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Canessa N, Iozzino L, Andreose S, Castelletti L, Conte G, Dvorak A, Ferrari C, Heitzman J, Macis A, Markiewicz I, Mattavelli G, Nicolò G, Picchioni M, Restuccia G, Rivellini G, Teti F, de Girolamo G. RISK aversion in Italian forensic and non-forensic patients with schizophrenia spectrum disorders. PLoS One 2023; 18:e0289152. [PMID: 37523390 PMCID: PMC10389697 DOI: 10.1371/journal.pone.0289152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/07/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Goal-directed decision-making is a central component of the broader reward and motivation system, and requires the ability to dynamically integrate both positive and negative feedback from the environment in order to maximize rewards and minimize losses over time. Altered decision-making processes, in which individuals fail to consider the negative consequences of their decisions on both themselves and others, may play a role in driving antisocial behaviour. AIM The main study aim was to investigate possible differences in loss and risk aversion across matched patients, all with a schizophrenia spectrum disorder (SSD), but who varied according to whether they had a history of serious interpersonal violence or not, and a sample of healthy controls with no history of violence. RESULTS The sample included 14 forensic and 21 non-forensic patients with SSD, and 41 healthy controls. Among the three decision-making variables under investigation, risk aversion was the only significant predictor of membership of the three groups, with greater risk aversion among non-forensic patients with SSD compared to healthy controls. No differences were observed across groups in loss aversion and choice consistency. CONCLUSIONS This evidence suggests a new potential treatment target for rehabilitative measures aimed at achieving functional improvements in patients with SSD by selectively leveraging the neuro-cognitive processing of reward.
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Affiliation(s)
- Nicola Canessa
- IUSS Cognitive Neuroscience (ICON) Center, Scuola Universitaria Superiore IUSS, Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, Pavia, Italy
| | - Laura Iozzino
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Unit of Epidemiological Psychiatry and Evaluation, Brescia, Italy
| | - Sonia Andreose
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Psychiatric Unit, Brescia, Italy
| | | | - Giovanni Conte
- Department of Mental Health, ASST di Brescia, Brescia, Italy
| | | | - Clarissa Ferrari
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Unit of Statistics, Brescia, Italy
| | - Janusz Heitzman
- Institute of Psychiatry and Neurology, Department of Forensic Psychiatry, Warsaw, Poland
| | - Ambra Macis
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Unit of Statistics, Brescia, Italy
| | - Inga Markiewicz
- Institute of Psychiatry and Neurology, Department of Forensic Psychiatry, Warsaw, Poland
| | - Giulia Mattavelli
- IUSS Cognitive Neuroscience (ICON) Center, Scuola Universitaria Superiore IUSS, Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, Pavia, Italy
| | - Giuseppe Nicolò
- REMS Minerva, Department of Mental Health, ASL Roma 5, Rome, Italy
| | - Marco Picchioni
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- St Magnus Hospital, Surrey, United Kingdom
| | | | | | - Fabio Teti
- Sistema Polimodulare di REMS Provvisorie, ASST di Mantova, Castiglione delle Stiviere, Italy
| | - Giovanni de Girolamo
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Unit of Epidemiological Psychiatry and Evaluation, Brescia, Italy
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Rossi R, Corbo D, Magni LR, Pievani M, Nicolò G, Semerari A, Quattrini G, Riccardi I, Colle L, Conti L, Gasparotti R, Macis A, Ferrari C, Carcione A. Metacognitive interpersonal therapy in borderline personality disorder: Clinical and neuroimaging outcomes from the CLIMAMITHE study-A randomized clinical trial. Personal Disord 2023:2023-74559-001. [PMID: 37227866 DOI: 10.1037/per0000621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Different psychotherapeutic approaches demonstrated their efficacy but the possible neurobiological mechanism underlying the effect of psychotherapy in borderline personality disorder (BPD) patients is poorly investigated. We assessed the effects of metacognitive interpersonal therapy (MIT) on BPD features and other dimensions compared to structured clinical management (SCM). We also assessed changes in amygdala activation by viewing emotional pictures after psychotherapy. One hundred forty-one patients were referred and 78 BPD outpatients were included and randomized to MIT or SCM. Primary outcome was emotional dysregulation assessed with the Difficulties in Emotion Regulation Scale (DERS). We also assessed BPD symptomatology, number of PD criteria, metacognitive abilities, state-psychopathology, depression, impulsiveness, interpersonal functioning, and alexithymia. A subset of 60 patients underwent functional magnetic resonance imaging before and after 1 year of psychotherapy to assess amygdala activation by viewing standardized emotional pictures (secondary outcome). DERS scores decreased in both groups (time effect p < .001). The Cohen's d effect size for change (baseline posttreatment) on DERS was very large (d = 0.84) in MIT, and large (d = 0.76) in SCM. Both groups significantly improved in depressive symptoms, state-psychopathology, alexithymia, and interpersonal functioning. MIT showed larger effect on metacognitive functions than SCM (Time × Group p < .001). Both interventions showed a significant effect on BPD symptomatology although SCM group showed a larger decrease. On the contrary, MIT group showed larger decrease in impulsivity and number of PD criteria. Interestingly, both MIT and SCM modulated amygdala activation in BPD patients. MIT is a valid and effective psychotherapy for BPD with an impact on amygdala activation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Roberta Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli
| | - Daniele Corbo
- Neuroradiology Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia
| | - Laura R Magni
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli
| | - Michela Pievani
- Laboratory Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli
| | | | | | - Giulia Quattrini
- Laboratory Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli
| | | | | | | | - Roberto Gasparotti
- Neuroradiology Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia
| | - Ambra Macis
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli
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de Girolamo G, Iozzino L, Ferrari C, Gosek P, Heitzman J, Salize HJ, Wancata J, Picchioni M, Macis A. A multinational case-control study comparing forensic and non-forensic patients with schizophrenia spectrum disorders: the EU-VIORMED project. Psychol Med 2023; 53:1814-1824. [PMID: 34511148 PMCID: PMC10106295 DOI: 10.1017/s0033291721003433] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND The relationship between schizophrenia and violence is complex. The aim of this multicentre case-control study was to examine and compare the characteristics of a group of forensic psychiatric patients with a schizophrenia spectrum disorders and a history of significant interpersonal violence to a group of patients with the same diagnosis but no lifetime history of interpersonal violence. METHOD Overall, 398 patients (221 forensic and 177 non-forensic patients) were recruited across five European Countries (Italy, Germany, Poland, Austria and the United Kingdom) and assessed using a multidimensional standardised process. RESULTS The most common primary diagnosis in both groups was schizophrenia (76.4%), but forensic patients more often met criteria for a comorbid personality disorder, almost always antisocial personality disorder (49.1 v. 0%). The forensic patients reported lower levels of disability and better social functioning. Forensic patients were more likely to have been exposed to severe violence in childhood. Education was a protective factor against future violence as well as higher levels of disability, lower social functioning and poorer performances in cognitive processing speed tasks, perhaps as proxy markers of the negative syndrome of schizophrenia. Forensic patients were typically already known to services and in treatment at the time of their index offence, but often poorly compliant. CONCLUSIONS This study highlights the need for general services to stratify patients under their care for established violence risk factors, to monitor patients for poor compliance and to intervene promptly in order to prevent severe violent incidents in the most clinically vulnerable.
