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Kim Y, Jang J, Kang HS, Lee J, Lee D, Yu H, Jang Y, Yoon J, Lee H, Ha TH, Park J, Myung W. Network Structure of Interpersonal Sensitivity in Patients With Mood Disorders: A Network Analysis. Psychiatry Investig 2024; 21:1016-1024. [PMID: 39219381 PMCID: PMC11421918 DOI: 10.30773/pi.2023.0411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 07/01/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVE Interpersonal sensitivity, characterized by a heightened awareness of others' behavior and emotions, is linked to mood disorders. However, current literature lacks a comprehensive analysis of how some items of the Interpersonal Sensitivity Measure (IPSM) interrelate and contribute to the overall construct. This study constructed a network for interpersonal sensitivity symptomatology to identify core IPSM items in patients with mood disorders. METHODS The IPSM, a 36-item self-report scale, was utilized to evaluate interpersonal sensitivity symptoms in 837 participants (major depressive disorder [MDD], n=265; bipolar I disorder [BD I], n=126; and bipolar II disorder [BD II], n=446). We performed exploratory graph analysis, employing regularized partial correlation models to estimate the network structure. Centrality analysis identified core IPSM symptoms for each mood disorder group. Network comparison tests assessed structural differences between the MDD and BD subgroups. RESULTS Network analysis detected five communities. Item 10 ("I worry about being criticized for things that I have said or done") showed the highest value in strength. Multiple items on "Interpersonal Worry/Dependency" and "Low Self-Esteem" showed high strength centrality. Network structure invariance and global strength invariance test results indicated no significant differences between the MDD and BD subgroups. CONCLUSION Our findings emphasize the importance of addressing "Interpersonal Worry/Dependency" and "Low Self-Esteem" in the IPSM network among mood disorder patients based on core items of the network. Additionally, targeted treatments and comprehensive strategies in this aspect could be crucial for managing mood disorders.
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Affiliation(s)
- Yuna Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Junwoo Jang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyo Shin Kang
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Jakyung Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Daseul Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyeona Yu
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yoonjeong Jang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Joohyun Yoon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyukjun Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Tae Hyon Ha
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jungkyu Park
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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Kwon SS, Jang Y, You JS, Lee CW, Yu H, Yoon J, Park YS, Ryoo HA, Lee D, Cho N, Ihm HK, Lee YC, Won HH, Kang HS, Ha TH, Myung W. Interpersonal sensitivity and childhood trauma in patients with major depressive disorder, bipolar I, and II disorder. Eur Arch Psychiatry Clin Neurosci 2024; 274:537-547. [PMID: 37195522 DOI: 10.1007/s00406-023-01619-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 05/04/2023] [Indexed: 05/18/2023]
Abstract
Childhood trauma and interpersonal sensitivity impact the development of mood disorders. In this study, we investigate the association between childhood trauma and interpersonal sensitivity in patients with mood disorders. A total 775 patients (major depressive disorder [MDD, n = 241], bipolar I disorder [BD I, n = 119], and bipolar II disorder [BD II, n = 415]) and 734 controls. For evaluation, we used the Childhood Trauma Questionnaire-Short Form (CTQ) and Interpersonal Sensitivity Measure (IPSM). We examined between-group differences for each subscale in the CTQ and IPSM. Patients with BD II had significantly higher IPSM total scores than patients with MDD, BD I, or controls. The CTQ total score was related to the IPSM total score in all participants and subgroups. Among the CTQ subscales, emotional abuse showed the highest correlation with the IPSM total score, while separation anxiety and fragile inner self showed higher positive correlations with CTQ than the other subscales of IPSM in all patient groups and the control group, respectively. The findings reveal that childhood trauma and interpersonal sensitivity are positively correlated among patients with MDD, BD I, and BD II, and that interpersonal sensitivity is higher in patients with BD II than those with BD I or MDD. Childhood trauma is associated with interpersonal sensitivity, and each trauma type has a different impact on mood disorders. We expect that this study will encourage future research on interpersonal sensitivity and childhood trauma in mood disorders to improve treatment approaches.
