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Ghahari D, Chaharlangi D, Bonato S, Sliekers S, Sockalingam S, Ali A, Benassi P. Educational Approaches Using Simulation for Psychiatric Risk Assessment: a Scoping Review. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2024; 48:61-70. [PMID: 37584887 DOI: 10.1007/s40596-023-01836-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 07/18/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVE The ability to assess a patient's risk of harm to self or others is a core competency for mental health clinicians which can have significant patient outcomes. With the growth of simulation in medical education, there is an opportunity to enhance education outcomes for psychiatric risk assessment. The purpose of this study was to determine how simulation is used to build competency in risk assessment and map its educational outcomes. METHODS The authors conducted a systematic scoping review using the Arksey and O'Malley framework. Electronic database searches were conducted by an academic librarian. Studies published before August 2022 which described simulation activities aimed at training clinicians in suicide, self-harm, and/or violence risk assessment were screened for eligibility. RESULTS Of the 21,814 articles identified, 58 studies were selected for inclusion. The majority described simulations teaching suicide risk assessment, and there was a notable gap for building competency in violence risk assessment. Simulation utility was demonstrated across emergency, inpatient, and outpatient settings involving adult and pediatric care. The most common simulation modality was patient actors. A smaller subset implemented technological approaches, such as automated virtual patient avatars. Outcomes included high learner satisfaction, and increases in psychiatric risk assessment knowledge, competency, and performance. CONCLUSION Simulation as an adjuvant to existing medical curricula can be used to teach risk assessment in mental health. Based on the results of our review, the authors provide recommendations for medical educators looking to design and implement simulation in mental health education.
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Affiliation(s)
| | | | - Sarah Bonato
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | | | - Sanjeev Sockalingam
- University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Amina Ali
- University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Paul Benassi
- University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
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Bahadur AG, Hargreaves F, Antinucci R, Sockalingam S, Abdool PS. Virtual Reality Simulation for Suicide Risk Assessment Training: Prevalence of Adverse Effects. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2024; 48:57-60. [PMID: 37258946 DOI: 10.1007/s40596-023-01799-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/08/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Virtual reality (VR) simulation is changing the landscape of simulation-based medical education. Immersive VR allows users to interact with a computer-generated environment and digital avatars using a VR headset and controllers. However, current literature regarding the use of immersive VR simulation in psychiatric medical education is sparse. This study describes its use and considerations regarding tolerability. METHODS At a mental health hospital in Canada, two immersive VR suicide risk assessment (SRA) case simulations were developed. These simulations have participants interview VR patients to characterize their suicide risk, offering a novel and safe way to engage healthcare providers in SRA training. Regarding user tolerability of these VR simulations, the Simulator Sickness Questionnaire (SSQ) was administered to participants after the simulation to characterize any motion sickness symptoms experienced. RESULTS Of the 22 participants in this study, the overall SSQ scores demonstrated good tolerability of the VR SRA, with the majority of participants reporting no or minimal simulator sickness symptoms. Moreover, the majority of participants reported being satisfied with this training and that the VR SRA simulation enhanced their learning experience. CONCLUSION These study findings are novel, given the current dearth of data regarding the use of immersive VR in simulation-based psychiatric medical education. Further studies exploring the educational effectiveness of VR SRA in simulation-based psychiatric medical education are indicated.
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Affiliation(s)
| | | | - Rachel Antinucci
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Sanjeev Sockalingam
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Petal S Abdool
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Ung TX, El-Den S, Moles RJ, O'Reilly CL. The Use of Mental Health Simulation in Pharmacy Practice and Education: A Systematic Review. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100058. [PMID: 37316135 DOI: 10.1016/j.ajpe.2023.100058] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/30/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To explore how mental health simulation has been used in the context of pharmacy practice and education, specifically what types of simulation techniques have been used, and which mental health-related content has been simulated. FINDINGS A literature search retrieved 449 reports, from which 26 articles pertaining to 23 studies were eligible for inclusion. Most studies were conducted in Australia. The most common type of simulation utilized was live simulated/standardized patient, followed by pre-recorded scenarios, role-play, and auditory simulation. While many study interventions included content relating to multiple mental illnesses and included activities other than simulation, the most simulated mental health content was enacting a person living with depression (with or without suicidal thoughts), mental health communication, followed by stress-induced insomnia, then hallucinations. Key outcomes from included studies were significantly improved student outcomes such as mental health knowledge, attitudes, social distance, and empathy scores, as well as highlighting the potential to further improve the mental healthcare skills of community pharmacists. SUMMARY This review demonstrates a varied use of techniques to simulate mental health in pharmacy practice and education. Future research is suggested to consider other simulation methods such as virtual reality and computer simulation, and to investigate how lesser-simulated mental health content such as psychosis could be incorporated. It is also recommended that future research provides greater detail on the development of the simulated content, such as involving people with lived experience of mental illness and mental health stakeholders in the development process to improve the authenticity of simulation training.
