Publications by authors named "Silvana Galderisi"

Article Synopsis
  • Many refugees and asylum seekers experience significant psychological distress due to traumatic events in their home countries, during migration, and upon arrival in host countries like Italy, leading to higher rates of mental disorders compared to the general population.
  • The study focused on a large group of adult refugees and asylum seekers in Campania, aiming to measure the prevalence of psychiatric disorders and understand the impact of various risk factors.
  • Diagnosis involved structured interviews and assessments of socio-demographic factors, migration status, reception center conditions, cognitive function, and past traumas, revealing a complex relationship between these factors and mental health outcomes.
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Academic psychiatry is essential for advancing mental health understanding and treatments. However, women encounter more obstacles hindering their progress in academia than men. This Editorial aims to highlight these obstacles and propose strategies to address them, advocating for a more supportive environment for women psychiatrists' ongoing growth and development.

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Background: Negative symptoms of schizophrenia are correlated with reduction of normal function and lower quality of life. They were newly defined by the NIMH-MATRICS Consensus in 2005, dividing the rating tools to assess them into first-generation scales, developed before the Consensus, and second-generation scales, based on the recently introduced definitions.

Methods: The COnsensus-based Standards for the selection of health Measurement Instrument (COSMIN) guidelines for systematic reviews were used to evaluate the quality of psychometric data of the first-generation scales that cover the 5 negative symptom domains of the NIMHS Consensus: the Scale for the Assessment of Negative Symptoms (SANS), the High Royds Evaluation of Negativity Scale (HEN), and the Negative Symptom Assessment-16 (NSA-16).

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Article Synopsis
  • Researchers tried to create models to predict how well people with first episode psychosis (FEP) would do after treatment, but it was hard to tell if these predictions worked for different groups of patients.
  • They tested these models using patients from two big studies in Europe and found out that while the models were somewhat accurate, they didn't work as well when applied to patients from a different study.
  • The results showed that it’s really important to check and improve these prediction models with independent samples of patients to make them better and more reliable in the future.
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  • Many people with schizophrenia do worse than average on memory and thinking tests, even if they seem fine to others.
  • Problems with thinking can happen before someone shows signs of schizophrenia and can still be present even when they’re feeling better.
  • A group of experts looked at the latest research about how to help people with these thinking problems and made suggestions to improve mental health care.
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The Positive and Negative Syndrome Scale (PANSS) is the most widely used rating scale to assess psychotic symptoms in patients with schizophrenia and other primary psychoses. However, a definitive consensus regarding its dimensional structure remains elusive. The present work aims to determine the number of dimensions of the scale through a network analysis approach in a sample of individuals experiencing first-episode schizophrenia spectrum disorder (FE-SSD) with minimal or no prior exposure to antipsychotic treatment.

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Background: Cognitive impairment (CI) is one of the most prevalent and burdensome consequences of COVID-19 infection, which can persist up to months or even years after remission of the infection. Current guidelines on post-COVID CI are based on available knowledge on treatments used for improving CI in other conditions. The current review aims to provide an updated overview of the existing evidence on the efficacy of treatments for post-COVID CI.

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Psychiatry shares most ethical issues with other branches of medicine, but also faces special challenges. The Code of Ethics of the World Psychiatric Association offers guidance, but many mental health care professionals are unaware of it and the principles it supports. Furthermore, following codes of ethics is not always sufficient to address ethical dilemmas arising from possible clashes among their principles, and from continuing changes in knowledge, culture, attitudes, and socio-economic context.

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Article Synopsis
  • The Cognitive Assessment Interview (CAI) measures cognitive impairment in individuals with schizophrenia and is recognized as a key tool alongside other performance-based measures like the MCCB.
  • Recent findings suggest negative symptoms, social cognition, and functional capacity significantly influence how cognitive impairment affects daily functioning.
  • A study involving 618 participants from Italian psychiatric clinics supports the CAI's validity and highlights the importance of interview-based assessments for understanding schizophrenia's complexities in clinical settings.
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  • The study investigates the link between neuroimaging biomarkers and negative symptoms (NS) and cognitive impairment (CI) in patients with schizophrenia (SCZ).
  • It involves 62 SCZ participants and uses regression analyses to explore the relationship between brain resting-state activity and various disease-related features.
  • Findings indicate different neural markers are associated with neurocognitive deficits and specific negative symptom domains, which could help identify actionable biomarkers for better clinical outcomes.
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  • Schizophrenia significantly reduces life expectancy, but available treatments can help, and personal traits like resilience and coping skills are crucial for recovery.
  • A study examined the genetic factors behind these personal traits in 490 schizophrenia patients, finding links to neuroticism and worry, alongside social influences.
  • The research points to biological mechanisms like hippocampal neurogenesis and specific microRNAs (miR-124 and miR-137) that may be key in understanding resilience and coping in schizophrenia, marking a significant advancement in this field.
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  • - The study examines the drug luvadaxistat, a DAAO inhibitor that increases d-serine levels, aimed at treating negative symptoms of schizophrenia through enhanced NMDAR signaling. - Conducted in a randomized, placebo-controlled format, the INTERACT trial included 256 participants and showed no significant improvement in negative symptoms after 12 weeks, but some cognitive enhancements with the 50 mg dose were noted. - Luvadaxistat was well-tolerated with no new safety concerns, indicating potential for further research, particularly regarding its effects on cognitive impairment in schizophrenia patients.
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Background: Codes of ethics provide guidance to address ethical challenges encountered in clinical practice. The harmonization of global, regional, and national codes of ethics is important to avoid gaps and discrepancies.

