Psychiatria Danubina最新文献

This article presents a qualitative study on the use of humour in Self-Help Groups. It investigates four Self- help Groups with different targets, in order to understand what motivates individuals to use humour, whether its perception differs when used by a participant or by the facilitator, and what types of humour are employed, following Martin's classification: Affiliative, Self-Enhancing, Aggressive, and Self-Defeating. The results show that humour serves the function of cohesion, cognitive restructuring, and emotional management. It appears to benefit both the individual and the group as a whole (e.g., reducing anxiety and sadness). No significant differences were found in the perception of humour when used by a participant versus the facilitator.

Background: Children infected with the Human Immunodeficiency Virus (HIV) exhibit the lowest neurodevelopmental scores. Mother-to-child-transmission prevention include perinatally and early antiretroviral therapy (ART) although long-term effects of in utero exposure to ART on neurodevelopment remain unclear. It was difficult to determine whether these reported neurodevelopmental scores were a direct result of HIV.

Methods: A systematic search was conducted to identify the environmental and neurobiological factors associated with HIV infection and their impact on neurodevelopment. It was carried out across four electronic databases: Scopus, PubMed, ProQuest and Cochrane Database of Systematic Reviews. We selected 15 articles published between 2012 and 2024.

Results: Regarding ART, 4 articles reported a positive effect of ART regardless of the age of initiation and duration. We couldn't identify caregiver distress as a risk factor.

Conclusions: Further research should include large cohort studies assessing long term consequences of ART exposition on children's neurodevelopment and impact of caregiver distress on child neurodevelopmental outcomes.

Background: Patient safety is considered to be crucial to health care quality. The Hospital Survey on Patient Safety Culture is generally used to assess the safety culture in somatic hospitals and unit level. The present study investigates the correlation between physicians and nurse providers in patient safety culture in all Slovenian psychiatric hospitals.

Subjects and methods: A quantitative cross-sectional, non-experimental study was conducted between November 2017 and February 2018 involving 434 (89.00%) nurses and 55 (11.00%) physicians from six psychiatric hospitals in Slovenia. We used the Slovenian version of the questionnaire of the Hospital Survey on Patient Safety Culture of the US Agency for Healthcare Research and Quality.

Results: Exploratory factor analysis for Slovenian psychiatry has given ten dimensions with 40 items. Multivariate regression analysis revealed that four psychiatric hospitals have a poor opinion on the "Management Support for Patient Safety" (F = 4.746, p <0.005). But depending on gender, women on average have a statistically significantly better opinion about the dimension "Management Support for Patient Safety" than men (t -1,995, p <0,047). There are also significant statistical differences between health care professionals who work in locked wards in regard to the two dimensions "Staff Overload and Response to Errors*" (F = 6.557, p = 0.002) and "Teamwork Between Organisational Units of the Hospital*" (F = 5.681, p = 0.004).

Conclusion: This is the first study on perception of patient safety culture in psychiatric hospitals in Slovenia. Significant statistical differences were identified in seven out of ten dimensions of patient safety culture perception.

Background: The aim of this study is to determine the effects of the bipolar disorder (BD) pharmacotherapy on the parameters of spectral-domain optical coherence tomography (SD-OCT) including retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and choroidal thickness (CT).

Subjects and methods: The patient group was divided into three subgroups according to the regular use of lithium (Li), sodium valproate plus valproic acid combination (SV-VPA), and any of the antipsychotics (AP). The OCT parameters were measured using the SD-OCT device.

Results: There were 36 subjects on Li treatment, 36 on SV-VPA treatment and 28 on AP treatment. In both eyes, RNFL subsectors, GCL, IPL were decreased in the BD group compared to the HC group, while CT increased (p<0.05). In the comparison between the BD subgroups, it was shown that RNFL subsectors, GCL, and IPL were higher in the Li group than in the SV-VPA and AP groups (p<0.05), and CT was similar between the BD subgroups (p>0.05). It was reported that there was a difference between smokers and non-smokers in the BD group only in terms of RNFL subsectors (p<0.05). In the BD group, a significant positive correlation was detected between disease duration, duration of relevant medication use and age and various RNFL parameters (p<0.05), while no relationship was found between GCL, IPL and disorder parameters (p>0.05).

Conclusions: This study compared the OCT parameters of euthymic state BD type 1 subjects with the HC group and showed that RNFL, GCL and IPL were decreased in the BD group, while CT was increased. It has been suggested that the use of Li may play a more effective role in protecting the RNFL subsectors, GCL and IPL than the use of SV-VPA and AP alone.