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Affiliation(s)
- Giovanni de Girolamo
- Unit of Epidemiological Psychiatry and Evaluation, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Laura Iozzino
- Unit of Epidemiological Psychiatry and Evaluation, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Pawel Gosek
- Department of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Janusz Heitzman
- Department of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Hans Joachim Salize
- Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Johannes Wancata
- Clinical Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Marco Picchioni
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- St Magnus Hospital, Haslemere, Surrey, UK
| | - Ambra Macis
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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4
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Buizza C, Strozza C, Sbravati G, de Girolamo G, Ferrari C, Iozzino L, Macis A, Kennedy HG, Candini V. Positive and negative syndrome scale in forensic patients with schizophrenia spectrum disorders: a systematic review and meta-analysis. Ann Gen Psychiatry 2022; 21:36. [PMID: 36088451 PMCID: PMC9463849 DOI: 10.1186/s12991-022-00413-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 06/19/2022] [Indexed: 01/10/2023] Open
Abstract
Among forensic patients with schizophrenia spectrum disorders, the association between symptomatology and violence is still not entirely clear in literature, especially because symptoms shift both during the acute phase of the illness and after. The aims were to investigate the level of symptomatology in forensic patients and to evaluate if there are differences in the level of symptoms between forensic and non-forensic patients. According to PRISMA guidelines, a systematic search was performed in PubMed, Web of Science, and ProQuest, using the following key words: "forensic" AND "Positive and Negative Syndrome Scale" OR "PANSS". A total of 27 studies were included in the systematic review, while only 23 studies in the meta-analysis. The overall sample included a total of 1702 participants, most commonly male and inpatients in forensic settings. We found that studies with an entirely male sample had significantly lower Positive PANSS ratings than studies with mixed samples. Although both forensic and non-forensic patients were affected by mild psychopathological symptoms, forensic patients presented higher ratings in all four PANSS scales. This meta-analysis shows that forensic patients reported a mild level of symptomatology, as assessed with the PANSS, and therefore might be considered as patients in partial remission. Among patients with schizophrenia, the association between symptoms and violence is very complex: many factors might be considered as key mediators and thus should be taken into account to explain this association. Further studies are needed.Trial registration all materials and data can be found on the OSF framework: https://osf.io/5ceja (date of registration: 8 September 2021).
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Affiliation(s)
- Chiara Buizza
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Cosmo Strozza
- Interdisciplinary Centre On Population Dynamics, University of Southern Denmark, 5000, Odense, Denmark
| | - Giulio Sbravati
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy
| | - Giovanni de Girolamo
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, Brescia, Italy
| | - Laura Iozzino
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy
| | - Ambra Macis
- Service of Statistics, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, Brescia, Italy
| | - Harry G Kennedy
- The National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.,Academic Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Valentina Candini
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy.
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5
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Pedrini L, Rossi R, Magni LR, Lanfredi M, Meloni S, Ferrari C, Macis A, Lopizzo N, Zonca V, Cattaneo A. Emotional Regulation in Teens and Improvement of Constructive Skills (EmoTIConS): study protocol for a randomized controlled trial. Trials 2021; 22:920. [PMID: 34906222 PMCID: PMC8670183 DOI: 10.1186/s13063-021-05886-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 11/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emotional dysregulation (ED) constitutes a relevant factor involved in the onset and maintenance of many mental disorders. Targeting ED during adolescence could be a determinant both to identify high-risk individuals and to promote preventive interventions. This study will aim to evaluate the impact of a brief Dialectical Behavioral Therapy (DBT)-based intervention for adolescent students by measuring changes in emotional regulation skills and impulsive behaviors. Moreover, alterations in biological features related to stress response and inflammation will be assessed as potential biological variables associated with ED. METHODS This is a randomized trial. A total of 20 classes of adolescent students will be recruited among high schools in Brescia, a city in northern Italy. They will be randomized to the psychoeducational intervention (experimental group) or to a control condition (control group). The intervention will be based on DBT Skills Training for Emotional Problem Solving for Adolescents, and will consist of four monthly, 2-h sessions (for a total of 8 h) scheduled during regular school time. Participants will be assessed at baseline, post-intervention, and at 3 and 6 months of follow-up. The primary outcome measures will be represented by changes in the use of emotional regulation skills and by changes in the frequency of impulsive behaviors. Salivary samples will be collected at baseline and post-intervention to explore possible biological features underlying ED. DISCUSSION Data from the present project will offer the opportunity to better understand the complex phenomenon of ED. Repeated assessment will cover several domains (emotional, behavioral, social, biological) as potential factors associated with ED. Moreover, it will be possible to establish the effect of the proposed intervention, thus helping to improve knowledge on the impact of school-based universal preventive programs. Finally, the current trial will propose an integrated screening and intervention-based model. Ultimately, this could reduce barriers to youths' mental health care by fostering collaboration between schools and mental health services. TRIAL REGISTRATION ClinicalTrials.gov NCT04349709 . Registered on April 16, 2020.
