Publications by authors named "Luca Pingani"

35 Publications

What are the effects of teaching Evidence-Based Health Care (EBHC) at different levels of health professions education? An updated overview of systematic reviews.

PLoS One 2021 22;16(7):e0254191. Epub 2021 Jul 22.

Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa.

Background: Evidence-based healthcare (EBHC) knowledge and skills are recognised as core competencies of healthcare professionals worldwide, and teaching EBHC has been widely recommended as an integral part of their training. The objective of this overview of systematic reviews (SR) was to update evidence and assess the effects of various approaches for teaching evidence-based health care (EBHC) at undergraduate (UG) and postgraduate (PG) medical education (ME) level on changes in knowledge, skills, attitudes and behaviour.

Methods And Findings: This is an update of an overview that was published in 2014. The process followed standard procedures specified for the previous version of the overview, with a modified search. Searches were conducted in Epistemonikos for SRs published from 1 January 2013 to 27 October 2020 with no language restrictions. We checked additional sources for ongoing and unpublished SRs. Eligibility criteria included: SRs which evaluated educational interventions for teaching EBHC compared to no intervention or a different strategy were eligible. Two reviewers independently selected SRs, extracted data and evaluated quality using standardised instrument (AMSTAR2). The effects of strategies to teach EBHC were synthesized using a narrative approach. Previously published version of this overview included 16 SR, while the updated search identified six additional SRs. We therefore included a total of 22 SRs (with a total of 141 primary studies) in this updated overview. The SRs evaluated different educational interventions of varying duration, frequency, and format to teach various components of EBHC at different levels of ME (UG, PG, mixed). Most SRs assessed a range of EBHC related outcomes using a variety of assessment tools. Two SRs included randomised controlled trials (RCTs) only, while 20 reviews included RCTs and various types of non-RCTs. Diversity of study designs and teaching activities as well as aggregated findings at the SR level prevented comparisons of the effects of different techniques. In general, knowledge was improved across all ME levels for interventions compared to no intervention or pre-test scores. Skills improved in UGs, but less so in PGs and were less consistent in mixed populations. There were positive changes in behaviour among UGs and PGs, but not in mixed populations, with no consistent improvement in attitudes in any of the studied groups. One SR showed improved patient outcomes (based on non-randomised studies). Main limitations included: poor quality and reporting of SRs, heterogeneity of interventions and outcome measures, and short-term follow up.

Conclusions: Teaching EBHC consistently improved EBHC knowledge and skills at all levels of ME and behaviour in UGs and PGs, but with no consistent improvement in attitudes towards EBHC, and little evidence of the long term influence on processes of care and patient outcomes. EBHC teaching and learning should be interactive, multifaceted, integrated into clinical practice, and should include assessments.

Study Registration: The protocol for the original overview was developed and approved by Stellenbosch University Research Ethics Committee S12/10/262.

Update Of The Overview: Young T, Rohwer A, Volmink J, Clarke M. What are the effects of teaching evidence-based health care (EBHC)? Overview of systematic reviews. PLoS One. 2014;9(1):e86706. doi: 10.1371/journal.pone.0086706.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0254191PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297776PMC
July 2021

L'associazione tra fumo di tabacco e crisi economiche in Italia.

Epidemiol Prev 2021 May-Jun;45(3):189-195

Department of Social Psychology and Development, University of Padova, Padova (Italy).

Objectives: to analyse the association between smoking behaviour and economic crises in Italy between 1993 and 2015.

Design: ecological study, carried out on data of the Italian National Institute of Statistics, by means of fixed-effect panel regressions.

Setting And Participants: the rate of smoking prevalence (disaggregated by gender and age) and the unemployment rate (disaggregated by gender and referring to individuals aged 15 or more) were collected for each of the twenty Italian regions. Also, percentage fluctuations of the national real gross domestic product (GDP) were collected to identify the years of severe economic crisis.

Main Outcome Measures: number of people who smoke per 100 people with the same features.

Results: among men, increased regional unemployment rate was associated with increased smoking behaviour only in the group aged 25-34 years. Differently, severe economic crises were associated with increased smoking in almost all age groups, except for men aged 15-24 years. A 1-point decrease in GDP was associated with 0.75 more smokers aged 15 years or more. The highest coefficient was reported among men aged 35-44 years, where a 1-point decrease in GDP was associated with 1.16 more smokers (every 100 men). This age group is also featured by the second highest prevalence of tobacco smoking (36.8%). Among women, a 1-point increase in the regional unemployment rate was associated with 0.08 less smokers every 100 women. Similarly, periods of severe economic crisis at national level were associated with reduced smoking behaviour among women aged 15 years or more, specifically those aged 15-24 years. Differently, women aged 25-34 and 65 years or more showed an association similar to that reported among men. In these groups, a 1-point decrease in GDP was associated with 0.67 and 1.08 more smokers every 100 women. While among the latter the prevalence of tobacco smoking is the lowest, among the former it is the third highest prevalence (21.69%). Therefore, increased smoking behaviour due to economic crises seems to occur especially among women aged 25-35 years old, as happens among men.

