Negative symptoms (NS) represent an important unmet need in schizophrenia (SZ) assessment and management. Despite NS are strongly associated with poorer functioning and quality of life, they are frequently underrecognized, inconsistently evaluated, and show limited response to current treatments. Although specific assessment tools and European Psychiatric Association (EPA) guidance on NS have been developed, their impact on routine clinical practice appears limited. This study aimed to investigate the competence and confidence of European Early Career Psychiatrists (ECPs) in NS evaluation and management.

The CARE project was a cross-sectional online survey directed towards ECPs from European countries.

828 ECPs’ responses were collected from 19 countries. The majority of ECPs were trainees (65.8%), reported theoretical training in negative symptoms (NS) and placements in schizophrenia-specialized settings (67.9% and 70.3%), while about half reported extracurricular NS training (51.1%) and involvement in clinical research (46.1%). Only 11% correctly identified NS domains, despite 65.7% felt well-trained in NS assessment tools. Just 15.9% correctly answered questions based on the EPA guidance papers. 46.7% and 25.9% ECPs reported feeling competent in NS evaluation and management, respectively. Gender (men) specialist status, research involvement, theoretical NS training, and placements in specialized SZ services predicted perceived competence. However, in-depth NS knowledge was predicted only by specialist status, engagement in clinical research, and extracurricular NS training.

Despite reported exposure to NS training, ECPs demonstrated limited knowledge of NS. Actions need to be taken to ensure that ECPs receive the highest standard of training in NS.

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.

The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders.

The sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions.

About 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome.

The finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.