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The present study examined internet users aged 18–24 years based on their generalised (i.e. internet and smartphone) and specific (i.e. gaming, frequency of gaming, time spent in video game sessions) problematic internet use behaviours, and their relations with sociodemographic variables and psychosocial risk factors. The sample included 851 Italian young adults (51.9% females; Mage = 21.62 ± 1.58 years). Five different profiles of young adults characterised by unique patterns of generalised and specific problematic internet use were identified through the latent profile analysis (LPA): (1) non-problematic internet users, (2) normative internet and gaming users, (3) non-problematic gamers, (4) problematic internet users, and (5) problematic gamers. Significant differences were observed among profiles on several auxiliary variables, with problematic internet users and problematic gamers displaying higher levels of psychological distress, emotion dysregulation, dissociative experiences, attachment insecurity and loneliness, as well as lower levels of satisfaction of basic psychological needs, self-esteem, and perceived social support. The study findings support the view that a relatively small subgroup of internet users may need tailored intervention to reduce their maladaptive use of internet services and improve their psychological well-being. [ABSTRACT FROM AUTHOR]

Self‐esteem and emotion dysregulation appear to be important factors in the psychological well‐being of trauma survivors. On the one hand, self‐esteem may act as a shield against the psychological consequences of traumatic experiences; on the other hand, emotion regulation can affect the way individuals deal with post‐traumatic affects (e.g., fear, terror, shame, and guilt). Consequently, the objective of this study was to investigate the role that emotion dysregulation and self‐esteem play in the well‐being of a sample of women after the traumatic experience of intimate partner violence (IPV). This study involved 282 women (meanage = 41.55, SD = 10.52) who experienced IPV in the last year. Conditional process analyses and Johnson‐Neyman analysis for regions of significance were performed. The results showed that emotion dysregulation mediated the relationship between post‐trauma affectivity (i.e., fear, terror, shame and guilt) and survivors' well‐being. Furthermore, self‐esteem negatively predicted lack of well‐being and acted as a moderator of the relationship between emotion dysregulation and lack of well‐being. In this regard, through the Johnson‐Neyman analysis for regions of significance, it was possible to identify a cut‐off value above which the relationship between emotion dysregulation and lack of well‐being became non‐statistically significant. This study contributed to understanding the role that emotion dysregulation and self‐esteem play in the well‐being of IPV survivors. In this regard, clinical implications will be presented. [ABSTRACT FROM AUTHOR]

Although studies have highlighted the role played by couple and parental relationships for children's psychosocial adjustment, especially in challenging situations, research on these two relationship domains has largely developed separately and mostly focussed on negative couple processes. However, Family Systems Theory highlights how these subsystems are interconnected, and studies inspired by this theoretical framework provide evidence of how the quality of the interparental relationship predicts the parent–child relationship. This study focussed on the association between two relational resources (dyadic coping and parent–child relationship quality) and children's emotional difficulties during the outbreak of the COVID‐19 pandemic in Italy. Five hundred ninety‐one Italian parents filled in an online self‐report questionnaire. A path analysis model was estimated to test the mediating role of parent–child relationship quality in the association between partner positive dyadic coping and children's emotional difficulties. The findings showed both a direct effect and an indirect effect of partner positive dyadic coping on children's emotional difficulties, because parent–child relationship quality partially mediated this association. Enhancing parents' ability to cope together with stress and the quality of the parent–child relationship might contribute to decrease children's vulnerability to emotional difficulties in challenging times. [ABSTRACT FROM AUTHOR]

Aims Alcohol use disorder (AUD) is a common mental disorder characterized by sex-gender differences (SGDs). The present study was aimed at evaluating attitudes displayed by Italian AUD treatment services towards investigating the presence of SGDs in their patients and implementing gender-specific treatments for female AUD patients. Methods Potential SGDs were initially investigated in a sample of AUD outpatients, subsequently followed by a national survey on the adoption of specific interventions for female AUD outpatients. Results The presence of SGDs was confirmed in a sample of 525 (332 men; 193 women) AUD outpatients, including a higher prevalence of anxiety and mood disorders, and episodes of violence and trauma among female AUD outpatients compared to males. Despite the presence of these SGDs, only <20% of a total of 217 Italian AUD treatment services reported the implementation of specific strategies for female AUD outpatients. The majority of services (94%) reported investigating episodes of violence and/or trauma, largely resorting to specific procedures only when these issues were detected. Conclusions Our findings confirm the presence of SGDs among AUD outpatients, including a higher prevalence of anxiety and mood disorders and episodes of violence and trauma among females compared with males. However, only a small number of services have adopted a gender medicine approach in AUD treatment. These results underline the urgency of investigating the specific needs of female, male, and non-binary AUD patients in order to personalize and enhance the effectiveness and appeal of AUD treatment. [ABSTRACT FROM AUTHOR]

Purpose: This study identifies potential predictors of unemployment and describes specific work difficulties and their determinants in a subgroup of employed people with multiple sclerosis (PwMS). The specific work difficulties were evaluated using a validated tool that measures the impact of respondents' symptoms and of workplace features. Methods: A cross-sectional study was carried out in Italy during 2021–2022. The subjects included were adults (18–65 years) with a diagnosis of MS, currently employed or unemployed. Logistic regression models were used to determine the association between each potential determinant and employment status, while linear regression models were used to determine the association between determinants and specific work difficulties. Results: The main risk factors associated with a higher risk of being unemployed were being older, living in the South of Italy/islands, and having a higher disability level, while protective factors against unemployment were having a high level of education and 'stable' employment (an open-ended contract). Fatigue was found to be associated with all work difficulties analyzed; mood disorders emerged as the main predictors of mental health-related work difficulties; level of disability and comorbidity significantly impacted physical health-related ones, and a good quality of life was found to improve both workplace-related and mental health-related difficulties at work. Conclusion: Identifying the most significant difficulties is a crucial step in the development of vocational rehabilitation interventions tailored to maximize the ability of PwMS to handle their job-related duties and demands. [ABSTRACT FROM AUTHOR]

To verify the effectiveness of experimental occupational therapy plus intensive standard rehabilitation compared to intensive standard rehabilitation alone on the reintegration to social activities of complex patients three months after hospital discharge. Patients with a score ≥ 9 on the Rehabilitation Complexity Scale at admission to an intensive rehabilitation ward were randomized to the control or experimental group. Both groups received intensive multidisciplinary rehabilitation aimed at recovering independence in the basic activities of daily life (ADL). The experimental group also received experimental occupational therapy services to address goals identified through the administration of the Canadian Occupational Performance Measure (COPM). Experimental occupational therapy began during the in-hospital phase and continued in the home-based setting. It consisted of teaching strategies, recommending aids, and providing personalized information regarding available community support. Ninety-two individuals with a mean age of 65 years (female 44.6%) were enrolled. The experimental group significantly improved participation measured by the Reintegration to Normal Living Index (mean changes 8.61, 95% CI: 1–16.23, p = 0.027). The performance and satisfaction scores of the COPM, both during hospitalization and after discharge, and independence in ADL also improved. No differences in mood disturbances were found. Early post-discharge occupational therapy integrated with multidisciplinary rehabilitation improves the social participation of complex patients. Future research should investigate the concrete feasibility of implementing this complex intervention cost-effectively and in different contexts. ClinicalTrials.gov Identifier NCT03668938 (first posted date 13/09/2018) Early post-discharge rehabilitation assists patients' transition from hospital to home by improving the management of problems they encounter. In complex patients, occupational therapy initiated during hospitalization and extended to the early post-discharge phase improves social participation, independence in basic and instrumental daily activities, and performance and satisfaction when carrying out relevant occupational activities. The strong partnership between the Occupational Therapist and the patient improves compliance to treatment, enhancing the chances of success of rehabilitation interventions. [ABSTRACT FROM AUTHOR]

