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Gian Maria GALEAZZI

Professore Ordinario
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze sede Policlinico


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Pubblicazioni

2022 - "It's All COVID's Fault!": Symptoms of Distress among Workers in an Italian General Hospital during the Pandemic [Articolo su rivista]
Mastroberardino, Michele; Cuoghi Costantini, Riccardo; De Novellis, Antonella Maria Pia; Ferrari, Silvia; Filippini, Costanza; Longo, Fedora; Marchi, Mattia; Rioli, Giulia; Valeo, Laura; Vicini, Roberto; Galeazzi, Gian Maria; D'Amico, Roberto; Vandelli, Paola
abstract

Background: Since the outbreak of the COVID-19 pandemic, healthcare workers (HCWs) have been faced with specific stressors endangering their physical and mental health and their functioning. This study aimed to assess the short-term psychological health of a sample of Italian HCWs and the related influencing factors. In particular, the study focused on the differences related to HCWs' gender and to having been directly in charge of COVID-19 patients or not. Methods: An online survey was administered to the whole staff of the Modena General University Hospital three months after the onset of the pandemic, in 2020. Demographic data and changes in working and living conditions related to COVID-19 were collected; mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21) and the Impact of Event Scale-Revised (IES-R). Results: 1172 out of 4788 members returned the survey (response rate = 24.5%), the male/female ratio was 30/70%. Clinically significant symptoms assessed according to the DASS-21 emerged among 21.0% of the respondents for depression, 22.5% for anxiety and 27.0% for stress. Symptoms suggestive of a traumatic reaction were reported by 19.0% of the sample. Symptoms of psychological distress were statistically associated with female gender, job role, ward, changes in lifestyle, whereas first-line work with COVID-19 patients was statistically associated with more stress symptoms. HCWs reported a significant level of psychological distress that could reach severe clinical significance and impact dramatically their quality of life and functioning. Conclusions: Considering the persistence of the international emergency, effective strategies to anticipate, recognize and address distress in HCWs are essential, also because they may impact the organization and effectiveness of healthcare systems.


2022 - Barriers in care pathways and unmet mental health needs in LGBTIQ + communities [Articolo su rivista]
Silveri, G.; Schimmenti, S.; Prina, E.; Gios, L.; Mirandola, M.; Converti, M.; Fiorillo, A.; Pinna, F.; Ventriglio, A.; Galeazzi, G. M.; Sherrif, N.; Zeeman, L.; Amaddeo, F.
abstract

Lesbian, gay, bisexual, transgender, intersex, queer people and minority gender identities and sexualities (LGBTIQ+) are often stigmatized and experience discrimination in health care settings, leading to poorer mental health outcomes and unmet needs compared to heterosexual and cisgendered peers. It is thus imperative that mental health providers consider and address structural challenges in order to reduce mental health inequalities of this population. This narrative review assessed the barriers that may prevent access to care and the pathways for care in LGBTIQ + communities. PubMed, PsycInfo, Embase, and Scopus were searched for papers published between December 2021 and February 2022. A total of 107 papers were included with studies reflecting five themes: (1) Unmet mental health needs; (2) Young people; (3) Substance abuse and addiction; (4) Barriers and pathways to care; and (5) Interventions. Findings demonstrate that LGBTIQ + people experience stigmatization and higher rates of substance misuse and mental ill health, which may lead to barriers in accessing health care services, and fewer tailored interventions being provided. These findings have implications for policy, health care screening, and how specialist services are structured. Substantial gaps in the evidence-base exist, and future research should examine how mental health care providers can challenge social issues that maintain discriminatory and stigmatizing practices, and support LGBTIQ + individuals to sustain their resilience.


2022 - Can a negative religious causal attribution of mental illness affect the phenomenon of public stigma? [Articolo su rivista]
Pingani, L.; Pinelli, G.; Coriani, S.; Ferrari, S.; Fierro, L.; Giberti, S.; Mattei, G.; Nasi, A. M.; Evans-Lacko, S.; Wesselmann, E. D.; Galeazzi, G. M.
abstract

This study assessed, through an exploratory approach, how religion-based negative causal attributions of mental illness may be associated to stigmatising attitudes and behaviours that contribute to public stigma in an Italian convenience sample. All participants (N = 311; average age = 33 years, 38.6% male) completed a set of three questionnaires: Religious Beliefs and Mental Illness Stigma Scale, the Attribution Questionnaire 27 and the Mental Health Knowledge Schedule. The study found support for two specific models. The Responsibility model involved four key predictors: participant age, the influence of religious beliefs in everyday choices, religious beliefs about the connection between morality/sin and mental illness and having participated in seminars about mental illness stigma. The Dangerousness model involved three exogenous variables: participating in mental illness stigma seminars, religious beliefs about morality/sin and mental illness, and participant age. This study allows the identification of variables that seem to activate or attenuate the models of “Personal Responsibility” and “Dangerousness”.


2022 - Childhood maltreatment mediates the effect of the genetic background on psychosis risk in young adults [Articolo su rivista]
Marchi, Mattia; Elkrief, Laurent; Alkema, Anne; van Gastel, Willemijn; Schubart, Chris D; van Eijk, Kristel R; Luykx, Jurjen J; Branje, Susan; Mastrotheodoros, Stefanos; Galeazzi, Gian M; van Os, Jim; Cecil, Charlotte A; Conrod, Patricia J; Boks, Marco P
abstract

Childhood maltreatment (CM) and genetic vulnerability are both risk factors for psychosis, but the relations between them are not fully understood. Guided by the recent identification of genetic risk to CM, this study investigates the hypothesis that genetic risk to schizophrenia also increases the risk of CM and thus impacts psychosis risk. The relationship between schizophrenia polygenetic risk, CM, and psychotic-like experiences (PLE) was investigated in participants from the Utrecht Cannabis Cohort (N = 1262) and replicated in the independent IMAGEN cohort (N = 1740). Schizophrenia polygenic risk score (SZ-PRS) were calculated from the most recent GWAS. The relationship between CM, PRS, and PLE was first investigated using multivariate linear regression. Next, mediation of CM in the pathway linking SZ-PRS and PLE was examined by structural equation modeling, while adjusting for a set of potential mediators including cannabis use, smoking, and neuroticism. In agreement with previous studies, PLE were strongly associated with SZ-PRS (B = 0.190, p = 0.009) and CM (B = 0.575, p < 0.001). Novel was that CM was also significantly associated with SZ-PRS (B = 0.171, p = 0.001), and substantially mediated the effects of SZ-PRS on PLE (proportion mediated = 29.9%, p = 0.001). In the replication cohort, the analyses yielded similar results, confirming equally strong mediation by CM (proportion mediated = 34.7%, p = 0.009). Our results suggest that CM acts as a mediator in the causal pathway linking SZ-PRS and psychosis risk. These findings open new perspectives on the relations between genetic and environmental risks and warrant further studies into potential interventions to reduce psychosis risk in vulnerable people.


2022 - DIFFERENZE DI GENERE NELLA COMORBILITÀ TRA SINTOMATOLOGIA ANSIOSO-DEPRESSIVA, SINDROME METABOLICA E ADENOMI COLORETTALI [Abstract in Atti di Convegno]
Rioli, Giulia; Bonamici, Caterina; Mancini, Stefano; Mattei, Giorgio; Alboni, Silvia; Sena, Paola; Roncucci, Luca; Fiore, Gianluca; Pingani, Luca; Ferrari, Silvia; Galeazzi, Gian Maria
abstract


2022 - Delirium in COVID-19 and post-liver transplant patients: an observational study [Articolo su rivista]
Fiore, Gianluca; Ferrari, Silvia; Cutino, Anna; Giorgino, Claudia; Valeo, Laura; Galeazzi, Gian M.; Marchi, Mattia
abstract


2022 - Differenze di genere nella comorbilità tra sintomatologia ansioso-depressiva, sindrome metabolica e adenomi colorettali [Abstract in Rivista]
Rioli, G.; Bonamici, C.; Mancini, S.; Mattei, G.; Alboni, S.; Sena, P.; Roncucci, L.; Fiore, G.; Pingani, L.; Ferrari, S.; Galeazzi, G. M.
abstract


2022 - Effectiveness and Quality of Life with Paliperidone Palmitate 3-Monthly in Comparison with Other Long-Acting Drugs [Articolo su rivista]
Di Lorenzo, Rosaria; Iorio, Anita; Pinelli, Margherita; Magarini, Federica Maria; Marchi, Mattia; Sacchetti, Andrea; Calogero, Chiara; Galeazzi, Gian Maria; Ferri, Paola; Rovesti, Sergio; Minarini, Alessandro
abstract

Purpose: Antipsychotic long-acting injections (AP-LAIs) are indicated for patients affected by schizophrenia especially those with poor treatment adherence. Patients and Methods: To compare paliperidone palmitate 3-monthly (PP3M), paliperidone palmitate one-monthly (PP1M) and haloperidol decanoate (HAL-D) treatment, we enrolled 90 patients with schizophrenia treated in Mental Health Center with one of the three AP-LAIs for at least six months and followed them for another 6 months. At 6 and 12 months of treatment we administered Clinical Global Impression-Severity, Global Assessment of Functioning and World Health Organization Quality of Life-26 items (WHOQOL-BREF). At 1-year treatment, we evaluated relapses (psychiatric hospitalizations and urgent consultations), side effects and drop-outs. Results: We did not highlight any statistically significant difference among the three treatments in relapses and scale scores. Weight increase was significantly higher in PP1M and PP3M groups. Twelve patients (13.3%) discontinued AP-LAI. At 1-year AP-LAI treatment, 69% of patients rated quality of life as “good” or “very good” and 71% declared themselves to be “satisfied” or “very satisfied”. Conclusion: HAL-D, PP1M and PP3M 1-year treatments were similarly effective in preventing relapses and improving quality of life and health satisfaction. All discontinuations in the new 3-monthly antipsychotic treatment were caused by patient refusal to continue it.


2022 - Experience of discrimination during COVID-19 pandemic: the impact of public health measures and psychological distress among refugees and other migrants in Europe [Articolo su rivista]
Marchi, M.; Magarini, F. M.; Chiarenza, A.; Galeazzi, G. M.; Paloma, V.; Garrido, R.; Ioannidi, E.; Vassilikou, K.; de Matos, M. G.; Gaspar, T.; Guedes, F. B.; Primdahl, N. L.; Skovdal, M.; Murphy, R.; Durbeej, N.; Osman, F.; Watters, C.; van den Muijsenbergh, M.; Sturm, G.; Oulahal, R.; Padilla, B.; Willems, S.; Spiritus-Beerden, E.; Verelst, A.; Derluyn, I.
abstract

Background: The COVID-19 pandemic has had a disproportionately hard impact on refugees and other migrants who are often exposed to the virus with limited means to protect themselves. We tested the hypothesis that during the COVID-19 pandemic, refugees and other migrants have suffered a negative impact on mental health and have been unjustly discriminated for spreading the disease in Europe (data collection from April to November 2020). Methods: Participants in the ApartTogether Survey (N = 8297, after listwise deletion of missing items final N = 3940) provided data regarding to their difficulties to adhere to preventive recommendations against COVID-19 infection (CARE), self-perceived stigmatization (SS), and psychological distress (PD). Structural Equation Modeling was used to investigate PD as a mediator in the pathway linking CARE to SS, while adjusting for the housing and residence status. To improve confidence in the findings, single hold-out sample cross-validation was performed using a train/test split ratio of 0.8/0.2. Results: In the exploratory set (N = 3159) SS was associated with both CARE (B = 0.200, p < 0.001) and PD (B = 0.455, p < 0.001). Moreover, PD was also associated with CARE (B = 0.094, p = 0.001) and mediated the effect of CARE on SS (proportion mediated = 17.7%, p = 0.001). The results were successfully replicated in the confirmation set (N = 781; total effect = 0.417, p < 0.001; proportion mediated = 29.7%, p < 0.001). Follow-up analyses also found evidence for an opposite effect (i.e., from SS to CARE, B = 0.132; p < 0.001), suggesting that there might be a vicious circle between the self-perceived stigmatization and the access to health care and the use of preventive measures against COVID-19 infection. Conclusions: Refugees and other migrants who had more difficulties in accessing health care and preventive measures against COVID-19 infection experienced worse mental health and increased discrimination. These negative effects appeared to be stronger for those with more insecure housing and residence status, highlighting from one side the specific risk of insecure housing in the impact of COVID-19 upon mental health and infection protection, and for another side the need to proper housing as a strategy to prevent both COVID-19 and mental distress.


2022 - Gender differences in Anxious-depressive symptomatology, Metabolic Syndrome and Colorectal Adenomas among outpatients undergoing colonoscopy: a cross-sectional study according to a PNEI perspective [Articolo su rivista]
Rioli, Giulia; Mattei, Giorgio; Bonamici, Caterina; Mancini, Stefano; Alboni, Silvia; Cannazza, Giuseppe; Sena, Paola; Roncucci, Luca; Pingani, Luca; Ferrari, Silvia; Galeazzi, Gian Maria
abstract


2022 - Historical micronutrient psychiatry: descriptive analysis of patients with pellagra admitted to the “San Lazzaro” asylum in Reggio Emilia (Italy) in the decade 1901-1910 [Articolo su rivista]
Pingani, L.; Garagnani, A.; Marchi, M.; Bombardieri, C.; Galeazzi, G. M.
abstract

This study aims at describing the socio-demographic and clinical characteristics of the patients affected by pellagra and admitted to the “San Lazzaro” psychiatric asylum (Reggio Emilia, Italy) from 1901 to 1910 besides exploring possible gender differences for the collected information. Data were collected from the admission register and clinical records of those patients who were admitted to the San Lazzaro Psychiatric Hospital receiving a diagnosis of pellagra at their first admission. The pellagrous patient population was characterised by a higher rate of hospitalisation for women (64.3%) and the number of hospitalised patients suffering from pellagra gradually decreased from 1901 (78; 8.3%) to 1910 (8;0.7%). The most common profession for men admitted with pellagra was farmer/agricultural labourer, while most of the women were housewives. A characteristic shared by both the male and female population of inpatients was very high rate of illiteracy: only one patient was recorded as being able to read and write. The generic diagnosis of “mental illness from pellagra” was predominant (70%), while “dementia from pellagra” accounts for 17.85% of the admission diagnoses: no statistically significant differences between men and women were found in the frequency of diagnosis. Half of the patients, both men and women, died while being inpatients. This study confirms previous findings about the case mix of pellagra patients admitted to psychiatric hospital at the beginning of the last century in northern Italy and highlights the significance of the relationship of psychiatry with other medical disciplines and the sociocultural milieu.


2022 - IL RUOLO DELL’INFIAMMAZIONE SISTEMICA CRONICA E DELLA VIA METABOLICA DELLE CHINURENINE NELLA COMORBIDITÀ TRA ANSIA, DEPRESSIONE E SINDROME METABOLICA: RISULTATI DI UNO STUDIO CROSS-SECTIONAL [Abstract in Atti di Convegno]
Rioli, Giulia; Bonamici, Caterina; Macini, Stefano; Mattei, Giorgio; Alboni, Silvia; Sena, Paola; Roncucci, Luca; Fiore, Gianluca; Pingani, Luca; Ferrari, Silvia; Galeazzi, Gian Maria
abstract


2022 - Il ruolo dell'infiammazione sistemica cronica e della via metabolica delle chinurenine nella comorbidilità tra ansia, depressione e sindrome metabolica: risultati di uno studio cross-sectional [Abstract in Rivista]
Rioli, G.; Bonamici, C.; Macini, S.; Mattei, G.; Alboni, S.; Sena, P.; Roncucci, L.; Fiore, G.; Pingani, L.; Ferrari, S.; Galeazzi, G. M.
abstract


2022 - Insecure adult attachment and reflective functioning as mechanisms of the relationship between traumatic life events and suicidal ideation: A path analysis [Articolo su rivista]
Musetti, Alessandro; Pingani, Luca; Zagaria, Andrea; Uberti, Daniele; Meli, Salvatore; Lenzo, Vittorio; Gori, Alessio; Franceschini, Christian; Galeazzi, Gian Maria
abstract

The relationship between traumatic life events and increased suicide risk has been well reported in literature. However, the complex nature of suicidality phenomena still hinders our ability to comprehend the mediation mechanism underlying this association. In this study, we examined the mediating role of adult attachment and reflective functioning in the relationship between traumatic life events and suicidal ideation. Nine hundred and fifty Italian adults completed an online survey evaluating traumatic life events, adult attachment, reflective functioning and suicidal ideation. The path analysis showed that the positive relationship between traumatic life events and suicidal ideation was partially mediated by attachment anxiety and reflective functioning. From a clinical point of view, these results support the relevance of evaluating and improving patients' ability to mentalize as a part of psychotherapeutic intervention aimed at reducing suicidality in people with a history of traumatic experiences and attachment anxiety.


2022 - L'impatto dello stigma [Capitolo/Saggio]
Pingani, Luca; Coriani, Sandra; Ferrari, Silvia; Maria Nasi, Anna; Galeazzi, Gian Maria
abstract


2022 - Machine-Learning for Prescription Patterns: Random Forest in the Prediction of Dose and Number of Antipsychotics Prescribed to People with Schizophrenia [Articolo su rivista]
Marchi, Mattia; Galli, Giacomo; Fiore, Gianluca; Mackinnon, Andrew; Mattei, Giorgio; Starace, Fabrizio; Galeazzi, Gian M
abstract

Objective: We aimed to predict antipsychotic prescription patterns for people with schizophrenia using machine learning (ML) algorithms.Methods: In a cross-sectional design, a sample of community mental health service users (SUs; n = 368) with a primary diagnosis of schizophrenia was randomly selected. Socio-demographic and clinical features, including the number, total dose, and route of administration of the antipsychotic treatment were recorded. Information about the number and the length of psychiatric hospitalization was retrieved. Ordinary Least Square (OLS) regression and ML algorithms (i.e., random forest [RF], supported vector machine, K-nearest neighborhood, and Naive Bayes) were used to estimate the predictors of total antipsychotic dosage and prescription of antipsychotic polytherapy (APP).Results: The strongest predictor of the total dose was APP. The number of Community Mental Health Centers (CMHC) contacts was the most important predictor of APP and, with APP omitted, of dosage. Treatment with anticholinergics predicted APP, emphasizing the strong correlation between APP and higher antipsychotic dose. RF performed better than OLS regression and the other ML algorithms in predicting both antipsychotic dose (root square mean error = 0.70, R-2 = 0.31) and APP (area under the receiving operator curve = 0.66, true positive rate = 0.41, and true negative rate = 0.78).Conclusion: APP is associated with the prescription of higher total doses of antipsychotics. Frequent attenders at CMHCs, and SUs recently hospitalized are often treated with APP and higher doses of antipsychotics. Future prospective studies incorporating standardized clinical assessments for both psychopathological severity and treatment efficacy are needed to confirm these findings.


2022 - Mental health for LGBTQI people: a policies' review [Articolo su rivista]
Ventriglio, A.; Mirandola, M.; Galeazzi, G. M.; Amaddeo, F.; Pinna, F.; Converti, M.; Fiorillo, A.
abstract

The mental health of lesbian, gay, bisexual, transgender, queer, intersexual (LGBTQI) individuals is significantly influenced by many factors such as difficulties in coming-out, poor acceptance, isolation and discrimination as well as minority-related stress. LGBTQI individuals, in fact, show a significant higher risk of mental health conditions, substance- use disorders and suicide. In addition, mental health services access may be difficult for personal and social barriers as well as a lack of adequate and specific mental health support. This review aims to assess and describe international policies, guidelines, position statements and recommendations regarding the promotion and protection of mental health rights for LGBTQI people. The search has been focussed on peer-reviewed papers, Governmental and Mental Health Association- Guidelines and Position Statements, Health Agencies - Guidelines and Position Statements (with a specific focus on mental health), LGBTQI Alliances and Foundations Publishing (with a specific focus on mental health). In addition, relevant international initiatives, and projects in the field of LGBTQI mental health will be described.


2022 - Mental health in transgender individuals: a systematic review [Articolo su rivista]
Pinna, F.; Paribello, P.; Somaini, G.; Corona, A.; Ventriglio, A.; Corrias, C.; Frau, I.; Murgia, R.; El Kacemi, S.; Galeazzi, G. M.; Mirandola, M.; Amaddeo, F.; Crapanzano, A.; Converti, M.; Piras, P.; Suprani, F.; Manchia, M.; Fiorillo, A.; Carpiniello, B.
abstract

Several lines of evidence indicate the prevalence of mental health disorders in Transgender (TG) individuals is higher than that of cisgender individuals or the general population. In this systematic review, we aim to propose a summary of some of the most significant research investigating mental health disorders’ prevalence among this population. We performed a double-blind systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting (PRISMA) on PUBMED/MEDLINE and SCOPUS, specifically using peer-reviewed articles examining the mental health status of transgender (TG) individuals. This review did not exclude any research based on publication date. The last search was performed in February 2022. The employed search strategy led to the selection of 165 peer-reviewed articles. The majority of these papers presented a cross-sectional design with self-reported diagnoses and symptoms, signaling a significant prevalence of mental health disorders amongst TG Individuals. Of the reviewed articles, 72 examined the prevalence of mood and anxiety disorders; 8 examined eating disorders; 43 examined the prevalence of suicidal or self-harm ideation or behaviors; 5 papers examined the prevalence of trauma and stress-related disorders; 10 examined the frequency of personality disorders; 44 examined substance use disorders; and 9 papers examined the prevalence of autism spectrum disorder. Finally, 22 studies reported on the prevalence of TG individuals diagnosed with co-morbid mental health disorders or unspecified mental disorders. Our findings coincide with existing research, which indicates TG individuals do experience a higher prevalence of mental health disorders than that of the general population or cisgender individuals. However, further research is needed to address the existing gaps in knowledge.


2022 - Neuroenhancements in the Military: A Mixed-Method Pilot Study on Attitudes of Staff Officers to Ethics and Rules [Articolo su rivista]
Sattler, S.; Jacobs, E.; Singh, I.; Whetham, D.; Bard, I.; Moreno, J.; Galeazzi, G.; Allansdottir, A.
abstract

Utilising science and technology to maximize human performance is often an essential feature of military activity. This can often be focused on mission success rather than just the welfare of the individuals involved. This tension has the potential to threaten the autonomy of soldiers and military physicians around the taking or administering of enhancement neurotechnologies (e.g., pills, neural implants, and neuroprostheses). The Hybrid Framework was proposed by academic researchers working in the U.S. context and comprises “rules” for military neuroenhancement (e.g., ensuring transparency and maintaining dignity of the warfighter). Integrating traditional bioethical perspectives with the unique requirements of the military environment, it has been referenced by military/government agencies tasked with writing official ethical frameworks. Our two-part investigation explored the ethical dimensions of military neuroenhancements with military officers – those most likely to be making decisions in this area in the future. In three workshops, structured around the Hybrid Framework, we explored what they thought about the ethical issues of enhancement neurotechnologies. From these findings, we conducted a survey (N = 332) to probe the extent of rule endorsement. Results show high levels of endorsement for a warfighter’s decision-making autonomy, but lower support for the view that enhanced warfighters would pose a danger to society after service. By examining the endorsement of concrete decision-making guidelines, we provide an overview of how military officers might, in practice, resolve tensions between competing values or higher-level principles. Our results suggest that the military context demands a recontextualisation of the relationship between military and civilian ethics.


2022 - Portrayals of narcolepsy from 1980 to 2020: a descriptive analysis of stigmatizing content in newspaper articles [Articolo su rivista]
Varallo, Giorgia; Pingani, Luca; Musetti, Alessandro; Galeazzi, Gian Maria; Pizza, Fabio; Castelnuovo, Gianluca; Plazzi, Giuseppe; Franceschini, Christian
abstract

Study objectives: The media are the primary source of information about health for the public. The media portrayal of narcolepsy might contribute to the stigmatization of people affected by this condition. This study aimed to describe how narcolepsy is portrayed in newspapers. Methods: We collected 257 newspaper articles from the digital archive of "La Stampa" published between 1980 and 2020 that mentioned key search terms. The content was assessed using an ad-hoc coding schema developed to evaluate the presence of sensationalistic title, negative language, stigmatizing content, stereotypical description, disclosure of a person diagnosed with narcolepsy, person with narcolepsy described as dangerous, presence of an accurate diagnosis, identifiable symptoms, indications about diagnostic and treatment services. The Chi-squared analysis was performed to identify changes over time in the type of content. Results: In 10.9% of the articles, there was a sensationalistic title; inappropriate, negative, and outdated language appeared in 10.5% of the articles. Stigmatizing and stereotypical content were reported in 19.5% and 14.8% of the articles, respectively. In 62.3% of the articles, it was disclosed that a person has narcolepsy, and in 5.1% of the articles patients with narcolepsy are described as dangerous. 30.4% of the articles referred to the presence of an accurate diagnosis, while 16.7% described identifiable symptoms. Services for diagnosis and treatment were mentioned in 24.1% of the articles. Changes over time in the content of articles are discussed. Conclusions: Our findings highlight areas for improvement in the media portrayal of narcolepsy and could help guide the development of new targeted antistigma campaigns.


2022 - Self-harm and suicidality among LGBTIQ people: a systematic review and meta-analysis [Articolo su rivista]
Marchi, M.; Arcolin, E.; Fiore, G.; Travascio, A.; Uberti, D.; Amaddeo, F.; Converti, M.; Fiorillo, A.; Mirandola, M.; Pinna, F.; Ventriglio, A.; Galeazzi, G. M.
abstract

Research evidence has consistently documented a higher risk of suicidality in the Lesbian, Gay, Bisexual, Transgender, Intersex, and Queer (LGBTIQ) population. This systematic review and meta-analysis aimed to report a detailed description of research data regarding the risk of Attempted Suicide (SA), Suicide Ideation (SI), and Non-Suicidal Self-Injury (NSSI) behaviours for LGBTIQ people and their subgroups. Medline, Scopus, PsycINFO, and EMBASE were searched for studies reporting a comparative estimation of SA, SI, and NSSI rates among LGBTIQ population and the general population (i.e. heterosexual/cisgender), without restrictions on participants’ age and setting for the enrolment. Pooled analyses were based on odds ratios (ORs, with 95% CIs), estimated through inverse variance models with random effects. Fifty studies were selected for the quantitative synthesis and included fifty samples involving 3.735.601 controls and 87.252 LGBTIQ people. LGBTIQ people reported an increased risk of SA (OR:4.36[95%CI:3.32;5.71]), SI (OR:3.76[95%CI:3.02;4.69]), and NSSI (OR:4.24[95%CI:3.23;5.55]). Among LGBTIQ subgroups, the Bisexual group has shown the highest risk of suicidality (SA, OR:6.71; SI, OR:5.04; NSSI, OR: 5.03), followed by the Lesbian-Gay for attempted suicide (SA, OR:6.03), and the Transgender-Intersex-Queer for suicide ideation and non-suicidal self-injury (SI and NSSI, OR:3.42). The quality of the evidence ranged from low to moderate. Our findings have shown that LGBTIQ people report a higher risk of suicidality compared with their cisgender/heterosexual peers. This evidence may contribute to the public awareness on LGBTQI mental health needs and suggest supportive strategies as well as preventive interventions (e.g. supportive programs, counselling, and destigmatizing efforts) as parts of a tailored health-care planning aimed to reduce psychiatric morbidity and mortality in this at-risk population.


