Rivista di psichiatria最新文献

Background: Cerebral palsy (CP) and autism spectrum disorder (ASD) are neurodevelopmental conditions that affect physical growth and developmental outcomes. While distinct, both can influence neuropsychological development, yet limited research has examined how growth indicators relate to developmental profiles in these groups. This pilot cross-sectional study examines the relationship between physical growth and neuropsychological development in children with CP and ASD, and compares their developmental characteristics.

Methods: This cross-sectional study included 27 children (CP: n=14; ASD: n=13). Anthropometric assessments included height-for-age (HAZ), weight-for-age (WAZ), BMI-for-age (BMIAZ), mid-upper arm circumference-for-age (MUACAZ), and skinfold thickness Z-scores (TSFAZ, SSFAZ). Neuropsychological development was measured using the Developmental Profile 3 (DP-3), covering physical, adaptive, cognitive, social-emotional, and communication domains.

Results: Children with ASD had significantly higher scores in physical development (median: 83.5 vs. 54.0, p=0.006), adaptive behavior (81.0 vs. 53.0, p=0.003), and overall development (78.0 vs. 58.0, p=0.035) than those with CP. No differences were found in cognitive, social-emotional, or communication domains. In the full sample, WAZ significantly correlated with adaptive behavior (r=0.491, p=0.015) and overall development (r=0.439, p=0.032). MUACAZ and TSFAZ were also associated with specific developmental domains (e.g., MUACAZ and adaptive behavior: r=0.445, p=0.033). Linear regression analysis confirmed that WAZ significantly predicted neurodevelopmental scores (β=6.20, p=0.022), explaining 46.5% of the variance when adjusted for age, gender, and parental age (Adjusted R²=0.465; p=0.040).

Conclusions: Children with CP show greater growth and developmental delays than those with ASD. Weight-for-age is a key predictor of neurodevelopment, especially adaptive behavior. These findings support integrating nutritional and developmental care in neurodevelopmental interventions.

Purpose: In Italy, people with severe mental disorders (SMDs) are often residents in mental health supported accommodations (SAs). SMDs are associated with persistent symptoms, functional impairment, and social exclusion. Although the goal of SAs is to promote personal recovery, defined as living life to the fullest potential, the adoption of such approaches remains challenging. The study aims to assess the effectiveness of personal recovery-oriented compared with standard treatment in enhancing patients' functioning, integrating the assessment with biological markers and innovative digital technologies. In addition, the study investigates whether such interventions can reduce the burden experienced by caregivers and mental health professionals.

Methods: EMPOWER-RES is a non-randomized multicenter clinical trial comparing patients in SAs receiving personal recovery-oriented treatment (n=36) and standard treatment (n=36). Patients will be matched by sex, age, and diagnosis. The personal recovery-oriented treatment will use the Mental Health Recovery Star, a tool that represents ten life dimensions and monitors the stages of change. Standardized assessments will be administered to patients, caregivers, and professionals baseline and after six months. A mobile application will collect real-time data on patients' daily experiences, mood and social interactions, while accelerometers will monitor their physical activity and sleep-wake rhythms.

Results: Not yet available.

Discussion and conclusions: The hypothesis is that personal recovery will significantly increase Personal and Social Functioning (PSP score ≥5 points at 6 months), reduce caregiver burden and professional burnout. The study will provide new insights to optimize mental health services and personalized therapeutic options for patients with SMDs living in SAs.

Aim: The aim of this umbrella review is to review existing studies within the literature on the subject in order to verify the real association between occupational factors, stress and law enforcement, also identifying the main associated factors.

Methods: The databases used for this review were PubMed and Scopus. The following were used for the search string: "work related stress", ("police" OR "public safety" OR "law enforcement") AND review.

Results: 16 papers were retrieved, 8 of which were considered in the final analysis. The results indicate that organizational, operational and professional factors are the most reported causes of work stress in law enforcement. The adoption of measures to improve the organizational structure is of utmost importance. The relationships between colleagues or with managers were also important, as a poor working environment has been found to greatly increase the risk of stress. Health also plays an important role, acting on the decrease of stress. Interventions of aid for the management of stress can be mindfulness, psychotherapy and yoga.

Conclusions: Mental disorders remain prevalent among law enforcement personnel and may have negative effects on officers' health and performance. Moreover, most research is based on observational studies, not necessarily indicating a causal relationship.