Conclusions: men in almost all age groups and women aged 25-34 and 65 years or more represent vulnerable groups in which smoking behaviour may increase in times of economic hardship. Therefore, specific policies should be implemented to prevent this occurrence, as well as the negative health outcomes of tobacco smoking.
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http://dx.doi.org/10.19191/EP21.3.P189.064DOI Listing
July 2021

Time Waits for No One: Longitudinal Study on the Effects of an Anti-Stigma Seminar on the Psychology Student Population.

Int J Environ Res Public Health 2021 05 19;18(10). Epub 2021 May 19.

Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy.

The primary aim is to describe the changes in the knowledge of mental health conditions, the attitudes toward the mentally ill, and the intended behaviour towards people with mental illness among the entire student population of the third year of a degree course in Psychology. A total of 570 students attended a seminar on stigma towards mental illness and were invited to complete an online survey which collected data on sociodemographic characteristics and three validated questionnaires evaluating different aspects of stigma at three different time points (pre-intervention, post-intervention, and at one year follow up). A total of 253 students (44.39%) completed the questionnaires at t0, t1, and t2. The mean age of the sample was 23.7 (SD = ±5.89), and 86.96% ( = 220) were females. Between t0 and t1, a statistically significant improvement was observed for all three outcomes, while the intended behaviour outcome was no longer significant between t1 and t2 (Z = -0.70; = 0.48). Females and who participated live at the seminar maintained a significant knowledge of mental illness and a better attitude toward community mental health care. The effects of the seminar focused on reducing stigma tended to diminish over time at one year follow-up, particular in relation to intended behaviour.
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http://dx.doi.org/10.3390/ijerph18105441DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8161382PMC
May 2021

Maladaptive Daydreaming in an Adult Italian Population During the COVID-19 Lockdown.

Front Psychol 2021 24;12:631979. Epub 2021 Mar 24.

Faculty of Human and Society Sciences, Kore University of Enna, Enna, Italy.

During the COVID-19 outbreak, individuals with or without mental disorders may resort to dysfunctional psychological strategies that could trigger or heighten their emotional distress. The current study aims to explore the links between maladaptive daydreaming (MD, i.e., a compulsive fantasy activity associated with distress and psychological impairment), psychological symptoms of depression, anxiety, and negative stress, and COVID-19-related variables, such as changes in face-to-face and online relationships, during the COVID-19 lockdown in Italy. A total of 6,277 Italian adults completed an online survey, including socio-demographic variables, COVID-19 related information, the 16-item Maladaptive Daydreaming Scale (MDS-16), and Depression, Anxiety, and Stress Scales-21 Items (DASS-21). Based on an empirically derived cut-off score, 1,082 participants (17.2%) were identified as probable maladaptive daydreamers (MDers). A binary logistic regression revealed that compared to controls, probable MDers reported that during the COVID-19 lockdown they experienced higher levels of anxiety and depression, decreased online social relationships, and, surprisingly, stable or increased face-to-face social relationships. Given the peculiar characteristics of the pandemic context, these findings suggest that the exposure to the risk of contagion had probably exacerbated the tendency of probable MDers to lock themselves inside their mental fantasy worlds, which in turn may have contributed to further estrangement from online social relationships and support, thus worsening their emotional distress.
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http://dx.doi.org/10.3389/fpsyg.2021.631979DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8024516PMC
March 2021

Translation and Validation of an Italian Language Version of the Religious Beliefs and Mental Illness Stigma Scale (I-RBMIS).

J Relig Health 2021 Feb 6. Epub 2021 Feb 6.

Department of Biomedical, Metabolic and Neural Sciences, Università degli Studi di Modena e Reggio Emilia, "De Sanctis" Pavilion - "San Lazzaro" University Campus, Via Amendola 2, 42121, Reggio Emilia, Italy.

The aim of this study is to validate the Italian version of the Religious Beliefs and Mental Illness Stigma Scale (I-RBMIS): a self-report measure of religious beliefs that may contribute to stigma regarding mental disorders. Scale validation included: linguistic validation; pilot test for understandability; face validity; factor analysis as test of dimensionality; Kaiser-Meyer-Olkin test to evaluate sample sampling adequacy; internal consistency was assessed using Cronbach's alpha; scale validity was assessed through concurrent criterion validity using as gold standard the Italian version of Attribution Questionnaire 27 and mental health knowledge schedule; A total of 311 people agreed to participate in the study. Face validity showed that 13 items out of 16 were completely understandable while only three items (4, 9 and 13) highlighted small lexical concerns. The average compilation time was under 4 min. Bartlett's test for sphericity was statistically significant (Χ = 1497.54; df = 120; p < 0.001). Cronbach's alpha values were acceptable both for the entire questionnaire (0.80) and for the morality/sin subscale (0.73), whereas it was slightly below the standard cutoff for the spiritually oriented causes/treatments (0.68). Scale validity showed a positive correlation between I-RBMIS and AQ-27-I, and a negative correlation between I-RBMIS and MAKS-I. I-RBMIS demonstrated good psychometric properties to assess stigmatizing religious beliefs toward mental illness in general population.
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http://dx.doi.org/10.1007/s10943-021-01195-9DOI Listing
February 2021

Diagnostic Agreement between Physicians and a Consultation-Liaison Psychiatry Team at a General Hospital: An Exploratory Study across 20 Years of Referrals.

