Psychiatria Danubina最新文献

Background: Visual snow syndrome (VSS) is a poorly understood neurological condition of unclear etiology, characterized by visual and non-visual symptoms that reduce quality of life. The objective of our study was to estimate the prevalence of young adults with visual snow in Russia.

Materials and methods: We conducted an online survey among 1,177 respondents over the age of 18 residing in Russia. The questionnaire was based on MIDAS, HIT-6, ICHD-3, GAD-7, CES-D.

Results: A total of 1085 individuals, divided into three groups: 48 participants with Visual Snow Syndrome (VSS), 36 participants with visual snow symptoms (VS), and 1001 participants without visual snow (control group). Tinnitus (p<0.001) and paresthesia (p<0.001) were more common in participants with VSS compared to the control group. VSS group also reported mood disorders more frequently than those in the other groups (29.2% VSS, 13.9% VS, 7.0% control, p<0.001). Additionally, VSS group exhibited more elevated anxiety levels on the GAD-7 scale compared to the other groups (p=0.005), suggesting a weak association between anxiety and VSS.

Conclusions: Diagnosed migraine, tinnitus, concentration problems, paresthesia, and verified psychiatric conditions were significantly more prevalent in the VSS group in our study. Tinnitus was significantly more frequent in the VS group. Diagnosed conditions across all ICD-10 classes were more frequently identified in the VSS group, with the strongest associations (moderate) found with ICD-10 codes: F80-F89 and F60-F69. Additionally ICD-10 codes F30-F39 were more frequently found in the VS group compared to the control group. Our study revealed that nearly all individuals with VSS in our sample (89.6%) had experienced symptoms for as long as they can remember. The prevalence of VS symptoms in Russia is 7.7% (6.2-9.3%) and VSS is 4.4% (3.2-5.7%).

This study aimed to evaluate the correlation between cognitive function and emotional dysregulation in patients suffering from psychiatric disorders hosted in rehabilitation facilities, but within this sample, there are also perpetrators of violence who are not residents in facilities but are followed in clinics for crimes related to family violence. All patients were administered the rating scale to investigate general impulsivity, perform psychopathological evaluation, evaluate aberrant salience, and conduct a general cognitive assessment.

Introduction: Several studies show an association between obesity, impulsivity, and anger. The condition of obesity has moreover an important correlation with Eating Disorders (EDs), the most frequent of which is Binge Eating Disorder (BED). Obese patients seem to express peculiarities regarding the expression of some emotional processes, including impulsivity, aggression and anger, compared with regular-weight patients and those without an ED.

Subject and methods: This is a cross-sectional study carried out on a population of 47 obese patients undergoing bariatric surgery. Patients underwent a psychiatric evaluation at the outpatient clinics of the Section of Psychiatry, Clinical Psychology and Psychiatric Rehabilitation of the University Hospital of Perugia. Levels of anger and impulsivity were characterized using the STAXI-2 and BIS-11 scores. Scores were compared based on sex, the presence/absence of EDs and on the presence/absence of psychiatric disorders attested during the evaluation.

Results: No statistically significative difference were detected on STAXI-2 and BIS-11 scores comparing men and women. People diagnosed with EDs had higher scores in the subscores of attention, cognitive complexity, motor impulsivity, non-planning impulsivity, and in the BIS-11 total score. No differences were detected in the STAXI-2 scores. When comparing patients on the presence/absence of psychiatric comorbidities, obese patients with a psychiatric diagnosis had higher scores on the impulsivity measures, but also a higher value on the ER index of the STAXI-2.

Conclusions: Obese subjects undergoing bariatric surgery represent a fragile population that must be carefully evaluated from a psychiatric point of view. Indeed, the co-existence of psychiatric comorbidities may underpin the present of trait-like characteristics, such as impulsivity and anger, that should be carefully considered when proposing treatment strategies.

Introduction: Previous animal-assisted interventions (AAI) studies have documented that human-animal interaction can reduce anxiety levels and improve social skills and quality of life. In recent decades there was a growing evidence on the benefits achievable through human-animal relationship in different categories of people, such as children with autism spectrum disorder, elderly patients affected by dementia, patients with psychiatric disorders and alcohol/drug addiction.

