Organizzazione Sociopsichiatrica Cantonale

The clinical high-risk for psychosis (CHR-P) paradigm has been widely applied in youth mental health, yet its prognostic validity in minors remains debated. This study aimed to provide an updated meta-analysis of transition rates to psychosis in children and adolescents at CHR-P, and to assess the influence of baseline antipsychotic (AP) exposure on transition outcomes. We conducted a systematic review and meta-analysis following PRISMA guidelines (PROSPERO CRD420251064505). PubMed/MEDLINE and the Cochrane Library were searched through August 30, 2025. Eligible studies included participants ≤18 years or samples with mean age <18 years, defined CHR-P status with validated instruments, and reported longitudinal data on transition to psychosis. Transition prevalences were pooled using random-effects models. Subgroup analyses evaluated the impact of baseline AP exposure. Thirty-two independent cohorts were included, comprising 2951 CHR-P individuals, almost all in adolescence. Across studies restricted to minors, overall transition converged at ∼16-17%, while broader samples with mean age <18 years but including young adults reached ∼23%, approximating adult CHR-P estimates (∼25%). Baseline AP exposure was consistently associated with a higher risk of transition (risk ratio ≈1.5), supporting its role as a negative prognostic factor. CHR-P criteria demonstrate prognostic validity in developmental populations, with transition rates in adolescents comparable to young adult cohorts and significantly higher than in CHR-P negative adolescents. In line with previous research in adult CHR-P, the need of AP at baseline is substantially associated with an increased risk for transition. Future research should broaden prognostic focus beyond transition alone to capture remission, persistence, and functional outcomes in this vulnerable group.

Subtle distortions of the experience of lived space have long been associated with schizophrenia. Although a body-centric transformation of space is considered an essential component of anomalous subjective experience in schizophrenia, its impact on the 2 major body-centric spatial constructs, that is, personal space (PS) and peripersonal space (PPS), is still not clear. This systematic review and meta-analysis have been set up to: (1) summarize the evidence on putative extensional differences of PS and PPS in schizophrenia as compared with controls, and (2) evaluate the quality and the limitations of available studies on the topic. Four electronic literature databases (MEDLINE, EMBASE, PsychINFO, and CINAHL) were searched with the keywords “Personal space OR Interpersonal distance AND Schizophrenia,” “Peripersonal space AND Schizophrenia” from inception until December 31, 2023, resulting in 15 studies on PS and 5 studies on PPS included in this systematic review. The 12 studies on PS included in the meta-analysis revealed that individuals with a diagnosis of schizophrenia place a larger interpersonal distance from the stimuli than controls, with a moderate effect size in both the fixed-effect model (Hedges’ g = 0.558 [95% confidence interval, CI: 0.445–0.671]; z = 9.67; P < 0.0001) and the random effects model (0.547 [0.294–0.799]; z = 4.77; P = 0.0006). The 5 studies included in the meta-analysis on PPS showed that individuals with a diagnosis of schizophrenia exhibit a narrower PPS than the controls at the fixed-effect (Hedges’ g = 1.043 [95%CI: .739–1.348]; z = 6.72; P < .0001), but not at the random effects model (1.318 [−0.721 to 3.359]; z = 1.79; P = .147). Heterogeneity was substantial in both meta-analyses. Overall, the findings indicate that both body-centered space constructs (PS and PPS) are affected in schizophrenia, with an enlargement PS and a reduction PPS, thereby supporting the distinction of these constructs. These modifications cohere with the subjective transformation of the lived space (aka espace vécu) reported in classical psychopathology and may be promising, neurodevelopmentally grounded, biomarkers of vulnerability to schizophrenia and its spectrum conditions.

Small area analysis is a health services research technique that facilitates geographical comparison of services supply and utilization rates between health service areas (HSAs). HSAs are functionally relevant regions around medical facilities within which most residents undergo treatment. We aimed to identify HSAs for psychiatric outpatient care (HSA-PSY) in Switzerland. We used HSAr, a new and automated methodological approach, and comprehensive psychiatric service use data from insurances to identify HSA-PSY based on travel patterns between patients' residences and service sites. Resulting HSA-PSY were compared geographically, demographically and regarding the use of inpatient and outpatient psychiatric services. We identified 68 HSA-PSY, which were reviewed and validated by local mental health services experts. The population-based rate of inpatient and outpatient service utilization varied considerably between HSA-PSY. Utilization of inpatient and outpatient services tended to be positively associated across HSA-PSY. Wide variation of service use between HSA-PSY can hardly be fully explained by underlying differences in the prevalence or incidence of disorders. Whether other factors such as the amount of services supply did add to the high variation should be addressed in further studies, for which our functional mapping on a small-scale regional level provides a good analytical framework.

