psychosis (FEP) and one with a chronic, multi-episode course (MEP). Methods. We tested 8 FEP (5 male) and 7 MEP (7 male) in- and outpatients, for basic symptoms with the Schizophrenia Proneness Instrument-Adult version (SPI-A) and for neurocognition with Raven's Color Progressive Matrices (CPM), Rey-Osterrieth's complex figure (Rey), Corsi's and Buschke-Fuld tests, the Wisconsin Card Sorting Test (WCST), the Stroop test, and the Trail Making Test (TMT). Results. PEP patients did not differ from MEP patients as for SPI-A scores. MEP patients were significantly more impaired on several subtests of Buschke-Fuld, the Rey, and the WCST with respect to FEE Impairment on the cognitive subscale of the SPI-A correlated with non-perseverative WCST errors, and on the self subscale of the SPI-A with impaired performance on the Buschke-Fuld. Further, in MEP, impairment on the body subscale of the SPI-A correlated inversely with number of categories completed of the WCST. Conclusions. Basic symptoms persist throughout the phases of schizophrenia and are relatively independent of cognitive performance. A chronic, multi-episode course is associated with increased cognitive impairment in schizophrenia.

AIM:Disorders usually first diagnosed in infancy, childhood or adolescence (DUFD-ICA) may have preceded the onset of psychosis by several years and share some co-morbidity with psychotic disorders, but only a few studies have investigated this aspect. We looked for past or current DUFD-ICA in a sample of first adult psychiatric service users assessed for the presence of an at-risk mental state with the Structured Interview for Psychosis-risk Syndromes (SIPS).METHODS:We interviewed with the SIPS 159 first-time help seekers (age range 13-30 years) at adult psychiatric services who volunteered to participate in the study. For psychiatric diagnoses, we used the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition-Text Revision. We also assessed retrospectively the presence of DUFD-ICA and administered the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning. The sample has been subdivided diagnostically into first-episode psychosis, multiple episode psychosis, ultra-high risk (UHR) and other diagnoses.RESULTS:The risk for having one of first-episode psychosis, multiple episode psychosis or UHR was over 3.45 higher in the DUFD-ICA-positive history group than in the non-DUFD-ICA. Grouping the UHR with the not full-blown psychosis cases resulted in a further increase of the risk to 4.71. DUFD-ICA-positive participants scored higher than non-DUFD-ICA on the Positive, Negative and Disorganization scales of the SIPS and on several core-psychotic BPRS items.CONCLUSIONS:A positive history of DUFD-ICA increases the risk of a diagnosis of prodromal or current psychosis at help seeking. Impaired neurodevelopment may be shared among the psychoses and DUFD-ICA.

The aim of the present article is to review research on the between physical activity and involvement in sports and suicidality This review of the literature indicated that physical activity and sports participation may have a beneficial impact on suicidality at least in boys and men and in some ethnic groups However it is not clear whether physical activity arty directly on suicidality (e g affecting the serotonergic system in the central nervous system) or through a mediating variable such as depression or higher self-esteem Furthermore, the review bar identified some inconsistency in the results, and methodological problems with the research have been identified

Suicidal behavior in peacekeepers is not well documented because only a few articles have investigated this field. These articles suggest that mental health problems represent the most important risk factor for suicide. The risk factors for suicide in peacekeepers can be divided into: (1) before deployment, such as parental psychosocial problems and negative life events, (2) during deployment, such as involuntary repatriation from service and exposure to combat, and (3) after peacekeeping service, such as PTSD and alcohol abuse. A good awareness of suicidal risk factors could help peacekeepers with their suicidal behaviour and permit planned suicidal prevention.

Impulsivity is a complex behavioral construct. Action without planning or reflection is central to most definitions of impulsivity. Thus, impulsivity appears to be associated with a failure of behavioral filtering processes outside of consciousness, with compromised ability to reflect on impending acts or to use knowledge and intelligence to guide behavior. Impulsive behavior, including aggression and suicide attempts, differs from corresponding premeditated behavior by having an inappropriately short threshold for response, lack of reflection, lack of modulation, and lack of potential gain, leading potentially to dissociation between an action and its intent. Impulsivity is a prominent and measurable characteristic of bipolar disorder that can contribute to risk for suicidal behavior. The purpose of this study was to investigate the relationship between impulsivity and severity of past suicidal behavior, a potential predictor of eventual suicide, in patients with bipolar disorder. Although the screening of BD patients for the risk factors is not fool-proof, the consideration of those risk factors is an important component of the clinical assessment of suicidal risk. The clinical unpredictablility can be especially challenging with BD patients, given the sometimes rapid shifts in mood (lability), strong reactivity to losses, frustrations or other stressors, impulsivity, disinhibiting effects of commonly abused central depressants including alcohol, comorbid anxiety disorders, and potential adverse effects of excessive use of antidepressants. Impulsivity/aggression has been reported to be related to suicidal behavior in several studies. For example, Mann and colleagues proposed a stress-diathesis model of suicidal behavior. Impulsivity, related to a genetic predisposition and dysfunction of the prefrontal cortex, is part of the diathesis predisposing individuals with suicidal ideation to act upon their impulse. Higher aggression may also contribute to the increased lethality of suicide attempts.Among all psychiatric disorders, BD carries the highest suicide risk. There is no good explanation as to why BD patients kill themselves more than patients with MDD or schizophrenia. Possibly BD patients are are more prone to dysphoric-irritable mixed states associated with higher degree of discontent and impulsivity. Impulsivity is also a relevant clinical factor in suicidal behavior and is a common trait among persons with BD. However, impulsivity has been tentatively associated. primarily with suicide attempts of limited lethality rather than with completed suicide. It is not clear whether relatively high rates of illness recurrence or the presence of rapid cycling (more than four recurrences within a year) increases risk of suicide in mood disorders. There may also be a genetic predisposition to suicide, but it has not been proven that this risk is independent of the risk for BD or depressive illness.

The aims of the present study were to examine clinical, personality, and sociodemographic predictors of suicide risk in a sample of inpatients affected by major affective disorders. The participants were 74 inpatients affected by major depressive disorder or bipolar disorder-I. Patients completed a semi-structured interview, the Beck Hopelessness Scale, the Aggression Questionnaire, the Barratt Impulsiveness Scale, and the Hamilton scales for depression and anxiety. Over 52% of the patients were high suicide risks. Those at risk reported more severe depressive-anxious symptomatology, more impulsivity and more hostility. Impulsivity, the use of antidepressants, anxiety/somatization, and the use of mood stabilizers (a negative predictor) resulted in accurate predicting of suicide intent. Impulsivity and antidepressant use were the strongest predictors even after controlling for several sociodemographic and clinical variables.