Background: Near-death experiences (NDEs) are profound subjective experiences that are reported by individuals who have been near death. These conscious experiences occur during critical states such as coma, cardiac arrest, or severe trauma. While the majority of NDEs are characterized by pleasant and often transformative elements like a sense of peace or connection to a higher consciousness, a significant minority of cases present with distressing, frightening, or even terrifying content. A key feature of NDEs is the out-of-body experience (OBE), where individuals feel as though they have left their physical body. Remarkably, some of these experiences include veridical perceptions, which are accurate observations of physical events that could not have been perceived from their unconscious state, and are later confirmed by third parties.

Case report: We present the rare case of a 25-year-old woman who sustained a severe traumatic brain injury following a high-speed car accident, necessitating her placement in a medically induced pharmacological coma for 20 days. Upon her recovery of consciousness, the patient recounted a deeply frightening NDE (scoring 28/32 on the Greyson NDE Scale) that included an OBE with specific, accurate perceptions of events that occurred while she was unconscious. These perceptions were later verified by medical personnel. Notably, the patient subsequently reported significant psychological and behavioral changes, including the complete resolution of her pre-accident suicidal ideation.

Conclusions: This case offers compelling evidence that challenges conventional reductionist models of consciousness, raising critical questions about its neurobiological basis. It also underscores the profound transformative potential of distressing NDEs and their implications for psychiatric practice. We discuss the importance of acknowledging and exploring these non-ordinary states of consciousness to better understand their psychological and neurobiological underpinnings.

Depressive disorder is a major global health concern and is often underdiagnosed due to stigma, unreliable self-reporting, and limited access to proper mental health screening tools. Despite recent advances, most existing automated approaches depend on questionnaires or multi-modal data, while efficient and reliable voice-only clinical detection frameworks remain limited, creating a clear research gap. Motivated by the need for a non-invasive, objective, and privacy-preserving diagnostic alternative, this study proposes SonoMind, an adaptive deep learning framework for early depression detection using voice signals. The methodology incorporates Adaptable Spectral Pairing for effective noise reduction, SynchroSonic Learning for synchronized feature extraction, and Adaptive Krill-Wolf Optimization for optimal feature selection, followed by a neural classification stage. The framework was evaluated using the publicly available DAIC-WOZ clinical interview dataset. Experimental results show that SonoMind achieves 97.22% accuracy, 100% precision, 95.92% recall, 97.92% F1-score, MAE of 0.027, and RMSE of 0.1666. These results confirm the robustness and reliability of the system, demonstrating its potential as a scalable and supportive tool for mental health professionals in voice-based depression screening.

The objective of this review is to examine the recent literature on intimate partner violence (IPV) and witnessing domestic violence (WDV) with a view to providing definitions, prevalence data for Italy and other countries, and for special populations (such as patients with severe mental illness), investigations into risk factors (alcohol, substances, child abuse) and the consequences for general and mental health. In addition to a free search with Google, Medline was interrogated, using PubMed and PsycInfo for both topics. A total of 757 publications were extracted from PubMed and 338 from PsycInfo for IPV and mental disorders, while 334 publications were found in PubMed and 205 in PsycInfo for WDV; updated epidemiological data was obtained from Italian websites (e.g. ISTAT, Office for National Statistics). We concluded that given the increasing incidence of domestic violence, health and academic institutions should frame the phenomenon in epidemiological and clinical terms, providing updated research data to the stakeholders in order to improve treatment and prevention practices.

This editorial accompanies the comprehensive review on Intimate Partner Violence (IPV) and Witnessing Domestic Violence (WDV) published in this issue, with a focus on their medico-legal implications. It highlights how clinical consequences - ranging from chronic pain syndromes to psychiatric sequelae - must be translated into legally cognizable injuries through rigorous forensic evaluation. Particular attention is given to the recognition of children as 'primary victims' of WDV, the evidentiary value of medical documentation, the duties of healthcare professionals under mandatory reporting frameworks, and the quantification of psychological harm in civil compensation. The discussion also considers institutional liability for omissions, the reciprocal expectations between clinicians and courts, and the research priorities necessary to align public health and justice. Ultimately, IPV and WDV must be understood as violations of fundamental rights that demand integration of clinical expertise, forensic rigor, and legal accountability.

Background: Mental pain (psychache) is a key risk factor for suicide, surpassing traditional constructs like depression and anxiety. While its correlation with suicidal ideation is well-established, few studies have evaluated its predictive value for actual suicide attempts in clinical populations. This study aimed to evaluate whether mental pain predicts short-term suicide attempts in a clinical sample, and to assess its potential role as a screening tool in suicide prevention.

