Rivista di psichiatria最新文献

{"title":"Catatonia and cognition: exploring the cognitive dimensions of catatonia as an overlooked aspect of schizophrenia. A systematic review.","authors":"Vjekoslav Peitl, Frane Paleka, Dalibor Karlović","doi":"10.1708/4548.45488","DOIUrl":"https://doi.org/10.1708/4548.45488","url":null,"abstract":"<p><strong>Background and objectives: </strong>Catatonia, a complex neuropsychiatric condition, is frequently linked to psychiatric illnesses, especially schizophrenia. While its motor and behavioral signs are well-recognized, cognitive deficits in catatonia are insufficiently studied. This systematic review investigates whether catatonia involves impairments in attention, executive functioning, and other cognitive areas, particularly in psychiatric conditions like schizophrenia.</p><p><strong>Methods: </strong>We performed a systematic literature review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. We searched PubMed, Scopus, and BioMed Central using terms related to catatonia and DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) cognitive domains, including only studies that specifically assessed cognitive deficits in individuals with catatonia.</p><p><strong>Results: </strong>Thirty studies were included, consistently revealing cognitive deficits in catatonia, especially in schizophrenia patients, affecting memory, executive functioning, attention, and perceptual skills. These deficits may reflect mechanisms shared with broader schizophrenia-related cognitive challenges.</p><p><strong>Conclusions: </strong>Cognitive deficits in catatonia, often neglected, are significant in schizophrenia, emphasizing the necessity for regular cognitive evaluations and further neurobiological research to enhance diagnosis and therapeutic strategies.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 4","pages":"165-172"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The unhealable wounds of war: epigenetic and intergenerational damage.]","authors":"Angela Iannitelli, Massimo Biondi","doi":"10.1708/4548.45485","DOIUrl":"https://doi.org/10.1708/4548.45485","url":null,"abstract":"<p><p>The consequences of war extend beyond the directly exposed generation, affecting the mental and physical health of descendants. Recent studies show that trauma can be transmitted intergenerationally through epigenetic mechanisms, altering gene expression without changes to the DNA sequence. This editorial explores the psychological impact of war, highlighting epigenetic effects in the offspring of survivors.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 4","pages":"141-143"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The utilization of artificial intelligence in mental health.","authors":"Alen Greš, Dijana Staver","doi":"10.1708/4548.45486","DOIUrl":"https://doi.org/10.1708/4548.45486","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is the simulation of human intelligence by machines, especially computer systems. It includes learning, reasoning, and problem-solving. Chatbots are AI-powered programs that simulates human conversation. This paper explores the growing role of AI, particularly chatbots, in the field of mental health.</p><p><strong>Methods: </strong>This review article is based on professional and scientific literature as the research method. The literature search was conducted using databases such as Google Scholar, PubMed, Scopus, and Web of Science that met the inclusion criteria.</p><p><strong>Results: </strong>The findings of this review suggest that chatbots, as AI-powered tools, provide continuous emotional support and can improve access to mental health support. They are particularly useful between therapy sessions and in crisis situations. Still, AI cannot replace human therapists. There are some ethical concerns, including misinformation and privacy risks.</p><p><strong>Conclusions: </strong>It is highly likely that AI has a bright future in mental health care. A balanced and well-regulated approach is essential for understanding how chatbots work: we can use them in an informed and rational way.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 4","pages":"145-149"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression and physical comorbidities: an integrated review of challenges and treatment approaches.","authors":"Alessandro Cuomo, Despoina Koukouna, Simone Pardossi, Mario Pinzi, Maria Beatrice Rescalli, Caterina Pierini, Andrea Fagiolini","doi":"10.1708/4548.45487","DOIUrl":"https://doi.org/10.1708/4548.45487","url":null,"abstract":"<p><p>Depression is a highly prevalent and debilitating condition that frequently coexists with various physical illnesses, including cardiovascular, metabolic, neurological, oncological, pulmonary, and gastrointestinal diseases. This bidirectional relationship complicates diagnosis, exacerbates disease burden, and negatively impacts clinical outcomes, quality of life, and treatment adherence. The underlying mechanisms involve neuroinflammation, autonomic dysfunction, metabolic dysregulation, and behavioral factors. The pharmacological management of depression in patients with comorbid physical conditions requires careful selection