The Precision Psychiatry. An Individualized Approach to the Diseases.

The Precision Psychiatry is a new emergent topic in Psychiatry, and is "an approach for treatment and prevention that takes into account each person's variability in genes, environment, and lifestyle". It promises to be even more transformative than in other fields of medicine, because the psychiatry has not yet benefited from the advanced diagnostic and therapeutic technologies that now form an integral part of other clinical specialties. It may be an epistemological change in the field of psychiatry. This paper briefly highlights the story, the features, and the future of the Precision Psychiatry. Indeed, this approach is becoming a reality with the availability of massive data (derived from physiological recordings, brain imaging, 'omics' biomarkers, environmental exposures, self-reported experience).

Assessing the critical issues of atypical antipsychotics in schizophrenic inpatients.

Antipsychotics are effective in reducing positive and disorganization symptoms of schizophrenia. Although SGAs initially all were believed to be more efficacious and tolerable than FGAs, several data show that the SGAs are no more effective than FGAs. In clinical practice, frequent switching of antipsychotic medications is widespread for lack of efficacy, adverse side effects, and partial or not-compliance response. This study suggested that most clinically stable inpatients with schizophrenia maintain their remission states after being switched to another atypical antipsychotic; but that at the end (after 20 years) of the observation period of our study, 11.54% of the patients assumed again typical antipsychotics (haloperidol).

Neurocognitive management of the primary negative symptoms of schizophrenia: a role of atypical antipsychotics.

Patients with schizophrenia have profound and disabling cognitive deficits while negative symptoms represent a separate symptom domain, with respect to depression, neurocognition, and social cognition. Particularly, primary negative symptoms of schizophrenia represent a diagnostic and therapeutic challenge, In this study we try to evaluate the cognitive symptoms in 51 primary negative schizophrenic inpatients by the administration of simple, fast and understandable scales (MMSE, DSST, EpiTrack, PANSS cognitive factor). We also evaluate the correlation with some SGAs (aripiprazole, quetiapine, olanzapine, paliperidone). Our results support the evidence of the use of simple, rapid and acceptable scales for cognitive evaluation in clinical practice. Overall data indicate no statistically significant variations of the negative symptomatology in all the examined sample, although a reduction of the statistical averages in each group is observed (paliperidone and olanzapine, particularly).

Psychiatric caregiver stress: clinical implications of compassion fatigue.

The capacity to work productively is a key component of health and emotional well-being. People who work in health care can be exposed to the fatigue of care. Compassion fatigue has been described as an occupational hazard specific to clinical work related severe emotional distress. In our study, we have evaluated compassion fatigue in a mental health group (47 psychiatric staff) and its relationship with inpatients (237 inpatients) affected by some psychiatric disorders. At baseline, the more significant data indicate a high percentage of Job Burnout and Compassion Fatigue in psychiatric nurses (respectively, 39.28%, 28.57%). Significant Compassion Fatigue percentage is present also in psychologist group (36.36%). Finally, in psychiatrists, the exposure to patients increased vicarious trauma (28.57%), but not job burnout. After a year of participation in Balint Groups, the psychiatric staff presented an overall reduction in total mean score in any administered scale (CBI: p<0.0000045; sCFs: (Vicarious Trauma: p<0.0288; Job Burnout: p<0.000001)). Thus, compassion fatigue causes concern among mental health professionals, and Balint Groups may represent a therapeutic strategy to help health professionals to face difficulties in challenging work environments.