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Affiliation(s)
- Tina X Ung
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia.
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
| | - Rebekah J Moles
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
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Pothireddy N, Lavigne JE, Groman AS, Carpenter DM. Developing and evaluating a module to teach suicide prevention communication skills to student pharmacists. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:449-456. [PMID: 35483810 DOI: 10.1016/j.cptl.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 01/13/2022] [Accepted: 02/27/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION This study aimed to determine whether a brief educational intervention for student pharmacists about individuals who exhibit suicide warning signs improves knowledge and confidence to recognize suicide warning signs, ask about suicide, validate feelings, and expedite referrals. METHODS This longitudinal, observational study was conducted with student pharmacists from two pharmacy schools in 2019. Students completed a suicide prevention module adapted from the Veteran Administration's S.A.V.E. suicide prevention gatekeeper training program (completion rate 67%). The module included a video case of an individual who exhibits suicide warning signs, a brief didactic lecture, and a role-play practice session. Text responses were coded by three independent raters. Students completed a multiple-choice pretest and posttest to assess knowledge and confidence. Paired samples t-tests were calculated to examine changes in students' knowledge and confidence scores. RESULTS Students' (N = 139) confidence and knowledge in recognizing and managing suicide warning signs improved significantly. There was improvement in how many students directly asked about suicide and expedited a referral. Most students (86%) reported planning to incorporate what they learned into practice. CONCLUSIONS In two schools of pharmacy, a brief suicide prevention module was implemented and adapted to the community pharmacy setting, which improved pharmacy students' knowledge and confidence to interact with an individual who exhibits suicide warning signs. S.A.V.E. teaches students how to communicate with an individual in crisis in a way that can be integrated into a busy pharmacy workflow, which may be why students planned to incorporate it into practice.
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Affiliation(s)
- Nithya Pothireddy
- UNC Eshelman School of Pharmacy, 301 Pharmacy Ln, Chapel Hill, NC 27599, United States.
| | - Jill E Lavigne
- St. John Fisher College Wegmans School of Pharmacy, 3690 East Ave, Rochester, NY 14618, United States.
| | - Aleah S Groman
- St. John Fisher College Wegmans School of Pharmacy, 3690 East Ave, Rochester, NY 14618, United States.
| | - Delesha M Carpenter
- UNC Eshelman School of Pharmacy, 220 Campus Drive, Karpen Hall, CPO 2125, Asheville, NC 28804, United States.
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Hawgood J, Krysinska K, Mooney M, Ozols I, Andriessen K, Betterridge C, De Leo D, Kõlves K. Suicidology Post Graduate Curriculum: Priority Topics and Delivery Mechanisms for Suicide Prevention Education. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9926. [PMID: 34574848 PMCID: PMC8469380 DOI: 10.3390/ijerph18189926] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND There has been limited attention to the development and delivery of tertiary suicide prevention curricula. The aim of this work was to describe the status of postgraduate suicide prevention education, with specific attention on examining the needs of the suicide prevention sector in Australia. METHOD An online survey was completed by 76 stakeholders in Australia. Current curriculum learning outcomes from Griffith University's postgraduate suicidology programs guided the development of the survey. RESULTS Four key learning domains were rated highest in importance by stakeholders. According to most stakeholders, skills-based qualifications were the most relevant type of qualification, and online modulized education was the most preferred delivery mode. Half of stakeholders supported suicide prevention professional development through a combination of financial support and study leave. CONCLUSIONS The survey provided invaluable feedback regarding the priorities of Australia's suicide prevention sector for content domains and delivery mechanisms for tertiary suicidology education. The findings showed the preferred type of organizational (employer) support that may be provided for employees to undertake such education. These findings will inform the future developments of Griffith University's suicidology programs and may motivate other universities to consider offering same or a similar type of education to support the suicide prevention sector toward saving lives.
