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Luciano M, Carmassi C, Sampogna G, Bertelloni CA, Abbate-Daga G, Albert U, Castellini G, Della Rocca B, Fantasia S, Menchetti M, Pedrinelli V, Pompili M, Signorelli MS, Tosato S, Fiorillo A. Longitudinal trajectories of psychosocial functioning in patients with pre-existing mental disorders after one year of COVID-19 pandemic. J Psychiatr Res 2024; 172:200-209. [PMID: 38401365 DOI: 10.1016/j.jpsychires.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 01/09/2024] [Accepted: 02/07/2024] [Indexed: 02/26/2024]
Abstract
Aims of the present study were to prospectively assess psychosocial functioning trajectories during the COVID pandemic and the possible impact of sociodemographic variables, as well as of COVID-19 pandemic-related factors, on these trajectories, in a sample of patients with pre-existing severe mental disorders. Moreover, we aimed at identifying predictors of impairment in psychosocial functioning over a period of 9 months of COVID-19 pandemic. Patients were recruited during the 3rd wave of the COVID-19 pandemic (T0, March-April 2021) while strict containment measures were applied in Italy, and reassessed after 3 months (T1, June-July 2021), and after 6 months from T1 (T2- November-December 2021), during the 4th wave of COVID pandemic. A sample of 300 subject (out of the 527 subjects recruited at baseline) completed the T2 evaluation. Patients were assessed by: Work and Social Adjustment Scale (WSAS) for psychosocial functioning, Generalized Anxiety Disorder 7-Item (GAD-7) for anxiety symptoms, Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms and the Impact of Events Scale-Revised, for post-traumatic symptoms. Cluster analyses identified 4 trajectories of functioning: the High, Stable Functioning group (N = 77), the Improvement Functioning group (N = 62), the Progressive Impairment group (N = 83) and the Persistent Severe Impairment group (N = 78) respectively. We found that predictors of higher WSAS score at T2 were higher WSAS score at T0 (B = 0.43, p < .001), PHQ scores at baseline >10 (B = 2.89, p < .05), while not living alone was found to be a protective factor (B = -2.5, p < .05). Results of the present study provides insights into the vulnerability of individuals with psychiatric disorders during times of crisis. Study findings can contribute to a better understanding of the specific needs of this population and inform interventions and support strategies.
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Affiliation(s)
- M Luciano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli,", Naples, Italy.
| | - C Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - G Sampogna
- Department of Psychiatry, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - C A Bertelloni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - G Abbate-Daga
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - U Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina - ASUGI, Trieste, Italy
| | - G Castellini
- Department of Health Sciences, University of Florence, Florence, Italy
| | - B Della Rocca
- Department of Psychiatry, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - S Fantasia
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Menchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - V Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Pompili
- Department of Neuroscience, Mental Health and Sense Organs, University of Rome "La Sapienza", Rome, Italy
| | - M S Signorelli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - S Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - A Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli,", Naples, Italy
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Carmassi C, Tosato S, Pedrinelli V, Bertelloni CA, Abbate-Daga G, Albert U, Castellini G, Luciano M, Menchetti M, Pompili M, Sampogna G, Signorelli M, Massimetti G, Fiorillo A. Longitudinal trajectories of anxiety and depression in subjects with different mental disorders after one year in the COVID-19 pandemic. Psychiatry Res 2024; 334:115680. [PMID: 38368843 DOI: 10.1016/j.psychres.2023.115680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 12/07/2023] [Accepted: 12/14/2023] [Indexed: 02/20/2024]
Abstract
The aim of this study was to prospectively assess the development and trajectories of anxiety and depressive symptoms among subjects with different mental disorders, during the 3rd wave of the COVID-19 pandemic (T0, March-April 2021) while strict containment measures were applied in Italy, and after 3 months (T1, June-July 2021), with reduced restrictive measures. A sample of 527 subjects, with different DSM-5 diagnoses, was enrolled at nine Italian psychiatric outpatient services. Assessments at T0 and T1 included the Generalized Anxiety Disorder 7-Item (GAD-7) for anxiety symptoms, and the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms. Differences in anxiety and depressive symptoms rates emerged across different mental disorders and a general improvement at T1 was detected for all of them in both the GAD-7 and PHQ-9 scores, except for Psychosis and Obsessive-Compulsive Disorder (OCD). Patients with Feeding and Eating Disorders (FED) reported statistically significantly higher: GAD-7 scores than those with Bipolar Disorder (BD), at both times, and Anxiety Disorders at baseline; PHQ-9 scores than all other diagnostic categories, at both times. Unemployment, no COVID-19 infection, OCD were predictive variables related to GAD-7 scores at T1, while being unmarried, BD or FED related to PHQ-9 scores at T1. Subjects with mental disorders reported anxiety and depressive symptoms during the third pandemic wave and most of patients showed an improvement over a 3-month follow-up, despite differences emerged among diagnostic categories and for the variables involved. Further studies are needed to deepen knowledge on pandemic impact on patients with mental disorders.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Carlo A Bertelloni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giovanni Abbate-Daga
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina - ASUGI, Trieste, Italy
| | - Giovanni Castellini
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Firenze, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Maurizio Pompili
- Department of Neuroscience, Mental Health and Sense Organs, University of Roma "La Sapienza", Roma, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Signorelli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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Dell’Oste V, Palego L, Betti L, Fantasia S, Gravina D, Bordacchini A, Pedrinelli V, Giannaccini G, Carmassi C. Plasma and Platelet Brain-Derived Neurotrophic Factor (BDNF) Levels in Bipolar Disorder Patients with Post-Traumatic Stress Disorder (PTSD) or in a Major Depressive Episode Compared to Healthy Controls. Int J Mol Sci 2024; 25:3529. [PMID: 38542503 PMCID: PMC10970837 DOI: 10.3390/ijms25063529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
Post-traumatic stress disorder (PTSD) is a highly disabling mental disorder arising after traumatism exposure, often revealing critical and complex courses when comorbidity with bipolar disorder (BD) occurs. To search for PTSD or depression biomarkers that would help clinicians define BD presentations, this study aimed at preliminarily evaluating circulating brain-derived-neurotrophic factor (BDNF) levels in BD subjects with PTSD or experiencing a major depressive episode versus controls. Two bloodstream BDNF components were specifically investigated, the storage (intraplatelet) and the released (plasma) ones, both as adaptogenic/repair signals during neuroendocrine stress response dynamics. Bipolar patients with PTSD (n = 20) or in a major depressive episode (n = 20) were rigorously recruited together with unrelated healthy controls (n = 24) and subsequently examined by psychiatric questionnaires and blood samplings. Platelet-poor plasma (PPP) and intraplatelet (PLT) BDNF were measured by ELISA assays. The results showed markedly higher intraplatelet vs. plasma BDNF, confirming platelets' role in neurotrophin transport/storage. No between-group PPP-BDNF difference was reported, whereas PLT-BDNF was significantly reduced in depressed BD patients. PLT-BDNF negatively correlated with mood scores but not with PTSD items like PPP-BDNF, which instead displayed opposite correlation trends with depression and manic severity. Present findings highlight PLT-BDNF as more reliable at detecting depression than PTSD in BD, encouraging further study into BDNF variability contextually with immune-inflammatory parameters in wider cohorts of differentially symptomatic bipolar patients.
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Affiliation(s)
- Valerio Dell’Oste
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (L.P.); (S.F.); (D.G.); (A.B.); (V.P.); (C.C.)
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
- UFCSMA Zona Valdinievole, Azienda USL Toscana Centro, 51016 Montecatini Terme, Italy
| | - Lionella Palego
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (L.P.); (S.F.); (D.G.); (A.B.); (V.P.); (C.C.)
- Department of Pharmacy, Section of Biochemistry, University of Pisa, 56126 Pisa, Italy; (L.B.); (G.G.)
| | - Laura Betti
- Department of Pharmacy, Section of Biochemistry, University of Pisa, 56126 Pisa, Italy; (L.B.); (G.G.)
| | - Sara Fantasia
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (L.P.); (S.F.); (D.G.); (A.B.); (V.P.); (C.C.)
| | - Davide Gravina
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (L.P.); (S.F.); (D.G.); (A.B.); (V.P.); (C.C.)
| | - Andrea Bordacchini
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (L.P.); (S.F.); (D.G.); (A.B.); (V.P.); (C.C.)
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (L.P.); (S.F.); (D.G.); (A.B.); (V.P.); (C.C.)
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
- UFSMA Zona Apuana, Azienda USL Toscana Nord Ovest, 54100 Massa, Italy
| | - Gino Giannaccini
- Department of Pharmacy, Section of Biochemistry, University of Pisa, 56126 Pisa, Italy; (L.B.); (G.G.)
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (L.P.); (S.F.); (D.G.); (A.B.); (V.P.); (C.C.)
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Castellini G, Tarchi L, Cassioli E, Ricca V, Abbate Daga G, Aguglia A, Albert U, Atti A, Barlati S, Blasi G, Carmassi C, Carrà G, De Fazio P, De Panfilis C, Di Lorenzo G, Ferrari S, Goracci A, Gramaglia C, Luciano M, Martinotti G, Menchetti M, Menculini G, Nanni MG, Nivoli A, Pinna F, Pompili M, Rosso G, Sambataro F, Sampogna G, Sani G, Serafini G, Signorelli MS, Tosato S, Ventriglio A, Viganò C, Volpe U, Fiorillo A. The interplay between mentalization, personality traits and burnout in psychiatry training: Results from a large multicenter controlled study. Acta Psychiatr Scand 2024; 149:177-194. [PMID: 38167781 DOI: 10.1111/acps.13649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/05/2023] [Accepted: 12/10/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND A better characterization of educational processes during psychiatry training is needed, both to foster personal resilience and occupational proficiency. METHODS An adequate coverage of medical residents at the national level was reached (41.86% of the total reference population, 29 out of 36 training centers-80.55%). Controls were recruited among residents in other medical specialties. All participants were assessed by questionnaires to evaluate early life experiences, attachment style, personality traits, coping strategies, emotional competencies. A Structural Equation Model (SEM) framework was employed to investigate the interplay between individual factors. RESULTS A total sample of 936 people was recruited (87.9% response-rate; 645 residents in psychiatry, 291 other medical residents). Psychiatry trainees reported a higher prevalence of adverse childhood experiences (emotional abuse, emotional neglect, physical neglect), greater attachment insecurity (anxious or avoidant) in comparison to other medical trainees. Psychiatry residents also reported higher social support-seeking as a coping strategy, lower problem-orientation, and lower transcendence. Lower neuroticism, higher openness to experience, and higher emotional awareness were also observed in psychiatry trainees. Psychiatry training was associated with a redefinition of conflict management skills as a function of seniority. The SEM model provided support for an interplay between early traumatic experiences, mentalization skills (coping strategies, emotion regulation), interpersonal competencies and occupational distress. CONCLUSIONS The findings of the present study supported a theoretical model based on mentalization theory for the interactions between personal and relational competencies in psychiatry training, thus providing potential target of remodulation and redefinition of this specific process of education.
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Affiliation(s)
- Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Livio Tarchi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS San Martino, Genoa, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Trieste, Italy
| | - Annarita Atti
- Section of Psychiatry, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia and Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Giuseppe Blasi
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Pasquale De Fazio
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Chiara De Panfilis
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Arianna Goracci
- Department of Molecular and Developmental medicine, University of Siena, Siena, Italy
| | - Carla Gramaglia
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, 'G. D'Annunzio' University, Chieti, Italy
| | - Marco Menchetti
- Section of Psychiatry, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Maria Giulia Nanni
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Alessandra Nivoli
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Gianluca Rosso
- Department of Neurosciences, University of Turin, Turin, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS San Martino, Genoa, Italy
| | - Maria Salvina Signorelli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Caterina Viganò
- Department of Biomedical and Clinical Sciences, Luigi Sacco and Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milano, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine and Surgery, Polytechnic University of Marche, Ancona, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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Carmassi C, Bertelloni CA, Dell'Oste V, Pedrinelli V, Fantasia S, Atti AR, Goracci A, Nanni MG, Massimetti E, Dell'Osso L, Bui E. The relationship between peritraumatic distress, mental health symptoms and functioning impairment in healthcare workers during the COVID-19 emergency. CNS Spectr 2024:1-23. [PMID: 38327004 DOI: 10.1017/s1092852923006338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
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Carmassi C, Pedrinelli V, Fantasia S, Andreoli D, Giovannoni F, Massimetti E, Cosio S, Dell'osso L, Gadducci A. Post-traumatic Stress and Depressive Symptoms in Women With Ovarian Cancer 3-6 Months After Diagnosis. Anticancer Res 2024; 44:829-838. [PMID: 38307582 DOI: 10.21873/anticanres.16875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 12/29/2023] [Accepted: 01/02/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND/AIM The potentially traumatic role of severe life-threatening medical conditions is still debated in psychiatry and not yet recognized, particularly among post-traumatic stress disorders. However, increasing evidence suggests the psychopathological impact of severe medical conditions related to their poor prognosis, high lethality, treatments heaviness and invasiveness. Ovarian cancer (OC) is one of the malignancies with the highest mortality and the aim of this study was to investigate post-traumatic stress and depressive symptoms in women 3 to 6 months after diagnosis. PATIENTS AND METHODS A sample of 83 women diagnosed with OC at different stages (from AI to IV) was recruited and assessed by means of the: Structural Clinical Interview for Mental Disorders according to DSM-5 (SCID-5), Trauma and Loss Spectrum Self-Report (TALS-SR), Impact Event Scale-Revised (IES-R), Hamilton Rating Scale for Depression (HAM-D), Mood Spectrum-Self Report (MOOD-SR), Work and Social Adjustment Scale (WSAS). RESULTS Full data on the psychiatric assessments were available for 45 patients: 13 (28.9%) patients reported a diagnosis of PTSD. Patients with PTSD reported statistically significant higher depressive symptoms and more severe impact on work and social functioning compared to those without PTSD. CONCLUSION Our results highlight the need to carefully assess the potentially traumatic burden of a diagnosis of OC and its association with depressive symptoms for their impact on patients' global functioning, in order to provide appropriate preventive and therapeutic interventions.
