S. Gili

P02-144 - Subjective well-being under neuroleptics (SWN): a predictor of clinical and psychosocial outcome in acute patients. preliminary data

Objectives To evaluate the subjective well-being of a group of patients who were hospitalized at the Institute of Psychiatry (Novara), compared to the severity of illness. Methods Patients are evaluated at admission and discharge through self-administration of the SWN (Subjective Well-being under Neuroleptics) scale, which contains five subscales (emotional regulation; self-control; mental functioning; social integration and physical functioning) assessing patients’ psychophysical and emotional well-being, calculating a value for each subscale and a total score. The clinician fills in the CGI (Clinical Global Impression) for each patient, which provides a global judgement in three areas: severity of illness, global improvement and therapeutic effectiveness. Results From June 2009, 51 patients were evaluated at admission and discharge: 26 diagnosed with psychosis and 25 diagnosed with personality disorders. Preliminary data suggest a meaningful improvement of the physical functioning in the psychotic group, a tendency to improvement of the social integration area in the personality disorders group. Among the psychotic group, the schizophrenic patients (n°=14) have shown an improvement in the self-control subscale. Conclusions Literature suggests that a high SWN score is associated with a better compliance and an early improvement of subjective well-being is a major predictor of the chance of remission. This study will allow to compare the subjective well-being evaluated by SWN with the clinical judgment of the CGI and above all if this can represent a predictor index for the compliance and the chance of remission.

Obesity: The influence of expressed emotion, anxiety and life events

Background Expressed Emotion (EE) can be described as a measure of the emotional temperature of the family climate and plays a role in disease course and outcome, especially in chronic illnesses. Overweight and obesity are severe problems with serious implications as far as health risks are concerned. The literature suggests having a high EE caregiver correlates with a worse treatment compliance in obese patients. Objectives To measure level of EE, stressful events and anxiety in obese patients and their caregivers; to investigate the possible correlations between treatment compliance and EE. Methods We recruited 190 obese patients and 125 caregivers. Socio-demographic features were recorded. Assessment included: Level of Expressed Emotion Scale (LEE), one version for patients and one for relatives in order to evaluate 4 dimensions: Intrusiveness, Emotional Response, Attitude toward Disease, Tolerance and Expectation; the Paykels Interview for Recent Life Events; STAI Y1 concerning state anxiety and STAI Y2 concerning trait anxiety; BMI (Body Mass Index) was measured at T0 and after 3,6 and 9 months. Results We have found a correlation between gender and trait anxiety, and an inverse correlation between age and trait anxiety both in patients and caregivers. The decrease of BMI during follow-up is statistically significant and this reduction seems to be affected by tolerance and expectation perceived by patients and the emotional response on behalf of caregivers. Conclusions Levels of EE should be considered when planning treatment interventions to enhance compliance in obese patients and to support change in their life-style.

Empathy and Social Cognition: a Comparison of Schizophrenic Patients and Healthy Controls

Introduction Patients affected by schizophrenia have deficits in social cognition, functioning and in properly interpreting facial expression. These disabilities contribute to global impairment in social and relational skills. Data started being collected in the context of the Italian-Network-of-Research-on-Psychosis, headed by Mario Maj and Silvana Galderisi, in our centre;collection went on also after the conclusion of the national project. Aims To compare social inference and facial emotion identification in schizophrenic patients and healthy controls. Material and Methods We recruited 50 patients with Schizophrenia and 50 healthy controls (HCs) matched for sex, age and level of education. Socio-demographic characteristics were gathered;assessment of both patients and HCs included The Awareness of Social Inference Test (TASIT) and the Facial Emotion Identification Test (FEIT);furthermore patients were assessed with the Positive and Negative Syndrome Scale (PANSS) and the Brief Negative Symptom Scale (BNSS). Results Some differences in socio-demographic variables emerged (patients are more often unemployed and single). Moreover, the preliminary analyses highlight several differences between schizophrenic patients and HCs at TASIT and FEIT:patients performed significantly worse than HCs in both tests, with longer reaction times. Discussion As expected schizophrenic patients showed social skills deficits and difficulties in identifying facial emotions. Our preliminary results point out disabilities in understanding social messages and interpreting human behaviour;these features underlie poor and limited social relationships proper to schizophrenia. 1 Galderisi S et al. The influence of illness-related variables, personal resources and context-related factors on real-life functioning of people with schizophrenia;WorldPsychiatry2014,13(3):275-287 2 Mucci A et al. The Specific Level of Functioning Scale: Construct validity, internal consistency and factor structure in a large Italian sample of people with schizophrenia living in the community Schizophr Res.2014Oct;159(1):144-50

