Clinical Neuropsychiatry最新文献

Objective: suicide represents the second leading cause of death among adolescents (WHO, 2021). A deeper understanding of the characteristics that lead to it is crucial to increase the ability of clinicians in evaluating, treating, and preventing it. The objective of this study is to analyze the differences in impulsivity, externalizing behaviors, emotion dysregulation, and alexithymia between two groups of adolescents, the first presenting suicidal ideation (SI), the second presenting at least one suicide attempt (SA), in an ideation-to-action framework.

Method: we conducted a retrospective study with 190 adolescents (M= 14.5, SD _age = 1.63; SI: n = 97, SA: n = 93). All were hospitalized in the Complex Operative Child Neuropsychiatry Hospital Unit (UOC-NPI) of the Hospital-University of Padua. Data were collected using the Youth Self-Report (YSR 11-18), Barratt's Impulsiveness Scale (BIS-11) and the Toronto Alexithymia Scale (TAS-20) questionnaires.

Results: the SA group obtained higher clinical scores in the YSR "rule-breaking behavior" and "conduct problems" scales, and in total TAS-20.

Conclusions: the role of externalizing problems and alexithymia could open new frontiers in the understanding of suicide. These new data could be useful for the implementation of early screening protocols and for directing clinical interventions, promoting greater emotion regulation and anger management skills among patients.

Objective: Comorbid depression is quite common in early psychosis and specifically related to suicidal behavior and poor long-term outcomes. However, Depressive Symptoms (DS) are often neglected in both research and treatment, especially at the psychosis onset. The goals of this investigation were: (a) to longitudinally explore DS levels in patients with First Episode Psychosis (FEP) during 24 months of follow-up, and (b) to investigate the associations of DS with psychopathology and intervention components of an "Early Intervention in Psychosis" (EIP) program across the follow-up period.

Method: The Global Assessment of Functioning (GAF) and the Positive And Negative Syndrome Scale (PANSS) were completed by 266 FEP subjects. A linear regression analysis with DS as the dependent parameter and psychopathological and treatment characteristics as independent variables was performed (both at baseline and across the follow-up period).

Results: DS had enduring associations with PANSS "Positive Symptoms" and "Negative Symptoms" subscores. During the investigation, FEP subjects significantly improved their DS severity levels. This was related to the number of individual psychotherapy meetings supplied within the EIP protocol, as well as to a higher antidepressant dose and a lower antipsychotic dose prescribed during the follow-up.

Conclusions: DS are quite prominent in FEP, even at the recruitment time in EIP services. Nevertheless, DS severity tends to diminish overtime, especially with the provision of specialized EIP treatments.

Objective: Prolonged social withdrawal (PSW) or hikikomori and problematic internet use (PIU) have attracted the attention of mental health experts worldwide. The scientific literature suggests a complex relationship between these conditions and psychotic-like experiences (PLEs) or disorders. In the present cross-sectional study, we tested the role of PIU symptoms as a moderator of the relationship between symptoms of PSW and PLEs in a sample of 238 Italian emerging adults.

Method: Data was collected using the 25-item Hikikomori Questionnaire, the Internet Disorder Scale, the Brief Prodromal Questionnaire, and the Brief Symptom Inventory. In addition, lifetime psychological disorders and drug and alcohol use during the last month were explored. No participant reported a lifetime episode of schizophrenia or other psychotic disorder.

Results: Symptoms of PSW and PIU were significantly associated with PLEs total distress and PLEs total number of symptoms endorsed, after adjustment for age and symptoms of depression and anxiety. Further, PIU symptoms moderated the relationship between symptoms of PSW and PLEs total distress (b= 2.745, s.e.= 1.089, p= 0.012). However, PIU symptoms did not moderate the relationship between PSW and PLEs total symptoms (b= 0.615, s.e.= 0.349, p= 0.078). This study is limited because the participants were most likely university students and because of the cross-sectional design.

Conclusions: Findings from this study partially support the role of high symptoms of PIU as a risk factor in the relationship between symptoms of PSW and PLEs. Future longitudinal research is needed to confirm our findings examining the temporal relationship between PSW, PIU, and PLEs using both dimensional and categorical approaches.

Objective: People with mental illness experience a significantly increased mortality rate, partly attributable to high rates of premature metabolic disease. Exercise is increasingly recognized as an evidence-based component of treatment for improving both physical and mental illness. Ensuring health care staff have the necessary competence to support and promote exercise is critical to successful implementation. The Exercise in Mental Illness Questionnaire-Health Professionals Version (EMIQ-HP) was developed to determine the knowledge, attitudes, barriers, and behaviors of health practitioners regarding the role of exercise in the treatment for mental illness. This study aimed to translate and validate the questionnaire into Italian language (EMIQ-HP-IT) and to determine its test-retest reliability.