2022 - The Effect of the Use of Hearing Aids in Elders: Perspectives [Articolo su rivista]
Monzani, Daniele; Nocini, Riccardo; Presutti, Maria Teresa; Gherpelli, Chiara; Di Berardino, Federica; Ferrari, Silvia; Galeazzi, Gian Maria; Federici, Gaia; Genovese, Elisabetta; Palma, Silvia
abstract

: Older adults with hearing loss have difficulties during conversation with others because an elevated auditory threshold reduces speech intelligibility, especially in noisy environments. Listening and comprehension often become exhausting tasks for hearing-impaired elders, resulting in social isolation and depression. The aim of the present study was to investigate the advantages of hearing aid use in relation to relief from listening-related fatigue, which is still controversial. Participants included a sample of 49 hearing-impaired elders affected by presbycusis for whom hearing aids were prescribed. The Modified Fatigue Impact Scale was used to assess cognitive, physical and psychosocial fatigue. The vitality subscale of the Short Form Health Survey 36 and a single item of the multi-dimensional Speech, Spatial and Quality Hearing Scale ("Do you have to put a lot of effort to hear what is being said in conversation with others?") were also used. The Cognitive Failures Questionnaire was used to investigate daily errors related to lack of memory and reduced mindedness. Hearing aids rehabilitation resulted in improved speech intelligibility in competing noise, and a significant reduction in cognitive and psychosocial fatigue and listening effort in conversation. Vitality was also improved and a significant reduction in the Cognitive Failures Questionnaire scores was observed. Findings from the study indicate that the use of hearing aids in older impaired-listeners provide them not only with an increased auditory function but also with a reduction in listening-related fatigue and mindedness.


2022 - The effect of ketamine on cognition, anxiety, and social functioning in adults with psychiatric disorders: A systematic review and meta-analysis [Articolo su rivista]
Marchi, Mattia; Magarini, Federica Maria; Galli, Giacomo; Mordenti, Federico; Travascio, Antonio; Uberti, Daniele; De Micheli, Edoardo; Pingani, Luca; Ferrari, Silvia; Galeazzi, Gian Maria
abstract

Background: It has been shown that ketamine can improve suicidality and depression. Evidence for other dimensions of psychopathology is lacking. We undertook a systematic review to investigate the effect of ketamine on cognition, anxiety, quality of life, and social functioning in adults with psychiatric disorders. Methods: PubMed (Medline), Scopus, PsycINFO, and EMBASE were searched up to April 2022. Randomized controlled trials (RCTs) on ketamine [or its S (+) enantiomer] reporting data on cognition, anxiety, quality of life, social functioning in adults with psychiatric disorders were included. Standardized mean difference (SMD) was used for summarizing continuous outcomes. Results: Twenty-two reports were included in the final selection, of which 20, corresponding to 1,298 participants, were included in the quantitative synthesis. Affective disorders were the predominant diagnostic category. Median follow-up time was 21 days. The evidence was rated moderate to very low. In most trials, ketamine was administered intravenously or as adjuvant to electro-convulsant therapy (ECT). Only 2 trials of intranasal esketamine were identified. The effect of ketamine on depression was confirmed (SMD: −0.61 [95% CI: −1.06; −0.16]). Furthermore, by pooling results of 6 RCTs, ketamine may be effective in reducing anxiety symptoms (SMD: −0.42 [95% CI: −0.84; 0.003]), particularly when administered not within ECT (5 trials; SMD: −0.58 [95% CI: −1.07; −0.09]). However, there was moderate heterogeneity of results. Patients treated with ketamine also had an improvement in social functioning (SMD: −0.31 [95% CI: −0.52; −0.10]), although the estimate was based only on 2 studies. No difference to comparators was found with respect to cognition and quality of life. Conclusion: Alongside the antidepressant effect, ketamine may also improve anxiety and social functioning in adults with affective disorders.


2021 - A theoretical guide for the integration of the clinical internships for interns and clinical tutors in the mental health professions [Articolo su rivista]
Dall'Aglio, Raffaella; Virga, Mariano; Catellani, Sara; Coriani, Sandra; Nasi, Anna Maria; Galeazzi, Gian Maria; Pingani, Luca
abstract

: The Degree Course in Psychiatric Rehabilitation Techniques from the University of Modena and Reggio Emilia (Italy) was established in 2001, with the aim of training health care workers with the competencies specified by the Ministerial Decree 182. Psychiatric Rehabilitation Technicians are graduated and qualified healthcare professionals who carry out rehabilitation and psychoeducational interventions with persons having mental health problems and related disabilities. The integration between theoretical knowledge and practical experimentation builds up professional competence and allows it to develop and consolidate profession-specific skills and to experiment with pre-socialisation for the job arena. Over the years, the necessity to develop an evaluation form of internship experience has arisen to provide detail in respect to the certification of competencies gained during the clinical internship, considering the complexity of the clinical services and of the service users that interns make contact with. The aim of this paper is to describe the Guide to Clinical Internships for Interns and Clinical Tutors, a useful instrument for interns to optimize their study and clinical internship experience for training as future mental health professionals with specific competencies in the technical and relational field and developing critical ability and autonomy of judgement.


2021 - Body perception treatment, a possible way to treat body image disturbance in eating disorders: a case-control efficacy study [Articolo su rivista]
Artoni, P; Chierici, M L; Arnone, F; Cigarini, C; De Bernardis, E; Galeazzi, G M; Minneci, D G; Scita, F; Turrini, G; De Bernardis, M; Pingani, L
abstract

The body image disturbance (BID) is a common symptom in eating disorders, often observed and described in anorexia nervosa (AN) and bulimia nervosa (BN). Recently, this symptom has also been observed in binge eating disorder (BED). The research underlines that the BID presents three different altered components: affective, cognitive, and perceptual one. Current treatments for BID have mainly focused on the affective and cognitive components. Nowadays, the need emerges for treatments focused also on the perceptual component of the BID. In this paper, we present the results of an efficacy study on the body perception treatment (BPT), a new treatment for BID focused on the perceptual component of the disorder.


2021 - Diagnostic agreement between physicians and a consultation-liaison psychiatry team at a general hospital: An exploratory study across 20 years of referrals [Articolo su rivista]
Marchi, M.; Magarini, F. M.; Mattei, G.; Pingani, L.; Moscara, M.; Galeazzi, G. M.; Ferrari, S.
abstract

Consultation-liaison psychiatry (CLP) manages psychiatric care for patients admitted to a general hospital (GH) for somatic reasons. We evaluated patterns in psychiatric morbidity, reasons for referral and diagnostic concordance between referring doctors and CL psychiatrists. Referrals over the course of 20 years (2000-2019) made by the CLP Service at Modena GH (Italy) were retrospectively analyzed. Cohen’s kappa statistics were used to estimate the agreement between the diagnoses made by CL psychiatrist and the diagnoses considered by the referring doctors. The analyses covered 18,888 referrals. The most common referral reason was suspicion of depression (n = 4937; 32.3%), followed by agitation (n = 1534; 10.0%). Psychiatric diagnoses were established for 13,883 (73.8%) referrals. Fair agreement was found for depressive disorders (kappa = 0.281) and for delirium (kappa = 0.342), which increased for anxiety comorbid depression (kappa = 0.305) and hyperkinetic delirium (kappa = 0.504). Moderate agreement was found for alcohol or substance abuse (kappa = 0.574). Referring doctors correctly recognized psychiatric conditions due to their exogenous etiology or clear clinical signs; in addition, the presence of positive symptoms (such as panic or agitation) increased diagnostic concordance. Close daily collaboration between CL psychiatrists and GH doctors lead to improvements in the ability to properly detect comorbid psychiatric conditions.


2021 - Factors associated with the transition of adolescent inpatients from an intensive residential ward to adult mental health services [Articolo su rivista]
Pontoni, G.; Di Pietro, E.; Neri, T.; Mattei, G.; Longo, F.; Neviani, V.; Neri, G.; Stagi, P.; Caffo, E.; Starace, F.; Galeazzi, G. M.
abstract

Transition of young people from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) is a complex process. Transition rates are heterogeneously reported, with wide definitions and ranges. Few data are available regarding predictive factors of a successful transition. We explored factors associated with transition in a cohort of former inpatients of a Children and Adolescents Intensive Treatment Ward (CAITW). Socio-demographic and clinical features of patients previously admitted to CAITW were matched to AMHS data for those patients having reached age requirements. We built multiple logistic regression models to identify factors associated with transfer to AMHS (either inpatient or outpatient) and with successful retention in treatment (RIT) at six (short RIT), 12 (intermediate RIT) and 24 months after transfer (long RIT). From a cohort of 322 inpatients, 126 reached the age threshold for transfer to AMHS in the study period. The transfer rate was 50%. Two years after transition-age boundary, CAMHS-AMHS continuity of care was found in 40% and disengagement in 6% of cases. Longer and multiple hospitalizations, atypical antipsychotics prescription and a diagnosis of psychotic disorders were factors associated with short and intermediate RIT. A positive psychiatric family history was negatively associated with successful short and intermediate RIT. Diagnosis of psychosis and learning-supported school attendance were associated with long RIT. Young adults with a history of psychiatric inpatient admission as children or adolescents have a relatively high rate of transition to AMHS. A diagnosis of psychosis seems to be the strongest predictor for transition in these patients. Further research should focus on patients’ schooling needs and on children of parents with mental health problems to enhance family and educational system engagement.


2021 - Group clinical supervision in adult mental health settings [Articolo su rivista]
Galletti, Martina; Moscara, Maria; Mattei, Giorgio; Balducci, Jessica; Sacchetti, Andrea; Venturi, Giulia; Visentini, Chiara; Ferrari, Silvia; Galeazzi, Gian M.
abstract


2021 - Impact of Antidepressant Prescriptions on Suicidal Behavior in Times of Severe Financial Strain [Articolo su rivista]
Sacchi, V.; Mattei, G.; Musetti, L.; Galeazzi, G. M.
abstract

This descriptive study observes the relationship between antidepressant prescriptions and the suicide rate in Italy in the 2000s to the mid-2010s, which includes a period of severe economic crisis. The observation period was from 2000 to 2015. Suicide and unemployment rates disaggregated by age and sex were collected from the Italian Institute of Statistics. Statistical analyses were performed using correlations between suicide rates and the defined daily dose, with reference to selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and other types of antidepressants. Fixed-effects panel regressions were also run. Increases in SSRIs prescriptions were associated with decreases in suicide rates among both men and women. However, when the analyses were adjusted for the rate of growth of the unemployment rate and for gross domestic product, the associations were weaker. The potential protective factor of SSRIs with respect to suicidal behavior may be reduced by severe recessions, especially when unemployment increases. © 2021 Wolters Kluwer Health, Inc. All rights reserved.


2021 - Irrational beliefs about COVID-19: A scoping review [Articolo su rivista]
Magarini, F. M.; Pinelli, M.; Sinisi, A.; Ferrari, S.; De Fazio, G. L.; Galeazzi, G. M.
abstract

Since the emergence of the recent Coronavirus Disease of 2019 (COVID-19) and its spread as a pandemic, there has been a parallel spread of false and misleading information, known as an infodemic. The COVID-19 infodemic has induced distrust in scientific communities, governments, institutions and the population, and a confidence crisis that has led to harmful health behaviours, also impacting on mental health. The aim of this study is to provide a scoping review of the scientific literature about COVID-19-related misinformation and conspiracy theories, focusing on the construction of a conceptual framework which is useful for the interpretation of the conspiracy theory phenomenon surrounding COVID-19, and its consequences. Particular socio-environmental conditions (i.e., low educational level, younger age), psychological processes and attitudes (such as low levels of epistemic trust, the avoidance of uncertainty, extraversion, collective narcissism, and a conspiracy-prone mindset), and contextual factors (e.g., high levels of self-perceived risk and anxiety) seem to underpin the adherence to beliefs that are not solely the domain of paranoids and extremists but a widespread phenomenon that has caused important health, social and political consequences.


2021 - Is Consultation-Liaison Psychiatry ‘Getting Old’? How Psychiatry Referrals in the General Hospital Have Changed over 20 Years [Capitolo/Saggio]
Ferrari, S; Mattei, G; Marchi, M; Galeazzi, Gm; Pingani, L
abstract


2021 - Is orthorexia nervosa a feature of obsessive-compulsive disorder? A multicentric, controlled study [Articolo su rivista]
Vaccari, G; Cutino, A; Luisi, F; Giambalvo, N; Navab Daneshmand, S; Pinelli, M; Maina, G; Galeazzi, G M; Kaleci, S; Albert, U; Atti, A R; Ferrari, S
abstract

The term orthorexia nervosa (ON) was coined to describe altered thoughts and behaviours related to healthy eating. The prevalence of ON was found to scale up to almost 90% among high-risk populations (ballet dancers, athletes, and health workers). ON seem to share psychopathological aspects with both Eating Disorders (ED) and Obsessive-Compulsive Disorder (OCD). The aim of the study was to analyse the frequency and intensity of ON symptoms among subjects diagnosed with OCD, hypothesising that they would be higher than in two control groups (subjects with anxiety-depressive disorders and general population).


2021 - L'associazione tra fumo di tabacco e crisi economiche in Italia [Articolo su rivista]
Mattei, G.; Leone, E.; Venturi, G.; Pingani, L.; Ferrari, S.; Galeazzi, G. M.; De Vogli, R.
abstract

OBJECTIVES: to analyse the association between smoking behaviour and economic crises in Italy between 1993 and 2015. DESIGN: ecological study, carried out on data of the Italian National Institute of Statistics, by means of fixed-effect panel regressions. SETTING AND PARTICIPANTS: the rate of smoking prevalence (disaggregated by gender and age) and the unemployment rate (disaggregated by gender and referring to individuals aged 15 or more) were collected for each of the twenty Italian regions. Also, percentage fluctuations of the national real gross domestic product (GDP) were collected to identify the years of severe economic crisis. MAIN OUTCOME MEASURES: number of people who smoke per 100 people with the same features. RESULTS: among men, increased regional unemployment rate was associated with increased smoking behaviour only in the group aged 25-34 years. Differently, severe economic crises were associated with increased smoking in almost all age groups, except for men aged 15-24 years. A 1-point decrease in GDP was associated with 0.75 more smokers aged 15 years or more. The highest coefficient was reported among men aged 35-44 years, where a 1-point decrease in GDP was associated with 1.16 more smokers (every 100 men). This age group is also featured by the second highest prevalence of tobacco smoking (36.8%). Among women, a 1-point increase in the regional unemployment rate was associated with 0.08 less smokers every 100 women. Similarly, periods of severe economic crisis at national level were associated with reduced smoking behaviour among women aged 15 years or more, specifically those aged 15-24 years. Differently, women aged 25-34 and 65 years or more showed an association similar to that reported among men. In these groups, a 1-point decrease in GDP was associated with 0.67 and 1.08 more smokers every 100 women. While among the latter the prevalence of tobacco smoking is the lowest, among the former it is the third highest prevalence (21.69%). Therefore, increased smoking behaviour due to economic crises seems to occur especially among women aged 25-35 years old, as happens among men. CONCLUSIONS: men in almost all age groups and women aged 25-34 and 65 years or more represent vulnerable groups in which smoking behaviour may increase in times of economic hardship. Therefore, specific policies should be implemented to prevent this occurrence, as well as the negative health outcomes of tobacco smoking.


2021 - Patient subjective experience of treatment with long-acting injectable antipsychotics: A systematic review of qualitative studies|Experiência subjetiva do paciente no tratamento com antipsicóticos injetáveis de ação prolongada: Uma revisão sistemática de estudos qualitativos [Articolo su rivista]
Fiore, G.; Bertani, D. E.; Marchi, M.; Cardoso, G.; Galeazzi, G. M.
abstract

Objective: To gain a better understanding of how long-acting injectable antipsychotic (LAI) therapy is perceived by patients. Methods: A search for qualitative studies has been carried out on PubMed, Google Scholar, PsycINFO and PsycArticles, yielding 11 studies suitable for a review of qualitative studies. The reporting approach chosen was meta-ethnography, following the ENTREQ statement recommendations. Key concepts common to the different studies were extrapolated and then analysed in a systematic and comparative way. Results: Some recurrent issues were associated with LAIs, such as fear of coercion, fear of needles and lack of knowledge about depot therapy. These topics are linked to each other and the patients most concerned about the disadvantages of LAIs are those who are less informed about them, or who have experienced coercion and trauma during hospitalisation. On the other hand, patients who had already received LAIs, and those who had a good therapeutic relationship with their healthcare providers expressed satisfaction with this form of treatment and its continuation. Conclusion: Long-acting injectable antipsychotics are a tool in the management of mental disorders, and a viable alternative to oral medication. Patients show curiosity towards this method of administration, but lack of knowledge is a common finding. Shared decision making about the use of LAIs antipsychotics requires that patients receive accurate information and support for their decision regarding medication.


2021 - Politiche del lavoro e salute mentale: L'integrazione socio-assistenziale come strumento per favorire percorsi di recovery [Articolo su rivista]
Venturi, G.; Mattei, G.; Pistoresi, B.; Nora, A.; Addabbo, T.; Galeazzi, G. M.
abstract

Work and mental health have always been in a complex and dynamic relationship. The working activity can act, depending on its characteristics, as a possible risk or protective factor against the onset of mental illness. At the same time, labour is used in mental health services as a rehabilitation tool, representing a real hallmark of recovery. Both aspects will be addressed in this paper. First, we will focus on the employment / unemployment status of patients affected by severe psychiatric disorders, and we will outline the relationship between suicide, unemployment, and social spending. Then, the legislative innovations (Regional Law 14/2015) introduced by the Emilia-Romagna Region will be illustrated. This law has redesigned the work integration programmes of “fragile and vulnerable” people, in order to reach a full integration of social and health interventions. The aim of this work is to raise awareness and promote a multidisciplinary dialogue between different agencies active in the field of public policies, work and mental health, to reconcile the intrinsic complexities of the relationship between work and mental health. To this end, some experiences of job placement will be described, based on a fruitful collaboration between different professionals (mental health professionals, social services and charities) and institutions in the Province of Modena.


2021 - Preliminary results of a multidisciplinary italian study adopting a psycho-neuro-endocrine-immunological (Pnei) approach to the study of colorectal adenomas [Articolo su rivista]
Mancini, S.; Alboni, S.; Mattei, G.; Rioli, G.; Sena, P.; Marchi, M.; Sacchetti, A.; Boarino, V.; Roncucci, L.; Galeazzi, G. M.; Ferrari, S.
abstract

Background and aim of the work: Colorectal mucosal precancerous lesions, metabolic syndrome (MetS) and psychiatric disorders may share a common low-grade local and systemic inflammation. Aim is to report on preliminary data concerning a research adopting a psycho-neuro-endocrine-immune (PNEI) approach to study outpatients undergoing colonoscopy. Methods: A sample of patients undergoing colonosco-py was cross-sectionally investigated. Data on colorectal adenomas, MetS, early atherosclerosis, anxious-de-pressive symptoms, personality traits, and inflammatory markers were statistically analyzed. Results: Sixty-two patients were recruited (female 50%, mean age: 60.8±9.4 years). The prevalence of adenomas and MetS was respectively of 45.2% and 41.9%. Anxiety and depressive symptoms were detected in 16 (32.7%) and 9 (18.4%) subjects, respectively. The presence of adenomas positively correlated with male sex (p=0.01), age (p<0.01), IL-6 (p=0.03), hsCRP (p=0.04), and MetS (p=0.03); it was also associated with hsCRP concentra-tion (aOR=3.81, p=0.03). Conclusions: Proinflammatory atherogenic status, psychological traits, increased mucosal inflammation, and metabolic parameters may share a common a pathogenic mechanism, worth studying.


2021 - Sarcosine as an add-on treatment to antipsychotic medication for people with schizophrenia: a systematic review and meta-analysis of randomized controlled trials [Articolo su rivista]
Marchi, M.; Galli, G.; Magarini, F. M.; Mattei, G.; Galeazzi, G. M.
abstract

Background: N-methyl-glycine (sarcosine) may improve symptoms of schizophrenia via NMDA-receptor modulation. We undertook a systematic review and meta-analysis to determine the short- and long-term effectiveness of sarcosine for schizophrenia. Research design and methods: The databases Medline, Scopus, EMBASE, Cochrane Library, and PsycINFO were searched. We included six independent randomized controlled trials of sarcosine as add-on treatment to current antipsychotic medication, involving 234 adult participants with schizophrenia, and reporting data on symptom severity. Standardized mean differences (SMDs) were used to assess continuous outcomes. Results: In all of the trials, sarcosine was administered orally at 2 g/day. Treatment with sarcosine did not show a significant effect size at any of the pre-established time points (2, 4, 6, or >6 weeks), due to marked quantitative heterogeneity. However, sarcosine was associated with significant reductions of symptom severity in the subgroups of people with chronic schizophrenia and no treatment resistance (namely, without added-on clozapine) in relation to the SMD after 6 weeks treatment at −0.36 and −0.31, respectively. Conclusions: People with chronic and non-refractory schizophrenia may benefit from the use of sarcosine as an add-on treatment to antipsychotic medication. Due to the good tolerability of this compound, future trials with larger sample sizes appear worthwhile.


2021 - The cost of caring during recent epidemics: a rapid review of risk factors, psychological manifestations, and strategies for its treatment [Articolo su rivista]
Ferrara, M.; Funaro, M. C.; Vacca, F.; Kusmann, F.; Tedeschini, E.; Galeazzi, G. M.; Scattoni, M. L.; Starace, F.
abstract

BACKGROUND: During epidemics, health care workers (HCWs) are particularly exposed to the risk of secondary trauma. If not effectively addressed, the consequences of such psychological distress can progress to more severe conditions. METHODS: A systematic search of several databases on the effect of SARS, MERS, and COVID-19 epidemics on the mental health of HCWs was performed according to both the Cochrane Handbook for Systematic Reviews of Interventions and the WHO Rapid Review Guide for Health Policy and Systems Research. RESULTS: The 77 reviewed studies highlighted that work organization and individual characteristics can add to mental health risk. Providing adequate training to prevent infection and prepare HCWs to handle the epidemic, strengthening team work to improve organization, and ensuring appropriate protective equipment is available can help prevent risk of psychiatric illness. CONCLUSIONS: Monitoring and addressing through tailored interventions the mental health consequences of pandemics in HCWs is necessary.


2021 - Therapeutic Factors in a Psychiatric Group Therapy: a Preliminary Validation of Therapeutic Factors Inventory-8, Italian Version [Articolo su rivista]
Landi, Giulia; Simoni, Elena; Isotta, Landi; Galeazzi, Gian Maria; Moscara, Maria; Pighi, Marcella; Ferri, Paola; DI LORENZO, Rosaria
abstract

Several studies support group therapy effectiveness due to the activation in patients of unique psychological mechanisms defined as non-specific therapeutic factors (Therapeutic Factors-TFs), which shape the setting and, at the same time, enhance the specific group therapeutic factors. The objectives of this study were to preliminarly validate Therapeutic Factors Inventory-8 (TFI-8) Italian version and identify group therapeutic factors. In a psychiatric residential facility, a weekly psychotherapeutic group was evaluated during 1 year. One scale on group process (TFI-8, Ferrara-Group Experience Scale) and three clinical scales (Brief Symptom Inventory-53, Sheehan Disability Scale, WHO Quality of Life-Bref) were administered to participating patients. Internal consistency, Exploratory Factor Analysis (EFA), convergent validity of TFI-8 were assessed. Correlations between TFI-8 and other scale scores and selected variables were pwerformed. Our sample consisted of 64 participants. TFI-8 showed good internal consistency (Chronbach’s alpha = 0.84), concurrent validity with Fe-GES (Rho = 0.42, p = 0.0008). EFA highlighted a single Factor, accounting for 92% of variance. TFI-8 was not significantly related to clinical scale scores. TFI-8 Italian version proved to be a valid and reliable tool which allowed us to identify one therapeutic factor indicating relational attraction in group therapy, composed of three dimensions: infusion of hope, cohesion and social learning.


2021 - Time Waits for No One: Longitudinal Study on the Effects of an Anti-Stigma Seminar on the Psychology Student Population [Articolo su rivista]
Pingani, Luca; Evans-Lacko, Sara; Coriani, Sandra; Ferrari, Silvia; Filosa, Maria; Galeazzi, Gian Maria; Lorenzini, Mattia; Manari, Tommaso; Musetti, Alessandro; Nasi, Anna Maria; Franceschini, Christian
abstract


2021 - Transition Between Sensitive Delusion of Reference and Mood Disorder: A Case Report [Articolo su rivista]
Esposito, C. M.; Fiorentini, A.; Callari, A.; Galeazzi, G. M.; Brambilla, P.
abstract

The Sensitive Delusion of Reference is a clinical entity described by Ernst Kretschmer and never integrated into mainstream nosographic systems. It represents the possibility of developing psychosis starting from a personality characterized by sensitivity, scrupulousness, and fear of judgment of others. The presentation of the following clinical case highlights how the overlap between this clinical entity and mood disorders leads to characteristic psychopathology, which has not been sufficiently detailed. In particular, the delusions, which always starts from the idea of reference and the shame in the face of the judgment of others, takes on characteristics of guilt during the depressive phases and persecutory themes during the activation phases. This clinical observation, which obviously needs to be confirmed on a larger scale, encourages a renewed interest in the concept of Kretschmer's Sensitive Delusion of Reference and creates the possibility of intersecting multiple psychopathological levels, for a more complete perspective on the individual case.


2021 - Translation and validation of an Italian language version of the Religious Beliefs and Mental Illness Stigma Scale (I-RBMIS) [Articolo su rivista]
Pingani, Luca; Giberti, Sara; Coriani, Sandra; Ferrari, Silvia; Fierro, Lucia; Mattei, Giorgio; Maria Nasi, Anna; Pinelli, Giorgia; Wesselmann, Eric D.; Galeazzi, Gian Maria
abstract

The aim of this study is to validate the Italian version of the Religious Beliefs and Mental Illness Stigma Scale (I-RBMIS): a self-report measure of religious beliefs that may contribute to stigma regarding mental disorders. Scale validation included: linguistic validation; pilot test for understandability; face validity; factor analysis as test of dimensionality; Kaiser–Meyer–Olkin test to evaluate sample sampling adequacy; internal consistency was assessed using Cronbach’s alpha; scale validity was assessed through concurrent criterion validity using as gold standard the Italian version of Attribution Questionnaire 27 and mental health knowledge schedule; A total of 311 people agreed to participate in the study. Face validity showed that 13 items out of 16 were completely understandable while only three items (4, 9 and 13) highlighted small lexical concerns. The average compilation time was under 4 min. Bartlett’s test for sphericity was statistically significant (Χ2 = 1497.54; df = 120; p < 0.001). Cronbach's alpha values were acceptable both for the entire questionnaire (0.80) and for the morality/sin subscale (0.73), whereas it was slightly below the standard cutoff for the spiritually oriented causes/treatments (0.68). Scale validity showed a positive correlation between I-RBMIS and AQ-27-I, and a negative correlation between I-RBMIS and MAKS-I. I-RBMIS demonstrated good psychometric properties to assess stigmatizing religious beliefs toward mental illness in general population.


