The impact of peri-natal stress on psychosis risk: Results from the Bo-FEP incidence study

Objective: According to the gene-environment interaction model the pathogenesis of psychosis relies on an adverse neuro-socio-developmental pathway. Perinatal stress represents an important risk factor for the development of psychosis because of the increasingly evident interference with socio-neuro-development in the earlier phases of life. We aim to investigate the correlation of perinatal risk factors with the onset of psychosis with a case-control-incidence study. Results: Patients (and their mothers) were eligible if they presented with first-episode psychosis at the Bologna West Community Mental Health Centre (Bo-West CMHC) between 2002 and 2012. The Bo-West CMHC serves a catchment area of about 200,000 people. The controls were recruited in the same catchment area and study period. 42 patients, 26 controls and their mothers were included. We collected the history of peri-natal stress and calculated crude and adjusted Odds Ratios for onset of first-episode psychosis. Adjusted logistic regression showed that psychosis onset was significantly associated with stressful situations during pregnancy, lower level of maternal physical health before or during pregnancy, use of anti-inflammatory drugs during pregnancy, and low level of maternal education. The results of our study suggest that stress during perinatal period increases the risk of developing psychosis

Childhood medical history and psychosis in adult life: Findings from the Bologna EU-GEI incidence and case–control study

Aim: To estimate the association between the inpatient admissions and Emergency Department (ED) visits before age of 18 years and adulthood-onset first-episode psychosis (FEP). Methods: We conducted a FEP incidence and case–control study and calculated the odds ratios (ORs) for incident FEP associated with inpatient admissions and ED visits prior to age of 18 years, adjusting our results for cannabis use, parental socio-economic class and childhood trauma. Results: In multivariate logistic regression analysis, odds of FEP increased significantly if the participant had a history of at least one inpatient admission (OR = 3.52; 95% confidence interval [95%CI] 1.07-11.54; P =.04) or at least one ED visit (OR = 8.93; 95%CI 2.41-33.14; P =.001) before age of 18. The associations remained significant adjusting for cannabis use, education, parental socio-economic class and childhood trauma. Conclusion: Consistently with the socio-neurodevelopmental model, we found a significant association between a positive history of hospital care in childhood and adulthood-onset psychosis

Somatization among ethnic minorities and immigrants: Why does it matter to Consultation Liaison Psychiatry?

The article describes the reasons why psychiatrists working in the field of consultation-liaison should be trained and aware of the relevance of culture in their everyday work. Moreover, the article aims at advertising the special-interest group on cultural CLP, a network of clinicians and researchers within the European Association of Psychosomatic Medicine that share their interest and activities in this subject

Validation of the Italian version of the Devaluation consumers' Scale and the Devaluation Consumers Families Scale

Objectives: This study aimed to assess the psychometric properties of the Italian versions of the Devaluation of Consumers Scale (DCS) and the Devaluation of Consumer Families Scale (DCFS), two short-scales examining public stigma towards people with mental disorders and their relatives. Methods: The scales were administered to 117 individuals with a clinical diagnosis of affective or non-affective psychoses (ICD 10 criteria F20-29, F30-33). Translation procedures were carried out according to accepted standards. Internal reliability was assessed using Cronbach's alpha coefficient. Convergent validity was evaluated in terms of correlation with the Global Functioning Scale (GAF) and with the Questionnaire on Users' Opinions (QUO). Known-group validity was assessed comparing patients at first-episode of psychosis and patients with a history of psychosis of at least 3 years (long-term psychosis). Results: The overall Cronbach's alpha value was 0.85 for DCS and 0.81 for DCFS; subscales' alpha values ranged from 0.80 to 0.55 for DCS, and from 0.68 to 0.55 for DCFS. Negative correlations were found between the Italian DCS and the DCFS total score and the QUO affective problems (DCS -0.33; DCFS -0.235) and social distance subscales (DCS -0.290; DCFS -0.356). Moreover, the GAF positively correlated with some of the DCS and DCFS subscales. Patients with long-term psychosis had higher scores in most DCS and DCFS subscales. Conclusion: The Italian translation of DCF and DCFS showed good internal consistency, known-group validity, and convergent validity. These psychometric properties support their application in routine clinical practice in Italy as well as their use in international studies

Migrant pathways to community mental health centres in Italy.

