[First episode psychoses: psychosocial, interpersonal and cognitive bases for a therapeutic approach]. / Le psicosi all'esordio: le basi psicosociali, interpersonali e cognitive per un razionale approccio terapeutico.

The occurrence of psychotic symptoms in first episode psychoses is the ultimate stage of a series of behavioural, cognitive and psychosocial signs. Among these, only a small set are pathognomonics, but more importantly, they continue to operate and to modify the clinical picture. The instability of diagnosis and outcome require a large series of multimodal and atheoretical treatment approaches. Interventions should be flexible, acceptable, intrinsically effective and evidence based. Clinical and therapeutic decisional algorithms will be presented to be adopted in mental health services for people at first episode psychoses.

[Efficacy of adjunctive donepezil for cognitive impairments in patients with schizophrenia]. / Studio dell'efficacia del donepezil sulle funzioni cognitive nel trattamento farmacologico di pazienti affetti da schizofrenia.

Schizophrenia generally manifests cognitive disorders of subjects affected by this illness. Acetylcholine is the main neurotrasmettitor involved in the modulation of cognitive processes as attention, memory and executive functions. The aim of our study is to examine the effects of anticholinesterasic drugs in addiction to atypical antipsychotics on cognitive functions in subjects with schizophrenia. Participant to the study 14 subjects affected by schizophrenia. Subjects have been divided in two sub-groups on the grounds of pharmachological treatment used. A first group (N= 8) it's been treated only with risperidone (monotherapy group); the second one (N=7) it's been treated with donepezil in addition to risperidone (donepezil+ risperidone group). The group treated with donepezil + risperidone evidenced, after 3 and 6 months, statistically significant improvements in attention, in executive functions and in understanding first order Theory of Mind. Our findings are in agreement with those reported by MacEwan et al. (2001). Even if preliminary, our results prove the effectiveness of using anticholinesterasics drugs in addition to atypical antipsychotic treatment, especially in improving attentive functioning.

[Social cognition and atypical antipsychotic agents in the treatment of persons with schizophrenia: preliminary data from a naturalistic study]. / Cognizione sociale ed antipsicotici atipici nel trattamento di persone affette da schizofrenia: dati preliminari da uno studio naturalistico.

Schizophrenia is a chronic disorder that begins in adolescence or in early adulthood. In schizophrenic disorder there are relevant deficits in social interaction. The aim of this study was to evaluate the efficacy of atypical antipsychotic drugs compared to a conventional antipsychotic in the treatment of psychotic symptoms and on cognitive functions of a group of people affected by schizophrenia. Effects of novel antipsychotic drugs on social functioning improvement, regarded as improvement in the ability to represent mental states, were thoroughly assessed. Our study was conducted in the form of naturalistic observation of a sample of 45 people affected by schizophrenia treated with haloperidol, clozapine and risperidone. Our results show that after one year of treatment there were significant positive results in social competence abilities in the group of people being treated with risperidone. Theses results may have a relevant impact on the improvement of quality of life in people affected by schizophrenia.