Cognitive deficits are considered a key feature of schizophrenia due to their substantial influence on the psychosocial outcome of subjects affected by this disorder. Several studies showed that moderate to severe cognitive impairments, including dysfunctions of social cognition, are already present during the early phases of the illness, in subjects with first-episode psychosis (FEPs). Psychosocial interventions, such as social skill training (SST), could therefore be implemented already upon occurrence of the first episode of psychosis to improve the overall functional outcome of schizophrenia, which represents to date an unmet need in the care of these patients.

The study aims to evaluate the use of SST to enhance social skills and real-life functioning in FEPs.

The sample included 7 FEPs (age between 15 and 40). The SST intervention included 30 sessions lasting 2 hours and delivered twice a week. Psychopathology, neurocognition, real life functioning, functional capacity and social cognition were assessed at baseline ad after training. Paired samples t-tests were performed to evaluate the effects of the intervention. All subjects were treated with second generation antipsychotics.

Significant improvements were observed in negative symptoms, social cognition, problem solving skills, as well as in global functioning (all p<0.05). Within real-life functioning, the improvement was greater for the domain of interpersonal relationships.

These preliminary findings suggest that SST might complement pharmacological treatment in FEPs to improve functional outcome in these subjects. Further studies with a higher sample size and a longer follow-up are required in order to confirm the present results.

Social cognition and skill deficits have been largely documented in subjects with schizophrenia (SCZs), and have a strong influence on the functional outcome of these subjects. Different behavioural interventions have been developed to target and improve social skills in SCZs. For instance, the Social Skills Training (SST) focuses on improving communication skills and assertiveness to facilitate disease management, independent living and real-life functioning of SCZs. SST seems also to have an impact on negative symptoms and social cognition.

The study aims to evaluate the effectiveness of SST in improving social cognition and negative symptoms in SCZs.

The sample included 8 chronic SCZs (age between 18 and 60), who completed 6 months of SST. The intervention consisted of two weekly group sessions of 2 hours each. We assessed psychopathology, neurocognition, real-life functioning, functional capacity and social cognition at baseline and after training. Paired samples t-tests were performed to evaluate the differences of the variables considered after completing the treatment.

Significant improvements in negative symptoms (p<.05), social cognition (p<.05), functional capacity (p<.001), activities of daily living (p<.001) and interpersonal relationships (p<.011) were found.

The present findings suggest that SST might ameliorate social cognition and negative symptoms which are generally not influenced by antipsychotic treatment. The integration of pharmacological and SST interventions might have an impact on major determinants of poor real-life functioning in SCZs.

Interactions between the pharmaceutical industry (PI) and psychiatrists have been under scrutiny recently, though there is little empirical evidence on the nature of the relationship and its intensity at psychiatry trainee level. We therefore studied the level of PI interactions and the underlying beliefs and attitudes in a large sample of European psychiatric trainees.

One thousand four hundred and forty-four psychiatric trainees in 20 European countries were assessed cross-sectionally, with a 62-item questionnaire.

The total number of PI interactions in the preceding two months varied between countries, with least interactions in The Netherlands (M (Mean) = 0.92, SD = 1.44, range = 0–12) and most in Portugal (M = 19.06, SD = 17.44, range = 0–100). Trainees were more likely to believe that PI interactions have no impact on their own prescribing behaviour than that of other physicians (M = 3.30, SD = 1.26 vs. M = 2.39, SD = 1.06 on a 5-point Likert scale: 1 “completely disagree” to 5 “completely agree”). Assigning an educational role to the pharmaceutical industry was associated with more interactions and higher gift value (IRR (incidence rate ratio) = 1.21, 95%CI = 1.12–1.30 and OR = 1.18, 95%CI = 1.02–1.37).

There are frequent interactions between European psychiatric trainees and the PI, with significant variation between countries. We identified several factors affecting this interaction, including attribution of an educational role to the PI. Creating alternative educational opportunities and specific training dedicated to PI interactions may therefore help to reduce the impact of the PI on psychiatric training.

There is a shortage of psychiatrists worldwide. Within Europe, psychiatric trainees can move between countries, which increases the problem in some countries and alleviates it in others. However, little is known about the reasons psychiatric trainees move to another country.

Survey of psychiatric trainees in 33 European countries, exploring how frequently psychiatric trainees have migrated or want to migrate, their reasons to stay and leave the country, and the countries where they come from and where they move to. A 61-item self-report questionnaire was developed, covering questions about their demographics, experiences of short-term mobility (from 3 months up to 1 year), experiences of long-term migration (of more than 1 year) and their attitudes towards migration.

A total of 2281 psychiatric trainees in Europe participated in the survey, of which 72.0% have ‘ever’ considered to move to a different country in their future, 53.5% were considering it ‘now’, at the time of the survey, and 13.3% had already moved country. For these immigrant trainees, academic was the main reason they gave to move from their country of origin. For all trainees, the overall main reason for which they would leave was financial (34.4%), especially in those with lower (<500€) incomes (58.1%), whereas in those with higher (>2500€) incomes, personal reasons were paramount (44.5%).

