Efficacy of LAI in first episode psychosis: an observational study--clinical reports.

The use of antipsychotics, especially second generation antipsychotics, represents the milestone treatment of "first episode of psychosis" (FEP). Although prodromal symptoms of psychosis have long been recognized, the clinical management of psychotic disorders conventionally begins at the first episode of frank psychosis, as it is well acknowledged that "duration of untreated psychosis" (DUP) is one of the main factor that negatively affects prognosis: a longer DUP is highly correlated to reduced response to treatment, poor clinical and social outcomes, and an overall worst prognosis. Long-acting injectable (LAI) formulations of antipsychotics have traditionally been used for those patients with psychosis with the most severe symptoms, poorest compliance, most hospitalizations and poorest outcomes; moreover it seems that psychiatrists tend to prescribe LAI at the latter stages of the disease. We retrospectively collected clinical and sociodemographic data regarding patients consecutively presenting with symptoms of FEP attending the Community Mental Health Service (CMHS) in Foggia from 1st June 2014 to 31st May 2015. We selected patients who attended the CMHS in Foggia with symptoms of FEP. Different scales were administered to assess symptoms severity, quality of life, side effects, adherence, and overall functionality. In our sample LAI treatment was found to be effective in treating symptoms associated to FEP, improved quality of life and it was associated with a clinically irrelevant incidence of extrapyramidal side effect. Considering that achieving a full symptoms remission in people affected by FEP is associated to better outcomes, and that DUP is associated to poor prognosis, LAIs could play an important role in improving overall recovery.

Language proficiency among hospitalized immigrant psychiatric patients in Italy.

BACKGROUND: and aim: Lack of cultural adaptation may risk or worsen mental illness among immigrants, and interfere with assessment and treatment. Language proficiency (LP) seems essential for access to foreign environments, and the limited research concerning its effects on mental health care encouraged this preliminary study. METHODS: We reviewed clinical records of all immigrant psychiatric patients hospitalized at the University of Foggia in 2004-09 (N = 85), and compared characteristics of patients with adequate versus inadequate LP. RESULTS: Subjects (44 men, 41 women; aged 35.7±10.0 years) represented 3.62±0.94% of all hospitalizations in six years. (2004-09). Most (60.0%) had emigrated from other European countries. Many were diagnosed with a DSM-IV unspecified psychosis (40.0%) or adjustment disorder (18.8%), and 45.9% were in first-lifetime episodes. Average comprehension and spoken LP was considered adequate in 62.4% and inadequate in 37.6%. In multivariate modelling, adequate LP was more prevalent among women, emigration from another European country, receiving more psychotropic drugs at hospitalization, and having entered Italy legally. CONCLUSION: Findings support an expected importance of LP among immigrant psychiatric inpatients, and encourage language assessment and training as part of the comprehensive support of such patients, especially men.