Ecological monitoring of physical activity, emotions and daily life activities in schizophrenia: the DiAPAson study

Background: Schizophrenia spectrum disorders (SSD) compromise psychosocial functioning, including daily time use, emotional expression and physical activity (PA). Objective: We performed a cohort study aimed at investigating: (1) the differences in PA, daily activities and emotions between patients with SSD and healthy controls (HC); (2) the strength of the association between these variables and clinical features among patients with SSD. Methods: Ninety-nine patients with SSD (53 residential patients, 46 outpatients) and 111 matched HC were assessed for several clinical variables, and levels of functioning by means of standardised clinical measures. Self-reported daily activities and emotions were assessed with a smartphone application for ecological momentary assessment (EMA), and PA levels were assessed with a wearable accelerometer for 7 consecutive days.FindingsPatients with SSD, especially those living in residential facilities, spent more time being sedentary, and self-reported more sedentary and self-care activities, experiencing higher levels of negative emotions compared with HC. Moreover, higher functioning levels among patients were associated with more time spent in moderate-to-vigorous activity. Conclusions: Sedentary behaviour and negative emotions are particularly critical among patients with SSD and are associated with more impaired clinical outcomes. Clinical implications: Mobile-EMA and wearable sensors are useful for monitoring the daily life of patients with SSD and the level of PA. This population needs to be targeted with specific rehabilitative programmes aimed at improving their commitment to structured daily activities

Quality of residential facilities in Italy: satisfaction and quality of life of residents with schizophrenia spectrum~disorders

Background Recovery and human rights promotion for people with Schizophrenia Spectrum Disorders (SSDs) is fundamental to provide good care in Residential Facilities (RFs). However, there is a concern about rehabilitation ethos in RFs. This study aimed to investigate the care quality of Italian RFs, the quality of life (QoL) and care experience of residents with SSD. Methods Fourty-eight RFs were assessed using a quality assessment tool (QuIRC-SA) and 161 residents with SSD were enrolled. Seventeen RFs provided high intensity rehabilitation (SRP1), 15 medium intensity (SRP2), and 16 medium-low level support (SRP3). Staff-rated tools measured psychiatric symptoms and psychosocial functioning; user-rated tools assessed QoL and satisfaction with services. RFs comparisons were made using ANOVA and Chi-squared. Results Over two-thirds patients (41.5 y.o., SD 9.7) were male. Seventy-six were recruited from SRP1 services, 48 from SRP2, and 27 from SRP3. The lowest QuIRC-SA scoring was Recovery Based Practice (45.8%), and the highest was promotion of Human Rights (58.4%). SRP2 had the lowest QuIRC-SA ratings and SRP3 the highest. Residents had similar psychopathology (p = 0.140) and functioning (p = 0.537). SRP3 residents were more employed (18.9%) than SRP1 (7.9%) or SRP2 (2.2%) ones, and had less severe negative symptoms (p = 0.016) and better QoL (p = 0.020) than SRP2 residents. There were no differences in the RF therapeutic milieu and their satisfaction with care. Conclusions Residents of the lowest supported RFs in Italy had less severe negative symptoms, better QoL and more employment than others. The lowest ratings for Recovery Based Practice across all RFs suggest more work is needed to improve recovery

The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent predictors of symptoms changes over time. Methods: The STAR Network \u201cDepot Study\u201d was a naturalistic, multicenter, observational, prospective study that enrolled people initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centers were assessed at three time points: baseline, 6-month, and 12-month follow-up. Psychopathological symptoms, attitude toward medication and treatment adherence were measured using the Brief Psychiatric Rating Scale (BPRS), the Drug Attitude Inventory (DAI-10) and the Kemp's 7-point scale, respectively. Linear mixed-effects models were used to evaluate whether attitude toward medication and treatment adherence independently predicted symptoms changes over time. Analyses were conducted on the overall sample and then stratified according to the baseline severity (BPRS < 41 or BPRS 65 41). Results: We included 461 participants of which 276 were males. The majority of participants had received a primary diagnosis of a schizophrenia spectrum disorder (71.80%) and initiated a treatment with a second-generation LAI (69.63%). BPRS, DAI-10, and Kemp's scale scores improved over time. Six linear regressions\u2014conducted considering the outcome and predictors at baseline, 6-month, and 12-month follow-up independently\u2014showed that both DAI-10 and Kemp's scale negatively associated with BPRS scores at the three considered time points. Linear mixed-effects models conducted on the overall sample did not show any significant association between attitude toward medication or treatment adherence and changes in psychiatric symptoms over time. However, after stratification according to baseline severity, we found that both DAI-10 and Kemp's scale negatively predicted changes in BPRS scores at 12-month follow-up regardless of baseline severity. The association at 6-month follow-up was confirmed only in the group with moderate or severe symptoms at baseline. Conclusion: Our findings corroborate the importance of improving the quality of relationship between clinicians and patients. Shared decision making and thorough discussions about benefits and side effects may improve the outcome in patients with severe mental disorders