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Affiliation(s)
- Jacinta Hawgood
- World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane 4111, Australia; (M.M.); (D.D.L.); (K.K.)
| | - Karolina Krysinska
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne 3010, Australia; (K.K.); (K.A.)
| | - Maddeline Mooney
- World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane 4111, Australia; (M.M.); (D.D.L.); (K.K.)
| | - Ingrid Ozols
- Department of Psychiatry, The University of Melbourne, Melbourne 3002, Australia;
- Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne 3800, Australia
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne 3010, Australia; (K.K.); (K.A.)
| | | | - Diego De Leo
- World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane 4111, Australia; (M.M.); (D.D.L.); (K.K.)
| | - Kairi Kõlves
- World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane 4111, Australia; (M.M.); (D.D.L.); (K.K.)
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Frick A, Osae L, Ngo S, Anksorus H, Williams CR, Rodgers PT, Harris S. Establishing the role of the pharmacist in mental health: Implementing Mental Health First Aid into the doctor of pharmacy core curriculum. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:608-615. [PMID: 33867054 DOI: 10.1016/j.cptl.2021.01.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 12/11/2020] [Accepted: 01/20/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The objective of this study was to assess the impact of implementing Mental Health First Aid (MHFA) training in a doctor of pharmacy (PharmD) curriculum on student pharmacists' knowledge, attitudes, self-efficacy, and empathy towards people with mental health conditions and/or crises. METHODS Participants were third-year PharmD students enrolled in Patient Care Experience, a required communication and ethics course. A survey was administered pre- and post-intervention (i.e. MHFA training). Student pharmacist self-efficacy in assisting someone developing a mental health condition or in crisis was evaluated using confidence measures from the MHFA action plan. Knowledge was measured using Mental Health Knowledge Statements. Attitudes were assessed with the Index of Attitudes Towards Mental Illness, and stigma was evaluated using the Social Distancing Scale. Empathy was measured with the Kiersma-Chen Empathy Scale. RESULTS Both pre- and post-intervention surveys were completed by 97 of 135 participants (71.9% response rate). MHFA training resulted in significantly increased self-efficacy and empathy. There were no significant differences in knowledge, attitudes, and stigma. CONCLUSIONS MHFA training was associated with increases in student pharmacist empathy and self-efficacy in providing support to individuals with mental health crises.
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Affiliation(s)
- Amber Frick
- Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina Eshelman School of Pharmacy, 3214 Kerr Hall, CB# 7569, 301 Pharmacy Lane, Chapel Hill, NC 27599, United States.
| | - Leah Osae
- University of North Carolina Eshelman School of Pharmacy, CB# 7569, 301 Pharmacy Lane, Chapel Hill, NC 27599, United States.
| | - Susan Ngo
- University of North Carolina Eshelman School of Pharmacy, CB# 7569, 301 Pharmacy Lane, Chapel Hill, NC 27599, United States.
| | - Heidi Anksorus
- Practice Advancement and Clinical Education Division, University of North Carolina Eshelman School of Pharmacy, 1318 Kerr Hall, CB# 7475, 301 Pharmacy Lane, Chapel Hill, NC 27599, United States.
| | - Charlene R Williams
- Practice Advancement and Clinical Education Division, University of North Carolina Eshelman School of pharmacy, One University Heights, CB# 2125, Asheville, NC 28804, United States.
| | - Philip T Rodgers
- Practice Advancement and Clinical Education Division, University of North Carolina Eshelman School of Pharmacy, 115M Beard Hall, CB# 7574, 301 Pharmacy Lane, Chapel Hill, NC 27599, United States.
| | - Suzanne Harris
- Practice Advancement and Clinical Education Division, University of North Carolina Eshelman School of Pharmacy, 1310 Kerr Hall, CB# 7574, 301 Pharmacy Lane, Chapel Hill, NC 27599, United States.