Int J Environ Res Public Health 2021 01 17;18(2). Epub 2021 Jan 17.

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287-41125 Modena, Italy.

Consultation-liaison psychiatry (CLP) manages psychiatric care for patients admitted to a general hospital (GH) for somatic reasons. We evaluated patterns in psychiatric morbidity, reasons for referral and diagnostic concordance between referring doctors and CL psychiatrists. Referrals over the course of 20 years (2000-2019) made by the CLP Service at Modena GH (Italy) were retrospectively analyzed. Cohen's kappa statistics were used to estimate the agreement between the diagnoses made by CL psychiatrist and the diagnoses considered by the referring doctors. The analyses covered 18,888 referrals. The most common referral reason was suspicion of depression ( = 4937; 32.3%), followed by agitation ( = 1534; 10.0%). Psychiatric diagnoses were established for 13,883 (73.8%) referrals. Fair agreement was found for depressive disorders (kappa = 0.281) and for delirium (kappa = 0.342), which increased for anxiety comorbid depression (kappa = 0.305) and hyperkinetic delirium (kappa = 0.504). Moderate agreement was found for alcohol or substance abuse (kappa = 0.574). Referring doctors correctly recognized psychiatric conditions due to their exogenous etiology or clear clinical signs; in addition, the presence of positive symptoms (such as panic or agitation) increased diagnostic concordance. Close daily collaboration between CL psychiatrists and GH doctors lead to improvements in the ability to properly detect comorbid psychiatric conditions.
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http://dx.doi.org/10.3390/ijerph18020749DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7830763PMC
January 2021

Anxiety, depression and personality traits in Italian medical students.

Riv Psichiatr 2020 Nov-Dec;55(6):342-348

Section of Clinical Neuroscience, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Background: Anxiety and depressive symptoms are common worldwide and, according to the World Health Organization, their prevalence has increased in the last decades. Further, dysfunctional personality traits are frequently coupled with anxiety and depressive symptoms. The prevalence of these symptoms is particularly relevant in medical students.

Methods: This study assessed the prevalence of anxiety and depressive symptoms in Italian medical students from the University of Modena and Reggio Emilia, by using the Hospital Anxiety and Depression Scale (HADS). Personality traits were assessed as well by employing the Personality Inventory for DSM-5, Brief Form (PID-5-BF), to explore their association with anxiety and depressive symptoms. A self-administered questionnaire was sent by e-mail to all the 944 students and 459 (48.6%) were enrolled. Besides the HADS and the PID-5-BF, the questionnaire included items concerning everyday life activities such as sports and academic features such as the years of attendance and average marks.

Results: A high prevalence of anxiety (n=92; 20%), depression (n=32; 7%), and comorbid anxiety-depressive symptoms (n=218; 47%) was reported. Multiple binary logistic analysis showed increased levels of anxiety and depression to be associated with personality traits, namely detachment and negative affect, and use of cognitive enhancers. On the other hand, sports activities, social activities and distraction were related to lower levels of symptoms.

Conclusions: Symptoms of depression and anxiety are common among Italian medical students and specific interventions should be implemented to target them.
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http://dx.doi.org/10.1708/3503.34892DOI Listing
December 2020

Validation of the Modena bleeding score in endoscopic sinus surgery.

Braz J Otorhinolaryngol 2020 Sep 30. Epub 2020 Sep 30.

University Hospital of Modena, Otolaryngology-Head and Neck Surgery Department, Modena, Italy.

Introduction: The Modena bleeding score is a categorical rating scale that allows the assessment of the surgical field in relation to bleeding during endoscopic surgery. It has recently been presented and validated in the field of endoscopic ear surgery by the present authors. The Modena bleeding score provides five grades for rating the surgical field during endoscopic procedures (from grade 1 - no bleeding to grade 5 - bleeding that prevents every surgical procedure except those dedicated to bleeding control).

Objective: The aim of this study was to validate the Modena bleeding score in the setting of endoscopic sinus surgery.

Methods: Fifteen three-minute videos of endoscopic sinus surgery procedures (each containing three bleeding situations) were evaluated by 15 specialists, using the Modena bleeding score. Intra and inter-rater reliability were assessed, and the clinical validity of the Modena bleeding score was calculated using a referent standard.

Results: The data analysis showed an intra-rater reliability ranging from 0.6336 to 0.861. The inter-rater reliability ranged from 0.676 to 0.844. The clinical validity was α = 0.70; confidence limits: 0.64 - 0.75, corresponding to substantial agreement.

Conclusion: The Modena bleeding score is an effective method to score bleeding during endoscopic sinus surgery. Its application in future research could facilitate the performance and efficacy assessment of surgical techniques, materials or devices aimed to bleeding control during endoscopic sinus surgery.
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http://dx.doi.org/10.1016/j.bjorl.2020.08.006DOI Listing
September 2020

Is Consultation-Liaison Psychiatry 'Getting Old'? How Psychiatry Referrals in the General Hospital Have Changed over 20 Years.