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Affiliation(s)
- Laura Pedrini
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - Roberta Rossi
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Laura Rosa Magni
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Mariangela Lanfredi
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Serena Meloni
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Statistics Service, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Ambra Macis
- Statistics Service, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Nicola Lopizzo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Valentina Zonca
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
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6
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Iozzino L, Harvey PD, Canessa N, Gosek P, Heitzman J, Macis A, Picchioni M, Salize HJ, Wancata J, Koch M, Ferrari C, de Girolamo G. Neurocognition and social cognition in patients with schizophrenia spectrum disorders with and without a history of violence: results of a multinational European study. Transl Psychiatry 2021; 11:620. [PMID: 34880208 PMCID: PMC8651972 DOI: 10.1038/s41398-021-01749-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/18/2021] [Accepted: 11/25/2021] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE Neurocognitive impairment has been extensively studied in people with schizophrenia spectrum disorders and seems to be one of the major determinants of functional outcome in this clinical population. Data exploring the link between neuropsychological deficits and the risk of violence in schizophrenia has been more inconsistent. In this study, we analyse the differential predictive potential of neurocognition and social cognition to discriminate patients with schizophrenia spectrum disorders with and without a history of severe violence. METHODS Overall, 398 (221 cases and 177 controls) patients were recruited in forensic and general psychiatric settings across five European countries and assessed using a standardized battery. RESULTS Education and processing speed were the strongest discriminators between forensic and non-forensic patients, followed by emotion recognition. In particular, increased accuracy for anger recognition was the most distinctive feature of the forensic group. CONCLUSIONS These results may have important clinical implications, suggesting potential enhancements of the assessment and treatment of patients with schizophrenia spectrum disorders with a history of violence, who may benefit from consideration of socio-cognitive skills commonly neglected in ordinary clinical practice.
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Affiliation(s)
- Laura Iozzino
- grid.419422.8Unit of Epidemiological Psychiatry and Evaluation, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Philip D. Harvey
- grid.26790.3a0000 0004 1936 8606Department of Psychiatry and Behavioral Sciences; Research Service, University of Miami Miller School of Medicine, Miami, FL USA
| | - Nicola Canessa
- grid.30420.350000 0001 0724 054XScuola Universitaria Superiore IUSS, IUSS Cognitive Neuroscience (ICoN) Center, Pavia, Italy ,grid.511455.1Cognitive Neuroscience Laboratory of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Pawel Gosek
- grid.418955.40000 0001 2237 2890Department of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Janusz Heitzman
- grid.418955.40000 0001 2237 2890Department of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Ambra Macis
- grid.419422.8Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Marco Picchioni
- grid.13097.3c0000 0001 2322 6764Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,St Magnus Hospital, Haslemere, Surrey UK
| | - Hans Joachim Salize
- grid.413757.30000 0004 0477 2235Medical Faculty Mannheim/Heidelberg University, Central Institute of Mental Health Mannheim, Mannheim, Germany
| | - Johannes Wancata
- grid.22937.3d0000 0000 9259 8492Clinical Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Marlene Koch
- grid.22937.3d0000 0000 9259 8492Clinical Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Clarissa Ferrari
- grid.419422.8Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giovanni de Girolamo
- Unit of Epidemiological Psychiatry and Evaluation, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
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7
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Lanfredi M, Macis A, Ferrari C, Meloni S, Pedrini L, Ridolfi ME, Zonca V, Cattane N, Cattaneo A, Rossi R. Maladaptive behaviours in adolescence and their associations with personality traits, emotion dysregulation and other clinical features in a sample of Italian students: a cross-sectional study. Borderline Personal Disord Emot Dysregul 2021; 8:14. [PMID: 33941285 PMCID: PMC8094601 DOI: 10.1186/s40479-021-00154-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 04/08/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Emotion Dysregulation (ED), childhood trauma and personality are linked to the occurrence of maladaptive behaviours in adolescence which, in turn, may be related to increased risk for psychopathology in the life course. We sought to explore the relationship among the occurrence of different clusters of maladaptive behaviours and ED, clinical features (i.e. impulsivity, childhood maltreatment, anxiety, depressive symptoms) and personality traits that have been found to be associated to Borderline Personality Disorder (BPD), in a sample of 179 adolescent students. METHODS Multiple Correspondence Analysis (MCA) was applied to detect clustered types of maladaptive behaviours and groups of students were defined as individuals engaging in these clustered behaviours (non-suicidal self-injury-NSSI, binge eating, binge drinking, cannabis use, and sexual risk behaviours). Logistic models were used to evaluate the association among clinical scales, and student groups. Mediation analysis was used to evaluate whether clinical features affected the association between personality traits and student groups. RESULTS MCA analysis allowed to identify three student groups: NSSI/binge eating (NSSI-BE) behaviours, other maladaptive behaviours and "none". Higher scores in ED, impulsivity, childhood maltreatment, anxiety and depressive symptoms increased the risk of belonging to the cluster of NSSI-BE behaviours compared to the other two groups. ED, depression and anxiety symptoms were found to be mediators of the relationship between specific personality traits, mainly pertaining to the negative affectivity construct, and NSSI/BE. CONCLUSIONS Individuals engaging in NSSI-BE behaviours represent a vulnerable adolescent population. ED, depression and anxiety were mediators of the relationship between a variety of personality traits related to BPD and NSSI and binge eating behaviours. Findings have important clinical implications in terms of prevention and interventions among adolescents engaging in self-damaging behaviours.
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Affiliation(s)
- Mariangela Lanfredi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy.
| | - Ambra Macis
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Serena Meloni
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy
| | - Laura Pedrini
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy
| | | | - Valentina Zonca
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Nadia Cattane
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Anna Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Pharmacological Biomolecular Sciences, University of Milan, Milano, Italy
| | - Roberta Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy
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8
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Bottesi G, Candini V, Ghisi M, Bava M, Bianconi G, Bulgari V, Carrà G, Cavalera C, Conte G, Cricelli M, Ferla MT, Iozzino L, Macis A, Stefana A, de Girolamo G. Personality, Schizophrenia, and Violence: A Longitudinal Study: The Second Wave of the VIORMED Project. J Pers Disord 2021; 35:236-254. [PMID: 31609185 DOI: 10.1521/pedi_2019_33_436] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study investigated the association between maladaptive personality traits, personality disorders (PDs), schizophrenia, and the risk of aggressive behavior. Ninety-four patients with a history of violence and 92 patients with no history of violence underwent a multidimensional baseline assessment. Aggressive behavior was monitored during a 1-year follow-up through the Modified Overt Aggression Scale. The Violent group scored significantly higher than the Control group on the Millon Clinical Multiaxial Inventory (MCMI-III) Antisocial, Sadistic, Borderline, and Paranoid personality scales. Irrespective of any history of violence, patients with PD as a primary diagnosis displayed more aggressive behaviors than those with a primary diagnosis of schizophrenia during the follow-up. Furthermore, the most significant predictor of aggressive behaviors over time was endorsing a primary diagnosis of PD. Identifying the crucial risk factors for violent recidivism would contribute to reducing aggressive behavior in this population.
