A public early intervention approach to first-episode psychosis: Treated incidence over 7 years in the Emilia-Romagna region

AimTo estimate the treated incidence of individuals with first-episode psychosis (FEP) who contacted the Emilia-Romagna public mental healthcare system (Italy); to examine the variability of incidence and user characteristics across centres and years. MethodsWe computed the raw treated incidence in 2013-2019, based on FEP users aged 18-35, seen within or outside the regional program for FEP. We modelled FEP incidence across 10 catchment areas and 7 years using Bayesian Poisson and Negative Binomial Generalized Linear Models of varying complexity. We explored associations between user characteristics, study centre and year comparing variables and socioclinical clusters of subjects. ResultsThousand three hundred and eighteen individuals were treated for FEP (raw incidence: 25.3 / 100.000 inhabitant year, IQR: 15.3). A Negative Binomial location-scale model with area, population density and year as predictors found that incidence and its variability changed across centres (Bologna: 36.55; 95% CrI: 30.39-43.86; Imola: 3.07; 95% CrI: 1.61-4.99) but did not follow linear temporal trends or density. Centers were associated with different user age, gender, migrant status, occupation, living conditions and cluster distribution. Year was associated negatively with HoNOS score (R = -0.09, p < .001), duration of untreated psychosis (R = -0.12, p < .001) and referral type. ConclusionsThe Emilia-Romagna region presents a relatively high but variable incidence of FEP across areas, but not in time. More granular information on social, ethnic and cultural factors may increase the level of explanation and prediction of FEP incidence and characteristics, shedding light on social and healthcare factors influencing FEP

A first episode psychosis case-control genetic association study

Background:GAP(genesandpsychosis) is a case-control studyof first episode psychosis conducted in London and Cambridge, which aims to identify genes conferring susceptibility to psychosis, and associated phenotypes including cognitive dysfunction and cerebral morphology. Methods:First episode psychosis cases have been recruited in South London and Maudsley NHS Trust and in Cambridge. A variety of demographic and clinical data have been collected. In a subset of these, neurocognitive assessments and MRIs have been performed. Samples have been taken for DNA, and in a subset for RNA and proteomic analysis. Genetic association analysis is being undertaken using a candidate gene approach. The genes chosen for the first wave of analysis include the current most promising candidates for suscept-ibility to psychosis (NRG1, dysbindin, DISC1, G72, etc) as well as candidates for susceptibility to cannabis misuse (COMT), cognitive dysfunction, dysregulation of brain morphology or susceptibility to bipolar disorder (e.g. LIS1), and candidates in the dopamine and serotonin neurotransmitter systems. Results:DNA has been collected from 302 patients to date. Of these, 72%aremale, and themeanage is 25 years; 187 areCaucasian; 115 are of black origin; and the rest are of other ormixed ethnicity. Genotyping is being undertaken in this sample and in matched controls. Conclusions:Data is being reported separately for a number of phenotypes forwhich there is already somedata. This presentationwill report the overall genetic association results

Congenital syphilis in Italy: a multicentre study

OBJECTIVE: To study the prevalence of congenital syphilis and its risk factors in Italy. STUDY DESIGN: Prospective study from 1 July 2006 to 30 June 2007. Data on mother-child pairs were collected for every syphilis seropositive mother. RESULTS: Maternal syphilis seroprevalence at delivery was 0.17%. 207 infants were born to 203 syphilis seropositive mothers. In 25 newborns it was possible to diagnose congenital syphilis (20/100,000 live births). Maternal risk factors included age <20 years, no antenatal care and no adequate treatment. The infected babies were more often preterm or weighed <2000 g at birth. DISCUSSION: Many syphilis seropositive mothers were foreign born but the risk of an infected newborn was not higher in foreign-born than in Italian seropositive women. The significant factors were lack of antenatal screening and inadequate maternal treatment. CONCLUSION: Syphilis is a re-emerging infection in Italy. Prevention strategies should include antenatal serological tests for all pregnant women and treatment for infected mothers