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Affiliation(s)
- Sarah Soonji Kwon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Yoonjeong Jang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
- Department of Health Science and Technology, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| | - Ji Seon You
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
- Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea
| | - Chan Woo Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Hyeona Yu
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Joohyun Yoon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Yun Seong Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Hyun A Ryoo
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Daseul Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Nayoung Cho
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Hong Kyu Ihm
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Yeong Chan Lee
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Hong-Hee Won
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyo Shin Kang
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Tae Hyon Ha
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea.
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Dong Y, Liu F, Jiang Y, Wei S. Neuroticism and Aggressive Behavior among Left-Behind Children: The Mediating Roles of Interpersonal Sensitivity and Bullying Victimization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11072. [PMID: 36078790 PMCID: PMC9518468 DOI: 10.3390/ijerph191711072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/29/2022] [Accepted: 09/02/2022] [Indexed: 06/15/2023]
Abstract
When children are "left behind", aggressive behavior is a common manifestation of problem behaviors, and several previous studies suggested that neuroticism has characteristics such as oversensitivity and impulsivity, which may be important predictors of aggressive behavior. However, the mediating mechanisms underlying this relationship are unknown. This study is designed to analyze how neuroticism leads to left-behind children's aggressive behaviors through mediators of interpersonal sensitivity and bullying victimization. A sample of 1478 Chinese children (67.72% left-behind children; 37.28% non-left-behind children) through whole-class contact and voluntary participation completed measurements of neuroticism, interpersonal sensitivity, bullying victimization, and aggressive behavior. Findings from the mediation analysis show that interpersonal sensitivity and bullying victimization could mediate the relationship between neuroticism and aggressive behavior among left-behind children separately and sequentially. These findings suggest helpful ways to reduce the aggressive behaviors of left-behind children by decreasing interpersonal sensitivity and bullying victimization.
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You Z, Liu Y, Tan Q, Xu Y, Zhang L, Andrasik F. Development and Validation of the Chinese Version of Short-Form of Interpersonal Sensitivity Measure (IPSM). Community Ment Health J 2021; 57:277-284. [PMID: 32472287 DOI: 10.1007/s10597-020-00646-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 05/23/2020] [Indexed: 10/24/2022]
Abstract
This study was conducted to develop a short form of the Interpersonal Sensitivity Measure (IPSM), translated into Chinese. A total of 1237 Chinese undergraduates, divided into four groups, participated during various phases of scale development. Exploratory factor analysis supported a five-factor structure of the IPSM-C among Chinese undergraduates, which is in accordance with the original model established by Boyce and Parker that contained 36 items. We next developed a 15-item short form of the IPSM (IPSM-CS) whose structural validity was comparable to the full form. All IPSM-CS sub-scales, as well as the total scale, showed good internal consistency, test-retest reliability and criterion-related validity. The present results indicate that the IPSM-CS may be a useful and reliable alternative to the original IPSM for individuals fluent in Chinese.
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Affiliation(s)
- Zhiqi You
- Department of Social Work, Huazhong Agricultural University, Wuhan, 430070, China.,Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, 430079, China
| | - Yan Liu
- School of Educational Science, Huazhong University of Science and Technology, Wuhan, 430074, China.,School-Based Mental Health Center, Hunan Railway Professional College, Zhuzhou, 412001, China
| | - Qianbao Tan
- School of Education, Hunan University of Science and Technology, Xiangtan, 411201, China.
| | - Yu Xu
- Department of Social Work, Huazhong Agricultural University, Wuhan, 430070, China
| | - Lu Zhang
- Department of Social Work, Huazhong Agricultural University, Wuhan, 430070, China.