This systematic review aimed to (1) synthesize average means and prevalence rates of adverse childhood experiences (ACEs) measured by the Adverse Childhood Experiences International Questionnaire (ACE‐IQ) in clinical and at‐risk samples; (2) discuss the ACE‐IQ prevalence and means according to participants' gender, age (both adults and <18 years old), and geographic area; (3) map relationships between ACE‐IQ scores and other outcomes; (4) detect methodological issues in studies. PRISMA guidelines were followed, searching studies in seven academic databases, including retrieval of grey literature. After screening, 23 studies were included. Results revealed the following: (1) several clinical (e.g., mood disorders and substance abuse) and at‐risk (e.g., criminal and low‐income) conditions were studied, with an average 4.93 mean and 81.74% prevalence of total ACEs; (2) there is a lack of data on males, with the prevalence of domestic violence and physical neglect being especially marked in minors, and no studies involving European and North‐American at‐risk samples; (3) ACE‐IQ scores were mostly related to substance abuse and risk‐taking behaviours; (4) major methodological issues were not‐randomized/convenience sampling techniques and a lack of methodological information on sample and procedure. In conclusion, the ACE‐IQ seems a promising tool in clinical/at‐risk samples, but more studies are needed to answer all research questions. [ABSTRACT FROM AUTHOR]

The COVID-19 medical emergency has ended worldwide, yet the psychological impact of these years of unprecedented changes on students' lives still needs to be deepened. Methods: This study aims to assess and compare COVID-19-related stressors (relationships and academic life; isolation; and fear of contagion) and psychophysical symptoms reported by 637 university students at three times, i.e., April 2020 (n = 197), April 2021 (n = 200), and April 2022 (n = 240). The impact of COVID-19-related stressors on psychophysical symptoms within each time was also tested. Results: In April 2022, perceived isolation and fear of contagion decreased from the peak registered in April 2021, but stress related to relationships and academic life remained high. An ongoing increase in psychophysical symptoms was found. More than 50% of students reported clinical levels of sleep disorders, depression, psychoticism, and interpersonal sensitivity. In April 2022, students still perceiving stress related to relationships and academic life and isolation were at risk for anxiety, somatization, and sleep disorders. Students still perceiving stress related to fear of contagion were also at risk for depression, obsessive–compulsive symptoms, and psychoticism. Conclusion: The findings emphasized the long-lasting effects of COVID-19-related stress on students' psychophysical health. Interventions must aim at supporting students in dealing with the complex post-pandemic adjustment process. [ABSTRACT FROM AUTHOR]

Introduction: Many mental disorders especially chronic serious ones such as schizophrenia-spectrum disorders, are disabling syndromes and impact on patients' social and cognitive functioning, including work activity. Thus, affected patients may show a particular socio-economic vulnerability and need specific social security as well as rehabilitation interventions, including pensions or job-placements. In Italy, the Working Group named 'Employment and Social Security/Insurance in Mental Health (ESSIMH)' was founded in 2020 in order to collect research evidence on mental illness, employment, social security, and rehabilitation. Methods: A descriptive, observational and multi-center study has been conducted in eleven Departments of Mental Health in Italy (Foggia, Brindisi, Putignano, Rome, Bologna, Siena, Pavia, Mantova, Genova, Brescia, and Torino) and involved 737 patients affected by major mental illness and classified in five diagnostic categories: psychoses, mood disorders, personality disorders, anxiety disorders, and others. The data collection was performed in 2020 among patients aged 18 to 70 years old. Results: The rate of employment in our sample was 35.8% (n = 264). Occupational disability in our sample was recognized in 58.0% of patients with a mean percentage of severity 51.7 ± 43.1; patients with psychoses (73%) reported higher disability followed by personality (60%) and mood disorders (47.3%) ones. In a logistic multivariate modeling, factors significantly associated with diagnosis were (a) higher level of occupational disability in psychoses; (b) higher number of job- placement programs among psychoses patients; (c) lower level of employment in psychoses; (d) more psychotherapy in personality disorder patients; and (e) more years of MHC program in psychoses patients; factors associated with sex were: (a) higher number of drive licenses among males; (b) more physical activity among males; and (c) higher number of job-placement programs among males. Conclusion: patients affected by psychoses were more likely to be unemployed, reported higher occupational disability as well as received more incentives and rehabilitation interventions. These findings confirmed that schizophrenia-spectrum disorders are disabling and patients need psychosocial support and interventions in the framework of a recovery-oriented treatment. [ABSTRACT FROM AUTHOR]

The closure of schools, social hubs, and extracurricular activities due to lockdown measures imposed to curb the spread of SARS‐CoV‐2, has increased the risk factors for students' mental health. This cross‐sectional study, conducted from March 2020 to March 2021, aimed to estimate socio‐emotional, cognitive, and affective disorders and substance use in a sample of first‐ and second‐grade high school students in Northern Italy. This study compared data from 284 Italian students' self‐perceptions along with the perceptions of their parents and teachers through a web‐based survey. The differences in the perceptions of the three groups (students, parents, and teachers) were analyzed using an analysis of variance test, applying a Bonferroni correction. The χ2 test was used to assess the comparison between students, parents, and teachers in the substance use questions. The results showed statistically significant differences among the three groups. The most important outcomes were sociality, scholastic performance, extracurricular activity, emotional symptoms, affective disorders (depression and anxiety), and substance use. These findings could be interesting for the promotion of mental health and prevention of psychopathological risks in students. Practitioner Points: The closure of schools due to COVID‐19 lockdown measures has increased the risk factors for students' mental health.There is significant differences among the perceptions of students, parents, and teachers, especially concerning sociality, scholastic performance, extracurricular activity, emotional symptoms, affective disorders, and substance use.Training initiatives should be developed to improve teachers' perceptions of their students and parents' perceptions of their children for the promotion of well‐being and the prevention of early school dropout, self‐addiction, and psychopathological risks in young people. [ABSTRACT FROM AUTHOR]

Problem: The global coronavirus (COVID‐19) pandemic has been challenging for adolescents. Indeed, with the closure of schools and social centers and reduction of extracurricular activities, increased social isolation has compounded difficulties in and with school performance, loneliness, and social networking. Increased risk of mental health problems, substance abuse, affective disorders, suicidal ideation, and suicide has been reported in adolescents. Methods: This cross‐sectional study assesses the association between loneliness, depression, anxiety, suicidal ideation, the use of social networks, and school achievement in a sample of Italian adolescents during the COVID‐19 pandemic. This study also explores emotional dysregulation through the association between affective disorders (depression and anxiety), substance use, and social networks. The sample comprises adolescents in the first and second grades of high school during the pandemic; participants received an email explaining the purpose of the e‐research. Data were collected using the Strengths and Difficulties Questionnaire, the Achenbach System of Empirically Based Assessment, and the Loneliness Scale. Findings: A total of 505 adolescents completed the web survey. Data revealed that students experienced difficulties with loneliness, problems with school achievement, and extracurricular activities. The mean scores for depression and anxiety were close to the borderline range. A total of 14.3% of adolescents intentionally harmed themselves or attempted suicide. Conclusions: This study raises concerns about the impacts of the pandemic on adolescents that require the attention of adult reference figures who deal with adolescents, such as parents, teachers, and healthcare professionals. Results indicate the necessity of providing early interventions aimed at the prevention of psychopathologies and the promotion of adolescent mental health due to the pandemic. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak and subsequent lockdown have dramatically impacted families' life, raising serious concerns about children's emotional wellbeing. However, few studies have investigated whether the impact of the COVID-19 lockdown on psychological adjustment in youngest can be moderated by maternal mood and, to our knowledge, none of them has adopted a longitudinal design. The main aim of the current study was to explore if the intensity and directionality of maternal mood symptoms moderated the trajectory of emotional and behavioural problems in Italian pre-schoolers from pre- to during the lockdown adopting a longitudinal design. To assess maternal anxiety and depression symptoms, the EPDS and the STAI-Y were filled in by 94 and 88 women before the lockdown, when their children were 1 (Wave P1) and 3 years old (Wave P2), respectively, and by 74 women during the lockdown, when their children were 4 years old (Wave L). Mothers also filled in the CBCL/1 ½–5 to assess their children's emotional and behavioural problems at each assessment wave. As a whole, children's emotional and behavioural problems significantly increased from pre- to during the lockdown. Furthermore, maternal mood moderated this trajectory. In particular, greater maternal mood symptoms were significantly associated with a greater increase in emotional reactive, anxious-depressed, withdrawn and aggressive symptoms during the lockdown. These results contribute to shed light on the role played by maternal emotional wellbeing in buffering the impact of the COVID-19 lockdown on children's behavioural development. Albeit preliminary, the current findings highlight the need to provide timely psychological interventions to distressed mothers to help their children to better cope with the effects of the pandemic. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnea can have a negative impact on children's and adolescents' neurocognitive abilities and hinder their academic and adaptive progress in academic, social, and/or behavioral dimensions. In this retrospective cross-sectional study, we investigated the influence of body weight conditions and allergy status on long-term mental health, cognitive development, and quality of life in children and adolescents who snored. Methods: The study sample included 47 subjects (age range 4.1 to 15.3 years) who exhibited high levels of snoring and underwent home-based polysomnography between 2015 and 2019. Follow-up assessments (3 years on average between baseline and follow-up) entailed phone interviews with the subject's parents/caregivers who completed three validated questionnaires investigating sleep, quality of life, and parental ratings. Results: We found a correlation between age at diagnosis and being retrospectively overweight and high levels of snoring. In addition to a higher risk of developing emotional symptoms (8.2% increase in retrospective overweight status for each unit increase in the emotional score at follow-up) and oppositional behavior (9% increase in retrospective overweight status for each unit of oppositional T points at follow-up), we also noted reduced long-term social symptoms (11% decrease in retrospective overweight status for each unit increase in the social score at follow-up) and cognitive symptoms (10.6% decrease in retrospective overweight status for each unit increase in the cognitive score at follow-up), as well as a 6.1% increase in retrospective allergy status for each unit increase in academic performance at follow-up. Conclusions: Snoring can have negative impacts on mental health and cognitive development in the long term. Early detection and intervention for neuropsychological disorders is important in children and adolescents who score high on snoring. In the long term, the effects of snoring on neuropsychological disorders may vary based on previous body weight and allergy status. [ABSTRACT FROM AUTHOR]

