UK National Institute of Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health, SLaM and the Institute of Psychiatry at King's College London, Psychiatry Research Trust, Maudsley Charity Research Fund, and th European Community's Seventh Framework Program grant (agreement No. HEALTH-F2-2009-241909 [Project EU-GEI]).

Substance use, medication adherence and outcome one year following a first episode of psychosis ABSTRACT Both substance use and poor medication adherence are associated with poor outcome in psychosis. To clarify the contributions of substance use and poor medication adherence to poor outcome in the year following a first episode of psychosis, 205 patients were evaluated for use of tobacco, alcohol, cannabis and stimulants at their psychosis onset, and in a 1-year follow-up. Data on medication adherence and symptom remission were also collected. Patients had high rates of overall substance use before (37-65%) and after psychosis onset (45-66%). 44% showed poor medication adherence and 55% did not reach remission from psychosis. Nicotine dependence and cannabis use after psychosis onset significantly predicted both poor medication adherence and nonremission, and poor medication adherence mediated the effects of these substances on nonremission. In conclusion, medication adherence lies on the causal pathway between nicotine dependence and cannabis on the one hand and non-remission on the other.

Background Psychosis is a condition influenced by an interaction of environmental and genetic factors. Gene expression studies can capture these interactions; however, studies are usually performed in patients who are in remission. This study uses blood of first episode psychosis patients, in order to characterise deregulated pathways associated with psychosis symptom dimensions. Methods Peripheral blood from 149 healthy controls and 131 first episode psychosis patients was profiled using Illumina HT-12 microarrays. A case/control differential expression analysis was performed, followed by correlation of gene expression with positive and negative syndrome scale (PANSS) scores. Enrichment analyses were performed on the associated gene lists. We test for pathway differences between first episode psychosis patients who qualify for a Schizophrenia diagnosis against those who do not. Results A total of 978 genes were differentially expressed and enriched for pathways associated to immune function and the mitochondria. Using PANSS scores we found that positive symptom severity was correlated with immune function, while negative symptoms correlated with mitochondrial pathways. Conclusions Our results identified gene expression changes correlated with symptom severity and showed that key pathways are modulated by positive and negative symptom dimensions.

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Little is known about hyperprolactinaemia (HPL) in first episode psychosis (FEP) patients. We

Introduction:Psoriasis is a multifactorial chronic infiammatory skin disease that often occurs in patients with overweight or obesity; obesity makes psoriasis less susceptible to therapy and a moderate weight loss improves drug response. Many studies shows connections between obesity and eating disorders, but few studies investigated the link between eating disorders and psoriasis.Objectives:To evaluate the presence of eating disorders and psychopathological traits in patients affected by psoriasis compared with a control population, and correlate this data with different features of cutaneous disease and BMI.Aims:To suggest the importance of a psychological support that could reduce the occurrence of loss of control over food.Methods:We enrolled 100 consecutive psoriatic outpatients and a control group of 100 selected non psoriatic outpatients, matched by BMI to the study group. The assessment battery was composed by the Psoriasis Area and Severity Index (PASI) score, the EDI and SCL-90R.Results:Most of EDI and SCL-90R subscales resulted more altered in psoriatic population compared to the controls (p < .001 for IA and ID, and p < .05 for GSI). Moreover, we noticed an association between the progressive weight gain and the impairment of most of EDI subscales, indicating the presence of an ED in only psoriasis group (p < .01).Conclusion:Psoriasis is associated with psychopathological traits and symptoms commonly associated with eating disorders. A multidisciplinary approach could have an important role to reduce the loss of control over food, to loss weight and to improve the drug response.

IntroductionThe original cognitive-behavioural model of bulimia nervosa (CBT-BN) proposes that specific dysfunctional cognitions and behavioural factors maintain BN, and has provided the basis for the widely used cognitive-behavioural therapy (CBT) of BN. However, Fairburn et al. (2003) noted that among treatment completers with BN, only 40% achieved full remission of the bulimic symptomatology. The enhanced CBT-BN model (CBT-E) proposed by the authors describes how four additional factors (i.e., clinical perfectionism, low self esteem, mood intolerance and interpersonal difficulties) interact with the core psychopathology of BN (i.e., over-evaluation of eating, weight, and shape and their control) to maintain the disorder.AimsThe goal of this study was to examine (a) the validity of the CBT-E model and (b) whether each of the four hypothesized maintenance factors intensifies the core psychopathology-bulimic symptomatology relationship in a clinical sample.MethodsData were analysed from 362 adults seeking treatment for BN (n = 167) or atypical BN (n =195) at four Italian specialized care centres, using latent variable structural equation modeling approach.ResultsBoth the measurement and the structural model were good fits for the data. All four hypothesized factors exacerbated the core psychopathology-bulimic symptomatology relationship. Core psychopathology explained approximately 47.7% of the variance of bulimic symptomatology. The inclusion of the direct effects and interaction terms increased the explained variance of bulimic symptomatology to 64%.ConclusionsOverall, results supported the validity of the CBT-E model and highlighted the importance of assessment and treatment of the four maintenance processes included in the CBT-E model.