of antidepressants to minimize adverse effects and drug interactions. Special considerations are necessary for patients with hepatic and renal impairment, as altered drug metabolism and clearance may increase the risk of toxicity or therapeutic inefficacy. Similarly, in pregnant and breastfeeding women, antidepressant selection must balance maternal benefits with fetal and neonatal safety. While SSRIs such as sertraline are generally preferred due to their relatively favorable safety profiles, medications like paroxetine and fluoxetine require caution due to potential teratogenic risks and higher infant exposure through breast milk. A comprehensive, multidisciplinary approach integrating psychiatric and medical care is essential to improve outcomes and ensure the safe and effective treatment of depression in individuals with chronic physical diseases and special populations.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 4","pages":"150-164"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Niaprazine in adult and elderly sleep disorders: results of an observational study on perceived efficacy and tolerability.]","authors":"Beniamino Palmieri, Maria Vadalà, Gaspare Palmieri","doi":"10.1708/4548.45489","DOIUrl":"https://doi.org/10.1708/4548.45489","url":null,"abstract":"<p><strong>Aim: </strong>The aim of the study was to define compliance and clinical efficacy on sleep disorders of a niaprazine-based galenic product; the active molecule marketed by an Italian pharmaceutical company since long time is no longer available as medical prescriptions are mostly oriented towards benzodiazepines and derivatives whose side effects in the medium-long term suggest however moderating and modulating their use. Niaprazine might therefore be prescribed in the interval drop out of benzodiazepines, or even as a primary therapeutic indication without significant side effects as widely confirmed by its previous historical use very frequent in children. Our research evaluated some aspects of prescribing pertinence and the clinical outcome results obtained with the use of galenic niaprazine in a cohort of patients with an indication for hypnoinducing treatment.</p><p><strong>Methods: </strong>In our observational and retrospective anecdotal study, we recruited, through the Second Opinion Network, 42 otherwise healthy volunteer subjects aged between 30 and 83 years, most of whom were engaged in a nighttime evening use of mobile phones, tablets and computers who complained of difficulty falling asleep and early morning awakenings partly due to physiological reasons (micturition stimuli, thirst, sweating or other). Each patient was instructed to take niaprazine 50 mg/ml produced in galenic formula by the Farmacia del Pavaglione in Bologna and supplied by the ACEF Spa company in Fiorenzuola d'Arda (Piacenza, Italy). Specifically, each patient took 8 drops before bedtime for a treatment period of 30 days. Each patient was then subjected to the following questionnaires at the beginning of the study and at the end of the treatment: 1) Sleep Disturbance Questionnaire (QDS). 2) Pittsburgh Sleep Quality Index (PSQI). 3) Insomnia Severity Index (ISI).</p><p><strong>Results: </strong>The data collected from the evaluation of the questionnaires (QDS, PSQI, and ISI) performed before and after the treatment showed that the quality of sleep and in general the quality of life of each patient was significantly increased (p<0.0001****).</p><p><strong>Conclusions: </strong>The results of our study confirm what is already known about the safety and handling of niaprazine formulated galenically in sleep disorders; in all cases its efficacy (only one drop out) was appreciated with a request to prolong its treatment, especially in subjects dedicated, in the evening hours, to cortical hyperarousal from prolonged (sometimes exhausting) use of technological means, low physical activity (and consequent poor cerebral oxygenation), and in those who had already benefited from the use of an industrial syrup based on niaprazine (Nopron) currently suppressed.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 4","pages":"174-181"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity and reliability of the COgnitive Complaints in Bipolar disorder Rating Assessment (COBRA) in Italian bipolar patients.","authors":"Caterina Portaluppi, Elena Teobaldi, Giorgia Porceddu, Camilla Garrone, Giuseppe Maina, Eduard Vieta, Gianluca Rosso","doi":"10.1708/4509.45086","DOIUrl":"https://doi.org/10.1708/4509.45086","url":null,"abstract":"<p><strong>Background: </strong>Although bipolar disorder (BD) and cognitive impairment are straightly connected, limited tools exist to capture the patient's perspective on cognitive decline and its impact on this disorder. The aims of the study are: 1) to assess the reliability and validity of the Italian version of a brief self-report scale (COgnitive Complaints in Bipolar disorder Rating Assessment - COBRA) among euthymic bipolar patients; 2) to investigate the relationship between the self-report scale, COBRA, the objective neurocognitive measure Screen for Cognitive Impairment in Psychiatry (SCIP), and the course of illness in BD.