| | - Frank Andrasik
- Department of Psychology, University of Memphis, Memphis, TN, 38152, USA
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Gao S, Assink M, Cipriani A, Lin K. Associations between rejection sensitivity and mental health outcomes: A meta-analytic review. Clin Psychol Rev 2017; 57:59-74. [DOI: 10.1016/j.cpr.2017.08.007] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 08/12/2017] [Accepted: 08/14/2017] [Indexed: 11/25/2022]
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Suzuki A, Matsumoto Y, Enokido M, Shirata T, Goto K, Otani K. Relationship between interpersonal sensitivity and leukocyte telomere length. BMC MEDICAL GENETICS 2017; 18:112. [PMID: 29017469 PMCID: PMC5634896 DOI: 10.1186/s12881-017-0473-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 10/01/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Telomeres are repetitive DNA sequences located at the ends of chromosomes, and telomere length represents a biological marker for cellular aging. Interpersonal sensitivity, excessive sensitivity to the behavior and feelings of others, is one of the vulnerable factors to depression. In the present study, we examined the effect of interpersonal sensitivity on telomere length in healthy subjects. METHODS The subjects were 159 unrelated healthy Japanese volunteers. Mean age ± SD (range) of the subjects was 42.3 ± 7.8 (30-61) years. Interpersonal sensitivity was assessed by the Japanese version of the Interpersonal Sensitivity Measure (IPSM). Leukocyte telomere length was determined by a quantitative real-time PCR method. RESULTS Higher scores of the total IPSM were significantly (β = -0.163, p = 0.038) related to shorter telomere length. In the sub-scale analysis, higher scores of timidity were significantly (β = -0.220, p = 0.044) associated with shorter telomere length. CONCLUSIONS The present study suggests that subjects with higher interpersonal sensitivity have shorter leukocyte telomere length, implying that interpersonal sensitivity has an impact on cellular aging.
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Affiliation(s)
- Akihito Suzuki
- Department of Psychiatry, Yamagata University School of Medicine, 2-2-2 Iidanishi, Yamagata, 990-9585, Japan.
| | - Yoshihiko Matsumoto
- Department of Psychiatry, Yamagata University School of Medicine, 2-2-2 Iidanishi, Yamagata, 990-9585, Japan
| | - Masanori Enokido
- Department of Psychiatry, Yamagata University School of Medicine, 2-2-2 Iidanishi, Yamagata, 990-9585, Japan
| | - Toshinori Shirata
- Department of Psychiatry, Yamagata University School of Medicine, 2-2-2 Iidanishi, Yamagata, 990-9585, Japan
| | - Kaoru Goto
- Department of Anatomy and Cell Biology, Yamagata University School of Medicine, 2-2-2 Iidanishi, Yamagata, 990-9585, Japan
| | - Koichi Otani
- Department of Psychiatry, Yamagata University School of Medicine, 2-2-2 Iidanishi, Yamagata, 990-9585, Japan
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Mohammadian Y, Mahaki B, Lavasani FF, Dehghani M, Vahid MA. The psychometric properties of the Persian version of Interpersonal Sensitivity Measure. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2017; 22:10. [PMID: 28400832 PMCID: PMC5361440 DOI: 10.4103/1735-1995.199093] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 09/27/2016] [Accepted: 10/29/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Investigating the psychometric properties of existing psychometric scales in societies with differing dynamics can help with their external validity. This research specifically aimed at standardization and validation of Interpersonal Sensitivity Measure (IPSM) scale in Iran. MATERIALS AND METHODS Persian version of the IPSM was produced through forward translation, reconciliation, and back translation. A total of 357, nonclinical students were selected through multistage sampling method and completed a set of questionnaires including IPSM. Internal consistency, convergent validity, divergent validity, and test-retest reliability of the Persian version of the IPSM were analyzed. To assess the construct validity, confirmatory factor analysis (CFA) was performed. RESULTS Total IPSM, as well as all subscales showed satisfactory internal consistency (Cronbach's α =0.86 and 0.51-0.71, respectively). Test-retest reliability at a 2-week interval was significant, with intraclass correlation coefficient ranging between 0.73 and 0.92. In terms of convergent validity, IPSM showed the significant positive correlation with self-report measures of depression, social anxiety, and anxious attachment style. IPSM showed negative correlation with Social Desirability Scale and secure (C subscale of avoidant attachment style [AAS]) and dependent (D subscale of AAS), thus demonstrated divergent validity with these constructs. According to the CFA, the responses of the sample in this study were fitted to the original five-factor structure. CONCLUSION The IPSM showed good validity and reliability and could be useful in assessing interpersonal sensitivity in Iranian population.