"FareAssieme" is a recovery-oriented community psychiatry model that has been implemented by the Mental Health Service of Trento since 1999. The approach is grounded in the active involvement of users and family members, with particular emphasis on experiential knowledge - the insights derived from lived experience of mental illness and recovery - as a resource for improving the quality of care and rehabilitation processes. At its core, the model involves the structured integration of Peer Support Experts (ESPs, Esperti in Supporto tra Pari), individuals with personal or familial experience of psychological distress who have attained a stable life balance and developed effective coping strategies. ESPs are embedded across all domains of the mental health service (SSM), including community teams, crisis services (territorial and hospital-based), residential settings, and front-office activities. Their role is to support others in their recovery journeys through narrative sharing and emotional proximity. ESPs have contributed to enhanced user engagement, improved service climate, and increased trust in providers. They have proven particularly effective in engaging individuals initially resistant to treatment, thereby facilitating stronger therapeutic alliances. The model also fostered the creation of the Participatory Planning Group (GPP), a deliberative body comprising users, families, ESPs, and professionals, which has developed several Operational Guidelines to standardize and disseminate shared practices within the SSM. "FareAssieme" stands as a validated model of participatory, recovery-oriented psychiatry. It highlights the transformative value of experiential knowledge within mental health services and makes a meaningful contribution to anti-stigma efforts and the co-construction of inclusive care pathways.

Restlessness is the essence of the thymic disease of those who present a "mixed picture" in the bipolar spectrum of any form. Depressive suffering, always significant for the patient, never presents itself alone, but is always accompanied by a constant state of internal anxiety, restlessness with internal and muscular tension, depressive-irritable or depressive-apathetic-confused state, a sense of existential anguish that sometimes gives no hint of future prospects, and very frequent somatic symptoms associated with mood malaise. All this is summarized in the concept of "Restlessness".

Background: To evaluate cognitive function of patients with newly diagnosed paroxysmal atrial fibrillation.

Materials and methods: In a single-center case-control study, we undertook 24 hours ECG monitoring of 6630 patients, among whom 97 showed paroxysmal atrial fibrillation (AF) Fourteen of the AF patients have informed consent to participate in the study. All patients had additional 24 hours ECG monitoring, along with transthoracic echocardiography, volumetric sphygmography, and the Montreal Cognitive Assessment (MoCA) test.

Results: The median MoCA score was 24 [22; 26], indicating mild cognitive impairment in nine of the 14 patients (64%, age 67.9 ± 8.6 y.o.). The least severe impairment was in visual-spatial perception (median 4 of 5 possible), and the most severe was in executive-functional skills (median 3 of 5). Despite the high mean arterial stiffness (CAVI > 8), there was no significant correlation with MoCA (rs = -0.256, p = 0.364). However, there was a significant negative Spearman correlation between MoCA and LV myocardial mass index (rs = -0.737, 95% CI [-0.914; -0.323], p = 0.003), indicating an association between declining cognitive function and myocardial structure.

Conclusions: In most of the patients with asymptomatic paroxysmal newly revealed AF, we observed mild cognitive impairment. Increased LV-indexed mass was associated with worse cognitive function in these AF patients (rs = -0.737, 95% CI [-0.914; -0.323], p = 0.003). This observation calls for investigation of the causal mechanism whereby myocardial remodeling in AF patients may impair brain function.

Background: Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system, where cognitive impairment can occur even without physical disability. The underlying mechanisms remain poorly understood. This study investigates the role of white matter lesion load (WMLL) in sustained cognitive decline (SCD) in a real-life MS cohort, using an artificial intelligence(AI)-based brain imaging approach.

Methods: Patients from the CHU Helora MS database with ≥3 SDMT assessments and serial brain MRIs were included. SCD was defined as a ≥4-point or ≥10% SDMT drop, confirmed 6 months later. Patients were stratified into two groups: those with SCD (COG) and those without (N-COG). WMLL was measured using a AI-based model that provides segmentation masks. Lesion volume was calculated by multiplying segmented voxels by voxel size.

Results: Of 109 eligible patients, 43 met inclusion criteria. Seven showed SCD; 36 did not. Imaging data were available for 5 COG and 21 N-COG patients. There was no significant difference in WMLL or its progression between patients with and without SCD. Fewer than half of the patients in the COG group showed an increase in WMLL over time, and those who did were older than the group average. WMLL changes were not a reliable marker of SCD. Consistent with previous findings, the COG group included more males, and disease control appeared more challenging. Vascular pathology may be misclassified by segmentation algorithms, which partially explain why the two patients with WMLL progression were older. Gray matter was not assessed, though it may play a key role in this phenomenon.

Conclusion: SCD did not consistently correlate with WMLL progression. Affected patients were predominantly male, consistent with a more aggressive disease course. WMLL may also be influenced by age-related factors. Alternative imaging biomarkers are needed to explain SCD in MS.