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Introduction: Psychiatric rehabilitation activities (PRA) aim at restoring community functioning and improving well-being and quality of life of patients, guiding them towards independence and taking responsibility for their own existence. PRA suitable to psychiatry emergency settings are crucial as they prepare effective postdischarge therapeutic programs. Our psychiatry emergency unit designed rapid group PRA based on a combination of personcentred, evidence-based interventions. Objectives: The aim of our study is to assess several aspects of our PRA: participation rate, degree of participants' satisfaction, perceived utility, and the quality of climate within the group. Methods: Self-report questionnaires were administered in our psychiatry emergency unit to acute patients during their hospitalization. Patients underwent our PRA, a structured weekly program based on a combination of cognitive-behavioural interventions such as Psycho-education, Cognitive Remediation and Social Skills Training. Results: From April to December 2018, 195 self-report questionnaires were administered. 88.5% of participants described PRA as very useful to their recovery process, 87% considered themselves very satisfied with the climate within the group and 86.1% of the sample was very satisfied with the quality of time spent on PRA. Conclusions: Monitoring our group program resulted in a positive feedback on PRA, with high rates of perceived efficacy and satisfaction. High acceptability makes this intervention a promising approach able to promote awareness and recovery in acute patients. The therapeutic effects of PRA possibly unfold through the enhanced ability to cope with stress and to manage personal vulnerabilities, along with an improvement of cognitive functions. [ABSTRACT FROM AUTHOR]

Attention deficit/hyperactivity disorder (ADHD) often persists into adulthood. Although its persistence and relative high prevalence, ADHD in adults is often underdiagnosed and undertreated in Italy, leading to poor clinical and functional outcomes, and higher costs of illness. The aims of the study were to identify the Italian mental health services for ADHD in adults, describe the diagnostic and treatment procedures they follow, and compare this offer with the recommendations of the German and English guidelines. The centres, that adopt a clinical and assessment protocol for adult ADHD diagnosis (carried out by specifically trained personnel) and prescribe pharmacological treatment for adult ADHD, were selected from the list of accredited services provided by the Appendix B.2 of the ISTISAN 16/37 Reports of the ISS. An ad-hoc survey including open-ended and close-ended questions was sent to each selected centre in February 2020. The overall picture resulting from the data analysis was compared with the recommendations of the German and English guidelines. The present survey shows that only a few centres are specialised in the diagnosis and treatment of ADHD in adults in Italy. Furthermore, there are no national guidelines for adult ADHD in Italy. The collected data also suggest that there is no a unified practice shared by the Centres both for the patient's transition from child and adolescent to adult mental health services and for the diagnostic-therapeutic process. It is therefore crucial to create specific protocols and develop national guidelines to better identify and diagnose ADHD in adults and provide targeted and more efficient multimodal treatments.

Background: Athanasios Koukopoulos proposed the primacy of mania hypothesis (PoM) in a 2006 book chapter and later, in two peer-reviewed papers with Nassir Ghaemi and other collaborators. This hypothesis supports that in bipolar disorder, mania leads to depression, while depression does not lead to mania., Objective: To identify evidence in literature that supports or falsifies this hypothesis., Method: We searched the medical literature (PubMed, Embase, PsycINFO, and the Cochrane Library) for peer-reviewed papers on the primacy of mania, the default mode function of the brain in normal people and in bipolar disorder patients, and on illusion superiority until 6 June, 2016. Papers resulting from searches were considered for appropriateness to our objective. We adopted the PRISMA method for our review. The search for consistency with PoM was filtered through the neurobiological results of superiority illusion studies., Results: Out of a grand total of 139 records, 59 were included in our analysis. Of these, 36 were of uncertain value as to the primacy of mania hypothesis, 22 favoured it, and 1 was contrary, but the latter pooled patients in their manic and depressive phases, so to invalidate possible conclusions about its consistency with regard to PoM. All considered studies were not focused on PoM or superiority illusion, hence most of their results were, as expected, unrelated to the circuitry involved in superiority illusion. A considerable amount of evidence is consistent with the hypothesis, although indirectly so., Limitations: Only few studies compared manic with depressive phases, with the majority including patients in euthymia., Conclusion: It is possible that humans have a natural tendency for elation/optimism and positive self-consideration, that are more akin to mania; the depressive state could be a consequence of frustrated or unsustainable mania. This would be consistent with PoM.