Methods: A longitudinal study on 179 psychiatric outpatients recruited at the University Hospital of Varese between 2020 and 2022. At baseline, participants completed the Psychache Scale (PAS), Beck Hopelessness Scale (BHS), Beck Depression Inventory-II (BDI-II), and Columbia Suicide Severity Scale (C-SSRS), among others. Sociodemographic, clinical, and laboratory data were also collected. Suicide attempts were tracked over a 12-month follow-up. Binary logistic regression was used to identify predictors of suicide attempts.

Results: Twenty-six patients attempted suicide during follow-up, with 24 cases occurring within the first 6 months. Higher scores on the PAS, BHS, BDI-II, and Columbia Severity Rating Scale (C-SSRS) were significantly associated with increased suicide risk. In logistic regression, the PAS emerged as an independent predictor: each point increase corresponded to a 3.8% rise in suicide attempt probability (p=0.015). The BDI-II showed the strongest model fit (R2=0.169). Unemployment and history of substance abuse were also significantly associated with increased risk. No significant associations were found with routine laboratory parameters.

Conclusions: The PAS, alongside the BDI-II, BHS, and C-SSRS scales may serve as an effective tool for early suicide risk detection, especially in psychiatric and primary care settings. Mental pain appears to be a relevant short-term risk indicator, highlighting the need for targeted screening and prevention strategies. Further research should explore its application in general healthcare to enhance suicide prevention efforts.

The well-being and performance of healthcare professionals in non-emergency settings are significantly influenced by job satisfaction and mental health. This scoping review aims to provide an overview of the relationships between job satisfaction and mental health in healthcare professionals. A comprehensive literature search identified 24 relevant cross-sectional studies conducted in various countries, including Australia, Brazil, and the United States. The studies included a diverse range of healthcare workers, such as physicians, nurses, and nurse managers. Most studies report that higher job satisfaction is associated with better mental health outcomes, while lower job satisfaction is linked to symptoms of anxiety, depression, burnout, and psychosomatic complaints. The association emerges across professions and countries, although its strength varies according to organizational and contextual factors. These findings indicate that monitoring job satisfaction may help identify early vulnerability to mental health problems among healthcare staff. Interventions that improve working conditions and recognition of professional roles can enhance satisfaction and reduce the risk of psychopathological outcomes. Clinically, these patterns reflect dimensions of psychological distress (e.g., emotional exhaustion, anxiety, depressed mood), suggesting that brief workplace screening and early support may be warranted. Given that the included studies are predominantly crosssectional, causal inferences remain tentative and future longitudinal research is needed to clarify directionality and trajectories.

Objective: To compare magnetic seizure therapy (MST) and modified electroconvulsive therapy (MECT) in adolescent major depressive disorder (MDD) regarding cognitive protection (assessed via the Montreal Cognitive Assessment, MoCA) and suicidality improvement (assessed via the Columbia-Suicide Severity Rating Scale, C-SSRS), with a focus on cognitive subdomains and the mediating role of cognitive changes.

Methods: This analysis stems from a prospective, assessor-blinded randomized controlled trial (RCT, ChiCTR2500098032) conducted from March 1 to April 30, 2025, at Shandong Mental Health Center, enrolling 120 adolescents aged 13-18 with MDD, randomized 1:1 to MST (n=60) or MECT (n=60). Primary outcome was the Beck Depression Inventory-II (BDI-II) percentage reduction; secondary outcomes included MoCA subdomain scores, C-SSRS suicidality, and adverse events (CTCAE 5.0). Correlation, mediation (Sobel test), and repeated-measures ANOVA (RM-ANOVA) assessed the cognitive-suicidality relationship. Assessments occurred at baseline and 7 days post-treatment.

Results: MECT yielded a higher BDI-II reduction rate, with no significant difference in response rate. MST significantly improved MoCA total score, particularly in memory, orientation, and executive function subdomains. MST enhanced suicidality outcomes, with a higher remission rate. The correlation between MoCA change and suicidality improvement was stronger in MST, with mediation analysis indicating a partial mediating role of MoCA improvement in MST. MST showed fewer adverse events and shorter reorientation time.

Conclusions: In adolescent MDD, MST offers efficacy comparable to MECT for depression relief, with superior cognitive protection (especially memory, orientation, and executive function) and safety. The association between cognitive improvement and suicidality reduction suggests MST may indirectly mitigate suicide risk via cognitive preservation, providing a novel treatment option. Multicenter, long-term studies are needed to confirm these findings.