</p><p><strong>Methods: </strong>Western all-white sample (n=216) included 108 BD patients and 108 healthy matched controls. The psychometric properties of the COBRA (e.g., internal consistency, retest reliability, discriminative validity, factorial analysis, ROC curve and feasibility) were analyzed. A screening neuropsychological battery was used for objective cognitive assessment.</p><p><strong>Results: </strong>The Italian version of the COBRA (COBRA-I) had a high internal consistency (Cronbach's alpha= 0.852) and retest reliability (ICC=0.848). Factor analysis validated the one-factor model, and the cut-off value was obtained with a score of 10.5. BD patients experienced greater cognitive complaints compared to control group suggesting a discriminative validity of the instrument. No significant correlation was found between COBRA and SCIP in the patients group. Higher COBRA scores were associated with BD type II, life-time hypomanic episodes and number of total episodes.</p><p><strong>Conclusions: </strong>The study proved the validity of the COBRA-I as a simple and reliable self-report instrument for screening or monitoring cognitive complaints in adult patients with BD.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 3","pages":"117-129"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and screening tools for psychic illness in asylum seekers and refugees: a narrative review.","authors":"Jacopo Santambrogio, Elisabetta Leon, Anna Maria Auxilia, Martina Capellazzi, Sergio Terrevazzi, Francesca Ceccon, Antonio Amatulli, Elena Miragliotta, Chiara Peri, Raffaele Bracalenti, Fabrizia Colmegna, Massimo Clerici","doi":"10.1708/4509.45084","DOIUrl":"https://doi.org/10.1708/4509.45084","url":null,"abstract":"<p><strong>Background: </strong>According to UNHCR, at the end of June 2024 there were 8 million asylum seekers and 43.7 million refugees worldwide, a 16% increase versus year end 2023 for both categories; these rapidly growing numbers are posing significant political, humanitarian, and healthcare challenges. These are persons who have been displaced due to wars, persecution, political and economic instability, climate change, and other disasters. Trauma, an inevitable consequence of forced displacement, is a crucial factor in the development of psychiatric diseases, causing short and long-term synaptic alterations. Post-traumatic stress disorder (PTSD), anxiety, depression, and impulse control disorders are prevalent in this sub-population; providing efficient mental health services is a global challenge that requires developing early mental health screening and treatment programs.</p><p><strong>Purpose: </strong>The main purpose of this study is to examine the available scientific literature regarding the scales used for evaluating psychiatric impairment in asylum seekers and refugees. We are particularly interested in analysing these psychometric scales from a culturally unbiased perspective, in which the psychiatric evaluation is devoid of cultural features that could influence the outcome of the interview.</p><p><strong>Method: </strong>We carried out a search on PubMed for articles published between inception and September 30, 2024 containing references to clinical and screening tools that evaluate mental illness among asylum seekers and refugees. Various scales are used to screen for PTSD (11), anxiety (12) and depression (11) with a significant heterogeneity in the number of items and how the scales are administered, but only one for identifying psychosis. Two tools were used to screen specifically for substance use disorders. In various studies, general scales were used for screening for mental illness. We found that in general there was little information regarding when and how the tools are administered, and if they are used for follow-up interviews.</p><p><strong>Conclusions: </strong>This review highlights the need to create a specific, easy-to-use tool that avoids cultural biases to screen for mental illness, including PTSD, anxiety, psychosis, substance abuse and suicidal tendences, among asylum seekers and refugees.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 3","pages":"93-102"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ulysses contract in the light of law 219/2017 on informed consent and advance directives.]","authors":"Giulia Ienco, Corinna Porteri","doi":"10.1708/4509.45087","DOIUrl":"https://doi.org/10.1708/4509.45087","url":null,"abstract":"<p><p>In contemporary bio-juridical debate, the expression 'Ulysses contract' is used to define a set of self-binding instruments through which a person who suffers from a mental disorder with a remitting-relapsing or cyclical pattern can make explicit their advance directives regarding psychiatric treatment (PAD), in anticipation of a crisis in which the subject's preferences may conflict with those previously expressed. Unlike other countries, Italy does not have a specific regulation regarding PAD; however, we believe that important hints may come from law 219/2017 regulating informed consent, advance directives and shared care planning. The aim of this paper is to provide an interpretation of shared care planning (SCP) in psychiatry and