Background: Many studies indicate that migrants in western countries have limited access to and low utilization of community mental health centres (CMHCs) despite the high prevalence of mental disorders. Aims: We aimed to compare migrant pathways to care across four CMHCs located in different Italian provinces and to identify pathway to care predictors. Methods: Migrants attending the four CMHCs between 1 July 1999 and 31 December 2007 were included in the study. Data were gathered retrospectively from clinical data sets and chart review. Results: Five hundred and eleven (511) migrants attended the four CMHCs, 61% were referred by GPs or other health services and 39% followed non-medical pathways to care (self-referral or through social and voluntary organizations), with important site variations. Younger age and being married were predictors of medical pathways to care; lacking a residence permit and having a diagnosis of substance abuse were related to non-medical pathways. Conclusions: Pathways to CMHCs are complex and influenced by many factors. Non-medical pathways to care seem to be frequent among migrants in Italy. More attention should be paid to developing psychiatric consultation liaison models that also encompass the social services and voluntary organizations

Migrant pathways to community mental health centres in Italy.

Background: Many studies indicate that migrants in western countries have limited access to and low utilization of community mental health centres (CMHCs) despite the high prevalence of mental disorders. Aims: We aimed to compare migrant pathways to care across four CMHCs located in different Italian provinces and to identify pathway to care predictors. Methods: Migrants attending the four CMHCs between 1 July 1999 and 31 December 2007 were included in the study. Data were gathered retrospectively from clinical data sets and chart review. Results: Five hundred and eleven (511) migrants attended the four CMHCs, 61% were referred by GPs or other health services and 39% followed non-medical pathways to care (self-referral or through social and voluntary organizations), with important site variations. Younger age and being married were predictors of medical pathways to care; lacking a residence permit and having a diagnosis of substance abuse were related to non-medical pathways. Conclusions: Pathways to CMHCs are complex and influenced by many factors. Non-medical pathways to care seem to be frequent among migrants in Italy. More attention should be paid to developing psychiatric consultation liaison models that also encompass the social services and voluntary organizations

A bioinformatics knowledge discovery in text application for grid computing

<p>Abstract</p> <p>Background</p> <p>A fundamental activity in biomedical research is Knowledge Discovery which has the ability to search through large amounts of biomedical information such as documents and data. High performance computational infrastructures, such as Grid technologies, are emerging as a possible infrastructure to tackle the intensive use of Information and Communication resources in life science. The goal of this work was to develop a software middleware solution in order to exploit the many knowledge discovery applications on scalable and distributed computing systems to achieve intensive use of ICT resources.</p> <p>Methods</p> <p>The development of a grid application for Knowledge Discovery in Text using a middleware solution based methodology is presented. The system must be able to: perform a user application model, process the jobs with the aim of creating many parallel jobs to distribute on the computational nodes. Finally, the system must be aware of the computational resources available, their status and must be able to monitor the execution of parallel jobs. These operative requirements lead to design a middleware to be specialized using user application modules. It included a graphical user interface in order to access to a node search system, a load balancing system and a transfer optimizer to reduce communication costs.</p> <p>Results</p> <p>A middleware solution prototype and the performance evaluation of it in terms of the speed-up factor is shown. It was written in JAVA on Globus Toolkit 4 to build the grid infrastructure based on GNU/Linux computer grid nodes. A test was carried out and the results are shown for the named entity recognition search of symptoms and pathologies. The search was applied to a collection of 5,000 scientific documents taken from PubMed.</p> <p>Conclusion</p> <p>In this paper we discuss the development of a grid application based on a middleware solution. It has been tested on a knowledge discovery in text process to extract new and useful information about symptoms and pathologies from a large collection of unstructured scientific documents. As an example a computation of Knowledge Discovery in Database was applied on the output produced by the KDT user module to extract new knowledge about symptom and pathology bio-entities.</p

Investigation of the effects of atmospheric pressure cold plasma on human cells and tissues

