First-contact incidence of psychosis in north-eastern Italy: influence of age, gender, immigration and socioeconomic deprivation.
BACKGROUND
Considerable variations in the incidence of psychosis have been observed across countries, in terms of age, gender, immigration status, urbanicity and socioeconomic deprivation.


OBJECTIVE
To evaluate the incidence rate of first-episode psychosis in a large area of north-eastern Italy and the distribution of the above-mentioned risk factors in individuals with psychoses.


METHODS
Epidemiologically based survey. Over a 3-year period individuals with psychosis on first contact with services were identified and diagnosed according to ICD-10 criteria.


RESULTS
In total, 558 individuals with first-episode psychosis were identified during 3,077,555 person-years at risk. The annual incidence rate per 100,000 was 18.1 for all psychoses, 14.3 for non-affective psychoses and 3.8 for affective psychoses. The rate for all psychoses was higher in young people aged 20-29 (incidence rate ratio (IRR) = 4.18, 95% CI 2.77-6.30), immigrants (IRR = 2.26, 95% CI 1.85-2.75) and those living in the most deprived areas (IRR = 2.09, 95% CI 1.54-2.85).


CONCLUSIONS
The incidence rate in our study area was lower than that found in other European and North American studies and provides new insights into the factors that may increase and/or decrease risk for developing psychosis.
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Antonio
A
Lasalvia
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Chiara
C
Bonetto
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Sarah
S
Tosato
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Gioia
G
Zanatta
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Doriana
D
Cristofalo
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Damiano
D
Salazzari
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Lorenza
L
Lazzarotto
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Mariaelena
M
Bertani
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Sarah
S
Bissoli
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Katia
K
De Santi
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Carla
C
Cremonese
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Moreno
M
De Rossi
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Francesco
F
Gardellin
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Luana
L
Ramon
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Maria
M
Zucchetto
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Francesco
F
Amaddeo
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Michele
M
Tansella
Antonio Lasalvia, MD, PhD, Chiara Bonetto, PhD, Sarah Tosato, MD, PhD, Gioia Zanatta, DClinPsy, Doriana Cristofalo, Edu Sci, Damiano Salazzari, Lorenza Lazzarotto, DClinPsy, Mariaelena Bertani, PhD, Sarah Bissoli, PhD, Katia De Santi, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona; Carla Cremonese, MD, Psychiatric Clinic, Department of Neuroscience, University of Padua, Padua; Moreno De Rossi, MD, Department of Mental Health, NHS, Local Health Authority Adria, Rovigo; Francesco Gardellin, MD, Department of Mental Health, NHS, Local Health Authority Vicenza; Luana Ramon, MD, Department of Mental Health, NHS, Local Health Authority Portogruaro, Venezia; Maria Zucchetto, MD, Department of Mental Health, NHS, Local Health Authority Padua; Francesco Amaddeo, MD, PhD, Michele Tansella, MD, Mirella Ruggeri, MD, PhD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy.
Mirella
M
Ruggeri
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D054242:Emigrants and Immigrants / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000453:epidemiology*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D012737:Sex Factors; D012931:Social Environment; D055815:Young Adult