Anxiety and Expressed Emotion in a Sample of Obese Patients

Introduction Expressed Emotion (EE) is a measure of the intensity of the affective family climate and plays a role in disease course and outcome. Especially in urban settings, obesity is a severe problem with serious implications as far as health risks are concerned. Having a high EE caregiver has been suggested to correlate with a worse treatment compliance in obese patients. Objectives To measure level of EE, stressful events and anxiety in obese patients and their caregivers; to investigate the possible correlations between compliance with treatment and emotional temperature of families. Methods We have already recruited more than 150 obese patients and their caregivers. Assessment included: Level of Expressed Emotion Scale (LEE), one version for patients and one for relatives in order to evaluate 4 dimensions: intrusiveness, emotional response, attitude toward disease, tolerance and expectation; the Paykel’s Interview for Recent Life Events; STAI Y1 concerning state anxiety and STAI Y2 concerning trait anxiety. Furthermore we collected demographic characteristics and BMI (Body Mass Index). Results Data collection and analyses are still ongoing. Preliminary results suggest a correlation between obesity and level of anxiety. We expect to find a correlation between level of EE and variation of BMI. Conclusions Levels of EE and anxiety should be considered when planning treatment interventions to enhance compliance in obese patients and to support change in their life-style.

EPA-0760 - Expressed emotion, life events and level of anxiety in eating disorders in comparison with other psychiatric diagnosis

Introduction Eating Disorders (EDs) are chronic illnesses requiring long-term care and significant involvement of carers. Expressed Emotion (EE) is a measure of the ‘emotional temperature’ of a family: an index of the relatives emotional answer in a certain situation. Literature suggests that EE scores are usually low in EDs families and the degree of family EE correlates with patients’ outcome. Objectives To compare EE, life events and anxiety between patients with diagnosis of EDs and patients with other psychiatric diagnosis. Aims To measure the level of EE in EDs families in order to improve the quality of health care. Methods We administered the following tests to 20 patients with EDs and 20 patients with other psychiatric diagnosis: the Level of Expressed Emotion Scale (LEE) in two versions, one for patients and one for relatives with the purpose of evaluating intrusiveness, emotional response, attitude toward disease, tolerance and expectation; the Paykels Interview for recent life events in which the subjects had to point out stressful events; STAI Y1 concerning state anxiety and STAI Y2 concerning trait anxiety. We also recruited co-habiting relatives and compared the relatives EE and the EE perceived by patients. Results Statistical analyses are still in progress. Our preliminary results suggest that levels of EE are higher among the patients with a diagnosis of EDs, in contrast with results obtained by literature. Conclusions We expect that our results will help to shed light on the issue of EE correlates to EDs.

EPA-0777 – Alexithymia, facial emotion identification and social inference in ed patients: a case-control study

Introduction Alexythimia, reduced cognitive empathy and emotion awareness and understanding are present among individuals with Eating Disorders (EDs). Facial expression is a reliable marker of emotion and an important source of social information. Thus, the ability to judge facial expression is essential for successful interpersonal interactions. Objectives To evaluate alexythimia, facial emotion identification and social inference abilities in a sample of ED patients, compared to a sample of patients with another psychiatric diagnosis and a group of healthy controls, matched by gender and age. Aims To describe a specific pattern of emotional dysregulation in ED patients. Methods ED patients and the Psychiatric Control Group are recruited at the Institute of Psychiatry in Novara, while healthy controls are recruited on a community basis. All patients and controls are females, aged 18–65. All patients are undergoing the Structured Clinical Interview for DSM-IV -Patient version (SCID-I-P), healthy controls are administered the Structured Clinical Interview for DSM-IV – Non Patient version (SCID-I-NP). All subjects are undergoing the following: SCID-II, Eating Disorder Inventory − 3 (EDI-3), Binge Eating Scale (BES), Beck Depression Inventory (BDI), Symptom Checklist − 90 (SCL-90), Facial Emotion Identification Test (FEIT), The Awareness of Social Inference Test (TASIT), Temperament and Character Inventory (TCI), Rosenberg Self-Esteem Scale (RSES), Interpersonal Reactivity Index (IRI), Toronto Alexithymia Scale (TAS-20). Results The recruitment and analysis of the samples are ongoing. The ED sample is expected to show greater alexythimia and a poorer performance at FEIT and TASIT, compared to the control samples. Conclusions Clinical implications will be discussed.