D. La Barbera

Failure to find association between childhood abuse and cognition in first-episode psychosis patients

This study investigated the relationship between severe childhood abuse and cognitive functions in first-episode psychosis patients and geographically-matched controls. Reports of any abuse were associated with lower scores in the executive function domain in the control group. However, in contrast with our hypothesis, no relationships were found amongst cases.

Alexithymia and personality traits of patients with inflammatory bowel disease

Psychological factors, specific lifestyles and environmental stressors may influence etiopathogenesis and evolution of chronic diseases. We investigate the association between Chronic Inflammatory Bowel Diseases (IBD) and psychological dimensions such as personality traits, defence mechanisms, and Alexithymia, i.e. deficits of emotional awareness with inability to give a name to emotional states. We analyzed a survey of 100 patients with IBD and a control group of 66 healthy individuals. The survey involved filling out clinical and anamnestic forms and administering five psychological tests. These were then analyzed by using a network representation of the system by considering it as a bipartite network in which elements of one set are the 166 individuals, while the elements of the other set are the outcome of the survey. We then run an unsupervised community detection algorithm providing a partition of the 166 participants into clusters. That allowed us to determine a statistically significant association between psychological factors and IBD. We find clusters of patients characterized by high neuroticism, alexithymia, impulsivity and severe physical conditions and being of female gender. We therefore hypothesize that in a population of alexithymic patients, females are inclined to develop psychosomatic diseases like IBD while males might eventually develop behavioral disorders.

Cognitive Assessment of OCD Patients: NeuroVR vs Neuropsychological Test.

This study aimed to evaluate the reliability and validity of the Neuro-Virtual Reality as tool for the neuropsychological assessment in OCD patients. We used the neuropsychological battery and a virtual version of the Multiple Errand Test (V-MET), developed using the NeuroVR software, in order to evaluate the executive functions, the ability to plan ahead on complex problem solving tasks in daily life in 30 obsessive compulsive disorder (OCD) patients and 30 healthy controls. The results showed the presence of difficulties of OCD patients: lower levels of divided attention and higher levels of errors; higher mean rank of inefficiencies, interpretation failures and rule breaks and longer time of execution of the whole task. By contrast, controls have higher level of efficiency and better performance. In addition, a significant correlation was found between the V-MET and the neuropsychological battery which confirms and supports the ecological validity of neurocognitive assessment through NeuroVirtual Reality.

Cannabis Users and Premorbid Intellectual Quotient (IQ)

The chapter focuses on premorbid intellectual quotient (IQ) in cannabis users, one of the most controversial topics in studies on the harmful effects of cannabis use on cognition. We critically reviewed the literature in order to propose a model that would be able to summarize the complex relationship between premorbid IQ and cannabis use, in determining different outcomes. Longitudinal studies that assessed IQ measures before and after cannabis consumption had yielded discordant findings. We, however, observed a relationship between higher premorbid IQ and recreational or discontinued use, while a lower premorbid IQ resulted as a predictor for regular or heavy cannabis use. Using these observations as a starting point, we sustain the hypothesis of a shared genetic vulnerability to psychosis and cannabis use, reflected on premorbid IQ, and able to influence the contact with the substance. In turn, cannabis may be a trigger for psychosis toward this continuum of neurodevelopmental vulnerability.

Cumulative social disadvantage and psychosis: findings from a southern Italy case-control study

IEPA 10th International Conference on Early Intervention in Mental Health – “Looking Back, Moving Forward” Milan, Italy, 20th – 22nd October 2016

Working Memory, Jumping to Conclusions and Emotion Recognition: a Possible Link in First Episode Psychosis (Fep)

Introduction 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). Aims To investigate a possible correlation between working memory, JTC and ER in FEP. Methods 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. Results 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%, χ 2 =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: r rho =0,276, p=0,003; Digit Symbol: r rho =0,275, p=0,002; Arithmetic: r rho =0,265, p=0,003; Block Design: r rho =0,292, p=0,001), but only Digit Span with ER (r rho =-0,239; p=0,021). In addition, we found that JTC and ER were significantly associated (r rho =-0,281; p=0,004). Conclusions 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.

EPA-1417 – Migration history and first episode psychosis: Results from EUGEI project- Italy

The excess of psychosis among migrants and ethnic minorities is a well defined phenomenon in North Europe, while it should be still demonstrated in south Europe. Because of the variation in prevalence and distribution of risk factors in different national contexts, similar studies in different countries are needed to test the hypotheses and to ensure the generalizability of the findings. Moreover, available studies have been mostly focused on risk factors of psychosis during the post migration phase (such as ethnic fragmentation, unemployment, etc) and among well established ethnic minorities (second and further generations of migrants). In Italy, first generation migrants are still the larger component of the ethnic minorities’ populations and we can evaluate risk factors of psychosis related to the migration history as whole considered (pre-migration, migration and post migration phases). I will present results on risk factors of psychosis among first generations migrants in the three sites involved in the EU-GEI Project in Italy (Bologna, Palermo and Verona) (European Network of National Schizophrenia Networks Studying Gene Environment Interactions Project EU-GEI European Communitys Seventh Framework Program, grant agreement No. HEALTH-F2-2009-241909). Particularly, I will discuss our efforts to understand the role of the migration process characteristics in the development of psychosis.

EPA-0874 – Social disadvantage and psychosis: a case control study on italian first-episodes of psychosis

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.