A high number of psychiatric trainees considered moving to another country, and their motivation largely reflects the substantial salary differences. These findings suggest tackling financial conditions and academic opportunities.

Current research suggested that avolition in patients with schizophrenia (SCZ) is not due to a deficit of hedonic experience, but to a poor ability to translate pleasurable experiences into motivational states. In line with this hypothesis, several evidences showed a preserved hedonic experience, even in the presence of severe trait anhedonia and avolition in SCZ.

To test the hypothesis that memory dysfunction, generally found in SCZ, could lead to inaccurate representations of emotional experiences and interfere with translation of pleasurable experience in motivation.

The present study was aimed to investigate the relationships between state and trait anhedonia, avolition and cognitive functioning in 35 SCZ.

In SCZ and matched healthy controls (HC) the Temporal experience of Pleasure (TEPS) and Chapman's scales were used to assess trait anhedonia. The MID task was used to assess in-the-moment hedonic experience. Avolition was measured by the Schedule for the Deficit Syndrome. MATRICS Consensus Cognitive Battery was used to assess cognition.

SCZ did not differ from HC on TEPS or on MID task performance but reported higher scores for trait social anhedonia. Trait social anhedonia was associated with memory dysfunction and showed a correlation with avolition.

Our results confirm the disjunction between state and trait anhedonia and demonstrate a relationship of the latter with memory impairment and avolition, suggesting that inaccurate representations of emotional experiences might impede their translation in motivation to act.

The authors have not supplied their declaration of competing interest.

Cognitive deficits are considered central and persistent features of schizophrenia and have a significant impact on outcome and quality of life. The computerized interactive remediation of cognition (CIRCuiTS) is a new computerized cognitive remediation program aimed at improving different cognitive domains in patients with schizophrenia. In particular, the program was designed to mainly rehabilitate executive functions, attention and memory by training each cognitive function through several exercises and by improving metacognition.

In the present study, CIRCuiTS was translated and adapted into Italian. The applicability and feasibility of the Italian version was evaluated. Moreover, preliminary data on the effectiveness of the program were investigated.

Four patients with a diagnosis of schizophrenia were recruited for the study. We investigated the changes in neurocognition, psychopathology, self-esteem and functional outcome at the end of the remediation program. The level of satisfaction of operators and participants was evaluated by means of the client satisfaction questionnaire (CSQ).

For each patient, the entire program took place through 2 weekly sessions of 50 minutes for a total duration of 40 sessions.

CIRCuiTS produced an improvement in all domains of neurocognition, disorganization, self-esteem and real-life functioning in the areas “self-care” and “interpersonal relationships”. Moreover, high levels of satisfaction were shown by CSQ for both, operators and participants.

The Italian version of CIRCuiTS demonstrates high levels of acceptability and feasibility for both, patients and clinicians. Additionally, preliminary data suggest that the use of CIRCuiTS provides an improvement on several aspects of the disease.

The authors have not supplied their declaration of competing interest.

Wellness self-management is an adaptation and expansion of the illness management and recovery, an internationally recognized best practice. WSM is a recovery-oriented, curriculum-based practice designed to help adults with severe mental health problems make decisions and take action to manage symptoms and improve their quality of life.

In the present study, the Italian translation of the WSM was implemented and validated. Moreover, the impact of its application in a day hospital setting on cognitive functions, psychopathology, personal resources and real-life functioning with respect to treatment as usual (TAU) was investigated.

The study was aimed at assessing the effectiveness of a semi-structured version of WSM in a day hospital setting in patients with severe mental illness.

Fourteen patients with a diagnosis of severe mental illness were recruited and randomly assigned to either WSM or TAU. WSM participants attended four 2-hour sessions per week for 1 month, including lessons selected on the basis of the goals of participants. Both groups received weekly planned treatment in the day-hospital setting and continued their pharmacotherapy.

The two groups of patients were comparable for age, education, cognitive functioning and psychopathological severity. WSM produced a significantly greater improvement in neurocognition, psychopathology, personal resources and real-life functioning with respect to TAU.

Our results offer promising preliminary evidence that the use of WSM provides an effective complement to current mental health treatment.

The authors have not supplied their declaration of competing interest.

People with schizophrenia exhibit deficits in neurocognitive and social cognitive (SC) processes which limit their social reintegration. SC was found to mediate in part the impact of neurocognitive dysfunctions on real-life functioning.

The purpose of this study was to implement a new intervention for patients with schizophrenia, the Social Cognition Individualized Activities Lab (So.C.I.A.L.) which trains both social cognition and neurocognitive functions.

To determine the efficacy of the So.C.I.A.L in improving SC by a comparison with a validated cognitive remediation (CR) intervention: the Social Skills And Neurocognitive Individualized Training (SSANIT).