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Affiliation(s)
- Claudia Carmassi
- Division of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy;
| | - Virginia Pedrinelli
- Division of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara Fantasia
- Division of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Debora Andreoli
- Division of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Federico Giovannoni
- Division of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Enrico Massimetti
- Division of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Stefania Cosio
- Division of Gynecology and Obstetrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Liliana Dell'osso
- Division of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Angiolo Gadducci
- Division of Gynecology and Obstetrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Carmassi C, Tani C, Lorenzoni V, Palla I, Fulvio G, Fantasia S, Andreozzi G, Trentin F, Conti L, Gaglioti A, Turchetti G, Dell'Osso L, Mosca M. Post-traumatic stress disorder and post-traumatic stress symptoms in patients with systemic autoimmune diseases during the COVID-19 pandemic. Clin Exp Rheumatol 2023:20482. [PMID: 38149633 DOI: 10.55563/clinexprheumatol/rnm6tz] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/04/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVES The COVID-19 outbreak led to an increase in mental disorders, particularly post-traumatic stress disorder (PTSD), in the general population and especially in high-risk populations such as patients with rheumatologic conditions. Although these latters are considered vulnerable to developing PTSD, few specific data have been particularly reported in the framework of the pandemic. The aim of the present study was to investigate PTSD and post-traumatic stress symptoms (PTSS) in a sample of patients with systemic autoimmune disease (SAD), followed in the framework of a prospective observational study during the pandemic. METHODS The PERMAS project is a prospective observational study including patients with SAD and involving the Rheumatology and the Psychiatric Clinics of the Azienda Ospedaliero Universitaria Pisana (AOUP, Pisa, Italy) and the Institute of Management of the Scuola Superiore Sant'Anna (Pisa, Italy). The assessments included: a data-sheet for sociodemographic and clinical characteristics; the Trauma and Loss Spectrum-Self Report (TALS-SR) and the Impact of Event Scale-Revised (IES-R), for PTSD and PTSS; the 36-item Short Form Survey (SF-36) to assess quality of life. RESULTS The total sample consisted of 252 patients with SAD, including 131 with connective tissue disease, 101 with arthritis and 20 with systemic vasculitis. The diagnostic groups differed significantly in age (p<0.001), gender (p<0.001), prevalence of full-blown and partial PTSD (p=0.001), and other psychopathologic variables. Connective tissue disease and SF-36 were significantly associated with the TALS-SR scores in both univariate (p<0.001) and multivariate (p<0.025; p<0.001) analyses. CONCLUSIONS Patients with SAD, and, in particular, patients with connective tissue diseases reported an increased risk of developing stress-related psychopathological symptoms, indicating the need for special psychological monitoring of this high-risk group.
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Affiliation(s)
- Claudia Carmassi
- Psychiatry Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Chiara Tani
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
| | | | - Ilaria Palla
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Giovanni Fulvio
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Sara Fantasia
- Psychiatry Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Gianni Andreozzi
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Francesca Trentin
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Lorenzo Conti
- Psychiatry Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Andrea Gaglioti
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | | | - Liliana Dell'Osso
- Psychiatry Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Marta Mosca
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
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8
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Conti L, Fantasia S, Violi M, Dell’Oste V, Pedrinelli V, Carmassi C. Emotional Dysregulation and Post-Traumatic Stress Symptoms: Which Interaction in Adolescents and Young Adults? A Systematic Review. Brain Sci 2023; 13:1730. [PMID: 38137178 PMCID: PMC10741474 DOI: 10.3390/brainsci13121730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 12/24/2023] Open
Abstract
Emotional dysregulation (ED) has recently been conceptualized as a transnosographic entity in major mental disorders, and increasing evidence has suggested association between ED and post-traumatic stress symptoms (PTSS), though the nature of this association is unclear. The aim of the present review was to examine the possible interplay between ED and trauma exposure in the literature, as well as a possible role for the comorbidity of PTSD or PTSS in adolescents and young adults. In particular, we explored whether ED may represent a risk factor for PTSD or, conversely, a consequence of traumatic exposure. This systematic review was conducted according to PRISMA 2020 guidelines in three databases (PubMed, Scopus, and Embase). The 34 studies included showed a wide heterogeneity in terms of the populations selected and outcomes examined. Most studies used the Difficulties in Emotion Regulation Scale (DERS) and examined the relationship between ED, trauma, and psychopathological manifestations after the occurrence of trauma, with a focus on child abuse. Although current data in the literature are heterogeneous and inconclusive, this research highlights the role of ED as a mechanism that may mediate vulnerability to PTSD, but also as a predictor of severity and maintenance of typical, atypical, or associated PTSD symptoms, suggesting prevention programs for PTSD and other mental disorders should support the development of emotion regulation strategies.
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Affiliation(s)
- Lorenzo Conti
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy (M.V.); (V.P.); (C.C.)
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Carmassi C, Sampogna G, Di Vincenzo M, Cipolla S, Toni C, Albert U, Carrà G, Cirulli F, Dell'Osso B, Fantasia S, Nanni MG, Pedrinelli V, Pompili M, Sani G, Tortorella A, Volpe U, Fiorillo A. Acute stress symptoms in general population during the first wave of COVID lockdown in Italy: Results from the COMET trial. Brain Behav 2023; 13:e3314. [PMID: 37990771 PMCID: PMC10726770 DOI: 10.1002/brb3.3314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/27/2023] [Accepted: 10/25/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND The coronavirus disease of 2019 (COVID-19) pandemic is an unprecedented traumatic event that has severely impacted social, economic, and health well-being worldwide. The COvid Mental hEalth Trial was specifically designed to evaluate the impact of the COVID-19 pandemic and its containment measures on the mental health of the Italian general population in terms of COVID-19-related acute stress disorder (ASD) symptoms. METHODS The present cross-sectional study is based on an online survey carried out in the period March-May 2020. Italian general adult population was invited to compile an anonymous survey, which included the severity of acute stress symptoms scale/National Stressful Events Survey Short Scale to investigate the occurrence and severity of ASD symptoms. RESULTS The final sample consisted of 20,720 participants. During the lockdown, subjects with pre-existing mental health problems reported a statistically significant higher risk of acute post-traumatic symptoms compared to the general population (B: 2.57; 95% CI:2.04-3.09; p < .0001) and health care professionals (B: .37; 95% CI: .02-0.72; p < .05). According to multivariate regression models, the levels of acute post-traumatic symptoms (p < .0001) were higher in younger and female respondents. Social isolation and sleep disorder/insomnia represented positive predictors of acute stress (B = 3.32, 95% CI = 3.08-3.57). CONCLUSIONS Concerns about the risk of infection as well as social isolation caused a higher incidence of acute post-traumatic stress symptoms that may predict the subsequent development of post-traumatic stress disorder symptoms in the long term.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
| | - Gaia Sampogna
- Department of PsychiatryUniversity of Campania “L. Vanvitelli”NaplesItaly
| | - Matteo Di Vincenzo
- Department of PsychiatryUniversity of Campania “L. Vanvitelli”NaplesItaly
| | - Salvatore Cipolla
- Department of PsychiatryUniversity of Campania “L. Vanvitelli”NaplesItaly
| | - Claudia Toni
- Department of PsychiatryUniversity of Campania “L. Vanvitelli”NaplesItaly
| | - Umberto Albert
- Department of Medicine, Surgery and Health SciencesUniversity of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina–ASUGITriesteItaly
| | - Giuseppe Carrà
- Department of Medicine and SurgeryUniversity of Milan BicoccaMilanoItaly
| | - Francesca Cirulli
- Center for Behavioral Sciences and Mental HealthNational Institute of HealthRomeItaly
| | - Bernardo Dell'Osso
- Neuroscience Research Center, Department of Biomedical and Clinical Sciences and Aldo Ravelli Center for Neurotechnology and Brain TherapeuticUniversity of MilanMilanoItaly
- Department of Psychiatry and Behavioral SciencesStanford UniversityStanfordCaliforniaUSA
| | - Sara Fantasia
- Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
| | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Neurosciences and RehabilitationUniversity of FerraraFerraraItaly
| | | | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and PsychologySapienza University of RomeRomeItaly
| | - Gabriele Sani
- Department of Neuroscience, Section of PsychiatryUniversity Cattolica del Sacro CuoreRomeItaly
- Department of Neuroscience, Sensory organs and Thorax, Department of PsychiatryFondazione Policlinico A. Gemelli IRCCSRomeItaly
| | | | - Umberto Volpe
- Clinical Psychiatry UnitDepartment of Clinical NeurosciencesUniversità Politecnica delle MarcheAnconaItaly
| | - Andrea Fiorillo
- Department of PsychiatryUniversity of Campania “L. Vanvitelli”NaplesItaly
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Cruz-Sanabria F, Violi M, Bazzani A, Bruno S, Massoni L, Bertelloni CA, Dell'Oste V, Frumento P, Faraguna U, Dell'Osso L, Carmassi C. Chronotype is differentially associated with lifetime mood and panic-agoraphobic spectrum symptoms in patients with bipolar disorder and healthy controls. CNS Spectr 2023; 28:726-738. [PMID: 36942635 DOI: 10.1017/s1092852923001207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE Although the association between chronotype and mood disorders has been consistently reported, conversely, attempts to measure the association between chronotype and anxiety symptoms have generated inconsistent results. We aimed at evaluating whether chronotype (assessed through subjective and objective measures) is associated with lifetime mood and panic-agoraphobic spectrum symptoms in healthy controls (HCs) and in patients with bipolar disorder (BD). METHODS Overall, 173 subjects, patients with BD in euthymic phase (n = 76) and HC (n = 97), were evaluated through the reduced Morningness-Eveningness Questionnaire (rMEQ), actigraphy monitoring and mood and panic-agoraphobic spectrum self-report (MOODS-SR and PAS-SR). The discrepancy between objective (actigraphic-based) versus subjective (rMEQ-based) circadian typology was estimated through the Circadian Classification Discrepancy Index (CCDI). RESULTS rMEQ-based evening chronotype (ET) was associated with higher scores in MOODS-SR depressive and rhythmicity and vegetative functions domains in HC and BD.Both ET and morning chronotypes (MT) were associated with higher PAS-SR scores in BD only. Actigraphic-based MT was associated with higher MOODS-SR depressive scores in HC. Likewise, the discrepancy between actigraphic-based and rMEQ-based circadian typology was associated with depressive symptoms in HC only. CONCLUSION Self-reported ET was consistently associated with mood symptoms, while associations with panic-agoraphobic symptoms only emerged in BD and involved both extreme chronotypes. The discrepancy between the preferred circadian typology (rMEQ-based) and the actual one (actigraphic-based) could contribute to depressive symptoms in HC. These results pave the way for interventional studies targeting circadian typology in an attempt to prevent or treat mental health disorders.
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Affiliation(s)
- Francy Cruz-Sanabria
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Miriam Violi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Bazzani
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Simone Bruno
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Leonardo Massoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Valerio Dell'Oste
- Department of Biotechnology Chemistry and Pharmacy, University of Siena, Siena, Italy
| | - Paolo Frumento
- Department of Political Sciences, University of Pisa, Pisa, Italy
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Luciano M, Sampogna G, D'Ambrosio E, Rampino A, Amore M, Calcagno P, Rossi A, Rossi R, Carmassi C, Dell'Osso L, Bianciardi E, Siracusano A, Della Rocca B, Di Vincenzo M, Fiorillo A. One-year efficacy of a lifestyle behavioural intervention on physical and mental health in people with severe mental disorders: results from a randomized controlled trial. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01684-w. [PMID: 37665401 DOI: 10.1007/s00406-023-01684-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/14/2023] [Indexed: 09/05/2023]
Abstract
This multicentric randomized controlled trial (RCT), carried out in six Italian University mental health sites, aims to test the efficacy of a six-month psychosocial intervention (LYFESTYLE) on Body Mass Index (BMI), body weight, waist circumference, fasting glucose, triglycerides, cholesterol, Framingham and HOmeostasis Model Assessment of insulin resistance (HOMA-IR) indexes in patients with schizophrenia, bipolar disorder, and major depression. Moreover, the efficacy of the intervention has also been tested on several other physical and mental health domains. Patients were randomly allocated to receive the six-month experimental intervention (LIFESTYLE) or a behavioural control intervention. All enrolled patients were assessed at baseline and after one year. We recruited 401 patients (206 in the experimental and 195 in the control group) with a diagnosis of schizophrenia or other psychotic disorder (29.9%), bipolar disorder (43.3%), or major depression (26.9%). At one year, patients receiving the experimental intervention reported an improvement in body mass index, body weight, waist circumference, HOMA-IR index, anxiety and depressive symptoms and in quality of life. Our findings confirm the efficacy of the LIFESTYLE intervention in improving physical and mental health-related outcomes in patients with severe mental illnesses after one year.
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Affiliation(s)
- M Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie 80039, Naples, Italy.
| | - G Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie 80039, Naples, Italy
| | - E D'Ambrosio
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - A Rampino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - M Amore
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - P Calcagno
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - A Rossi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - R Rossi
- Department of System Medicine, University of Rome Tor Vergata, Rome, Italy
| | - C Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - L Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - E Bianciardi
- Department of System Medicine, University of Rome Tor Vergata, Rome, Italy
| | - A Siracusano
- Department of System Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Bianca Della Rocca
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie 80039, Naples, Italy
| | - M Di Vincenzo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie 80039, Naples, Italy
| | - A Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie 80039, Naples, Italy
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Cruz-Sanabria F, Faraguna U, Violi M, Bruno S, Gravina D, Bonelli C, Bazzani A, Massoni L, Musetti L, Simoncini M, Frumento P, Dell'Osso L, Carmassi C. Effects of exogenous melatonin on sleep and circadian rhythm parameters in bipolar disorder with comorbid delayed sleep-wake phase disorder: An actigraphic study. J Psychiatr Res 2023; 165:96-104. [PMID: 37487294 DOI: 10.1016/j.jpsychires.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/02/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023]
Abstract
The present study evaluates the effect of exogenous melatonin (exo-MEL) on sleep and circadian parameters in patients with bipolar disorder (BD) and delayed sleep-wake phase disorder (DSWPD). BD euthymic patients (n = 83, mean age = 45.13 ± 13.68, males 56%) were evaluated for chronotype (reduced Morningness-Eveningness Questionnaire [rMEQ]), sleep quality (Pittsburgh Sleep Quality Index), sleep and circadian parameters (actigraphic monitoring). Patients that fulfilled criteria for DSWPD (n = 25) were treated for three months with exo-MEL 2 mg administered approximately 4 h before the sleep onset time (SOT) actigraphically-determined at baseline. Sleep and circadian parameters at baseline (T0) and after the exo-MEL treatment (T1) were compared using paired Wilcoxon test. In patients that completed the treatment (n = 19), the rMEQ score increased between T0 (median = 8.0 [IQR = 7.0, 11.0]) and T1 (median = 13.5 [IQR = 9.3, 15.0], p-value = 0.006), the SOT was advanced between T0 (median = 00:55 [IQR = 00:25, 01:39] and T1 (median = 00:09 [IQR = 23:41, 01:04], p-value = 0.039), the sleep efficiency and total sleep time increased (T0: median = 84.4 [IQR = 81.3, 89.4]; T1 (median = 90.3 [IQR = 85.5, 92.9] %, p-value = 0.01, and T0: median = 7.20 [IQR = 6.15, 8.15]; T1: median = 7.7 [IQR = 7.0, 9.3] hours, p-value = 0.04, respectively). These results indicate that in BD with comorbid DSWPD, the self-reported chronotype, the sleep onset time, and sleep efficiency and duration were modified after a personalized treatment with exo-MEL, suggesting its potential efficacy in improving sleep patterns in BD. The absence of proper control groups and of treatment randomization constitute limitations of our study and further randomized controlled trials are required to confirm our results.
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Affiliation(s)
- Francy Cruz-Sanabria
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, via Savi 10, 56126, Pisa, Italy.