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Affiliation(s)
- Youkhabeh Mohammadian
- Center of Excellence in Psychiatry and Clinical Psychology, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Behzad Mahaki
- Department of Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Fathali Lavasani
- Center of Excellence in Psychiatry and Clinical Psychology, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Dehghani
- Center of Excellence in Psychiatry and Clinical Psychology, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadkazem Atef Vahid
- Center of Excellence in Psychiatry and Clinical Psychology, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
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Masillo A, Valmaggia LR, Lanna A, Brandizzi M, Lindau JF, Curto M, Solfanelli A, Kotzalidis GD, Patanè M, Godeas L, Leccisi D, Girardi P, Fiori Nastro P. Validation of the Italian version of interpersonal sensitivity measure (IPSM) in adolescents and young adults. J Affect Disord 2014; 156:164-70. [PMID: 24439250 DOI: 10.1016/j.jad.2013.12.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 12/05/2013] [Accepted: 12/05/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND Interpersonal sensitivity is a personality trait that describes as excessive awareness of both the behaviour and feelings of others. High interpersonal sensitivity has been associated with the development and maintenance of mental health problems. This study aimed to examine whether the Italian version of the interpersonal sensitivity measure (IPSM) has good internal consistence and convergent validity. METHODS Validity was established on a sample of 153 Italian adolescents and young adult help seekers for several psychological problems. These subjects were divided in two groups - depressive spectrum disorder group (n=42) and other diagnosis group (n=111) - according to Structured Clinical Interview (SCID-I) for DSM-IV and Kiddie-Sads-Present and Lifetime Version (K-SADS-PL). For convergent validity, we studied the correlation between total and each subscale IPSM scores and the General Symptoms (included depressive and dysphoric symptoms) of Prodromal Questionnaire. RESULTS The internal consistency were adequate and comparable to the original Boyce and Parker study. The validity was good, as indicated by both the convergent validity analysis and the depressive spectrum disorder group and other diagnosis group comparison. LIMITATIONS The absence of another scale measuring interpersonal sensitivity to assess the construct validity of IPSM; the clinical heterogeneity of the sample; the absence of test re-test reliability of the instrument. CONCLUSIONS Analysis of the results of internal consistency and convergent validity of the IPSM indicates that this version translated into Italian is valid and reliable.
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Affiliation(s)
- A Masillo
- Department of Neurology and Psychiatry, Sapienza University of Rome, Faculty of Medicine and Odontology, Rome 00156, Italy.
| | - L R Valmaggia
- Department of Psychology, King's College London, Institute of Psychiatry, UK; Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, UK
| | - A Lanna
- Department of Computer, Control, and Management Engineering "A. Ruberti", Sapienza University of Rome, Rome, Italy
| | - M Brandizzi
- Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - J F Lindau
- Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - M Curto
- Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - A Solfanelli
- Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - G D Kotzalidis
- Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - M Patanè
- Department of Neurology and Psychiatry, Sapienza University of Rome, Faculty of Medicine and Odontology, Rome 00156, Italy
| | - L Godeas
- Community Mental Health Service, ASL Rome H, Rome, Italy
| | - D Leccisi
- Community Mental Health Service, ASL Rome H, Rome, Italy
| | - P Girardi
- Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - P Fiori Nastro
- Department of Neurology and Psychiatry, Sapienza University of Rome, Faculty of Medicine and Odontology, Rome 00156, Italy
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