Nine stabilized patients accepted to participate in this pilot study. Five were randomized to So.C.I.A.L. and 4 to SSANIT. The two programs were matched for the overall treatment duration (20 weeks), as well as frequency and duration of the sessions. Both interventions included individual sessions of neurocognitive individualized training; So.C.I.A.L included group sessions on Emotion Recognition and Theory of Mind, while SSANIT group sessions of Social Skills Individualized Training.

No group difference was found for changes in neurocognition, while a significant group effect was observed for changes in SC, due to improvement only in the So.C.I.A.L. group.

The study results showed a specific effect of the So.C.I.A.L. on SC, beyond the effect on neurocognition. Further studies are needed to assess the impact of So.C.I.A.L. on real-life functioning in a larger group of subjects.

The authors have not supplied their declaration of competing interest.

The abnormal bodily phenomena questionnaire (ABPq) originates from the analysis of clinical files of more than 350 patients with schizophrenia. It consists in a semi-structured interview created to evaluate the subjective anomalies in feelings, sensations, perceptions and cognition in the domain of the lived body.

The present study is aimed at providing preliminary data for the validation of the Italian version of the ABPq.

The ABPq was translated and adapted into Italian. ABPq scores were correlated to those obtained by the schizophrenia proneness instrument, Adult version–body perception disturbances (SPI-A E, body) that evaluates the same kind of phenomena, in order to examine its convergent validity. Moreover, ABPq was correlated to psychopathological domains assessed by the Positive and Negative Syndrome Scale (PANSS) and by the Brief Negative Symptom Scale (BNSS).

The experimental sample included 40 clinically stable patients. Our findings showed a strong correlation between ABPq and SPI-A E, body. An association of ABPq total score with the positive and disorganized dimensions was also observed.

Our preliminary data suggest that the Italian version of ABPq has a good convergent validity. The presence of abnormal bodily phenomena resulted to be associated to a greater severity of the disease and therefore it could be hypothesized that they represent an indicator of clinical severity.

The authors have not supplied their declaration of competing interest.

The delay between psychosis onset and initiation of treatment (duration of untreated psychosis, DUP) is associated with a poorer treatment response and overall functional outcome. In Europe several early detection and intervention programs have been developed to reduce the DUP and promote Phase-specific Treatments (PsTs).

To review the evidence of a) the effectiveness of European Early Interventions (EEIs) in reducing DUP; b) an impact of PsTs on clinical and social outcomes; and c) EEIs cost-effectiveness.

A literature search in PubMed, PsychInfo, Cochrane and individual journals through cross-referencing was performed. All European Randomized Controlled Trials (RCTs) designed to reduce DUP and/or to implement PsTs for people with first-episode psychosis were included in the review.

Studies examining early detection programs compared with Standard Care (SC) reported discrepant findings as to their impact on the DUP. PsTs generally reduce hospitalizations and improve service engagement when compared with SC; their impact on other clinical variables, e.g. symptomatology and social functioning, is unclear. Studies assessing EEIs cost-effectiveness in comparison with SC consistently report an advantage for EEIs in the long run.

EEIs, as compared to SC, show several advantages that seem to result in an overall reduction in the cost of care. Therefore, the development of EEI is recommended.

On the other hand, some inconsistencies in the reported results suggest that EEIs should include psychosocial interventions targeting unmet needs of schizophrenia patients, such as cognitive dysfunction and negative symptoms.

SG received honoraria or Advisory board/consulting fees from the following companies: Lundbeck, Janssen Pharmaceuticals, Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and Gedeon-Richter. All other authors have declared.

The increased use of the MATRICS Consensus Cognitive Battery (MCCB) to investigate cognitive dysfunctions in schizophrenia fostered interest in its sensitivity in the context of family studies. As various measures of the same cognitive domains may have different power to distinguish between unaffected relatives of patients and controls, the relative sensitivity of MCCB tests for relative–control differences has to be established. We compared MCCB scores of 852 outpatients with schizophrenia (SCZ) with those of 342 unaffected relatives (REL) and a normative Italian sample of 774 healthy subjects (HCS). We examined familial aggregation of cognitive impairment by investigating within-family prediction of MCCB scores based on probands’ scores.

Multivariate analysis of variance was used to analyze group differences in adjusted MCCB scores. Weighted least-squares analysis was used to investigate whether probands’ MCCB scores predicted REL neurocognitive performance.

SCZ were significantly impaired on all MCCB domains. REL had intermediate scores between SCZ and HCS, showing a similar pattern of impairment, except for social cognition. Proband's scores significantly predicted REL MCCB scores on all domains except for visual learning.

In a large sample of stable patients with schizophrenia, living in the community, and in their unaffected relatives, MCCB demonstrated sensitivity to cognitive deficits in both groups. Our findings of significant within-family prediction of MCCB scores might reflect disease-related genetic or environmental factors.