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, via Savi 10, 56126, Pisa, Italy; Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Viale del Tirreno, 341/A/B/C, 56128, Calambrone, Pisa, Italy
| | - Miriam Violi
- Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56127, Pisa, Italy
| | - Simone Bruno
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, via Savi 10, 56126, Pisa, Italy
| | - Davide Gravina
- Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56127, Pisa, Italy
| | - Chiara Bonelli
- Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56127, Pisa, Italy
| | - Andrea Bazzani
- Institute of Management, Scuola Superiore Sant'Anna, piazza Martiri della libertà 33, 56127, Pisa, Italy
| | - Leonardo Massoni
- Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56127, Pisa, Italy
| | - Laura Musetti
- Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56127, Pisa, Italy
| | - Marly Simoncini
- Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56127, Pisa, Italy
| | - Paolo Frumento
- Department of Political Sciences, University of Pisa, via Serafini 3, 56126, Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56127, Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56127, Pisa, Italy
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Sampogna G, Caraci F, Carmassi C, Dell'Osso B, Ferrari S, Martinotti G, Sani G, Serafini G, Signorelli MS, Fiorillo A. Efficacy and tolerability of desvenlafaxine in the real-world treatment of patients with major depression: a narrative review and an expert opinion paper. Expert Opin Pharmacother 2023; 24:1511-1525. [PMID: 37450377 DOI: 10.1080/14656566.2023.2237410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Major depressive disorder (MDD) is a common severe mental disorder, requiring a tailored and integrated treatment. Several approaches are available including different classes of antidepressants various psychotherapeutic approaches, and psychosocial interventions. The treatment plan for each patient with MDD should be differentiated on the basis of several clinical, personal, and contextual factors. AREAS COVERED Desvenlafaxine - a serotonine-noradrenergic reuptake inhibitor (SNRI) antidepressant - has been approved in the United States in 2008 for the treatment of MDD in adults, and has been recently rediscovered by clinicians due to its good side-effect profile and its clinical effectiveness. A narrative review on efficacy, tolerability and use of desvenlafaxine in clinical practice was carried out. The keywords: 'major depression', 'depression,' 'desvenlafaxine,' 'efficacy,' 'clinical efficacy,' 'side effects', 'tolerability,' 'elderly patients', 'consultation-liaison', 'menopausal', 'young people', 'adolescent' were entered in PubMed, ISI Web of Knowledge, Scopus and Medline. No time limit was fixed, the search strategy was implemented on May 10, 2023. EXPERT OPINION Desvenlafaxine should be listed among the optimal treatment strategies for managing people with MDD, whose main strengths are: 1) ease of dosing; 2) favorable safety and tolerability profile, 3) absence of sexual dysfunctions, weight gain and low rate of discontinuation symptoms; 4) low risk of drug-drug interactions.
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Affiliation(s)
- Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Filippo Caraci
- Department of Drug and Health Sciences, University of Catania, Catania, Italy
- Unit of Neuropharmacology and Translational Neurosciences, Oasi Research Institute-IRCCS, Troina, Italy
| | | | - Bernardo Dell'Osso
- Neuroscience Research Center, Department of Biomedical and Clinical Sciences and Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milano, Italy
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, USA
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Dipartimento Ad attività Integrata di Salute Mentale E Dipendenze Patologiche, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Gabriele Sani
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Hearth, Rome, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS, San Martino, Genoa, Italy
| | - Gianluca Serafini
- Department of Psychiatry, Department of Neuroscience Head, Neck and Thorax, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Maria Salvina Signorelli
- Department of Clinical and Experimental Medicine, AOU Policlinico Hospital, University of Catania, Catania, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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Marazziti D, Carmassi C, Cappellato G, Chiarantini I, Massoni L, Mucci F, Arone A, Violi M, Palermo S, De Iorio G, Dell’Osso L. Novel Pharmacological Targets of Post-Traumatic Stress Disorders. Life (Basel) 2023; 13:1731. [PMID: 37629588 PMCID: PMC10455314 DOI: 10.3390/life13081731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is a psychopathological condition with a heterogeneous clinical picture that is complex and challenging to treat. Its multifaceted pathophysiology still remains an unresolved question and certainly contributes to this issue. The pharmacological treatment of PTSD is mainly empirical and centered on the serotonergic system. Since the therapeutic response to prescribed drugs targeting single symptoms is generally inconsistent, there is an urgent need for novel pathogenetic hypotheses, including different mediators and pathways. This paper was conceived as a narrative review with the aim of debating the current pharmacological treatment of PTSD and further highlighting prospective targets for future drugs. The authors accessed some of the main databases of scientific literature available and selected all the papers that fulfilled the purpose of the present work. The results showed that most of the current pharmacological treatments for PTSD are symptom-based and show only partial benefits; this largely reflects the limited knowledge of its neurobiology. Growing, albeit limited, data suggests that the hypothalamic-pituitary-adrenal axis, opioids, glutamate, cannabinoids, oxytocin, neuropeptide Y, and microRNA may play a role in the development of PTSD and could be targeted for novel treatments. Indeed, recent research indicates that examining different pathways might result in the development of novel and more efficient drugs.
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Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, 56100 Pisa, Italy (L.D.)
- Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, 56100 Pisa, Italy (L.D.)
| | - Gabriele Cappellato
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, 56100 Pisa, Italy (L.D.)
| | - Ilaria Chiarantini
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, 56100 Pisa, Italy (L.D.)
| | - Leonardo Massoni
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, 56100 Pisa, Italy (L.D.)
| | - Federico Mucci
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, 56100 Pisa, Italy (L.D.)
| | - Alessandro Arone
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, 56100 Pisa, Italy (L.D.)
| | - Miriam Violi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, 56100 Pisa, Italy (L.D.)
| | - Stefania Palermo
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, 56100 Pisa, Italy (L.D.)
| | - Giovanni De Iorio
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, 56100 Pisa, Italy (L.D.)
| | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, 56100 Pisa, Italy (L.D.)
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Sampogna G, Di Vincenzo M, Luciano M, Della Rocca B, Albert U, Carmassi C, Carrà G, Cirulli F, Dell’Osso B, Nanni MG, Pompili M, Sani G, Tortorella A, Volpe U, Fiorillo A. The effect of social media and infodemic on mental health during the COVID-19 pandemic: results from the COMET multicentric trial. Front Psychiatry 2023; 14:1226414. [PMID: 37575576 PMCID: PMC10412935 DOI: 10.3389/fpsyt.2023.1226414] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/28/2023] [Indexed: 08/15/2023] Open
Abstract
On January 30, 2020, the World Health Organization (WHO) declared the status of pandemic due to the COVID-19 infection. The initial phases of the pandemic were characterized by uncertainty and public fears. In order to cope with such unexpected conditions, people adopted different coping strategies, including search for information, accessing Internet, and using social media. The present study based on the COMET collaborative research network aims to: (1) assess use of Internet and of social media among the Italian general population; (2) explore differences in web usage between people with pre-existing mental disorders and the general population; (3) identify changes over time in social media usage along the phase 1 of the pandemic; (4) identify the clinical, socio-demographic and contextual predictors of excessive use of social media. A significant increase in time spent on Internet, with an average time of 4.8 ± 0.02 h per day, was found in the global sample of 20,720 participants. Compared with the general population, Internet use was significantly higher in people with pre-existing mental disorders (5.2 ± 0.1 h vs. 4.9 ± 0.02; p < 0.005). According to the multivariate logistic regression model, the risk of excessive use of social media and Internet was significantly higher in people with moderate levels of depressive symptoms (OR: 1.26, CI 95%: 0.99 to 1.59, p < 0.0.005); while protective factors were being students (OR: 0.72, CI 95%: 0.53 to 0.96, p < 0.0029) and living in central Italy (OR: 0.46, CI 95%: 0.23 to 0.90, p < 0.002). The evaluation of social media and Internet use by the general population represents a first step for developing specific protective and supportive interventions for the general population, including practical suggestions on how to safely use Internet and social media.
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Affiliation(s)
- Gaia Sampogna
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Matteo Di Vincenzo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Bianca Della Rocca
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
- Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina—ASUGI, Trieste, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy
| | - Francesca Cirulli
- Center for Behavioral Sciences and Mental Health, National Institute of Health, Rome, Italy
| | - Bernardo Dell’Osso
- Neuroscience Research Center, Department of Biomedical and Clinical Sciences and Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milano, Italy
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, United States
| | - Maria Giulia Nanni
- Department of Neurosciences and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, University Cattolica del Sacro Cuore, Rome, Italy
- Department of Neuroscience, Sensory Organs and Thorax, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
- Department of Psychiatry, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | | | - Umberto Volpe
- Clinical Psychiatry Unit, Department of Clinical Neurosciences, Università Politecnica delle Marche, Ancona, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
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16
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Carmassi C, Amatori G, Cappelli A, Brosio E, Chauvel H, Dell'Osso L, Bui E. [Grief: from the physiological reaction to the psychopathology.]. Riv Psichiatr 2023; 58:154-159. [PMID: 37409432 DOI: 10.1708/4064.40477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
The death of a loved one is a universal experience, and marker of the human condition. Grief, the cognitive, emotional, and behavioral responses to bereavement, is both a ubiquitous and a unique psychological process. Thus, health providers often find themselves in a dilemma, caught between the need to alleviate an individual's distress and impairment, and the danger of overly "pathologizing" their grief reaction. This chapter reviews how acute grief reactions generally evolve over time, the clinical presentation of complicated grief, and finally, other psychiatric disorders that might develop or be precipitated in the aftermath of the death of a loved one, particularly prolonged grief disorder.
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Affiliation(s)
- Claudia Carmassi
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa
| | - Giulia Amatori
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa
| | - Andrea Cappelli
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa
| | - Enrico Brosio
- Service de Psychiatrie, Centre Hospitalier Universitaire de Caen Normandie, France - Faculté de Médecine, Université de Caen Normandie, France
| | - Hélène Chauvel
- Service de Psychiatrie, Centre Hospitalier Universitaire de Caen Normandie, France
| | | | - Eric Bui
- Service de Psychiatrie, Centre Hospitalier Universitaire de Caen Normandie, France - Faculté de Médecine, Université de Caen Normandie, France - Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
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17
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Scaffei E, Mazziotti R, Conti E, Costanzo V, Calderoni S, Stoccoro A, Carmassi C, Tancredi R, Baroncelli L, Battini R. A Potential Biomarker of Brain Activity in Autism Spectrum Disorders: A Pilot fNIRS Study in Female Preschoolers. Brain Sci 2023; 13:951. [PMID: 37371429 DOI: 10.3390/brainsci13060951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 05/29/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
Autism spectrum disorder (ASD) refers to a neurodevelopmental condition whose detection still remains challenging in young females due to the heterogeneity of the behavioral phenotype and the capacity of camouflage. The availability of quantitative biomarkers to assess brain function may support in the assessment of ASD. Functional Near-infrared Spectroscopy (fNIRS) is a non-invasive and flexible tool that quantifies cortical hemodynamic responses (HDR) that can be easily employed to describe brain activity. Since the study of the visual phenotype is a paradigmatic model to evaluate cerebral processing in many neurodevelopmental conditions, we hypothesized that visually-evoked HDR (vHDR) might represent a potential biomarker in ASD females. We performed a case-control study comparing vHDR in a cohort of high-functioning preschooler females with ASD (fASD) and sex/age matched peers. We demonstrated the feasibility of visual fNIRS measurements in fASD, and the possibility to discriminate between fASD and typical subjects using different signal features, such as the amplitude and lateralization of vHDR. Moreover, the level of response lateralization was correlated to the severity of autistic traits. These results corroborate the cruciality of sensory symptoms in ASD, paving the way for the validation of the fNIRS analytical tool for diagnosis and treatment outcome monitoring in the ASD population.
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Affiliation(s)
- Elena Scaffei
- Department of Neuroscience, Psychology, Drug Research and Child Health NEUROFARBA, University of Florence, 50135 Florence, Italy
- IRCCS Stella Maris Foundation, Viale del Tirreno, 56128 Pisa, Italy
| | - Raffaele Mazziotti
- IRCCS Stella Maris Foundation, Viale del Tirreno, 56128 Pisa, Italy
- Institute of Neuroscience, National Research Council, Via Moruzzi 1, 56124 Pisa, Italy
| | - Eugenia Conti
- IRCCS Stella Maris Foundation, Viale del Tirreno, 56128 Pisa, Italy
| | - Valeria Costanzo
- IRCCS Stella Maris Foundation, Viale del Tirreno, 56128 Pisa, Italy
| | - Sara Calderoni
- IRCCS Stella Maris Foundation, Viale del Tirreno, 56128 Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy
| | - Andrea Stoccoro
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56100 Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy
| | | | - Laura Baroncelli
- Institute of Neuroscience, National Research Council, Via Moruzzi 1, 56124 Pisa, Italy
| | - Roberta Battini
- IRCCS Stella Maris Foundation, Viale del Tirreno, 56128 Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy
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18
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Dell’Osso L, Nardi B, Bonelli C, Gravina D, Benedetti F, Amatori G, Battaglini S, Massimetti G, Luciano M, Berardelli I, Brondino N, De Gregorio M, Deste G, Nola M, Reitano A, Muscatello MRA, Pompili M, Politi P, Vita A, Carmassi C, Cremone IM, Carpita B, Maj M. Investigating suicidality across the autistic-catatonic continuum in a clinical sample of subjects with major depressive disorder and borderline personality disorder. Front Psychiatry 2023; 14:1124241. [PMID: 37275986 PMCID: PMC10234210 DOI: 10.3389/fpsyt.2023.1124241] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 05/04/2023] [Indexed: 06/07/2023] Open
Abstract
Background Recent literature has highlighted that catatonia may be more prevalent among psychiatric patients than previously thought, beginning from autism spectrum disorders (ASD), for which it has been suggested to represent a severe late consequence, but also among individuals with mood disorders and borderline personality disorder (BPD). Interestingly, one critical point shared by these conditions is the increased risk of suicidality. The aim of this study was to evaluate how the presence and the prevalence of catatonic symptoms may shape and correlate with suicidal risk in a sample of individuals with major depressive disorder (MDD) or BPD. Methods We recruited two clinical samples of subjects (BPD and MDD) and a control group without a diagnosis according to DSM-5 (CTL). Subjects were assessed with the catatonia spectrum (CS) and the MOODS-SR for evaluating suicidality. Results In the total sample, suicidality score was significantly and positively correlated with all CS domains and CS total score. Correlation and regression analyses highlighted specific patterns of association among Catatonia spectrum domains and suicidality in the MDD and BPD group and in the total sample. Conclusion In both disorders, higher catatonic traits are linked to higher suicidal tendencies, confirming the high risk of suicide for this population. However, different patterns of association between catatonic symptoms and suicidality were highlighted in the two disorders.