BackgroundThe impact of neobladder and urostomy on bladder cancer patient’s health-related quality of life (HR-QoL) is controversial and many issues currently remain under-investigated. Initial studies pointed out that the emotional responses of caregivers might be ‘contagious’, influencing emotional reactions in bladder cancer patients undergoing radical cystectomy.MethodsThree hundred and eighty-two bladder cancer patients (aged M = 67.29 years; SD = 9.23) (16.9% (65) were female and 82.9% (319) were male) and their caregivers were enrolled. Data were collected prospectively: at T0 (1 month before the surgery), at T1 (2 weeks after the surgery, at patient discharge from the hospital) and at T2 (6-month follow-up). At each time point (T0, T1 and T2), a set of questionnaires (EORT QLQ-C30 and emotion thermometer) were given to patients and their caregivers.ResultsAll patients reported a general improvement in the HR-QoL and global health status/QoL from T0 to T2 (p < 0.001). No significant differences were observed between neobladder and urostomy. At T0, the emotional thermometer total scoring in caregivers was positive in relation to HR-QoL (p < 0.001) and negative in relation to the patient’s perception of QoL (p < 0.001) and global health (p < 0.001). Similar trends were observed at T1 and T2.ConclusionsThese results suggest that patients and their caregiver’s emotional reactions to cancer are deep-rooted and strongly interconnected, and they provide innovative insights for the clinical management of bladder cancer patients.

To evaluate outcomes of XEN-augmented Baerveldt drainage device implantation in refractory glaucoma and factors predicting surgical success. All eyes undergoing XEN-augmented Baerveldt for refractory open-angle glaucoma at a tertiary glaucoma centre between January 2016 and November 2017 were retrospectively enrolled. Intraocular pressure (IOP), number of anti-glaucomatous medications and postoperative adverse events (AEs) were analysed for 1year postoperatively. Surgical success was defined as achieving (1) an IOP ≤ 15mmHg or (2) ≤ 18mmHg, with or without (qualified) or without medications (complete). Any subsequent glaucoma surgery was considered failure. Out of 60 eyes enrolled, 12-month data were available for 41 eyes (71.4%). Mean age was 64.7 ± 23.1years (50% female). Following surgery, IOP decreased significantly from a baseline of 29.9 ± 13.2 to 15.2 ± 6.6mmHg (- 49.2%; P < 0.0001) at 12months. Anti-glaucoma medications decreased from 3.0 ± 1.3 to 1.3 ± 0.9. Complete success was achieved by 14.6% of eyes using both the ≤ 15mmHg and the ≤ 18mmHg thresholds, and qualified success was achieved in 43.9% and 48.8%, respectively. Throughout the follow-up period, AEs were observed in 51.2% (hypotony = 24.4%; XEN blockage = 17.1%; displacement of XEN gel stent = 4.9%; hyphema = 4.9%). The 12-month success rate was significantly higher in patients who presented an IOP ≤ 10 mmHg at 1week (58.6%, P = 0.001). Overall, 41.5% of patients required reoperation at 12months (58.8% revision of the surgery; 41.2% transscleral cyclodestruction). XEN-augmented Baerveldt is a safe and moderately effective technique to reduce IOP and anti-glaucoma medications in refractory glaucoma. IOP at 1week seems to be a predictor for surgical success. Nevertheless, a high proportion of patients requires reoperation.

Integrating the psychosocial perspective in oncology is warranted. Here, we introduce a structured psychological intervention, the clinical-care focused psychological interview (CLiC), to address patients’ needs in the relationship with health professionals, clinical pathway and decision-making process. The perceived utility and feasibility of the CLiC were evaluated in a preliminary sample of 30 patients who were candidates to undergo a radical cystectomy at the European Institute of Oncology, Milan, Italy. Patients reported a very high satisfaction with the interview, because it prepared them for their upcoming surgery by gathering more information about their clinical pathway and allowed them to discover the information they still needed. 30% stated that CLiC helped them to reorganise their thoughts and 36.7% understood the role of psychological intervention in the clinical pathway. Only 20% considered the CLiC useful in helping to build their relationship with the clinical staff. Before an invasive surgery such as radical cystectomy, patients’ need for information regarding the upcoming surgery seems to prevail. Knowing the future consequences and adjusting toward the disease could be paramount for patients in facing uncertainty and they might feel that creating a relationship with physicians could be a secondary issue. However, our data show that a structured psychological intervention such as the CLiC interview can collect important information for patients and healthcare professionals to develop real patient-centred care.

Cet article présente le Fil rouge, un outil élaboré au sein d’une plate-forme d’intervenants de la région bruxelloise, et destiné à recueillir et transmettre les informations relatives aux enfants placés. Il est constitué de plusieurs sections : une ligne de vie, un génogramme, un répertoire, une anamnèse et un résumé du travail des intervenants successifs. Il sauvegarde les informations et les événements concernant l’enfant ainsi que ses relations avec sa famille. Trois vignettes illustrent l’utilité du Fil rouge pour les bénéficiaires qui y contribuent et pour les professionnels qui se le transmettent. L’enfant, l’adolescent ou l’adulte ont la possibilité d’y retrouver des éléments nécessaires pour pouvoir comprendre leur histoire et les interventions qui les concernent.