Int J Environ Res Public Health 2020 10 10;17(20). Epub 2020 Oct 10.

Department of Biomedical, Metabolic Sciences and Neurosciences, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy.

There is an ever-growing awareness of the health-related special needs of older patients, and Consultation-Liaison Psychiatry Services (CLPS) are significantly involved in providing such age-friendly hospital care. CLPS perform psychiatric assessment for hospitalized patients with suspected medical-psychiatric comorbidity and support ward teams in a bio-psycho-social oriented care management. Changes in features of the population referred to a CLPS over a 20-year course were analysed and discussed, especially comparing older and younger referred subjects. Epidemiological and clinical data from all first psychiatric consultations carried out at the Modena (North of Italy) University Hospital CLPS in the period 2000-2019 ( = 19,278) were included; two groups of consultations were created according to the age of patients: OV65 (consultations for patients older than 64 years) and NONOV65 (all the rest of consultations). Consultations for OV65 were about 38.9% of the total assessments performed, with an average of approximately 375 per year, vs. the 589 performed for NOV65. The number of referrals for older patients significantly increased over the 20 years. The mean age and the male/female ratio of the sample changed significantly across the years in the whole sample as well as both among OV65 and NOV65. Urgent referrals were more frequent among NOV65 and the rate between urgent/non urgent referrals changed differently in the two subgroups. The analysis outlined recurring patterns that should guide future clinical, training and research activities.
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http://dx.doi.org/10.3390/ijerph17207389DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7601334PMC
October 2020

Affective and Sexual Needs of Residents in Psychiatric Facilities: A Qualitative Approach.

Behav Sci (Basel) 2020 Aug 3;10(8). Epub 2020 Aug 3.

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287-41125 Modena, Italy.

Background: The affective and sexual needs of psychiatric patients are often under-considered, although they contribute significantly to their general well-being. Such topics are critical for Residential Psychiatric Facilities Users (RPFUs), whose daily life is paced by therapeutic settings. The aim of this paper is to better understand how sexuality and affectivity are expressed by the RPFUs at the Mental Health Department of Modena, within psychiatric residential settings.

Methods: Adult RPFUs took part into two audio recorded focus groups. Digital transcripts were analyzed using MAXQDA software in order to perform qualitative narrative analysis, so as to develop a hierarchical code system a posteriori (derived from the data).

Results: Eleven participants (eight RPFUs and three investigators) attended the first focus group, and eight participants (5 RPFUs and 3 investigators) attended the second focus group. 175 interventions were analyzed and coded under seven thematic areas: (a) contraception and sexually transmitted disease prevention ( = 17); (b) affective needs ( = 11); (c) personal experiences ( = 61); (d) regulation of sexual relations ( = 18); (e) Mental Health Professionals' (MHPs) openness towards the topic = 17); (f) MHPs' responses to RPFUs' sexual behaviors ( = 33); and (g) RPFUs proposals ( = 18). The highlighted topics suggest that affective and sexual relations commonly occur within residential psychiatric facilities, even if mental health services often fail to recognize and address RPFUs' affective and sexual needs as well as to provide effective solutions to manage them.

Conclusions: RPFUs expressed a request for support to fulfill their affective and sexual needs and dedicated spaces for sexual activities to relieve their discomfort, while MHPs highlighted a need for awareness, training, and shared problem-solving strategies.
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http://dx.doi.org/10.3390/bs10080125DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464764PMC
August 2020

Stigma on Mental Health among High School Students: Validation of the Italian Version of the Attribution Questionnaire-27 (AQ-27-I) in a High School Student Population.

Int J Environ Res Public Health 2020 07 19;17(14). Epub 2020 Jul 19.

Department of Biomedical, Metabolic Sciences and Neurosciences, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy.

The purpose of this study was to describe the psychometric characteristics of the AQ-27-I in a high school student population. Students aged between 17 and 20 years and attending the fourth and fifth year of a scientific high school in Milan were approached at the school and were asked to fill in an anonymous socio-demographic form and the AQ-27-I. Cronbach's alpha was used to estimate the instrument reliability and confirmatory factor analysis (CFA) was conducted and compared to the original English version factor structure. The AQ-27-I demonstrated acceptable internal consistency, with a Cronbach's alpha of 0.87 and only one subscale (Personal responsibility) with an alpha lower than 0.60. Fit indices were very positive for the Dangerousness Model supporting the factor structure and paths of the original version. The Personal Responsibility Model, on the other hand, showed some weakness, concerning the process dynamics of the model. The results obtained are similar with those from other studies carried out in Italy and other countries. The questionnaire can be used for the quantitative description of stereotypes, emotions and behaviors associated with stigma in mental health in high school student populations.
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http://dx.doi.org/10.3390/ijerph17145207DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400441PMC
July 2020

Can stigmatizing attitudes be prevented in psychology students?

J Ment Health 2021 Aug 24;30(4):488-493. Epub 2020 Jan 24.

Department of Medicine and Surgery, Università degli Studi di Parma, Parma, Italy.

Background: Stigmatizing attitudes have been found among psychology students in many studies, and they are becoming more common with time.

