Schizophrenia is complex and clinically heterogeneous psychiatric disorder that has an evidenced genetic basis. Several reports indicate a possible role of the activation of the immune system in the pathogenesis of schizophrenia. CD28 is a molecule expressed on T-cells that provides the major co-stimulatory signal required for activation of immune response. For many years now, it has been strongly advocated that biological underpinnings of schizophrenia should be investigated with respect to subpopulations of subjects defined by homogenous symptomatology.

To investigate the association of polymorphism of the CD28 gene (T17int3C) with respect to schizophrenia symptomatology.

105 patients diagnosed with schizophrenia according to ICD-10 criteria and 380 controls were included in the study. The patients were diagnosed using the Operational Criteria for Psychotic Illness checklist (OPCRIT). Based on confirmatory factor analysis on OPCRIT items performed by Serretti et al. (2004), in our study we considered five factors of symptomatology (mania, positive symptoms, disorganization, depression and negative symptoms).

There was significant difference in distribution of genotypes between patients with schizophrenia with co-occurring manic symptoms and without co-occurring manic symptoms (respectively CC and/or TC: 23% vs. 47%, TT: 77% vs. 53%, p=0,040). There was also difference in distribution of genotypes between patients with schizophrenia with co-occurring depressive symptoms and without cooccurring depressive symptoms (respectively CC and/or TC: 24% vs. 47%, TT: 76% vs. 53%, p=0,043).

We have shown that CD28 gene polymorphism might increase risk for affective (depressive and/or manic) symptom dimension in schizophrenic patients.

Age of onset has been related to the severity of cognitive decline in learning, memory, attention and motor speed.

44 patients at their onset diagnosed with schizophrenia and schizophrenia form disorders performed neuropsychological testing based on Luria‘s methodology during 5-years follow-up. Assessment was done twice in acute state and twice in remission on the first and second years of observation and then annually in remission. The patients were assigned to subgroups within the onset: adult onset (n=33, 1st group mean age- 25, 33±5,64) and early onset (n=11, 2nd group, mean age-15, 61±2, 92).

At the onset patients of the 1st group presented deficit of the main cognitive functions (verbal and visual memory, gnosis, spatial motor skills, verbal and non-verbal thinking, attention, neurodynamics and executive functioning) during the first 2 years which corresponded to the worsening of clinical state over time. Later on these variables remained stable with further decline of visual memory and visual gnosis by the end of the follow-up.

Neurocognitive parameters of the 2nd group such as praxis, gnosis, visual-spatial recognition, verbal thinking and non-verbal thinking, verbal and visual memory, neurodynamics and executive functioning were considerably poor at the onset in comparison to the 1st group. Moreover, no dynamics has been revealed during follow- up period except overpatching of non-verbal thinking, the parameter which has significantly improved in five years outcome (p< 0, 05).

The following results indicate different courses of cognitive deterioration in the follow-up period in patients with various age of onset.

Teamwork in psychiatry is a very specific property of care organization, especially in the Italian tradition and daily practice. The purpose of the study was to define and describe the main variables that might influence and determine it.

A 15-item ad hoc questionnaire was specially designed and administered to health professionals of Modena Department of Mental Health. This questionnaire contained socio-demographic data (age, sex, longevity of service), professional characteristics, personal level of satisfaction and identification, and opinions on “ideality” and “reality” of teamwork. Statistical analysis was conducted to explore significant correlations.

Satisfaction rate was 46.2%, identification rate 59.1%. Teamwork seems to function well as far as “information circulation” and “making practical decisions”, but lacks in “reciprocal understanding” and “reciprocal emotional support”. The level of correspondence between ideal and real teamwork is strongly correlated to satisfaction (p = 0), identification (p = 0), but not to age, sex or duration of service. The priority of teamwork was “discussion of clinical cases”.

This study attempts to suggest difficulties and limits of contemporary care organization in Italian psychiatry, but also offers several ideas for organizational, administrative, clinical, and human improvements. It represents a first step to analyze and identify the qualitative determinants of psychiatric teamwork.

Disulfiram is an aversive medication that works by making the drinking of alcohol an unpleasant experience (FDA approved since 1951) and most study of understanding alcohol abuse and dependence are based on it. Also, the combined Cognitive Behavioral Therapy (CBT) and disulfiram assurance treatment was substantially effective in patients with alcohol disorders.

We conducted 150 male patients range of age 20-60 and treated in Special Hospital on Addictions for 3 months period of time (inpatient setting).The recommended dose of disulfiram was 250 mg. All patients were diagnosis of alcohol dependence according the ICD-X, excluded psychosis and no one was unable to take disulfiram for medical reason. We used medical history of illness, psychiatric interview and semi structured CBT protocol for alcohol disorder and CBT sessions (2 sessions per week). Control group were 80 patients on disulfiram assurance therapy (alone).

CBT plus disulfiram assurance (N=150): 93(62%) maintaining sobriety and absence of drinking for 3 months; 44 (29,33%) maintaining sobriety for 2 months and 13 (8,66%) absence of drinking only 1 - 1,5 month.Disulfiram assurance therapy alone (control group) (N=80): 41 (51,25%) maintaining sobriety of drinking for 3 months; 22 (27,5%) less than 3 months; 10 (12,5%) for 1,5 - 2 months and 7 patients (8,75%) drop-out after a week without no relevant or medical reasons.

In this paper was shown the high level of effectiveness for the CBT combined with disulfiram assurance therapy according the maintaining sobriety and absence of drinking.