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Low incidence of psychosis in Italy: confirmation from the first epidemiological study in Sicily

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Abstract

Purpose

The incidence of psychotic disorders varies in different geographical areas. As there have been no reports from Southern Italy, this study aimed to determine the incidence rate of first-episode psychosis in Palermo, Sicily.

Methods

All patients, aged 18–65 years, presenting with a first episode of psychosis (FEP) (ICD-10 F20–29, F30–33) to mental health services in Palermo, were recorded over a 3-year period. Incidence rates of psychotic disorders and their 95% confidence intervals (95% CI) were estimated. Poisson regression was applied to estimate the differences in incidence rate ratio (IRR) by age, sex and migrant status.

Results

Two hundred and four FEP participants were identified during the 3 years; 183 (89.7%, males n = 112) participants were native Italians and 21 were migrants (10.3%, males n = 14). The crude incidence of all psychoses was 15.9 (95% CI 13.7–18.1). As predicted, the risk of schizophrenia F20 was higher in males compared to females (adjusted IRR = 1.99, 95% CI 1.36–2.88) and in migrants compared to native Italians (adjusted IRR = 4.02, 95% CI 2.39–6.75).

Conclusions

This study, the first from Sicily, confirms previous findings from Northern Italy that the risk of schizophrenia and other psychoses is much lower in Italian cities than those reported from cities in Northern Europe; the reasons for this disparity may provide important clues to the aetiology of psychosis.

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Acknowledgements

This study was run by the research team of the Section of Psychiatry of the Department of Experimental Biomedicine and Clinical Neuroscience with the contribution of the colleagues working at the mental health services of the Department of Mental Health of Palermo (ASP 6) and at Private Psychiatric Hospitals of Palermo. The study was supported by the AESOP and the Genetics and Psychosis (GAP) study teams of the Institute of Psychiatry, King’s College London. No specific funding has been provided to realize this study. James Kirkbride is supported by a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society (Grant Number: 101272/Z/13/Z). A special acknowledgment is addressed to all the patients who accepted to take part in the study.

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    Authors and Affiliations

    1. Unità Operativa di Psichiatria, Azienda Ospedaliera Universitaria “P. Giaccone”, via del Vespro 129, 90127, Palermo, Italy

      A. Mulè & D. La Barbera

    2. Sezione di Psichiatria del Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche (BioNeC), Università di Palermo, Via Gaetano La Loggia 1, 90100, Palermo, Italy

      L. Sideli, L. Ferraro, C. La Cascia, C. Sartorio, F. Seminerio & D. La Barbera

    3. Dipartimento di Scienze Economiche, Aziendali e Statistiche (DSEAS), Università di Palermo, Viale delle Scienze, 90128, Palermo, Italy

      V. Capuccio

    4. St. Patricks University Hospital, Trinity College Dublin, Dublin, Ireland

      P. Fearon

    5. Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Università degli Studi di Palermo, Piazza delle Cliniche, 3, 90100, Palermo, Italy

      L. Ferraro & F. Seminerio

    6. Division of Psychiatry, UCL, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK

      J. B. Kirkbride

    7. Department of Psychosis Studies, Institute of Psychiatry, King’s College, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK

      G. Tripoli & R. M. Murray

    8. Department of Social, Genetic and Developmental Psychiatry, Institute of Psychiatry, King’s College, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK

      M. Di Forti

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    1. A. Mulè
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    Correspondence to A. Mulè.

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    A. Mulè, L. Sideli, D. La Barbera and R. M. Murray contributed equally to this work.

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    Mulè, A., Sideli, L., Capuccio, V. et al. Low incidence of psychosis in Italy: confirmation from the first epidemiological study in Sicily. Soc Psychiatry Psychiatr Epidemiol 52, 155–162 (2017). https://doi.org/10.1007/s00127-016-1322-4

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    • DOI: https://doi.org/10.1007/s00127-016-1322-4

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