2021 - “Shedding Light on Light”: A Review on the Effects on Mental Health of Exposure to Optical Radiation [Articolo su rivista]
Bertani, Davide Elia; De Novellis, Antonella Maria Pia; Farina, Riccardo; Latella, Emanuela; Meloni, Matteo; Scala, Carmela; Valeo, Laura; Galeazzi, Gian Maria; Ferrari, Silvia
abstract

In relation to human health and functioning, light, or more specifically optical radiation, plays many roles, beyond allowing vision. These may be summarized as: regulation of circadian rhythms; consequences of direct exposure to the skin; and more indirect effects on well-being and functioning, also related to lifestyle and contact with natural and urban environments. Impact on mental health is relevant for any of these specifications and supports a clinical use of this knowledge for the treatment of psychiatric conditions, such as depression or anxiety, somatic symptom disor-der, and others, with reference to light therapy in particular. The scope of this narrative review is to provide a summary of recent findings and evidence on the regulating functions of light on human beings’ biology, with a specific focus on mental health, its prevention and care.


2020 - Affective and sexual needs of residents in psychiatric facilities: A qualitative approach [Articolo su rivista]
Landi, G.; Marchi, M.; Ettalibi, M. Y.; Mattei, G.; Pingani, L.; Sacchi, V.; Galeazzi, G. M.
abstract

Background: The affective and sexual needs of psychiatric patients are often under-considered, although they contribute significantly to their general well-being. Such topics are critical for Residential Psychiatric Facilities Users (RPFUs), whose daily life is paced by therapeutic settings. The aim of this paper is to better understand how sexuality and affectivity are expressed by the RPFUs at the Mental Health Department of Modena, within psychiatric residential settings. Methods: Adult RPFUs took part into two audio recorded focus groups. Digital transcripts were analyzed using MAXQDA software in order to perform qualitative narrative analysis, so as to develop a hierarchical code system a posteriori (derived from the data). Results: Eleven participants (eight RPFUs and three investigators) attended the first focus group, and eight participants (5 RPFUs and 3 investigators) attended the second focus group. 175 interventions were analyzed and coded under seven thematic areas: (a) contraception and sexually transmitted disease prevention (N = 17); (b) affective needs (N = 11); (c) personal experiences (N = 61); (d) regulation of sexual relations (N = 18); (e) Mental Health Professionals' (MHPs) openness towards the topic (N = 17); (f) MHPs' responses to RPFUs' sexual behaviors (N = 33); and (g) RPFUs proposals (N = 18). The highlighted topics suggest that affective and sexual relations commonly occur within residential psychiatric facilities, even if mental health services often fail to recognize and address RPFUs' affective and sexual needs as well as to provide effective solutions to manage them. Conclusions: RPFUs expressed a request for support to fulfill their affective and sexual needs and dedicated spaces for sexual activities to relieve their discomfort, while MHPs highlighted a need for awareness, training, and shared problem-solving strategies.


2020 - Analisi retrospettiva di una serie di stalker violenti [Analisi retrospettiva di una serie di stalker violenti] [Articolo su rivista]
Sgarbi, C.; Mattei, G.; Sinisi, A.; Gallocchio, F.; Ferrari, S.; Galeazzi, G. M.; De Fazio, L.
abstract

Stalking is often complicated by violent acts, which can be severe or even lethal. We analysed data collected in 2010 for the “Stalking and Risk of Violence” project, summarized in a database of 59 cases of stalking resulting in severe violence. A descriptive analysis and uni – and multivariate logistic regression analyses were carried out on the sample, in order to identify factors associated with severe violence. The univariate analysis revealed that substances abuse, previous convictions, threating behaviours, a low level of education in the stalker were often accompanied by a violent outcome. The multivariate analysis showed that previous contact of the stalker with mental health centres was associated with substance abuse, lurking and the homicidal outcome of the stalking. Further research is needed to confirm these findings in prospective cohorts and to take them into account in prevention programs


2020 - Anxiety, depression and personality traits in Italian medical students [Articolo su rivista]
Bertani, Davide E.; Mattei, Giorgio; Ferrari, Silvia; Pingani, Luca; Galeazzi, Gian Maria
abstract

Background. Anxiety and depressive symptoms are common worldwide and, according to the World Health Organization, their prevalence has increased in the last decades. Further, dysfunctional personality traits are frequently coupled with anxiety and depressive symptoms. The prevalence of these symptoms is particularly relevant in medical students. Methods. This study assessed the prevalence of anxiety and depressive symptoms in Italian medical students from the University of Modena and Reggio Emilia, by using the Hospital Anxiety and Depression Scale (HADS). Personality traits were assessed as well by employing the Personality Inventory for DSM-5, Brief Form (PID-5-BF), to explore their association with anxiety and depressive symptoms. A self-administered questionnaire was sent by e-mail to all the 944 students and 459 (48.6%) were enrolled. Besides the HADS and the PID-5-BF, the questionnaire included items concerning everyday life activities such as sports and academic features such as the years of attendance and average marks. Results. A high prevalence of anxiety (n=92; 20%), depression (n=32; 7%), and comorbid anxiety-depressive symptoms (n=218; 47%) was reported. Multiple binary logistic analysis showed increased levels of anxiety and depression to be associated with personality traits, namely detachment and negative affect, and use of cognitive enhancers. On the other hand, sports activities, social activities and distraction were related to lower levels of symptoms. Conclusions. Symptoms of depression and anxiety are common among Italian medical students and specific interventions should be implemented to target them.


2020 - Can stigmatizing attitudes be prevented in psychology students? [Articolo su rivista]
Pingani, L.; Coriani, S.; Galeazzi, G. M.; Nasi, A. M.; Franceschini, C.
abstract

Background: Stigmatizing attitudes have been found among psychology students in many studies, and they are becoming more common with time. Aims: This study examines whether participation in clinical psychology lessons reduces levels of stigmatization in a population of psychology students and whether it leads to any change in stigmatization. Methods: The study is a pre/post evaluation of the effectiveness of clinical psychology lessons (63 hours of lectures) as a tool to fight stigma. The presence of stigmatizing attitudes was detected using the Italian version of the Attribution Questionnaire-27 (AQ-27-I). Stigmatization was described before and after the lessons with structured equation modeling (SEM). Results: Of a total of 387 students contacted, 302 (78.04%) agreed to be involved in the study, but only 266 (68.73%) completed the questionnaires at both t0 and t1. A statistically significant reduction was seen in all six scales and the total score on the AQ-27-I. The models defined by the SEM (pre- and post-intervention) showed excellent model fit indices and described different dynamics of the phenomenon of stigma. Conclusions: A cycle of clinical psychology lessons can be a useful tool for reducing stigmatizing attitudes in a population of students seeking a psychology degree.


2020 - Clinical and Socio-demographic Variables Associated with the Outcome of Vocational Rehabilitation Programs: A Community-Based Italian Study [Articolo su rivista]
Mattei, G; Venturi, G; Alfieri, S; Colombini, N; Ferrari, S; Rigatelli, M; Starace, F; Galeazzi, G M
abstract

This study aims to identify clinical and socio-demographic variables associated with the outcome of vocational rehabilitation programs (VRPs). All users of an Italian Community Mental Health Centre (CMHC) included in VRPs delivered according to the model of Supported Employment in years 2011-2016 were retrospectively enrolled. Fifty users who ended the program with employment were compared with fifty users who dropped out, with respect to clinical and socio-demographic variables. VRPs lasting less than 6 months and oriented toward the competitive labor market had a higher probability of employment. Among users who successfully ended the VRP, the median of health interventions significantly decreased after employment. In the same group of users, less non-health interventions strictly linked to the VRP were required, when compared with users who dropped out. We conclude that employment is associated with improvement of users' clinical conditions and reduced workload for the CMHC.


2020 - Collective trauma and experience of uncertainty: a comparison between the 2012 earthquake and the 2020 pandemic in Italy [Articolo su rivista]
Moscara, M.; Mattei, G.; Galeazzi, G. M.
abstract

The situation of uncertainty several people faced in Italy due to the SARS-CoV-2 epidemic suggested this contribution concerning the potential outcomes in some safety areas of the primary needs of the individual: safety and security needs, love and belonging needs, esteem, and self-actualization. When uncertainty features one or more of them, the risk of health outcomes increases, specifically with respect to mental health. This contribution compares the experience of the severe earthquake that hit Emilia-Romagna region (North Italy) in May 2012 and the epidemic of CoViD-19 officially started in Italy in February 2020. Both experiences were lived by the authors, as citizens and mental health professionals. The considerations presented stemmed out from the clinical experience and are articulated around some key words: surprise, length, places, society, work, welfare, feelings, economics. Similarities and differences are presented, suggesting that new therapeutic devices are necessary, to hold and treat patients during this specific epidemic, as well as during future ones. Up to the moment we have just been able to chase the shadow, by integrating medieval systems (quarantine) and hyper-technological systems (i.e., the most advanced resuscitation techniques).


2020 - Digital Interventions for Screening and Treating Common Mental Disorders or Symptoms of Common Mental Illness in Adults: Systematic Review and Meta-analysis [Articolo su rivista]
Sin, J.; Galeazzi, G.; Mcgregor, E.; Collom, J.; Taylor, A.; Barrett, B.; Lawrence, V.; Henderson, C.
abstract

BACKGROUND: Digital interventions targeting common mental disorders (CMDs) or symptoms of CMDs are growing rapidly and gaining popularity, probably in response to the increased prevalence of CMDs and better awareness of early help-seeking and self-care. However, no previous systematic reviews that focus on these novel interventions were found. OBJECTIVE: This systematic review aims to scope entirely web-based interventions that provided screening and signposting for treatment, including self-management strategies, for people with CMDs or subthreshold symptoms. In addition, a meta-analysis was conducted to evaluate the effectiveness of these interventions for mental well-being and mental health outcomes. METHODS: Ten electronic databases including MEDLINE, PsycINFO, and EMBASE were searched from January 1, 1999, to early April 2020. We included randomized controlled trials (RCTs) that evaluated a digital intervention (1) targeting adults with symptoms of CMDs, (2) providing both screening and signposting to other resources including self-care, and (3) delivered entirely through the internet. Intervention characteristics including target population, platform used, key design features, and outcome measure results were extracted and compared. Trial outcome results were included in a meta-analysis on the effectiveness of users' well-being and mental health outcomes. We also rated the meta-analysis results with the Grading of Recommendations, Assessment, Development, and Evaluations approach to establish the quality of the evidence. RESULTS: The electronic searches yielded 21 papers describing 16 discrete digital interventions. These interventions were investigated in 19 unique trials including 1 (5%) health economic study. Most studies were conducted in Australia and North America. The targeted populations varied from the general population to allied health professionals. All interventions offered algorithm-driven screening with measures to assess symptom levels and to assign treatment options including automatic web-based psychoeducation, self-care strategies, and signposting to existing services. A meta-analysis of usable trial data showed that digital interventions improved well-being (3 randomized controlled trials [RCTs]; n=1307; standardized mean difference [SMD] 0.40; 95% CI 0.29 to 0.51; I2=28%; fixed effect), symptoms of mental illness (6 RCTs; n=992; SMD -0.29; 95% CI -0.49 to -0.09; I2=51%; random effects), and work and social functioning (3 RCTs; n=795; SMD -0.16; 95% CI -0.30 to -0.02; I2=0%; fixed effect) compared with waitlist or attention control. However, some follow-up data failed to show any sustained effects beyond the post intervention time point. Data on mechanisms of change and cost-effectiveness were also lacking, precluding further analysis. CONCLUSIONS: Digital mental health interventions to assess and signpost people experiencing symptoms of CMDs appear to be acceptable to a sufficient number of people and appear to have enough evidence for effectiveness to warrant further study. We recommend that future studies incorporate economic analysis and process evaluation to assess the mechanisms of action and cost-effectiveness to aid scaling of the implementation.


2020 - Effectiveness of vocational rehabilitation programs carried out according to the Emilia-Romagna Regional Act 14/2015 [Articolo su rivista]
Spiga, G.; Mattei, G.; Alfieri, S. G.; Colombini, N.; Galeazzi, G. M.
abstract

The aim of this retrospective observational study was to measure the effectiveness of VRPs carried out in an Italian Community Mental Health Center (CMHC) according to the regional Act 14/2015. As far as clinical variables are concerned, we compared a group of patients included in vocational rehabilitation according to the Regional Act 14/2015 (exposed, group A and B) with a non-experimental group of patients of the same CMHC who were not included in such programs (not exposed, group C). Among the exposed, we distinguished between those who successfully ended the VRP with employment (group A) and those who dropped out (group B). Statistics were carried out by means of simple and multiple binary logistic regressions, and Student’s t-test. A total of 117 patients were enrolled in this study, divided into three groups: group A (N.=57), group B (N.=19), and group C (N.=41). It was noted that none of the users had organic comorbidities. We found that having a Social Services caseworker allocated was associated with higher odds of being included in group A (OR=11.49, 95% CI: 3.56-37.03), while receiving long-acting antipsychotic therapy was negatively associated with the same outcome (OR=0.19, 95% CI: 0.05-0.67). Notably, patients included in VRPs did not need compulsory admissions during the follow-up period. As far as group A is concerned, the number of visits at the CMHC decreased for 61% of the individuals, and drug prescription decreased or remained stable for 75% of the patients. Notably, in this group, the mean number of visits to the CMHC significantly reduced after the beginning of VRPs (t=2.32, P=0.03). Our data indicate that VRPs can promote clinical stabilization for CMHCs users, which has been confirmed by the international literature.


2020 - Experiences, opinions and current policies on users' choice and change of the allocated primary mental health professional: A survey among directors of community mental health centers in the Emilia-Romagna region, Italy [Articolo su rivista]
Rioli, G.; Ferrari, S.; Henderson, C.; Galeazzi, G. M.
abstract

Background: The subject of how the initial allocation of the primary mental health professional (PMHP) in community mental health services is made and the frequency and management of users' requests to choose and/or change their allocated PMHPs has been scarcely investigated. The present paper is aimed at exploring the experiences and opinions of directors of community mental health centers (CMHC) on this topic. Methods: A cross-sectional survey was conducted. Electronic ad hoc questionnaires with both multiple choice and open-ended questions were e-mailed to the institutional addresses of CMHC directors in the Emilia-Romagna Region (Northern Italy) with the consent of their heads of department and the Ethical Committee. Quantitative data were analysed by means of Microsoft Excel software and STATA 14.2 (College Station, TX), while the qualitative analysis was performed using the Nvivo12 software. Results: Twenty-eight questionnaires were collected (response rate: 71.8%) that were equally distributed between males and females. For the initial PMHP allocation, casual allocation by "fixed-rota" was commonly performed (39.3%). Moreover, hope for a change of prescription by a different psychiatrist was the most frequent reason for users' requests to change their PMHP. In two mental health departments only (Parma and Bologna), written guidelines to manage users' requests of change of PMHP were available. In this context, most participants classified the explored topics as relevant and believed that written policies, especially if shared with users, could be useful. Conclusions: In Emilia-Romagna CMHCs, neither users nor professionals were generally involved in the initial choice of the PMHP. Further national-level studies should be conducted in order to confirm this finding. Additionally, written and shared guidelines for managing users' request to choose/change their PHMP may be useful.


2020 - Investigating the association between physicians self-efficacy regarding communication skills and risk of “burnout” [Articolo su rivista]
Messerotti, Andrea; Banchelli, Federico; Ferrari, Silvia; Barbieri, Emiliano; Bettelli, Francesca; Bandieri, Elena; Giusti, Davide; Catellani, Hillary; Borelli, Eleonora; Colaci, Elisabetta; Pioli, Valeria; Morselli, Monica; Forghieri, Fabio; Galeazzi, Gian Maria; Marasca, Roberto; Bigi, Sarah; D’Amico, Roberto; Martin, Peter; Efficace, Fabio; Luppi, Mario; Potenza, Leonardo
abstract


2020 - Is consultation-liaison psychiatry ‘getting old’? How psychiatry referrals in the general hospital have changed over 20 years [Articolo su rivista]
Ferrari, S.; Mattei, G.; Marchi, M.; Galeazzi, G. M.; Pingani, L.
abstract

There is an ever-growing awareness of the health-related special needs of older patients, and Consultation-Liaison Psychiatry Services (CLPS) are significantly involved in providing such age-friendly hospital care. CLPS perform psychiatric assessment for hospitalized patients with suspected medical-psychiatric comorbidity and support ward teams in a bio-psycho-social oriented care management. Changes in features of the population referred to a CLPS over a 20-year course were analysed and discussed, especially comparing older and younger referred subjects. Epidemiological and clinical data from all first psychiatric consultations carried out at the Modena (North of Italy) University Hospital CLPS in the period 2000–2019 (N = 19,278) were included; two groups of consultations were created according to the age of patients: OV65 (consultations for patients older than 64 years) and NONOV65 (all the rest of consultations). Consultations for OV65 were about 38.9% of the total assessments performed, with an average of approximately 375 per year, vs. the 589 performed for NOV65. The number of referrals for older patients significantly increased over the 20 years. The mean age and the male/female ratio of the sample changed significantly across the years in the whole sample as well as both among OV65 and NOV65. Urgent referrals were more frequent among NOV65 and the rate between urgent/non urgent referrals changed differently in the two subgroups. The analysis outlined recurring patterns that should guide future clinical, training and research activities.


2020 - La relazione tra credito e comportamento suicidario in Italia [Working paper]
Mattei, G.; Pistoresi, B.; Galeazzi, G. M.
abstract

In this study we assessed the relation between suicide rates and credit cycle in Italy between 1990 and 2014, by means of fixed effects panel regressions, stratified by age, gender, and region. We also tested the possible mitigating role played by active labor market programs, public unemployment spending and overall expenditure in social protection measures. Credit cycle was proxied by the rate of growth of the credit to Gross Domestic Product (GDP) ratio. The analysis pointed out that in Italy credit cycle and suicide rates are complementary: when the former decreases, the latter increase. This association is noticeable among men: a decrease of 1% in the rate of growth of the credit to GDP ratio induces an increase of around 1.18-1.31% in the suicide rate. Young men aged 25-34 seem more vulnerable to this phenomenon. The association between credit cycle and suicidal behavior is noticeable both during normal and abnormal time periods (in this study, the latter is represented by the late-2000s financial crisis), in particular, among men aged 34-44. In contrast, suicidal behaviors among women do not seem to be influenced by credit cycle, but only by severe economic crises. With respect to social protection measures, only the amount of public unemployment spending proved to significantly moderate the relation between suicides and credit cycle, though with a regional specificity (only in the North-East of Italy). Our study suggests that access to credit may be a major determinant of psychological well-being for men, but not for women, both during normal times and during severe economic recessions. Also, both credit and social protection measures might be considered proxies of social capital, which are potentially able to counterbalance the increased level of anomie that may accompany periods of financial instability. Further research is needed to test the validity of our findings and assumptions in case of other countries.


2020 - Mental health and gambling in Italy during the economic crisis [Articolo su rivista]
Santoro, A.; Sacchi, V.; Mattei, G.; Galeazzi, G. M.
abstract

we investigated the relation between mental health and gambling during the recent economic crisis in Italy, by means of a descriptive study. The following regional variables were collected: health indicators, i.e. male and female rate of hospitalizations due to psychiatric disorders per 100,000 people (as proxy of the prevalence of mental disorders) and rate of hospital beds per 10,000 people; macroeconomic indicators (male and female unemployment rate, real GDP per capita); gambling indicators (annual overall expenditure in euros on gambling, namely slot machines, Bingo, horserace betting, sports betting and numerical games). Statistics were carried out by means of fixed-effects panel regressions. All data were retrieved from the Italian Institute of Statistics and from the Italian Agency of customs and monopolies. Expenditure on gambling in Italy steadily increased in years 2006-2016, rising from 7 billion euros to 13 billion euros. In the same period, a steady decrease in GDP was noticeable, coupled with increased UR. At regional level, Lombardy had the highest expenditure on gambling (290 Euros per adults in 2016), while Sicily, Calabria and Basilicata had the lowest. The results of regression models are displayed in Table I. Among both men and women increased UR was associated with decreased hospitalizations due to alcohol and substance use disorders, and with increased hospitalizations due to anxiety, somatoform, dissociative and personality disorders. Only among men, increased UR was associated with increased hospitalizations due to mood disorders at the 10% significance level. With respect to the rate of growth of GDP, a decrease in the latter was associated with increased substance and mood disorders among men. The same results were noticeable among women, though at the 10% significance level when substance use disorder was investigated. Noticeably, decreased GDP was associated with increased alcohol consumption among women but not among men


2020 - Off-label prescription of psychotropic medications in a sample of Italian psychiatrists working in private practice: a cross sectional study [Articolo su rivista]
Bonamici, Caterina; Guicciardi, Alessia; Curti, Alex; Atti, Anna Rita; Balducci, Jessica; Mattei, Giorgio; Valle, Letizia; Galeazzi, Gian Maria; Ferrari, Silvia
abstract

Background Off-label prescription refers to the use of a drug outside the terms of its Marketing Authorization. According to the literature, this practice is particularly common in clinical psychiatry. Objective To describe patterns of off-label prescription in a sample of Italian psychiatrists working in private practice. Methods An ad hoc questionnaire was developed and sent by e-mail to a sample of Italian psychiatrists working in private practice in the Region Emilia-Romagna. The questionnaire assessed frequency of off-label prescription, reasons associated with it, diagnostic categories more often associated with such practice, main sources of information used to support off-label prescription, and psychotropic agents most commonly prescribed off-label, as well as medical-legal implications. Data were analysed by means of univariate and multivariate ordered logistic regressions. Results Fifty psychiatrists (female: 44%) out of 129 who received the e-mail invitation responded (response rate: 39%). Off-label prescription was found to be inversely proportional to clinicians’ age (OR = 10.53 [95% CI 2.13-52.13]). Most commonly, second-generation antipsychotics (SGAs) were prescribed to patients diagnosed with personality disorders (PDs) (OR = 0.08 [95% CI 0.02-0.36]). A higher rate of off-label prescription was also associated to relying more on pharmaceutical sales representatives (OR = 0.58 [95%CI 0.01-0.30]) or personal professionals’ clinical experience (OR = 0.05 [95% CI 0.01-0.36]) and less on other colleagues’ experience (OR = 11.80 [95% CI 4.16-33.50]) as source of information. Conclusions Off-label prescription is common, especially among young psychiatrists, who frequently rely on previous personal clinical experience, especially when prescribing SGAs for treating patients with PDs. Respondents pointed to the need for further research and training on the topic addressed by the present study.


2020 - Stigma on Mental Health among High School Students: Validation of the Italian Version of the Attribution Questionnaire-27 (AQ-27-I) in a High School Student Population [Articolo su rivista]
Ferrari, Silvia; Bressi, Cinzia; Busnelli, Elisa; Mattei, Giorgio; Pozzoli, Sara; Oliva, Anna; Galeazzi, Gian Maria; Pingani, Luca
abstract


2020 - The COVID-19 recession might increase discriminating attitudes toward LGBT people and mental health problems due to minority stress [Articolo su rivista]
Mattei, G.; Russo, T.; Addabbo, T.; Galeazzi, G. M.
abstract

This letter to the Editor points the attention to the fact that the foreseen economic downturn related to the COVID 19 Crisis may lead to an increase to the discrimination of the lgbtiq+ population. This may lead to an increase to the minority streess experienced by this population and, consequently, to mental health difficulties. It supports this warning analysing and reporting data from he first survey on discrimination based on gender, sexual orientation and ethnicity was performed by the Italian National Institute of Statistics in 2011 (ISTAT, 2015) on a sample of about 8,000 individuals aged 18-74 years.


2020 - The choice and the change of the allocated primary mental health professional in community-based mental health services: A focus-group qualitative study [Articolo su rivista]
Rioli, G.; Ferrari, S.; Vandelli, R.; Giambalvo, N.; Minarini, A.; Artoni, C.; Galli, G.; Galeazzi, G. M.
abstract

Objectives It is generally agreed that it is important to take into consideration users' preferences in the choice of their allocated primary mental health professional (PMHP). Our aim was to explore experiences of users, care givers and psychiatrists on users' initial choice and request of change the PMHP in Community Mental Health Services (CMHSs). Methods Three focus groups were conducted in March-May 2017 in two CMHSs in Modena, Northern Italy. Transcripts were analyzed using MaxQda 11. Results Six users, 7 psychiatrists and 5 care givers were enrolled. Casual or fixed allocation is commonly performed (so-called “fixed rota”). Lack of empathy and a bad therapeutic relationship seem to be the most important reasons to change the PMHP. Conclusions Neither users nor professionals are generally involved in the initial choice of the PMHP. The availability of evidence-based guidelines for managing users' request to choose/change the PHMP may improve quality of care.


2020 - The impact of trauma, substance abuse, and psychiatric illness on suicidal and self-harm behaviours in a cohort of migrant detainees: An observational, prospective study [Articolo su rivista]
Marchi, Mattia; Artoni, Cecilia; Longo, Fedora; Magarini, Federica Maria; Aprile, Giovanni; Reggianini, Corinna; Florio, Debora; De Fazio, Giovanna Laura; Galeazzi, Gian Maria; Ferrari, Silvia
abstract

According to the WHO, detainees attempt suicide ten times more than the general population.


2020 - The relationship between credit and suicide in Italy [Articolo su rivista]
Mattei, Giorgio; Pistoresi, Barbara; Galeazzi, Gian Maria
abstract

OBJECTIVES: to analyse the association between suicide rates and credit to the economy in Italy, and the potential role of social protection measures (SPMs) as buffering mechanism. DESIGN: descriptive study. SETTING AND PARTICIPANTS: data were derived from the Italian National Institute of Statistics and from the Organisation for Economic Co-operation and Development. Fixed-effects panel regressions were run to test the association between male and female suicide rates and the rate of growth of the credit-to-GDP (CTG) ratio. The buffering role of social protection measures was investigated. The observation period was from 1990 to 2014. MAIN OUTCOME MEASURES: regional male and female rates of suicide. RESULTS: male suicide rate is influenced by the rate of growth of the CTG ratio: a one-unit decrease in the latter is associated with 1.26 more suicides every 10,000 people. This marginal effect was significant at 1% for men, but not significant for women. Unemployment rate and periods of mass job loss were not associated with the outcome. With respect to SPMs, only public unemployment spending was able to moderate the association between suicide rate and rate of growth of the CTG ratio. A one-unit increase in the rate of growth of public unemployment spending was associated with 0.12 less suicides every 10,000 people, but only among men. Younger and older men were more affected by credit reduction, namely those aged 15-44 years and 75 years or more. Differently, women were not influenced by credit reduction, but only by increased UR in the group aged 55-64 years. CONCLUSIONS: access to credit is a major determinant of psychological well-being for men, but not for women. The rate of growth of the CTG ratio may be more useful than other macroeconomic indicators at identifying the mental health outcomes of economic crises.