Methods: In the present study ten patients from psychiatric residential facilities belonging to the EPASSS Foundation were approached to participated in this study. Patients followed a rehabilitation project named "Animal-Mente". This project originated from the collaboration of the psychiatric residential facilities belonging to the EPASSS Foundation with "La coda di Ulisse", a Third Sector Organization (ETS) which represents the Apulian reference centre for AAI. Outcome assessments were conducted at recruitment (time 0) and after animal-assisted intervention (time 1).

Results: Significative improvements were found for symptomatology as emerged from the BPRS scale's results. Aspects of recovery with a special focus on hope and determination were assessed by the RAS scale, which showed a significative difference between before and post intervention.

Conclusions: Our data highlighted the feasibility of Animal-Assisted Interventions (AAI) in community mental health services. Our study underlined the opportunity of AAI in an integrative recovery oriented psychiatric rehabilitation program involving mental health department, psychiatric residential facilities and third sector organizations in a network activity.

Artificial intelligence (AI) offers new perspectives in the healthcare sector, ranging from clinical decision support tools to new treatment strategies or alternative patient remote monitoring. However, as a disruptive technology, AI is associated with potential barriers, limitations and challenges for appropriate integration in medical practice. To avoid potential patient safety risks and harm, a robust regulatory framework is crucial to guide health professionals in their AI adoption in clinical practice. The European Union offers a new legal framework for the development and deployment of AI systems, the AI Act. This regulation was approved in March 2024 and will be fully applicable by 2025 to ensure that AI technologies are safe, transparent, and respect fundamental rights. However, these new regulatory concepts may be obscure for clinicians. This article aims to provide health professionals with the preliminary key points of regulation needed to interact adequately with these new AI applications and consider the potential risks of AI systems to patient safety.

Background: This study aims to investigate the association of adverse childhood experiences (ACE) and depressive symptoms on suicidality in patients with schizophrenia (SCZ) in the Outpatient Consultative Department of the Riga Centre of Psychiatry and Narcology (RPNC).

Subjects and methods: A descriptive cross-sectional study was conducted in adult outpatients with SCZ who had not been hospitalized for at least three months. Suicidality was assessed using the Risk Assessment Suicidality Scale (RASS). Depressive symptoms were evaluated with the Calgary Depression Scale for Schizophrenia (CDSS), and ACE were investigated using the Childhood Trauma Questionnaire - Short Form (CTQ-SF). Statistical methods used: Chi-squared test, Fisher's exact test.

Results: In total 60 outpatients diagnosed with SCZ were interviewed. It was found that the association between ACE and the frequency of suicide attempts in the study participants during lifetime was statistically significant (χ²=7.255, p=0.027). Self-harm attempts during whole life also differed between participants with and without childhood abuse history (χ²=9.902, p=0.002). Suicidal ideation was observed statistically significantly more often in patients with ACE in comparison with those without ACE (χ²=24.935, p<0.001). Patients with positive childhood abuse history were also observed to be depressed more often (χ²=4.659, p=0.031) in comparison with patients without ACE. Suicidal ideation was found to be more frequent among respondents who were observed to be depressed (CDSS score > 6) during the interview (χ²=14.614, p<0.001).

Conclusions: This study contributes to the existing body of knowledge on suicide attempts, suicidal ideation, and the prevalence of depression in patients with schizophrenia (SCZ) who have a history of childhood abuse. Findings indicate that suicidal ideation is more prevalent among patients experiencing depression at the time of the interview. Personalized interventions are recommended for patients with SCZ who have adverse childhood experiences (ACE) due to their increased risk of suicide attempts.

Obesity and weight gain represent a challenging issue in people suffering from schizophrenia and other severe mental illnesses (SMI). Most of clinical guidelines for the management of overweight and obesity in people with SMI share a stepwise approach starting with more conservative interventions, with diet, physical activity, lifestyle coaching and behavioral modifications. The aim of this study was to evaluate the effectiveness of a group weight management program in a real-world outpatient Italian setting. Data from 100 patients diagnosed with schizophrenia or bipolar disorder, undergone to a group metabolic management program, were analyzed through a 12 months follow-up. The main body weight (kgs) decreased from 98.01±18.30 at baseline to 93.29±17.36 (p>0.001) at 6 months to 90.35±17.90 at 12 months. Parallel statistically significant decreases were found for BMI, waist circumference, glycaemia and systolic blood pressure. After patients' segmentation into normal-weight, overweight and obese at baseline, the significant of the decrease emerged only between baseline and the 6-month endpoint, thus suggesting that the program was successful in the short-term. Notwithstanding the limitations of the study, the 12-month intervention evaluated demonstrated feasibility and a high retention rate. This allowed a relevant weight reduction during the first six months, followed by durable maintenance until the end of the study. Current NICE recommendation guidance indicates that people with SMI, particularly those on antipsychotic treatment, should be provided with integrated nutrition and exercise programmes by their healthcare professional. Future research should focus on the effectiveness and cost-effectiveness of this kind of interventions and their reliability in the different real-world healthcare settings.

