title: Low incidence of psychosis in Italy: confirmation from the first epidemiological study in Sicily.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Unità Operativa di Psichiatria, Azienda Ospedaliera Universitaria "P. Giaccone", via del Vespro 129, 90100 Palermo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mulè
authors.affiliation: Sezione di Psichiatria del Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche (BioNeC), Università di Palermo, Via Gaetano La Loggia 1, 90100 Palermo, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Sideli
authors.affiliation: Dipartimento di Scienze Economiche, Aziendali e Statistiche (DSEAS), Università di Palermo, Viale delle Scienze, 90128 Palermo, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Capuccio
authors.affiliation: St. Patricks University Hospital and Trinity College Dublin, Ireland.
authors.forename: P
authors.initials: P
authors.lastname: Fearon
authors.affiliation: Sezione di Psichiatria del Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche (BioNeC), Università di Palermo, Via Gaetano La Loggia 1, 90100 Palermo, Italy.|Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Università degli Studi di Palermo, Piazza delle Cliniche, 3, 90100 Palermo, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Ferraro
authors.affiliation: Division of Psychiatry, UCL, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, United Kingdom.
authors.forename: J B
authors.initials: JB
authors.lastname: Kirkbride
authors.affiliation: Sezione di Psichiatria del Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche (BioNeC), Università di Palermo, Via Gaetano La Loggia 1, 90100 Palermo, Italy.
authors.forename: C
authors.initials: C
authors.lastname: La Cascia
authors.affiliation: Sezione di Psichiatria del Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche (BioNeC), Università di Palermo, Via Gaetano La Loggia 1, 90100 Palermo, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Sartorio
authors.affiliation: Sezione di Psichiatria del Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche (BioNeC), Università di Palermo, Via Gaetano La Loggia 1, 90100 Palermo, Italy.|Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Università degli Studi di Palermo, Piazza delle Cliniche, 3, 90100 Palermo, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Seminerio
authors.affiliation: Department of Psychosis Studies and Biomedical Research, Institute of Psychiatry, King's College, De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom.
authors.forename: G
authors.initials: G
authors.lastname: Tripoli
authors.affiliation: Department of Social, Genetic and Developmental Psychiatry, Institute of Psychiatry King's College, De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Di Forti
authors.affiliation: Unità Operativa di Psichiatria, Azienda Ospedaliera Universitaria "P. Giaccone", via del Vespro 129, 90100 Palermo, Italy.|Sezione di Psichiatria del Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche (BioNeC), Università di Palermo, Via Gaetano La Loggia 1, 90100 Palermo, Italy.
authors.forename: D
authors.initials: D
authors.lastname: La Barbera
authors.affiliation: Department of Psychosis Studies and Biomedical Research, Institute of Psychiatry, King's College, De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom.
authors.forename: R M
authors.initials: RM
authors.lastname: Murray
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000453:epidemiology*; D012559:Schizophrenia / Q000453:epidemiology*; D012802:Sicily / Q000453:epidemiology; D055815:Young Adult
keywords: Incidence; Italy; Psychosis; Schizophrenia