Psychiatria Danubina最新文献

Introduction: Obesity represents a global health crisis and results from complex interactions between psychological, environmental, and genetic factors. Any therapeutic approach should consider the social, personal, and psychological characteristics of the obese subject, as well as possible medical complications. This study investigates sex differences in candidates for bariatric surgery.

Subjects and methods: This is a cross-sectional study including subjects who underwent psychiatric pre-surgical evaluation. The evaluation comprised a clinical interview and the administration of self-report questionnaires that assessed socio-demographic and clinical aspects. Descriptive and bivariate analyses and a multivariate logistic regression model were performed to evaluate variables significantly associated with sex in bariatric surgery candidates.

Results: The sample consisted of 173 subjects, of which 71.1% were women. Significant differences between men and women were detected in employment status, birth nationality, psychopathological history, organic comorbidities, and BMI value. There were no significant differences in clinical aspects.

Conclusion: Obesity has a significant impact on global health. Women and men who are considering bariatric surgery represent two different populations in demographic, personal, and social characteristics. Therefore, a sex-tailored approach is essential to guarantee adequate support in the management of the various aspects of obesity.

Cognitive reserve (CR) is essential in reducing natural cognitive decline. Identified in neurodegenerative pathologies, it also increasingly plays a role in the development of the symptomatic processes of numerous psychiatric pathologies. CR could help identify subgroups of elderly patients affected by primary psychosis and mood disorders and evaluate their correlation with diagnostic and therapeutic trajectories. Our observational study assessed the correlation between cognitive reserve and cognitive and psychopathological trajectories in a group of elderly inpatients in health residential centers. After two years of observation, the results indicate a correlation between cognitive reserve levels and psychopathological and cognitive trajectories. No significant variations or correlations were observed between another investigation factor, aberrant salience, and the symptoms in the above trajectories.

Suicidality (meaning ideation, self-harm and attempt to suicide) are major public health problems in adolescence and represent a worldwide public health concern. Non-suicidal self-injury (NSSI), often simply called self-injury, is the act of harming your own body on purpose, for example by cutting or burning yourself. NNSI is a common mental health threat among adolescents and it's usually not meant as a suicide attempt. Unfortunately, suicide is the second most common cause of death in young people worldwide and represents a public health problem. For this reason, we analyzed retrospective data from patients admitted in the Psychiatric Hospital from July 1^st 2023 to June 30^th 2024 to identify clinical features, risk factors of suicidality by analyzing the assessment we administered at time of hospitalization: Patient Health Questionnaire (PHQ-9), Ask Suicide Questionnaire (ASQ), G.T. MSRS scale. Within the 50 subjects of the sample, 30 patients attempt to suicide (60%); the large majority (90%) met the criteria for mixed state. This study shows that there is a high prevalence of mixed states in the inpatient unit admission, which is demonstrated both from the prescription of mood stabilizers, and confirmed by the diagnosis of mixed states rated with the scale. The use of structured interview with patient and families add on assessment suicide risk scale are fundamental, in order to guide a tailored psychopharmacological treatment, and improve prognosis.

Background: While the literature on caregiver-assessment scales often focuses on the quantitative and psychometric aspects of the scales, we wished to examine the discourse on caregiving, caregivers and care-recipients (particularly, people with dementia) produced by these scales. What discourse does it help to crystallise and naturalise by dint of being used widely, with unresolved ethical and political issues?

Methods: We analysed two well-known scales that are widely used in both research and clinical settings and conceived among others for people with dementia: Zarit and, offering a sharp contrast, the CRA. We performed semantic network analysis using EVOQ software (https://www.evoq.be/) to visualise the links between the terms.

Results: Whereas the Zarit scale is entirely built around a view of caregiving and the care-recipient as a burden, the CRA offers a different discourse. Instead of considering the provision of help as an emotional load, the desire to help is highlighted. Rather than considering the care-recipient as a weight, the recognition of his or her contribution to the relationship with the caregiver is suggested. Moreover, the caregiver is presented as a relative who is capable of active strategies in order to cope with the reality of care without becoming exhausted.

