Systematic review of current observational evidence suggests that exposure to first-generation and second-generation AP drugs is associated with an increased risk of pneumonia. The present systematic review expands previous knowledge by showing that the increased risk not only applies to elderly individuals but also to younger patients. The information about the risk of pneumonia for individual compounds is still very limited.

Beyond pain: can antidepressants improve depressive symptoms and quality of life in patients with neuropathic pain? Background Neuropathic pain, defined by the lnternational Association for the Study of Pain (IASP)as "pain arising as a direct consequence of a lesion or disease affecting the somatosensory system" [42], is a complex and potentially disabling condition, considered as a separate nosological entity despite the large variety of etiologic factors implied [19].Neuropathic pain secondary to medical conditions is a largely studied, yet difficult to treat phenomenon, affecting a large population of patients and burdened by both physical and psychosocial consequences. Recent studies have indeed pointed out that severe pain is one of the main predictors of depression, anxiety and low quality of life in patients with such chronic conditions, including for instance diabetes, spinal cord injuries, and cancer [57,76,84].Neuropathic pain shares with depression and with other neuropsychiatric disorders a multiplicity of neurotransmitters potentially involved in its pathophysiology and phenomenology [6,49]. Indeed, recent studies suggest that chronic stress, including stress-related psychiatric disorders, exacerbates neuropathic pain via the integration of stress-affect-related information with nociceptive information in the amygdala [48,91]. This might partially explain the high levels of anxious and depressive symptoms occurring in this population of patients [10,12,13,14,26,65,68,93]; symptoms which in turn play a key role on the personal experience of pain and, in general, on quality of life, thus complicating and aggravating the burden associate with this illness [35].Neuropathic pain and depression, furthermore, share some relevant principles of treatment, as conventional analgesics used in nociceptive pain are usually ineffective in alleviating neuropathic pain, while the use of antidepressants has been supported by evidence of efficacy. As a result, based on randomized clinical trials, certain

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Aim To examine the incidence of with first‐episode psychosis (FEP) in the Integrated Department of Mental Health and Pathological Addictions in Ferrara, Italy, and to examine the association between the Duration of Untreated Psychosis (DUP) and the clinical course. Methods Participants recruited in 2013–2019 were assessed with the Health of the Nation Outcome Scale (HoNOS) every 6 months for 24 months. Hierarchical growth models analysed changes of global severity (HoNOS total scores) and symptom dimensions. Regression modelled factors associated with remission (HoNOS < 8) and clinical improvement (<12). Results The incidence of FEP was 21.5 (95%CI: 21.2–21.9) cases per 100 000 person year. Among participants (n = 86, mean age 23, 76% males), baseline HoNOS scores were higher for those with a longer DUP. More than half subjects reached clinical remission (61.6%) or improvement (82.6%), while very few (2.3%) were re‐hospitalized. HoNOS total scores decayed with a mixed linear/quadratic trend, with a slower decay among migrants. A longer DUP was associated with reduced improvements of positive symptoms and lower likelihood of clinical improvement (OR: 0.84; 95%CI: 0.73–0.96). Conclusions Patients from the FEP program of Ferrara reached good clinical outcomes. Nonetheless, individuals with a longer DUP may need additional clinical attention. Systematic monitoring of clinical outcomes may be an optimal strategy to improve the outcomes of FEP in the real world.

IntroductionThe screen for cognitive impairment in psychiatry (SCIP) is a brief, accessible scale designed for detecting cognitive deficits in psychiatric disorders.ObjectivesThe objective of this study is to test the SCIP's validity as a cognitive test by comparison with standard neuropsychological scale using the Pearson's correlation.Aims Test the convergent and discriminant validity of the SCIP within the Italian SCIP validation project.MethodsPatients between 18 and 65 years who are in a stable phase of the disease, diagnosed with schizophrenia, schizoaffective disorder or bipolar I disorder were enrolled in this study, from the community mental health department of Ferrara.ResultsThe tests were administered to 110 patients (mean age: 45 ± 11,4) and to 86 controls (mean age: 35 ± 12,6) of both sex. SCIP presents high correlation with the R-BANS total score (P < 0.01) and the subscales (verbal learning test-immediate, working memory, verbal fluency test, verbal learning test-delayed, processing speed test, P < 0.01). There are significant differences (P < 0.01) in all SCIP dimensions between patient and control group (Table 1).ConclusionsOur analysis confirm the results of the English, French and Spanish version of the SCIP regarding convergent and discriminant validity. The SCIP represents a valid, simple and brief screening tool for the cognitive evaluation of patients with schizophrenia-spectrum disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.