Psychiatria Danubina最新文献

Psychiatry is an ever-changing field connected to new spirit of time, knowledge and technology, particularly in our era of artificial intelligence and psychopolitics. There is a growing recognition of the essential link between geography, culture, human rights, psychopolitics and mental health. Geopsychiatry offers a critical lens through which we can better understand and respond to global mental health challenges. Mental health or the health of mind is interconnected with the health of local place and likewise with the health of the earth. By integrating geography, ecology and mental health sciences in additive (multidisciplinary), interactive (interdisciplinary) and holistic (transdisciplinary) way the nascent field of geopsychiatry provides a special and ecological framework for understanding how the environment shapes both individual and collective mental health in the Anthropocene. The global environmental and geopolitical crisis, migrations, urban overcrowding and climate changes emphasize the need for a new paradigm that connects mental health with planetary health.

Metformin is the most widely used oral insulin-sensitizing agent. There is a significant association between long-term metformin therapy and an increased prevalence of vitamin B12 deficiency. Vitamin B12 deficiency is one of the causes of pseudo-dementia. This paper presents a rare case of pseudo-dementia in a 60-year-old Caucasian woman caused by vitamin B12 deficiency induced by the use of metformin, a vegetarian diet, and smoking. In diabetics with cognitive disorders who are on biguanide therapy, it is necessary to determine the level of vitamin B12 in the serum in order to rule out possible pseudo-dementia and to avoid possible hematological and neurological disorders. Unfortunately, vitamin B12 deficiency remains frequently unrecognized in those patients.

Background: This study investigates impairments in real-life functioning domains among patients with affective disorders (depression and mania), addressing gaps in understanding the relationship between symptom severity and functional outcomes. The research aims to assess real-life functioning domains in clinical populations exhibiting varying degrees of affective disorder severity.

Subjects and methods: A cross-sectional study was conducted with 23 outpatients (16 with depression, 7 with mania) and 44 healthy controls. Participants were assessed using the Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), and Specific Levels of Functioning Scale (SLOF). Statistical analyses included Chi-square tests for functional impairments and Pearson's correlations to examine associations between symptom severity and functioning.

Results: Key findings demonstrate significant functional deficits in depressive patients across all measured domains (physical functioning, personal care, interpersonal relationships, social acceptability, activities, and work skills), with particularly pronounced impairments in physical functioning (χ²=12.25, p<0.001) and personal care skills (universally low scores). Manic patients exhibited comparable domain-specific impairments, though with less pronounced severity differentiation. Notably, symptom severity (measured via HDRS/YMRS scales) showed minimal correlation with functional outcomes, with the exception of an inverse relationship between depression severity and social acceptability (r=-0.56, p<0.03). Limitations include modest sample sizes and cross-sectional design, warranting future longitudinal research with larger cohorts.

Conclusions: Affective disorders broadly impair real-life functioning irrespective of symptom severity, except for depression's inverse relationship with social acceptability. This finding suggests that functional impairments in affective disorders may represent independent disease dimensions rather than simple byproducts of symptom intensity, emphasizing the need for targeted psychosocial interventions alongside symptom management.

Background: Healthcare workers (HCWs) face significant occupational stressors that increase their risk of psychological symptoms, including anxiety, depression, and burnout. In particular, nurse may experience higher psychological distress due to unique workplace demands. However, direct comparisons between nurses and other HCWs within tertiary care hospitals remain limited. This retrospective study aimed to compare work-related stress levels and mental health outcomes in nurses versus other HCWs seeking psychological or psychiatric support through the Occupational Health Service (OHS) of a tertiary care hospital in central Italy.

Subjects and methods: This is a retrospective cross-sectional study analyzing healthcare workers (HCWs) who accessed psychological or psychiatric support through an Occupational Counseling Service (OCS) over a three-year period. Medical records of 155 HCWs who accessed the OHS from January 2022 to December 2024 were reviewed. Sociodemographic, occupational, clinical, and psychometric data were collected. Subgroup analyses compared nurses (n=79) to other professionals (n=76) regarding psychological distress, psychiatric diagnoses, and treatment. Correlations between personal/family psychiatric history and work-related stress were also assessed.

Results: Nurses exhibited significantly higher levels of depressive symptoms and anxiety compared to other HCWs. A positive personal and/or family history of anxiety and mood disorders was present in 26.5% of the full cohort and correlated significantly with work-related stress and burnout (p<0.001). Burnout and secondary traumatic stress were prevalent across all groups, although compassion satisfaction remained relatively preserved.

Conclusions: Nurses demonstrated greater vulnerability to affective symptoms and work-related stress compared to other HCWs, underscoring the need for tailored mental health support within occupational health frameworks. Early identification and intervention strategies are crucial to mitigate psychological distress and improve wellbeing among hospital staff.

The phenomena of solitude and loneliness the author of this essay describes as two etiologically different states of mind. They are approached by the neuroscientific, psychodynamic, artistic expressive, philosophical and psychotherapeutic points of view. With some clinical examples and artistic illustrations the author tries to clarify his approach to the topic.

Stigma and discrimination against people with mental health problems remain prevalent, despite increasing global efforts to combat them. Organizations like the Lancet Commission and the WHO emphasize the media's crucial role in shaping public perception, advocating for responsible reporting and the involvement of individuals with lived experience. While some positive shifts in media portrayal have been observed (e.g., in prime-time TV series), negative representations, dehumanizing language, and the perpetuation of stereotypes persist across various media forms, including gaming and news. In Belgium, a specific incident involving stigmatizing media coverage led to the development of the "Stigma in the Media" charter. This charter provides guidelines for journalists. It stresses the importance of accurate information, appropriate terminology, respect for privacy and human dignity, and avoiding sensationalism. The charter aims to foster an empathetic and respectful media environment, promoting responsible discussions about mental health and encouraging positive societal change. Initial results suggest the charter is positively impacting media reporting on mental health in Belgium.

