This Section of Epidemiology and Psychiatric Sciences regularly appears in each issue of the Journal to describe relevant studies investigating the relationship between neurobiology and psychosocial psychiatry in major psychoses. The aim of these Editorials is to provide a better understanding of the neural basis of psychopathology and clinical features of these disorders, in order to raise new perspectives in every-day clinical practice. Autism spectrum disorders are characterized by core deficits with regard to three domains, i.e. social interaction, communication and repetitive or stereotypic behaviour. It is crucial to develop intervention strategies helping individuals with autism, their caregivers and educators in daily life. For this purpose, virtual reality (VR), i.e. a simulation of the real world based on computer graphics, can be useful as it allows instructors and therapists to offer a safe, repeatable and diversifiable environment during learning. This mini review examines studies that have investigated the use of VR in autism. Key words: autism spectrum disorders, rehabilitation, virtual environment, virtual reality.Autism spectrum disorders (ASDs) are a group of pervasive developmental disorders characterized by core deficits in three domains, i.e. social interaction, communication and repetitive or stereotypic behaviour (American Psychiatric Association, 2000), occurring more often in boys than girls (4:1). There has been a significant increase of ASDs over the past few decades, with an incidence of approximately 4 per 10 000 to 6 per 1000 children (Lasalvia & Tansella 2009;Pejovic Milovancevic et al. 2009;Faras et al. 2010). The causes of autism remain largely unknown, but there is evidence that genetic, neurodevelopmental and environmental factors are involved, alone or in combination, as possible causal or predisposing effects of developing autism (Pensiero et al. 2009). Although the degree of impairment among individuals suffering from autism may vary, the impact on affected individuals and their families is generally life-changing. Most studies of ASDs are focused on epidemiology, genetics and neurobiology, but more intervention research is needed to help individuals with autism, their caregivers and educators. In this context, it is crucial to develop tools for neurocognitive habilitation enabling children with ASDs to increase their ability to perform daily-life activities. A rather promising tool has recently emerged in many domains of rehabilitation, namely virtual reality (VR) (Parsons et al. 2009). VR is a simulation of the real world based on computer graphics and can be used as an educational and therapeutic tool by instructors and therapists to offer children a safe environment for learning. Virtual environments (VEs) simulate the real world as it is or create completely new worlds, and provide experiences that can help patients understand concepts as (Email: marcella.bellani@univr.it or paolo.brambilla@uniud.it)Epidemiology and Psychiatric Sciences (2011), 20, 235-238.

The paradoxical advantage of patients with AN in detail-based body processing may be associated to their tendency to routinely explore body parts as a consequence of their obsessive worries about body appearance.

Patients with anorexia nervosa (AN) suffer from severe disturbances of body perception. It is unclear, however, whether such disturbances are linked to specific alterations in the processing of body configurations with respect to the local processing of body part details. Here, we compared a consecutive sample of 12 AN patients with a group of 12 age-, gender- and education-matched controls using an inversion effect paradigm requiring the visual discrimination of upright and inverted pictures of whole bodies, faces and objects. The AN patients presented selective deficits in the discrimination of upright body stimuli, which requires configural processing. Conversely, patients and controls showed comparable abilities in the discrimination of inverted bodies, which involves only detail-based processing, and in the discrimination of both upright and inverted faces and objects. Importantly, the body inversion effect negatively correlated with the persistence scores at the Temperament and Character Inventory, which evaluates increased tendency to convert a signal of punishment into a signal of reinforcement. These results suggest that the deficits of configural processing in AN patients may be associated with their obsessive worries about body appearance and to the excessive attention to details that characterizes their general perceptual style.

Researchers’ interest have recently moved toward the identification of recurrent psychopathological profiles characterized by concurrent elevations on different behavioural and emotional traits. This new strategy turned to be useful in terms of diagnosis and outcome prediction. We used a person-centred statistical approach to examine whether different groups could be identified in a referred sample and in a general-population sample of children and adolescents, and we investigated their relation to DSM-IV diagnoses. A latent class analysis (LCA) was performed on the Child Behaviour Checklist (CBCL) syndrome scales of the referred sample (N = 1225), of the general-population sample (N = 3418), and of the total sample. Models estimating 1-class through 5-class solutions were compared and agreement in the classification of subjects was evaluated. Chi square analyses, a logistic regression, and a multinomial logistic regression analysis were used to investigate the relations between classes and diagnoses. In the two samples and in the total sample, the best-fitting models were 4-class solutions. The identified classes were Internalizing Problems (15.68%), Severe Dysregulated (7.82%), Attention/Hyperactivity (10.19%), and Low Problems (66.32%). Subsequent analyses indicated a significant relationship between diagnoses and classes as well as a main association between the severe dysregulated class and comorbidity. Our data suggested the presence of four different psychopathological profiles related to different outcomes in terms of psychopathological diagnoses. In particular, our results underline the presence of a profile characterized by severe emotional and behavioural dysregulation that is mostly associated with the presence of multiple diagnosis.

Results showed altered self-body representation in BN, but not BED patients, as the neuropsychological consequences of posterior parietal cortex dysfunctions.

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