Conclusions: The comparison of our two analyses shows the extent to which the scales produce a discourse which needs to be examined before use, given its epistemological, ethical and political significance. Clinicians and researchers need to make choices between the many existing instruments and be able to justify them. Their reasons should include not only the psychometric qualities of the chosen tool, but also the discourse that it underpins, so as to avoid contributing to the promotion of a vision of care and its givers and recipients that would be reductive, moving us further away from a caring society.

This review explores the interplay between neurobiological, psychological, and social factors that underpin moral behavior and motivation. Integrating insights from neuropsychiatry, it examines the roles of key brain regions such as the prefrontal cortex, amygdala, and anterior cingulate cortex, as well as neurotransmitters like serotonin and dopamine, in shaping moral reasoning and ethical decision-making. The historical evolution of moral motivation theories, from ancient philosophy to modern psychological and neurobiological perspectives, provides a foundation for understanding intrinsic and extrinsic motivators, emotional influences, and the impact of social norms and cultural contexts. The review also addresses the effects of psychiatric disorders on moral behavior, highlighting how conditions like antisocial personality disorder, frontotemporal dementia, and schizophrenia can lead to moral deficits. By presenting a multidisciplinary approach, this review offers a comprehensive understanding of moral motivation and behavior, emphasizing the importance of fostering ethical conduct and addressing moral challenges in clinical, educational, and societal settings.

Background: To estimate quality of life (QOL) in patients with frequent extrasystolic arrhythmia (ES) using the SF-36 Health Status Survey.

Materials and methods: The patient group consisted of 634 individuals (42-79 y.o) with ES >700 per 24 hours, as diagnosed by Holter ECG, and the control group included 106 patients (38-79 y.o.) with ES <700 per 24 hours. None of the patients had atrial fibrillation. The "early" ES subgroup A (n=192) experienced ES preceding the transmitral blood flow peak in the cardiac cycle (peak E) according to pulsed wave Doppler in transthoracic echocardiography (EchoCG). The "late" subgroup B (n=442) had ES after the transmitral blood flow peak, irrespective of the electric topic localization. Laboratory and instrumental methods included standard lipidograms, Holter ECG, EchoCG, Doppler ultrasound of brachiocephalic arteries, and coronary angiography. For QOL evaluation, we used the SF-36 Health Status Survey.

Results: The patient groups did not differ with respect to main laboratory findings, instrumental parameters, and comorbidities, with the exception of type and quantity of ES. Physical and mental health to the SF-36 Health Status Survey indicated lower summary point scores in patient subgroup A ("early" ES) in comparison with the control group. The parameters were non-significantly lower in subgroup B.

Conclusions: The SF-36 Health Status Survey serves to assess the QOL in patients with ES. Frequent ES, especially its "early" variant in which ventricular systole precedes the transmitral blood flow peak in the biomechanic cardiac cycle is a predictor for lower QOL scores in patients with cardiovascular pathology.

Pregnancy is a period of transition with physical changes in the maternal body but also mental and psychological ones. This phase may be accompanied by symptoms of anxiety, depression or irritability, which are part of non-pathological adaptation mechanisms. These symptoms can, however, be intense and constitute real psychiatric syndromes, particularly when the woman presents vulnerability factors. While fetal exposure to alcohol and other drugs is one of the leading preventable causes of developmental delay and birth defects in newborns, substance use during pregnancy is common, particularly in Europe. There is no amount and no time during pregnancy where consuming alcohol and other substances of abuse is safe. This narrative review reflects the point of view of the obstetrician, the constraints of his therapeutic framework with its limitations of time, training and tools to detect and manage substance-related disorders. Validated detection questionnaires are poorly adapted to obstetric practice; detection and first brief interventions can be delegated to save time but at the risk of reducing the involvement of the obstetrician. The combined management of pregnancy and addictions by a psychiatrist and an obstetrician comes up against different frameworks and working deadlines in the two disciplines.