Atmospheric pressure cold plasma (APCP) is a novel tool in medicine for tissue disinfection. We recently reported that 2 minutes of APCP generated by a new portable device that ionizes a flow of helium gas exerted an antimicrobial effect, mainly due to the action of reactive oxygen species (ROS) (P. Brun et al., 2012). Since ROS induced DNA lesions that could lead to point mutations, before using plasma in medical treatment it is important to ascertain the safe usage of this device. In the study presented, we analysed the presence of ROS levels, pre-mutagenic 8-oxodeoxyguanosine (8-OHdG) and the expression of OGG1, a DNA glycosylase specific for the removal of 8-OHdG lesions in cell (fibroblasts and keratocytes) cultures. ROS levels in APCP-exposed microorganisms and keratocytes were detected by 2’,7’-dichlorofluorescein diacetate (HDCF-DA) fluorescence; the potential genotoxic effects of plasma were evaluated by analyses of cell cycle distribution, externalization of phosphatidylserine, HPLC determination of 8-OHdG expression, qRT-PCR and Western blotting of OGG1 gene and protein, at set time intervals. Our results demonstrated that APCP induced ROS formation in exposed human cells, a transient 8-OHdG expression and a consequent adaptative OGG1 response at the transcriptional and translational level. In conclusion, the short application of APCP to cells and tissues has a disinfection effect and leads to time-restricted ROS generation and to oxidative-stress related responses

Mapping research activity on mental health disorders in Europe: Study protocol for the Mapping_NCD project

© 2016 The Author(s). Background: Mental health disorders (MHDs) constitute a large and growing disease burden in Europe, although they typically receive less attention and research funding than other non-communicable diseases (NCDs). This study protocol describes a methodology for the mapping of MHD research in Europe as part of Mapping_NCD, a 2-year project funded by the European Commission which seeks to map European research funding and impact for five NCDs in order to identify potential gaps, overlaps, synergies and opportunities, and to develop evidence-based policies for future research. Methods: The project aims to develop a multi-focal view of the MHD research landscape across the 28 European Union Member States, plus Iceland, Norway and Switzerland, through a survey of European funding entities, analysis of research initiatives undertaken in the public, voluntary/not-for-profit and commercial sectors, and expert interviews to contextualize the gathered data. The impact of MHD research will be explored using bibliometric analyses of scientific publications, clinical guidelines and newspaper stories reporting on research initiatives. Finally, these research inputs and outputs will be considered in light of various metrics that have been proposed to inform priorities for the allocation of research funds, including burden of disease, treatment gaps and cost of illness. Discussion: Given the growing burden of MHDs, a clear and broad view of the current state of MHD research is needed to ensure that limited resources are directed to evidence-based priority areas. MHDs pose a particular challenge in mapping the research landscape due to their complex nature, high co-morbidity and varying diagnostic criteria. Undertaking such an effort across 31 countries is further challenged by differences in data collection, healthcare systems, reimbursement rates and clinical practices, as well as cultural and socioeconomic diversity. Using multiple methods to explore the spectrum of MHD research funding activity across Europe, this project aims to develop a broad, high-level perspective to inform priority setting for future research

The incidence of psychotic disorders among migrants and minority ethnic groups in Europe: Findings from the multinational EU-GEI study

BackgroundIn Europe, the incidence of psychotic disorder is high in certain migrant and minority ethnic groups (hence: 'minorities'). However, it is unknown how the incidence pattern for these groups varies within this continent. Our objective was to compare, across sites in France, Italy, Spain, the UK and the Netherlands, the incidence rates for minorities and the incidence rate ratios (IRRs, minorities v. the local reference population).MethodsThe European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study was conducted between 2010 and 2015. We analyzed data on incident cases of non-organic psychosis (International Classification of Diseases, 10th edition, codes F20-F33) from 13 sites.ResultsThe standardized incidence rates for minorities, combined into one category, varied from 12.2 in Valencia to 82.5 per 100 000 in Paris. These rates were generally high at sites with high rates for the reference population, and low at sites with low rates for the reference population. IRRs for minorities (combined into one category) varied from 0.70 (95% CI 0.32-1.53) in Valencia to 2.47 (95% CI 1.66-3.69) in Paris (test for interaction: p = 0.031). At most sites, IRRs were higher for persons from non-Western countries than for those from Western countries, with the highest IRRs for individuals from sub-Saharan Africa (adjusted IRR = 3.23, 95% CI 2.66-3.93).ConclusionsIncidence rates vary by region of origin, region of destination and their combination. This suggests that they are strongly influenced by the social context