Evidence suggests that adolescents respond positively to simple, early interventions, including psychosocial support and educational interventions, even when offered in non-clinical settings. Cinematherapy can help manage life challenges, develop new skills, increase awareness, and offer new ways of thinking about specific problems. This pilot trial was conducted in Italy, aiming to investigate the effects of a six-week filmmaking course on the psychological well-being of adolescents (N = 52) with emotional/behavioural problems and neurodevelopmental disorders. At the end of the project, most participants showed improvements mostly in social skills, such as social cognition (p = 0.049), communication (p = 0.009), and motivation (p = 0.03), detected using the SRS Social Responsiveness Scale. In addition, social awareness (p = 0.001) increased in all patients. Statistically significant differences resulted in four sub-scales of Youth Self-Report Scale: withdrawn/depressed (p = 0.007), social problems (p = 0.003), thought problems (p < 0.001), and rule-breaking behaviour (p = 0.03); these results showed a decrease in emotional and behavioural problems. This study is an innovative therapeutic and educational approach based on the filmmaking art. This research can offer an empirical basis for the effectiveness of alternative therapeutic tools in child and adolescent psychiatric disorders. At the same time, it can be replicated in broader contexts (e.g., school and communities) to promote children's psychological well-being. [ABSTRACT FROM AUTHOR]

Previous evidence showed significant discrepancies in psychiatric services utilization between migrants and reference populations. Our study aims were to evaluate incidence and characteristics of psychiatric hospitalizations of migrant patients compared with reference populations and to assess how the COVID-19 pandemic affected admissions. All patients admitted to the psychiatric ward "SPDC-Malpighi" of the Bologna Mental Health Department from 01/01/2018 to 31/12/2020 were included. Differences in sociodemographic and clinical characteristics were tested by migrant status. Incidence rate ratios of hospital admissions by migrant status were estimated via Poisson regression considering population-at-risk, gender, and age-group. Migrants had higher hospitalization rates due to any psychiatric disorder (IRR = 1.16). The risk was especially pronounced among women (IRR = 1.25) and within the youngest age-group (IRR = 3.24). Young migrants had also a greater risk of compulsory admission (IRR = 3.77). Regarding admissions due to a specific diagnosis, we found relevant differences in hospitalization rates for psychosis, mood disorders, and personality disorders. Finally, migrants were more likely to be admitted via Emergency Department and less likely to be referred from a specialist. During the year of pandemic (2020) we observed an increase in the proportion of migrants admitted voluntarily or compulsorily. Migrants, especially those from the youngest age-group, had higher hospitalization rates for any disorder. Younger migrants were also at higher risk of compulsory treatment. The distribution of psychiatric admissions during the pandemic period seemed to have further increased discrepancies in mental healthcare needs and provision between migrants and the reference population. Tailored interventions and policies are urgently needed to address this issue. [ABSTRACT FROM AUTHOR]

Stress adjustment and resilience after multiple natural disaster exposure, specifically two successive earthquakes (i.e. 2009 and 2016 earthquakes) have been investigated in persons with mental disorder and compared to a clinical sample evaluated after the first seismic 2009 event. Seventy-one persons referred to the Mental Health Service of L'Aquila for psychotic, mood and anxiety disorders, were evaluated for 'bounce back resilience' (BRS) and subjective adjustment after the 2016 natural disaster, the earthquake that hit Central Italy. They had already been exposed to a previous natural disaster, the earthquake that hit L'Aquila in 2009 (i.e. '2009/2016 sample'). The 2016 evaluations have been compared to that previously obtained at the 2009 event in an independent clinical sample (i.e. '2009 sample'). A relevant lower number of persons refer a good adjustment after the second natural disaster when compared to the assessment performed on the independent clinical '2009 sample'. After the second natural disaster, the total sample showed no differences in BRS scores compared to the 2009 sample. However, when diagnoses were taken into account, the highest BRS scores were observed in the sample of persons with psychoses and mood disorders in the '2009/2016 sample'. In contrast, those with anxiety disorders showed the lowest one. Among mental health service clients hit twice by a natural disaster in seven years, those with anxiety disorders are 'sensitized' to the trauma, therefore susceptible of more problematic adjustment. [ABSTRACT FROM AUTHOR]

Suicidal attempts (SA) represent heterogeneous behaviours ranging in their seriousness from fatal and near‐fatal (high‐lethality) cases to those that do not require medical attention (low lethality). These considerations stress the need to identify high‐risk individuals for high lethality SA in order to target suicide preventive interventions. The present study aims at evaluating the role of sociodemographic and clinical variables and examining personality pathological features in predicting high lethality SA. The sample was composed by 94 patients who were consecutively admitted to the Mood Disorders Unit of the San Raffaele Turro Hospital in Milan. The results of binary logistic regression analyses showed that previous SA and current suicide ideation play a role in predicting serious SA. Considering the DSM‐5 personality dysfunctional domains assessed by the Personality Inventory for DSM‐5, our logistic regression analyses suggested that high lethality SA was associated with Detachment PID‐5 domain. Finally, binary hierarchical regression analysis showed that Detachment domain remained a significant predictor of serious SA over and above the effect of previous SA and suicide ideation. As a whole, our results highlight the importance of a multidimensional approach to develop adequate assessment, effective treatments and prevention of high lethality SA risk. [ABSTRACT FROM AUTHOR]