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Affiliation(s)
- Gioia Bottesi
- Department of General Psychology, University of Padova, Padova, Italy
| | - Valentina Candini
- Department of General Psychology, University of Padova, Padova, Italy.,Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Marta Ghisi
- Department of General Psychology, University of Padova, Padova, Italy
| | - Mattia Bava
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Giorgio Bianconi
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Mental Health, ASST Ovest Milanese, Milano, Italy
| | - Viola Bulgari
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.,Division of Psychiatry, University College London, London, UK
| | - Cesare Cavalera
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Psychology, Catholic University of the Sacred Heart, Milano, Italy
| | - Giovanni Conte
- Department of Mental Health, ASST Spedali Civili of Brescia, Italy
| | - Marta Cricelli
- Department of Mental Health, Asst-Rhodense G. Salvini di Garbagnate, Milano, Italy
| | - Maria Teresa Ferla
- Department of Mental Health, Asst-Rhodense G. Salvini di Garbagnate, Milano, Italy
| | - Laura Iozzino
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Ambra Macis
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Alberto Stefana
- Department of Mental Health, ASST Spedali Civili of Brescia, Italy
| | - Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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9
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Cavalera C, Ferrari C, Bianconi G, Bulgari V, Candini V, Carrà G, Clerici M, Conte G, Cricelli M, Ferla MT, Iozzino L, Macis A, Stefana A, Ornaghi A, de Girolamo G. Substance use disorders and violent behaviour in patients with severe mental disorders: A prospective, multicentre study. Aust N Z J Psychiatry 2020; 54:1212-1223. [PMID: 33045843 DOI: 10.1177/0004867420963732] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The relationship between alcohol and substance use and the risk of violence exhibited by patients with mental disorders is under-researched. This prospective cohort study aims to compare patients with severe mental disorders and with different substance use behaviors in terms of sociodemographic and clinical characteristics, hostility, impulsivity and aggressive behaviors. Furthermore, this study aims to assess differences in violent behaviors during a 1-year monitoring follow-up. METHODS A total of 378 participants with severe mental disorders from Italian residential facilities and from four Departments of Mental Health (244 outpatients and 134 residential patients) were enrolled. Participants were categorized as Persons with Current Substance Use, Persons with Former Substance Use and Persons with Non-Substance Use. All these patients underwent a complex multidimensional assessment, including the lifetime and current substance use; a subsample of outpatients was also assessed with a laboratory substance assay including the testing for specific substances. We assessed the differences among these three groups in hostility, impulsivity and aggressive behaviors. RESULTS The results of the close 1-year monitoring show a significantly higher risk of violence for patients with severe mental disorders Persons with Current Substance Use compared to Persons with Former Substance Use and Persons with Non-Substance Use. Persons with Current Substance Use showed significantly higher scores for irritability, negativism and verbal assault compared to Persons with Non-Substance Use. Persons with Former Substance Use showed significantly higher scores for lifetime history of aggressive behaviors compared with patients with Persons with Non-Substance Use. CONCLUSION These findings suggest that patients with comorbid mental illness and substance use disorders should be referred for specific interventions to reduce aggressive behavior and ensure patient well-being and community safety.
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Affiliation(s)
- Cesare Cavalera
- Department of Psychology, Catholic University of the Sacred Heart, Milano, Italy.,Department of Mental Health, ASST Ovest Milanese, Milano, Italy
| | - Clarissa Ferrari
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Viola Bulgari
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Valentina Candini
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Division of Psychiatry, University College London, London, UK
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Department of Mental Health, ASST Monza, Milano, Italy
| | - Giovanni Conte
- Department of Mental Health, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Marta Cricelli
- Department of Mental Health, ASST Rhodense G. Salvini di Garbagnate, Milano, Italy
| | - Maria Teresa Ferla
- Department of Mental Health, ASST Rhodense G. Salvini di Garbagnate, Milano, Italy
| | - Laura Iozzino
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Ambra Macis
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Alberto Stefana
- Department of Mental Health, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Alessandra Ornaghi
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Department of Mental Health, ASST Monza, Milano, Italy
| | - Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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10
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Manenti R, Gobbi E, Baglio F, Macis A, Ferrari C, Pagnoni I, Rossetto F, Di Tella S, Alemanno F, Cimino V, Binetti G, Iannaccone S, Bramanti P, Cappa SF, Cotelli M. Effectiveness of an Innovative Cognitive Treatment and Telerehabilitation on Subjects With Mild Cognitive Impairment: A Multicenter, Randomized, Active-Controlled Study. Front Aging Neurosci 2020; 12:585988. [PMID: 33304267 PMCID: PMC7701275 DOI: 10.3389/fnagi.2020.585988] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/19/2020] [Indexed: 11/13/2022] Open
Abstract
Background In recent years, the potential usefulness of cognitive training procedures in normal aging and mild cognitive impairment (MCI) have received increased attention. Objective The main aim of this study was to evaluate the efficacy of the face-to-face cognitive virtual reality rehabilitation system (VRRS) and to compare it to that of face-to-face cognitive treatment as usual for individuals with MCI. Moreover, we assessed the possibility of prolonging the effects of treatment with a telerehabilitation system. Methods A total of 49 subjects with MCI were assigned to 1 of 3 study groups in a randomized controlled trial design: (a) those who received face-to-face cognitive VRRS (12 sessions of individualized cognitive rehabilitation over 4 weeks) followed by telerehabilitation (36 sessions of home-based cognitive VRRS training, three sessions for week); (b) those who received face-to-face cognitive VRRS followed by at-home unstructured cognitive stimulation (36 sessions of home-based unstructured cognitive stimulation, three sessions for week); and (c) those who received face-to-face cognitive treatment as usual (12 sessions of face-to-face cognitive treatment as usual). Results An improvement in memory, language and visuo-constructional abilities was observed after the end of face-to-face VRRS treatment compared to face-to-face treatment as usual. The application of home-based cognitive VRRS telerehabilitation seems to induce more maintenance of the obtained gains than home-based unstructured stimulation. Discussion The present study provides preliminary evidence in support of individualized VRRS treatment and telerehabilitation delivery for cognitive rehabilitation and should pave the way for future studies aiming at identifying optimal cognitive treatment protocols in subjects with MCI. Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT03486704.
