S. Galderisi, ItalyProfessor of Psychiatry at the University of Campania Luigi Vanvitelli, Naples, Italy & Past President of the European Psychiatric Association Department of Psychiatry
Moderator Of 7 Sessions
EPA 2021 Janssen-sponsored satellite symposium online summary:
This symposium will provide delegates with expert perspectives on optimum schizophrenia management under the challenging conditions of the COVID-19 pandemic. The session will examine considerations for maintenance treatment and long-term care, optimisation of the multidisciplinary team approach to schizophrenia care, and balancing caring for both the mental and physical health of patients with schizophrenia. Topics will include the use of telemedicine in schizophrenia management, recommendations for delivering optimum treatment continuity under social distancing conditions, and the pros and cons of monitoring schizophrenia treatment adherence and outcomes in person as well as through alternative monitoring approaches. In addition, the changes in exposure to antipsychotic medication in patients with schizophrenia during the pandemic will be discussed.
This will be a highly engaging symposium, offering a multitude of fresh perspectives on the current hot topics in schizophrenia management and providing the virtual audience with the opportunity to further benefit from additional insights delivered during our expert faculty discussion.
Educational financial support is provided by Janssen.
Cognitive dysfunctions represent a core feature of schizophrenia, are present at any stage of the disease and also in subjects at high risk for psychosis (UHR), and have a significant impact on subject’s psychosocial functioning. Pharmacological treatment is modestly effective on cognitive dimension while there is considerable evidence of the efficacy of cognitive remediation interventions on cognition and functioning of patients with schizophrenia. The Symposium has the aim of updating knowledge about the effectiveness and applicability of cognitive remediation techniques in schizophrenia, with a focus also on new developments and technologies. In particular: - will be presented a systematic review on the factors and ingredients influencing response to cognitive remediation in schizophrenia; will be discussed the applicability of cognitive remediation programs in UHR subjects and their effectiveness in preventing transition to psychosis; - will be discussed the biological signatures and effects of cognitive remediation, as revealed especially by neuroimaging techniques; - finally, a specific lecture will address the present and future developments of cognitive remediation for psychoses, focusing also on programs using new technologies, and discussing promises and limitations of the new approaches in the digital era.
Presenter Of 13 Presentations
Welcome and introduction
LIVE Q&A- Full faculty discussion
LIVE: Closing remarks
ECP0024 - Precision Medicine in Psychosis: Translating Findings from Research into Clinical Practice
Precision medicine is “an emerging approach for treatment and prevention that takes into account each person’s variability in genes, environment, and lifestyle” . The terminology is increasingly used in psychiatry, and especially in research relevant to the prediction of psychosis onset, response to treatment and functional outcome. While this is an important step-forward for the discipline, at this stage it is very important to promote the translation of research findings into clinical practice, as much as possible.
Nowadays the availability of machine learning and artificial intelligence tools, together with advances in data storage and data security, enable the integration of neuroimaging, biological, clinical and cognitive data.
By overcoming current limitations in multiple domain data analysis these tools may lead to the identification of reliable diagnostic, prognostic and therapeutic markers in routine clinical care, as well as to the prediction of clinically meaningful outcomes (e.g., psychosis onset, symptomatic and functional outcome, and treatment response).
Precision medicine in psychiatry is a developing science, deserving further large-scale research, translational approaches and refinement that, hopefully, will soon be an integral part of every-day clinical practice. However, challenges in pursuing this strategy should not be underestimated, and efforts should be made to constantly advocate for more investments in human and financial resources in psychiatry, and to concentrate on the use of widely available and not too expensive and time-consuming methods.
1Toward Precision Medicine. Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease. Washington, DC: National Academies Press; 2011.
S0141 - Predictors of Real-life Functioning in Subjects with Schizophrenia: A 4-year Follow-up Study
In a cross-sectional study, the Italian Network for Research on Psychoses (INReP) found that variables relevant to the disease, personal resources and social context explain 53.8% of real-life functioning variance in a large sample of community dwelling people with schizophrenia.
In a longitudinal study, the INReP aimed to identify baseline predictors of main domains of real-life functioning, i.e. work skills, interpersonal relationships and everyday life skills, at 4-year follow-up.
We assessed psychopathology, social and non-social cognition, functional capacity, personal resources, and context-related factors, as well as real-life functioning as the main outcome. We used structural equation modeling (SEM) and latent change score (LCS) model to identify predictors of real-life functioning domains at follow-up and changes from baseline in the same domains.
Six-hundred-eighteen subjects took part in the study. Neurocognition predicted everyday life and work skills; avolition predicted interpersonal relationships; positive symptoms work skills, and social cognition work skills and interpersonal functioning. Higher neurocognitive abilities predicted the improvement of everyday life and work skills, as well as of social cognition and functional capacity; better baseline social cognition predicted the improvement of work skills and interpersonal functioning, and better baseline everyday life skills predicted the improvement of work skills.
Several variables which predict important aspects of functional outcome of people with schizophrenia are not routinely assessed and are not systematically targeted by intervention programs in community mental health services. A larger dissemination of practices such as cognitive training and personalized psychosocial interventions should be promoted in mental health care.