2020 - Users' choice and change of allocated primary mental health professional in community-based mental health services: A scoping review [Articolo su rivista]
Rioli, Giulia; Ferrari, Silvia; Henderson, Claire; Vandelli, Riccardo; Galli, Giacomo; Minarini, Alessandro; Galeazzi, Gian Maria
abstract

Background. The recovery model in mental health care emphasizes users’ right to be involved in key decisions of their care, including choice of one’s primary mental health professional (PMHP). Aims. The aim of this paper was to provide a scoping review of the literature on the topic of users’ choice, request of change and preferences for the PMHP in community mental health services. Method. A search of Pubmed, Cochrane Library, Web of Science and PsycINFO for papers in English was performed. Additional relevant research articles were identified through authors’ personal bibliography. Results. 2774 articles were screened and 38 papers were finally included. Four main aspects emerged: 1) the importance, for users, to be involved in the choice of their PMHP; 2) the importance, for users, of the continuity of care in the relationship with their PMHP; 3) factors of the user/PMHP dyad influencing users’ preferences; 4) the effect of choice on treatments’ outcomes. Conclusions. While it is generally agreed that it is important to consider users’ preferences in choosing or requesting to change their PMHP, little research on this topic is available. PMHPs’ and other stakeholders’ views should also be explored in order to discuss ethical and practical issues.


2020 - Validation of the Modena bleeding score in endoscopic sinus surgery [Articolo su rivista]
Alicandri-Ciufelli, M.; Pingani, L.; Maccarrone, F.; Anschuetz, L.; Mariano, D.; Galeazzi, G. M.; Presutti, L.; Molinari, G.
abstract

Introduction: The Modena bleeding score is a categorical rating scale that allows the assessment of the surgical field in relation to bleeding during endoscopic surgery. It has recently been presented and validated in the field of endoscopic ear surgery by the present authors. The Modena bleeding score provides five grades for rating the surgical field during endoscopic procedures (from grade 1 − no bleeding to grade 5 − bleeding that prevents every surgical procedure except those dedicated to bleeding control). Objective: The aim of this study was to validate the Modena bleeding score in the setting of endoscopic sinus surgery. Methods: Fifteen three-minute videos of endoscopic sinus surgery procedures (each containing three bleeding situations) were evaluated by 15 specialists, using the Modena bleeding score. Intra and inter-rater reliability were assessed, and the clinical validity of the Modena bleeding score was calculated using a referent standard. Results: The data analysis showed an intra-rater reliability ranging from 0.6336 to 0.861. The inter-rater reliability ranged from 0.676 to 0.844. The clinical validity was α = 0.70; confidence limits: 0.64 − 0.75, corresponding to substantial agreement. Conclusion: The Modena bleeding score is an effective method to score bleeding during endoscopic sinus surgery. Its application in future research could facilitate the performance and efficacy assessment of surgical techniques, materials or devices aimed to bleeding control during endoscopic sinus surgery.


2020 - Why candidates for liver transplantation should be considered as frail patients [Articolo su rivista]
Moscara, M.; Mattei, G.; Ferrari, S.; Galeazzi, G. M.
abstract


2019 - Acquired Hearing Loss, Anger, and Emotional Distress: The Mediating Role of Perceived Disability [Articolo su rivista]
Ferrari, Silvia; Monzani, Daniele; Gherpelli, Chiara; Mackinnon, Andrew; Mongelli, Francesca; Federici, Gaia; Forghieri, Matilde; Galeazzi, Gian Maria
abstract

The aim of the study was to test whether acquired hearing loss (AHL)-related perceived disability mediates the association between AHL and psychological outcomes, including anger. Two-hundred ninety-seven consecutive outpatients with AHL assessed by pure tone average (PTA) loss completed the following: Hearing Handicap Inventory for Adults (HHIA), State-Trait Anger Expression Inventory-2 (STAXI-2), Brief Symptom Inventory (BSI), Diagnostic Criteria for Use in Psychosomatic Research (DCPR), and Social Functioning Questionnaire. In the sample, composed of 44.5% males with a mean age of 53.8 and a mean PTA of 30.7, AHL was associated to perceived hearing handicap, also correlating to all psychological measures except DCPR demoralization. Associations were stronger between the HHIA-Emotional Subscale, STAXI-2 State Anger and Feeling Angry, and BSI-Somatization, Interpersonal Sensitivity, Depression, and Psychoticism. Perceived disability predicted the presence of almost all psychosocial outcomes and confirms to be the most significant target of clinical action.


2019 - Affective and sexual needs of residents in psychiatric facilities [Articolo su rivista]
Ettalibi, Mohamed Y.; Marchi, Mattia; Magarini, FEDERICA MARIA; Landi, Giulia; Mattei, Giorgio; Pingani, Luca; Galeazzi, Gian M.
abstract

INTRODUCTION: The expression of affectivity and sexuality are fundamental human rights. However, people diagnosed with severe mental disorders (SMDs) living in psychiatric facilities may find it difficult to fulfil their needs, which may be neglected and misunderstood by mental health professionals (MHPs). This paper summarizes current knowledge on this topic using a narrative review. EVIDENCE ACQUISITION: PubMed, PsycINFO, Web of Science and Scopus were searched for studies of the affectivity and sexual needs of service users with SMDs living in residential and other long-term-stay facilities. Of the 451 articles initially retrieved, 26 met the inclusion criteria of this review. EVIDENCE SYNTHESIS: The findings were reported under six main headings: sexual, affective and relational needs of mental health service users, views of MHPs on users’ sexuality, policies on the regulation and responses to users’ sexual and affective needs, sexual education and training aimed at both mental health service users and professionals, HIV/sexually transmitted diseases (STD) risk assessment and prevention programs, and contraception. CONCLUSIONS: Sexual relations are generally prohibited or discouraged within residential facilities, but it has nevertheless been found that many residents are sexually active. The denial of their sexual needs by residential staff and the absence of any dedicated setting for sexual relations within facilities are sources of substantial distress for residents. Studies have also found a lack of knowledge of STDs among users and discomfort of MHPs in dealing with the topic. Hence, educational and training interventions for both users and MHPs should be implemented. Specific policies and guidelines could be coproduced to enhance patients’ emotional and relational capabilities and encourage them to adopt healthier and safer sexual practices.


2019 - Factors Associated with Long-Stays in an Italian Psychiatric Intensive Treatment Facility: 1-Year Retrospective Observational Analysis [Articolo su rivista]
Di Lorenzo, Rosaria; Teresa, Olmi; Rioli, Giulia; Galeazzi, Gian Maria; Ferri, Paola
abstract

Psychiatric Intensive Treatment Facilities (PITF) are health inpatient settings for patients affected by sub-acute psychiatric disorders with impaired personal and social functioning. The aim of this study is to analyse the demographic and clinical variables related to long-stays in an Italian PITF in order to highlight the risk factors for stay lengthening. We retrospectively collected the selected variables from all patients and their stays in a PITF from 1 to 11-2016 to 31-10-2017.We divided the stays according to the median of duration, ≤29 and > 29 days, to compare selected variables in the two groups of stay length. Patients hospitalized for >29 days more frequently presented “Self-neglect”, nursing diagnosis NANDA-I, and needed economic social service support.Multiple linear regression revealed that the presence of some variables as “many medical consultations”, “economic social service support”, “clinical interviews extended to institutional figures” were statistically significantly associated with an increased stay duration, suggesting that both clinical severity and difficult economic conditions were associated with the lengthening of stay. The knowledge of these factors can contribute to improve psychiatric treatments, reducing potential risk conditions for patient institutional dependence.


2019 - How to Measure Knowledge About Mental Disorders? Validation of the Italian Version of the MAKS [Articolo su rivista]
Pingani, Luca; Gaia, Sampogna; Sara, Evans-Lacko; Benedetta, Gozzi; Vincenzo, Giallonardo; Mario, Luciano; Galeazzi, Gian Maria; Andrea, Fiorillo
abstract

The aim of this study is to validate the Italian version of the Mental Health Knowledge Schedule (MAKS-I). The validation process included: linguistic validation; analysis of the feasibility; face validity; internal consistency; floor and the ceiling effects; divergent validity. Multiple linear regression was performed to examine the relationship between mental health knowledge and independent variables. MAKS-I was administered to 453 people. The linguistic validation was successful and face validity of the questionnaire showed no critical issues. The estimated composite reliability was 0.638. Divergent validity was supported by lack of statistical significant correlation between MAKS-I and RIBS-I with a positive correlation index. Participation in seminars or conferences related to the issue of mental health stigma, gender, qualification and having a first or second-degree relatives with a psychiatric disorder can be considered possible predictors of the MAKS-I score. MAKS-I is a reliable questionnaire to assess mental health knowledge and familiarity with psychiatric clinical conditions in Italian language.


2019 - Impact of a day hospital facility on type and length of hospital stay: a cost-effectiveness analysis [Articolo su rivista]
Pollutri, Gabriella; Mattei, Giorgio; Colombini, Niccolò; Galeazzi, Gian M.
abstract

We evaluated whether participation in rehabilitation activities carried out at the Community Mental Health Center (CMHC) of Castelfranco Emilia (Modena, Italy) is associated with an improvement in relevant clinical outcomes measures. Also, we performed a cost-effectiveness analysis to estimate any reduction in admission costs related to the intervention.d female patients, aged ≥18, from the caseload ofthe CMHC of Castelfranco Emilia. The study was approved by the Local Ethical Committee of the Province of Modena and by the Local Health Agency of Modena. The sample was divided into two groups. The firstgroup was made up of patients attending the day hospital facility between January 1, 2008 and December 31, 2017. This group was compared with a non-experimental control group, made up of patients that did not attend the day hospital facility in the same period. Statistical analysis was performed by means of linear and logistic regressions, both univariate and multivariate. Also, Student’s t-test and Wilcoxon-Mann-Whitney’s Test were used, when appropriate.The sample was made up of 126 users (women: 57%),61 attending and 65 not attending the day hospital facility. Mean age was 49±14 years. The most common diagnoses were schizophrenic spectrum disorders (57%) and mood disorders (20%). The statistical analysis showed a reduction in the number of admissions in patients who attended the day hospital facility (z=2.79, P<0.01). By comparing attending and not attending patients, increased odds of voluntary admissions were noticeable among the former at the 10% significance level (OR=2.49, P=0.07). Compulsory admissions were more common in the control group rather than among patients attending the day hospital facility (38% vs. 19%, P=0.05). Also, though not confirmed at the multiple regression analysis, a trend towards an increase of the use of non-scheduled interventions and a reduction in the number of days as inpatients were noticeable among patients attending the day hospital facility. As far as the cost-effectiveness analysis is concerned, the estimated reduction in hospitalization costs was € 56.135 over 10 years


2019 - Minority stress and mental health among LGBT populations: an update on the evidence [Articolo su rivista]
Mongelli, Francesca; Perrone, Daniela; Balducci, Jessica; Sacchetti, Andrea; Ferrari, Silvia; Mattei, Giorgio; Galeazzi, Gian M.
abstract

INTRODUCTION: In the past five years, researchers have increasingly turned to the study of mental health outcomes in LGBT populations. The present paper summarizes recent literature on the relationship between minority stress experienced by sexual minorities and mental health. EVIDENCE ACQUISITION: PsycINFO, PubMed, and the EBSCO Psychology and Behavioral Science Collection were searched for papers concerning minority stress and mental health disparities in LGBT populations, published between 1 January 2014 and 30 June 2018. All collected papers were screened using the following criteria: study involving &gt;50 individuals; written in English; focusing on clinical outcomes of depression, suicidality, and substance use in relation to experienced minority stress. EVIDENCE SYNTHESIS: Sixty-two papers were included in this review. Findings are reported under three main headings: studies primarily focused on depression, studies concerning suicidality and suicide attempts, and papers analyzing the correlation between substance use and minority stress in LGBT populations. The included studies supported the minority stress model as a framework to better explain disparities in mental health outcomes in sexual minority populations. Higher rates of depression, suicidality, and substance use are reported in LGBT populations, as are the related minority stressors analyzed. CONCLUSIONS: Sexual minorities still face numerous mental health disparities. Research indicates that the levels of minority stressors positively predict mental health outcomes. Specific policies designed to support the civil rights of sexual minorities may help to overcome such inequalities.


2019 - Personality traits and physical activity may be involved in colorectal carcinogenesis: preliminary data from a cross-sectional study on patients undergoing colonoscopy [Articolo su rivista]
Marchi, Mattia; Mattei, Giorgio; Mancini, Stefano; Roncucci, Luca; Galeazzi, Gian M.; Ferrari, Silvia
abstract

The preliminary results of a study aiming at assessing potential risk factors for carcinogenesis, including metabolic and inflammatory parameters, life-style, psychosocial and personality traits, according to a holistic approach are here reported and briefly described. The presence of at least one adenoma was significantly associated to the TCI Self Transcendence (ST) domain (OR=1.36, p=0.04) and to the absence of regular physical activity (OR=0.14, P=0.03), that may suggest pathways to definition of high risk for metabolic syndrome and carcinogenesis.


2019 - Psychiatric referral in the terminally ill patient [Articolo su rivista]
Mattei, Giorgio; Colantoni, Alessandra; Visentini, Chiara; Galeazzi, Gian Maria; Ferrari, Silvia
abstract

The distinction between physiological and dysfunctional emotions in end-of-life care may be hard, for a twofold reason: on the one hand, the patient as a subject, with specific clinical features, personality, system of values; on the other hand, the clinical judgment by involved health professionals, particularly their specific cut-offs in discrimination between normal suffering and psychopathology. Both excessive/untimely medicalization and underestimation of medical conditions such as anxiety, depression, suicidal ideation, and insomnia may be a risk while dealing with end-of-life patients. Prompt, reliable psychiatric diagnosing contributes significantly to the major goal of dignity in death. The aims of a psychiatric consultation for patients with end-stage diseases should be: controlling concomitant psychiatric symptoms, managing pain and physical symptoms, assisting patient and relatives in the crisis-management, mediating conflicts between patient, family and ward personnel, and planning advocacy.


2019 - Rating surgical field quality in endoscopic ear surgery: proposal and validation of the "Modena Bleeding Score" [Articolo su rivista]
Alicandri-Ciufelli, M; Pingani, L; Mariano, D; Anschuetz, L; Molinari, G; Marchioni, D; Bonali, M; Galeazzi, Gm; Presutti, L.
abstract

PURPOSE: To develop and validate a bleeding score that could be applied in endoscopic ear surgery (EEarS). METHODS: A prospective validation study was performed. A new bleeding score, called "Modena Bleeding Score" (MBS), was created by the authors. It provides five grades for rating the surgical field during EEarS procedures (from grade 1-no bleeding to grade 5-bleeding that prevents every surgical procedure except those dedicated to bleeding control). A preliminary "face validity" was performed by 18 ENT specialists to assess possible misunderstandings in interpreting the scale. Then, 15 videos of endoscopic ear surgery procedures, each divided into three parts (t0, t1, and t2), were subsequently evaluated by 15 specialists, using MBS. The videos were randomly selected and assigned. Intra-rater reliability and inter-rater reliability were calculated. The clinical validity of the instrument was calculated using a referent standard (i.e., four ENT experts whose ratings were compared to those obtained by the former sample). RESULTS: The face validity showed a good consensus about the clarity and comprehension of the scale; both intra and inter-rater reliability demonstrated good performance (intra-rater reliability ranged from 0.741 to 0.991 and inter-rater reliability was 0.790); clinical validity also showed positive values, ranging from 0.75 to 0.93. CONCLUSIONS: MBS has proved to be an effective method to rate surgical field during EEarS, with good-to-excellent performances. Its use would possibly help comparisons of groups in clinical trials or comparisons between studies.


2019 - Stability of Psychiatric Diagnoses in Candidates to Liver Transplantation Referred to a Consultation-Liaison Psychiatry Service [Articolo su rivista]
Mattei, Giorgio; Moscara, Maria; Balducci, Jessica; Cavana, Silvia; Cherubini, Melissa; Piemonte, Chiara; Ferrari, Silvia; Galeazzi, Gian Maria
abstract

Objective: To investigate the stability over time of the psychiatric diagnoses among candidates to liver transplantation referred to a consultation-liaison psychiatric service. Method: Descriptive study, carried out at the Consultation-Liaison Psychiatry Service (CLPS) placed at the Modena (Italy) General University Hospital. All patients waiting for liver transplantation and repeatedly referred to the CLPS were enrolled. The observation period was from 1 January 2008 to 31 December 2013. Pearson’s coefficients were calculated to measure diagnostic stability (index referral vs. last referral). Results: One hundred patients were assessed (males 67%; mean age 53 ± 7 years old). The mean number of referrals for patients was 3 ± 2. The stability rate of psychiatric diagnosis was 64%. The following diagnoses or conditions were all significantly stable (i.e., all featured by r &gt; 0.5 and p &lt; 0.05): Adjustment disorder, depressive disorder, comorbid anxiety/depressive disorder, substance use disorder (including alcohol), absence of any disorder, and presence of any disorder. Conclusions: The good level of diagnostic stability displayed in the sample may be a function of the clinical and organizational “style” of the CLPS, namely the focus on identifying the prevailing personality traits, defensive mechanisms, and relational patterns.


2019 - The Association Between Symptoms of Anxiety, Depression, and Cardiovascular Risk Factors: Results From an Italian Cross-Sectional Study [Articolo su rivista]
Rioli, Giulia; Tassi, Silvia; Mattei, Giorgio; Ferrari, Silvia; Galeazzi, Gian Maria; Mancini, Stefano; Alboni, Silvia; Roncucci, Luca
abstract

Cardiovascular diseases, anxiety, and depression are among the most frequent clinical conditions in the Western world, often in comorbidity. Evidence regarding a shared pathophysiology suggests a mediating role by chronic systemic inflammation. The aims of this study were to measure the association between anxiety and depressive symptoms, cardiovascular risk factors, and inflammatory markers. Outpatients aged 40 years or more undergoing colonoscopy after positive fecal occult blood test were enrolled; the following data were collected: body mass index, blood pressure, blood glucose, lipid profile, C-reactive protein (CRP) level, carotid thickness, Hospital Anxiety and Depression Scale, Temperament and Character Inventory, INTERdisciplinary MEDicine Self-Assessment, and 36-Item Short-Form Health Survey scores. Fifty-four patients were enrolled; 30.2% had anxiety symptoms, 18.9% depressive symptoms, and 9.4% concomitant anxiety-depressive symptoms. Anxiety symptoms were associated with low high-density lipoprotein levels. Depressive symptoms were associated with CRP levels, providing supporting evidence for the role of inflammation in the pathophysiology of depression.


2018 - Are patients with pre-orthotopic liver transplant psychiatric consultation different in bio-psycho-social complexity from other consultation inpatients? A study from a Consultation-Liason Psychiatric Service. [Abstract in Rivista]
Cavana, S; Mattei, G; Rioli, G; Galletti, M; Perrone, D; Moscara, M; Galeazzi, Gm; Ferrari, S.
abstract

Are patients with pre-orthotopic liver transplant psychiatric consultation different in bio-psycho-social complexity from other consultation inpatients? A study from a Consultation-Liason Psychiatric Service.


2018 - Efficacy of animal assisted therapy on people with mental disorders: an update on the evidence [Articolo su rivista]
Spattini, Ludovica; Mattei, Giorgio; Raisi, Francesca; Ferrari, Silvia; Pingani, Luca; Galeazzi, Gian M.
abstract

INTRODUCTION: Animal assisted therapy (AAT) is a structured form of animal assisted intervention (AAI), which specifically adopts animals in healthcare services and education facilities, to achieve therapeutic goals. Although such interventions are widely used, nowadays, evidence supporting them is still largely lacking. A previously published review of the literature highlighted some promising effects of AAT on people presenting psychiatric disorders, though the quality of the studies included was generally low. In order to provide an update of recent evidence, the aim of this study was to systematically review randomized controlled trials (RCTs) published since 2000, involving people affected by mental disorders and receiving AAT. EVIDENCE ACQUISITION: The following databases were searched: CINHAL, EBSCO Psychology and Behavioural Science Collection, PubMed and Web of Science. 115 papers were obtained and screened: 28 were from CINHAL, PsycINFO and Psychology and Behavioural Science Collection altogether, 15 from PubMed and 72 from Web of Science. In addition to this, grey literature and references of already published reviews and meta-analyses on the topic were searched, resulting in the addition of 6 further articles. After screening, 10 RCTs were included in this review. EVIDENCE SYNTHESIS: Studies involving outpatients were more frequent than those involving inpatients; sample size was generally low. The majority of studies adopted scales routinely used in clinical trials, with a good level of validity and reliability. Five out of ten studies reported significant differences in the main outcomes favouring AAT. Most of the studies did not include any follow-up; yet, where prospective data were available, the benefits of AAT appeared long lasting. Drop-out rates were higher in studies involving outpatients. However, the only trial which enrolled both inpatients and outpatients showed a higher drop-out rate among the inpatients group, possibly due to their more severe psychopathology. CONCLUSIONS: Though a paucity of available studies partly limits our findings, AAT seems to improve empathy, socialization and communication, and to favour therapeutic alliance among patients who have difficulties with therapeutic programs adherence. AAT appears to be a feasible and well-received intervention, potentially with few or no side effects reported. However there is a need for further studies with larger sample sizes and high-quality research standards.


2018 - Excess mortality in people with mental illness: findings from a Northern Italy psychiatric case register [Articolo su rivista]
Starace, Fabrizio; Mungai, Francesco; Baccari, Flavia; Galeazzi, Gian Maria
abstract

Purpose People with mental disorders show mortality rates up to 22.2 times higher than that of the general population. In spite of progressive increase in life expectancy observed in the general population, the mortality gap of people suffering from mental health problems has gradually widened. The aim of this paper was to study mortality rates in people suffering from mental illness in a cohort of people (16,981 subjects) in the local mental health register of the province of Modena during the decade 2006–2015. Methods Standardized Mortality Ratios (SMRs) were calculated to compare the mortality of people with mental disorders to the mortality of people living in the province of Modena and the excess of mortality was studied in relation to the following variables: gender, age group, diagnosis and causes of death. In addition, Poisson regression analysis was performed to study the association between patient characteristics and mortality. Results An overall excess mortality of 80% was found in subjects under the care of mental health services as compared to the reference population (SMR = 1.8, 95% CI 1.7–1.9). Subjects in the 15–44 year group presented the highest SMR (9.2, 95% CI 6.9–11.4). The most prevalent cause of death was cancer (28.1% of deaths). At the Poisson regression, the diagnosis “Substance abuse and dependence” showed the highest relative risk (RR) (4.00). Moreover, being male, single, unemployed and with a lower qualification was associated with higher RRs. Conclusions Our study confirms that subjects with mental illness have higher SMR. Noteworthy, the overall higher risk of mortality was observed in the younger age group.


2018 - How the use of the term “schizo*” has changed in an Italian newspaper from 2001 to 2015: Findings from a descriptive analysis [Articolo su rivista]
Pingani, Luca; Sampogna, Gaia; Borghi, Giulia; Nasi, Annamaria; Coriani, Sandra; Luciano, Mario; Galeazzi, Gian Maria; Evans-Lacko, Sara; Fiorillo, Andrea
abstract

The study aims to report the number of newspaper articles including the word “schizo” in the period 2001 – 2015 and to identify possible predictors reinforcing negative stereotypes about people with schizophrenia. The electronic archives of the Italian newspaper “La Stampa” have been searched for the term “schizo”. Selected articles were grouped in articles related to mental health (rMH) or article not related to mental health (nrMH). 946 articles were identified. Schizophrenia-related terms were used in 356 (36.03%) article rMH, which mainly reinforce negative stereotypes regarding mental illness both in rMH and nrMH groups. Over time, only in the rMH group a significant reduction of articles reinforcing negative stereotypes was found. Several factors have been identified as predictors of article reinforcing negative stereotypes: unnecessarily dramatic or sensational headline or content; inaccurate or not in the correct context use of medical terminology; emphasis to the illness rather than to the person; mental disorders are the same; disclosure of particular individual has a mental illness. Although there has been a significant reduction in stigmatizing articles, in the rMH group one article out of three reinforces negative stereotypes.


2018 - Mental health, work and care: the value of multidisciplinary collaboration in psychiatry and occupational medicine [Articolo su rivista]
Mattei, Giorgio; Venturi, Giulia; Ferrari, Silvia; Galeazzi, Gian Maria
abstract

Objectives To investigate the relation between work and mental health in a multidisciplinary fashion. Methods This overview is based on books and articles purposely extracted from national and international literature published in the fields of psychiatry, occupational medicine, economics and labor law, written in Italian and English, without time limits; it is part of the BUDAPEST-RP Project launched in 2010 to study the effects of the economic crisis on the Italian population. Results Some features of work and the labour market in the context of the Fourth Industrial Revolution (desynchronization of time, increased external control, need of orderliness in the work relationships-i.e., decreased tolerance of work-conflicts, e.g., between the employer and the Unions-, hypernomia and heteronomy) mirror some psychopathological aspects of the pre-morbid personality prone to develop depression, and may act as environmental risk factors. This, coupled with increased unemployment and precariousness, especially affecting the young, prompt to finding evidence-based strategies to promote employment of people affected by mental disorders, seriously hit by unemployment in the years following the Great Recession. Conclusions Work organization is the common denominator between the work environment conceived as a risk or protective factor for psychiatric disorders and the use of work in the field of psychiatric rehabilitation, by means of vocational rehabilitation programs. Given the intrinsic complexity of this common ground, networking is required between professionals of different backgrounds, to develop a multidisciplinary approach in the fields of care, research and education, and to foster a better integration between occupational health and psychiatry.


2018 - Metabolic Syndrome, Anxiety and Depression in a Sample of Italian Primary Care Patients [Articolo su rivista]
Mattei, Giorgio; Padula, Maria Stella; Rioli, Giulia; Arginelli, Lodovico; Bursi, Roberto; Bursi, Serena; Epifani, Antonio Matteo; Pingani, Luca; Rigatelli, Marco; Rosato, Francesca Maria; Sacchetti, Andrea; Galeazzi, Gian Maria; Ferrari, Silvia
abstract

This cross-sectional study aimed at measuring the correlation and association of anxiety, depression and comorbid anxiety-depression symptoms with metabolic syndrome (MetS) in a sample of Italian primary care patients who attended their General Practitioner clinics over a 1-month period in 2013. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depressive symptoms. The sample was made up of 129 patients (57% women; mean age, 61 ± 12 years). The prevalence of MetS varied from 40% (Adult Treatment Panel III-Revised criteria) to 48% (International Diabetes Federation criteria). The prevalence of symptoms of anxiety, depression and comorbid anxiety and depression was, respectively, 26%, 2%, and 15%. MetS (defined according to Adult Treatment Panel III-Revised criteria) was associated with comorbid anxiety-depressive symptoms (odds ratio [OR] = 3.84, 95% confidence interval [CI] = 1.26–11.71), but not with anxiety or depressive symptoms only. Out of the individual components of MetS, enlarged waist circumference was associated with anxiety symptoms (OR = 4.22, 95% CI = 1.56–11.44).