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Affiliation(s)
- Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Benedetta Nardi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Chiara Bonelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Davide Gravina
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesca Benedetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giulia Amatori
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Simone Battaglini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Isabella Berardelli
- Department of Neuroscience, Mental Health and Sense Organs, University of Roma “La Sapienza”, Rome, Italy
| | - Natascia Brondino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Marianna De Gregorio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Giacomo Deste
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Marta Nola
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Antonino Reitano
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | | | - Maurizio Pompili
- Department of Neuroscience, Mental Health and Sense Organs, University of Roma “La Sapienza”, Rome, Italy
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ivan Mirko Cremone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
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19
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Carmassi C, Cruz-Sanabria F, Gravina D, Violi M, Bonelli C, Dell’Oste V, Pedrinelli V, Frumento P, Faraguna U, Dell’Osso L. Exploratory Study on the Associations between Lifetime Post-Traumatic Stress Spectrum, Sleep, and Circadian Rhythm Parameters in Patients with Bipolar Disorder. Int J Environ Res Public Health 2023; 20:3566. [PMID: 36834262 PMCID: PMC9967425 DOI: 10.3390/ijerph20043566] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/05/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
The present study aimed at exploring whether lifetime post-traumatic stress spectrum symptoms are associated with chronotype in patients with bipolar disorder (BD). Moreover, we explored whether the chronotype can moderate the potential associations between lifetime post-traumatic stress spectrum symptoms and rest-activity circadian and sleep-related parameters. A total of 74 BD patients were administered the Trauma and Loss Spectrum Self-Report (TALS-SR) lifetime version for lifetime post-traumatic stress spectrum symptoms, the Pittsburgh Sleep Quality Index (PSQI) for self-reported sleep quality, and the Reduced Morningness-Eveningness Questionnaire (rMEQ) to discriminate evening chronotypes (ETs), neither chronotype (NT), and morning chronotype (MT). Actigraphic monitoring was used to objectively evaluate sleep and circadian parameters. Patients classified as ET reported significantly higher scores in the re-experiencing domain, as well as poorer sleep quality, lower sleep efficiency, increased wake after sleep onset, and delayed mid-sleep point compared with both NT and MT (p-value ≤ 0.05). Moreover, ET presented significantly higher scores in the TALS-SR maladaptive coping domain than NT and lower relative amplitude than MT (p-value ≤ 0.05). Moreover, higher TALS-SR total symptomatic domains scores were significantly correlated with poor self-reported sleep quality. Regression analyses showed that the PSQI score maintained the association with the TALS total symptomatic domains scores after adjusting for potentially confounding factors (age and sex) and that no interaction effect was observed between the chronotype and the PSQI. Conclusions: This exploratory study suggests that patients with BD classified as ET showed significantly higher lifetime post-traumatic stress spectrum symptoms and more disrupted sleep and circadian rhythmicity with respect to other chronotypes. Moreover, poorer self-reported sleep quality was significantly associated with lifetime post-traumatic stress spectrum symptoms. Further studies are required to confirm our results and to evaluate whether targeting sleep disturbances and eveningness can mitigate post-traumatic stress symptoms in BD.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Francy Cruz-Sanabria
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56126 Pisa, Italy
| | - Davide Gravina
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Miriam Violi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Chiara Bonelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Valerio Dell’Oste
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
| | - Paolo Frumento
- Department of Political Sciences, University of Pisa, 56126 Pisa, Italy
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56126 Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, 56128 Pisa, Italy
| | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
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20
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Dell’Oste V, Fantasia S, Gravina D, Palego L, Betti L, Dell’Osso L, Giannaccini G, Carmassi C. Metabolic and Inflammatory Response in Post-Traumatic Stress Disorder (PTSD): A Systematic Review on Peripheral Neuroimmune Biomarkers. Int J Environ Res Public Health 2023; 20:2937. [PMID: 36833633 PMCID: PMC9957545 DOI: 10.3390/ijerph20042937] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 06/01/2023]
Abstract
Several heterogeneous pathophysiology pathways have been hypothesized for being involved in the onset and course of Post-Traumatic Stress Disorder (PTSD). This systematic review aims to summarize the current evidence on the role of inflammation and immunological dysregulations in PTSD, investigating possible peripheral biomarkers linked to the neuroimmune response to stress. A total of 44 studies on the dysregulated inflammatory and metabolic response in subjects with PTSD with respect to controls were included. Eligibility criteria included full-text publications in the English language, human adult samples, studies involving both subjects with a clinical diagnosis of PTSD and a healthy control group. The research was focused on specific blood neuroimmune biomarkers, namely IL-1β, TNF-α, IL-6 and INF-γ, as well as on the potential harmful role of reduced antioxidant activity (involving catalase, superoxide dismutase and glutathione peroxidase). The possible role of the inflammatory-altered tryptophan metabolism was also explored. The results showed conflicting data on the role of pro-inflammatory cytokines in individuals with PTSD, and a lack of study regarding the other mediators investigated. The present research suggests the need for further studies in human samples to clarify the role of inflammation in the pathogenesis of PTSD, to define potential peripheral biomarkers.
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Affiliation(s)
- Valerio Dell’Oste
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
| | - Sara Fantasia
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Davide Gravina
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Lionella Palego
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Laura Betti
- Department of Pharmacy, University of Pisa, 56126 Pisa, Italy
| | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | | | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
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21
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De Berardis D, Fornaro M, Carmassi C. Editorial: Comorbidity in bipolar disorder, volume II. Front Psychiatry 2023; 14:1115357. [PMID: 36926462 PMCID: PMC10011613 DOI: 10.3389/fpsyt.2023.1115357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 02/13/2023] [Indexed: 03/08/2023] Open
Affiliation(s)
- Domenico De Berardis
- Department of Psychiatry, Azienda Sanitaria Locale 4, Teramo, Italy.,School of Nursing, University of L'Aquila, L'Aquila, Italy.,International Centre for Education and Research in Neuropsychiatry, Samara State Medical University, Samara, Russia
| | - Michele Fornaro
- School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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22
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Carmassi C, Pedrinelli V, Antonini C, Dell'Oste V, Gravina D, Nardi B, Bertelloni CA, Massimetti G, Nieto-Munuera J, Dell'Osso L. Validation of the Spanish Version of the Trauma and Loss Spectrum Self-Report (TALS-SR): A Study on Healthcare Workers Facing the COVID-19 Pandemic. Neuropsychiatr Dis Treat 2023; 19:495-506. [PMID: 36896340 PMCID: PMC9990502 DOI: 10.2147/ndt.s396540] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/17/2022] [Indexed: 03/06/2023] Open
Abstract
Background The present study aimed at reporting about the validity and reliability of the Spanish version of the Trauma and Loss Spectrum-Self Report (TALS-SR), an instrument based on a multidimensional approach to Post-Traumatic Stress Disorder (PTSD) and Prolonged Grief Disorder (PGD), including a range of threatening or traumatic experiences and significant losses, besides the spectrum of peri-traumatic stress reactions and post-traumatic stress symptoms that may occur. Methods A sample of 87 Health Care Workers (HCWs) employed in the COVID-19 Emergency Department at the Virgen de la Arrixaca and Reina Sofia Hospitals (Murcia, Spain) during the pandemic, was consecutively recruited and fulfilled the TALS-SR. Assessments also included the Impact of Event Scale-Revised (IES-R), to examine post-traumatic stress symptoms and probable PTSD. Nineteen HCWs fulfilled the TALS-SR again after three weeks from baseline for test-retest reliability. Results This study provides evidence of good internal consistency and test-retest reliability of the Spanish version of the TALS-SR. Strong support for the internal validity structure was obtained, with positive and significant correlations between the five symptomatologic domains and the symptomatologic total score. Significant and good correlations between the TALS-SR symptomatologic domains and the IES-R total and single domains' scores were found. The Questionnaire also demonstrated to discriminate between subjects with and without PTSD, with subjects with PTSD showing significantly higher mean scores in each domain of the TALS-SR. Conclusion This study validates the Spanish version of TALS-SR, providing a useful instrument for a spectrum approach to PTSD and confirms the potential utility of this psychometric tool in both clinical practice and research settings.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
| | - Corinna Antonini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
| | - Davide Gravina
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Benedetta Nardi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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23
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Cruz-Sanabria F, Carmassi C, Bruno S, Bazzani A, Carli M, Scarselli M, Faraguna U. Melatonin as a Chronobiotic with Sleep-promoting Properties. Curr Neuropharmacol 2023; 21:951-987. [PMID: 35176989 PMCID: PMC10227911 DOI: 10.2174/1570159x20666220217152617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/26/2022] [Accepted: 02/10/2022] [Indexed: 11/22/2022] Open
Abstract
The use of exogenous melatonin (exo-MEL) as a sleep-promoting drug has been under extensive debate due to the lack of consistency of its described effects. In this study, we conduct a systematic and comprehensive review of the literature on the chronobiotic, sleep-inducing, and overall sleep-promoting properties of exo-MEL. To this aim, we first describe the possible pharmacological mechanisms involved in the sleep-promoting properties and then report the corresponding effects of exo-MEL administration on clinical outcomes in: a) healthy subjects, b) circadian rhythm sleep disorders, c) primary insomnia. Timing of administration and doses of exo-MEL received particular attention in this work. The exo-MEL pharmacological effects are hereby interpreted in view of changes in the physiological properties and rhythmicity of endogenous melatonin. Finally, we discuss some translational implications for the personalized use of exo-MEL in the clinical practice.
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Affiliation(s)
- Francy Cruz-Sanabria
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa - Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa - Italy
| | - Simone Bruno
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa - Italy
| | - Andrea Bazzani
- Institute of Management, Scuola Superiore Sant’Anna, Pisa – Italy
| | - Marco Carli
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa - Italy
| | - Marco Scarselli
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa - Italy
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa - Italy
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Pisa, Italy
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24
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Marazziti D, Carter CS, Carmassi C, Della Vecchia A, Mucci F, Pagni G, Carbone MG, Baroni S, Giannaccini G, Palego L, Dell’Osso L. Sex matters: The impact of oxytocin on healthy conditions and psychiatric disorders. Compr Psychoneuroendocrinol 2022; 13:100165. [PMID: 36590869 PMCID: PMC9800179 DOI: 10.1016/j.cpnec.2022.100165] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/12/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Oxytocin (OT) is involved in the regulation of physiological processes and emotional states, with increasing evidence for its beneficial actions being mediated by the autonomic and immune systems. Growing evidence suggests that OT plays a role in the pathophysiology of different psychiatric disorders. Given the limited information in humans the aim of this study was to retrospectively explore plasma OT levels in psychiatric patients, particularly focusing on sex-related differences, as compared with healthy controls. The patients studied here were divided into three groups diagnosed with obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD) or major depressive disorder (MDD). Plasma OT levels were significantly different between healthy men and women, with the latter showing higher values, while none of the three psychiatric groups showed sex-related differences in the parameters measured here. The intergroup analyses showed that the OT levels were significantly higher in OCD, lower in PTSD and even more reduced in MDD patients than in healthy subjects. These differences were also confirmed when gender was considered, with the exception of PTSD men, in whom OT levels were similar to those of healthy men. The present results indicated that OT levels were higher amongst healthy women than men, while a sex difference was less apparent or reversed in psychiatric patients. Reductions in sex differences in psychopathologies may be related to differential vulnerabilities in processes associated with basic adaptive and social functions.
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Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, University of Pisa, Italy,Saint Camillus International University of Health and Medical Sciences – UniCamillus, Rome, Italy,Corresponding author. Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 57, 56100, Pisa, Italy.
| | - C. Sue Carter
- Kinsey Institute, Indiana University, Bloomington, IN, USA,Department of Psychology, University of Virginia, Charlottesville, VA, USA
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | | | - Federico Mucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Italy,Department of Psychiatry, North-Western Tuscany Region NHS Local Health Unit, Lucca Zone, Lucca, Italy
| | - Giovanni Pagni
- Department of Psychiatry, North-Western Tuscany Region NHS Local Health Unit, Lunigiana Zone, Aulla, Italy
| | - Manuel G. Carbone
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Varese, Italy
| | - Stefano Baroni
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | | | | | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
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25
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Dell’Osso L, Lorenzi P, Nardi B, Carmassi C, Carpita B. Post Traumatic Growth (PTG) in the Frame of Traumatic Experiences. Clin Neuropsychiatry 2022; 19:390-393. [PMID: 36627947 PMCID: PMC9807114 DOI: 10.36131/cnfioritieditore20220606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The psychopathological consequences of traumatic experiences have been object of study from the beginning of medical science. During the last centuries, the scientific literature in the field of mental health mainly focused on the negative consequences of traumatic events. More recently, increasing interest was paid to the features of resilience and to the possible positive consequences of trauma, leading to the concept of Post Traumatic Growth (PTG). However, the eventual co-existence of both the conditions should also be considered. The role of vulnerability and environmental factors in the balance between positive and negative outcomes after life events is discussed, particularly in light of a neurodevelopmental approach to psychopathology.
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Affiliation(s)
- Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Primo Lorenzi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Benedetta Nardi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy,Corresponding author Barbara Carpita, M.D., PhD Department of Clinical and Experimental Medicine University of Pisa, Pisa, Italy Via Roma 67 56127 Pisa E-mail: Phone: (+39)3911105675
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Cruz-Sanabria F, Andreoni N, Bazzani A, Starace F, Bruno S, Frumento P, Carmassi C, Faraguna U. Eveningness and ruminations are independently associated with poor sleep quality in healthy youths. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Buselli R, Veltri A, Corsi M, Marino R, Baldanzi S, Chiumiento M, Caldi F, Foddis R, Guglielmi G, Cristaudo A, Dell'Osso L, Carmassi C. Affective temperament and mood spectrum symptoms in workers suffering from work-related stress disorders. J Affect Disord 2022; 317:354-359. [PMID: 36058355 DOI: 10.1016/j.jad.2022.08.124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/04/2022] [Accepted: 08/28/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Adjustment Disorders (AD) which develop in response to work-related stressors represent a model of psychiatric occupational disease. Major Depressive Episodes (MDE) although often associated to work-related stressors are unlikely recognized by insurance institutes as occupational diseases. Affective temperament and mood spectrum symptoms are possible factors of vulnerability to stress. The aim of this study was to investigate if temperaments and mood spectrum symptoms had a different distribution among workers exposed to occupational stress and suffering from different psychiatric disorders (AD, MDE). METHODS 156 AD and 97 MDE patients were recruited and evaluated with scales for perceived stress (PSM) and work-related stress (JCQ), for psychopathological symptoms (BDI-II, SAS), for affective temperament (TEMPS-A[P]) and for lifetime mood spectrum symptoms (MOODS-SR). Group comparisons and correlation analyses between variables were performed by parametric or non-parametric statistical tests according to variables distribution. RESULTS The diagnostic groups did not differ for perceived and occupational stress levels. MDE patients reported significantly higher BDI-II score and MOODS-SR scores than AD ones. The hyperthymic temperament was significantly more frequent in AD than in MDE group. The hyperthymic score, differently from other dimensions of temperament and from mood spectrum components, negatively correlated or did not correlate with psychopathological symptoms severity and perceived stress levels. LIMITATIONS Predictive limitation because of cross-sectional design. CONCLUSIONS The hyperthymic temperament as opposed to lifetime subtreshold mood symptoms appears to be more represented in patients suffering from occupational AD than in MDE ones. Acknowledging vulnerability factors to job stress could support clinicians in occupational diseases prevention and management.