thus contribute to the discussion on the implementation of law 219/2017 for people with mental disorders. The article presents a description of PAD in the international context, highlights their value for the subject's self-determination, and considers obstacles and facilitators to advance directives in psychiatry resulting from the literature. Building on these elements and considering the SCP specificity, SCP is suggested as a tool for making advance decisions on treatment in the context of mental disorders, specifically of those with a remitting-relapsing or cyclical pattern. The study also points to the need for an interdisciplinary dialogue between the bioethical, legal and clinical field in order to confirm the validity of SCP in psychiatry, including with regards to Ulysses contracts, and to provide practical guidance to ensure its applicability.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 3","pages":"130-140"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of workload on the development of burnout syndrome in Covid-19 intensive care nurses: a systematic review.","authors":"Silvano Biagiola, Norma Alfieri, Sofia Di Mario, Giulia Evangelista, Daniela Grima, Susanna Sodo, Giuseppe La Torre","doi":"10.1708/4509.45085","DOIUrl":"https://doi.org/10.1708/4509.45085","url":null,"abstract":"<p><strong>Background: </strong>Nowadays, it is well-known that burnout is a syndrome that mainly affects the helping professions. The nursing profession is obviously among those categories of workers that can develop burnout and, precisely because of its proximity to people who suffer associated with high workloads characterized by high emotional impacts.</p><p><strong>Aim: </strong>The aim of this systematic review is, therefore, to highlight whether the high nursing workload during the pandemic has contributed to the onset of burnout syndrome in nurses who served in intensive care units (ICUs) dedicated to the care of Covid-19 patients.</p><p><strong>Methods: </strong>A systematic review was carried out. The main scientific databases were consulted, such as PubMed, Scopus, Web of Sciences and CINAHL analyzing all the papers present in literature. Using PRISMA guidelines, fifteen articles were included in the review. The protocol for this review has been registered on PROSPERO, the international prospective register of systematic reviews (PROSPERO ID: CRD42024502094). The quality assessment of the articles included in this review was conducted using the Newcastle-Ottawa Scale (NOS) for observational studies.</p><p><strong>Results: </strong>In accordance with the literature, all the 15 included studies documented high levels of burnout among ICU professionals, nevertheless those levels were greater than the ones registered in the pre-pandemic period. In Covid-19 era, nurses experienced higher levels of burnout compared to other professions and working as a nurse was identified as an independent risk factor for increased risk of burnout. As reported by all included studies, the overwhelming severity of Covid-19 patients entailed a significant increase in workload for health care providers, particularly nurses. Ultimately, this increase showed a significant correlation with increased burnout risk.</p><p><strong>Conclusions: </strong>The review highlights the correlation between workload and burnout of nurses in Covid-19 intensive care units. It is expected that this and other studies will contribute to a better understanding of the importance of assigning the adequate workload to nurses.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 3","pages":"103-116"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Music Hospital: an acceptability study of music therapy activities in a psychiatric ward through listening and analysis of auteur tunes.]","authors":"Stefano Ventruto, Dalila Talevi, Francesca Pacitti, Alessandro Rossi, Paolo Stratta","doi":"10.1708/4487.44878","DOIUrl":"https://doi.org/10.1708/4487.44878","url":null,"abstract":"<p><p>A study was conducted on the acceptability of a music therapy intervention in a group context, in a psychiatric ward where people with acute psychopathological conditions are hospitalized. The objectives of the intervention are both therapeutic (stress reduction) and informative-descriptive, on topics ranging from stress management, to the first signs of crisis and drugs. For this purpose, musical stimuli provided by the presentation, listening and analysis of author's pieces were used, through the diffusion of pleasant sounds at moderate rhythm and volume among patients and operators. Acceptability was assessed through a satisfaction questionnaire. The responses to the questionnaire were very positive, confirming the narrative observations of the operators who found favorable ways of interacting with the patients with whom they shared the activity in all its contents. Participation in the music therapy intervention in a group context led users to an improvement in their stress management skills and to a more positive adaptation to the condition of hospitalization.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 2","pages":"81-87"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}