Methods: We compare the European Psychiatric Association (EPA) and the World Psychiatric Association (WPA) Codes of Ethics, addressing main key points, similarities, and divergences.

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Despite the functional impact of cognitive deficit in people with psychosis, objective cognitive assessment is not typically part of routine clinical care. This is partly due to the length of traditional assessments and the need for a highly trained administrator. Brief, automated computerised assessments could help to address this issue.

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Approximately 8 % of patients with schizophrenia are diagnosed before age 18, and 18 % experience their first symptoms before age 18. This narrative review explores the management of patients with early-onset schizophrenia (EOS) and childhood-onset schizophrenia (COS) from diagnosis to their transition to adult care settings. Early diagnosis of schizophrenia in children and adolescents is essential for improving outcomes, but delays are common due to overlapping of symptoms with developmental phenomena and other psychiatric conditions, including substance use, and lack of clinicians' awareness.

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The pathophysiology of schizophrenia and bipolar disorder involves a complex interaction between genetic and environmental factors that begins in the early stages of neurodevelopment. Recent advancements in the field of induced pluripotent stem cells (iPSCs) offer a promising tool for understanding the neurobiological alterations involved in these disorders and, potentially, for developing new treatment options. In this review, we summarize the results of iPSC-based research on schizophrenia and bipolar disorder, showing disturbances in neurodevelopmental processes, imbalance in glutamatergic-GABAergic transmission and neuromorphological alterations.

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Background: We examined the course of illness over a 12-month period in a large, international multi-center cohort of people with a first-episode schizophrenia spectrum disorder (FES) in a naturalistic, prospective study (PSYSCAN).

Method: Patients with a first episode of schizophrenia, schizoaffective disorder (depressive type) or schizophreniform disorder were recruited at 16 institutions in Europe, Israel and Australia. Participants (N = 304) received clinical treatment as usual throughout the study.

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Article Synopsis
  • This study examines how various factors like negative symptoms, processing speed, and emotion recognition influence functional outcomes in individuals with schizophrenia.
  • Researchers used different scales and tests to assess symptoms and cognitive abilities in 150 subjects across Europe, analyzing their impact on daily functioning.
  • Findings revealed that negative symptoms, particularly expressive and motivational deficits, significantly mediate the effects of cognitive impairments on real-life functioning, indicating specific pathways for improving outcomes in patients.
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Background: Stakeholders worldwide increasingly acknowledge the need to address coercive practices in mental healthcare. Options have been described and evaluated in several countries, as noted recently in major policy documents from the World Health Organization (WHO) and World Psychiatric Association (WPA). The WHO's QualityRights initiative promotes human rights and quality of care for persons with mental health conditions and psychosocial disabilities.

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Background: Mental disorders that are comorbid with chronic infectious diseases may worsen clinical outcomes and patients' quality of life. We hypothesized that depression and/or anxiety syndromes or symptoms comorbid with human immunodeficiency virus (HIV) or hepatitis B virus (HBV) infection might stem from shared biological mechanisms.

Methods: We conducted a systematic review applying the PRISMA statement by searching into the PubMed, APA PsycInfo, and Scopus databases.

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Background: The conceptualization of negative symptoms (NS) in schizophrenia is still controversial. Recent confirmatory factor-analytic studies suggested that the bi-dimensional model (motivational deficit [MAP] and expressive deficit [EXP]) may not capture the complexity of NS structure, which could be better defined by a five-factor (five NS domains) or a hierarchical model (five NS domains as first-order factors, and MAP and EXP, as second-order factors). A validation of these models is needed to define the structure of NS.

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  • * The study involved 736 participants screened, with 402 completing detailed cognitive and clinical assessments, revealing that those with CI experienced more severe mental health issues and poorer overall functioning compared to those without cognitive impairment.
  • * Additionally, 45% of participants demonstrated cognitive deficits in areas like attention and memory, and worse cognitive functioning was associated with higher LDH blood levels, suggesting the need for regular cognitive assessments and possible training programs for affected individuals.
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