People with severe mental illness (SMI) -schizophrenia, bipolar disorder and major depressive disorder -appear at risk for cardiovascular disease (CVD), but a comprehensive meta-analysis is lacking. We conducted a large-scale meta-analysis assessing the prevalence and incidence of CVD; coronary heart disease; stroke, transient ischemic attack or cerebrovascular disease; congestive heart failure; peripheral vascular disease; and CVD-related death in SMI patients (N53,211,768) versus controls (N5113,383,368) (92 studies). The pooled CVD prevalence in SMI patients (mean age 50 years) was 9.9% (95% CI: 7.4-13.3). Adjusting for a median of seven confounders, patients had significantly higher odds of CVD versus controls in cross-sectional studies (odds ratio, OR51.53, 95% CI: 1.27-1.83; 11 studies), and higher odds of coronary heart disease (OR51.51, 95% CI: 1.47-1.55) and cerebrovascular disease (OR51.42, 95% CI: 1.21-1.66). People with major depressive disorder were at increased risk for coronary heart disease, while those with schizophrenia were at increased risk for coronary heart disease, cerebrovascular disease and congestive heart failure. Cumulative CVD incidence in SMI patients was 3.6% (95% CI: 2.7-5.3) during a median follow-up of 8.4 years (range 1.8-30.0). Adjusting for a median of six confounders, SMI patients had significantly higher CVD incidence than controls in longitudinal studies (hazard ratio, HR51.78, 95% CI: 1.60-1.98; 31 studies). The incidence was also higher for coronary heart disease (HR51.54, 95% CI: 1.30-1.82), cerebrovascular disease (HR51.64, 95% CI: 1.26-2.14), congestive heart failure (HR52.10, 95% CI: 1.64-2.70), and CVDrelated death (HR51.85, 95% CI: 1.53-2.24). People with major depressive disorder, bipolar disorder and schizophrenia were all at increased risk of CVD-related death versus controls. CVD incidence increased with antipsychotic use (p50.008), higher body mass index (p50.008) and higher baseline CVD prevalence (p50.03) in patients vs. controls. Moreover, CVD prevalence (p50.007), but not CVD incidence (p50.21), increased in more recently conducted studies. This large-scale meta-analysis confirms that SMI patients have significantly increased risk of CVD and CVD-related mortality, and that elevated body mass index, antipsychotic use, and CVD screening and management require urgent clinical attention.Key words: Cardiovascular disease, severe mental illness, schizophrenia, bipolar disorder, major depression, coronary heart disease, cerebrovascular disease, congestive heart failure, premature mortality (World Psychiatry 2017;16:163-180) People with severe mental illness (SMI) -including schizophrenia, bipolar disorder, major depressive disorder, and their related spectrum disorders -have a life expectancy shortened of 10-17.5 years compared to the general population 1,2 . While suicide explains some of this reduced life expectancy 3 , it is now established that physical diseases account for the overwhelming majority of premature mortality 4,5 . Among physical conditions, c...

A higher number of diagnoses of EDs were found in sexual minority women, with a symptomatology characterized by higher occurrence of binge eating and purging, as well as lower body dissatisfaction and drive for thinness, compared with heterosexual peers.

The relationships of personal resources with symptom severity and psychosocial functioning have never been tested systematically in a large sample of people with schizophrenia. We applied structural equation models to a sample of 921 patients with schizophrenia collected in a nationwide Italian study, with the aim to identify, among a large set of personal resources, those that may have an association with symptom severity or psychosocial functioning. Several relevant demographic and clinical variables were considered concurrently. Poor service engagement and poor recovery style, as well as older age and younger age at onset, were related to greater symptom severity and poorer social functioning. Higher resilience and higher education were related to better social functioning only. Poor problem-focused coping and internalized stigma, as well as male gender and depression, were related to symptom severity only. The explored variables showed distinctive and partially independent associations with symptom severity and psychosocial functioning. A deeper understanding of these relationships may inform treatment decisions.

In our study, both WS and WLS were associated with baseline "core" clinical variables and provided complementary abilities to predict weight gain and remission at the end of treatment. If replicated, our data suggest the importance of considering both WS and WLS as useful clinical variables in the baseline assessment of ED.

Results remained unaltered when investigating recessive and dominant models. Conclusions 5HTTLPR does not seem to be associated with ED in general, or with AN or BN in particular. Future studies in ED should explore the role of ethnicity and psychiatric comorbidity as a possible source of bias.

Meta-analysing data results from 11 studies and 7225 subjects show that COMT Val158Met polymorphism is not associated with EDs. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Introduction and aimsIn this study, we aim to assess the role of weight suppression (WS) in eating disorders, not only from a quantitative point of view but also assessing the speed of the weight loss by using a new parameter: the weight loss rate (WLR). We analysed the role of these two indexes in different eating disorders domains, considering both eating behaviours and outcome profiles.MethodsThe sample consisted of 414 patients, including 62 with AN binge purge subtype (ANBP), 146 with AN restrictive subtype (ANR) and 206 with bulimia nervosa (BN). Data about response to treatment were available for a subsample of 201 patients. A cross-sectional design was used for the clinical symptoms detected during the initial assessment and a longitudinal design was adopted for the response to treatment analysis.ResultsNo significant relationship emerged between both WS and WLR and variables collected at baseline assessment. We observed, on the contrary, a significant association between WS and weight gain at the end of treatment. High WLR predicted remission of binge eating and compensatory behavior in BN patients. We further analyzed our data to identify threshold values of both WS and WLR of clinical utility.ConclusionsThe role of WS and WLR as predictive factors in the outcome of eating disorders is of great interest and these initial results remark the usefulness of collecting these data during the initial assessment in order to plan a tailored therapeutic intervention.Disclosure of interestThe authors have not supplied their declaration of competing interest.

<p>Italy is one of the countries most exposed to hydrogeological risk in Europe. From the hydrological point of view, alluvial phenomena and rainfall-induced landslides have a common origin, since both of them are caused by intense surface runoff causing slope instability or water overflow in the drainage network. In particular, the territory of central Italy has a complex orography, where heterogeneous basins with different areas co-exist. Vast basins such as that of the Tiber, are found in geographical areas contiguous to minor hydrographic basins, which are mainly located along the eastern slope of the Apennines. Due to this complexity of the landscape, the territorial response to precipitation can be different and alluvial phenomena can be the result of different processes, with the precipitation as a common denominator. Floods or flash floods, but also rainfall-triggered landslides represent the main effects at the ground, due to intense or persistent rains. In general, river floods are considered more predictable than flash floods, since the latter are linked to very localized rain events, concentrated over a short period of time. The predictability of landslides is associated with attentive monitoring, based on the definition of rainfall thresholds.In this work, the hydrological model developed by Cetemps (CHyM) is applied for the simulation and detection of areas subjected to hydrological stress of a large geographical domain, which includes all of Central Italy, during diverse severe weather event impacting Central Italy in the recent years. We propose the validation of three different stress indices on a geographical area of ​​about 65 500 km2, including basins of very different sizes and characterized by heterogeneous substrates. The main purpose is to present a unique tool for the forecast on a regional scale of hydrogeological stresses induced by precipitation. The identification of stress conditions is given through the use of indices, able to detect areas affected by floods, flash floods and landslides, also providing a key to discriminate and classify these three different phenomena.</p>