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Affiliation(s)
- Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Ambra Macis
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Ilaria Pagnoni
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Sonia Di Tella
- IRCCS, Fondazione Don Carlo Gnocchi - ONLUS, Milan, Italy
| | - Federica Alemanno
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Hospital and Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Giuliano Binetti
- MAC Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Sandro Iannaccone
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Hospital and Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Stefano F Cappa
- NEtS, Scuola Universitaria Superiore IUSS-Pavia, Pavia, Italy.,IRCCS Fondazione Mondino, Pavia, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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11
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Gobbi E, Cotelli M, Manenti R, Ferrari C, Macis A, Bianconi G, Candini V, Clerici M, Ferla MT, Iozzino L, Vita A, de Girolamo G. Neuropsychological features in patients with severe mental disorders and risk of violence: A prospective multicenter study in Italy. Psychiatry Res 2020; 289:113027. [PMID: 32417593 DOI: 10.1016/j.psychres.2020.113027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 01/24/2023]
Abstract
In Severe Mental Disorders (SMDs) the most important cognitive deficits involve the Executive Functions (EFs). In this study we examined the association between EFs and aggressive behaviour in outpatients with SMDs. We included a total of 247 outpatients divided into two groups: 'cases', patients with a history of violence (N=126) and 'non-violent' (N=121). We compared their EFs score and then categorized the participants into four groups (Pathological Non-Violent comparison group; Non-Pathological Non-Violent comparison group; Pathological Violent cases and Non-Pathological Violent cases), based on the scores of a subtest assessing processing speed (i.e., Symbol-coding task) of the Brief Assessment of Cognition in Schizophrenia (BACS). We followed the 4 groups during a 1-year follow-up (FU) monitoring violent behaviour with the Modified Overt Aggression Scale (MOAS). According to the classification based on the BACS-Symbol Coding Task we found no statistically significant differences between subgroups in MOAS scores. We only found that the trend curve for PV was almost consistently over the other group curves in the MOAS 'aggression against people'. Our results suggested a worse performance in the violent compared to non-violent group in EFs. Despite this evidence, the score on the processing speed task was not associated with aggressive behaviour during FU.
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Affiliation(s)
- Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy.
| | - Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Clarissa Ferrari
- Statistics Service, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Ambra Macis
- Statistics Service, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Giorgio Bianconi
- Department of Mental Health, ASST Ovest Milanese, 20025 Milano, Italy
| | - Valentina Candini
- Epidemiological and Evaluation Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, 25125 Brescia, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy; Dipartimento di Salute Mentale e Dipendenze (DSMD), ASST Monza, 20900 Monza, Italy
| | - Maria Teresa Ferla
- Department of Mental Health, ASST-Rhodense G. Salvini of Garbagnate, 20020 Milano, Italy
| | - Laura Iozzino
- Epidemiological and Evaluation Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, 25125 Brescia, Italy
| | - Antonio Vita
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, 25123 Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, 25133 Brescia, Italy
| | - Giovanni de Girolamo
- Epidemiological and Evaluation Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, 25125 Brescia, Italy.
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12
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de Girolamo G, Rocchetti M, Benzi IMA, Agosta S, Casiraghi L, Ferrari C, De Franceschi N, Macis A, Pogliaghi S, Starace F. DAily time use, Physical Activity, quality of care and interpersonal relationships in patients with Schizophrenia spectrum disorders (DiAPASon): an Italian multicentre study. BMC Psychiatry 2020; 20:287. [PMID: 32513140 PMCID: PMC7278132 DOI: 10.1186/s12888-020-02588-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/05/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Schizophrenia spectrum disorders (SSD) are ranked among the leading causes of disabilities worldwide. Many people with SSD spend most of their daily time being inactive, and this is related to the severity of negative symptoms. Here, we present the 3-year DiAPAson project aimed at (1) evaluating the daily time use among patients with SSD living in Residential Facilities (RFs) compared to outpatients with SSD and to the general population (Study 1); (2) evaluating the quality of staff-patient relationships, its association with specific patient outcomes and the quality of care provided in RFs (Study 2); and (3) assessing daily activity patterns in residential patients, outpatients with SSD and healthy controls using real-time methodologies (Study 3). METHODS Study 1 will include 300 patients with SSD living in RFs and 300 outpatients; data obtained in these clinical populations will be compared with normative data obtained by the National Institute of Statistics (ISTAT) in the national survey on daily time use. Time use assessments will consist of daily diaries asking participants to retrospectively report time spent in different activities. In Study 2, a series of questionnaires will be administered to 300 residential patients (recruited for Study 1) to evaluate the quality of care and staff-patient relationships, level of well-being and burnout of RFs' staff, and quality of RFs using a European standardized questionnaire (QuIRC-SA). In Study 3, the daily time use will be evaluated in a subgroup of 50 residential patients, 50 outpatients and 50 healthy controls using the Experience Sampling Method approach (participants will complete a brief questionnaire -about time use, mood and perceived energy- on a smartphone 8 times a day for 1 week) to compare retrospective and real-time reports. Moreover, their level of physical activity, sleep patterns, and energy expenditure will be monitored through a multi-sensor device. DISCUSSION This project is highly innovative because it combines different types of assessments (i.e., retrospective and real-time reports; multi-sensor monitoring) to trace an accurate picture of daily time use and levels of physical activity that will help identify the best therapeutic options promoting daily activities and physical exercise in patients with SSD. TRIAL REGISTRATION ISRCTN registry ID ISRCTN21141466.
