The aim of the present study is to see if the changes in the regional cerebral blood flow (rCBF) experienced by restrictive anorexia nervosa (AR) and bulimia nervosa (BN) patients, following the exposure to their own body image, persist at follow-up.

Three single photon emission computed tomography (SPECT) were performed on nine patients with a DSM-IV diagnosis of AR, 13 with BP, and 12 controls: at rest, following a neutral stimulus, and after exposure to their previously filmed whole body image. Body dissatisfaction was measured by means of the Body Dissatisfaction Questionnaire (BSQ). One year later the same assessment was repeated.

Following the exposure to their own body image, BN showed an increase in body dissatisfaction, which was associated with the increase in the rCBF of the Right Temporal Area. Those changes persisted at follow-up.

More specific long term therapies are needed for the treatment of the averse response showed by ED patients to their own body image exposure that is associated with the hyperactivation of the right temporal area when they are confronted with their whole body image.

Observational studies have reported earlier onset of psychosis in schizophrenic patients with a history of cannabis use. Earlier age of onset of schizophrenia has been associated with a poorer outcome. We aimed to examine whether cannabis use determined an earlier onset of schizophrenia in a sample of first episode patients, in an area with one of Europe's highest rates of cannabis use.

116 subjects with first episode psychosis and subsequent diagnosis of schizophrenia (after a 12-month follow-up) were included Age at first antipsychotic treatment (A1T) was used as proxy for age of psychosis onset, and acted as dependent variable for the statistical analysis. Cannabis use was evaluated retrospectively, and divided into three groups according to peak frequency (never, sporadic/frequent, daily).

46 (39.7%) subjects had never used cannabis, 23 (19.9%) had done so sporadically/frequently, and 47 (40.5%) daily. A1T differed between the three groups (mean, in years and [SD]: 27.0 [4.94]; 25.7 [4.44] and 24.5 [4.36]; p = 0.033) and diminished as cannabis use increased (linear tendency; p = 0.009). Post-hoc analysis showed that cannabis use (irrespective of frequency) was significantly associated with decrease in A1T (p = 0.033), as shown by the first contrast [1 −1/2 −1/2]. Post-hoc contrast showed that cannabis users had a significantly lower age of onset of psychosis (mean decrease, in years: 1.93; CI (confidence interval) 95%: 0.17–3.70; p = 0.033).

Cannabis use was significantly associated with a decrease in age of onset of schizophrenia. Age of onset of the disease correlated with frequency of cannabis use.

The electronic Schizophrenia Treatment Adherence Registry (e-STAR) is a prospective, observational study of patients with schizophrenia designed to evaluate long-term treatment outcomes in routine clinical practice.

Parameters were assessed at baseline and at 3 month intervals for 2 years in patients initiated on risperidone long-acting injection (RLAI) (n = 1345) or a new oral antipsychotic (AP) (n = 277; 35.7% and 36.5% on risperidone and olanzapine, respectively) in Spain. Hospitalization prior to therapy was assessed by a retrospective chart review.

At 24 months, treatment retention (81.8% for RLAI versus 63.4% for oral APs, p < 0.0001) and reduction in Clinical Global Impression Severity scores (−1.14 for RLAI versus −0.94 for APs, p = 0.0165) were significantly higher with RLAI. Compared to the pre-switch period, RLAI patients had greater reductions in the number (reduction of 0.37 stays per patient versus 0.2, p < 0.05) and days (18.74 versus 13.02, p < 0.01) of hospitalizations at 24 months than oral AP patients.

This 2 year, prospective, observational study showed that, compared to oral antipsychotics, RLAI was associated with better treatment retention, greater improvement in clinical symptoms and functioning, and greater reduction in hospital stays and days in hospital in patients with schizophrenia. Improved treatment adherence, increased efficacy and reduced hospitalization with RLAI offer the opportunity of substantial therapeutic improvement in schizophrenia.

To identify the presence of factors associated with treatment outcome in patients under group cognitive-behavioral therapy (GCBT) for obsessive-compulsive disorder (OCD).

This study evaluated 181 patients with OCD that attended a 12-session weekly GCBT program. Response criteria were: ≥35% reduction in Y-BOCS scores and global improvement score of the Clinical Global Impression (CGI) ≤ 2 at post-treatment evaluation. Sociodemographic data, OCD characteristics, and treatment data were studied.

In the bivariate analysis, the following variables showed statistical significance (p < 0.20) to enter the regression model: being woman (p = 0.074), greater insight (p = 0.017) and better quality of life (QOL) in all domains before treatment (p = 0.053), overall severity of disease according to the CGI (p = 0.007), number of associated comorbidities (p = 0.063), social phobia (p = 0.044), and dysthymia (p = 0.072). In the final regression model, these variables were associated with response to GCBT: female gender (p = 0.021); WHOQOL-BREF psychological domain (p = 0.011); insight (p = 0.042); and global improvement score of the CGI severity-scale before therapy (p = 0.045).

Special attention should be paid to patients with poor insight, increasing the cognitive aspects of the therapy in an attempt to modify the rigidity and fixity of their beliefs. In addition, male patients should be more observed, since they showed lower chance of response to GCBT when compared to women. Patients with more severe global symptoms (CGI) are poorer responders to GCBT, which indicates that not only obsessive-compulsive symptoms (OCS) should be evaluated, since other symptoms, such as depression and anxiety, may affect the treatment; therefore, an attempt to reduce these symptoms, prior to the treatment of OCD, should be considered as an option in some cases.

Individuals with psychosis are known to have a lower self-esteem compared to the general population, in part because of social stigma, paternalistic care, long periods of institutionalization and negative family interactions. This study aimed at assessing the efficacy of a self-esteem enhancement program for individuals with severe mental illness and at analyzing the results in their European context.

