Introduction: From January 2013, the Departments of Mental Health (DMHs) in
Emilia-Romagna region (Northern Italy) developed specialized care protocols for early
intervention in psychosis. Within this common organizational context, the Parma DMH
first created the "Parma At-Risk Mental States" (PARMS) program as a diffused
("liquid") service for early detection and intervention for individuals at "Clinical High
Risk for Psychosis" (CHR-P). The aims of this presentation were: (1) to carefully
describe the PARMS structural organization and its development over time, (2) to
discuss the subsequent implementation of CHR-P services in the other regional DMHs,
and (3) to examine specific process and outcome indicators across 10 years of clinical activity.
Methods: All participants were adolescent and young adult help-seekers (aged 12-25
years) at CHR-P in accordance with well-defined psychometric criteria (CAARMS).
The program included a 2-year comprehensive treatment package combining
psychosocial interventions (i.e., individual psychotherapy, psychoeducational sessions
for family members, and a recovery- oriented case management), together with
pharmacological therapy (where appropriate).
Results: At entry, 180 CHR-P individuals were provided with our dedicated protocol of
care. Specifically, 15% of them dropped out across the follow-up. The "Duration of
Untreated Illness" (DUI) overall decreased over time. Most of them had "Attenuated
Psychotic Symptoms" (75.1%). The most common DSM-5 diagnoses were anxiousdepressive
disorders, personality disorders (especially schizotypal and borderline
personality disorder), and brief psychotic disorder. Along the follow-up period, there
was a statistically significant improvement in several clinical and functioning outcomes
scales (i.e., CAARMS, PANSS, GAF, and HoNOS scores).
Conclusions: A specialized, evidence-based care protocol for CHR-P individuals within
Italian adult and child/adolescent psychiatric services is feasible and lead to
improvement in clinical and functioning outcomes. This also allows CHR-P adolescents
to reduce the high risk of falling through the child/adult service gap.