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Affiliation(s)
- Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - Matteo Rocchetti
- Department of Mental Health and Dependence, ASST of Pavia, Pavia, Italy ,grid.8982.b0000 0004 1762 5736Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Ilaria Maria Antonietta Benzi
- grid.419422.8Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Sara Agosta
- grid.476047.60000 0004 1756 2640Department of Mental Health and Dependence, AUSL of Modena, Modena, Italy
| | - Letizia Casiraghi
- Department of Mental Health and Dependence, ASST of Pavia, Pavia, Italy ,grid.8982.b0000 0004 1762 5736Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Clarissa Ferrari
- grid.419422.8Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Nicola De Franceschi
- grid.7637.50000000417571846Department of Information Engineering, University of Brescia, Brescia, Italy
| | - Ambra Macis
- grid.419422.8Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Silvia Pogliaghi
- grid.5611.30000 0004 1763 1124Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Fabrizio Starace
- grid.476047.60000 0004 1756 2640Department of Mental Health and Dependence, AUSL of Modena, Modena, Italy
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13
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Cotelli M, Manenti R, Ferrari C, Gobbi E, Macis A, Cappa SF. Effectiveness of language training and non-invasive brain stimulation on oral and written naming performance in Primary Progressive Aphasia: A meta-analysis and systematic review. Neurosci Biobehav Rev 2020; 108:498-525. [DOI: 10.1016/j.neubiorev.2019.12.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 10/11/2019] [Accepted: 12/03/2019] [Indexed: 12/14/2022]
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14
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Candini V, Ghisi M, Bianconi G, Bulgari V, Carcione A, Cavalera C, Conte G, Cricelli M, Ferla MT, Ferrari C, Iozzino L, Macis A, Nicolò G, Stefana A, de Girolamo G. Aggressive behavior and metacognitive functions: a longitudinal study on patients with mental disorders. Ann Gen Psychiatry 2020; 19:36. [PMID: 32518577 PMCID: PMC7271462 DOI: 10.1186/s12991-020-00286-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Metacognitive functions play a key role in understanding which psychological variables underlying the personality might lead a person with a severe mental disorder to commit violent acts against others. The aims of this study were to: (a) investigate the differences between patients with poor metacognitive functioning (PM group) and patients with good metacognitive functioning (GM group) in relation to a history of violence; (b) investigate the differences between the two groups in relation to aggressive behavior during a 1-year follow-up; and (c) analyze the predictors of aggressive behavior. METHODS In a prospective cohort study, patients with severe mental disorders with and without a lifetime history of serious violence were assessed with a large set of standardized instruments and were evaluated bi-monthly with MOAS in order to monitor any aggressive behavior. The total sample included 180 patients: 56% outpatients and 44% inpatients, and the majority were male (75%) with a mean age of 44 (± 9.8) years, and half of them had a history of violence. The sample was split into two groups: poor metacognition (PM) group and good metacognition (GM) group, according to MAI evaluation scores. RESULTS The PM patients reported a history of violence more frequently than GM patients, during the 1-year follow-up, but no differences between groups in aggressive and violent behavior were found. The strongest predictors of aggressive behavior were: borderline and passive-aggressive personality traits and a history of violence, anger, and hostility. The metacognitive functions alone did not predict aggressive behavior, but metacognitive functions interacted with hostility and angry reactions in predicting aggressive behavior. CONCLUSIONS This study led to some important conclusions: (a) some aspects closely related to violence are predictive of aggressive behavior only in patients with poor metacognition, thus good metacognition is a protective factor; (b) poor metacognition is associated with a history of violence, which in turn increases the risk of committing aggressive behavior.
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Affiliation(s)
- Valentina Candini
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, Via Pilastroni 4, Brescia, Italy
| | - Marta Ghisi
- Department of General Psychology, University of Padova, Padova, Italy
| | | | - Viola Bulgari
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, Via Pilastroni 4, Brescia, Italy
| | - Antonino Carcione
- Training School in Cognitive Psychotherapy, Terzo Centro di Psicoterapia Cognitiva-Scuola Italiana di Cognitivismo Clinico (SICC), Rome, Italy
| | - Cesare Cavalera
- Department of Psychology, Catholic University of the Sacred Heart, Milano, Italy
| | - Giovanni Conte
- Department of Mental Health, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Marta Cricelli
- Department of Mental Health, Asst-Rhodense G.Salvini di Garbagnate, Milano, Italy
| | - Maria Teresa Ferla
- Department of Mental Health, Asst-Rhodense G.Salvini di Garbagnate, Milano, Italy
| | - Clarissa Ferrari
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, Brescia, Italy
| | - Laura Iozzino
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, Via Pilastroni 4, Brescia, Italy
| | - Ambra Macis
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, Brescia, Italy
| | - Giuseppe Nicolò
- Training School in Cognitive Psychotherapy, Terzo Centro di Psicoterapia Cognitiva-Scuola Italiana di Cognitivismo Clinico (SICC), Rome, Italy
| | - Alberto Stefana
- Department of Mental Health, ASST Spedali Civili of Brescia, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, Via Pilastroni 4, Brescia, Italy
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15
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Scocco P, Macis A, Ferrari C, Bava M, Bianconi G, Bulgari V, Candini V, Carrà G, Cavalera C, Clerici M, Conte G, Cricelli M, Ferla MT, Iozzino L, Stefana A, de Girolamo G. Publisher Correction: Self-harm behaviour and externally-directed aggression in psychiatric outpatients: a multicentre, prospective study (viormed-2 study). Sci Rep 2019; 9:20382. [PMID: 31892738 PMCID: PMC6938511 DOI: 10.1038/s41598-019-56963-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Paolo Scocco
- Department of Mental Health, ULSS 6 Euganea, Padova, Italy
| | - Ambra Macis
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Mattia Bava
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | | | - Viola Bulgari
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Valentina Candini
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.,Division of Psychiatry, University College London, London, UK
| | - Cesare Cavalera
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Psychology, Catholic University of the Sacred Heart, Milano, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.,Department of Mental Health, ASST of Monza, Monza, Italy
| | - Giovanni Conte
- Department of Mental Health, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Marta Cricelli
- Department of Mental Health, Asst-Rhodense G.Salvini of Garbagnate, Milano, Italy
| | - Maria Teresa Ferla
- Department of Mental Health, Asst-Rhodense G.Salvini of Garbagnate, Milano, Italy
| | - Laura Iozzino
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Alberto Stefana
- Department of Mental Health, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
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16
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Scocco P, Macis A, Ferrari C, Bava M, Bianconi G, Bulgari V, Candini V, Carrà G, Cavalera C, Clerici M, Conte G, Cricelli M, Teresa Ferla M, Iozzino L, Stefana A, de Girolamo G. Self-harm behaviour and externally-directed aggression In psychiatric outpatients: a multicentre, prospective study (viormed-2 study). Sci Rep 2019; 9:17857. [PMID: 31780679 PMCID: PMC6882905 DOI: 10.1038/s41598-019-53993-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 10/26/2019] [Indexed: 12/03/2022] Open
Abstract
The aim of the project was to investigate differences between outpatients with Severe Mental Disorders (SMDs) with and without a history of Self-Harm behaviour (SHb) and/or Violent behaviour against other people (Vb) in relation to: (a) socio-demographic and clinical characteristics, (b) violent behaviour during a 1-year FU, (c) predictors of SHb and Vb during the FU. Outpatients with SMDs, with and without a history of Vb were enrolled. They were divided in four groups: patients with lifetime Vb (V), patients with both Vb and SHb (V-SH), patients with only SHb (SH) and patients with no history of SHb and Vb (control group, CONT). The frequency and severity of SHb and Vb during the FU were assessed every two weeks by the MOAS. Overall 246 patients were enrolled. BPRS-E Depression item, the SLOF Social acceptability, the BDHI Indirect Aggression, the BIS Motor Impulsiveness and the STAXI-2 Control-Out showed significant correlations with all the four groups (p < 0.030). V and V-SH patient groups reached higher scores in all MOAS sub-scales. Age among the SH group and BPRS-E affect-anxiety subscale among the V group significantly predicted aggression against people. In people with SMDs a history of SHb or Vb is associated with different medium-term outcomes.