SOS - Piattaforme e Impatti Offshore. Report tecnico: II Campagna oceanografica 1-2 novembre 2018

Nell’ambito del protocollo di intesa sottoscritto dal Ministero dell’Ambiente e della Tutela del Mare ed il Consiglio Nazionale delle Ricerche (06/07/2015), con l’obiettivo di promuovere la ricerca e l’innovazione nel settore della tutela ambientale, è stata istituita la convenzione per la realizzazione di un sistema integrato di previsione della dispersione di idrocarburi in mare e monitoraggio ambientale in corrispondenza delle piattaforme situate nell’Adriatico e nel Canale di Sicilia denominata “SOS Piattaforme e Impatti Off-Shore” (m_amte.PNM.REGISTRO UFFICIALE.U.0000939.17-01.2017). Le attività presentate in questo documento fanno riferimento alla sezione Macro-Attività D: monitoraggio, elaborazione ed approfondimento conoscitivo delle matrici acqua, biota e sedimenti intorno alle piattaforme di estrazione di idrocarburi nelle aree critiche con significativo impatto antropico sugli ecosistemi marini-costieri finalizzato alla comprensione degli impatti sugli ecosistemi marini dovuti alla presenza delle piattaforme offshore nonché ad evidenziare possibili relazioni di causa-effetto associabili allo scarico in mare delle acque di strato. In particolare, vengono presentate le attività di monitoraggio nell’area caratterizzata dalla presenza di 10 piattaforme off-shore ENI situate nella zona costiera compresa tra Ravenna e Pescara. L’obiettivo è lo studio delle modalità di dispersione in mare delle acque di produzione e la caratterizzazione chimico-fisica ed ecotossicologica delle stesse e delle matrici ambientali (acqua, sedimenti, biota) per la valutazione di eventuali danni a organismi selezionati. Inoltre, l’azione di ricerca è volta alla definizione di un approccio metodologico innovativo per le future attività di monitoraggio, da effettuare attorno alle piattaforme off-shore per la verifica di processi e meccanismi di impatto sull’ambiente e l’ecosistema, principalmente da parte dello scarico di acque di produzione. La presente relazione descrive le attività di campionamento e acquisizione dati effettuate durante la II campagna oceanografica svolta nel periodo 1-2 novembre 2018 a bordo della nave R/V G. Dallaporta del Consiglio Nazionale del Ricerche

SOS - Piattaforme e Impatti Offshore. Report tecnico: III Campagna oceanografica 12-18 giugno 2019