Method: The questionnaire was translated from English to Italian then back translated using an established protocol. To determine the test-retest reliability of the EMIQ-HP-IT, mental health professionals from an Italian psychiatric hospital completed the questionnaire on two separate occasions, seven days apart. Intra-class correlation coefficients (ICC) were calculated for each item. Twenty-five mental health professionals (4 psychiatrists, 9 psychologists, 10 nurses and 2 exercise specialists) completed the EMIQ-HP-IT.

Results: Except for two items, ICCs ranged from 0.48 to 0.92. The test-retest reliability of the EMIQ-HP-IT demonstrated comparable results to the English version.

Conclusions: The EMIQ-HP-IT is a reliable measure of practitioners' knowledge, attitudes, beliefs, and behaviors regarding exercise interventions for people with mental illness.

Objective: Intolerance to uncertainty is a trait-like disposition largely studied in psychopathology and known to be involved in many psychological disorders. Yet, the very operationalization of this construct has prompted debate in the literature. Three different models have regularly been discussed: a correlated two-factor solution, a bifactorial solution, and a single-factor structure. A growing body of evidence suggests that the bifactorial model represents the adequate factorial solution; however, its validity has never been tested in a large French-speaking sample. Moreover, uncertainty remains regarding the associations between IUS-R and other psychological constructs, especially stress and depression. This project was designed to overcome these limitations.

Method: To do so, we translated the scale into French and tested (n = 728) via confirmatory factor analyses (CFA) whether the French version would better fit with a bifactorial-, correlated, or single-factor structure, as implied by previous works. We also examined the internal reliability of the IUS-R, as well as its associations with concurrent measures of stress, depression, anxiety, and worry.

Results: The results pointed to a bifactorial structure as the best-fitting model and provided evidence for a strong general intolerance of uncertainty factor that was more reliable and accounted for significantly more common variance than each subscale factor individually.

Conclusions: We discuss how this bifactorial structure impacts the conceptualization of IU.

Objective: Next to its well-known benefits, Internet may trigger harmful consequences due to its abuse, thus delineating clinical pictures that are similar to abuse disorders, such as Problematic Internet Use (PIU). The matter becomes more elusive for sportsmen, as data regarding PIU in this specific group are scarce, particularly for tennis players. Therefore, our aim was to assess the prevalence and the features of PIU in a sample of either in current activity or retired professional tennis players, as compared with healthy controls.

Method: Twenty-five professional tennis players were evaluated during two events held in two different European countries and were matched to an equal number of healthy subjects who were not performing any agonistic sport. The characteristics of Internet use were assessed by a specific instrument we developed (QUNT). Statistical analyses were carried out to evaluate both demographic and QUNT features and the possible intergroup differences.

Results: Retired athletes presented statistically significant lower scores compared to both athletes in current activity and control subjects in the "Time spent online" and in the "Addiction to pornography" domains. Athletes in current activity presented statistically significant higher scores compared to retired athletes in the "Ludopathy" and Total score domains. Male athletes had a statistically significant lower score in the "Addiction to pornography" domain compared to both female and male healthy controls.

Conclusions: Tennis players frequently indulge in the use of Internet facilities, particularly those in current activity, thus potentially being more vulnerable to PIU. Men and women seem to use Internet for different activities. The lifestyle that professional tennis players are obliged to follow might provide an explanation of our findings.

Objective: This mixed-methods study aimed to explore the role of externalizing traits in moderating the relationship between COVID-19 risk perception and vaccine hesitancy in patients diagnosed with cancer. A community-based participatory approach - comprising a preliminary qualitative inquiry and a subsequent cross-sectional research - was used to promote effective vaccination campaigns.

Method: 12 people diagnosed with cancer and 7 cancer professionals were recruited for the qualitative inquiry, 356 people either under cancer treatment or in follow-up care for the cross-sectional research.A phenomenological analysis explored the transcripts of two focus groups. The cross-sectional research tested the hypothesis emerged during the previous qualitative inquiry through self-reported questionnaires and moderated regression.

Results: Phenomenological analysis suggested a pivotal role of externalizing traits in vaccine hesitancy. Moderated regression revealed how the association between risk perception and vaccine hesitancy is moderated by externalizing traits, even when controlled for treatment adherence.

Conclusions: In the present study we found a stronger relationship between risk perception and vaccine hesitancy for patients with higher levels of externalizing traits. We suggest that vaccination campaigns should be personality-informed to offer individualized and effective solutions. Patients with externalizing traits may cope dysfunctionally with vaccination campaigns.

The failure of biological psychiatry to deliver on its promises of enlightening the origin of psychiatric disorders and optimizing their treatment is due to invalid theoretical postulates that derive from an outdated conceptualization of human biology. The crisis of biological psychiatry depends on its identification with functional biology. A major contribution of evolutionary biology (the other current of biological thought) is to integrate the study of environmental variables (developmental, interpersonal, and ecological) with those mechanisms that are the field of study of functional biology (genetics, anatomy, and physiology). A new theoretical framework based on the integration of functional and evolutionary explanations can revitalize the crippled field of biological psychiatry.