Anorexia nervosa (AN) has the highest mortality rate among psychiatric disorders. Adult AN patients have a chronic history of treatment dropout due to denial of their psychological and physical disease states, which may be connected to defense mechanisms. We developed an assessment protocol to evaluate the psychological functioning of patients undergoing a psychodynamic approach for eating disorders (PAED), aimed at identifying the psychological factors associated with intervention success or dropout. We analyzed the case of an adult patient who quit treatment at the start and discussed her psychological functioning profile. We present the case of a 45-year-old woman with enduring AN, who entered the PAED program at an Italian hospital. In adult AN patients, denial and acting out may have significant impacts on clinic compliance. This hampers establishing a relationship with the clinic and the success of the psychological work aimed at promoting mental awareness and insights into the disorder. This highlights the need to consider which aspects of the initial psychological assessment are predictive of dropout in AN patients.

Background: To estimate quality of life (QoL) in patients with paroxysmal atrial fibrillation (AF) using the SF-36 Health Status Survey.

Materials and methods: In a single-center study involving 6,630 patients, we defined a group of 97 patients having an incidental finding of atrial fibrillation (AF). The control group included 99 patients from the same primary cohort, but without paroxysmal AF. The two study groups matched closely in anthropometric parameters and comorbidity. All patients underwent standard laboratory and instrumental research methods. In the primary visit, at the time of AF detection, we evaluated the patients QoL using the classical SF-36 Health Status Survey. At the second visit (6±0.5 months follow-up) and third visit (12±0.5 months follow-up), we re-evaluated the QoL using the SF-36 Health Status Survey.

Results: The absolute majority (95/97; 98%) of patients of the main group had a special variant of extrasystoles, namely the early atrial "P on T" type (versus 4.0% incidence in the control group) [OR 846 (382;187,000)]. The main group showed a significantly greater frequency of supraventricular extrasystoles. At the 1^st visit, there was no group differences in QoL scores between the main and control groups (p>0.05). However, at 6 and 12 months follow-up, metrics of physical and mental health differed significantly between groups stratified by low and high QoL (p<0.05). The asymptomatic patients with paroxysmal AF and high compliance in oral anticoagulant therapy showed higher physical activity and social functioning.

Conclusions: Paroxysmal AF in asymptomatic patients is a predictor for declining QoL during 12 months follow-up in patients with cardiovascular pathology. The paroxysmal AF patients who had high compliance of oral anticoagulant therapy proved to have improved physical activity and social functioning.

The psychiatry inpatient ward of Trento (SPDC: italian acronym for Servizio Psichiatrico di Diagnosi e Cura - i.e. Psychiatric Service for Diagnosis and Treatment) operates with an open-door policy, emphasising a recovery-oriented approach. The professionals are capable of adopting the patient's perspective as a "person" rather than seeing them as a "patient", allowing them the freedom and responsibility to make decisions about their own lives. The SPDC of Trento is a no-restraint psychiatric ward, where relational restraint is prioritised, and patients' responsibility is maximised, avoiding, where possible, the use of physical restraint. In 2022, our SPDC introduced the so-called I.R.O.N. interventions (Italian: Interventi Relazionali prolungati ad Orientamento No restraint - no-restraint-oriented relational interventions). These interventions are used in situations of patient agitation to ease tension and resolve crises by employing methods that are both "gentle" and "iron" at the same time, highlighting the determination, patience, and 'relational time' required from the work team. At the end of the intervention, the strategies implemented are described in a register and later shared with the work team. At the end of the year, individuals who have demonstrated their commitment to supporting their colleagues will be awarded an "IRON parchment". A special "Talk Down Champion" parchment will be awarded to the person who manages to consistently maintain this style of work, always in agreement with the team and the safety of all (operators and patients).