Nell’ambito del protocollo di intesa sottoscritto dal Ministero dell’Ambiente e della Tutela del Mare ed il Consiglio Nazionale delle Ricerche (06/07/2015), con l’obiettivo di promuovere la ricerca e l’innovazione nel settore della tutela ambientale, è stata istituita la convenzione per la realizzazione di un sistema integrato di previsione della dispersione di idrocarburi in mare e monitoraggio ambientale in corrispondenza delle piattaforme situate nell’Adriatico e nel Canale di Sicilia denominata “SOS Piattaforme e Impatti Off-Shore” (m_amte.PNM.REGISTRO UFFICIALE.U.0000939.17-01.2017). Le attività presentate in questo documento fanno riferimento alla sezione Macro-Attività D: monitoraggio, elaborazione ed approfondimento conoscitivo delle matrici acqua, biota e sedimenti intorno alle piattaforme di estrazione di idrocarburi nelle aree critiche con significativo impatto antropico sugli ecosistemi marini-costieri finalizzato alla comprensione degli impatti sugli ecosistemi marini dovuti alla presenza delle piattaforme offshore nonché ad evidenziare possibili relazioni di causa-effetto associabili allo scarico in mare delle acque di strato. In particolare, vengono presentate le attività di monitoraggio nell’area caratterizzata dalla presenza di 10 piattaforme off-shore ENI situate nella zona costiera compresa tra Ravenna e Pescara. L’obiettivo è lo studio delle modalità di dispersione in mare delle acque di produzione e la caratterizzazione chimico-fisica ed ecotossicologica delle stesse e delle matrici ambientali (acqua, sedimenti, biota) per la valutazione di eventuali danni a organismi selezionati. Inoltre, l’azione di ricerca è volta alla definizione di un approccio metodologico innovativo per le future attività di monitoraggio, da effettuare attorno alle piattaforme off-shore per la verifica di processi e meccanismi di impatto sull’ambiente e l’ecosistema, principalmente da parte dello scarico di acque di produzione. La presente relazione descrive le attività di campionamento e acquisizione dati effettuate durante la III campagna oceanografica svolta nel periodo 12-18 Giugno 2019 a bordo dell’imbarcazione Rocco Uno

Ecological monitoring of physical activity, emotions and daily life activities in schizophrenia: the DiAPAson study

Background Schizophrenia spectrum disorders (SSD) compromise psychosocial functioning, including daily time use, emotional expression and physical activity (PA).Objective We performed a cohort study aimed at investigating: (1) the differences in PA, daily activities and emotions between patients with SSD and healthy controls (HC); (2) the strength of the association between these variables and clinical features among patients with SSD.Methods Ninety-nine patients with SSD (53 residential patients, 46 outpatients) and 111 matched HC were assessed for several clinical variables, and levels of functioning by means of standardised clinical measures. Self-reported daily activities and emotions were assessed with a smartphone application for ecological momentary assessment (EMA), and PA levels were assessed with a wearable accelerometer for 7 consecutive days.FindingsPatients with SSD, especially those living in residential facilities, spent more time being sedentary, and self-reported more sedentary and self-care activities, experiencing higher levels of negative emotions compared with HC. Moreover, higher functioning levels among patients were associated with more time spent in moderate-to-vigorous activity.Conclusions Sedentary behaviour and negative emotions are particularly critical among patients with SSD and are associated with more impaired clinical outcomes.Clinical implications Mobile-EMA and wearable sensors are useful for monitoring the daily life of patients with SSD and the level of PA. This population needs to be targeted with specific rehabilitative programmes aimed at improving their commitment to structured daily activities

Does social cognition change? Evidence after 4 years from the Italian Network for Research on Psychoses

BackgroundDeficits in social cognition (SC) are significantly related to community functioning in schizophrenia (SZ). Few studies investigated longitudinal changes in SC and its impact on recovery. In the present study, we aimed: (a) to estimate the magnitude and clinical significance of SC change in outpatients with stable SZ who were assessed at baseline and after 4 years, (b) to identify predictors of reliable and clinically significant change (RCSC), and (c) to determine whether changes in SC over 4 years predicted patient recovery at follow-up. MethodsThe reliable change index was used to estimate the proportion of true change in SC, not attributable to measurement error. Stepwise multiple logistic regression models were used to identify the predictors of RCSC in a SC domain (The Awareness of Social Inference Test [TASIT]) and the effect of change in TASIT on recovery at follow-up. ResultsIn 548 participants, statistically significant improvements were found for the simple and paradoxical sarcasm of TASIT scale, and for the total score of section 2. The reliable change index was 9.8. A cut-off of 45 identified patients showing clinically significant change. Reliable change was achieved by 12.6% and RCSC by 8% of participants. Lower baseline TASIT sect. 2 score predicted reliable improvement on TASIT sect. 2. Improvement in TASIT sect. 2 scores predicted functional recovery, with a 10-point change predicting 40% increase in the probability of recovery. ConclusionsThe RCSC index provides a conservative way to assess the improvement in the ability to grasp sarcasm in SZ, and is associated with recovery