Suicide ideation and behaviors are major health issues in the field of mental health. Several psychological and psychosocial factors have been taken into account as possible predictors of suicidality. Only recently affective temperaments have been considered as possible factors linked to suicide. This study aims to investigate the relationship between affective temperaments and suicidality, including the lifetime onset of suicide ideation, lifetime presence of suicide attempts and the total number of lifetime suicide attempts. This is a naturalistic multicentric observational study, involving outpatient units of seven University sites in Italy. Patients were administered with the short version of TEMPS-M and the Columbia Suicide Severity Rating Scale. A total of 653 participants were recruited, with a diagnosis of bipolar (55.7%), unipolar (35.8%) and cyclothymic disorder (8.4%). Regression models showed that the presence of lifetime suicide behaviors was increased in patients presenting trait related impulsivity (p < 0.0001), poor free-interval functioning (p < 0.05), higher number of affective episodes (p < 0.01), higher number of hospitalizations (p < 0.0001), cyclothymic and irritable affective temperaments (p < 0.05 and p < 0.05, respectively). Conversely, the presence of hyperthymic affective disposition reduced the likelihood of having suicidal behaviors (p < 0.01). Lifetime suicidal ideation was associated with trait-related impulsivity (p < 0.001), poor free-interval functioning (p < 0.05), higher number of affective episodes (p < 0.001) and of hospitalizations (p < 0.001). Depressive temperaments increased the likelihood of presenting suicidal ideation (p < 0.05), along with irritable temperaments (p < 0.01), contrary to hyperthymic affective (p < 0.05). Results of the present study confirm that affective disposition has a significant impact on the onset of suicidal ideation and behaviors, and that affective dispositions should be assessed in clinical settings to identify people at risk of suicide. Moreover, a wider clinical evaluation, including different clinical psychopathological dimensions, should be taken into consideration to develop effective preventive interventions. [ABSTRACT FROM AUTHOR]

Individuals with different personality traits, temperaments, and psychological symptoms have different attitudes toward the pandemic experiences and restrictive measures. The aim of the present study was to evaluate the associations between the psychological factors and the attitudes toward COVID-19, experienced during the third pandemic wave in Italy, in a sample of individuals with psychiatric disorders. Between March and September 2021, 53 patients with mood disorders and other mental disorders completed a survey composed of self-report questionnaires that assessed sleep quality, depressive and hypomanic symptoms, and temperament and personality traits. Positive and negative attitudes toward the pandemic experience were assessed using an ad hoc questionnaire. The results showed that individuals with more severe depressive symptoms were less prone to adhere to government guidelines, and were more convinced that the pandemic was not a real problem. Reduced sleep quality was associated with increased skepticism toward official explanations concerning the causes of COVID-19. Lastly, negative affect and cyclothymic temperament predicted the disposition toward COVID-19 vaccines. In conclusion, these findings highlighted that some psychological aspects and psychiatric symptoms could influence the beliefs about COVID-19 and compliance with government recommendations. Further research is needed to provide indications on how to improve the current healthcare policy. [ABSTRACT FROM AUTHOR]

Background: The symptomatology in Burning Mouth Syndrome (BMS) is complex and it should be considered in accordance with a biopsychosocial model. Objectives: To evaluate the multidimensional aspects of pain with a complete battery of tests and to analyse its relationship with potential predictors such as mood disorders, sleep and quality of life. Methods: Forty patients with BMS versus an equal number of age and sex‐matched healthy controls were enrolled. The VAS, SF‐MPQ, BPI, PD‐Q, BDI‐II, STAI, PSQI, ESS, SF‐36 and OHIP‐14 were administered. Results: The scores of the VAS, SF‐MPQ, BPI, PD‐Q, BDI‐II, STAI, PSQI, SF‐36 and OHIP‐14 were statistically significantly higher in the BMS patients than the controls (p <.001**). A strongly linear correlation between pain (VAS, SF‐MPQ, BPI and PD‐Q) and disease onset (STAI, BDI‐II, PSQI and sub‐items of SF‐36 and OHIP‐14) was found. In the multiple regression analysis, the contributions of the BDI‐II and OHIP‐14 were found to be statistically significant with the SF‐MPQ, PD‐Q and BPI in terms of severity and interference, while the contributions of the STAI and sleep were found to be statistically significant with the SF‐MPQ and BPI in terms of severity and interference, respectively. Conclusions: Pain tests are differently correlated with mood and quality of life. Therefore, a complete analysis of the patient requires several tools to better understand the multidimensional aspects of pain in BMS. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has generated an unprecedented global crisis that is profoundly affecting mental health and mental health care. The aim of this study was to survey a relatively large group of Italian physicians about their perceived impact of COVID-19 on the mental health of the Italian population and about their suggestions on the best strategies to address the current and future challenges. Methods: One thousand two hundred eighty-one (1,281) physicians were surveyed between November 2021 and February 2022. Results: Eighty-one percent of respondents reported an increase in the number of people with mental illness presenting to their practice during the COVID-19 pandemic. Thirty-four percent reported a 26–50% increase in the number of people with mental illness in their community; approximately 33% reported a 1–25% increase; and 26.9% reported a 51–75% increase. The most commonly reported mental issues that increased because of COVID-19 were agitation, mood and anxiety disorders. Regarding the suggested strategies to address future challenges related to the COVID-19 pandemic, 34.6% of respondents recommended providing psychoeducation to the general population for early detection of mental illness and developing strategies to reduce the impact of COVID-19-related stress. In addition, 12.6% of respondents suggested improving telehealth services, while 12.3% suggested the need for increased funding for community-based care. When asked about physicians' opinion on the possibility of an increased prevalence of mental illness in the next 12 months, more than 30% of them predicted an increase in stress-related illnesses, while 25.2% were more concerned about a worsening of the ongoing clinical conditions of patients with previous psychiatric disorders. However, 21% of respondents believed that people's ability to cope with the pandemic would increase in the next 12 months. Conclusions: This study confirmed a strong and negative impact on the mental health of the past 2 years of COVID-19 pandemic in the Italian population. Providing psychoeducation to the general population and improving the availability of telemedicine services could reduce the impact of future challenges related to the pandemic. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence of disordered eating behaviors (DEBs) in a large sample of Italian adolescents with type 1 diabetes and to explore potential demographic, clinical, and psychological differences (understood as emotional and behavioral problems) among adolescents with and without DEBs. Method: Adolescents (11–19 years) with type 1 diabetes completed the Diabetes Eating Problems Survey‐revised (DEPS‐r) and the Youth Self Report (YSR). Demographic and clinical data were also collected. Results: Of 690 adolescents with type 1 diabetes (mean age 14.97 ± 1.81, n = 337 girls) assessed in this study, 28.1% (21% boys, 35% girls) were DEPS‐r positive (score ≥ 20). Girls had higher DEPS‐r total scores (p <.0001, d =.42) than boys, although no age differences were found in mean DEPS‐r total scores (p =.961). In both genders, adolescents with DEBs had significantly higher zBMI (p <.0001, d =.52) and HbA1c values (p <.0001, d =.54) and showed more emotional and behavioral problems (both as internalizing and externalizing problems) than those without DEBs (all p <.0001). These differences were largely confirmed in all age groups. Adolescents reporting insulin misuse had higher HbA1c values (p =.001, d =.26), higher DEPS‐r mean scores (p <.0001, d = 1.07), and greater psychological problems (all p <.001) than those who did not. Discussion: DEBs are prevalent among adolescents with type 1 diabetes, and those with eating problems showed adverse clinical and psychological conditions. Routine screening for DEBs and of general psychological condition should be a fundamental part of diabetes care, especially during adolescence. Public significance statement: This nationwide study indicated that DEBs are common in adolescents with T1D, and those suffering from them show poorer clinical conditions and higher emotional and behavioral problems. As such, it offers important contributions for those working with EDs and in the T1D field, as it provides a deeper understanding of the co‐occurring DEBs–emotional/behavioral problems in youths with T1D and highlights the importance of continuous monitoring of their psychological condition by a multidisciplinary team. [ABSTRACT FROM AUTHOR]

Introduction: Depression in schizophrenia is associated with poor outcomes and suicide risk. However, it is overlooked in both research and clinical practice, especially in First Episode Schizophrenia (FES). Methods: In this letter to the editor, we reported relevant findings on relevant comorbid depressed mood in an Italian sample of FES patients during a 1-year follow-up period within an "Early Intervention in Psychosis" (EIP) program. The Positive And Negative Syndrome Scale (PANSS) was completed by 159 participant. Results: At baseline, 53 (33.3%) participants showed a relevant depressed mood (as measured with a PANSS "Depression" G6 item subscore of ≥ 5). At entry, a relevant depressed mood was associated with a greater percentage of females and a higher PANSS "Positive Symptoms" score. Across the follow-up, FES individuals improved their depression severity levels. This reduction was significantly related to improvments in positive symptoms levels. Conclusions: Depression is relatively common in FES, already at the recruitment in EIP services. However, its severity decreases overtime within specialized EIP programs. [ABSTRACT FROM AUTHOR]

