International Conference on Early Psychosis – Speaker: Nella Lo Cascio, Alice Masillo

17-19 November 2014 - Tokyo, Japan - 9th International Conference on Early Psychosis -  Oral Session 12 - Tuesday, November 18, 4:30 - 5:55 pm, Fuji

Self-Disturbances in Early Psychosis
Chair: Barnaby Nelson, University of Melbourne
Co-Chair: Marco Armando, Sapienza University of Rome
Speakers: Nella Lo Cascio, Alice Masillo

Speaker Nella Lo Cascio:
Assessment of Self Disturbances in High Risk Adolescents and Clinical Controls: Preliminary Findings from a Multi-Center Psychosis Prevention Program
N Lo Cascio1,2, E Monducci1,2, G Colafrancesco3, M Armando2, C Dario1, M Patanè1, N Girardi1, C Battaglia5, C Margarita3, R Saba1, A Raballo4, P Fiori Nastro1; 1Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy, 2Department of Neurosciences and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy, 3Pediatrics and pediatric Neuropsychiatry, Sapienza University of Rome, Rome, Italy, 4Department of Mental Health, AUSL di Reggio Emilia, Reggio Emilia, Italy, 5Institute of Psychiatry and Psychology, Catholic University Medical School, Rome, Italy., 6
Background Two sets of high risk criteria are commonly used in the early detection of psychosis: the Ultra-High Risk (UHR) and the Cognitive Disturbances (COGDIS) criteria. Besides these, Parnas and colleagues have developed the Examination of Anomalous Self-Experience (EASE) for the assessment of Self-Disturbances (SD), which are considered a specific subjective phenotype of schizophrenia. Methods This is a multi-center study. The sample consists to date of 79 non-psychotic adolescents aged 14-18. The following instruments were administered: 1) The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version; 2) The Structured Interview for Prodromal Syndromes; 3) The Schizophrenia Proneness Instrument – Child and Youth version; 4) The EASE; 5) The Global Functioning Role and Social Scales. Data were analyzed using non-parametric tests. Results 48 subjects were classified at High Risk (HR) for psychosis, according to UHR or COGDIS criteria; 31 subjects were classified as clinical controls (CC). Compared to CC, HR had higher total EASE scores (10.1 ± 4.8 vs. 5.6 ± 4.1, p = 0.001), as well as higher domain scores of “Cognition and Stream of Consciousness” (4.3 ± 2.5 vs. 2.1 ± 2.0, p = 0.001), “Self-Awareness” (4.1 ± 2.8 vs. 2.8 ± 2.3, p = 0.040) and “Presence and Existential Reorientation” (0.6 ± 1.0 vs. 0.1 ± 0.4, p = 0.009). No correlations were found between SD and Global Functioning scores. Discussion SD seem to be confirmed as a specific subjective phenotype of schizophrenia-spectrum disorders. Thus, the EASE may be a valid early detection instrument.

Speaker Alice Masillo:
Interpersonal sensitivity and functioning impairment in the At Risk Syndrome for Psychosis
A. Masillo1, L. Valmaggia2,3, R. Saba1, M. Brandizzi1, J.F. Lindau4, M. Curto4, A. Stefanelli4, F. Narilli1, D. DiPietro5, M. D'Alema5, P. Girardi4, P. Fiori-Nastro1; 1Department of Neurology and Psychiatry, Sapienza University of Rome, Faculty of Medicine and Odontology, Rome, Italy, 2King's College London, Institute of Psychiatry, 3South London and Maudsley NHS Trust, 4Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy, 5Community Mental Health Service, ASL Rome H, Rome, Italy, 6
Background A personality trait that often elicits poor and uneasy interpersonal relationships is interpersonal sensitivity. The aim of the present study was to explore the relationship between interpersonal sensitivity and psychosocial functioning in the Attenuated Psychosis Syndrome (APS). Method A total sample of 147 adolescents and young adult who were help-seeking for emerging mental health problems participated to the study. The sample was divided into two groups: 39 APS who scored 18 or over on the Prodromal Questionnaire (PQ) and met criteria for the Structured Interview for Prodromal Symptoms (SIPS), and 108 Negative Screening (NS) who scored 17 or less on PQ. The whole sample completed the Interpersonal Sensitivity Measure (IPSM), the Global Functioning: Social and Role Scale (GF:SS; GF:RS) and the Global Assessment of Functioning scale (GAF). Results Individuals with APS showed higher IPSM scores and lower GF:SS, GF:RS and GAF scores than NS participants. A statistically significant correlation between interpersonal sensitivity and psychosocial functioning impairment was found among both groups. Conclusion This study suggests interpersonal sensitivity was strongly associated with social functioning impairment. Considering that psychosocial functioning impairment was found to be associated with considerably decreased subjective quality of life within people with APS, detecting and treating subjective psychopathological aspects (i.e. interpersonal sensitivity) associated with it seems to be an importnt therapeutic target for APS.

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