A randomized cross-over study including 54 outpatients with a diagnosis of schizophrenia from Geneva, Switzerland, was conducted. Twenty-four were recruited from an outpatient facility receiving traditional psychiatric care whereas 30 came from an outpatient facility with case-management care. Psychosocial, diagnostic and symptom measures were taken for all the subjects before treatment, after treatment, and at 3-months' follow-up.

Results indicated significant positive self-esteem module effects on self-esteem, self-assertion, active coping strategies and symptom for the participants receiving case-management care. Results were not significant for those receiving traditional care. However, 71% of all participants expressed satisfaction with the module.

Individuals with schizophrenia appear to be benefit from the effects of the self-esteem module, particularly when they are involved in a rehabilitation program and followed by a case manager who liaises with the other partners of the multidisciplinary team. This encourages reconsidering the interventions' format and setting in order to ensure lasting effects on the environment and in turn on coping, self-esteem and overall empowerment.

Patients with affective disorders are at high risk of suicide, especially during inpatient treatment and during the first year after discharge.

A blinded case-control design was used. The study included a total national sample of patients with affective disorder admitted during the period from January 1, 1994 to December 31, 1995, who died because of suicide, either during admission or shortly after discharge.

A history of suicide attempt was a significant risk factor (IRR 4.9; 95% CI 2.1–11.6). Loss of job during the year prior to the index admission was associated with an increase in suicide risk (IRR: 2.9; 95% CI 1.2–7.5). Clinical improvement during the index admission (IRR: 0.3; 95% CI 0.1–0.7), and treatment with antidepressant drugs at the censoring date (IRR: 0.3; 95% CI 0.1–0.7) were associated with a decrease in suicide risk.

Improved treatment may be a key factor in suicide prevention in patients during, and shortly after hospitalisation with affective disorders. Also, there is a need to be especially aware of suicide risk in patients with little or no improvement at discharge.

Depression after childbirth is a major problem affecting 10–22% of all mothers. In Italy, postnatal depression has not yet been systematically studied.

In this retrospective study we have sought to identify risk factors, assessed during pregnancy, and their importance for postnatal depression symptoms in a sample of 297 Italian women attending ante-natal classes organised by the local Consultorio Familiare Unit of the National Health Service, Italy. The Postpartum Depression Predictors Inventory – revised form (PDPI-Revised), was used to identify risk factors, 8–9 month of pregnancy. A double-test strategy using the Edinburgh Postnatal Depression Scale (EPDS) and 12-item General Health Questionnaire (GHQ12), was administered to screen women with a higher occurrence of symptoms of postnatal depression six–eight weeks after delivery. Women with high EPDS (<8) and high GHQ12 (<3) scores were compared with those who had scored below the EPDS and/or GHQ12 threshold scores.

We found that 13% of the women studied showed high postnatal depressive symptomatology, which is very similar to rates of prevalence of postnatal depression in the first year after the birth of the child reported in other Western World studies. Feeling anxious during pregnancy is a strong predictor of high symptoms of depression at 6–8 weeks after delivery. However, University education and friends' support appear to be important protective factors.

These findings could be useful both for Italian health professionals and for researchers interested in the transcultural aspects of postnatal depression.

To evaluate the performance of the French version of the Mood Disorder Questionnaire (MDQ) in patients attending a general psychiatric outpatient service as well as whether MDQ scores are independent of patient mood state at time of completion.

183 patients completed the MDQ and were assessed with the MADRS and YMRS scales, before being interviewed with the SCID (time 1). MDQ, MADRS and YMRS assessment was repeated four to six weeks later (time 2).

According to the SCID, 44 patients were suffering from bipolar spectrum disorder and 102 from unipolar disorder (37 patients dropped out). The MDQ provided high specificity (83.3%). Sensitivity was 63.6%, with better identification of bipolar I (85.0%) than bipolar II patients (45.8%). In the whole sample, test-retest reliability was satisfactory (kappa = 0.64). Modest correlations were observed between the number of endorsed MDQ items and YMRS scores at time 1 (Spearman r = 0.19; p = 0.021) and time 2 (r = 0.26; p = 0.002).

Despite some fluctuations over time and a discrete influence of symptom severity, the screening algorithm can be used reliably, whether in the acute or remission phase of a depressive episode.

The purpose of this study was to investigate the degree of agreement among parents, teachers and adolescents with respect to the Child Behavior Checklist (CBCL), the Teacher's Report Form (TRF), and the Youth Self Report (YSR). In addition we evaluated the suitability of these three forms (CBCL, TRF and YSR) in terms of their contribution to understanding internalizing and externalizing disorders in youths being referred to a child and adolescent unit of a psychiatric care facility.

A total of 611 patients aged 11–18 years (mean age 13.0, SD 1.6) were assessed using the CBCL, the TRF and the YSR.

Intraclass coefficients (ICC) showed low to moderate agreement among informants. Furthermore, the level of agreement was generally less among patients suffering from internalizing disorders than for young patients who displayed externalizing disorders. Logistic regression revealed that the TRF internalizing syndrome scale, the CBCL internalizing syndrome scale and gender were relevant prognostic factors for the occurrence of internalizing disorders in youth. The YSR internalizing syndrome scale, on the other hand, was not a relevant factor among adolescents of a clinical target population. Likewise, only the TRF externalizing syndrome scale, the CBCL externalizing syndrome scale and gender were relevant prognostic factors for the occurrence of externalizing disorders in youth.

Particularly the CBCL and TRF are useful instruments in assessing internalizing and externalizing disorders in adolescents referred to a mental health setting.