Juliana Fortes Lindau

Interpersonal sensitivity and functioning impairment in youth at ultra-high risk for psychosis

A personality trait that often elicits poor and uneasy interpersonal relationships is interpersonal sensitivity. The aim of the present study was to explore the relationship between interpersonal sensitivity and psychosocial functioning in individuals at ultra-high risk for psychosis as compared to help-seeking individuals who screened negative for an ultra-high risk of psychosis. A total sample of 147 adolescents and young adult who were help seeking for emerging mental health problems participated in the study. The sample was divided into two groups: 39 individuals who met criteria for an ultra-high-risk mental state (UHR), and 108 (NS). The whole sample completed the Interpersonal Sensitivity Measure (IPSM) and the Global Functioning: Social and Role Scale (GF:SS; GF:RS). Mediation analysis was used to explore whether attenuated negative symptoms mediated the relationship between interpersonal sensitivity and social functioning. Individuals with UHR state showed higher IPSM scores and lower GF:SS and GF:RS scores than NS participants. A statistically negative significant correlation between two IPSM subscales (Interpersonal Awareness and Timidity) and GF:SS was found in both groups. Our results also suggest that the relationship between the aforementioned aspects of interpersonal sensitivity and social functioning was not mediated by negative prodromal symptoms. This study suggests that some aspects of interpersonal sensitivity were associated with low level of social functioning. Assessing and treating interpersonal sensitivity may be a promising therapeutic target to improve social functioning in young help-seeking individuals.

Psychological distress and coping strategies in patients attending a dermatology outpatient clinic

Background  Psychological distress is frequent among dermatological patients. The development of a positive attitude toward diagnosis and treatment is thought to be critical for successful coping and mental health outcomes.

Validation of the Italian version of interpersonal sensitivity measure (IPSM) in adolescents and young adults

BACKGROUND Interpersonal sensitivity is a personality trait that describes as excessive awareness of both the behaviour and feelings of others. High interpersonal sensitivity has been associated with the development and maintenance of mental health problems. This study aimed to examine whether the Italian version of the interpersonal sensitivity measure (IPSM) has good internal consistence and convergent validity. METHODS Validity was established on a sample of 153 Italian adolescents and young adult help seekers for several psychological problems. These subjects were divided in two groups - depressive spectrum disorder group (n=42) and other diagnosis group (n=111) - according to Structured Clinical Interview (SCID-I) for DSM-IV and Kiddie-Sads-Present and Lifetime Version (K-SADS-PL). For convergent validity, we studied the correlation between total and each subscale IPSM scores and the General Symptoms (included depressive and dysphoric symptoms) of Prodromal Questionnaire. RESULTS The internal consistency were adequate and comparable to the original Boyce and Parker study. The validity was good, as indicated by both the convergent validity analysis and the depressive spectrum disorder group and other diagnosis group comparison. LIMITATIONS The absence of another scale measuring interpersonal sensitivity to assess the construct validity of IPSM; the clinical heterogeneity of the sample; the absence of test re-test reliability of the instrument. CONCLUSIONS Analysis of the results of internal consistency and convergent validity of the IPSM indicates that this version translated into Italian is valid and reliable.

The combination of depressive symptoms and smoking shorten life expectancy among the aged.

BACKGROUND Depression is a potential risk factor for mortality among the aged and it is also associated with other chronic diseases and unhealthy lifestyles that may also affect mortality. The purpose of this study was to investigate the association between depressive symptoms and mortality, controlling for health, nutritional status, and life-style factors. METHODS A cohort of elderly people (N = 167) was followed-up for ten years. Information on socio-demographic characteristics, medical history, smoking, and alcohol consumption was collected. The primary outcome was all-cause mortality; the secondary outcome was cancer-specific mortality. The Geriatric Depression Scale (GDS-15) was used to assess depression. Using a multivariable Cox proportional hazards regression, we examined the association between depressive symptoms and mortality. RESULTS Elderly people with depression (scoring above the depression cut-off of 7) had a 53% increased risk of mortality (relative risk (RR) 1.53; 95%CI: 1.05-2.24) compared to non-depressed subjects. The combination of depressive symptoms with smoking was associated with a particularly higher risk of mortality (RR: 2.61; 95%CI: 1.28-5.31), after controlling for potential confounders. CONCLUSIONS Depressive symptoms are associated with a significantly increased risk of all-cause mortality. The combination of depressive symptoms and smoking shorten life expectancy among the aged.