Aims: This study examines whether participation in clinical psychology lessons reduces levels of stigmatization in a population of psychology students and whether it leads to any change in stigmatization.

Methods: The study is a pre/post evaluation of the effectiveness of clinical psychology lessons (63 hours of lectures) as a tool to fight stigma. The presence of stigmatizing attitudes was detected using the Italian version of the Attribution Questionnaire-27 (AQ-27-I). Stigmatization was described before and after the lessons with structured equation modeling (SEM).

Results: Of a total of 387 students contacted, 302 (78.04%) agreed to be involved in the study, but only 266 (68.73%) completed the questionnaires at both t0 and t1. A statistically significant reduction was seen in all six scales and the total score on the AQ-27-I. The models defined by the SEM (pre- and post-intervention) showed excellent model fit indices and described different dynamics of the phenomenon of stigma.

Conclusions: A cycle of clinical psychology lessons can be a useful tool for reducing stigmatizing attitudes in a population of students seeking a psychology degree.
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http://dx.doi.org/10.1080/09638237.2020.1714004DOI Listing
August 2021

How to Measure Knowledge About Mental Disorders? Validation of the Italian Version of the MAKS.

Community Ment Health J 2019 11 23;55(8):1354-1361. Epub 2019 May 23.

Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie, 80138, Naples, Italy.

The aim of this study is to validate the Italian version of the Mental Health Knowledge Schedule (MAKS-I). The validation process included: linguistic validation; analysis of the feasibility; face validity; internal consistency; floor and the ceiling effects; divergent validity. Multiple linear regression was performed to examine the relationship between mental health knowledge and independent variables. MAKS-I was administered to 453 people. The linguistic validation was successful and face validity of the questionnaire showed no critical issues. The estimated composite reliability was 0.638. Divergent validity was supported by lack of statistical significant correlation between MAKS-I and RIBS-I with a positive correlation index. Participation in seminars or conferences related to the issue of mental health stigma, gender, qualification and having a first or second-degree relatives with a psychiatric disorder can be considered possible predictors of the MAKS-I score. MAKS-I is a reliable questionnaire to assess mental health knowledge and familiarity with psychiatric clinical conditions in Italian language.
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http://dx.doi.org/10.1007/s10597-019-00416-6DOI Listing
November 2019

Rating surgical field quality in endoscopic ear surgery: proposal and validation of the "Modena Bleeding Score".

Eur Arch Otorhinolaryngol 2019 Feb 2;276(2):383-388. Epub 2019 Jan 2.

Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Via del Pozzo 71, 41125, Modena, Italy.

Purpose: To develop and validate a bleeding score that could be applied in endoscopic ear surgery (EEarS).

Methods: A prospective validation study was performed. A new bleeding score, called "Modena Bleeding Score" (MBS), was created by the authors. It provides five grades for rating the surgical field during EEarS procedures (from grade 1-no bleeding to grade 5-bleeding that prevents every surgical procedure except those dedicated to bleeding control). A preliminary "face validity" was performed by 18 ENT specialists to assess possible misunderstandings in interpreting the scale. Then, 15 videos of endoscopic ear surgery procedures, each divided into three parts (t0, t1, and t2), were subsequently evaluated by 15 specialists, using MBS. The videos were randomly selected and assigned. Intra-rater reliability and inter-rater reliability were calculated. The clinical validity of the instrument was calculated using a referent standard (i.e., four ENT experts whose ratings were compared to those obtained by the former sample).

Results: The face validity showed a good consensus about the clarity and comprehension of the scale; both intra and inter-rater reliability demonstrated good performance (intra-rater reliability ranged from 0.741 to 0.991 and inter-rater reliability was 0.790); clinical validity also showed positive values, ranging from 0.75 to 0.93.

Conclusions: MBS has proved to be an effective method to rate surgical field during EEarS, with good-to-excellent performances. Its use would possibly help comparisons of groups in clinical trials or comparisons between studies.
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http://dx.doi.org/10.1007/s00405-018-05268-6DOI Listing
February 2019

How the use of the term "schizo*" has changed in an Italian newspaper from 2001 to 2015: Findings from a descriptive analysis.

Psychiatry Res 2018 12 31;270:792-800. Epub 2018 Oct 31.

Department of Psychiatry, Università degli Studi della Campania "Luigi Vanvitelli", Largo Madonna delle Grazie, 1, 80138 Napoli, Italy.

The study aims to report the number of newspaper articles including the word "schizo" in the period 2001 - 2015 and to identify possible predictors reinforcing negative stereotypes about people with schizophrenia. The electronic archives of the Italian newspaper "La Stampa" have been searched for the term "schizo". Selected articles were grouped in articles related to mental health (rMH) or article not related to mental health (nrMH). 946 articles were identified. Schizophrenia-related terms were used in 356 (36.03%) article rMH, which mainly reinforce negative stereotypes regarding mental illness both in rMH and nrMH groups. Over time, only in the rMH group a significant reduction of articles reinforcing negative stereotypes was found. Several factors have been identified as predictors of article reinforcing negative stereotypes: unnecessarily dramatic or sensational headline or content; inaccurate or not in the correct context use of medical terminology; emphasis to the illness rather than to the person; mental disorders are the same; disclosure of particular individual has a mental illness. Although there has been a significant reduction in stigmatizing articles, in the rMH group one article out of three reinforces negative stereotypes.
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http://dx.doi.org/10.1016/j.psychres.2018.10.076DOI Listing
December 2018

Use and Propensity to Use Substances as Cognitive Enhancers in Italian Medical Students.