2018 - Stakeholders' views on vocational rehabilitation programs: a call for collaboration with Occupational Health Physicians [Articolo su rivista]
Mattei, Giorgio; Sacchi, Valentina; Alfieri, Salvatore; Bisi, Antonella; Colombini, Niccolò; Ferrari, Silvia; Giubbarelli, Giuseppe; Gobba, Fabriziomaria; Modenese, Alberto; Pingani, Luca; Rigatelli, Marco; Rossetti, Marisa; Venturi, Giulia; Starace, Fabrizio; Galeazzi, Gian Maria
abstract

The triple-dip recession taking place in Italy in 2008-2014 impacted negatively on health, mainly by increasing the rate of unemployment. This increased the prevalence of mental health disorders, while reducing the number of available places on vocational rehabilitation programs (VRPs) delivered by the psychiatric services.


2018 - Use and Propensity to Use Substances as Cognitive Enhancers in Italian Medical Students [Articolo su rivista]
Pighi, Marcella; Pontoni, Giancarlo; Sinisi, Arianna; Ferrari, Silvia; Mattei, Giorgio; Pingani, Luca; Simoni, Elena; Galeazzi, Gian Maria
abstract

International media has paid attention to the use of substances by healthy subjects to enhance cognitive performance. Medical students are liable to use cognitive enhancers (CE) with the aim of improving academic performance. The study explored use and attitudes toward the use of CE in Italian medical students. The authors anonymously surveyed 433 medical students of the University of Modena and Reggio Emilia with an ad hoc 36-items questionnaire. CE were broadly defined as any substance taken with the purpose of improving cognitive functions, from readily available beverages and substances, such as coffee, tea, energy drinks, and supplements to prescription only medication, such as psychostimulants and modafinil. Response rate was 83.8% (n = 363). While the majority of the students (74.7%; n = 271) said that they had used substances to improvecognitivefunctions,only2students(0.6%)reportedtheuseofprescription-onlymedications in the last 30 days. Main reasons for not taking prescription-only drugs were concerns about safety and side effects, reported by 83.3% of students (n = 295). A positive attitude toward use was held by 60.3% (n = 219) subjects. The surveyed Italian medical students used many substances as CE, but this did not seem to apply significantly to psychostimulants. A multivariable analysis showed that the followingvariableswererelatedtothepropensitytousesubstancesasCE:malegender,self-reported memory impairment, concerns about worsening of cognitive performance, lifetime use of at least one illegal substance, use of any substance (both legal or illegal) in the last 30 days.


2017 - An Italian observational study on subclinical cardiovascular risk factors and depressive symptomatology. A suggestion for the potential utility of a sinergic cardio-psychiatric perspective [Abstract in Rivista]
Tassi, S.; Rioli, Giulia; Mattei, Giorgio; Mancini, Stefano; Alboni, Silvia; Roncucci, Luca; Sena, Paola; Mariani, Francesco; Marchi, Mattia; Fabbrizi, Andrea; Feltri, L.; Visentini, Chiara; Pollutri, Gabriella; Artoni, Cecilia; Saraceni, Serena; Galli, Giacomo; Spiga, Giulia; Minarini, Alessandro; Perrone, Daniela; Galletti, Martina; Giambalvo, Nina; Montardi, Giulia; Galeazzi, Gian Maria; Ferrari, Silvia
abstract

Introduction Growing evidence has been collected over the complex, intertwined pathophysiological connection among subclinical cardiovascular (CV) disease, i.e. atherosclerosis, systemic low pro-inflammatory states and psychiatric disorders/symptomatology (anxiety, depression), with controversial results. Aim Aim of this study was to investigate the possible link between subclinical CV risk factors (atherosclerosis), depressive symptoms, and inflammation. Methods Cross-sectional study. Inclusion criteria: outpatients aged ≥40 years, attending colonoscopy after positive faecal occult blood test, negative medical history for cancer. Collected data: blood pressure, glycaemia, lipid profile, waist circumference, BMI, PCR (C reactive protein), LPS (bacterial lipopolysaccharide), ultrasound carotid intima-media thickness (c-IMT). Psychometric tests: HADS, TCI, IMSA, SF36. Statistical analysis performed with STATA13. Results The 54 patients enrolled were equally distributed by gender. CV risk factors were common in the study population, with 33 patients (61.11%) with hypertension, 14 (25.93%) with hyperglycaemia, 20 (37.4%) with hypertriglyceridemia, 19 (35.19%) with low HDL and 64.81% with overweight. High levels of PCR were found in 24 subjects (44.44%). Right c-IMT was increased in 26.41% of the sample, and 11.32% had an atheromatous plaque. Left c-IMT was increased in 24.53% of patients, with a plaque in 7.55% of them. Clinically relevant depressive symptoms were found in the 18.87% of the sample and were statistically significantly associated with PCR (OR = 28.63; P = 0.01). Conclusions Evidence contributing to the so-called “inflammation theory” of depression and supporting the association between mood and CV disorders was here collected, supporting the need for a multidisciplinary approach to the diagnosis and treatment of such conditions, assuming a clinically-translated PNEI (psycho-neuro-endocrino-immunological) perspective.


2017 - An update on Current Clinical Management of Eating Disorders. [Articolo su rivista]
Spattini, Ludovica; Rioli, Giulia; Longo, Fedora; Ferrari, Silvia; Galeazzi, Gian Maria
abstract

This paper aims to review the most updated literarature on the clinical management of Eating Disorders.


2017 - An update on intimate partner violence and mental health [Articolo su rivista]
Rioli, Giulia; Sgarbi, Chiara; Moretti, Valentina; Sinisi, Arianna; DE FAZIO, Giovanna Laura; Giambalvo, Nina; Ferrari, Silvia; Galeazzi, Gian Maria
abstract

INTRODUCTIONː Intimate partner violence (IPV) is a problem worldwide and a human rights issue. The present paper summarizes recent literature on the relationship between IPV and mental health, exploring risk factors for psychiatric patients to be victims and/or perpetrators of violent behavior in intimate relationships. EVIDENCE ACQUISITION: A search of PubMed, PsychINFO and Cochrane Library databases was performed, looking for papers concerning IPV and psychiatry published between 2011 and 2016. Papers were retrieved and reviewed according to PRISMA statement guidelines. Only research papers with sample sizes >50 adult subjects were included, leading to a first selection of 1486 records. Titles and abstracts were independently screened by three pairs of researchers, following predefined criteria agreed by the authors, yielding 93 articles for review. EVIDENCE SYNTHESIS: Mental disorders, especially posttraumatic stress disorder (PTSD) and depression, are associated with risk for perpetrating IPV. Confounding factors of this association are substance use/dependence, childhood adversity, previous IPV perpetration. Psychiatric patients are at high risk of becoming victims of IPV, but specific risk factors for victimization in this population have been poorly investigated. Rates of PTSD, depression, anxiety and substance use disorders are higher among IPV victims than in the general population. Interpersonal variables and social factors play a key role both in the onset and in the recovery from mental disorders in the aftermath of IPV. CONCLUSIONS: Individuals suffering from a mental disorder are prone to be both victims and perpetrators of IPV. Further research efforts are needed to elucidate the risk factors for victimization, in order to devise effective risk management strategies.


2017 - Cardiovascular risk factors, anxiety symptoms and inflammation markers: Evidence of association from a cross-sectional study [Abstract in Rivista]
Rioli, Giulia; Tassi, S.; Mattei, Giorgio; Alboni, Silvia; Mancini, Stefano; Artoni, Cecilia; Galletti, Martina; Giambalvo, Nina; Galli, Giacomo; Marchi, Mattia; Minarini, Alessandro; Montardi, Giulia; Perrone, Daniela; Pollutri, Gabriella; Roncucci, Luca; Saraceni, Serena; Spiga, Giulia; Visentini, Chiara; Galeazzi, Gian Maria; Ferrari, Silvia
abstract

Introduction Anxiety disorders and Cardiovascular (CV) diseases, among the most common disorders in Western World, are often comorbid. A chronic systemic inflammatory state might be a shared underlining pathophysiological mechanism. Aims To investigate the association between anxiety symptoms, CV risks factors and inflammatory markers in an outpatient sample. Methods Cross-sectional study. Inclusion criteria: outpatients aged ≥40 years, attending colonoscopy after positive faecal occult blood test, negative medical history for cancer. Collected data: blood pressure, glycaemia, lipid profile, waist circumference, BMI, PCR (C Reactive Protein), LPS (bacterial Lipopolysaccharide). Psychometric tests: HADS, TCI, IMSA, SF36. Statistical analysis performed with STATA13. Results Fifty four patients enrolled (27 males, 27 females). Sixteen patients (30.19%) were positive for anxiety symptoms. Thirty-three patients (61.11%) had hypertension, 14 (25.93%) hyperglycaemia and 64.81% were overweight, with frank obesity (BMI≥ 30) in 11 subjects (20.37%). Anxiety symptoms were associated with low hematic HDL values (OR = 0.01; P = 0.01) and high concentration of triglycerides (OR = 0.023; P = 0.02) at the multiple regression model. At the univariate logistic analysis, anxiety was associated with LPS (OR = 1.06; P = 0.04). Conclusions Further evidence over the epidemiological link between common mental disorders and CV diseases was collected, with possible hints on pathophysiology and causative mechanisms related to inflammation. The importance of screening for anxiety and depression in medical populations is confirmed. Suggestions on future availability of screening tools based on inflammatory-related indicators should be the focus of future research.


2017 - Effectiveness and acceptability of psycho-education group intervention for people hospitalized in psychiatric wards and nurses [Articolo su rivista]
Mattei, G.; Raisi, F.; Burattini, M.; Galeazzi, G. M.; Mazzi, F.; Pingani, L.; Reggianini, C.; Rigatelli, M.; Righi, A.; Starace, F.; Vallone, P.; Ferrari, S.
abstract

Objective: To assess effectiveness and acceptability of a Psycho-education Group Intervention (PGI) on a sample of patients admitted to a Psychiatric Inpatient Unit (PIU) and on ward nurses. Methods: Case-control study. PGI was delivered according to the model of Vendittelli and colleagues (2008). Male and female patients aged 18-70 were eligible. Cases attended the PGI, while controls did not. A 5-item ad hoc Likert-scale was used to record ward atmosphere. The Italian version of the Simple Feedback Question Form for people attending Cognitive Behaviour Therapy Group (SFQF-CBTG) was administered to each patient before discharge. The primary outcome was readmission rate after 6 months from discharge, secondary outcomes were ratings of ward atmosphere by nurses and feed-back from people hospitalized. All Statistics were performed with STATA 13.1. Results: Fifty-two patients were enrolled, 17 cases and 35 controls. No significant differences emerged in the primary outcome, though compulsory readmissions were noticeable only among controls. Ratings of ward atmosphere in relation to group activities did not differ. Seventeen SFQF-CBTG were filled in. Most cases reported at discharge to have found the group "helpful", stating that "they would attend it in the future again", and "group topics were not difficult". Conclusions: No evidence emerged in favour or against effectiveness of the PGI for patients and ward nurses, though the intervention was rated as acceptable and feasible.


2017 - Impact of anxiety-depressive symptoms on outpatients’ quality of life: Preliminary results from an Italian observational study [Abstract in Rivista]
Tassi, S.; Rioli, Giulia; Mattei, Giorgio; Ferrari, Silvia; Galeazzi, Gian Maria
abstract

Introduction Several studies have shown an association between the Short-Form 36 (SF36) scores and anxiety-depressive symptoms, suggesting that depression in particular could reduce Quality of Life (QoL) to the same, and even greater, extent than chronic noncommunicable diseases, such as diabetes and hypertension. Aims To explore the relationshipamongQoL and anxiety, depressive and anxiety-depressive symptoms in an outpatient sample. Methods Cross-sectional study. Inclusion criteria: outpatients aged ≥40 years, without history for cancer, attending colonoscopy after positive faecal occult blood test. Collected data: blood pressure, blood glucose, lipid profile. Psychometric test: Hospital Anxiety and Depression Scale (HADS). QoL was assessed with SF36. Statistics performed with STATA13. Results 54 patients enrolled (27 females). Sixteen patients (30.2%) were positive for anxiety symptoms, ten (18.9%) for depressive symptoms and five (9.4%) for anxiety-depressive symptoms. The perceived QoL was precarious in twelve subjects (22.2%): eight (15.9%) had low score (≤ 42) at “Mental Component Summary” (MCS) subscale, three (5.7%) at the “Mental Health” item and one patient (1.9%) at the “Vitality” one. At the multiple regression analysis, depressive (OR = 28.63; P = 0.01) and anxiety-depressive symptoms (OR = 11.16; P = 0.02) were associated with MCS. Conclusions The association emerging from the present study between depressive/anxiety symptoms and the MCS component of SF36 is consistent with available literature. Study design and small sample size do not allow to generalize results, that need further studies to be confirmed.


2017 - Impact of the economic crisis on health-related behaviors in Italy [Articolo su rivista]
Mattei, Giorgio; DE VOGLI, Roberto; Ferrari, Silvia; Pingani, Luca; Rigatelli, Marco; Galeazzi, Gian Maria
abstract

Evidence exists supporting the impact of the Great Recession on health-related behaviors internationally, though few studies are available concerning the Italian population.


2017 - Indicators of Complex Care During the Consultation-Liaison Psychiatry Activity at the Transplant Center of the Policlinico Hospital, Modena [Articolo su rivista]
Mattei, Giorgio; Laghi, Alessandro; Balduzzi, Sara; Moscara, Maria; Piemonte, Chiara; Reggianini, Corinna; Rigatelli, Marco; Ferrari, Silvia; Pingani, Luca; Galeazzi, Gian Maria
abstract

OBJECTIVE: The objective of this study was to identify possible biopsychosocial predictors of organizational complexity in patients referred to the consultant psychiatrist for assessment before liver transplantation. METHODS: This was a case-control study. All psychiatric consultations performed before and after liver transplantation from January 1, 2008 to December 31, 2013 were included. Complexity was operationalized as "undergoing two or more psychiatric consultations". Controls were defined as patients who were assessed only once by the consultant. Cases were represented by patients who underwent two or more consultations. Statistical analysis was performed with STATA 13.1, using logistic regressions. RESULTS: In this study, 515 consultations were requested for 309 patients potentially eligible for liver transplantation. Controls were 209 (67.6%); cases were 100 (32.4%). Positive psychiatric history (odds ratio [OR] = 2.44; 95% confidence interval [CI], 1.43-4.16), viral or toxic (alcohol- or drug-related) liver disease (OR = 1.93; 95% CI, 1.09-3.42), use of psychotropic medications at the baseline (OR = 2.15; 95% CI, 1.14-4.07), and female gender (OR = 1.77; 95% CI, 1.01-3.11) were significantly associated with an increased probability of being cases. CONCLUSIONS: Positive psychiatric history, viral or toxic liver disease, use of psychotropic medications at the index referral, and female gender are possible biopsychosocial predictors of complexity in patients eligible for liver transplantation.


2017 - La consulenza psichiatrica nel paziente candidato a trapianto di fegato Implicazioni per la clinica, la formazione e la ricerca [Articolo su rivista]
Mattei, Giorgio; Moscara, Maria; Ferrari, Silvia; Galeazzi, Gian Maria
abstract

Resoconto e riflessioni rispetto all'attività di consulenza psichiatrica nell'ambito dell'iter trapiantologico epatico, relative a questioni cliniche (es. necessità di lavoro in rete per i pazienti a rischio di ricaduta nella dipendenza da alcool), a questioni formative (necessità per operatori di formarsi nella valutazione prognostica e di complessità bio-psico-sociale) e a questioni di ricerca (breve descrizione delle attività svolte ed in corso da parte del servizio di consulenza psichiatrica dell'Università di Modena & Reggio Emilia/Dipartimento di Salute Mentale di Modena).


2017 - N-acetylcysteine in the treatment of psychiatric disorders: current status and future prospects [Articolo su rivista]
Minarini, Alessandro; Ferrari, Silvia; Galletti, Martina; Giambalvo, Nina; Perrone, Daniela; Rioli, Giulia; Galeazzi, Gian Maria
abstract

N-acetylcysteine (NAC) is widely known for its role as a mucolytic and as an antidote to paracetamol overdose. There is increasing interest in the use of NAC in the treatment of several psychiatric disorders. The rationale for the administration of NAC in psychiatric conditions is based on its role as a precursor to the antioxidant glutathione, and its action as a modulating agent of glutamatergic, dopaminergic, neurotropic and inflammatory pathways. Areas covered: This study reviews the available data regarding the use of NAC in different psychiatric disorders including substance use disorders, autism, obsessive-compulsive spectrum disorders, schizophrenia, depression, bipolar disorder. Promising results were found in trials testing the use of NAC, mainly as an add-on treatment, in cannabis use disorder in young people, depression in bipolar disorder, negative symptoms in schizophrenia, and excoriation (skin-picking) disorder. Despite initial optimism, recent findings regarding NAC efficacy in autism have been disappointing. Expert opinion: These preliminary positive results require further confirmation in larger samples and with longer follow-ups. Given its high tolerability and wide availability, NAC represents an important target to investigate in the field of new adjunctive treatments for psychiatric conditions.


2017 - Situazione, qualità della vita e trattamento di persone dimesse dall'Ospedale Psichiatrico Giudiziario di Reggio Emilia: Follow up a due anni [Articolo su rivista]
Moretti, Valentina; Sinisi, Arianna; Mattei, Giorgio; Galeazzi, Gian Maria
abstract

Il processo di superamento degli Ospedali Psichiatrici Giudiziari (OPG) Italiani ha comportato la dimissione della maggioranza delle persone recluse. Scopo dello studio è effettuare un follow-up dei pazienti dimessi da un reparto dell’OPG di Reggio Emilia. Attraverso la somministrazione di questionari rivolti a pazienti e operatori sono stati valutati: funzionamento del percorso di dimissione, recidive di violenza, condizioni psicopatologiche, terapia e qualità della vita dei pazienti. I risultati relativi a 23 pazienti mostrano che la dimissione verso strutture a minore intensità assistenziale è possibile e apprezzata. Non si sono rilevate correlazioni significative tra gli esiti e le misure di valutazione del rischio pre-dimissione. Fenomeni che necessitano di monitoraggio sono alcuni casi di suicidio nella coorte iniziale di 63 pazienti e il ricorso a terapie farmacologiche off label.


2016 - Acute and transient psychoses: Clinical and nosological issues [Articolo su rivista]
Castagnini, Augusto C; Galeazzi, Gian Maria
abstract

This article examines the clinical, epidemiological and nosological aspects of short-lived psychotic disorders as currently classified under ‘acute and transient psychotic disorders’ in ICD-10 and ‘brief psychotic disorder’ in DSM-5. After describing earlier diagnostic concepts such as bouffée délirante, cycloid psychosis, reactive psychosis and schizophreniform psychosis, we present an overview of the literature and discuss implications for classification, diagnosis and treatment of these conditions, pointing out differences from longer-lasting psychotic disorders.


2016 - Posturographic destabilization in eating disorders in female patients exposed to body image related phobic stimuli [Articolo su rivista]
Forghieri, M; Monzani, Daniele; Mackinnon, A; Ferrari, Silvia; Gherpelli, Chiara; Galeazzi, Gian Maria
abstract

Human postural control is dependent on the central integration of vestibular, visual and proprioceptive inputs. Psychological states can affect balance control: anxiety, in particular, has been shown to influence balance mediated by visual stimuli. We hypothesized that patients with eating disorders would show postural destabilization when exposed to their image in a mirror and to the image of a fashion model representing their body ideal in comparison to body neutral stimuli. Seventeen females patients attending a day centre for the treatment of eating disorders were administered psychometric measures of body dissatisfaction, anxiety, depression and underwent posturographic measures with their eyes closed, open, watching a neutral stimulus, while exposed to a full length mirror and to an image of a fashion model corresponding to their body image. Results were compared to those obtained by eighteen healthy subjects. Eating disordered patients showed higher levels of body dissatisfaction and higher postural destabilization than controls, but this was limited to the conditions in which they were exposed to their mirror image or a fashion model image. Postural destabilization under these conditions correlated with measures of body dissatisfaction. In eating disordered patients, body related stimuli seem to act as phobic stimuli in the posturographic paradigm used. If confirmed, this has the potential to be developed for diagnostic and therapeutic purposes.


2015 - Apple or pear? A cross sectional study on the association between body shape and symptoms of anxiety and depression in primary care female patients [Abstract in Rivista]
Rioli, G; Mattei, Giorgio; Ferrari, Silvia; Bursi, S; Rigatelli, Marco; Pingani, Luca; Galeazzi, Gian Maria
abstract

INTRODUCTION - "Apple" body shape (Waist-to-Hip Ratio, WHR>1) is a documented risk factor for cardiovascular diseases, the first cause of morbility and mortality in Western societies. Mental disorders, especially anxiety and depression, are also related to cardiovascular diseases with accumulating evidence that these conditions have in common a dysregulation of inflammatory pathways. Nevertheless, joint assessment of WHR and symptoms of anxiety and depression has not been reported commonly so far. AIM - To explore the association between WHR and symptoms of anxiety and depression in a female primary care sample. METHODS - Cross-sectional design. Evaluation of all consecutive women undergoing a GP consultation in a Northern Italy Practice. Exclusion criteria: age <40 or >80; use of antidepressants or antipsychotics; previous stroke or heart attack; obesity due to hereditary. Psychometric assessment was done by HADS (Hospital Anxiety and Depression Scale). Statistical analysis was performed using STATA. RESULTS - 125 women were assessed. WHR was inversely associated to HADS-Anxiety subscale score (β=-5.28, p=.02) e HADS-Depression subscale score(β=-4.02, p=.04) in the 40-60 years’ subgroup. In particular, WC was positively related to HADS-A (β=13.39, p=.02) e HADS-D (β=10.38, p=.03) while HC was inversely associated to HADS-A (β=-11.3, p=.01) and HADS-D (β=-8.6, p=.03). No associations were found in older groups. CONCLUSION - 'Pear” body shape (WHR<1), with a peripheral distribution of fat, is inversely associated to symptoms of anxiety and depression in women aged 40 to 60. The post-menopausal transition to the 'apple” model, with a central fat distribution, could explain the lack of correlations in women >60 years.


2015 - Association between anxiety and depressive symptoms with metabolic syndrome in primary care: Results of an Italian cross-sectional study involving outpatients [Abstract in Rivista]
Mattei, G; Rioli, G; Ferrari, Silvia; Galeazzi, Gian Maria; Bursi, S; Padula, Sm; Pingani, Luca; Rigatelli, Marco
abstract

Background: Metabolic syndrome (MetS) is a heterogeneous entity represented by the coexistence of multiple alterations: abdominal adiposity, impaired glucose tolerance, hypertriglyceridemia, HDL hypocolesterolemia and hypertension. Symptoms of anxiety and depression are frequently comorbid with MetS. Aim of the present study was to measure the association between symptoms of anxiety and depression with the five criteria of MetS in outpatients attending GPs' practices. Method: This is a cross-sectional study, involving male and female patients aged 40–80 attending five GPs' practices within one month in Modena, Northern Italy approved by the local Ethical Committee. All patients were screened for the presence of MetS and depressive/ anxiety symptoms, using the Hospital Anxiety and Depression Scale. Exclusion criteria: age b40 or N80; use of antidepressants or antipsychotics; previous stroke, heart attack or cardiovascular disease; diagnosed psychotic or mood disorder (according to the DSM-IV-TR); diabetes; pregnancy; hereditary disease linked to obesity. All data were adjusted for socio-demographic confounders. Multiple logistic analysis performed with STATA 13.0. Results: 128 subjects were enrolled in the study (55 men and 73 women), 48 presented with MetS (ATP-III-Revised criteria). MetS was associated with depression only in the female group (OR =6.33, p= 0.01), also when adjusting for age (OR =5.13, p= 0.02). MetS was not associated with anxiety in both males and females, and with depression in men. Among the individual components of MetS, only waist circumference was associated with anxiety in the female group (OR=4.40, p=0.04) also when adjusting for age (OR=4.34, p=0.04). Conclusion: Women aged between 40 and 60, presenting with MetS and attending the primary care services should been regularly screened for the presence of depression. Chronic systemic inflammation could represent the biological link between MetS and psychological symptoms. Further researches are needed to better clarify this possible relation.


2015 - Association between symptoms of anxiety and depression and BMI in Primary Care patients: a cross sectional study [Abstract in Rivista]
Mattei, Giorgio; Rioli, G; Ferrari, Silvia; Bursi, S; Pingani, Luca; Rigatelli, Marco; Galeazzi, Gian Maria
abstract

Background: Metabolic syndrome (MetS) is a heterogeneous entity represented by the coexistence of multiple alterations: abdominaladiposity, impaired glucose tolerance, hypertriglyceridemia, HDL hypocolesterolemia and hypertension. Symptoms of anxiety and depression are frequently comorbid with MetS. Aim of the present study was to measure the association between symptoms of anxiety and depression with the five criteria of MetS in outpatients attending GPs' practices. Method: This is a cross-sectional study, involving male and female patients aged 40–80 attending five GPs' practices within one month in Modena, Northern Italy approved by the local Ethical Committee. All patients were screened for the presence of MetS and depressive/ anxiety symptoms, using the Hospital Anxiety and Depression Scale. Exclusion criteria: age b40 or N80; use of antidepressants or antipsychotics; previous stroke, heart attack or cardiovascular disease; diagnosed psychotic or mood disorder (according to the DSM-IV-TR); diabetes; pregnancy; hereditary disease linked to obesity. All data were adjusted for socio-demographic confounders. Multiple logistic analysis performed with STATA 13.0. Results: 128 subjects were enrolled in the study (55 men and 73 women), 48 presented with MetS (ATP-III-Revised criteria). MetS was associated with depression only in the female group (OR =6.33, p= 0.01), also when adjusting for age (OR =5.13, p= 0.02). MetS was not associated with anxiety in both males and females, and with depression in men. Among the individual components of MetS, only waist circumference was associated with anxiety in the female group (OR=4.40, p=0.04) also when adjusting for age (OR=4.34, p=0.04). Conclusion: Women aged between 40 and 60, presenting with MetS and attending the primary care services should been regularly screened for the presence of depression. Chronic systemic inflammation could represent the biological link between MetS and psychological symptoms. Further researches are needed to better clarify this possible relation.


2015 - I disturbi muscolo-scheletrici lavoro-correlati negli addetti alle professioni sanitarie: cause, sintomi, rimedi [Articolo su rivista]
Roggia, E.; Gobba, Fabriziomaria; Rovesta, Claudio; Galeazzi, Gian Maria; Monzani, Daniele
abstract

I DMS-LC, ai quali si associano quasi costantemente dolore e limitazione funzionale, comprendono le infiammazioni tendinee (tendinopatia della cuffia dei rotatori, epicondilite, borsite del ginocchio) riferibili per lo più a sovraccarichi funzionali, le sindromi compressive (sindrome del tunnel carpale), le degenerazioni/dislocazioni dei dischi intervertebrali con conseguente insorgenza di sindromi compressive a livellodelle radici dei nervi spinali (cervico-brachialgia, lombo-sciatalgia) o più genericamente le mialgie distrettuali (soprattutto del collo del trapezio e della schiena) a patogenesi multifattoriale. Anche alcune patologie cronico-degenerative delle articolazioni, come ad esempio l’osteoartrosi del ginocchio, sono più frequenti in alcune categorie di lavoratori rispetto alla popolazione in generale .