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Affiliation(s)
- Paolo Scocco
- Department of Mental Health, ULSS 6 Euganea, Padova, Italy
| | - Ambra Macis
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Mattia Bava
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | | | - Viola Bulgari
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Valentina Candini
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.,Division of Psychiatry, University College London, London, UK
| | - Cesare Cavalera
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Psychology, Catholic University of the Sacred Heart, Milano, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.,Department of Mental Health, ASST of Monza, Monza, Italy
| | - Giovanni Conte
- Department of Mental Health, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Marta Cricelli
- Department of Mental Health, Asst-Rhodense G.Salvini of Garbagnate, Milano, Italy
| | - Maria Teresa Ferla
- Department of Mental Health, Asst-Rhodense G.Salvini of Garbagnate, Milano, Italy
| | - Laura Iozzino
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Alberto Stefana
- Department of Mental Health, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
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17
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Lanfredi M, Macis A, Ferrari C, Rillosi L, Ughi EC, Fanetti A, Younis N, Cadei L, Gallizioli C, Uggeri G, Rossi R. Effects of education and social contact on mental health-related stigma among high-school students. Psychiatry Res 2019; 281:112581. [PMID: 31586833 DOI: 10.1016/j.psychres.2019.112581] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 09/25/2019] [Accepted: 09/26/2019] [Indexed: 12/30/2022]
Abstract
Poor knowledge and stigma toward people with mental illness negatively affect intentions to seek help among adolescents. The study aimed to assess the impact of three school-based interventions and to explore whether positive changes in attitudes were linked to more favorable changes in desire for social distance and seeking help. A total of 221 upper secondary students were allocated to three interventions: 1. social contact; 2. Mental Health Literacy (MHL) conducted by clinicians; 3. MHL conducted by dis-peer instructors. Measures of knowledge, attitudes, views on empowerment and recovery, willingness to interact, and help seeking were collected. Generalized Estimating Equations and Structural Equation Modeling (SEM) were used to evaluate scores differences between interventions through time, and to test the interrelationships between knowledge, attitudes variables and the two outcomes of interest. Findings showed that all groups improved in knowledge, attitudes, empowerment, willingness to interact, and seeking help. SEM revealed that the increase in knowledge was significantly associated with the General attitudes toward people with mental illness construct that, in turn, was positively associated with willingness to interact and seeking help. Results encourage the use of anti-stigma interventions in order to decrease negative attitudes toward mental illness and improve behavioral intentions among students.
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Affiliation(s)
- Mariangela Lanfredi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - Ambra Macis
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Luciana Rillosi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Cadone Ughi
- SISM - Segretariato Italiano Studenti in Medicina, sede locale di Brescia, Italy
| | - Agnese Fanetti
- SISM - Segretariato Italiano Studenti in Medicina, sede locale di Brescia, Italy
| | - Nadia Younis
- SISM - Segretariato Italiano Studenti in Medicina, sede locale di Brescia, Italy
| | - Lorenza Cadei
- SISM - Segretariato Italiano Studenti in Medicina, sede locale di Brescia, Italy
| | - Caterina Gallizioli
- SISM - Segretariato Italiano Studenti in Medicina, sede locale di Brescia, Italy
| | - Guido Uggeri
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Roberta Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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18
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Marizzoni M, Ferrari C, Macis A, Jovicich J, Albani D, Babiloni C, Cavaliere L, Didic M, Forloni G, Galluzzi S, Hoffmann KT, Molinuevo JL, Nobili F, Parnetti L, Payoux P, Pizzini F, Rossini PM, Salvatore M, Schönknecht P, Soricelli A, Del Percio C, Hensch T, Hegerl U, Tsolaki M, Visser PJ, Wiltfang J, Richardson JC, Bordet R, Blin O, Frisoni GB. Biomarker Matrix to Track Short Term Disease Progression in Amnestic Mild Cognitive Impairment Patients with Prodromal Alzheimer’s Disease. J Alzheimers Dis 2019; 69:49-58. [DOI: 10.3233/jad-181016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Moira Marizzoni
- Laboratory of Neuroimaging and Alzheimer’s Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Ambra Macis
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Jorge Jovicich
- Center for Mind/Brain Sciences, University of Trento, Italy
| | - Diego Albani
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Claudio Babiloni
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Rome, Italy
- Hospital San Raffaele Cassino, Cassino (FR), Italy
| | - Libera Cavaliere
- Laboratory of Neuroimaging and Alzheimer’s Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Mira Didic
- Aix-Marseille Université, Inserm, INS UMR_S 1106, Marseille, France
- APHM, Timone, Service de Neurologie et Neuropsychologie, APHM Hôpital Timone Adultes, Marseille, France
| | - Gianluigi Forloni
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Samantha Galluzzi
- Laboratory of Neuroimaging and Alzheimer’s Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - José Luis Molinuevo
- Alzheimer’s Disease Unit and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, and Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalunya, Spain
| | - Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lucilla Parnetti
- Clinica Neurologica, Università di Perugia, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - Pierre Payoux
- INSERM; Imagerie cérébrale et handicaps neurologiques UMR 825, Toulouse, France
| | - Francesca Pizzini
- Department of Diagnostics and Pathology, Neuroradiology, Verona University Hospital, Italy
| | - Paolo Maria Rossini
- Department of Gerontology, Area of Neuroscience, Neurosciences & Orthopedics, Catholic University, Policlinic A. Gemelli Foundation Rome, Italy
| | | | - Peter Schönknecht
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | | | | | - Tilman Hensch
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Magda Tsolaki