Brain Sci 2018 Nov 9;8(11). Epub 2018 Nov 9.

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41124, Italy.

International media has paid attention to the use of substances by healthy subjects to enhance cognitive performance. Medical students are liable to use cognitive enhancers (CE) with the aim of improving academic performance. The study explored use and attitudes toward the use of CE in Italian medical students. The authors anonymously surveyed 433 medical students of the University of Modena and Reggio Emilia with an ad hoc 36-items questionnaire. CE were broadly defined as any substance taken with the purpose of improving cognitive functions, from readily available beverages and substances, such as coffee, tea, energy drinks, and supplements to prescription only medication, such as psychostimulants and modafinil. Response rate was 83.8% ( = 363). While the majority of the students (74.7%; = 271) said that they had used substances to improve cognitive functions, only 2 students (0.6%) reported the use of prescription-only medications in the last 30 days. Main reasons for not taking prescription-only drugs were concerns about safety and side effects, reported by 83.3% of students ( = 295). A positive attitude toward use was held by 60.3% ( = 219) subjects. The surveyed Italian medical students used many substances as CE, but this did not seem to apply significantly to psychostimulants. A multivariable analysis showed that the following variables were related to the propensity to use substances as CE: male gender, self-reported memory impairment, concerns about worsening of cognitive performance, lifetime use of at least one illegal substance, use of any substance (both legal or illegal) in the last 30 days.
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http://dx.doi.org/10.3390/brainsci8110197DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266090PMC
November 2018

Stakeholders' views on vocational rehabilitation programs: a call for collaboration with Occupational Health Physicians.

Med Lav 2018 05 11;109(3):201-9. Epub 2018 May 11.

Department of Diagnostic, Clinical and Public Health Medicine, Section of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy - Via del Pozzo, 71 - 41124 Modena (Italy).

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

Objectives: To explore the different points of views of stakeholders (namely, users and professionals) involved in VRPs developed inside an Italian Community Mental Health Center (CMHC).

Methods: A sample of users, psychiatrists, educators and nurses of an Italian CMHC involved in VRPs took part in a focus group. Content analysis was performed with MAXQDA 12, by developing a hierarchical code system a posteriori (i.e., derived from the data). The respondent validation phase was carried out by means of a multiple-choice questionnaire, administered to all participants.

Results: A total of 86 emerging issues were coded, divided into two macro-areas: Positive and Negative Reinforcements (48 contributions, 56%, and 38 contributions, 44%, respectively), further subdivided into three areas: professional (service) factors, personal (i.e, user-related) factors, and work environment features (including relationships in the workplace). Some contributions raised issues concerning occupational health protection (e.g. need of information about the rights and duties of the users-workers, as well as the risks they are exposed to in the workplace).

Conclusions: The analysis suggested to address specific issues concerning work and VRPs by means of psycho-education group interventions currently carried out at CMHCs, and pointed to the need to foster collaboration between mental health professionals and the occupational health physician of the company where the VRP is started and where the user might be employed.
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http://dx.doi.org/10.23749/mdl.v109i3.6844DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7689794PMC
May 2018

Metabolic Syndrome, Anxiety and Depression in a Sample of Italian Primary Care Patients.

J Nerv Ment Dis 2018 05;206(5):316-324

This cross-sectional study aimed at measuring the correlation and association of anxiety, depression and comorbid anxiety-depression symptoms with metabolic syndrome (MetS) in a sample of Italian primary care patients who attended their General Practitioner clinics over a 1-month period in 2013. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depressive symptoms. The sample was made up of 129 patients (57% women; mean age, 61 ± 12 years). The prevalence of MetS varied from 40% (Adult Treatment Panel III-Revised criteria) to 48% (International Diabetes Federation criteria). The prevalence of symptoms of anxiety, depression and comorbid anxiety and depression was, respectively, 26%, 2%, and 15%. MetS (defined according to Adult Treatment Panel III-Revised criteria) was associated with comorbid anxiety-depressive symptoms (odds ratio [OR] = 3.84, 95% confidence interval [CI] = 1.26-11.71), but not with anxiety or depressive symptoms only. Out of the individual components of MetS, enlarged waist circumference was associated with anxiety symptoms (OR = 4.22, 95% CI = 1.56-11.44).
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http://dx.doi.org/10.1097/NMD.0000000000000807DOI Listing
May 2018

Impact of the economic crisis on health-related behaviors in Italy.

Int J Soc Psychiatry 2017 Nov 23;63(7):649-656. Epub 2017 Aug 23.

1 Section of Psychiatry, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.

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

Aim: To assess the impact of the late 2000s economic crisis on health-related behaviors linked to population mental health in Italy.