2015 - Is hyperglycemia associated with anxious-depressive symptoms? An Italian study in primary care setting [Abstract in Rivista]
Rioli, G; Mattei, Giorgio; Galeazzi, Gian Maria; Ferrari, Silvia; Bursi, S; Pingani, Luca; Rigatelli, Marco
abstract

Background: Recent researches exploring the relationship between impaired glucidic tolerance, hyperglycemia or frank type II diabetes mellitus and symptoms of anxiety and depression, mostly conducted on in-patients or highly selected samples and on foreign populations, have reported conflicting results. Nevertheless, these medical and mental conditions are often comorbid in clinical practice. Chronic and systemic inflammation could represent the trait d\'union between these conditions. Primary care represents an interesting setting for exploring this comorbidity, given the high prevalence of psychiatric symptoms displayed by patients. The aims of this research was to measure the association between hyperglycemia and symptoms of anxiety and/or depression in out-patients, and to fill the lack of studies on comorbidity between depression and anxiety disorders and medical conditions in Primary Care services. Method: The present was a cross-sectional study. We evaluated all consecutive patients undergoing a GP consultation in a Northern Italy practice. Exclusion criteria: age b40 or N80; use of antidepressants or antipsychotics medication; psychosis (schizophrenia, schizoaffective, bipolar, organic, or tall as psychotic disorder by DSM IV-TR) or major depression; pregnancy; previous stroke or heart attack; type I diabetes mellitus. The psychometric assessment was done by HADS (Hospital Anxiety and Depression Scale). Blood Glucose measurements (BM) in the last 6 months were considered in our analysis. Hyperglycemia cutoff: blood glucose N100 mg/dl. The statistical analysis was performed using STATA with multiple linear regressions. Results: 209 subjects were recruited in our study (84 men and 125 women). Of those, 48 (22.9%) were affected by hyperglycemia: 22 were men and 26 women. Hyperglycemia was related to HADS-D score in the men sample (β = .44, p = .01). No association was found between hyperglycemia and HADS-A, either in men or in women. Conclusion: The presence of hyperglycemia, well-known cardiovascular risk factor, may have a clinical value in predicting the presence of depressive symptoms, especially in men. Further studies should examine whether our results are generalizable to other populations and whether they are applicable to clinical depression. Molecular researches could focus on clarifying the pathophysiological reasons for such association, also exploring reasons for sex differences.


2015 - Is low blood pressure always healthy? Evidence of an inverse association between depressive symptoms and arterial blood pressure in a primary care sample [Abstract in Rivista]
Rioli, G; Mattei, Giorgio; Galeazzi, Gian Maria; Ferrari, Silvia; Bursi, S; Pingani, Luca; Rigatelli, Marco
abstract

Background: Common mental health problems, such as anxiety and depression, have been related to the imbalance of the autonomous nervous system, also involved in blood pressure regulation. Low blood pressure readings have mainly been regarded as positive, but recent studies suggest low blood pressure is correlated with depression. The aim of the present research was to investigate the relationship between symptoms of anxiety and depression and blood pressure measures in a primary care sample. Method: We conducted a cross-sectional study that received the approval of the local Ethical Committee. All consecutive patients undergoing a GP consultation in a Northern Italy practice were evaluated, with the following exclusion criteria: age b40 or N80; use of antidepressants or antipsychotics medication; psychosis or major depression; previous stroke or heart attack; type I diabetes mellitus; obesity related to hereditary conditions; pregnancy. The psychometric assessment was done by HADS (Hospital Anxiety and Depression Scale). Arterial blood pressure was measured twice using a stethoscope and a sphygmomanometer at the right upper arm after 5 min of seated rest; the mean measure was considered. High Blood Pressure (BP) cut-offs: systolic BP ≥130 mm Hg and/or diastolic BP ≥ 85 mm Hg, according to IDF 2005 guidelines. The statistical multiple linear regression analysis was performed using STATA. Results: 209 subjects were enrolled in the study (125 women and 89 men). 122 subjects (58.1% of the whole sample) suffered from high blood pressure, and 98 of them (46.7%) followed an antihypertensive pharmacological therapy. A statistically significant inverse correlation between high diastolic BP and symptoms of depression at the HADS-D scale (β= −.28, p= .01) was found in the whole sample. The association was maintained in the male subsample, also after stratification by age, especially in the 40–60 years' group of patients (β=−.53, p =.04). On the contrary, no significant association was found between anxiety and BP measures. Conclusion: This study confirms an inverse association between high diastolic BP and depression at epidemiological level in an outpatients sample; longitudinal studies are needed in order to examine temporal occurrence and to explore the pathophysiology and the molecular mechanism at the basis of this association. Further researches should also investigate whether our results are generalizable to other populations.


2015 - La colonizzazione del rischio. Note sulla pratica della valutazione e gestione del rischio di violenza in psichiatria [Risk colonisation. Comments on assessment and risk management of violence in psychiatry] [Articolo su rivista]
Moretti, Valentina; Galeazzi, Gian Maria
abstract

The last decades have seen a growing interest in the topic on violence risk assessment and management for mentally disordered offenders. More and more often, professionals are requested to assess and manage this risk, in a process which could be defined as “risk colonisation”. In this context, a number of structured risk assessment tools have appeared, which claim to allow to take complex decision, such as those concerning the application of coercive measures, in a reliable and precise manner. We express our doubts on this practice, not limited to ethical issues, highlighting the technical shortcomings of these tools, in particular their insufficient positive predictive value, and some limits of the model of mental health and of patient-professional relationship their adoption often corresponds to. We hope professionals adopt instead a therapeutic risk taking stance, involving the coproduction of shared goals users and professionals contribute to in the context of a supporting team-user relationship. This means to share human, professional, and advocacy skills, involving other appropriate agencies and stakeholders, so that these goals are attained in a context which is sufficiently safe and responsive to needs.


2015 - Neuroenhancer use amongst Italian medical students: a survey [Abstract in Rivista]
Pighi, Marcella; Ferrari, Silvia; Pingani, Luca; Pontoni, G; Rigatelli, Marco; Galeazzi, Gian Maria
abstract

Introduction. Increasing use of substances by university students to improve cognitive performance ('neuroenhacement') has been reported. This refers not only to over-the-counter supplements, energy drinks, coffee and tobacco, but also to psychostimulants and modafinil. Little is known about this phenomenon in Italy. Aims. To explore prevalence of use of substances as cognitive enhancers by Italian medical students and their attitudes towards prescription-only medication (methylphenidate, amphetamine, atomoxetine, modafinil) used for this purpose. Methods An ad hoc questionnaire was distributed to 433 medical students of the University of Modena and Reggio Emilia. Valid response rate was 83.8% (N=363). Results 271 students (74.7%) reported use of substances to improve cognition in the last 30 days. Coffee (73%, N=265) and tea (33.3%, N=121) were the most used, followed by caffeinated sodas (15.7%, N=57), tobacco (10.2%, N=37) and vitamin B supplements (8.8%, N=32). Prescription-only medicines were used by 2 students (0.6%) and, overall, only 4 students reported lifetime use (1.2%). 295 (83.3% ) students mentioned concerns about safety and side effects as main reasons not to use. Use of cognitive enhancers as a group in the last 30 days slightly correlated with alcohol (r = 0.124; p = 0.023) and cannabis use (r = 0.114; p = 0.036). Conclusions Italian medical students use many substances as cognitive enhancers, but this seems not to apply to psychostimulants and modafinil. Cultural and regulatory differences may underlie this difference with other Countries, which warrants further research.


2015 - Nimodipine in otolaryngology: from past evidence to clinical perspectives [Articolo su rivista]
Monzani, Daniele; Genovese, Elisabetta; Pini, Luigi Alberto; DI Berardino, F; Alicandri Ciufelli, Matteo; Galeazzi, Gian Maria; Presutti, Livio
abstract

As L-type voltage-gated calcium channels (VGCCs) control Ca(2+) influx and depolarisation of cardiac and vascular smooth muscle, they represent a specific therapeutic target for calcium channel blockers (CCBs), which are approved and widely used to treat hypertension, myocardial ischaemia and arrhythmias. L-type currents also play a role in calcium entry in the sensory cells of the inner ear. In hair cells of both cochlea and labyrinth, calcium cytoplasmic influx is the first physiological process that activates complex intracellular enzymatic reactions resulting in neurotransmitter release. Excessive calcium ion entry into sensory cells, as a consequence of L-VGCCs malfunction is responsible for over-activation of phospholipase A2 and C, protein kinase II and C, nitric oxide synthase and both endonucleases and depolymerases, which can cause membrane damage and cellular death if the cytoplasmic buffering capacity is overcome. Nimodipine, a highly lipophilic 1-4 dihydropyridine that easily crosses the brain-blood barrier, is generally used to reduce the severity of neurological deficits resulting from vasospasm in patients with subarachnoid haemorrhage. Moreover, due to its selective blocking activity on L-channel calcium currents, nimodipine is also suggested to be an effective countermeasure for cochlear and vestibular dysfunctions known as channelopathies. Indeed, experimental data in amphibians and mammalians indicate that nimodipine has a stronger efficacy than other CCBs (aminopyridine, nifedipine) on voltage-dependent whole-cell currents within hair cells at rest and it is the only agent that is also effective during their mechanically induced depolarisation. In humans, the efficacy of nimodipine is documented in the medical management of peripheral vestibular vertigo, sensorineural hearing loss and tinnitus, even in a pathology as complex as Ménière's disease. Nimodipine is also considered useful in the prophylaxis of damage to the facial and cochlear nerves caused by ablative surgery of cerebellopontine tumours; it has been recently hypothesised to accelerate functional recovery of recurrent nerve lesions during thyroid cancer surgery. Further trials with adequate study design are needed to test the efficacy of nimodipine in the treatment of vertigo due to cerebrovascular disease and vestibular migraine.


2015 - Occupational health physicians and the impact of the Great Recession on the health of workers: a qualitative study [Articolo su rivista]
Mattei, Giorgio; Ferrari, Silvia; Giubbarelli, C; Pingani, Luca; Uracci, Gm; Rigatelli, Marco; Galeazzi, Gian Maria
abstract

Background: Italy is one of the Eurozone members where the 2008 “Great Recession” struck worst, with a 9% drop in national GDP between 2008 and 2013. The negative effects of the recession on the health of the Italian population were documented on a nation-wide level. However, few local or regional studies are currently available in the scientific literature. Objectives: To assess the impact on workers’ health of the economic recession in the industrial area of Sassuolo (Modena, Northern Italy), and to provide recommendations for targeted interventions. Methods: Two focus groups were conducted, involving 8 occupational health physicians (OHPs) active in the area. Rough descriptions were analyzed using MAXQDA 11, according to the principles of grounded theory. Results: 261 segments were coded, divided into four areas. The first, “changes in contemporary world”, pointed out that the recession may have just made pre-existing problems worse, accelerating reductions in staff and workers’ benefits. The second, “social area”, highlighted a decrease in vertical social capital and the beginning of new trends in emigration. The third, “work area”, covered workers’ fear of losing their jobs if they were ill and a reduction in horizontal social capital, namely difficult relations between co-workers. The fourth, “medical area”, indicated a general worsening of workers’ health in the Sassuolo ceramic district compared to previous years. The OHPs reported an increase in muscular- skeletal complaints, gastritis, tension-type headache, irritable bowel syndrome symptoms, back pain, panic attacks, insomnia, tachycardia, and other medically unexplained symptoms. Anxiety problems seemed to prevail over depressive manifestations. An increase was reported for antidepressants and benzodiazepines consumption. Conclusions: The local impact of the economic crisis on health was mainly negative, consistent with available national data. Mental health professionals could work together with OHPs, e.g., through Balint Group-like meetings, to develop targeted psychosocial and clinical interventions addressing the medical, psychological and social needs of workers, also involving advocacy and fostering workers’ empowerment.


2015 - Psychiatric consultations in pre-orthoptic liver transplantation patients with substance use disorders: focus on timing of cessation and referral and retention by community service [Abstract in Rivista]
Reggianini, Corinna; Moscara, Maria; Ferrari, Silvia; Laghi, A; Mattei, Giorgio; Piemonte, Chiara; Rigatelli, Marco; Galeazzi, Gian Maria
abstract

Introduction: In Italy, 6 months of abstinence from alcohol/substances are required before OLT, evidence for this recommendation remaining controversial. No standard approach linking abstinence duration at the index psychiatric pre-OLT evaluation to referral to Community Services is followed. Aims: To report data of the Modena Consultation-Liaison Psychiatric Service (MCLPS) for pre-OLT patients with Substance Use Disorders (SUDs), and to evaluate patients’ concordance with referrals. Methods: Case-control study. Data source: database of MCLPS. Psychiatric evaluations pre-OLT from 01/01/2008 to 31/12/2013 were extracted. Patients were controls if they had a SUD and abstinent for more than 6 months; cases if they had a SUD with less than 6 months of abstinence. Chi-squared analysis was performed with STATA 13.0. Results: 515 consultations were requested for 309 pre-OLT patients, 36.3% (N=112) of patients had a current or past SUD. Controls were 80 (71.3%), while cases - who had stopped use less than 6 months before the consultation, or were still using- were 20 (17.9%). 52.5% of controls (N=42) and 85.0% of cases (N=17) were referred to community services (Chi 5.71; p=0.02). 70.0% of cases (N=14) and 33.6% of controls (N=27) were seen at least twice (Chi 7.22; p=0.01). 16.7% (N=2) of cases and 23.5 % (N=4) of controls referred to community services reported concordance with Consultant’s recommendation at reassessment, a non-significant difference with cases (Chi 0.00; p=1.00). Conclusions: Consistently with previously research in this field, no difference of concordance with recommendations emerged between patients with SUD with different duration of abstinence.


2015 - Tako-Tsubo cardiomyopathy and psychiatric disorders: Review of comorbidity [Abstract in Rivista]
Rioli, Giulia; Galeazzi, Gian Maria; Ferrari, Silvia; Rigatelli, Marco
abstract

Background: In recent times, the connections between mental health and cardiac outcomes have been under increasing investigation. Tako-Tsubo Cardiomyopathy (TTC) is also called “broken heart syndrome”, since it has been described to occur after emotionally stressful events; it presents as an acute reversible coronary syndrome due to a transient failure of the left ventricle, in the absence of obstructive coronary heart disease. It has a 10-timehigher prevalence in postmenopausal women and may have a strong correlation with biopsycho- social stress. Aim: To review existing studies on TTC in comorbidity with psychiatric disorders. Method: Four PubMed literature searches performed during January 2015 (search terms: tako-tsubo AND psy*; tako-tsubo AND anxiety; tako-tsubo AND depression; tako-tsubo AND mania) provided 9 references: 4 case reports, 2 reviews, 2 prospective studies and 1 case–control study. Results: Not only chronic psychological stress (present in 2/3 of these patients, on average), but also a high co-occurrence of anxiety and depression (from 50 to 70% of patients with this cardiopathy), panic attacks (diagnosed in almost 20% of women with tako-tsubo), subthreshold and full-blown PTSD (co-morbid in almost 40% of patients according to a 2-year prospective study) were associated with TTC. It has been suggested that changes in circulating levels of catecholamines combined to heart's abnormal response to these hormones could be at the pathophysiological basis for such associations. Conclusion: The present literature review confirms a high cooccurrence of comorbid conditions with increased sympathetic activity (in particular anxiety, depression and panic disorder), which could be risk factors for TTC. More studies, especially longitudinal ones, are needed to better clarify the causative pathways of this usually reversible, but potentially lethal, syndrome, especially among post-menopausal women.


2015 - The impact on mental health of the economic recession in the district of Sassuolo (Modena): opinions of local occupational physicians. [Abstract in Rivista]
Mattei, Giorgio; Urraci, Gm; Ferrari, Silvia; Galeazzi, Gian Maria; Rigatelli, Marco
abstract

INTRODUCTION The recent economic recession and the subsequent strategy of austerity have deceased the amount of resources devoted to health care. They may also have contributed to the deterioration of the population health. AIM To assess the impact on mental health of the economic recession in the district of Sassuolo (Modena), by collecting and analyzing opinions of local Occupational Physicians. METHODS Qualitative survey, by focus groups, conducted in Sassuolo (Modena), industrial center of ceramics, involving 8 Occupational Physicians active in the area. Rough descriptions analyzed independently by GU and GM using MAXQDA, with the independent supervision of a third researcher (SF), according to the principles of the General Grounded Theory. The second focus group was intendened as respondent validation of the first, yet it gathered further data, up to theortical saturation. RESULTS Two focus groups, about one hour long, attended by 8 Occupational Physicians, 7 during the first focus group, 4 during the second (of these, 3 attending both focus groups). The coding process yielded 261 segments, divided into four main areas: "changes in contemporary world" (16 coded segments), "social area" (82 coded segments), "medical area" (94 coded segments), "working area" (69 coded segments). CONCLUSIONS The impact of the economic crisis on health produced mainly negative consequences, locally, consistently with national data. Psychiatrists should work together with Occupational Physicians to develop targeted interventions, addressing social, political and medical needs. A more structured liaison between Psychiatry and Occupational Medicine is an interesting and useful tool for future action and advocacy.


2015 - Young and burnt? Italian contribution to the international BurnOut Syndrome Study (BOSS) among residents in psychiatry [Articolo su rivista]
Ferrari, Silvia; Cuoghi, Giulia; Mattei, Giorgio; Carra, Elena; Volpe, U; Jovanovic, N; Beezhold, J; Rigatelli, Marco; Galeazzi, Gian Maria; Pingani, Luca
abstract

The Burnout Syndrome (BS) is a common condition among health care professionals, yet data concerning its prevalence and associated factors among psychiatric residents are lacking. Objectives: To report the results of the Italian contribution to "BOSS", an international multicentre research project aiming at estimating the burden of BS among residents in psychiatry, and at identifying factors contributing to its development and prevention. Methods: Cross-sectional study. The BOSS online questionnaire, which collected socio-demographic data and five psychometric tools (MBI-GS, AWLS, PHQ-9, SIBQ, BFI), was administered electronically to 180 Italian residents in psychiatry. Simple and multiple linear regressions were performed to analyse data. Results: 108 questionnaires provided data for the study (response rate: 60%). Mean age: 30.5 +/- 3.7 years. Eighty percent of the sample were female. A moderate level of BS emerged, related to work conditions, absence of major depression, satisfaction with pay or less academic activity. Only 0.9% (N=1) of the sample showed PHQ-9 scores suggestive of major depression, while lifetime suicidal ideation was admitted by 16% of residents. For the three dimensions of the MBIGS, Italian sample scores were consistent with previously published results concerning pooled data in a FrenchCroatian sample, reporting moderate levels of BS. Higher workload, symptoms of depression and lower satisfaction predicted higher levels of Emotional Exhaustion and Cynicism. Conclusions: Italian residents in psychiatry showed overall moderate levels of BS, related to workload and work organization. Other alerts of psychic distress were found among participants, namely symptoms of depression, suicidal ideation and use of psychotropic medications.


2013 - Recovery from posttraumatic stress symptoms: a qualitative study of attributions in survivors of war. [Articolo su rivista]
D., Ajdukovic; D., Ajdukovic; M., Bogic; T., Franciskovic; Galeazzi, Gian Maria; A., Kucukalic; D., Lecic Tosevski; M., Schützwohl; S., Priebe
abstract

Abstract OBJECTIVE: The study explored factors to which people traumatized by war attribute their recovery from posttraumatic symptoms and from war experiences. METHODS: In-depth interviews were conducted with two groups of participants with mental sequelae of the war in the former Yugoslavia: 26 people who had recovered from posttraumatic stress disorder (PTSD) and 17 people with ongoing symptoms of PTSD. Participants could attribute their recovery to any event, person or process in their life. The material was subjected to thematic analysis. RESULTS: Eight themes covered all factors to which participants attributed their recovery. Six themes described healing factors relevant for both groups of participants: social attachment and support, various strategies of coping with symptoms, personality hardiness, mental health treatment, received material support, and normalization of everyday life. In addition to the common factors, recovered participants reported community involvement as healing, and recovered refugees identified also feeling safe after resolving their civil status as helpful. Unique to the recovered group was that they maintained reciprocal relations in social attachment and support, employed future-oriented coping and emphasised their resilient personality style. CONCLUSIONS: The reported factors of recovery are largely consistent with models of mental health protection, models of resilience and recommended interventions in the aftermath of massive trauma. Yet, they add the importance of a strong orientation towards the future, a reciprocity in receiving and giving social support and involvement in meaningful activities that ensure social recognition as a productive and valued individual. The findings can inform psychosocial interventions to facilitate recovery from posttraumatic symptoms of people affected by war and upheaval.


2013 - Subjective quality of life in war-affected populations [Articolo su rivista]
Matanov, Aleksandra; Giacco, Domenico; Bogic, Marija; Ajdukovic, Dean; Franciskovic, Tanja; Galeazzi, Gian Maria; Kucukalic, Abdulah; Lecic Tosevski, Dusica; Morina, Nexhmedin; Popovski, Mihajlo; Schützwohl, Matthias; Priebe, Stefan
abstract

Exposure to traumatic war events may lead to a reduction in quality of life for many years. Research suggests that these impairments may be associated with posttraumatic stress symptoms; however, wars also have a profound impact on social conditions. Systematic studies utilising subjective quality of life (SQOL) measures are particularly rare and research in post-conflict settings is scarce. Whether social factors independently affect SQOL after war in addition to symptoms has not been explored in large scale studies.


2013 - Trauma and suicidality in war affected communities [Articolo su rivista]
Jankovic, J.; Bremner, S.; Bogic, M.; Lecic Tosevski, D.; Ajdukovic, D.; Franciskovic, T.; Galeazzi, Gian Maria; Kucukalic, A.; Morina, N.; Popovski, M.; Schützwohl, M.; Priebe, S.
abstract

Abstract PURPOSE: The aim was to assess whether experiences of war trauma remain directly associated with suicidality in war affected communities when other risk factors are considered. MATERIALS AND METHODS: In the main sample 3313 participants from former Yugoslavia who experienced war trauma were recruited using a random sampling in five Balkan countries. In the second sample 854 refugees from former Yugoslavia recruited through registers and networking in three Western European countries. Sociodemographic and data on trauma exposure, psychiatric diagnoses and level of suicidality were assessed. RESULTS: In the main sample 113 participants (3.4%) had high suicidality, which was associated with number of potentially traumatic war experiences (odds ratio 1.1) and war related imprisonment (odds ratio 3) once all measured risk factors were considered. These associations were confirmed in the refugee sample with a higher suicidality rate (10.2%). DISCUSSION AND CONCLUSIONS: Number of potentially traumatic war experiences, in particular imprisonment, may be considered as a relevant risk factor for suicidality in people affected by war.


2012 - Factors associated with mental disorders in long-settled war refugees: Refugees from the former Yugoslavia in Germany, Italy and the UK [Articolo su rivista]
Bogic, Marija; Ajdukovic, Dean; Bremner, Stephen; Franciskovic, Tanja; Galeazzi, Gian Maria; Kucukalic, Abdulah; Lecic Tosevski, Dusica; Morina, Nexhmedin; Popovski, Mihajlo; Schützwohl, Matthias; Wang, Duolao; Priebe, Stefan
abstract

Abstract PURPOSE: The aim was to assess whether experiences of war trauma remain directly associated with suicidality in war affected communities when other risk factors are considered. MATERIALS AND METHODS: In the main sample 3313 participants from former Yugoslavia who experienced war trauma were recruited using a random sampling in five Balkan countries. In the second sample 854 refugees from former Yugoslavia recruited through registers and networking in three Western European countries. Sociodemographic and data on trauma exposure, psychiatric diagnoses and level of suicidality were assessed. RESULTS: In the main sample 113 participants (3.4%) had high suicidality, which was associated with number of potentially traumatic war experiences (odds ratio 1.1) and war related imprisonment (odds ratio 3) once all measured risk factors were considered. These associations were confirmed in the refugee sample with a higher suicidality rate (10.2%). DISCUSSION AND CONCLUSIONS: Number of potentially traumatic war experiences, in particular imprisonment, may be considered as a relevant risk factor for suicidality in people affected by war.


2012 - Psychological symptoms as long-term consequences of war experiences [Articolo su rivista]
Priebe, S; Jankovic Gavrilovic, J; Bremner, S; Ajdukovic, D; Franciskovic, T; Galeazzi, Gian Maria; Kucukalic, A.; Lecic Tosevski, D.; Morina, N.; Popovski, M.; Schtzwohl, M.; Bogic, M.
abstract

Background/Aims: War experiences can affect mental health, but large-scale studies on the long-term impact are rare. We aimed to assess long-term mental health consequences of war in both people who stayed in the conflict area and refugees. Method: On average 8 years after the war in former Yugoslavia, participants were recruited by probabilistic sampling in 5 Balkan countries and by registers and networking in 3 Western European countries. General psychological symptoms were assessed on the Brief Symptom Inventory and posttraumatic stress symptoms on the Impact of Event Scale-Revised. Results: We assessed 3,313 interviewees in the Balkans and 854 refugees. Paranoid ideation and anxiety were the severest psychological symptoms in both samples. In multivariable regressions, older age, various specific war experiences and more traumatic experiences after the war were all associated with higher levels of both general psychological and posttraumatic stress symptoms in both samples. Additionally, a greater number of migration stressors and having only temporary legal status in the host country were associated with greater severity of symptoms in refugees. Conclusions: Psychological symptoms remain high in war-affected populations many years after the war, and this is particularly evident for refugees. Traumatic war experiences still predict higher symptom levels even when the findings have been adjusted for the influence of other factors. Copyright © 2012 S. Karger AG, Basel.


2011 - Mental disorders, psychological symptoms and quality of life 8 years after an earthquake: findings from a community sample in Italy [Articolo su rivista]
Priebe, Stefan; Marchi, Fabio; Bini, Lucia; Flego, Martina; Costa, Ana; Galeazzi, Gian Maria
abstract

Various studies assessed mental disorders and psychological symptoms following natural disasters, including earthquakes. Yet, samples were often non-representative, and the periods of time between earthquake and assessments were usually short. This study aims to assess the prevalence of mental disorders, level of psychological symptoms and subjective quality of life in a random sample in a rural region in Italy 8 years after an earthquake.