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Affiliation(s)
- Rodolfo Buselli
- Occupational Health Unit, U.O. Medicina Preventiva del Lavoro, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Antonello Veltri
- Occupational Health Unit, U.O. Medicina Preventiva del Lavoro, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
| | - Martina Corsi
- Occupational Health Unit, U.O. Medicina Preventiva del Lavoro, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Riccardo Marino
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Sigrid Baldanzi
- Occupational Health Unit, U.O. Medicina Preventiva del Lavoro, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Martina Chiumiento
- Occupational Health Unit, U.O. Medicina Preventiva del Lavoro, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Fabrizio Caldi
- Occupational Health Unit, U.O. Medicina Preventiva del Lavoro, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Rudy Foddis
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giovanni Guglielmi
- Occupational Health Unit, U.O. Medicina Preventiva del Lavoro, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Alfonso Cristaudo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Liliana Dell'Osso
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudia Carmassi
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Orsolini L, Volpe U, Albert U, Carmassi C, Carrà G, Cirulli F, Dell'Osso B, Del Vecchio V, Di Nicola M, Giallonardo V, Luciano M, Menculini G, Nanni MG, Pompili M, Sani G, Sampogna G, Tortorella A, Fiorillo A. Use of social network as a coping strategy for depression among young people during the COVID-19 lockdown: findings from the COMET collaborative study. Ann Gen Psychiatry 2022; 21:44. [PMID: 36372894 PMCID: PMC9660093 DOI: 10.1186/s12991-022-00419-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 10/04/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Use of social media (SM) has exponentially grown particularly among youths in the past two years, due to COVID-19-related changing lifestyles. Based on the Italian COvid Mental hEalth Trial (COMET), we investigated the association between SM use and depressive symptoms among Italian young adults (aged 18-24). METHODS The COMET is a nationwide multi-center cross-sectional study that investigated socio-demographic data, social networking addiction (BSNAS), depression, anxiety, and stress (DASS-21), as well as impulsiveness (BIS-15) and aggressiveness (AQ) in a large sample of youngsters, in order to assess the association between BSNAS and DASS-21 indices. Mediation analyses were performed to evaluate the role of impulsiveness and aggressive personality traits in the association between SM use (SMU) and depression. RESULTS 75.8% of the sample (n = 491) had a problematic SMU. SMU was reduced by high AQ and high DASS-21 scores (F = 42.338, p < 0.001, R2 = 0.207). Mediation analyses showed that SMU negatively predicted depressive symptomatology with the interaction mediated by AQ total (ß = - 0.1075), physical (ß = - 0.207) and anger (ß = - 0.0582), BIS-15 total (ß = - 0.0272) and attentional (ß = - 0.0302). High depressive levels were predicted by high AQ scores, low SMU levels, low verbal and physical AQ, and low attentional BIS-15 (F = 30.322, p < 0.001, R2 = 0.273). Depressive symptomatology negatively predicted SMU with their interaction mediated by AQ total (ß = - 0.1640), verbal (ß = 0.0436) and anger (ß = - 0.0807), BIS-15 total (ß = - 0.0448) and attentional (ß = - 0.0409). CONCLUSIONS SMU during the early phases of the COVID-19 pandemic could have a beneficial role in buffering negative consequences linked to social isolation due to quarantine measures, despite this association being mediated by specific personality traits.
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Affiliation(s)
- Laura Orsolini
- Clinical Psychiatry Unit, Department of Clinical Neurosciences/DIMSC, School of Medicine, Università Politecnica delle Marche, Via Tronto 10/A, 60126, Ancona, Italy
| | - Umberto Volpe
- Clinical Psychiatry Unit, Department of Clinical Neurosciences/DIMSC, School of Medicine, Università Politecnica delle Marche, Via Tronto 10/A, 60126, Ancona, Italy.
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, Trieste, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy
| | | | - Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences Luigi Sacco, Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy
| | - Valeria Del Vecchio
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Marco Di Nicola
- Department of Neuroscience, Section of Psychiatry, University Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | | | - Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | | | - Maria Giulia Nanni
- Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, University Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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Dell’Osso L, Amatori G, Massimetti G, Nardi B, Gravina D, Benedetti F, Bonelli C, Luciano M, Berardelli I, Brondino N, De Gregorio M, Deste G, Nola M, Reitano A, Muscatello MRA, Pompili M, Politi P, Vita A, Carmassi C, Maj M. Investigating the relationship between autistic traits and symptoms and Catatonia Spectrum. Eur Psychiatry 2022; 65:e81. [DOI: 10.1192/j.eurpsy.2022.2334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Nardi B, Del Prete L, Amatori G, Carpita B, Carmassi C, Pompili M, Dell'Osso L. An attempted "suicide pact" in Covid-19 era - psychiatric perspectives. BMC Psychiatry 2022; 22:686. [PMID: 36333800 PMCID: PMC9636834 DOI: 10.1186/s12888-022-04333-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND A "suicide pact" is a joint and actively induced death of two individuals with the essential and unavoidable characteristic of a mutual consent. One of the partners (dominant in the relationship, commonly male) usually induces the action and in most cases, it is the one who actively carries it out. Undiagnosed psychopathological dimension or pathological subthreshold traits are found in those who enter into suicide agreements, the presence of cluster B personality traits such as narcissistic or borderline is of particular relevance in the dominant partner, while in the submissive one dependent personality traits are more frequent. As in the case of other similar health emergencies, COVID-19 pandemic seems to lead to greater suicidality, including the "suicide pacts" of couples whose motivation varies including firstly financial problems, strictly followed by fear of infection and not being able to return home from abroad. CASE PRESENTATION We reported a case of a couple who entered a suicide agreement consequently to the economic difficulties caused by COVID-19 pandemic, hospitalized in our department. Both partners were assessed with Adult Autism Subthreshold Spectrum (AdAS Spectrum) and both crossed the threshold for clinically relevant autistic traits (M = 67; F = 49). CONCLUSION This case further confirms the link between COVID-19 pandemics and suicidality. The role of autism spectrum traits as a vulnerability factor towards the development of severe psychopathological consequences after traumatic events is also stressed.
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Affiliation(s)
- Benedetta Nardi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56127, Pisa, Italy.
| | - Luca Del Prete
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56127, Pisa, Italy
| | - Giulia Amatori
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56127, Pisa, Italy
| | - Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56127, Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56127, Pisa, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Faculty of Medicine and Psychology, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56127, Pisa, Italy
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Carmassi C, Tosato S, Bertelloni CA, Pedrinelli V, Cappelli A, Abbate-Daga G, Albert U, Castellini G, Luciano M, Menchetti M, Pompili M, Sampogna G, Signorelli MS, Massimetti G, Fiorillo A. PTSD trajectories across different mental disorders in the second year of the COVID-19 pandemic in Italy: a naturalistic, longitudinal, multicenter study. Int Rev Psychiatry 2022; 34:797-808. [PMID: 36546718 DOI: 10.1080/09540261.2022.2145184] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The potentially traumatic impact of the COVID-19 pandemic in subjects with pre-existing mental disorders is still unclear, especially regarding its long-term consequences. The aim of this study was to prospectively assess post-traumatic stress disorder (PTSD) and post-traumatic stress symptoms (PTSS) in patients with mental disorders, during the 3rd wave of the infection (T0, March-April 2021) while strict containment measures were applied in Italy, and after 3 months (T1, June-July 2021), with reduced restrictive measures. A total sample of 527 subjects, with different DSM-5 diagnoses, was consecutively enrolled at nine Italian psychiatric outpatient services. Assessments at T0 included: the Trauma and Loss Spectrum-Self Report (TALS-SR), the Impact of Event Scale-Revised (IES-R) and the Work and Social Adjustment Scale (WSAS). These two latter were repeated at T1. Results showed that at T0, 43.6% of the sample reported symptoms of PTSD, with females (p = .004), younger subjects (p = .011), unemployed/students (p = .011), and living with their parental families (p = .017), resulting more affected. Differences in PTSD rates emerged across diagnostic groups ranging from 10% in patients with psychoses up to 59% in those with feeding and eating disorders. An improvement at T1 emerged in all diagnostic groups for the IES-R scores, while WSAS scores improved only in subjects with mood disorders. In conclusions, subjects with mental disorders presented relevant rates of PTSD and PTSS at 1-year into the pandemic. Further long-term studies are needed to follow-up the course of pandemic traumatic burden especially in patients with severe mental disorders.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Cappelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giovanni Abbate-Daga
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina - ASUGI, Trieste, Italy
| | | | - Mario Luciano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Maurizio Pompili
- Department of Neuroscience, Mental Health and Sense Organs, University of Rome "La Sapienza", Rome, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Maria Salvina Signorelli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli," Naples, Italy
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Dell'Osso B, Viganò C, Conti D, Scarpa C, Casati L, Albert U, Carmassi C, Carrà G, Cirulli F, Nanni MG, Pompili M, Sampogna G, Sani G, Tortorella A, Volpe U, Fiorillo A. Insomnia and related factors in patients with pre-existing psychiatric disorders compared to the general population during the COVID-19 lockdown: Findings from the multicentric COMET study. Compr Psychiatry 2022; 118:152345. [PMID: 35988374 PMCID: PMC9364932 DOI: 10.1016/j.comppsych.2022.152345] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/30/2022] [Accepted: 08/06/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has heavily impacted social, economic and health systems worldwide. Necessary confinement measures have, in turn, contributed to the occurrence of several stress-related conditions and deterioration of pre-existing mental conditions, including insomnia. OBJECTIVE The present study sought to investigate the occurrence and severity of insomnia during the COVID-19 lockdown among psychiatric patients and in the general population in the largest Italian sample examined to date. Potential factors associated with a risk of developing insomnia in the global sample were examined as well. METHODS A sample of 20,720 people (5.5% of them being psychiatric patients) was assessed through an online survey conducted during lockdown between March and May 2020. To investigate the occurrence and severity of sleep related issues, the Insomnia Severity Index (ISI) was used. In order to evaluate factors associated with the severity of insomnia in the global sample, multivariate linear regression models were performed. RESULTS During the lockdown, patients with pre-existing mental disorders reported a mean higher score on the ISI scale (p < 0.001) compared to the general population. According to the multivariate regression models, the first three weeks of lockdown were significantly associated with a higher risk of insomnia, but the risk disappeared in the fourth week. Other associated factors included: the presence of a pre-existing mental disorder, ages 24 to 64 years old, and/or being female (p < 0.001). CONCLUSIONS Although containment measures represent essential public health strategies to avoid the spread of the COVID-19 pandemic, sleep was one of the aspects affected during the early stages of the lockdown in both people with pre-existing mental disorders and general population. As an integral part of COVID-19 intervention, it is useful to raise awareness about these issues and to adopt both preventive and therapeutic interventions.
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Affiliation(s)
- Bernardo Dell'Osso
- ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Italy; "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
| | - Caterina Viganò
- ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Italy
| | - Dario Conti
- ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Italy
| | - Carolina Scarpa
- ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Italy
| | - Lorenzo Casati
- ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina - ASUGI, Trieste, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy
| | - Francesca Cirulli
- Center for Behavioral Sciences and Mental Health, National Institute of Health, Rome, Italy
| | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, University Cattolica del Sacro Cuore, Rome, Italy,Department of Psychiatry, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | | | - Umberto Volpe
- Clinical Psychiatry Unit, Department of Clinical Neurosciences, Università Politecnica delle Marche, Ancona, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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Pompili M, Innamorati M, Erbuto D, Luciano M, Sampogna G, Abbate-Daga G, Barlati S, Carmassi C, Castellini G, De Fazio P, Di Lorenzo G, Di Nicola M, Ferrari S, Goracci A, Gramaglia C, Martinotti G, Nanni MG, Pasquini M, Pinna F, Poloni N, Serafini G, Signorelli M, Tortorella A, Ventriglio A, Volpe U, Fiorillo A. High depression symptomatology and mental pain characterize suicidal psychiatric patients. Eur Psychiatry 2022; 65:e54. [PMID: 36041998 PMCID: PMC9491079 DOI: 10.1192/j.eurpsy.2022.2312] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Symptoms of depression are transdiagnostic heterogenous features frequently assessed in psychiatric disorders, that impact the response to first-line treatment and are associated with higher suicide risk. This study assessed whether severe mental pain could characterize a specific phenotype of severely depressed high-risk psychiatric patients. We also aimed to analyze differences in treatments administered. METHODS 2,297 adult patients (1,404 females and 893 males; mean age = 43.25 years, SD = 15.15) treated in several Italian psychiatric departments. Patients were assessed for psychiatric diagnoses, mental pain, symptoms of depression, hopelessness, and suicide risk. RESULTS More than 23% of the patients reported high depression symptomatology and high mental pain (HI DEP/HI PAIN). Compared to patients with lower symptoms of depression, HI DEP/HI PAIN is more frequent among females admitted to an inpatient department and is associated with higher hopelessness and suicide risk. In addition, HI DEP/HI PAIN (compared to both patients with lower symptoms of depression and patients with higher symptoms of depression but lower mental pain) were more frequently diagnosed in patients with personality disorders and had different treatments. CONCLUSIONS Patients reporting severe symptoms of depression and high mental pain presented a mixture of particular dangerousness (high trait hopelessness and the presence of suicide ideation with more frequency and less controllability and previous suicide behaviors). The presence of severe mental pain may act synergically in expressing a clinical phenotype that is likewise treated with a more complex therapeutic regime than that administered to those experiencing symptoms of depression without mental pain.
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Affiliation(s)
- Maurizio Pompili
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Denise Erbuto
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Giovanni Abbate-Daga
- Eating Disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Claudia Carmassi
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Pasquale De Fazio
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marco Di Nicola
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Dipartimento ad Attività Integrata di Salute Mentale e Dipendenze Patologiche, AUSL - IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Arianna Goracci
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Carla Gramaglia
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.,Psychiatry Division, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Maria Giulia Nanni
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Nicola Poloni
- Division of Psychiatry, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS San Martino, Genoa, Italy
| | - Maria Signorelli
- Department of Clinical and Experimental Medicine, AOU Policlinico Hospital, University of Catania, Catania, Italy
| | | | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine and Surgery, Polytechnic University of Marche, Ancona, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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Carmassi C, Conti L, Gravina D, Nardi B, Dell'Osso L. Emotional dysregulation as trans-nosographic psychopathological dimension in adulthood: A systematic review. Front Psychiatry 2022; 13:900277. [PMID: 36104987 PMCID: PMC9464828 DOI: 10.3389/fpsyt.2022.900277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Emotional dysregulation (ED) is characterized by inappropriate emotional reactions related to environmental or cognitive stimuli. In most recent years, increasing interest has been devoted to its definition and detection across mental disorders for its detrimental role progressively highlighted in both neurodevelopment and adult mental disorders, with implications on the severity of clinical manifestations. The aim of this systematic review was to evaluate and gather the scientific evidence about ED in adult psychiatric population to elucidate the concept of ED as trans-nosographic entity. Methods The electronics databases PubMed, Scopus and Web of Science was reviewed to identify studies in accordance with the PRISMA guidelines; at the end of the selection process a total of 29 studies (N = 709; N = 658; N = 1,425) was included. All studies included assessed the presence of ED symptoms, by means of a validate scale in adult (>18 years of age), in clinically diagnosed patients as well as healthy control participants. Results Our results suggest ED as a trans-diagnostic factor across multiple mental disorders, such as bipolar disorder, attention deficit hyperactivity disorder, autism spectrum disorder, personality disorders; a better definition of this concept could be helpful to interpret and clarify many clinical cases and improve their diagnostic and therapeutic management.