Methods: Descriptive study. Health indicators came from the Italian Institute of Statistics database (years 2000-2015). Statistics performed by means of linear regression models.

Results: Increased smokers (β = 1.68, p = .03), heavy smokers, that is, people smoking 11-20 cigarettes per day (β = 2.18, p = .04) or more than 20 cigarettes per day (β = 1.04, p < .01) and mean number of smoked cigarettes per day (β = 0.56, p = .02) were noticeable. Also, prevalence of overweight increased (β = 0.91, p = .04), while the Italian families' expenditure for alcoholic beverages decreased (β = -812.80, p = .01). Alcohol consumption decreased (β = -0.60, p < .01), especially in men (β = -0.95, p < .01); binge drinking increased in years 2009-2010. No change was noticeable in the diet indicators collected.

Conclusion: The economic crisis may have increased smoking, overweight and binge drinking in Italy (though data on the latter phenomenon are not conclusive), and reduced overall alcohol consumption.
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http://dx.doi.org/10.1177/0020764017726097DOI Listing
November 2017

Income inequality and mental illness-related morbidity and resilience: a systematic review and meta-analysis.

Lancet Psychiatry 2017 07 25;4(7):554-562. Epub 2017 May 25.

Personal Social Service Research Unity, London School of Economics and Political Science, London, UK.

Background: Studies of the association between income inequality and mental health have shown mixed results, probably due to methodological heterogeneity. By dealing with such heterogeneity through a systematic review and meta-analysis, we examine the association between income inequality, mental health problems, use of mental health services, and resilience (defined as the ability to cope with adversity).

Methods: We searched the Global Health, PsychARTICLES, PsycINFO, Social Policy and Practice, Embase and MEDLINE databases up to July 6, 2016, for quantitative studies of the association of income inequality with prevalence or incidence of mental disorders or mental health problems, use of mental health services, and resilience. Eligible studies used standardised instruments at the individual level, and income inequality at the aggregated, contextual, and ecological level. We extracted study characteristics, sampling, exposure, outcomes, statistical modelling, and parameters from articles. Because several studies did not provide enough statistical information to be included in a meta-analysis, we did a narrative synthesis to summarise results with studies categorised as showing either a positive association, mixed results, or no association. The primary outcome in the random-effects meta-analysis was mental health-related morbidity, defined as the prevalence or incidence of any mental health problem. This study is registered with PROSPERO, number CRD42016036377.

Findings: Our search identified 15 615 non-duplicate references, of which 113 were deemed potentially relevant and were assessed for eligibility, leading to the inclusion of 27 studies in the qualitative synthesis. Nine articles found a positive association between income inequality and the prevalence or incidence of mental health problems; ten articles found mixed results, with positive association in some subgroups and non-significant or negative association in other subgroups; and eight articles found no association between income inequality and mental health problems. Of the nine articles included in our meta-analysis, one reported a positive association between income inequality and mental health problems, six reported mixed results, and two reported no association. Pooled Cohen's d effect sizes for the association between income inequality and any mental disorder or mental health problems were 0·06 (95% CI 0·01-0·11) for any mental disorder, and 0·12 (0·05-0·20) for depressive disorders. Our meta-regression analysis showed that none of the factors considered (sample size, contextual level at which income inequality was assessed, quality assessment, type of instruments, and individual income as control variable) explained heterogeneity between studies (I 89·3%; p<0·0001). Only one study investigated the association between income inequality and resilience; it found greater income inequality was associated with higher prevalence of depression only among individuals with low income. The only study of the role of income inequality as a determinant of the use of mental health services reported no association.

Interpretation: Income inequality negatively affects mental health but the effect sizes are small and there is marked heterogeneity among studies. If this association is causal and growing income inequality does lead to an increase in the prevalence of mental health problems, then its reduction could result in a significant improvement in population wellbeing.

Funding: None.
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http://dx.doi.org/10.1016/S2215-0366(17)30159-1DOI Listing
July 2017

Stigma in the context of schools: analysis of the phenomenon of stigma in a population of university students.

BMC Psychiatry 2016 Feb 9;16:29. Epub 2016 Feb 9.

Institute of Psychology, Illinois Institute of Technology, 3424 S. State Street, Chicago, USA.

Background: Students have stereotyped views about people with mental illness. In particular, they believe that these persons are incurable, dangerous, unpredictable and responsible for their condition. This study aims to investigate the levels of public stigma in an Italian university population.

Methods: The Attribution Questionnaire 27 - Italian Version (AQ-27-I) was administered to a sample of students from the Faculty of Medicine and Surgery of the University of Modena and Reggio Emilia. After examining the psychometric characteristics of the AQ-27-I (Cronbach's Alpha and Confirmatory Factor Analysis), multiple linear regression analyses were carried out to identify the predictors of stigmatizing attitudes in this population.

Results: Three hundred and eleven students completed the questionnaire, with a response rate of 32.81 % (out of the 948 contacted by email). The AQ-27-I showed good psychometric properties with an α = .68, and the fit indices of the models that partially supported the factor structure and paths. The two variables identified as possible predictors of stigmatizing attitudes (total score of AQ-27-I) were age and time spent reading newspapers.