Background: Oral lichen planus (OLP) is an immune-mediated inflammatory chronic disease of the oral mucosa, with different patterns of clinical manifestations which range from keratotic manifestations (K-OLP) to predominantly non-keratotic lesions (nK-OLP). The aim of the study was to analyze the differences in the clinical, psychological profile and symptoms between Italian patients of the North and Central-South with K-OLP and nK-OLP. Methods: 270 K-OLP and 270 nK-OLP patients were recruited in 15 Italian universities. The Numeric Rating Scale (NRS), Total Pain Rating Index (T-PRI), Hamilton Rating Scales for Depression and for Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) were administered. Results: The Central-South K-OLP (CS-K-OLP) patients reported a higher frequency of pain/burning compared with the K-OLP patients of the North (N-K-OLP) with higher scores in the NRS and T-PRI (p value < 0.001**). The CS-K-OLP and the CS-nK-OLP patients showed higher scores in the HAM-D, HAM-A, PSQI and ESS compared with the Northern patients (p value < 0.001**). Multivariate logistic regression revealed that the NRS and T-PRI showed the greatest increase in the R2 value for the CS-K-OLP (DR2 = 9.6%; p value < 0.001**; DR2 = 9.7% p value < 0.001**; respectively) and that the oral symptoms (globus, itching and intraoral foreign body sensation) and PSQI showed the greatest increase in the R2 value for the CS-nK-OLP (DR2 = 5.6%; p value < 0.001**; DR2 = 4.5% p value < 0.001** respectively). Conclusions: Pain and mood disorders are predominant in patients with OLP in the Central-South of Italy. Clinicians should consider that the geographical living area may explain the differences in oral symptoms and psychological profile in OLP. [ABSTRACT FROM AUTHOR]

The importance of psychopathy in the forensic and criminal justice domains is largely due to its robust associations with aggression and violent behavior. Hence, investigators have increasingly been interested in elucidating potential mechanisms linking psychopathy and aggression. Recent research highlighted previously overlooked associations between psychopathy and difficulties in emotion regulation, the process responsible for monitoring, evaluating, and managing one's emotional experience, as well as for guiding behavior under intense emotional arousal. Yet, it remains unclear whether emotion dysregulation may be helpful to explain well-documented associations between psychopathy and aggression. The present study examined whether emotion dysregulation mediated associations (i.e., explained a significant portion of the shared variance) between psychopathy and aggression across community (N = 521) and offender (N = 268) samples. Participants completed self-report measures of psychopathy, emotion dysregulation, trait aggressiveness (i.e., anger, hostility, physical and verbal aggression), as well as reactive and proactive aggression. Across both samples, psychopathy had significant indirect effect on all indices of aggression through emotion dysregulation, with the exception of verbal aggression. These findings support the relevance of emotion regulation for the construct of psychopathy and its maladaptive correlates and highlight the potential relevance of focusing on emotion regulation as a possible target for interventions aimed at reducing aggression among individuals with psychopathic traits. [ABSTRACT FROM AUTHOR]

• Italian residential care during COVID-19 lockdown protected adolescents. • RC adolescents reported fewer sleep quality issues than their peers. • During lockdown, girls expressed lower subjective wellbeing but better relational wellbeing. • "Length of placement effect" linked longer stays with increased irritability and less continuity. • Tailored interventions for girls and those with longer placements are needed. COVID-19 lockdown has been worldwide considered one of the major collective traumatic experiences for everyone, vulnerable adolescents included. Surprisingly, however, research on the experiences of adolescent living in residential care (RC) – considered it to be particularly exposed to traumas and developmental challenges – has been underdeveloped in the pandemic scenario. Bridging this gap and drawing on a national survey with Italian adolescents living in RC, the current study examines their psychosocial wellbeing, i.e., their perceived subjective and relational wellbeing, during lockdown. In terms of subjective wellbeing, results show increased irritability, but, differently from general population, no sleep quality deterioration. In terms of relational wellbeing, we document a general sense of safeness and protection in RC, a significant sense of being listened to by caregivers, and continuity of care with professionals and keypersons. We confirm and display two distinctive effects as well: a) the "gender effect" – i.e., compared to boys, girls reported higher irritability, and b) the "length of placement in RC" effect – i.e., adolescents living in RC for more than 3 years reported increased irritability and a lower relational wellbeing, counterbalanced by a higher competence in keeping their contact with their schoolmates outside RC. Proposals for targeted psychosocial interventions, limitations and implications for future research in the developmental areas are discussed in the conclusions. [ABSTRACT FROM AUTHOR]

To evaluate the usefulness of the DSM‐5 maladaptive personality domains in explaining the similarities and differences among four disorders included in the obsessive–compulsive spectrum, 428 Italian community‐dwelling women (mean age = 31.96 years, SD = 12.30 years) were administered the Obsessive–Compulsive Spectrum Disorder Scales and the Personality Inventory for DSM‐5‐Short Form as part of an ongoing online survey on women's health. Multiple Indicators Multiple Causes (MIMIC) confirmatory bifactor analysis results showed that the OCSD general factor (i.e., obsessive–compulsive spectrum factor) was positively associated with Negative Affectivity, whereas Body Dysmorphic Disorder (BDD), Hoarding Disorder (HD), and Skin‐Picking Disorder (SPD) specific factors showed significant and substantial differential relationships with dysfunctional personality domains. Specifically, BDD was positively associated with Negative Affectivity, Detachment and Psychoticism domains; HD was associated with high Negative Affectivity and Psychoticism; and SPD was associated with Detachment. © 2020 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Drawing on the model of balanced affect, the Francis Burnout Inventory (FBI) conceptualised good work-related psychological health among religious leaders in terms of negative affect being balanced by positive affect, and operationalised this model with two 11-item scales. Factor analysis on data provided by 287 Catholic priests and religious sisters in Italy proposes reducing each of these scales to 10 items. Construct validity of these revised scales was supported against an independent measure of wellbeing. [ABSTRACT FROM AUTHOR]

Background: Demoralization, as assessed through the Diagnostic Criteria for Psychosomatic Research-Demoralization (DCPR/D) interview or the Demoralization Scale (DS), has been found to affect about 30% of patients with medical disorders, while few studies have been done in patients with psychiatric disorders.Methods: A convenience sample of 377 patients with ICD-10 diagnoses of mood, anxiety, stress-related disorders or other non-psychotic disorders was recruited from two Italian university psychiatry centers. The DCPR/D interview and the Italian version of the DS (DS-IT) were used to assess demoralization and the Patient Health Questionnaire-9 (PHQ-9) to assess depression.Results: Demoralization was diagnosable in more than 50% of the patients. Factor analysis of the DS-IT indicated four main factors, Meaninglessness/Helplessness, Disheartenment, Dysphoria and Sense of Failure, explaining 62% of the variance of the scale. Patients with bipolar or unipolar major depression and personality disorders had the highest prevalence of demoralization (DCPR/D) and the highest scores on all the DS-IT factors in comparison with patients with adjustment or anxiety disorders. About 50% of patients with moderate demoralization (DS-IT) were not clinically depressed (PHQ-9 <10), while almost all with severe demoralization were depressed.Limitations: Prospective studies on larger samples with other psychiatric disorders, also taking into account subjective incompetence, are needed. Since the DCPR/D assesses demoralization as a categorical construct, a dimensional framework should be necessary.Conclusions: The findings enrich the research on demoralization, showing for the first time the importance of this construct, as measured by the DCPR/D and the DS-IT, in patients with psychiatric disorders. [ABSTRACT FROM AUTHOR]