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Affiliation(s)
| | - Lorenzo Conti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Orsini A, Foiadelli T, Sica A, Santangelo A, Carli N, Bonuccelli A, Consolini R, D’Elios S, Loddo N, Verrotti A, Di Cara G, Marra C, Califano M, Fetta A, Fabi M, Bergamoni S, Vignoli A, Battini R, Mosca M, Baldini C, Assanta N, Marchese P, Simonini G, Marrani E, Operto FF, Pastorino GMG, Savasta S, Santangelo G, Pedrinelli V, Massimetti G, Dell’Osso L, Peroni D, Cordelli DM, Corsi M, Carmassi C. Psychopathological Impact in Patients with History of Rheumatic Fever with or without Sydenham's Chorea: A Multicenter Prospective Study. Int J Environ Res Public Health 2022; 19:10586. [PMID: 36078300 PMCID: PMC9517806 DOI: 10.3390/ijerph191710586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/20/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
Sydenham's chorea (SC) is a post-streptococcal autoimmune disorder of the central nervous system, and it is a major criterium for the diagnosis of acute rheumatic fever (ARF). SC typically improves in 12-15 weeks, but patients can be affected for years by persistence and recurrencies of both neurological and neuropsychiatric symptoms. We enrolled 48 patients with a previous diagnosis of ARF, with or without SC, in a national multicenter prospective study, to evaluate the presence of neuropsychiatric symptoms several years after SC's onset. Our population was divided in a SC group (n = 21), consisting of patients who had SC, and a nSC group (n = 27), consisting of patients who had ARF without SC. Both groups were evaluated by the administration of 8 different neuropsychiatric tests. The Work and Social Adjustment Scale (WSAS) showed significantly (p = 0.021) higher alterations in the SC group than in the nSC group. Furthermore, 60.4% (n = 29) of the overall population experienced neuropsychiatric symptoms other than choreic movements at diagnosis and this finding was significantly more common (p = 0.00) in SC patients (95.2%) than in nSC patients (33.3%). The other neuropsychiatric tests also produced significant results, indicating that SC can exert a strong psychopathological impact on patients even years after its onset.
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Affiliation(s)
- Alessandro Orsini
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | - Thomas Foiadelli
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
| | - Attilio Sica
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | - Andrea Santangelo
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | - Niccolò Carli
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | - Alice Bonuccelli
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | - Rita Consolini
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | - Sofia D’Elios
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | - Nicolò Loddo
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
| | - Alberto Verrotti
- Department of Pediatrics, University of Perugia, 06123 Perugia, Italy
| | - Giuseppe Di Cara
- Department of Pediatrics, University of Perugia, 06123 Perugia, Italy
| | - Chiara Marra
- Child Neurology Unit, University of Bologna, 40126 Bologna, Italy
| | - Maria Califano
- Child Neurology Unit, University of Bologna, 40126 Bologna, Italy
| | - Anna Fetta
- Child Neurology Unit, University of Bologna, 40126 Bologna, Italy
| | - Marianna Fabi
- Child Neurology Unit, University of Bologna, 40126 Bologna, Italy
| | - Stefania Bergamoni
- Childhood and Adolescence Neurology and Psychiatry Unit, ASST GOM Niguarda, 20121 Milan, Italy
| | - Aglaia Vignoli
- Childhood and Adolescence Neurology and Psychiatry Unit, ASST GOM Niguarda, 20121 Milan, Italy
- Health Sciences Department, Università degli Studi di Milano, 20121 Milan, Italy
| | - Roberta Battini
- Department of Clinical and Experimental Medicine, University of Pisa, 56121 Pisa, Italy
- Department of Developmental Neuroscience, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, 56121 Pisa, Italy
| | - Marta Mosca
- Department of Clinical and Experimental Medicine, University of Pisa, 56121 Pisa, Italy
| | - Chiara Baldini
- Department of Clinical and Experimental Medicine, University of Pisa, 56121 Pisa, Italy
| | - Nadia Assanta
- Heart Hospital, G. Monasterio Tuscan Foundation, 54100 Massa, Italy
| | - Pietro Marchese
- Heart Hospital, G. Monasterio Tuscan Foundation, 54100 Massa, Italy
| | - Gabriele Simonini
- Pediatric Rheumatology, Meyer Children Hospital, University of Florence, 50134 Florence, Italy
| | - Edoardo Marrani
- Pediatric Rheumatology, Meyer Children Hospital, University of Florence, 50134 Florence, Italy
| | - Francesca Felicia Operto
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy
| | - Grazia Maria Giovanna Pastorino
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy
| | | | - Giuseppe Santangelo
- Child Neuropsychiatry Unit, ISMEP—P.O. Cristina—ARNAS Civico, Via dei Benedettini 1, 90100 Palermo, Italy
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56121 Pisa, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, 56121 Pisa, Italy
| | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, 56121 Pisa, Italy
| | - Diego Peroni
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56121 Pisa, Italy
| | | | - Martina Corsi
- Occupational Health Department, Azienda Ospedaliero Universitaria Pisana, Via Paradisa 2, 56124 Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, 56121 Pisa, Italy
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Carrà G, Crocamo C, Bartoli F, Riboldi I, Sampogna G, Luciano M, Albert U, Carmassi C, Cirulli F, Dell’Osso B, Menculini G, Nanni MG, Pompili M, Sani G, Volpe U, Fiorillo A. Were anxiety, depression and psychological distress associated with local mortality rates during COVID-19 outbreak in Italy? Findings from the COMET study. J Psychiatr Res 2022; 152:242-249. [PMID: 35753244 PMCID: PMC9212315 DOI: 10.1016/j.jpsychires.2022.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The mental health of the Italian population declined at the onset of the COVID-19 pandemic. However, nationwide population prevalence estimates may not effectively reproduce the heterogeneity in distress responses to the pandemic. In particular, contextual determinants specific to COVID-19 pandemic need to be considered. We thus aimed to explore the association between local COVID-19 mortality rates and mental health response among the general population. METHODS We capitalised on data (N = 17,628) from a large, cross-sectional, national survey, the COMET study, run between March and May 2020. While psychological distress was measured by General Health Questionnaire-12 (GHQ-12), the Depression, Anxiety and Stress Scale-21 Items (DASS-21) was used to assess relevant domains. In addition, a Covid-19 mortality ratio was built to compare single regional mortality rates to the national estimate and official statistics were used to control for other area-level determinants. RESULTS Adjusted ordered regression analyses showed an association between mortality ratio and moderate (OR = 1.10, 95%CI 1.03-1.18) and severe (OR = 1.11, 95%CI 1.03-1.21) DASS-21 anxiety levels. No effects of mortality ratio on GHQ-12 scores and DASS-21 depression and stress levels, uniformly high across the country, were estimated. CONCLUSIONS Although we could not find any association between regional COVID-19 mortality ratio and depression or psychological distress, anxiety levels were significantly increased among subjects from areas with the highest mortality rates. Local mortality rate seems a meaningful driver for anxiety among the general population. Considering the potentially long-lasting scenario, local public health authorities should provide neighbouring communities with preventive interventions reducing psychological isolation and anxiety levels.
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Affiliation(s)
- Giuseppe Carrà
- Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy,Division of Psychiatry, University College London, London, UK
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy
| | - Francesco Bartoli
- Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy
| | - Ilaria Riboldi
- Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy.
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina – ASUGI, Trieste, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesca Cirulli
- Center for Behavioral Sciences and Mental Health, National Institute of Health, Rome, Italy
| | - Bernardo Dell’Osso
- Department of Biomedical and Clinical Sciences Luigi Sacco and Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milano, Italy
| | | | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, University Cattolica del Sacro Cuore, Rome, Italy,Department of Psychiatry, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Umberto Volpe
- Clinical Psychiatry Unit, Department of Clinical Neurosciences, Università Politecnica delle Marche, Ancona, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
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Carpita B, Migli L, Chiarantini I, Battaglini S, Montalbano C, Carmassi C, Cremone IM, Dell’Osso L. Autism Spectrum Disorder and Fetal Alcohol Spectrum Disorder: A Literature Review. Brain Sci 2022; 12:brainsci12060792. [PMID: 35741677 PMCID: PMC9221419 DOI: 10.3390/brainsci12060792] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/07/2022] [Accepted: 06/15/2022] [Indexed: 02/06/2023] Open
Abstract
Fetal alcohol spectrum disorders (FASD) are a group of conditions associated with the effects of prenatal alcohol exposure and characterized by somatic and neuropsychological alterations. On the other hand, autism spectrum disorder (ASD) is characterized by a multifaceted neurobehavioral syndrome. Since alcohol can affect every stage of brain development, some authors hypothesized that in utero alcohol exposure might be linked to an increased risk of ASD in subjects with genetic vulnerability. The present review aimed to summarize the available literature on the possible association between FASD and ASD, also focusing on the reported clinical overlaps and on the possible shared pathogenic mechanisms. Studies in this field have stressed similarities and differences between the two conditions, leading to controversial results. The available literature also highlighted that both the disorders are often misdiagnosed or underdiagnosed, stressing the need to broaden the perspective, paying specific attention to milder presentations and sub-syndromic traits.
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Pompili M, Erbuto D, Innamorati M, Luciano M, Sampogna G, Abbate-Daga G, Barlati S, Carmassi C, Castellini G, De Fazio P, Di Lorenzo G, Di Nicola M, Ferrari S, Gramaglia C, Nanni MG, Pasquini M, Pinna F, Poloni N, Serafini G, Signorelli M, Ventriglio A, Volpe U, Fiorillo A. The Relationship Between Mental Pain, Suicide Risk, and Childhood Traumatic Experiences: Results From a Multicenter Study. J Clin Psychiatry 2022; 83. [PMID: 35704708 DOI: 10.4088/jcp.21m14176] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective: Mental pain and exposure to maltreatment are significant risk factors for suicidal behavior. This study aimed to investigate whether mental pain could be associated with a recent suicide attempt and whether it could mediate the relationship between childhood traumatic experiences and suicide risk in psychiatric patients. Methods: A multicenter observational study was organized as a joint project with representatives of numerous mixed Italian academic and clinical settings. Between December 2017 and March 2020, batteries of tests were administered to patients, assessing suicidal ideation and behavior, mental pain (usual and worst mental pain in the past 15 days), depression, and childhood maltreatment. Results: A total of 2,137 psychiatric patients (1,313 women and 824 men) were included in the final sample, and 315 reported having attempted suicide in the last 3 months. Suicide attempters (compared to nonattempters) had higher odds of reporting worse mental pain (odds ratios [ORs] between 1.02 and 1.17; P < .001) and suicidal intent with/without a specific plan (ORs between 11.57 and 11.77; P < .001). They also had higher odds of having a personality disorder (borderline personality disorder: ORs between 2.65 and 3.01; P < .001; other personality disorders: ORs between 1.96 and 2.28; P < .01) and major depression (ORs between 1.62 and 1.70; P < .05). Childhood trauma was associated with suicide risk directly (standardized effects between 0.06 and 0.07; P < .01) and indirectly through mental pain (usual mental pain: standardized indirect effect = 0.11, P < .001; worst mental pain in the past 15 days: standardized indirect effect = 0.12, P < .001). Conclusions: Mental pain constitutes a crucial framework for assessing the individual need for psychiatric help. Assessing mental pain allows identification of the main ingredient of suicide risk and puts the clinician in a strategic position to unlock some motives behind the wish to die. Further research is needed to learn if childhood adversities may interact with adult mental pain and thus foster suicide risk.