- 3rd Neurologic Clinic, Medical School, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pieter Jelle Visser
- Department of Neurology, Alzheimer Centre, VU Medical Centre, Amsterdam, The Netherlands
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, LVR-Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August-University, Goettingen, Germany
- iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Jill C. Richardson
- Neurosciences Therapeutic Area, GlaxoSmithKline R&D, Gunnels Wood Road, Stevenage, UK
| | - Régis Bordet
- University of Lille, Inserm, CHU Lille, U1171-Degenerative and vascular cognitive disorders, Lille, France
| | - Olivier Blin
- Aix Marseille University, UMR-CNRS 7289, Service de Pharmacologie Clinique, AP-HM, Marseille, France
| | - Giovanni B. Frisoni
- Laboratory of Neuroimaging and Alzheimer’s Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
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19
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Barlati S, Stefana A, Bartoli F, Bianconi G, Bulgari V, Candini V, Carrà G, Cavalera C, Clerici M, Cricelli M, Ferla MT, Ferrari C, Iozzino L, Macis A, Vita A, de Girolamo G. Violence risk and mental disorders (VIORMED-2): A prospective multicenter study in Italy. PLoS One 2019; 14:e0214924. [PMID: 30990814 PMCID: PMC6467378 DOI: 10.1371/journal.pone.0214924] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 03/23/2019] [Indexed: 11/19/2022] Open
Abstract
Background The management of mentally ill offenders in the community is one of the great challenges imposed on community psychiatry. Aim The aim of this study was to analyze the association between sociodemographic, clinical, and psychosocial factors and violent behavior in a sample of outpatients with severe mental disorders. Method This was a prospective cohort study with a baseline cross-sectional design used to provide a detailed analysis of patients’ profiles, followed by a longitudinal design to measure aggressive and violent behavior during a 1-year follow-up. Patients with severe mental disorders, with or without a history of violence, were enrolled in four Italian Departments of Mental Health and underwent a comprehensive multidimensional assessment. Results The sample included 247 outpatients, for a total of 126 cases and 121 controls. Compared to controls, patients with a history of violence had a greater frequency of lifetime domestic violence, a greater lifetime propensity to misuse substances, and a higher number of compulsory admissions. The forthnightly monitoring during the 1-year follow-up did show statistically significant differences in aggressive and violent behavior rates between the two groups. Verbal aggression was significantly associated with aggression against objects and physical aggression. Moreover, outpatients with an history of violence showed statistically significant higher MOAS scores compared to both residential patients with an history of violence, assessed in the first wave of this project, and all controls. Conclusions Patients with a history of violence had specific characteristics and showed a greater occurrence of additional community violence during a 1-year observation period. Our results may assist clinicians in implementing standardized methods of patient assessment and violence monitoring in outpatient mental health services and may prompt improved collaboration between different community services.
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Affiliation(s)
- Stefano Barlati
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alberto Stefana
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Francesco Bartoli
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | | | - Viola Bulgari
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Valentina Candini
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Cesare Cavalera
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Department of Psychology, Catholic University of the Sacred Heart, Milano, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
- Department of Mental Health, San Gerardo Hospital of Monza, Italy
| | - Marta Cricelli
- Department of Mental Health, ASST-Rhodense G.Salvini of Garbagnate, Milano, Italy
| | - Maria Teresa Ferla
- Department of Mental Health, ASST-Rhodense G.Salvini of Garbagnate, Milano, Italy
| | - Clarissa Ferrari
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Laura Iozzino
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Ambra Macis
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Antonio Vita
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- * E-mail:
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20
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Ciuti C, Marcello C, Macis A, Onnis E, Solinas R, Lai C, Concu A. Improved aerobic power by detraining in basketball players mainly trained for strength. ACTA ACUST UNITED AC 1996. [DOI: 10.1080/15438629609512063] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Ciuti C, Marcello C, Papoff MV, Macis A, Tintrup F, Concu A. Differences in cardiovascular profiles induced by mental arithmetic and by hand-eye task. Boll Soc Ital Biol Sper 1994; 70:265-70. [PMID: 7702830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Five young, healthy male students performed two different psychophysical tests each lasting 1 min. The first test (A) consisted of mental arithmetic with digiting of results on a keyboard; the second test (G) consisted of playing an electronic game based on hand-eye coordination. Before and during each test, subjects remained seated with their thoraxes connected to an impedance cardiography monitor which gave, non invasively, beat-by-beat values of heart rate (HR), cardiac output (CO), stroke volume (SV) and left ventricle ejection time (VET). Systolic (SBP) and diastolic (DBP) arterial blood pressures were measured by means of a sphygmomanometer and total peripheral vascular resistance (TPR) and mean systolic ejection rate (MSER) were calculated. During test A, CO (A = +30%, G = +14%), HR (A = +26%, G = +2%) and SBP (A = +16%, G = +10%) increased more than during test G, while SV (A = +3%, G = +12%) and MSER (A = +11%, G = +14%) increased less and TPR (A = -13%, G = -7%) and VET (A = -7%, G = -2%) decreased more than in G. It was concluded that the analysis of a more complete cardiovascular profile may enhance distinctions among the behavioural stressors that induced different combinations in cognitive and sensory-motor responses.
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Affiliation(s)
- C Ciuti
- Institute of Human Physiology, University of Cagliari
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