It has been reported that abnormal experiences could be common in the general “healthy” population, with the vast majority of individuals never proceeding to manifest a frank mental disorder.

This study aimed to quantify subthreshold psychiatric symptoms in the general population.

The protocol included clinicodemographic data and a mental symptoms questionnaire, and additionally, the CES-D, STAI-S, RASS, and the GloDiS to assess depression, anxiety, suicidality, and functional impairment, respectively. The data were collected online and anonymously from 1504 persons (75.66% females; 23.73% males). Descriptive statistics, risk ratios, and factor analysis were utilized.

Clinical depression was present in approximately 10%, any somatic disorder in 20.21% (9.90% both), and a history of any mental disorder was present in 42.75%. The healthy individuals (46.94% of the study sample) were experiencing distress (8.6%) and subthreshold mental symptoms (attenuated psychotic, schizotypal distrust, emotional lability, conformity, and interpersonal and social functioning). Attenuated psychotic symptoms are present in almost 10%, and the conversion rate to any kind of psychosis was probably 0.5% per year until the age of 40, with one-third of these persons eventually converting. Beyond the age of 40, no conversion to psychosis seems to occur. All aspects of symptoms correlated weakly but significantly with aspects of functional impairment.

The results of the current study are in accord with the literature and suggest that a significant number of persons in the general population experience attenuated psychiatric symptoms and mild functional impairment without ever manifesting an overt mental disorder. There is a need for further research on this matter to confirm these findings and to explore their implications both for mental and somatic health and the provision of health care.

Clinical equipoise regarding preventative treatments for psychosis has encouraged the development and evaluation of psychosocial treatments, such as cognitive behavioural therapy (CBT).

A systematic review and meta-analysis was conducted, examining the evidence for the effectiveness of CBT-informed treatment for preventing psychosis in people who are not taking antipsychotic medication, when compared to usual or non-specific control treatment. Included studies had to meet basic quality criteria, such as concealed and random allocation to treatment groups.

Our search produced 1940 titles, out of which we found seven completed trials (six published). The relative risk (RR) of developing psychosis was reduced by more than 50% for those receiving CBT at every time point [RR at 6 months 0.47, 95% confidence interval (CI) 0.27–0.82, p = 0.008 (fixed-effects only: six randomized controlled trials (RCTs), n = 800); RR at 12 months 0.45, 95% CI 0.28–0.73, p = 0.001 (six RCTs, n = 800); RR at 18–24 months 0.41, 95% CI 0.23–0.72, p = 0.002 (four RCTs, n = 452)]. Heterogeneity was low in every analysis and the results were largely robust to the risk of an unpublished 12-month study having unfavourable results. CBT was also associated with reduced subthreshold symptoms at 12 months, but not at 6 or 18–24 months. No effects on functioning, symptom-related distress or quality of life were observed. CBT was not associated with increased rates of clinical depression or social anxiety (two studies).

CBT-informed treatment is associated with a reduced risk of transition to psychosis at 6, 12 and 18–24 months, and reduced symptoms at 12 months. Methodological limitations and recommendations for trial reporting are discussed.

Alterations of the hypothalamic-pituitary-adrenal (HPA) axis and of its peripheral indices have been reported in both normal and pathological anxiety with controversial findings. The aim of the present study was to investigate the possible correlations between serum cortisol and dehydroepiandrosterone-sulfate (DHEA-S) levels and DHEA-S/cortisol ratio, and panic-agoraphobic spectrum dimensions in a sample of healthy subjects.

Forty-two healthy subjects of both sexes, with no current or lifetime psychiatric disorders, were assessed by means of the Structured Clinical Interview for DSM-IV (SCID-I/P) and the so-called Panic Agoraphobic Spectrum-Self Report lifetime version (PAS-SR).

Significant, negative correlations were found between cortisol levels and the total score of the separation sensitivity, panic-like symptoms, and medication/substance sensitivity PAS-SR domains. The PAS-SR total and the panic-like symptoms domain scores were positively related to the DHEAS/cortisol ratio. When the sample was divided in women and men, these correlations were present in women only.

These findings, while indicating the presence of significant relationships between panic-agoraphobic traits and some indices of HPA axis functioning in healthy women, would suggest this as one of the factors explaining the greater vulnerability of women to cross the line between normal and pathological anxiety.

Further studies are needed to explore gender differences in the relationships between HPA axis alterations and the panic-agoraphobic spectrum dimensions.