During the 2024-2025 school year, the "P. Secco Suardo" Institute in Bergamo organized an educational orientation project for all those students who, having reached the end of their studies, were either afraid of choosing their future path or had no idea what they wanted at all and lived in mental confusion. Orientation is an essential new concept introduced within the educational themes of Europe, which we can no longer do without in our schools.

Background: Dissociative symptoms are increasingly recognised as early indicators of psychopathological vulnerability in adolescence and young adulthood. This study investigates the correlates of dissociation in a sample of youths referred to a psychiatric outpatient service.

Subjects and methods: This study was conducted on a sample of 45 patients aged 14-25 referred to the second-level outpatient clinic for adolescent and young adult psychopathology at the University Hospital of Perugia, Italy. Patients were grouped based on their Dissociative Experiences Scale-II (DES-II) scores (≤30% vs. >30%), and data were analysed using bivariate comparisons.

Results: Youths with clinically significant dissociation showed earlier psychiatric onset, reduced social connectedness, increased rates of social withdrawal and non-suicidal self-injury, and elevated attentional impulsivity. Higher scores on depressive, cyclothymic, and anxious temperaments were also observed, along with more severe depressive and anxiety symptoms. The high dissociation group reported greater psychological distress and a broader range of psychotic-like experiences on the Prodromal Questionnaire-Brief (PQ-B).

Conclusions: These findings suggest that dissociation in youths is linked to two partially overlapping trajectories: one involving emotional dysregulation and behavioural impulsivity, and another marked by cognitive-perceptual anomalies and unreality experiences. Dissociation may thus act as a transdiagnostic risk factor across mood and psychotic-spectrum vulnerability. Early identification and integrated treatment strategies focusing on affect regulation, cognitive control, and interpersonal functioning may help prevent the progression to more severe psychopathological states.

Background: Social anxiety (SA) disorder is a common psychological condition; however, its boundaries with autism spectrum disorder remain a subject of debate. This study examines the contribution of personality, cognitive, and autistic traits to manifestations of SA in adults. To assess how personality, cognitive, and autistic traits affect SA and to define the impact of autistic features on its development.

Methods: The study included 72 adults (42 women, 30 men) over 18, with different levels of SA and autistic traits. Participants completed several questionnaires: Social Anxiety and Social Phobia Questionnaire, HEXACO-60-PI-R60 Personality Questionnaire, Hostility Scale, Cognitive Styles Questionnaire, Autism Spectrum Quotient, Behavior Self-Regulation Style Questionnaire, and an Emotional Intelligence Test.

Results: Two groups were studied: (A) high SA with low autistic traits, and (B) high SA with high autistic traits. T-tests and regression analyses were used. No significant differences in overall SA were found between the groups; however, individuals with pronounced autistic traits exhibited greater anxiety in situations requiring initiative and being under observation. Group B demonstrated higher scores on all autism spectrum scales and distinctive personality profiles (low extraversion, high honesty/humility, vigilance, and negativism. Regression analysis revealed distinct predictive factors for SA in the two groups. For Group A this included the following parameters: Liveliness, lower Sociability, decreased Modeling of Conditions, heightened Sentimentality and increased Attention to Detail (89% of the variance in SA scores). For Group B they included low Social Self-Esteem, reduced Flexibility, diminished Reliability, elevated Dependence, and stronger Field Independence (92% of the variance in SA scores).

Conclusion: Personality and cognitive predictors of SA differ depending on the presence of autistic traits. The data confirm the necessity of a differentiated diagnostic and therapeutic approach. Future studies should employ longitudinal research designs to investigate causal relationships between variables.

Background: Adolescents and young adults present elevated suicide risk, which remains a major public health concern. This study aims to characterize the clinical and psychosocial features of adolescents and young adults referred for psychiatric consultation after a suicide attempt.

Subjects and methods: We conducted a retrospective observational study at the University Hospital of Perugia, Italy, analyzing 72 patients aged 14-35 who received their first psychiatric evaluation during medical hospitalization. Patients were divided into two groups: those referred after a suicide attempt (SA group, n=36) and those referred for other psychiatric concerns (non-SA group, n=36). Data were extracted from structured consultation reports and included sociodemographic, clinical, and psychopathological variables. Bivariate analyses compared the two groups using appropriate statistical tests.

Results: Compared to the non-SA group, the SA group had significantly higher rates of unemployment, positive psychiatric family history, previous suicide attempts, insomnia prior to admission, anxiety symptoms with both psychic and somatic features, personality disorders, and mood stabilizer use. SA patients also showed lower cooperativeness during interviews and were more likely to be assessed with suicidal ideation. More than one third of SA patients were assessed as euthymic post-attempt.

Conclusions: Key clinical markers of suicide risk in youths may include unemployment, family psychiatric history, insomnia, anxiety with somatic and psychic features, and personality disorders. The clinical profile of suicide attempters suggests a possible contribution of bipolar spectrum diathesis and affective dysregulation. Early, multidimensional risk assessment and integrated intervention strategies in liaison psychiatry are essential to improve detection and prevention of suicidality in youth.