2010 - Experience of human rights violations and subsequent mental disorders - a study following the war in the Balkans [Articolo su rivista]
Priebe, S; Bogic, M; Ashcroft, R; Franciskovic, T; Galeazzi, Gian Maria; Kucukalic, A; Lecic Tosevski, D; Morina, N; Popovski, M; Roughton, M; Schützwohl, M; Ajdukovic, D.
abstract

War experiences are associated with substantially increased rates of mental disorders, particularly Post-Traumatic Stress Disorder (PTSD) and Major Depression (MD). There is limited evidence on what type of war experiences have particularly strong associations with subsequent mental disorders. Our objective was to investigate the association of violations of human rights, as indicated in the 4th Geneva Convention, and other stressful war experiences with rates of PTSD and MD and symptom levels of intrusion, avoidance and hyperarousal. In 2005/6, human rights violations and other war experiences, PTSD, post-traumatic stress symptoms and MD were assessed in war affected community samples in five Balkan countries (Bosnia-Herzegovina, Croatia, Kosovo, Macedonia, and Serbia) and refugees in three Western European countries (Germany, Italy, United Kingdom). The main outcome measures were the MINI International Neuropsychiatric Interview and the Impact of Event Scale-Revised. In total 3313 participants in the Balkans and 854 refugees were assessed. Participants reported on average 2.3 rights violations and 2.3 other stressful war experiences. 22.8% of the participants were diagnosed with current PTSD and also 22.8% had MD. Most war experiences significantly increased the risk for both PTSD and MD. When the number of rights violations and other stressful experiences were considered in one model, both were significantly associated with higher risks for PTSD and were significantly associated with higher levels of intrusion, avoidance and hyperarousal. However, only the number of violations, and not of other stressful experiences, significantly increased the risk for MD. We conclude that different types of war experiences are associated with increased prevalence rates of PTSD and MD more than 5 years later. As compared to other stressful experiences, the experience of human rights violations similarly increases the risk of PTSD, but appears more important for MD.


2010 - Mental disorders following war in the Balkans: a study in 5 countries [Articolo su rivista]
Priebe, Stefan; Bogic, Marija; Ajdukovic, Dean; Franciskovic, Tanja; Galeazzi, Gian Maria; Kucukalic, Abdulah; Lecic Tosevski, Dusica; Morina, Nexhmedin; Popovski, Mihajlo; Wang, Duolao; Schützwohl, Matthias
abstract

War experience may affect mental health. However, no community-based study has assessed mental disorders several years after war using consistent random sampling of war-affected people across several Western countries.


2010 - The different psychological profiles of subjects attending melanoma screening campaigns and those delaying diagnosis: an aid for designing preventive campaigns? [Articolo su rivista]
Forghieri, Matilde; Longo, Caterina; Galeazzi, Gian Maria; Rigatelli, Marco; Seidenari, Stefania; Pellacani, Giovanni
abstract

Patient delay in seeking medical attention for melanoma (MM) constitutes one of the main challenges in designing prevention campaigns. No conclusive studies exploring psychological aspects of those patients, using standardized psychometric instruments, are currently available. We hypothesized that the attitude toward illness of subjects attending the melanoma screening day (EMD) would differ from patients diagnosed with MM following the usual clinical pathways. Five psychometric tests, assessing attitude toward illness, were administered both to EMD and MM groups, this latter further divided into two subgroups (good and bad detectors, GD and BD) considering the histo-clinical characteristics of the lesion. The Mann-Whitney U Test and Pearson Chi Square test were used to compare EMD patients with the other groups and to compare psychometric scores between GD and BD. BD and GD groups showed significant differences. Interestingly, the BD group was characterized by higher scores in Temperament and Character Inventory Fearful subscale, Multidimensional Health Locus of Control Powerful Others scale and Illness Behaviour Questionnaire General Hypochondriasis, Affective Disturbance and Irritability subscales. BD patients tend to react in a phobic manner to medical recommendations and they appear to favour external and more assertive help, which would suggest choosing a more direct approach in proposing a prevention campaign. Although this is a pilot study and further studies are needed, it gives new insight to build up more effective prevention campaigns for those patients.


2010 - The structure of post-traumatic stress symptoms in survivors of war: confirmatory factor analyses of the Impact of Event Scale--revised [Articolo su rivista]
Morina, N; Böhme, Hf; Ajdukovic, D; Bogic, M; Franciskovic, T; Galeazzi, Gian Maria; Kucukalic, A; Lecic Tosevski, D; Popovski, M; Schützwohl, M; Stangier, U; Priebe, S.
abstract

The study aimed at establishing the factor structure of the Impact of Event Scale-Revised (IES-R) in survivors of war. A total sample of 4167 participants with potentially traumatic experiences during the war in Ex-Yugoslavia was split into three samples: two independent samples of people who stayed in the area of conflict and one sample of refugees to Western European countries. Alternative models with three, four, and five factors of post-traumatic symptoms were tested in one sample. The other samples were used for cross-validation. Results indicated that the model of best fit had five factors, i.e., intrusion, avoidance, hyperarousal, numbing, and sleep disturbance. Model superiority was cross-validated in the two other samples. These findings suggest a five-factor model of post-traumatic stress symptoms in war survivors with numbing and sleep disturbance as separate factors in addition to intrusion, avoidance and hyperarousal.


2009 - Anger, social dysfunction and psychopathological distress in hearing- impaired patients [Abstract in Rivista]
M., Forghieri; Monzani, Daniele; Galeazzi, Gian Maria; C., Gherpelli; Rigatelli, Marco
abstract

17th EPA Congress


2009 - Experiences of Stalking Victims and requests for Help in Three European Countries. A Survey. [Articolo su rivista]
Galeazzi, Gian Maria; Bucar Rucman, A.; DE FAZIO, Giovanna Laura; Groenen, A.
abstract

To explore the experience of requesting help by victims of stalking in different eUROPEAN COUNTRIES A DETAILED SURVEY WAS COMPLETED BY 391 VICTIMS OF STALKING IN BELGIUM, iTALY AND sLOVENIA.


2008 - A proposito dei disturbi di personalità gravi e pericolosi [Abstract in Atti di Convegno]
Galeazzi, Gian Maria; Curci, P.
abstract

riflessioni in tema di diagnosi e trattamento di Disturbi di Personalità


2008 - Chiedete e vi sarà "dato". Le domande di Rosenhan e la carenza di risposte trent'anni dopo [Abstract in Atti di Convegno]
Galeazzi, Gian Maria; Curci, P.
abstract

quesiti senza risposta in psichiatria


2008 - Frequent attenders in primary care: impact of medical, psychiatric and psychosomatic diagnoses [Articolo su rivista]
Ferrari, Silvia; Galeazzi, Gian Maria; Mackinnon, Andrew; Rigatelli, Marco
abstract

Background: Anxiety, mild depression and somatization are common in Primary Care (PC). Several studies have suggested that they may play a role in causing an excessive use of health care services, especially when combined to medical morbidity. The present case-control study explored how psychiatric and psychosomatic diagnoses and perceived quality of life are associated to the phenomenon of frequent attendance.Methods: The 50 most frequent attenders (FAs) in a one-year period at a PC clinic in Italy were compared to 50 randomly selected average frequency attenders at the same clinic. Socio-demographic and medical data were collected from PC files. The SCID-brief version for research and the Structured Interview for Diagnostic Criteria for use in Psychosomatic Research (DCPR) were administered to both patient groups. Quality of life was also assessed.Results: FA status was associated with being female, older, less well educated, and living with their spouse and/or children. Medical-psychiatric comorbidity was more frequent in the FA group than in the control group. The median number of psychosomatic-DCPR syndromes per patient was 4 among FAs compared to only 1 in controls. Functional somatic symptoms secondary to a psychiatric disorder, type A behaviour, irritable mood, and demoralization were significantly associated with being an FA. Perceived quality of life was significantly lower among FAs, although this was no longer significant after adjusting for socio-demographic variables. Conclusions: The present study confirms the association between medical-psychiatric comorbidity and frequent utilization of PC resources. It suggests a role for DCPR criteria in revealing sub-threshold psychiatric comorbidity predicting a pattern of frequent attendance.


2008 - Psychological profile and social behaviour of working adults with mild or moderate hearing loss. [Articolo su rivista]
Monzani, Daniele; Galeazzi, Gian Maria; Genovese, Elisabetta; A., Marrara; A., Martini
abstract

In this study, an assessment was made of the global assumption that working adults with a mild to moderate sensorineural hearing loss experience more negative emotional reactions and socio-situational limitations than subjects with no hearing problems and that a deterioration of health-related quality of life on these specific domains would occur. Comparisons between 73 hearing-impaired subjects and 96 controls, well-matched for socio-demographic variables, were performed using the HHIA, MOS 36-Item Short Form Health Survey (SF-36) and SFQ questionnaires scores and revealed that the former experience a higher level of perceived hearing handicap and a deterioration of health-related quality of life while investigating emotional and socio-situational domains than the latter (p < 0.005). While investigating the psychological distress dimension of the hearing-impaired subjects by means of the Symptom Check List (SCL-90-R), it emerged that they are more prone to depression, anxiety, interpersonal sensitivity, and hostility than subjects with no hearing problems (p < 0.05). It is argued that the sensory impairment, with its associated disability, may discourage hearing-impaired individuals from exposing themselves to socially challenging situations, producing isolation that leads to depression, irritability, feelings of inferiority. The same psychological symptoms, on the other hand, can compound and worsen the picture by influencing social behaviour of the affected persons. Further prospective studies are needed to address this issue. Nevertheless, it is concluded that Audiology Services, despite the time and costs involved, should improve their diagnostic ability by exploring more areas of hearing-impaired subjects concerns in order not to overlook their potentially reduced psychosocial well-being.


2007 - Constraints perceived by psychiatrists working in community mental health services. Development and pilot study of a novel instrument [Articolo su rivista]
Galeazzi, Gian Maria; Mackinnon, Andrew; Curci, Paolo
abstract

An inventory of institutional constraints perceived as limiting therapeutic choices was developed and completed by psychiatrists working in Italian public mental health services. Constraints considered most limiting were social and institutional pressures toward social control, violence risk assessment and prevention, and lack of control over workload. The total mean score of the perceived constraints instrument was significantly negatively correlated with ratings of perceived freedom in therapeutic choices and with overall job satisfaction. Reliability was good (alpha = 0.85). Addressing perceived constraints may result in more choice options to reach therapeutic goals in a collaborative framework with patients, and improve job satisfaction.


2007 - Experience and Pathways to Care of Women Victims of Stalking in Six European Countries [Abstract in Atti di Convegno]
DE FAZIO, Giovanna Laura; Galeazzi, Gian Maria
abstract

Background: The Modena Group on Stalking is a network of researchers based in Modena (S. Luberto – coordinator- with authors), involving Belgium (G. Vervaeke, A. Groenen), the Netherlands (P. Emmelkamp, J. Kamphuis), United Kingdom (D. James, F. Farnham), Spain (M. Aebi, M. Lopez) and Slovenja (M. Goradz, A. Bucar). The Group has been funded by the European Commission Daphne program to combat violence against children, young people and women.Aims: To outline the second research project of the Group, addressing pathways to care of women victims of stalking in the six participating Countries. A collection of fact sheets for helping professional and victims will be produced during the project.Method: The investigators will collect data on stalking of women in the six Countries by an online questionnaire translated into five languages. The questionnaire asks about characteristics of the stalking campaign, its practical and psychological effects (through standardized rating scales such as IES-R, GHQ-28 and WHO-5 Wellbeing Index, plus an ad hoc coping scale). Respondents will also detail contacts with all Agencies they asked for help and satisfaction with interventions.Results: Ten fact sheets were produced covering definition of stalking, prevalence, risk of physical violence, resources for receiving help and information, and other topics. Collection of data from the online questionnaire will start in September 2006 and end in March 2007.Conclusion: The fact sheets may be used for information and training activities. Analysis of data may show significant differences in terms of pathways to care and outcome for victims of stalking across countries. This will be useful to inform proposed harmonisation of services and guidelines for professionals and agencies dealing with this crime at the European level.


2007 - Impatto e percorsi di aiuto di vittime di stalking italiane: i risultati di un questionario online [Capitolo/Saggio]
Galeazzi, Gian Maria; DE FAZIO, Giovanna Laura
abstract

Il contributo riporta i dati relativi a un campione italiano di 127 vittime di stalking cha hanno compilato un questionario online sull'esperienza delle molestie assillanti in rapporto alla loro salute psicofisica ed ai percorsi di aiuto intrapresi


2007 - Italian social psychiatry research: what gets published in peer reviewed journals? [Articolo su rivista]
Galeazzi, Gian Maria; Priebe, Stefan
abstract

To explore the current state of Italian social psychiatry research as evidenced by original papers published in peer-reviewed journals 2004-2006.Aims - To explore the current state of Italian social psychiatry research as evidenced by original papers published in peer-reviewed journals 2004-2006. Methods - Electronic databases and hand searches of leading peer-reviewed journals were used to identify original research papers published in 2004-2006, addressing a social psychiatric issue, having at least one Italian author, and reporting data from Italian samples. Results - A total of 174 papers were identified. A substantial proportion reported findings of international collaborative research. Quantitative methods dominated, with 86 papers on cross-sectional surveys. Only 18 papers showed results of intervention trials with pre and post measures. Most common target group were psychiatric patients in community mental health services which featured in 93 papers. Conclusions - There is a critical mass of Italian social psychiatry research, dominated by a few research centres and with considerable amount of international collaboration. The findings of this survey might reflect the relative shortage of national funding for social psychiatry research.


2007 - Le vittime di stalking [Capitolo/Saggio]
DE FAZIO, Giovanna Laura; Galeazzi, Gian Maria
abstract

Gli autori tratteggiano le principali caratteristiche delle vittime del fenomeno dello stalking


2007 - Una controversia di trent’anni: Rosenhan, la diagnosi psichiatrica , e il rapporto utenti-operatori. [Articolo su rivista]
Galeazzi, Gian Maria; Curci, P.
abstract

Non disponibile


2006 - A review on the stalking mental health professionals by patients, prevention and management issues. [Articolo su rivista]
Galeazzi, Gian Maria; DE FAZIO, Giovanna Laura
abstract

The article reports a review of the literature on stalking perpetrated on helping professionals


2006 - Early intervention in the pre-psychotic phase: a survey among expert and non-expert psychiatrists and general practitioners [Articolo su rivista]
Galeazzi, Gian Maria; Elkins, K.; Pingani, Luca; Rigatelli, Marco
abstract

Objectives: This study aimed at exploring views and comparing level of consensus across different groups of mental health professionals regarding the appropriateness of preventive interventions targeted at subjects with risk factors for the development of psychosis. Method: A survey was completed by 135 members of the International Early Psychosis Association ( IEPA), by 110 psychiatrists working in the Italian Region Emilia Romagna, and by 114 general practitioners working in the Province of Modena. The survey used three hypothetical case scenarios where a client, having tested positive for future psychosis to an imaginary infallible screening instrument, presents with either ( a) no symptoms and no interest in intervention; (b) no symptoms but requesting intervention; ( c) with some degree of anxiety and depression and requests assistance. Results: Mixed views prevailed on appropriateness of specific interventions across all groups regarding the hypothetical case scenario presented. Judgments varied according to clients' preferences and level of distress. IEPA members showed more inclination than other professionals to consider appropriate psychological and pharmacological intervention in an asymptomatic pre-psychotic state. The propensity for suggesting drug treatment was related to the belief that untreated psychosis causes neurotoxicity. Conclusions: Experts seem to have a more liberal view on the appropriateness of preventive interventions than community mental health psychiatrists and general practitioners. Further research addressing factors that influence experts' views seems warranted.


2006 - Posturographic stabilisation of healthy subjects exposed to full-length mirror image is inversely related to body-image preoccupations [Articolo su rivista]
Galeazzi, Gian Maria; Monzani, Daniele; Gherpelli, Chiara; Covezzi, R; Guaraldi, Gian Paolo
abstract

Affective states, anxiety in particular, have been shown to negatively influence human postural control efficiency as measured by posturographic means, while exposure to a full-length mirror image of one's body exerts a stabilizing effect. We tested the hypothesis that body image concerns and preoccupations would relate negatively to this stabilising effect. Sixty-six healthy students, who screened negative for psychiatric disorders, completed rating scales for anxiety, depression and body image concerns. Posturography recordings of body sway were taken under three conditions: with eyes closed, looking at a vertical bar and looking at a full-length mirror. The Eyes Open/Mirror Stabilometric Quotient [EOMQ=(sway path with eyes closed/sway path looking at the mirror)x100], an index of how much postural control is stabilized by mirror feedback in comparison to the visual vertical bar condition, was significantly inversely related to body image concerns and preoccupations, and to trait anxiety. This finding confirms the impact of emotional factors on human postural control, which warrant further studies. If confirmed in clinical populations characterized by high levels of body image disturbances, e.g. eating disorders, it could lead to developments in the assessment and monitoring of these patients.


2006 - Somatizzazione in profughi dell'ex-Jugoslavia [Abstract in Atti di Convegno]
Galeazzi, Gian Maria; M., Flego; M., Romagnoli; G., Neri; gruppo di ricerca, Connect
abstract

Viene esplorata la dimensione della somatizzazione in profughi dell'ex- Jugoslavia


2006 - TC6E SHOULD WE SUGGEST INTERVENTIONS WHEN RISK OF PSYCHOSIS IS VERY HIGH BUT SYMPTOMS AND DISTRESS LOW OR ABSENT? [Abstract in Rivista]
Galeazzi, Gian Maria; K., Elkins; L., Pingani; Rigatelli, Marco
abstract

Not available


2006 - The Italian version of the Body Cathexis Scale [Articolo su rivista]
Orlandi, E; Covezzi, R; Galeazzi, Gian Maria; Guaraldi, G. P.
abstract

Various questionnaire measures have been developed to study body attitude and affect. The Body Cathexis Scale (BCS) was the first psychometric instrument devised to measure body dissatisfaction. In this study we report the validation of the Italian version of the BCS. Reliability and validity studies were conducted on 86 female subjects with eating disorders and 404 general population subjects.


2006 - Trauma psichico nei profughi dell'ex-Jugoslavia. Il progetto di ricerca CONNECT [Poster]
Romagnoli, Masa; Sukaj, Elma; Colombini, Niccolò; Galeazzi, Gian Maria
abstract

Studio osservazionale con follow-up ad un anno della morbilità psichiatrica e della disabilità sociale degli eventi traumatici in conflitti bellici e dello stress migratorio in popolazioni di profughi


2006 - Users' Perceptions and Views on Violence and Coercion in Mental Health [Capitolo/Saggio]
Abderhalden, Christoph; Hahn, Sabine; Bonner, Yvonne D. B.; Galeazzi, Gian Maria
abstract

non disponibile


2006 - Views on psychosis and judgment of appropriateness of early interventions in pre-psychotic phase: A survey of members of the International Early Psychosis Association [Articolo su rivista]
Galeazzi, Gian Maria; Elkins, K.; Pingani, Luca; Rigatelli, Marco
abstract

Background: The evidence base for preventive interventions in psychosis during the pre-psychotic phase is still scarce. Professional views on this topic may be influenced by individual and professional background factors. Aims: To study factors that possibly influence judgmentsmade bymental health professionals dedicated to early psychosis on the appropriateness of early interventions during the pre-psychotic phase. Method: Members of the International Early Psychosis Association (IEPA) were asked general questions about concepts of psychosis and about three case scenarios describing a client in the pre-psychotic phase. Results: Views of 325 respondents were collected. About half the respondents thought that psychotic experiences exist on a continuum with normal experiences. Psychologists were more likely than other professional groups to endorse this view. A total of 52.6% of respondents (n¼171) believed that untreated psychotic episodes cause irreversible brain changes. Psychologists were less likely to endorse this view, which was associated with a willingness to offer pharmacologic interventions in pre-psychotic phases. More than 80% agreed, in most severe cases, on proposing lifestyle changes and psychological interventions. Conclusions: When challenged with case scenarios, mental health professionals with clinical and research experience with patients with early psychosis expressed varied opinions on the appropriateness of pre-psychotic interventions, especially concerning pharmacologic treatment. Professional views on this topic were related not only to the level of symptoms and degree of active request for help from the client, but also to the professional’s role and different conceptions of psychosis endorsed. These aspects warrant further study. Declaration of interest: G. M. Galeazzi and K. Elkins are members of the IEPA. Funding is detailed in Acknowledgments.


2005 - Disruptive and dangerous behaviour by patients on acute psychiatric wards in three European centres [Articolo su rivista]
Bowers, Len; Douzenis, Athanassios; Galeazzi, Gian Maria; Forghieri, Matilde; Tsopelas, Christos; Simpson, Alan; Allan, Teresa
abstract

The disturbed behaviour of acute in-patients can have serious consequences, and methods of management are contentious and vary between countries. Little is known about this variation and its relationship to the characteristics of in-patient populations.


2005 - Evaluation of stalking cases by police: a European multy-centre study [Abstract in Atti di Convegno]
DE FAZIO, Giovanna Laura; Galeazzi, Gian Maria; A., Groenen
abstract

Little research data are available regarding perception and attitudinal factors affecting recognition ofstalking cases, appropriateness of interventions and/or referrals and risk assessments in stalking cases bypolice.This presentation reports findings of a multi-centre European study, funded by the European Commission’sDaphne Program to prevent and combat violence against children, young people and women.Sociodemographic, cultural and attitudinal factors (emerging from attitudinal questions regarding courtshipbehaviours and stalking as a phenomenon) that could influence the evaluation of stalking cases wereexplored in police officers using a survey presenting 16 case vignettes. There were 12 typical a prioriderivedstalking scenarios depicting varying degrees of severity of harassing behaviours having strangers,acquaintances and ex-partners as perpetrators and 4 controls vignettes, considered not to be stalking casesby the researchers. For each vignette, Likert type and multiple-choice questions explored perceptions andevaluation of risk of complicating violence, abnormality and illegality of the behaviours, intervention468options and support- and treatment- needs for both victim and stalker. 328 front-desk policemen fromBelgium, Italy, the Netherlands and United Kingdom responded. Results showed that, in general, policeofficers were able to discriminate stalking from non-stalking vignettes. Italian police officers rated stalkingvignettes as depicting more normal situations than Dutch and English colleagues, and less illegal than allother countries’ colleagues, reflecting differences in national availability of specific laws prosecuting thiscrime. The severity of the stalking behaviours depicted in the vignettes did influence police officers’recognition of the behaviour as stalking and also their ratings on the risk of physical violence. Italian policeofficers rated risk higher when stalkers stalked strangers instead of an ex-partner or an acquaintance, whenresearch shows that this is not the case. The findings point at clear information and training needs on thetopic of stalking in the population explored.


2005 - Il problema diagnostico dei disturbi somatoformi [Relazione in Atti di Convegno]
Rigatelli, Marco; Ferrari, Silvia; Galeazzi, Gian Maria
abstract

la diagnosi di somatizzazione è complessa e resa ancor più tale dall'attuale nosografia psichiatrica


2005 - Psychiatric disorders and depression in multiple sclerosis outpatients: impact of disability and interferon beta therapy. [Articolo su rivista]
Galeazzi, Gian Maria; Ferrari, Silvia; Giaroli, Giovanni; Mackinnon, Andrew; Merelli, Elisa; Motti, L; Rigatelli, Marco
abstract

Associations between psychopathology and gender, duration of MS, disability and therapy with beta-interferons were studied in multiple sclerosis (MS) outpatients. A controlled descriptive epidemiological study was carried out in two Italian outpatient MS centres on 50 outpatients with clinically definite relapsing-remitting MS presenting for regular follow-up and 50 healthy controls matched for sex, age and educational level. Subjects were assessed with the Structured Clinical Interview for DSM-IV (SCID I), the Beck Depression Inventory (BDI) and the State Trait Anxiety Inventory (STAI). MS patients reported a higher prevalence of psychiatric disorders (odds ratio 3.17), with 46\% (n=23) suffering from major depressive disorder. The risk of suffering from any non-mood psychiatric disorder was also higher in MS patients than in controls (odds ratio 2.67). Risk factors for depression were female sex and severity of disability, but not therapy with interferon beta or longer duration of illness. Disability level, but not therapy with beta-interferons, is a risk factor for depression in MS outpatients. Regular screening for depression in this population is appropriate.