The Italian version of the 92-item Prodromal Questionnaire: Concurrent validity with the SIPS and factor analysis in a sample of 258 outpatients aged 11–36 years

BACKGROUND Current early screeners for psychosis-risk states have still to prove ability in identifying at-risk individuals. Among screeners, the 92-item Prodromal Questionnaire (PQ-92) is often used. We aimed to assess the validity of its Italian translation in a large Italian adolescent and young adult help-seeking sample. METHODS We included all individuals aged 12-36years seeking help at psychiatric mental health services in a large semirural Roman area (534,600 population) who accepted to participate. Participants completed the Italian version of the PQ-92 and were subsequently assessed with the Structured Interview of Prodromal/Psychosis-Risk Syndromes (SIPS). We examined diagnostic accuracy (sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios) and content, concurrent, and convergent validity between PQ-92 and SIPS using Cronbachs alpha, Cohens kappa, and Spearmans rho, respectively. We tested the validity of adopted cut-offs through Receiver Operating Characteristic (ROC) curves plotted against SIPS diagnoses and the instruments factor-structure through Principal Component Analysis. RESULTS PQ-92 showed high internal consistency, acceptable diagnostic accuracy and concurrent validity, and excellent convergent validity. ROC analyses pointed to scores of 18 on the Positive subscale and 36 on the total PQ-92 as best cut-offs. The Scree-test identified a four-factor solution as fitting best. CONCLUSIONS Psychometric properties of Italian PQ-92 were satisfactory. Optimal cut-offs were confirmed at ≥18 on the positive subscale, but at ≥36 on the total scale was able to identify more SIPS-positive cases.

Impairment in Social Functioning differentiates youth meeting Ultra-High Risk for psychosis criteria from other mental health help-seekers: A validation of the Italian version of the Global Functioning: Social and Global Functioning: Role scales

Social and occupational impairments are present in the schizophrenia prodrome, and poor social functioning predicts transition to psychosis in Ultra-High Risk (UHR) individuals. We aimed to: 1) validate the Italian version of the Global Functioning: Social (GF: S) and Global Functioning: Role (GF: S) scales; 2) evaluate their association with UHR criteria. Participants were 12-21-years-old (age, mean=15.2, standard deviation=2.1, male/female ratio=117/120) nonpsychotic help-seekers, meeting (N=39) or not (N=198) UHR criteria. Inter-rater reliability was excellent for both scales, which also showed good to excellent concurrent validity, as measured by correlation with Global Assessment of Functioning (GAF) scores. Furthermore, GF:S and GF: R were able to discriminate between UHRs and non-UHRs, with UHRs having lower current scores. After adjusting for current GAF scores, only current GF:S scores independently differentiated UHR from non-UHR (OR=1.33, 95%CI: 1.02-1.75, p=0.033). Finally, UHR participants showed a steeper decrease from highest GF:S and GF: R scores in the past year to their respective current scores, but not from highest past year GAF scores to current scores. GF:S/GS: R scores were not affected by age or sex. GF:S/GF: R are useful functional level and outcome measures, having the advantage over the GAF to not confound functioning with symptom severity. Additionally, the GF:S may be helpful in identifying UHR individuals.

Youth mental health services in Italy: An achievable dream?

“Liberiamo il futuro” (LIF) project was designed to assess psychological problems of adolescents and young adults and to identify individuals at high‐risk for developing a psychosis through a collaboration between a University team, Child and Adolescent Mental Health Services and Adult Mental Health Services. This paper presents the baseline demographic and clinical characteristics of the cohort, particularly the nature and severity of psychopathology.

Interpersonal sensitivity and attenuated psychotic symptoms: a prediction model

Aims: The first aim was to determine the cost-effectiveness of CBTuhr to prevent first-episode psychosis in ultra-high risk (UHR) at 18 and 48 months. The second aim was to develop an optimized prediction model of a first-episode psychosis. Methods: 196 help-seeking UHR patients participated in the Early Detection Intervention (EDIE) study in the Netherlands. All individuals were treated with routine care (RC) for non-psychotic disorders. The experimental group received add-on CBTuhr to prevent psychosis. Results: The CBTuhr intervention was cost saving at 18 and 48 months follow-up. This was achieved by less hospital admissions and a reduction in other service costs. Societal costs were reduced because more treated patients were employed. Prognostic modelling identified 3 UHR risk classes with 4%, 13% and 70% risk for transition within 18 months. In the highest risk class, transition to psychosis emerged on average ≥ 8 months earlier than in the lowest risk class. Conclusions: Using prognostic modelling and proactive care can accomplish health gain at lower costs.