Background: Several studies have challenged the traditional unipolar‐bipolar dichotomy in favor of a more dimensional approach. Objective: To evaluate the differences in mood spectrum between patients with bipolar disorder (BD) and major depressive disorder (MDD) during a major depressive episode (MDE). Method: Study participants were 145 patients with BD and 155 patients with MDD recruited at three University Medical Centers in Italy. All study subjects met Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for MDE and completed the Mood Spectrum‐Self‐Report‐Last Month questionnaire. Results: Patients with BD endorsed more items in the mood manic/hypomanic and energy depressive subdomains of the MOODS‐SR questionnaire. Significant differences were also found for specific depressive and manic items, which were more frequently endorsed by patients with BD. A large number of patients with BD, but also a considerable number of patients with MDD, endorsed manic items during a depressive episode. Conclusions: There are differences between BD and MDD in terms of the number and type of mood spectrum items that are endorsed during a MDE, which may help to identify patients with BD when a retrospective assessment of a history of mania or hypomania is not possible or not reliable. A high number of patients with BD and a considerable number of patients with MDD endorsed several items in the manic section of the mood, energy, and cognition domains, this confirming the centrality of mixed features in patients with mood disorders and the need for a unitary, dimensional, descriptive and dynamic approach to MDD and BD, such as the recently proposed ACE (Activity, Cognition, Energy) model. [ABSTRACT FROM AUTHOR]

Calls to screen for men's emotional health during the perinatal period have been increasing in recent times, given that emotional health screening for women is now well embedded in many clinical services. Although the Edinburgh Postnatal Depression Scale (EPDS) has been used for women, and also validated for men, a recent examination of this measure showed that it may not be ideal for men (or women). This study screened expectant fathers with the EPDS and a more recent measure, the Matthey Generic Mood Questionnaire, which has been designed to overcome some of the limitations of the EPDS. Expectant fathers in Italy (N = 145) and Australia (N = 185) were recruited from community antenatal clinics or classes, and these fathers completed the 2 measures. Results showed that on both measures, a meaningfully higher rate (2–8 times higher) of men in the Australian sample than men in the Italian sample screened positive for mood difficulties. The Matthey Generic Mood Questionnaire's ability to detect a variety of negative emotions, coupled with its clinically useful questions of allowing men to express why they feel distressed, and whether they would like to speak to a health professional about this, indicates that it could be a useful measure for health services wishing to screen men for emotional difficulties in the perinatal period. Public Significance Statement: With the increasing recognition that men's mental health needs during pregnancy and postpartum are important, this study provides health services evidence for a new resource when deciding how best to screen for men's emotional health. This study found that a new self-report measure of mood that does not depend on the endorsement of a select set of symptoms was suitable for the expectant fathers in Italy and Australia. On this new measure, both sets of expectant fathers were open to expressing what their difficulties were, and some also openly expressed a wish to talk about their issues further with a health professional. [ABSTRACT FROM AUTHOR]

Background: Lithium is the mainstay for the maintenance treatment of mood disorders (MD), but its efficacy needs to be weighed against its side effects profile. Here, we assessed retrospectively the clinical response to long-term lithium treatment, as well as the rate of associated metabolic side effects.Methods: Clinical data were collected from patients treated with lithium for at least 12 months at the Lucio Bini Center for Mood Disorders in Cagliari, Italy. Clinical response was determined as the difference in number of mood episodes and percent of illness time before and during lithium treatment. Symptomatic values of metabolic parameters (plasma levels of glucose, cholesterol, urea nitrogen [BUN], creatinine, TSH, white blood cells [WBC]), and Body Mass Index (BMI) were determined.Results: We studied 323 MD patients (60.2% women). The percent of illness time was significantly reduced for both depressive (F = 4.94, p<0.0001), and manic (F = 3.95, p < 0.0001) episodes, whereas the rates of episodes/year were significantly reduced for mania (F = 2.01, p = 0.02), but not for depression (F = 1.54, p = 0.06). Rates of MD patients with symptomatic values of metabolic parameters were 14.3% for WBC ≥10,000/µl, 26.9% for glucose levels ≥100 mg/dl, 54.2% for cholesterol levels ≥200 mg/dl, 7.5% for BUN ≥50 mg/dl, 21.9% for creatinine levels ≥1.2 mg/dl, and 20.9% for TSH levels ≥3.50 mU/l.Conclusions: Long-term lithium treatment was clinically effective, but the rates of metabolic effects were substantial although some of them were also associated with older age. Lithium-treated patients should receive accurate clinical monitoring to decrease the impact of long-term side effects. [ABSTRACT FROM AUTHOR]

In many contexts, individuals with lower socioeconomic status, especially immigrants, have a higher burden of negative alcohol-related consequences and a higher probability of receiving a psychiatric diagnosis. This study aimed at exploring sociodemographic and clinical characteristics associated with harmful use of alcohol (HUA) among immigrant patients. A cross-sectional study was conducted in Rome (Italy) on a sample of 330 immigrant patients admitted to the gastroenterology outpatient clinic of the INMP (March 2013–October 2014). HUA was evaluated through the Alcohol Use Disorders Identification Test (AUDIT) questionnaire. The presence of psychiatric disorders was diagnosed through SCID I–II interviews. The association between sociodemographic characteristics and psychiatric disorders and HUA was evaluated through a multivariate log-binomial regression model. HUA was associated with unemployment, longer stay in Italy, mood disorder and not being married, especially among African immigrants. We provide original findings about a selected, hard-to-investigate population, suggesting priorities in interventions on HUA among specific vulnerable subgroups. [ABSTRACT FROM AUTHOR]

Despite the occurrence of several earthquakes, only a few studies were conducted in Italy on the psychological impact in children and adolescents, with data mostly collected within one year after the disaster. This cross-sectional study aimed at exploring the prevalence of both post-traumatic stress disorder (PTSD) and emotional/behavioral difficulties, as well as at identifying their main predictors, among youths 2 years after the earthquake that hit Northern Italy in 2012. 682 children and adolescents (9–14 years) living in two districts (earthquake zone vs control zone) were administered an exposure questionnaire, the UCLA PTSD-Index for DSM-IV, and the Strengths and Difficulties Questionnaire (SDQ) and 1162 parents were assessed through the Symptom Checklist-90 (SCL-90). The prevalence of a likely PTSD in the earthquake zone was 1.9% (4.4% near the epicenter) and the total PTSD score in the affected area was significantly higher than in the control zone. 14.9% of youths living in the earthquake zone had a borderline/abnormal SDQ total difficulties score and 87.5% of youth with a likely PTSD also had a SDQ total score in the borderline/abnormal range. Regression analysis showed that the number of lifetime traumatic events (e.g., death of a relative) was the best predictor of children/adolescents psychological difficulties 2 years after the earthquake, followed by severity of exposure (personal injuries and losses) and parental psychopathology. Despite some limitations, this study highlights that youths may exhibit PTSD symptoms years after disasters, often in comorbidity with behavioral/emotional difficulties, stressing the need for long-term surveillance and interventions in exposed populations. [ABSTRACT FROM AUTHOR]

Purpose: To investigate to which extent occupational status, and job titles, were associated with types of hospitalisations and psychiatric diagnoses among inpatients of Friuli Venezia Giulia Region, Italy. Methods: Cross-sectional study based on 10 years register data (2008–2017) on 2929 subjects hospitalised in General Hospital Psychiatric Units. Odds ratios (OR) of hospitalisations and psychiatric diagnoses for occupational status and job titles were calculated by logistic regression analysis. Results: Employed were at lower risk of urgent and involuntary hospitalisation. The risk of urgent hospitalisation was higher for affective, organic or other disorders, while all psychiatric diagnoses were at lower risk of involuntary hospitalisation than psychosis. Using white collars as reference category, army showed a higher risk for urgent hospitalisation (OR = 2.3) and affective disorders (OR = 1.9). A higher risk for affective disorders was found in managers (OR = 2.0). Blue collars were at higher risk for alcohol and substance abuse (OR = 1.7). Conclusions: Employment was protective for urgent and involuntary hospitalisations and severe diagnoses. Hospitalisation for affective disorders was more likely in managers, army, and for substances abuse in blue collars. More research is needed to assess the association between specific occupational groups and involuntary hospitalisation. Employment was shown to be a protective factor for both urgent and involuntary hospitalisations and diagnosis of severe mental disorder. Managers, police and military forces were at higher risk of being hospitalised for affective disorders, while blue collars were at higher risk of hospitalisation for alcohol and substances abuse. Future research would benefit from a better analysis on the association between more specific occupational groups and hospitalisation for psychiatric disorders, with a particular focus on involuntary treatment. Further research is needed to compare the risk of hospitalisation for mental disorders in temporary or permanent position, according to recent international changes in labour market and its impact on mental health. [ABSTRACT FROM AUTHOR]