2005 - Riconoscimento e percezione dello stalking da parte di agenti di polizia e di medici di medicina generale: uno studio multicentrico europeo. [Capitolo/Saggio]
DE FAZIO, Giovanna Laura; Galeazzi, Gian Maria; the Modena Group on, Stalking
abstract

Lo studio riporta i dati di una ricerca sulla percezione ed il riconoscimento professionale dello stalking


2005 - Stalking-Perceptions and Attitudes Amongst Helping Professions. An EU Cross-National Comparison [Articolo su rivista]
JAN H., Kamphuis; Galeazzi, Gian Maria; DE FAZIO, Giovanna Laura; PAUL M. G., Emmelkamp; F., Farnham; Anne, Groenen; David, James; Geert, Vervaeke
abstract

The article reports the perception and the attitudes on stalking of a group of helping professionals in different European countries


2005 - Stalking: il fenomeno, la ricerca [Capitolo/Saggio]
DE FAZIO, Giovanna Laura; Galeazzi, Gian Maria
abstract

Rassegna sul fenomeno dello stalking e sullo stato dell'arte della ricerca


2005 - Stalking: phenomenon and research [Capitolo/Saggio]
DE FAZIO, Giovanna Laura; Galeazzi, Gian Maria
abstract

Introduction; Why is it difficult to define stalking?; How widespread is stalking?; Why is it difficult to prosecute stalking?; Unsolved problems; Stalking and the helping professions: research by the Modena Group on Stalking; References


2005 - The stalking of mental health professionals by patients. [Articolo su rivista]
Galeazzi, Gian Maria; Elkins, K.; Curci, P.
abstract

non disponibile


2004 - Costruzioni e ragioni degli artefatti psichiatrici. [Articolo su rivista]
Galeazzi, Gian Maria; Curci, P.
abstract

Non disponibile


2004 - Editoriale [RIVISTA SPERIMENTALE DI FRENIATRIA] [Articolo su rivista]
Galeazzi, Gian Maria; Curci, P.
abstract

Non disponibile


2004 - Eppendorf Schizophrenia Inventory (ESI): presentazione della versione italiana. [Articolo su rivista]
Galeazzi, Gian Maria; Spiliopulos, P.; Curci, P.
abstract

Introduzione Le esperienze soggettive dei pazienti con psicosi, oltre a rappresentare un momento fondamentale dell’incontro clinico e del prendersi cura, costituiscono un tema imprescindibile per un tentativo di comprensione dei fenomeni psicotici che voglia andare al di là della mera rilevazione di aspetti comportamentali facilmente osservabili ed operazionalizzabili. Da dieci anni a questa parte, sono apparsi numerosi richiami a questa linea di ricerca che si discosta dalla semplice registrazione e catalogazione di comportamenti obiettivabili dall’esterno (1) (2). Sebbene ci siano state diverse proposte di modelli e strumenti relativi a esperienze soggettive psicosi-correlate (3)-(6), in Italia la concettualizzazione che ha avuto finora più impatto e risonanza è quella dei Sintomi di Base (7)-(17). Il modello dei sintomi di base valorizza la capacità del paziente di autopercepire, e comunicare come spiacevoli e limitanti, fini cambiamenti, deficit e anomalie, presenti anche nelle fasi prodromiche ed interepisodiche di malattia, a carico del funzionamento percettivo, della forma del pensiero, della comprensione e della produzione del linguaggio, della cenestesi, della motricità, della vitalità generale, ecc. Tali sintomi sono stati proposti rispecchiare la forma autopercepibile più prossima alla vulnerabilità alla psicosi, costituendone l’espressione attingibile dal soggetto, a cui corrisponderebbero specifici deficit neuropsicologici (soprattutto a carico dell’elaborazione delle informazioni) "a monte" della consapevolezza del paziente, in ambito "transfenomenico". Secondo il modello, i sintomi di base, attraverso complessi meccanismi di transizione su cui influirebbero fattori di stress e variabili psicologiche (tra cui il coping), sociali e biologiche, potrebbero evolvere verso quadri di franco scompenso psicotico. Klosterkötter, infatti (9), ha descritto vere e proprie sequenze di transizione tra sintomi di base e sintomi di primo rango schneideriani, in cui si attraverserebbero fasi successive denominate di irritazione, di esternalizzazione e di concretizzazione psicotica. Secondo questo modello di sviluppo dei sintomi positivi dai sintomi di base, l’inizio delle fasi produttive sarebbe innescato da una messa in tensione delle risorse cognitive e affettive già deficitarie con peggioramento a spirale delle capacità di far fronte all’incremento della complessità e intensità degli stimoli, fino alla rottura della normale cornice di riferimento della realtà, con il ristabilimento, attraverso il coagularsi di esperienze pienamente psicotiche, di un livello accettabile di stimolazione e una riduzione del livello di angoscia. Meno lineare sarebbe l’interpretazione del rapporto tra sintomi di base e sintomi negativi (16). Una riscontrata correlazione tra sintomi negativi e sintomi di base è stata interpretata in chiave processuale, come se gli aspetti comportamentali dei sintomi negativi rilevati dalle scale di valutazione eterosomministrate corrispondessero al classico esito difettuale, risultato terminale della trasformazione di sintomi di base non caratteristici per psicosi in sintomi di base caratteristici, fino a vere e proprie esperienze psicotiche di tipo positivo. Sebbene nella concettualizzazione originaria questi stadi siano, nella gran maggioranza dei casi, reversibili lungo le varie fasi di malattia, in certi casi tale percorso a ritroso non si produrrebbe e la sintomatologia negativa emergerebbe come risultato finale, vuoi come effetto di meccanismi di coping di ritiro attivo, vuoi come esito di un presunto effetto neurotossico dello stato di psicosi protratta con sintomi floridi. Altri Autori (12) si sono discostati da questa interpretazione sequenziale e hanno concettualizzato la correlazione tra sintomi di base e sintomi negativi come un epifenomeno degli aspetti di alogia e compromissione delle funzioni linguistiche, elementi centrali dei sintomi negat


2004 - Frequent attenders of primary care: getting to know them [Abstract in Rivista]
Ferrari, Silvia; Galeazzi, Gian Maria; Rigatelli, Marco
abstract

Frequent attenders of primary care: getting to know them


2004 - Il farmaco nel percorso terapeutico: fra rigidità e flessibilità, linee guida e giudizio clinico. [Articolo su rivista]
Galeazzi, Gian Maria; Curci, P.
abstract

Non disponibile


2004 - Interrater reliability, prevalence, and relation to ICD-10 diagnoses of the Diagnostic Criteria for Psychosomatic Research in consultation-liaison psychiatry patients. [Articolo su rivista]
Galeazzi, Gian Maria; Ferrari, Silvia; Andrew, Mackinnon; Rigatelli, Marco
abstract

The Diagnostic Criteria for Psychosomatic Research (DCPR) have been proposed by an international group of psychosomatic investigators as an operationalized tool for the assessment of psychological distress in medical patients. The aims of the present study were to evaluate interrater reliability, the distribution of DCPR syndromes, and their relationship with ICD-10 diagnostic categories. One hundred consecutive patients who were referred for psychiatric consultation in a university general hospital consented to assessment for DCPR syndromes as elicited in a joint interview conducted by two researchers. The results showed excellent interrater agreement, with kappa values for the 11 DCPR syndromes ranging from 0.69 to 0.97. More patients met criteria for one or more of the DCPR (87\%) than for an ICD-10 diagnosis (75\%). Four DCPR syndromes were particularly prevalent: demoralization, alexithymia, illness denial, and type A behavior. DCPR criteria appear to be a useful, reliable, and promising approach in the assessment and description of psychological distress in medical patients. They may serve as a focus of intervention studies in this population.


2004 - Morale of mental health professionals in Community Mental Health Services of a Northern Italian Province [Articolo su rivista]
Galeazzi, Gian Maria; Delmonte, Sara; Fakhoury, Walid; Priebe, Stefan
abstract

To explore morale of psychiatrists and psychiatric nurses working in Community Mental Health Centres (CMHC) in an Italian Province, and identify influential factors.


2004 - Problems of early intervention in psychosis [Abstract in Atti di Convegno]
Galeazzi, Gian Maria; Elkins, Kathryn; Rigatelli, Marco
abstract

Important questions reamin open about indications, potentials and limitations of intervention programs for individuals considered at very high risk of later psychotic development. The authors review problems in this research area.


2004 - Stalking: intervention, approaches and training needs in helping professions [Abstract in Atti di Convegno]
Galeazzi, Gian Maria; DE FAZIO, Giovanna Laura
abstract

stalking and violence against women


2004 - The nosographic issue of “new psychiatric disorders” [Relazione in Atti di Convegno]
Galeazzi, Gian Maria; Curci, P.
abstract

Non disponibile


2004 - Una psicosi kretschmeriana in corso di malattia di Parkinson. [Articolo su rivista]
Galeazzi, Gian Maria
abstract

Sintomi psicotici e deliri accompagnano di frequente la malattia di Parkinson. Alterazioni del ritmo sonno-veglia con insonnia ed effetti indesiderati della terapia antiparkinsoniana sono ritenuti importanti fattori causali o che contribuiscono al quadro. Gli interventi consigliati sono la riduzione o, comunque, l'adeguamento della terapia dopaminomimetica, misure per ristabilire il normale ritmo sonno-veglia, e l'utilizzo di antipsicotici atipici. L'Autore descrive lo sviluppo di un delirio di tipo persecutorio in un paziente con malattia di Parkinson, trattato con pergolide 2 mg/die. Il paziente si presentò inizialmente con allucinazioni uditive e visive di tipo elementare, ma sviluppò progressivamente la convinzione di tipo delirante che i vicini lo avessero per caso scoperto mentre era impegnato in pratiche masturbatorie in casa sua e che, pertanto, parlassero male di lui, lo spiassero e lo disturbassero intenzionalmente. Il quadro psicotico si risolse con quetiapina 200 mg/die, ma nei successivi 10 mesi ebbe una ricaduta psicotica seguita da un episodio depressivo postpsicotico, che richiesero un aumento della dose di quetiapina e l'uso a breve termine di antidepressivi. La sua terza ricaduta, 18 mesi dopo la presentazione iniziale, ebbe solo una risposta parziale a quetiapina 400 mg/die, pertanto la si sostituì con clozapina, con cui si ottenne una remissione al dosaggio di 75 mg/die. Si è fornito, inoltre, un intervento psicoterapico per affrontare il senso di vergogna del paziente per la sua disabilità e lo stigma interiorizzato per la sua condizione neurologica. Il caso presentato ricorda aspetti del costrutto del delirio di rapporto dei sensitivi di Kretschmer, che si può considerare un precursore dei moderni modelli di vulnerabilità/stress/coping della psicosi e che sottolinea l'interazione fra tratti di personalità, eventi «chiave» e contesto psicosociale. Il costrutto si è rivelato utile nel guidare considerazioni diagnostiche e prognostiche e gli interventi terapeutici.


2004 - Women Victims of Stalking and Helping Professions: Recognition and Intervention in the Italian Context [Relazione in Atti di Convegno]
DE FAZIO, Giovanna Laura; Galeazzi, Gian Maria
abstract

Background: Stalking is a heterogeneous and complex behavioural pattern, whose definition and recognition entail subjective elements, which can influence not only the request of help by the victim but also the recognition and the response of helping professionals. Objective: To study factors influencing perception, recognition and the judgment of appropriateness of interventions in stalking cases by primary helping professionals. Methods: The study was conducted in the frame of a multicentric collaboration of the Daphne Research Program of the European Commission. The Italian preliminary results are reported. 50 general practitioners and 50 police officers completed a survey presenting vignettes portraying stalking of women by men and control situations. Subjects were asked to rate the degree of abnormality and illegality of behaviours, to indicate appropriate referrals and interventions for victims and perpetrators and to answer attitudinal questions on stalking in general. Results: General practitioners gave higher ratings of abnormality of the behaviours portrayed in the stalking vignettes, while judgment of illegality tended to be lower in both groups. General practitioners suggested the opportunity of mental health support in favour of the victims of stalking with higher frequency than police officers, which tended to favour criminal justice interventions. Preferred intervention for the stalker indicated by both groups was again mental health care, followed by police actions, while legal options were less considered. General attitudes considering stalking more a nuisance than a crime did inversely correlate with the judgment of illegality of the behaviours. Professional role but not sex of the respondent did influence ratings. Training received by both groups in dealing with stalking cases and the degree to which law assists in this task were considered not optimal. Conclusions: These preliminary results suggest that recognition and response to stalking situations are influenced by professional and personal attitudes, calling for the need of more targeted information, training, and of inter-disciplinary efforts in dealing with this common and serious form of violence.


2003 - Current factors affecting the choice of psychiatry as a specialty: an Italian study [Articolo su rivista]
Galeazzi, Gian Maria; Secchi, Cesare; Curci, Paolo
abstract

Abstract Objective: This study examined the differential impact of factors hypothesized to affect the choice of psychiatry as a specialty in Italy. Method: A 38-item Likert-type questionnaire about factors that potentially affect the choice of a career in psychiatry was administered to 97 Italian medical school graduates sitting for an admission examination to psychiatric residencies and to 82 colleagues sitting for an admission examination to an internal medicine residency. The two groups' ratings on the questionnaire items were compared. Results: Response rates were 49.5% and 45.1%, respectively, for the psychiatry and the internal medicine groups. Future psychiatrists did not differ from future internists in sociodemographic characteristics. They rated 13 factors on the questionnaire more positively than did their colleagues who were pursuing internal medicine, and many had chosen psychiatry very early (40% had done so before medical school). Some of the more positively rated factors were experience with mental illness either personally or by a relative or close friend, efficacy of psychiatric treatments, the degree to which psychiatric practice is perceived to be evidence based, research opportunities, and curiosity about the topic of "madness." Conclusions: Findings confirm earlier work in North American samples showing a substantial cross-cultural consistency in motives for choosing psychiatry as a discipline. A strong, early interest and curiosity among these students, often present in the premedical and pre-clerkship years, suggests some benefit in targeting this group for recruitment. Keywords


2003 - Editoriale del numero monografico "Violenza e Psichiatria" [Recensione in Rivista]
Bonner, Y.; Galeazzi, Gian Maria; Secchi, C.
abstract

Non disponibile


2003 - Etica e ricerca nella Psichiatria di Comunità [Abstract in Atti di Convegno]
Galeazzi, Gian Maria; Neri, G.; Curci, P.
abstract

etica, ricerca, psichiatria di comunità


2003 - Introduzione [La sindrome delle molestie assillanti (stalking)] [Capitolo/Saggio]
Curci, Paolo; Galeazzi, Gian Maria; Secchi, Cesare
abstract

Non disponibile


2003 - Le Molestie Assillanti nella relazione terapeutica in psichiatria. [Monografia/Trattato scientifico]
Galeazzi, Gian Maria; Curci, P.
abstract

Non disponibile


2003 - Lettera del dott. Gian Maria Galeazzi [Articolo su rivista]
Galeazzi, Gian Maria
abstract

Non disponibile


2003 - Stalking and mental health professionals [Abstract in Atti di Convegno]
Galeazzi, Gian Maria
abstract

The presentation discusses the results of a survey conducted in the Province of Modena, Italy, which asked mental health professionals whether they have ever experienced stalking by their patients.


2003 - Stalking e mass media [Capitolo/Saggio]
Curci, P.; Galeazzi, Gian Maria; Secchi, C.
abstract

Non disponibile


2002 - Consultation-liaison psychiatry in obstetrics and gynecology. [Articolo su rivista]
Rigatelli, Marco; Galeazzi, Gian Maria; G., Palmieri
abstract

Data documenting the activity of Modena and Reggio Emilia University Hospital Consultation-Liaison Psychiatry Psychosomatic Service (C-LPPS) to the 59 bed gynecological-obstetric unit are compared to the corresponding European Consultation Liaison Workgroup (ECLW) study results and discussed in the light of recent epidemiological studies suggesting a low rate of detection and psychiatric referral in obstetric and gynecological patients. All psychiatric consultations of gynecological-obstetric inpatients during a 3-year (1996-1998) period were included in this study and data were derived from valid and reliable consultation forms tested for reliability. Within the 3-year period 55 patients were referred to C-LPPS by the gynecological-obstetric unit for psychiatric consultation. Referral rate was 0.5% of the admitted patients in the unit. The gynecological-obstetric group represented 2.5% (vs. 4.5% ECLW study) of all psychiatric consultations requested in the study period. The most frequent reasons for referral were: current psychiatric symptoms (47.3% Modena study vs. 39% ECLW), psychiatric history (20% vs. 7.3%), unexplained physical symptoms (12.7% vs. 16.2%) and coping-compliance problems (3.6% vs. 16.6%). The most common ICD-10 psychiatric diagnoses were: neurotic, anxiety and adjustment disorders (41.8% vs. 31.2%), mood disorders (29% vs. 18.4%), personality disorders (7.3% vs. 6.1%), schizophrenic and other psychotic disorders (5.5% vs. 7%).


2002 - Fattori di scelta di psichiatria come specializzazione. [Articolo su rivista]
Galeazzi, Gian Maria; Curci, P.
abstract

Non disponibile


2002 - La sindrome del molestatore assillante (stalking) e i media. [Capitolo/Saggio]
Galeazzi, Gian Maria; Gemini, L.; Curci, P.
abstract

Non disponibile


2002 - La valutazione della qualità [Capitolo/Saggio]
Rigatelli, Marco; Bertoncelli, B; Galeazzi, Gian Maria
abstract

Not available


2002 - Riflessioni sull'appropriatezza del ricovero ospedaliero nel Servizio Psichiatrico. [Relazione in Atti di Convegno]
Galeazzi, Gian Maria; Burattini, M.; Drusiani, C.; Curci, P.
abstract

Non disponibile


2001 - Diagnosi operazionalizzata, linee guida terapeutiche, giudizio clinico. [Articolo su rivista]
Curci, Paolo; Galeazzi, Gian Maria
abstract

Assai numerose nella letteratura italiana ed internazionale sono le valutazioni, più o meno esplicite, di ricercatori e clinici soddisfatti per l’attendibilità diagnostica raggiunta attraverso l’impiego dei correnti criteri operazionalizzati per la diagnosi dei disturbi mentali. Anche Allan Tasman, Presidente uscente dell’Associazione degli Psichiatri Americani, partecipa di questa soddisfazione; tuttavia, in un recente discorso centrato sulla relazione medico-paziente (1), subito dopo essersi compiaciuto per i progressi fatti nel migliorare l’attendibilità delle diagnosi DSM, manifesta preoccupazione per il pericolo, da lui avvertito come molto concreto, “di stare formando una generazione di psichiatri carenti anche delle minime capacità psicoterapeutiche”. In questo breve contributo proponiamo, in termini problematici, una riflessione sulle implicazioni del concetto di giudizio clinico tra diagnosi operazionalizzata e linee guida terapeutiche. Accanto al requisito della copresenza di un numero minimo di sintomi o comportamenti (spesso indipendentemente dalle loro differenti combinazioni) rilevabili dal diagnosta o dall’entourage del paziente o riferiti all’anamnesi, i criteri prescritti (oltre a varie clausole di esclusione) richiedono che, per un buon numero di disturbi, al gruppo di caratteristiche così individuate, sia associato un “disagio clinicamente significativo” e/o “menomazione nel funzionamento sociale, lavorativo o in altre aree importanti”. Se è stato posto un notevole impegno, nei manuali diagnostico-statistici a cui ci riferiamo, per cercare di operazionalizzare (a) i criteri sintomatologici dei disturbi, la definizione di “disagio clinicamente significativo” rimane sfuggente e poco approfondita. Nella Introduzione del DSM-IV (3) si riconosce che l’uso del giudizio clinico per valutare non solo l’entità, ma il significato stesso del quadro sindromico rilevato (se cioè si tratti di un disturbo o meno), è uno dei problemi nell’utilizzo del manuale e, forse sbrigativamente, si ammette che il giudizio clinico possa giustificare una certa diagnosi per un individuo anche se la presentazione non è tale da soddisfare completamente i criteri del disturbo; d’altra parte, si scoraggia un’applicazione troppo flessibile e idiosincrasica dei criteri convenzionali dello strumento. Nella stessa sezione gli estensori del DSM sottolineano il fatto che i criteri e le descrizioni del testo sono destinati all’impiego da parte di persone con adeguato addestramento clinico ed esperienza nella diagnosi, giustamente sollevando un punto problematico, ma eludendolo in maniera tautologica e autoreferenziale.


2001 - La "sindrome del molestatore assillante" (Stalking): una patologia della comunicazione e della relazione. [Abstract in Atti di Convegno]
Galeazzi, Gian Maria; Curci, Paolo
abstract

Viene inquadrata dal punto di vista epidemiologico, clinico e comportamentale la sindrome dello stalking


2001 - La Psichiatria di Consultazione nell'Ospedale Generale [Articolo su rivista]
Rigatelli, Marco; Ferrari, Silvia; Galeazzi, Gian Maria
abstract

Not available


2001 - La sindrome del molestatore assillante (stalking): una rassegna. [Articolo su rivista]
Galeazzi, Gian Maria; Curci, P.
abstract

Obiettivo Fornire allo psichiatra italiano una rassegna esauriente della letteratura internazionale riguardante gli aspetti legali, epidemiologici e psichiatrici dello stalking, un pattern comportamentale (noto anche come erotomania borderline, molestie ed inseguimento ossessivo), che ha guadagnato la crescente attenzione di media e ricercatori negli ultimi dieci anni. Metodo È stata eseguita una ricerca bibliografica computerizzata e manuale. I temi trattati riguardano le definizioni legali e psichiatriche dello stalking, la sua epidemiologia, la prevalenza, il significato per i comportamenti di molestie della psicopatologia dell�aggressore, la descrizione dei diversi tipi di comunicazioni intrusive e molestie, le reazioni delle vittime, le tipologie di molestatori proposte nella letteratura, le minacce e il rischio di violenza, gli effetti psicologici per le vittime e il loro trattamento. Risultati e conclusioni Lo stalking è un fenomeno relazionale comune e complesso spesso legato a grave psicopatologia nel molestatore e causa di pesanti conseguenze psicologiche per le vittime. Gli Autori propongono e discutono il costrutto della "Sindrome del molestatore assillante" come uno strumento utile per inquadrare le informazioni disponibili in maniera coerente e meglio guidare la comprensione e l�intervento clinico nei casi di stalking.


2000 - Applicazione di modelli di collaborazione tra la psichiatria e la medicina. PPCC (Psychiatric Primary Care Clinic = Ambulatorio Psichiatrico per la Medicina di Base): un progetto australiano di shared care. [Articolo su rivista]
Galeazzi, Gian Maria
abstract

Non disponibile


2000 - Audiovisual sexual stimulation by virtual glasses is effective in inducing complete cavernosal smooth muscle relaxation: a pharmacocavernosometric study. [Articolo su rivista]
E. S., Pescatori; V., Silingardi; Galeazzi, Gian Maria; Rigatelli, Marco; A., Ranzi; W., Artibani
abstract

Audiovisual sexual stimulation (AVSS) is frequently employed to promote cavernosal smooth muscle relaxation (SMR) in hemodynamic diagnostic settings for erectile dysfunction. Our aim has been to adapt conventional AVSS to the particular test conditions of pharmacocavernosometry and pharmacocavernosography (DICC), by the use of virtual glasses. Thirty-seven consecutive patients undergoing DICC were randomized in two groups: no-AVSS and AVSS through commercially available virtual glasses (VG-AVSS) with tri-dimensional capabilities and stereophonic headphones. Such device partially excludes the patient from the surrounding environment. In both groups a standard dose of vasoactive agents was intracavernosally administered, and possibly repeated (re-dosing), until complete SMR was obtained (3 doses/patient maximum). Psychometric tests (State Trait Anxiety Inventory and ad hoc visual analogue scales for embarrassment, stress and pain) were administered before and after DICC. The no-AVSS group consisted of 18 patients, the AVSS group of 19. Number of needed vasoactive agent doses: in the no-AVSS group 6 patients needed 1 dose, 3 patients 2, 9 patients 3 (mean dose number: 2.17); in the AVSS group 15 patients needed 1 dose, 1 patient 2, 3 patients 3 (mean dose number: 1.37). The difference in the number of doses used in the two groups was statistically significant (Student's t-test P = 0.007). Complete SMR, regardless of the number of used doses: in the no-AVSS group 9 patients (50%) achieved complete SMR, in the AVSS group 16 patients (84.2%). The difference in the two groups was statistically significant (chi-square P = 0.026). From evaluated psychometric measures no statistically significant difference between the two groups was detected. VG-AVSS significantly promotes complete SMR without increasing test related stress or anxiety. Its induced arousal suggests the possibility of performing dynamic evaluations of the erectile function with the oral agent sildenafil in place of intracavernosally administered vasoactive agents. VG-AVSS furthermore constitutes a promising tool for the investigation of normal physiology and pathophysiology of female sexual function.


2000 - Diagnostic problems in psychosomatics [Abstract in Rivista]
Rigatelli, Marco; Galeazzi, Gian Maria; Ottloini, F.
abstract

Not available


1999 - New strategies for the general hospital psychiatrist: the complexity of care prediction. An european study. [Articolo su rivista]
Rigatelli, Marco; Barbieri, C.; Poletti, R.; De Jonge, P.; Huyse, F.; Herzog, T.; Lobo, A.; Slaets, J.; Stein, B.; Galeazzi, Gian Maria
abstract

NOT AVAILABLE


1998 - Complessità delle cure nei reparti medici nell'ospedale generale: uno studio europeo [Abstract in Atti di Convegno]
Galeazzi, Gian Maria; Rigatelli, Marco; Grassi, L.
abstract

Gli autori presentano un modello originale di valutazione e di intervento per lo psichiatra in un Ospedale Generale, incentrato sulla predizione della complessità assistenziale del paziente al momento del ricovero.


1998 - LA DEPRESSIONE NELLA PATOLOGIA GASTROENTEROLOGICA [Articolo su rivista]
Rigatelli, Marco; Galeazzi, Gian Maria; Barbieri, C; Neviani, V.
abstract

Not available


1998 - La psicosomatica nell'istituzione ospedaliera. [Relazione in Atti di Convegno]
Rigatelli, Marco; Poletti, R.; Barbieri, C.; Cappella, F; Galeazzi, Gian Maria; Ranuccini, R.
abstract

Non disponibile


1998 - Lo psichiatra e i pazienti "non suoi": proposta di un referto per la consulenza psichiatrica-psicosomatica in Ospedale Generale. [Relazione in Atti di Convegno]
Casolari, L.; Barbieri, C.; Galeazzi, Gian Maria; Poletti, R.; Rigatelli, Marco
abstract

Non disponibile


1998 - Scegliere lo Psichiatra per quel paziente (l'invio da un Servizio di Consulenza Psichiatrica Psicosomatica). [Relazione in Atti di Convegno]
Barbieri, C.; Galeazzi, Gian Maria; Rigatelli, Marco
abstract

Non disponibile


1998 - Studio europeo sulla qualità in psichiatria di consultazione: l’”esperienza modenese”. [Articolo su rivista]
Rigatelli, Marco; Galeazzi, Gian Maria; Barbieri, C.; Bertoncelli, B.; Casolari, L.; Cavicchioli, C.; Poletti, R.; Pastorelli, A.; Baraghini, G. F.; Herzog, T.; STEIN B., Eclw
abstract

Non disponibile


1997 - Complessità dell'assistenza come organizzatore dell'attività di consulenza psichiatrica-psicosomatica: dalla ricerca alla clinica. [Relazione in Atti di Convegno]
Galeazzi, Gian Maria; Barbieri, C.; Cavicchioli, Chiara; Poletti, R.; Rigatelli, Marco
abstract

Non disponibile


1997 - La consulenza psichiatrica nel reparto di malattie infettive [Capitolo/Saggio]
Rigatelli, Marco; Galeazzi, Gian Maria; Cavicchioli, Chiara; Natali, Alfredo; Pietri, Giulia; Poletti, R.
abstract

non disponibile


1997 - La gestione riabilitativa di alcuni pazienti con comorbilità medico-psichiatrica. [Capitolo/Saggio]
Rigatelli, Marco; Galeazzi, Gian Maria
abstract

Non disponibile


1997 - La psichiatria di Liaison italiana e i suoi collegamenti con il resto d'Europa. [Articolo su rivista]
Rigatelli, Marco; Barbieri, C.; Cavicchioli, Chiara; Galeazzi, Gian Maria; Pietri, Giulia; Poletti, R.
abstract

Non disponibile


1997 - Time is now: per la psichiatria di consultazione. [Articolo su rivista]
Rigatelli, Marco; Galeazzi, Gian Maria
abstract

Non disponibile


1996 - Il ruolo dei fattori psichici nei pazienti con disturbo vertiginoso [Capitolo/Saggio]
Rigatelli, Marco; Barbieri, C; Galeazzi, Gian Maria
abstract

La Funzione dell'equilibrio. Anatomia e fisiologia del sistema dell'equilibrio. I disturbi dell'equilibrio.La terapia dei disaturbi dell'equilibrio. Il ruolo dei fattori psichici nei pazienti con disturbo vertiginoso. Vestibologia forense.


1996 - The liaison psychiatrist turns up neuropsychiatry in the General Hospital. [Abstract in Atti di Convegno]
Rigatelli, Marco; Cavicchioli, C.; Galeazzi, Gian Maria; Natali, A.; Pietri, G.; Poletti, R.
abstract

Non disponibile


1995 - L'urgenza psichiatrica nei reparti non psichiatrici dell'Ospedale Generale: riflessione sui risultati di uno studio multicentrico europeo. [Abstract in Atti di Convegno]
Rigatelli, Marco; Casolari, L; Galeazzi, Gian Maria; Natali, A; Pietri, G; Poletti, R
abstract

Discussione su uno studio multicentrico riguardante le richieste di consulenza psichiatrica urgente.


1991 - [Orientation strategy implicit in spatial attention] [Articolo su rivista]
Galeazzi, Gian Maria; Mucignat, C; Barbieri, C; Rizzolatti, G; Umiltà, C.
abstract

In this experiment, two rows of four boxes, one above and the other below the fixation point, were displayed on a computer monitor. A cognitive numeric cue indicated one of the four external boxes, where the attention was to be directed. Stimuli, however, could occur in any of the eight boxes. The subject was instructed to respond to the imperative stimulus as fast as possible, regardless of its location. Four time intervals between cue and stimulus presentation (SOAs) were employed in order to disclose the route along which attention is moved. With the shortest SOA (100 msec) an indication that attention movements follow the cartesian/orthogonal axes was shown.