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Hung MS, Chow MC, Chien WT, Wong PY. Effectiveness of the Mental Health First Aid programme for general nursing students in Hong Kong: A randomised controlled trial. Collegian 2021. [DOI: 10.1016/j.colegn.2020.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Witry M, Clayden A. Student pharmacist personal and work experiences with people displaying warning signs of suicidal ideation. Ment Health Clin 2020; 10:244-249. [PMID: 32685336 PMCID: PMC7337995 DOI: 10.9740/mhc.2020.07.244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Introduction Student pharmacists, in their roles as trainees, technicians, and peers, may interact with people displaying suicide warning signs. Providing suicide gatekeeping training to student pharmacists may prepare them to engage people at risk. Measuring the extent to which student pharmacists have encountered people displaying warning signs of suicide may help contextualize the potential importance of training student pharmacists in suicide gatekeeping. The objective was to describe student pharmacists' awareness of someone they know having attempted or died by suicide and whether they have heard statements suggesting suicide risk in their personal and work life. Methods An anonymous electronic survey was administered to 111 student pharmacists before engaging in question-persuade-refer training as part of their second-year pharmacy curriculum. Respondents were asked for demographics and if Someone ever told you something concerning where you wondered if they were thinking about suicide for both work and one's personal life. Descriptive statistics and chi-squared tests were used to compare items by gender. Results There were 111 responses to the survey for a 100% response rate. Concerning statements related to suicide were reported by 71.2% of respondents in their personal life and by 34.2% of students while at work. There were no differences based on gender. Discussion A significant proportion of student pharmacists have personal, peer, and professional exposure related to people with potential suicidal ideation. These findings emphasize the need for broad approaches for training students and pharmacists in suicide gatekeeping as a new public health role.
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Affiliation(s)
- Matthew Witry
- Graduate Student, University of Iowa School of Social Work, Iowa City, Iowa
| | - Alyssa Clayden
- Graduate Student, University of Iowa School of Social Work, Iowa City, Iowa
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Nursing students’ experiences of mental health first aid training: A qualitative descriptive study. Collegian 2019. [DOI: 10.1016/j.colegn.2019.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Niedermier J, Kasick D. Maintaining Personal Safety: Understanding and Addressing Aggression and Violence in the Health Care Setting. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2018; 14:10722. [PMID: 30800922 PMCID: PMC6342432 DOI: 10.15766/mep_2374-8265.10722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 05/20/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION A 2-hour introductory lecture-discussion curriculum was developed to provide medical students and residents with education about personal safety in the health care setting. The course focused on providing learners with proactive and practical advice for understanding, recognizing, and responding to difficult patients or others who may pose risks of violence. It was designed for participants to gain knowledge about initial management of often unfamiliar situations before untoward behaviors escalate to violence. METHODS Eight hundred thirty-eight medical students participated in this required element of the third-year psychiatry clerkship experience. Sixty first-year through fourth-year psychiatry residents participated as part of departmental orientation. Instructors provided the same seminar for both learner groups throughout the project's duration. In addition to a PowerPoint presentation, learners participated in discussion about personal safety threats in the health care setting. Evaluations were obtained, and more recent cohorts also completed a postcourse assessment of knowledge. RESULTS Results suggested that learners from both groups viewed the session favorably, indicating the personal safety curriculum was beneficial and practical and helped increase their knowledge about this important topic. The session received a high number of positive comments from learners, reinforcing its valuable take-home message. DISCUSSION Given the growing magnitude and understanding of risk of aggression and violence in health care settings, we incorporated a required personal safety session into our psychiatry residency and medical school curricula. The session's emphasis was on preventative and proactive strategies to employ with patients before and during escalation of potentially violent situations.
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Affiliation(s)
- Julie Niedermier
- Associate Professor, Department of Psychiatry, Ohio State University College of Medicine
| | - David Kasick
- Associate Professor, Department of Psychiatry, Ohio State University College of Medicine
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Gramaglia C, Zeppegno P. Medical Students and Suicide Prevention: Training, Education, and Personal Risks. Front Psychol 2018; 9:452. [PMID: 29686635 PMCID: PMC5900055 DOI: 10.3389/fpsyg.2018.00452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 03/19/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Carla Gramaglia
- Psychiatry Institute, Dipartimento di Medicina Traslazionale, Università degli Studi del Piemonte Orientale, Novara, Italy.,Struttura Complessa di Psichiatria, Azienda Ospedaliero Universitaria Maggiore della Carità di Novara, Novara, Italy
| | - Patrizia Zeppegno
- Psychiatry Institute, Dipartimento di Medicina Traslazionale, Università degli Studi del Piemonte Orientale, Novara, Italy.,Struttura Complessa di Psichiatria, Azienda Ospedaliero Universitaria Maggiore della Carità di Novara, Novara, Italy
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