The current study aimed to examine whether executive functioning (EF) moderates the expected association between poor parental supervision and emotional-behavioral problems among early adolescents with and without a migration background in Italy. In total, 97 Chinese immigrant and 165 Italian nonimmigrant early adolescents, aged 11 to 13 years (52% girls), completed a series of performance and computer-based tasks assessing their EFs, whereas primary caregivers rated their own parental supervision and their offspring's emotional-behavioral problems. Regression analyses indicated that in both groups, a better working memory capacity was associated with fewer problems. Moreover, low levels of inhibitory control strengthened the association between poor parental supervision and emotional-behavioral problems. In addition, among Chinese immigrant youth, higher levels of cognitive flexibility enhanced the link between poor parental supervision and emotional-behavioral problems. Results underscore the importance of parental supervision and EF processes for Chinese immigrant youths' psychological functioning. [ABSTRACT FROM AUTHOR]

Background Decreasing gender differences in mental health are found largely in countries in which the roles of men and women have improved in terms of opportunities for employment, education, child care and other indicators of increasing gender equality. In this study, we examine how European welfare regimes influence this association between mental health and the social roles that men and women occupy. Methods The EU-World Mental Health data are used, which covers the general population in 10 European countries (n = 37 289); Countries were grouped into four welfare regions: Liberal regime (Northern Ireland), Bismarckian regime (Belgium, Germany, the Netherlands and France), Southern regime (Spain, Italy, Portugal) and Central-Eastern regime (Romania and Bulgaria). The lifetime prevalence of mood, anxiety and alcohol disorders was determined by using the Composite International Diagnostic Interview 3.0. Overall prevalence rates along with odds ratios by means of bivariate logistic regression models are calculated to compare the presence of common mental disorders in women versus men per welfare regime. Results Overall prevalence of common mental disorders is highest in the Liberal regime and lowest in the Central/Eastern regime. The gender gap in mental disorders is largest in the Southern regime and smallest in the Liberal regime. Marital status and certain employment positions help to explain variation in mental disorders across and within welfare regimes. Conclusion Most prominent pathways linking gender to mental ill-health being are related to marital status and certain employment positions. However, these pathways also show substantial variation across welfare regimes. [ABSTRACT FROM AUTHOR]

Background: Affective temperaments have been shown to be related to psychiatric disorders and suicidal behaviors. Less is known about the potential contributory role of affective temperaments on suicide risk factors. In the present study, we investigated whether the effect of affective temperaments on suicide risk was mediated by other variables, such as hopelessness, mentalization deficits, dissociation, psychological pain, and depressive symptoms. Methods: Several assessment instruments, including the Mini International Neuropsychiatric Interview (MINI); the Temperament Evaluation of Memphis, Pisa, and San Diego Autoquestionnaire (TEMPS-A); the Beck Hopelessness Scale (BHS); the Gotland Male Depression Scale (GMDS); the Dissociative Experiences Scale (DES); the Psychological Pain Assessment Scale (PPAS); and the Mentalization Questionnaire (MZQ), were administered to 189 psychiatrically hospitalized patients (103 women, 86 men) in Rome, Italy. Results: In single-mediator models, hopelessness, depressive symptoms, and mentalization, but not psychological pain or dissociation, were significant mediators in the association between prevalent temperament and suicide risk. In a multiple-mediator model, a significant indirect effect was found only for depression. Results demonstrated that patients with negative temperaments reported higher suicide risk, psychological pain, hopelessness, and depression, and less mentalization than patients with no prevalent temperament or hyperthymic temperaments. Conclusions: Hopelessness, depression, and mentalization are all factors that mediate the relation between affective temperaments and suicide risk. Identifying factors that mediate the effects of affective temperamental makeup on suicide risk should enhance screening and intervention efforts. [ABSTRACT FROM AUTHOR]

Estimates of depressive disorders in the elderly vary depending on how cases are defined. We estimated the prevalence of subthreshold depression (SD) and clinically significant depression (D) in a population of 70–74-year-olds. We also looked for associations with sociodemographic factors and perceptions of self. Participants underwent a multidimensional assessment (social, medical, and neuropsychological). The estimated prevalence of SD was 15.71% (95% CI: 13.70–17.72), while that of D was 5.58% (95% CI: 4.31–6.85). Multinomial logistic regression analysis revealed that female gender and dissatisfaction with family relationships were related to SD and D. A self-perception of physical age as older than actual age (but not comorbidity) and greater self-perceived stress caused by negative life events both increased the probability of SD. The likelihood of D was decreased in those who perceived their own health as good, whereas a self-perception of mental age as older than actual age and dissatisfaction with relationships with friends were both significantly associated with D. Both SD and D emerged as key problems in our population. Female gender and self-perceptions of various characteristics, which can be explored through simple questions, are associated with late-life depression in elderly people independently of their actual physical condition and other characteristics. [ABSTRACT FROM AUTHOR]

The study, conducted on Italian preadolscents aged 11 to 13 belonging to the general population, aims to investigate the relationship between the emotional functioning, namely, alexithymia, and the risk of developing behavioral and emotional problems measured using the Strength and Difficulty Questionnaire. The latent class analysis approach allowed to identify two latent variables, accounting for the internalizing (emotional symptoms and difficulties in emotional awareness) and for the externalizing problems (conduct problems and hyperactivity, problematic relationships with peers, poor prosocial behaviors and externally oriented thinking). The two latent variables featured two latent classes: the difficulty in dealing with problems and the strength to face problems that was representative of most of the healthy participants with specific gender differences. Along with the analysis of psychopathological behaviors, the study of resilience and strengths can prove to be a key step in order to develop valuable preventive approaches to tackle psychiatric disorders. [ABSTRACT FROM AUTHOR]

Background: Worldwide, approximately one in eight children or adolescents suffer from a mental disorder. The present study was designed to determine the cross-national prevalence of mental health problems in children aged 6-11 across seven European countries including Italy, Germany, the Netherlands, Lithuania, Bulgaria, Romania, and Turkey.Methods: Data were collected on 7682 children for whom either parent- or teacher SDQ were completed.Results: The present study provides country-specific normative banding for both parent- and teacher SDQ scores. Overall, 12.8 % of children have any probable disorder, with rates ranging from 15.5 % in Lithuania to 7.8 % in Italy, 3.8 % of children have a probable emotional disorder, 8.4 % probable conduct disorder, and 2.0 % probable hyperactivity/inattention. However, when adjusting for key sociodemographic variables and parental psychological distress, country of residence did not predict the odds of having any disorder. For specific disorders, however, country of residence does have an effect on the odds of presenting with mental health problems.Conclusions: As normative data are key in the comparison of mental health status on an international level, the present data considerably advance the possibilities of future research. Furthermore, the findings underline the importance of controlling for a number of sociodemographic and parental variables when conducting international comparisons of child mental health. In addition, the findings suggest that efforts are needed locally to assist in the detection and prevention of parental psychological distress. [ABSTRACT FROM AUTHOR]

Background: Conflicting evidence exists about the relationship between psychotic symptoms and suicidality in mood disorders. We aimed to investigate the lifetime suicidality and its relationship with dimensions of the psychotic spectrum over the lifespan among subjects with bipolar I (BD I) or major depressive disorder (MDD). Methods: 147 Consecutive out- and inpatients with BD I or MDD presenting for treatment at 11 Italian Departments of Psychiatry were administered the Structured Clinical Interview for DSM-IV Axis I Disorders, the Structured Clinical Interview for the Psychotic Spectrum (SCI-PSY, lifetime version) and the Mood Spectrum Self-Report (MOODS-SR, lifetime version). Results: Subjects with psychotic features did not differ from those without for MOODS-SR suicidality score. Controlling for age, gender and diagnosis (MDD/BD I), the SCI-PSY total score (p = .007) and Paranoid (p = .042), Schizoid (p = .007) and Interpersonal Sensitivity (p < .001) domain scores independently predicted lifetime MOODS-SR suicidality score in the overall sample. Conclusions: Psychotic features, as evaluated upon the presence of delusions or hallucinations, are not associated with suicidality among subjects with BD I or MDD. However, more subtle dimensions of the psychotic spectrum, such as Interpersonal Sensitivity, Paranoid and Schizoid symptoms, show a significant relationship with lifetime suicidality. Our findings highlight the potential usefulness of a spectrum approach in the assessment of psychotic symptoms and suicide risk among subjects with BD I or MDD. [ABSTRACT FROM AUTHOR]