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Affiliation(s)
- Maurizio Pompili
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.,Corresponding author: Maurizio Pompili, MD, PhD, Department of Psychiatry Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035 00189, Rome, Italy
| | - Denise Erbuto
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli," Naples, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli," Naples, Italy
| | - Giovanni Abbate-Daga
- Eating Disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia and Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Pasquale De Fazio
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marco Di Nicola
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Carla Gramaglia
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Psychiatry Division, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Maria Giulia Nanni
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Nicola Poloni
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Varese, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS San Martino, Genoa, Italy
| | - Maria Signorelli
- Department of Clinical and Experimental Medicine, AOU Policlinico Hospital, University of Catania, Catania, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine and Surgery, Polytechnic University of Marche, Ancona, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli," Naples, Italy
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Trentin F, Fulvio G, Andreozzi G, Cigolini C, Da Rio M, Dell’Oste V, Elefante E, Fattorini F, Fonzetti S, Lorenzoni V, Maffi M, Navarro García IC, Palla I, Pedrinelli V, Scagnellato L, Schilirò D, Valevich A, Gaglioti A, Carmassi C, Tani C, Dell’osso L, Turchetti G, Mosca M. AB1410 IMPACT OF COVID-19 PANDEMIC ON HEALTHCARE RESOURCE USE AND CLINICAL OUTCOMES IN A COHORT OF PATIENTS WITH SYSTEMIC AUTOIMMUNE DISEASES- AN INTERIM ANALYSIS FROM THE PER-MAS PROJECT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundManagement of the health emergency caused by COVID-19 pandemic majorly disrupted the delivery of healthcare services to patients with chronic conditions like Systemic Autoimmune Diseases (SAD), both because resources were mainly channeled towards the care of infected patients, but also because patients tended to avoid seeking medical care for fear of becoming infected. PER-MAS is a 2-year project aimed at assessing the clinical, psychopathological, and socio-economic impact of COVID-19 in a cohort of patients with SAD.ObjectivesTo assess the impact of COVID-19 pandemic on drug withdrawal, disease flares and hospitalizations for disease exacerbation in a cohort of patients with SAD through an interim analysis of data from the PER-MAS project.MethodsA sample of 214 consecutive patients was recruited in a reference center for rare and complex autoimmune diseases from April 2021 to January 2022. Inclusion criteria were definite diagnosis of SAD (Connective Tissue Disease (CTD), Inflammatory Arthritis (IA) or Vasculitis), regular follow-up and at least 2 years of disease. Patients were asked to fill out an extensive self-administered questionnaire on disease activity and healthcare resource use during the pandemic (March 2020-moment of assessment). Pre-pandemic (March 2019-February 2020) and early pandemic (March 2020-February 2021) clinical data were recorded through retrospective chart review and patient interview.ResultsAt enrolment, 119 patients were affected by CTDs (55.6%), 71 by IA (33.18%), 24 by vasculitis (11.21%), with mean age 50.44± 12.97, and mean disease duration 11.17 ± 8.94. 30.37% took steroids, 39.7% hydroxychloroquine, 61.68% DMARDs, and 9.3% vasoactive drugs.Overall, disease course was similar in pre-pandemic and early pandemic phase: in the first period, rheumatologic condition was stable in 57.35% of patients, persistently active in 27.3% and 35.61% had ≥ 1 episode of disease exacerbation (mean 0.665±1.15, range 0-6); in the second period, 60.56% of patients was stable, 24.88% persistently active, and 39.44% had ≥1 exacerbation (mean 0.49 ±0.77, range 0-4). Mean number of visits (2.56±2.57 and 2.61±2.79), hospitalizations (0.168±0.698 and 0.14±0.473, p=0.6), number of patients with outpatient visits=0 (7.47 vs 7%), and number of patients with ≥ 1 hospital admission (10.28 vs 11.6%) were also similar, while the number of patients with hospital admissions for disease exacerbation was significantly higher in the second period (6.1 vs 11.21%, p=0.001).170 patients completed the survey: from March 2020 to enrolment, 18.2% suspended ≥1 anti-rheumatic drug (6.25% of them for fear of contracting COVID-19 disease, 15.6% for difficulty in obtaining medications), 20% self-managed ≥ 1 disease exacerbation, and 40% had ≥ 1 telemedicine consult. From March to July 2020, 41.76% had their visit rescheduled (35.23% for hospital access restrictions, 5.3% for travel restrictions, 1.17% for fear). Conversely, only 14.7% of patients had their visit rescheduled (8.23% for hospital access restrictions, 4.7% for other reasons) from July 2020 to enrolment.ConclusionIn the early pandemic phase, overall disease course was similar to the pre-pandemic phase, but we observed an increase in the number of patients with ≥ 1 hospitalization for disease. Moreover, despite our efforts, patients reported a non-negligible rate of drug discontinuation for non-medical indication and difficulty to get access to rheumatologic consultation, highlighting the need of alternative organizational models in case of future pandemics.AcknowledgementsGiulia Sacco for helping in patient recruitment and data management.Disclosure of InterestsFrancesca Trentin: None declared, Giovanni Fulvio: None declared, Gianni Andreozzi: None declared, Cosimo Cigolini: None declared, Mattia Da Rio: None declared, Valerio Dell’Oste: None declared, Elena Elefante: None declared, Federico Fattorini: None declared, Silvia Fonzetti: None declared, Valentina Lorenzoni: None declared, Michele Maffi: None declared, Inmaculada Concepción Navarro García: None declared, Ilaria Palla: None declared, Virginia Pedrinelli: None declared, Laura Scagnellato: None declared, Davide Schilirò: None declared, Anastasiya Valevich: None declared, Andrea Gaglioti: None declared, Claudia Carmassi: None declared, Chiara Tani: None declared, Liliana Dell’Osso: None declared, Giuseppe Turchetti: None declared, Marta Mosca Speakers bureau: Lilly, Astra Zeneca, GSK, Consultant of: Lilly, Astra Zeneca, GSK
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Fulvio G, Pedrinelli V, Andreozzi G, Trentin F, Fantasia S, Fonzetti S, Fustini C, Da Rio M, Cappellato G, Cigolini C, Schilirò D, Maffi M, Scagnellato L, Valevich A, Fattorini F, Navarro García IC, Palla I, Lorenzoni V, Gaglioti A, Carmassi C, Tani C, Turchetti G, Dell’Osso L, Mosca M. OP0197 POST-TRAUMATIC STRESS DISORDER AND SYMPTOMS IN PATIENTS WITH RHEUMATIC AND MUSCULOSKELETAL DISEASES DURING THE COVID-19 PANDEMIC: PRELIMINARY RESULTS FROM THE PERMAS STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe COVID-19 pandemic, with its uncertainties, fears of contagion, mass lockdowns and containment measures, has dramatically impacted on people’s everyday lives leading to an increased risk of mental disorders, particularly Post-Traumatic Stress Disorder (PTSD). Despite evidence in general population and healthcare workers1,2, scant data emerged on vulnerable populations, such as of patients with chronic illness, particularly rheumatic and musculoskeletal diseases (RMDs)3,4, who also underwent difficulties in the management and treatment of their disorders.ObjectivesTo assess PTSD and post-traumatic stress symptoms in a sample of patients with RMDs, during the COVID-19 pandemic in Italy.MethodsPERMAS is a monocentric prospective observational study led by the Rheumatology Unit, the Psychiatric Clinic and the Institute of Management of the School of Advanced Studies. Patients with a RMD diagnosis, were consecutively enrolled from May 2021 to January 2022. During the visit, sociodemographic characteristics and psychopathological data were collected through online survey, whereas clinical data were collected by physician. The survey included the Trauma and Loss Spectrum- Self Report (TALS-SR) and the Impact of Event Scale- Revised (IES-R), aimed to assess symptomatological PTSD and post-traumatic stress symptoms related to the impact of the COVID-19 pandemic.ResultsA total of 194 eligible patients, with a mean age of 50.3±12.17 years, was included: 142 (73.19%) were females; 112 (57.74%) patients reported connective tissue diseases (CTD), 63 (32.47%) arthritis and 19 (9.8%) vasculitis. A total of 33 (17%) subjects reported a symptomatological PTSD by means of the TALS-SR. The prevalence of Partial PTSD (defined by at least 2 out of the 4 criteria for DSM-5 diagnosis of the disorder) was 56.7%, with significant higher rates among females (90, 81.8%) with respect to males (20, 18.2%) (p=.013). Accordingly, a IES-R mean total score of 21.90 ±15.98 was found in the total sample and a gender difference emerged, with higher mean scores among females rather than males (23.42 ±16.26 vs 21.90 ±15.98, p=.031).ConclusionThe present findings point out high prevalence rates of symptomatological PTSD among patients suffering from RMDs, highlighting the potentially traumatic burden of the COVID-19 pandemic in this particular population, especially among females, suggesting the need of further investigations to address tailored prevention and intervention strategies.References[1]Fiorillo A, Sampogna G, Giallonardo V, Del Vecchio V, Luciano M, Albert U, Carmassi C, Carrà G, Cirulli F, Dell’Osso B, Nanni MG, Pompili M, Sani G, Tortorella A, Volpe U. Effects of the lockdown on the mental health of the general population during the COVID-19 pandemic in Italy: Results from the COMET collaborative network. Eur Psychiatry 2020; 63(1), e87.[2]Carmassi C, Dell’Oste V, Bui E, Foghi C, Bertelloni CA, Atti AR, Buselli R, Di Paolo M, Goracci A, Malacarne P, Nanni MG, Gesi C, Cerveri G, Dell’Osso L. The interplay between acute post-traumatic stress, depressive and anxiety symptoms on healthcare workers functioning during the COVID-19emergency: A multicenter study comparing regions with increasing pandemic incidence. J Affect Disord 2022; 298(Pt A), 209-216.[3]Garrido-Cumbrera M, Marzo-Ortega H, Christen L, Plazuelo-Ramos P, Webb D, Jacklin C, Irwin S, Grange L, Makri S, Frazão Mateus E, Mingolla S, Antonopoulou K, Sanz-Gómez S, Correa-Fernández J, Carmona L, Navarro-Compán V. Assessment of impact of the COVID-19 pandemic from the perspective of patients with rheumatic and musculoskeletal diseases in Europe: results from the REUMAVID study (phase 1). RMD 2021; 7(1), e001546. doi: 10.1136/rmdopen-2020-001546[4]Wang XA, Duculan R, Mancuso CA. Coping Mechanisms Mitigate Psychological Stress in Patients With Rheumatologic Diseases During the COVID-19 Pandemic. J Clin Rheumatol 2021. doi: 10.1097/RHU.0000000000001757Disclosure of InterestsGiovanni Fulvio: None declared, Virginia Pedrinelli: None declared, Gianni Andreozzi: None declared, Francesca Trentin: None declared, Sara Fantasia: None declared, Silvia Fonzetti: None declared, Chiara Fustini: None declared, Mattia Da Rio: None declared, Gabriele Cappellato: None declared, Cosimo Cigolini: None declared, Davide Schilirò: None declared, Michele Maffi: None declared, Laura Scagnellato: None declared, Anastasiya Valevich: None declared, Federico Fattorini: None declared, Inmaculada Concepción Navarro García: None declared, Ilaria Palla: None declared, Valentina Lorenzoni: None declared, Andrea Gaglioti: None declared, Claudia Carmassi: None declared, Chiara Tani: None declared, Giuseppe Turchetti: None declared, Liliana Dell’Osso: None declared, Marta Mosca Speakers bureau: Lillly, Astra Zeneca, GSK, Consultant of: Lillly, Astra Zeneca, GSK
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Dell'Osso L, Massoni L, Battaglini S, Cremone IM, Carmassi C, Carpita B. Biological correlates of altered circadian rhythms, autonomic functions and sleep problems in autism spectrum disorder. Ann Gen Psychiatry 2022; 21:13. [PMID: 35534878 PMCID: PMC9082467 DOI: 10.1186/s12991-022-00390-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 04/15/2022] [Indexed: 02/05/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by a complex and multifaceted neurobehavioral syndrome. In the last decades, several studies highlighted an increased prevalence of sleep problems in ASD, which would be associated with autonomic system and circadian rhythm disruption. The present review aimed to summarize the available literature about sleep problems in ASD subjects and about the possible biological factors implicated in circadian rhythm and autonomic system deregulation in this population, as well as possible therapeutic approaches. Shared biological underpinnings between ASD symptoms and altered circadian rhythms/autonomic functions are also discussed. Studies on sleep showed how ASD subjects typically report more problems regarding insufficient sleep time, bedtime resistance and reduced sleep pressure. A link between sleep difficulties and irritability, deficits in social skills and behavioral problems was also highlighted. Among the mechanisms implicated, alteration in genes related to circadian rhythms, such as CLOCK genes, and in melatonin levels were reported. ASD subjects also showed altered hypothalamic pituitary adrenal (HPA) axis and autonomic functions, generally with a tendency towards hyperarousal and hyper sympathetic state. Intriguingly, some of these biological alterations in ASD individuals were not associated only with sleep problems but also with more autism-specific clusters of symptoms, such as communication impairment or repetitive behaviors Although among the available treatments melatonin showed promising results, pharmacological studies for sleep problems in ASD need to follow more standardized protocols to reach more repeatable and reliable results. Further research should investigate the issue of sleep problems in ASD in a broader perspective, taking into account shared pathophysiological mechanisms for core and associated symptoms of ASD.
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Affiliation(s)
- Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, Italy
| | - Leonardo Massoni
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, Italy
| | - Simone Battaglini
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, Italy
| | - Ivan Mirko Cremone
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, Italy
| | - Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, Italy.
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Amatori G, Cappelli A, Carmassi C, Rodgers RF, Bui E. Impact of the COVID-19 pandemic on mental health among women: An editorial. International Journal of Mental Health 2022. [DOI: 10.1080/00207411.2022.2066299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Giulia Amatori
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Cappelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Rachel F. Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA, USA
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France
| | - Eric Bui
- Department of Psychiatry, Caen University Hospital, Caen, France
- Faculty of Medicine, University of Caen Normandy, Caen, France
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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Carmassi C, Pacciardi B, Gravina D, Fantasia S, De Pascale G, Cutuli SL, Bertelloni CA, Dell’Osso L. Pharmacological Treatment of Acute Psychiatric Symptoms in COVID-19 Patients: A Systematic Review and a Case Series. Int J Environ Res Public Health 2022; 19:4978. [PMID: 35564372 PMCID: PMC9099660 DOI: 10.3390/ijerph19094978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 02/04/2023]
Abstract
Delirium and psychomotor agitation are relevant clinical conditions that may develop during COVID-19 infection, especially in intensive care unit (ICU) settings. The psychopharmacological management of these conditions is receiving increasing interest in psychiatry, considering hyperkinetic delirium as one of the most common neuropsychiatries acute consequences in COVID-19 recovery patients. However, there are no actual internationally validated guidelines about this topic, due to the relatively newly introduced clinical condition; in addition, a standardized psychopharmacologic treatment of these cases is a complex goal to achieve due to the risk of both drug-drug interactions and the vulnerable conditions of those patients. The aim of this systematic review and case series is to evaluate and gather the scientific evidence on pharmacologic handling during delirium in COVID-19 patients to provide practical recommendations on the optimal management of psychotropic medication in these kinds of patients. The electronic databases PubMed, Embase and Web of Science were reviewed to identify studies, in accordance with the PRISMA guidelines. At the end of the selection process, a total of 21 studies (n = 2063) were included. We also collected a case series of acute psychomotor agitation in COVID-19 patients hospitalized in ICU. Our results showed how the symptom-based choice of the psychotropic medication is crucial, and even most of the psychotropic drug classes showed good safety, one must not underestimate the possible drug interactions and also the possible decrease in vital functions which need to be strictly monitored especially during treatment with some kinds of molecules. We believe that the evidence-based recommendations highlighted in the present research will enhance the current knowledge and could provide better management of these patients.
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Affiliation(s)
- Claudia Carmassi
- Psychiatric Unit, Department of Clinical and Experimental Medicine, AOUP, University of Pisa, 56126 Pisa, Italy; (C.C.); (B.P.); (S.F.); (C.A.B.); (L.D.)
| | - Bruno Pacciardi
- Psychiatric Unit, Department of Clinical and Experimental Medicine, AOUP, University of Pisa, 56126 Pisa, Italy; (C.C.); (B.P.); (S.F.); (C.A.B.); (L.D.)
| | - Davide Gravina
- Psychiatric Unit, Department of Clinical and Experimental Medicine, AOUP, University of Pisa, 56126 Pisa, Italy; (C.C.); (B.P.); (S.F.); (C.A.B.); (L.D.)
| | - Sara Fantasia
- Psychiatric Unit, Department of Clinical and Experimental Medicine, AOUP, University of Pisa, 56126 Pisa, Italy; (C.C.); (B.P.); (S.F.); (C.A.B.); (L.D.)
| | - Gennaro De Pascale
- Department of Emergency, Catholic University of the Sacred Heart, 00168 Rome, Italy; (G.D.P.); (S.L.C.)
| | - Salvatore Lucio Cutuli
- Department of Emergency, Catholic University of the Sacred Heart, 00168 Rome, Italy; (G.D.P.); (S.L.C.)
| | - Carlo Antonio Bertelloni
- Psychiatric Unit, Department of Clinical and Experimental Medicine, AOUP, University of Pisa, 56126 Pisa, Italy; (C.C.); (B.P.); (S.F.); (C.A.B.); (L.D.)
| | - Liliana Dell’Osso
- Psychiatric Unit, Department of Clinical and Experimental Medicine, AOUP, University of Pisa, 56126 Pisa, Italy; (C.C.); (B.P.); (S.F.); (C.A.B.); (L.D.)
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Carmassi C, Dell’Oste V, Barberi FM, Bertelloni CA, Pedrinelli V, Dell’Osso L. Mental Health Symptoms among General Practitioners Facing the Acute Phase of the COVID-19 Pandemic: Detecting Different Reaction Groups. Int J Environ Res Public Health 2022; 19:ijerph19074007. [PMID: 35409690 PMCID: PMC8998411 DOI: 10.3390/ijerph19074007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/13/2022] [Accepted: 03/24/2022] [Indexed: 01/13/2023]
Abstract
During the 2020 first wave of the COVID-19 pandemic, general practitioners (GPs) represented the first line of primary care and were highly exposed to the pandemic risks, with a consequent risk of developing a wide range of mental health symptoms. However, scant data are still available on factors associated with a worse outcome. The aim of the present study was to investigate mental health symptoms in 139 GPs in the aftermath of the first COVID-19 national lockdown in Italy, detecting groups of subjects with different depressive, anxiety, and post-traumatic stress symptom severity. The impact of the mental health symptoms on quality of life and individual functioning were also evaluated. A cluster analysis identified three groups with mild (44.6%), moderate (35.3%), and severe psychopathological burden (20.1%). Higher symptom severity was related to younger age, fewer years in service as GPs, working in a high incidence area for the pandemic, having a relative at risk of medical complications due to COVID-19, besides more severe global functioning impairment, burnout, and secondary traumatic stress. The present findings showed that GPs, forced to perform their professional activity in extremely stressful conditions during the COVID-19 pandemic, were at high risk of developing mental health problems and a worse quality of life.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
| | - Valerio Dell’Oste
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
- Correspondence: ; Tel.: +39-050-2219760; Fax: +39-050-2219787
| | - Filippo Maria Barberi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
| | - Carlo Antonio Bertelloni
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
| | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (F.M.B.); (C.A.B.); (V.P.); (L.D.)