Psychiatry has the historical opportunity to shape the future of mental health care, medicine, and society. The term New Brave Psychiatry refers to challenges to psychiatry in our volatile, uncertain, complex and ambiguous (VUCA) world. The present and the future of psychiatry lie on the recognizing these challenges and resolving them. Transdisciplinary multiperspective integrative view on psychiatry (TIP) involving creative, person-centered narrative psychopharmacotherapy (CP-CNP) and empathization-based cognitive-emotional-behavioral therapy (EB-CEBT) as an art and practice of the empathic learning organization are presented in this article as well as the culture of empathy as a cornerstone of good clinical practice and mental health. We should all be driven by the vision of psychiatry and other mental health disciplines for a better world and promotion of mental health for all as a part of the Global Enlightenment 2.0 for Sustainability of the Earth System.

Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that affects a significant proportion of the world's population, particularly children and adolescents. The sensory processing issues can be an evidence-based target for therapeutic/corrective interventions by controlling the intensity and targeted replacement of maladaptive sensory stimuli with neutral stimuli using virtual reality or augmented reality.

Subjects and methods: We searched for articles on Pubmed. The search query included ((VR or virtual reality) or (AR or augmented reality)) and (children or adolescents) and (ASD or autism spectrum disorder or autism).

Results: Our criteria were met by 25 articles. 19 articles used VR, 5 articles used AR and 1 article used MR. Most interventions offer children and adolescents with ASD individualized tasks. Immersive VR games developed collaborative skills. Other systems encourage and teach directed facial gaze. Evaluation of the effectiveness of learning in VR/AR environment is carried out by means of different scales, qualitative analysis of surveys, questionnaires and interviews, studying the number and duration of eye contacts between the participant and the avatar. It should be noted that almost all studies were conducted on small samples, so their results allow us to draw only preliminary conclusions about the effectiveness of VR /AR.

Conclusions: The following key areas of VR/AR technologies for children and adolescents with high-functioning ASD can be identified: communicating with an avatar, including answering its questions, tracking the child's gaze and encouraging the child to look at the face, placing it in social situations close to real life, practicing common everyday situations, learning to recognize emotions. A VR/AR-based therapy approach may help children with autism spectrum disorder without cognitive impairment to develop higher levels of adaptation in terms of social and communication skills. However, more research is needed to evaluate the effectiveness of different methods.

Introduction: There is growing evidence supporting dietary interventions in major depressive disorders and other mental disorders. The WPA Action Plan 2023-2026 prioritises several actions including the improvement and the preservation of mental health through the adoption of healthy lifestyle choices illustrated in the Healthy Lifestyles Hub and research. Greater emphasis on physical activity, nutrition and sleep hygiene between patients and psychiatric staff is an objective of WPA Action Plan 2023-2026.

Methods: The survey was conducted from May to June 2024 using Google Forms. A questionnaire was administered to a sample of mental health professionals and consisted of statements investigating specific knowledge in nutritional Psychiatry and adoption of strategies to improve nutritional interventions in mental health. With this study, we aimed to investigate insight and attitudes on nutrition in mental health among a sample of psychiatrists and psychologists resident in Italy.

Results: 110 participants (61 psychologists, 46 adult psychiatrists and 3 child psychiatrists) agreed to participate in our survey. 89.2% (n=91) of them worked in southern Italy. The majority of participants were female (77.98%) and reported working in a Mental Health Centre (n=41, 37,27%), followed by psychiatric residential facilities (n=22, 20%), private practice (n=19, 17.27%), hospital (n=14, 12.73%), university research centre (n=4. 3.64%), other non specified institute (n=10; 9.09%). When asked the importance of a nutritional approach in the context of mental disorders no difference was found between the professional groups (p-value 0.653). Female gender is most represented, although not significantly (p-value 0.161). The need for further research in the field of nutritional psychiatry is widely considered by all mental health professionals, but without professional (p-value=0.416) and gender differences (p-value=0.426). Psychologists statistically significantly reported the need for specific training in nutritional psychiatry (p-value 0.004). We found a significant coefficient between number of years of working experience and nutritional training needs among all health professionals (tau -0.169; p-value = 0.022).

Conclusions: Specific nutrition training courses both for adult and child psychiatrists and psychologists are needed in order to increase awareness on nutrition as a well-being contributing factor in the biopsychosocial model.