Aims: This article aims to (1) explore the levels of perceived insecurity in a sample of patients with mood or anxiety disorders and (2) assess whether living in ‘big cities’ can influence the levels of patients’ perceived insecurity and social contacts compared to living in a non-urbanized context. Methods: A total of 24 Italian mental health centers (MHCs) have been invited to participate. Twenty patients consecutively accessing the MHC have been recruited. All patients have been assessed using validated assessment tools. Results: The sample consisted of 426 patients, mostly female, with a mean age of 45 years. Globally, 52.2% of patients had a diagnosis of mood disorders, and 37.8% had anxiety disorders. Half of the sample declared that the main feeling toward life is uncertainty; higher levels of pessimistic views toward life have been detected in patients living in urban areas. A positive association between negative attitudes toward life and higher levels of depressive and anxiety symptoms, poor social functioning and higher levels of perceived psychological distress has been found. Conclusion: Our findings confirm the presence of a common sense of perceived uncertainty among our sample. Such attitude toward life can have a detrimental impact on patients’ psychological and physical well-being, contributing to high levels of distress. [ABSTRACT FROM AUTHOR]

Background: Apathy is well described in neurodegenerative conditions, however to date there is no evidence of significant isolated apathy in subjects free from other neurological and psychiatric co-morbidites. Identifying isolated apathy in subjects free from neuropsychiatric conditions could contribute to refining current concepts of apathy and reevaluate its nosological classification as an independent clinical syndrome.Methods: We assessed apathy and perceived quality of life in a group of 2751 adults (age 19-40 years) free from neuropsychiatric or medical conditions. Subjects with and without elevated apathy were compared on measures of depression, self-efficacy, behavioral inhibition, and behavioral activation.Results: Observed prevalence of isolated elevated apathy was 1.45%. Subjects with apathy presented with reduced quality of life and lower behavioral activation compared to apathy-free subjects, while there was no difference between the two groups on measures of depression, self-efficacy, and perceived social skills.Limitations: The main limitation of this study is the use of self-report questionnaires.Conclusions: Isolated, ecologically-relevant apathy can be found in adults independently from the presence of subclinical depression or of concurrent medical conditions. Apathy screening should be considered in the evaluation of young non-depressed subjects with reduced perceived quality of life. [ABSTRACT FROM AUTHOR]

The question of how to quantify insufficient coping behavior under chronic stress is of major clinical relevance. In fact, chronic stress increasingly dominates modern work conditions and can affect nearly every system of the human body, as suggested by physical, cognitive, affective and behavioral symptoms. Since freshmen students experience constantly high levels of stress due to tight schedules and frequent examinations, we carried out a 3-center study of 1,303 students from Italy, Spain and Argentina in order to develop socioculturally independent means for quantifying coping behavior. The data analysis relied on 2 self-report questionnaires: the Coping Strategies Inventory (COPE) for the assessment of coping behavior and the Zurich Health Questionnaire which assesses consumption behavior and general health dimensions. A neural network approach was used to determine the structural properties inherent in the COPE instrument. Our analyses revealed 2 highly stable, socioculturally independent scales that reflected basic coping behavior in terms of the personality traits activity-passivity and defeatism-resilience. This replicated previous results based on Swiss and US-American data. The percentage of students exhibiting insufficient coping behavior was very similar across the study sites (11.5-18.0%). Given their stability and validity, the newly developed scales enable the quantification of basic coping behavior in a cost-efficient and reliable way, thus clearing the way for the early detection of subjects with insufficient coping skills under chronic stress who may be at risk of physical or mental health problems. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Introduction: Lithium is a highly specific and evidence-supported drug for the acute and maintenance treatment of bipolar disorder. Methods: The purpose of this study was to calculate the prevalence and incidence of lithium use and to investigate the prescribing patterns of other mood-stabilizing agents in lithium users. We analyzed lithium utilization from 2000 to 2010 in a large area in Italy on the basis of dispensing data drawn from the regional administrative database. For each calendar year those who had at least one recorded dispensation of lithium were defined as lithium users. Those who received more than 4 dispensations per year were defined as lithium-treated. Results: Rates of lithium utilization did not change during the observation period, but the amount of drug prescribed increased as a result of longer treatment and higher doses. The prevalence of use showed an initial increase of 8 % (2000-2002), followed by a 13 % decrease (2002- 2006) and a subsequent rise of 11 % (2006-2010). The prevalence of treatment grew by 38 % during the whole observation period. The proportion of former lithium users who received other drugs or discontinued any treatment increased from 41 % in 2002 to 52 % in 2006, and then fell to 40 % in 2010. Conclusion: The initial decline (2002-2006) and the subsequent rise (2006-2010) of lithium use can be explained by a fall and rise of new prescriptions. This finding together with a similar but opposite change in prescriptions of the other mood-stabilizing agents suggests a temporary change in prescribing attitudes which was subsequently reconsidered. [ABSTRACT FROM AUTHOR]

Background Several studies have suggested that maternal eating disorders (EDs) represent a significant risk factor for children's affective and behavioral development. Yet, little emphasis has been placed on the paternal role. Objectives The present longitudinal study aimed to clarify the role of maternal EDs and the influence of paternal psychological profiles on children's emotional development. Method Our sample was composed of N = 64 families with firstborn children selected through preschools, primary schools, and outpatient clinics in central Italy. Parents and children participated in a 6-year longitudinal protocol that included a diagnostic interview conducted by clinicians (Structured Clinical Interview for DSM-IV Axis I Disorders [SCID-I]), a self-report (Symptom Checklist-90-Revised [SCL-90-R]), and a parental report-form questionnaire (Child Behavior Checklist [CBCL]). Results The influence of mothers' EDs on their children's emotional development was confirmed. Moreover, fathers' anxiety and obsessive-compulsive problems in association with mothers' EDs and depressive symptoms influenced the onset of both internalizing and externalizing difficulties in their children over time. Conclusion Our results suggest that fathers' psychopathological risk affects the development of emotional problems in children with mothers who have EDs. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Abstract: Background: The objective of the study was to determine if community surveys, conducted 3 times over a period of 20years in a small district of Sardinia (Italy), confirm the increase in depressive disorders reported in the recent literature. Methods: Three community surveys were carried out on randomized samples of the same Sardinian mining area in 1988, 1998 and 2008. The surveys were conducted using the interview “Present State Examination” in 1988 (depression diagnosed with ICD-IX) and the CIDI-S in 1998 and 2008 (major depression diagnosed with ICD-X). The three surveys produced estimates of one-month prevalence and of lifetime prevalence in 1998 and 2008. Results: Our work found a substantial decrease in depressive disorders from the survey conducted in 1998 to the survey in 2008 using a similar methodology, except in the youngest age group, which showed an increase in the rate. A decrease in the frequency of depressive disorders compared to what was found 20years ago was also observed. However, in this case the comparison is more problematic because of use of different diagnostic systems. Discussion: The research seems to show a decrease in depressive disorders over the past two decades. While the small population examined makes it difficult to generalize the overall findings, this study suggests that the hypothesis of an increase in the incidence of depressive disorders since the 1980s in western countries, should have exceptions. A complex interaction between socio-economic (mining closure and large migration) and biological factors (possible selective migration) is likely to influence changes in the prevalence of mood disorders. However, due to certain limitations of this study, this hypothesis may be considered from a heuristic perspective. [Copyright &y& Elsevier]