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Conti E, Scaffei E, Bosetti C, Marchi V, Costanzo V, Dell’Oste V, Mazziotti R, Dell’Osso L, Carmassi C, Muratori F, Baroncelli L, Calderoni S, Battini R. Looking for “fNIRS Signature” in Autism Spectrum: A Systematic Review Starting From Preschoolers. Front Neurosci 2022; 16:785993. [PMID: 35341016 PMCID: PMC8948464 DOI: 10.3389/fnins.2022.785993] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/08/2022] [Indexed: 01/16/2023] Open
Abstract
Accumulating evidence suggests that functional Near-Infrared Spectroscopy (fNIRS) can provide an essential bridge between our current understanding of neural circuit organization and cortical activity in the developing brain. Indeed, fNIRS allows studying brain functions through the measurement of neurovascular coupling that links neural activity to subsequent changes in cerebral blood flow and hemoglobin oxygenation levels. While the literature offers a multitude of fNIRS applications to typical development, only recently this tool has been extended to the study of neurodevelopmental disorders (NDDs). The exponential rise of scientific publications on this topic during the last years reflects the interest to identify a “fNIRS signature” as a biomarker of high translational value to support both early clinical diagnosis and treatment outcome. The purpose of this systematic review is to describe the updating clinical applications of fNIRS in NDDs, with a specific focus on preschool population. Starting from this rationale, a systematic search was conducted for relevant studies in different scientific databases (Pubmed, Scopus, and Web of Science) resulting in 13 published articles. In these studies, fNIRS was applied in individuals with Autism Spectrum Disorder (ASD) or infants at high risk of developing ASD. Both functional connectivity in resting-state conditions and task-evoked brain activation using multiple experimental paradigms were used in the selected investigations, suggesting that fNIRS might be considered a promising method for identifying early quantitative biomarkers in the autism field.
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Affiliation(s)
- Eugenia Conti
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Elena Scaffei
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
- Department of Neuroscience, Psychology, Drug Research and Child Health NEUROFARBA, University of Florence, Florence, Italy
- *Correspondence: Elena Scaffei,
| | - Chiara Bosetti
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Viviana Marchi
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Valeria Costanzo
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Valerio Dell’Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Raffaele Mazziotti
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Filippo Muratori
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Laura Baroncelli
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
- Institute of Neuroscience, National Research Council, Pisa, Italy
| | - Sara Calderoni
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberta Battini
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Carmassi C, Pedrinelli V, Dell'Oste V, Bertelloni CA, Grossi C, Gesi C, Cerveri G, Dell'Osso L. PTSD and Depression in Healthcare Workers in the Italian Epicenter of the COVID-19 Outbreak. Clin Pract Epidemiol Ment Health 2022; 17:242-252. [PMID: 35173794 PMCID: PMC8728562 DOI: 10.2174/1745017902117010242] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 08/12/2021] [Accepted: 09/24/2021] [Indexed: 12/27/2022]
Abstract
Background: Increasing evidence highlights the susceptibility of Healthcare Workers to develop psychopathological sequelae, including Post-Traumatic Stress Disorder (PTSD) and depression, in the current COronaVIrus Disease-19 (COVID-19) pandemic, but little data have been reported in the acute phase of the pandemic. Objective: To explore Healthcare Workers’ mental health reactions in the acute phase of the COVID-19 pandemic in the first European epicenter (Lodi/Codogno, Italy), with particular attention to post-traumatic stress and depressive symptoms and their interplay with other psychological outcomes. Methods: 74 Healthcare Workers employed at the Azienda Socio Sanitaria Territoriale of Lodi (Lombardy, Italy) were recruited and assessed by means of the Impact of Event Scale- Revised, the Professional Quality of Life Scale-5, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 item, the Resilience Scale and the Work and Social Adjustment Scale. Socio-demographic and clinical variables were compared across three subgroups of the sample (No PTSD, PTSD only, PTSD and depression). Results: A total of 31% of subjects endorsed a diagnosis of PTSD and 28.4% reported PTSD comorbid with major depression. Females were more prone to develop post-traumatic stress and depressive symptoms. Subjects with PTSD and depression groups showed high levels of PTSD, depression, burnout and impairment in functioning. Anxiety symptoms were higher in both PTSD and depression and PTSD groups rather than in the No PTSD group. Conclusion: Our results showed high rates of PTSD and depression among Healthcare Workers and their comorbidity overall being associated with worse outcomes. Current findings suggest that interventions to prevent and treat psychological implications among Healthcare Workers facing infectious outbreaks are needed.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
| | | | - Chiara Grossi
- Department of Mental Health and Addiction, ASST Lodi, Lodi, Italy
| | - Camilla Gesi
- Department of Mental Health and Addiction, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Carmassi C, Dell'Osso L, Bertelloni CA, Pedrinelli V, Dell'Oste V, Cordone A, Ruggeri M, Schimmenti S, Bonetto C, Tosato S. Three-Month Follow-up Study of Mental Health Outcomes After a National COVID-19 Lockdown: Comparing Patients With Mood or Anxiety Disorders Living in an Area With a Higher Versus Lower Infection Incidence. J Clin Psychiatry 2022; 83. [PMID: 35143122 DOI: 10.4088/jcp.21m14172] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: The COVID-19 pandemic and the related containment measures can represent a traumatic experience, particularly for populations living in high incidence areas and individuals with mental disorders. The aim of this study was to prospectively examine posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms since the end of the first COVID-19 pandemic wave and Italy's national lockdown in subjects with mood or anxiety disorders living in 2 regions with increasing pandemic incidence. Methods: 102 subjects with a DSM-5 anxiety or mood disorder were enrolled from June to July 2020 and assessed at baseline (T0) and after 3 months (T1) with the Impact of Event Scale-Revised, Patient Health Questionnaire-9, Generalized Anxiety Disorder 7-Item, and Work and Social Adjustment Scale. At T1, subjects were also assessed by means of the Trauma and Loss Spectrum Self-Report for PTSD. Results: At T0, subjects from the high COVID-19 incidence area showed higher levels of traumatic symptoms than those from the low COVID-19 incidence area (P < .001), with a decrease at T1 with respect to T0 (P = .001). Full or partial DSM-5 PTSD related to the COVID-19 pandemic emerged in 23 subjects (53.5%) from the high COVID-19 incidence area and in 9 (18.0%) from the low COVID-19 incidence area (P < .001). Conclusions: Subjects with mood or anxiety disorders presented relevant rates of PTSD, depressive, and anxiety symptoms in the aftermath of the lockdown, and in most cases these persisted after 3 months. The level of exposure to the pandemic emerged as a major risk factor for PTSD development. Further long-term studies are needed to follow up the course of traumatic burden.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Annalisa Cordone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Mirella Ruggeri
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Simone Schimmenti
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Bonetto
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Corresponding author: Sarah Tosato, MD, PhD, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy P.le Scuro 10, 37134 Verona, Italy
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Carmassi C, Dell'Oste V, Bui E, Foghi C, Bertelloni CA, Atti AR, Buselli R, Di Paolo M, Goracci A, Malacarne P, Nanni MG, Gesi C, Cerveri G, Dell'Osso L. The interplay between acute post-traumatic stress, depressive and anxiety symptoms on healthcare workers functioning during the COVID-19 emergency: A multicenter study comparing regions with increasing pandemic incidence. J Affect Disord 2022; 298:209-216. [PMID: 34728285 PMCID: PMC8556686 DOI: 10.1016/j.jad.2021.10.128] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/30/2021] [Accepted: 10/20/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) deployed to the frontline during the COVID-19 pandemic are at risk for developing mental disorders, with a possible impact on their wellbeing and functioning. The present study aimed at investigating post-traumatic stress symptoms (PTSS), anxiety and depressive symptoms and their relationships with impairment in the functioning impairment among frontline HCWs from three Italian regions differently exposed to the first wave of the COVID-19 emergency: Tuscany (low), Emilia-Romagna (medium) and Lombardy (high). METHODS 514 frontline HCWs were consecutively enrolled in hospital units devoted to the treatment of COVID-19 patients. They completed the IES-R, PHQ-9 and GAD-7 to assess PTSS, depressive and anxiety symptoms respectively, and the WSAS to investigate functioning impairment. RESULTS A total of 23.5% of HCWs reported severe PTSS, 22.4% moderate-severe anxiety symptoms, 19.3% moderate-severe depressive symptoms and 22.8% impairment in global functioning. HCWs from the higher-exposure regions reported significantly higher scores in all instruments than those from lower-exposure regions. In a multiple linear regression model, PTSS, depressive and anxiety symptoms presented a significant positive association with the functioning impairment. Both PTSS and depression resulted to be independently related to functioning impairment. LIMITATIONS The cross-sectional design and the use of self-report instruments. CONCLUSIONS Depressive and PTSS appear to be the greatest contributors to functioning impairment in HCWs exposed to a massive stressful sanitary event as the COVID-19 pandemic. A more accurate assessment of work-related mental health outcomes in such population could help planning effective prevention strategies and therapeutic interventions.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy.
| | - Eric Bui
- Department of Psychiatry, Caen University and Caen University Hospital, Caen, France
| | - Claudia Foghi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Anna Rita Atti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Rodolfo Buselli
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Marco Di Paolo
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Arianna Goracci
- Department of Molecular and Developmental medicine, University of Siena, Siena, Italy
| | - Paolo Malacarne
- Anaesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Maria Giulia Nanni
- Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Camilla Gesi
- Department of Mental Health and Addiction, ASST Fatebenefratelli-Sacco, Milan, Italy
| | | | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Volpe U, Orsolini L, Salvi V, Albert U, Carmassi C, Carrà G, Cirulli F, Dell’Osso B, Luciano M, Menculini G, Nanni MG, Pompili M, Sani G, Sampogna G, Group W, Fiorillo A. COVID-19-Related Social Isolation Predispose to Problematic Internet and Online Video Gaming Use in Italy. Int J Environ Res Public Health 2022; 19:ijerph19031539. [PMID: 35162568 PMCID: PMC8835465 DOI: 10.3390/ijerph19031539] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 12/17/2022]
Abstract
COVID-19 pandemic and its related containment measures have been associated with increased levels of stress, anxiety and depression in the general population. While the use of digital media has been greatly promoted by national governments and international authorities to maintain social contacts and healthy lifestyle behaviors, its increased access may also bear the risk of inappropriate or excessive use of internet-related resources. The present study, part of the COVID Mental hEalth Trial (COMET) study, aims at investigating the possible relationship between social isolation, the use of digital resources and the development of their problematic use. A cross sectional survey was carried out to explore the prevalence of internet addiction, excessive use of social media, problematic video gaming and binge watching, during Italian phase II (May-June 2020) and III (June-September 2020) of the pandemic in 1385 individuals (62.5% female, mean age 32.5 ± 12.9) mainly living in Central Italy (52.4%). Data were stratified according to phase II/III and three groups of Italian regions (northern, central and southern). Compared to the larger COMET study, most participants exhibited significant higher levels of severe-to-extremely-severe depressive symptoms (46.3% vs. 12.4%; p < 0.01) and extremely severe anxiety symptoms (77.8% vs. 7.5%; p < 0.01). We also observed a rise in problematic internet use and excessive gaming over time. Mediation analyses revealed that COVID-19-related general psychopathology, stress, anxiety, depression and social isolation play a significant role in the emergence of problematic internet use, social media addiction and problematic video gaming. Professional gamers and younger subjects emerged as sub-populations particularly at risk of developing digital addictions. If confirmed in larger and more homogenous samples, our findings may help in shedding light on possible preventive and treatment strategies for digital addictions.
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Affiliation(s)
- Umberto Volpe
- Clinical Psychiatry Unit, Department of Clinical Neurosciences, School of Medicine, Università Politecnica delle Marche, Via Tronto 10/A, 60126 Ancona, Italy; (L.O.); (V.S.)
- Correspondence: ; Tel.: +39-71-596-3301; Fax: +39-71-596-3540
| | - Laura Orsolini
- Clinical Psychiatry Unit, Department of Clinical Neurosciences, School of Medicine, Università Politecnica delle Marche, Via Tronto 10/A, 60126 Ancona, Italy; (L.O.); (V.S.)
| | - Virginio Salvi
- Clinical Psychiatry Unit, Department of Clinical Neurosciences, School of Medicine, Università Politecnica delle Marche, Via Tronto 10/A, 60126 Ancona, Italy; (L.O.); (V.S.)
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina—ASUGI, 34148 Trieste, Italy;
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milan Bicocca, 20126 Milan, Italy;
| | | | - Bernardo Dell’Osso
- Department of Biomedical and Clinical Sciences Luigi Sacco, Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, 20157 Milano, Italy;
| | - Mario Luciano
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.L.); (G.S.); (A.F.)
| | - Giulia Menculini
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy;
| | - Maria Giulia Nanni
- Department of Neurosciences and Rehabilitation, University of Ferrara, 44124 Ferrara, Italy;
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University of Rome, 00100 Rome, Italy;
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, University Cattolica del Sacro Cuore, 00100 Rome, Italy;
- Fondazione Policlinico A. Gemelli IRCCS, 00100 Rome, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.L.); (G.S.); (A.F.)
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.L.); (G.S.); (A.F.)
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50
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Carmassi C, Cordone A, Bertelloni CA, Cappelli A, Pedrinelli V, Sampogna G, Massimetti G, Dell'Oste V, Dell'Osso L. A longitudinal study of post-traumatic stress, depressive and anxiety symptoms trajectories in subjects with Bipolar Disorder during the COVID-19 pandemic. Eur Psychiatry 2022; 65:e8. [PMID: 35022099 PMCID: PMC8853854 DOI: 10.1192/j.eurpsy.2021.2247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Bipolar disorder (BD) is recognized to be at high risk for developing negative psychopathological sequelae to potentially traumatic events. Nevertheless, scant data are still available about the effects of the COVID-19 emergency on the clinical course of BD. The present study examined prospectively the development and trajectories of post-traumatic stress, depressive, and anxiety symptoms among subjects with BD that were followed in an outpatient psychiatric clinic at the time of pandemic onset. Methods A cohort of 89 subjects with BD was enrolled during the first wave of the COVID-19 pandemic, and assessed at baseline (T0), 2-months (T1), and 6-months (T2) follow-up. A K-means cluster analysis was used to identify distinct trajectories of depressive, anxiety, and post-traumatic stress symptoms during the three time points. Results We identified three trajectories: the Acute reaction (13.5%); the Increasing severity (23.6%); and the Low symptoms (62.9%) groups, respectively. In the Acute reaction group a significant prevalence of female gender was reported with respect to the Low symptoms one. Subjects in the Increasing severity group reported significantly lower employment rate, and higher rate of relatives at risk for COVID-19 medical complications. Subjects in the Increasing Severity group reported higher rates of previous hospitalization and manic symptoms at baseline than those included in the Low symptoms one. Conclusions Our results describe three distinct symptom trajectories during the COVID-19 emergency in a cohort of subjects suffering from BD, suggesting the need of a long-term follow-up for detecting the impact of the COVID-19 pandemic in this vulnerable population.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Annalisa Cordone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Andrea Cappelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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