Epidemiology and Psychiatric Sciences

Original Articles

Psychosis Incident Cohort Outcome Study (PICOS). A multisite study of clinical, social and biological characteristics, patterns of care and predictors of outcome in first-episode psychosis. Background, methodology and overview of the patient sample

A. Lasalviaa1 c1, S. Tosatoa1, P. Brambillaa2, M. Bertania1, C. Bonettoa1, D. Cristofaloa1, S. Bissolia1, K. De Santia1, L. Lazzarottoa1, G. Zanattaa1, G. Marrellaa1, R. Mazzoncinia1, M. Zanonia1, N. Garzottoa3, C. Dolcea4, S. Nicolaua5, L. Ramona6, C. Perlinia7, G. Rambaldellia7, M. Bellania7, M. Tansellaa1, M. Ruggeria1 and the PICOS-Veneto Group

a1 Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy

a2 DISM, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy and Scientific Institute IRCCS ‘E. Medea’, Udine, Italy

a3 Department of Mental Health, 1st Psychiatric Service, ULSS 20, Verona, Italy

a4 Department of Mental Health, ULSS 6, Vicenza, Italy

a5 Department of Mental Health, ULSS 22, Isola d/S, VR, Italy

a6 Department of Mental Health, ULSS 10, Portogruaro, VE, Italy

a7 Department of Public Health and Community Medicine, Section of Psychiatry and Inter-University Centre for Behavioural Neurosciences University of Verona, Verona, Italy


Aims. This paper aims at providing an overview of the background, design and initial findings of Psychosis Incident Cohort Outcome Study (PICOS).

Methods. PICOS is a large multi-site population-based study on first-episode psychosis (FEP) patients attending public mental health services in the Veneto region (Italy) over a 3-year period. PICOS has a naturalistic longitudinal design and it includes three different modules addressing, respectively, clinical and social variables, genetics and brain imaging. Its primary aims are to characterize FEP patients in terms of clinical, psychological and social presentation, and to investigate the relative weight of clinical, environmental and biological factors (i.e. genetics and brain structure/functioning) in predicting the outcome of FEP.

Results. An in-depth description of the research methodology is given first. Details on recruitment phase and baseline and follow-up evaluations are then provided. Initial findings relating to patients' baseline assessments are also presented. Future planned analyses are outlined.

Conclusions. Both strengths and limitations of PICOS are discussed in the light of issues not addressed in the current literature on FEP. This study aims at making a substantial contribution to research on FEP patients. It is hoped that the research strategies adopted in PICOS will enhance the convergence of methodologies in ongoing and future studies on FEP.

(Received February 28 2012)

(Revised April 04 2012)

(Accepted April 04 2012)

(Online publication June 15 2012)