Conclusions: Antistigma campaigns are needed in university contexts, targeted in particular to students in health professions.
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http://dx.doi.org/10.1186/s12888-016-0734-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4748532PMC
February 2016

Young and burnt? Italian contribution to the international BurnOut Syndrome Study (BOSS) among residents in psychiatry.

Med Lav 2015 May 4;106(3):172-85. Epub 2015 May 4.

Department of Diagnostic-Clinical Medicine and Public Health, University of Modena & Reggio Emilia, Modena, Italy.

Background: The Burnout Syndrome (BS) is a common condition among health care professionals, yet data concerning its prevalence and associated factors among psychiatric residents are lacking.

Objectives: To report the results of the Italian contribution to "BOSS", an international multicentre research project aiming at estimating the burden of BS among residents in psychiatry, and at identifying factors contributing to its development and prevention.

Methods: Cross-sectional study. The BOSS online questionnaire, which collected socio-demographic data and five psychometric tools (MBI-GS, AWLS, PHQ-9, SIBQ, BFI), was administered electronically to 180 Italian residents in psychiatry. Simple and multiple linear regressions were performed to analyse data.

Results: 108 questionnaires provided data for the study (response rate: 60%). Mean age: 30.5 ± 3.7 years. Eighty percent of the sample were female. A moderate level of BS emerged, related to work conditions, absence of major depression, satisfaction with pay or less academic activity. Only 0.9% (N=1) of the sample showed PHQ-9 scores suggestive of major depression, while lifetime suicidal ideation was admitted by 16% of residents. For the three dimensions of the MBI-GS, Italian sample scores were consistent with previously published results concerning pooled data in a French-Croatian sample, reporting moderate levels of BS. Higher workload, symptoms of depression and lower satisfaction predicted higher levels of Emotional Exhaustion and Cynicism.

Conclusions: Italian residents in psychiatry showed overall moderate levels of BS, related to workload and work organization. Other alerts of psychic distress were found among participants, namely symptoms of depression, suicidal ideation and use of psychotropic medications.
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May 2015

University students' identification of stigmatizing schizophrenia in Italian newspapers.

Am J Orthopsychiatry 2015 Mar;85(2):139-44

Department of Psychiatry, University of Naples SUN.

Stigma associated with mental disorders represents one main obstacle to receive appropriate care for people with mental disorders. Compared to adults, university students have higher levels of stigmatizing attitudes toward patients with schizophrenia. The primary aim of this case-control study was to assess university students' ability to identify stigma toward schizophrenia in Italian newspapers. Secondary aims were: a) to explore differences in stigmatizing attitudes among two different groups of university students (health professionals [HP] and nonhealth professionals [n-HP]) and b) to compare the attitudes of these two groups with those of a sample of expert psychiatrists. The electronic archives of two Italian newspapers were searched using the term "schizo" (as a word or part of it). One hundred seventy articles published between January and December 2011 were identified. Students from the HP group and expert psychiatrists had a higher ability to detect stigmatizing attitudes in newspapers. Students from the n-HP group had a higher concordance with the experts on the topics "characteristics of the article" and "services and rights." Our findings highlight the importance of targeting university students with correct and updated information about schizophrenia and its psychosocial consequences.
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http://dx.doi.org/10.1037/ort0000053DOI Listing
March 2015

[Shall psychiatry change its target? Reflections on the evolving role of psychiatry].

Riv Psichiatr 2015 Jan-Feb;50(1):3-7

In this paper we will describe cultural, social and scientific changes occurred in psychiatry in the last years, identifying the new target for mental health professionals. Groups of young psychiatrists from the Italian Psychiatric Association, the European Psychiatric Association and the World Psychiatric Association have established an international network that launched a debate on the future role of psychiatry. In a rapidly changing world, there is the need to: 1) adapt training in psychiatry to the modern world; 2) identify the new target of mental health professionals; 3) enhance the image of psychiatry in the society; 4) overcome stigma towards people with mental disorders. In recent years, socio-cultural and scientific changes have had a significant impact on the psychiatrists' clinical practice. Mental health professionals should deal with these changes appropriately in order to overcome the current "crisis" of psychiatry, which should be considered as a developmental phase rather than a conceptual one. From time to time psychiatry is criticized both from inside and outside the profession. The current crisis was unavoidable due to the recent socio-cultural changes, but it should be considered an opportunity to adapt the profession to modern times.
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http://dx.doi.org/10.1708/1794.19524DOI Listing
December 2016

The crisis in psychiatry: a public health perspective.

Int Rev Psychiatry 2014 Aug;26(4):530-4

Human Resource Development, Local Health Agency , Reggio Emilia Italy.

The role and responsibilities of psychiatry and psychiatrists have changed significantly in recent decades as a consequence of changes in society. The target of psychiatrists has moved from the treatment of specific mental disorders to the management of a wide range of psychological conditions. Following these changes, a public health approach has been claimed as necessary for psychiatric practice and research, given the current ongoing crisis in mental health. If we want to promote a public health approach, the following actions should be responsibly taken by modern mental health professionals: (1) the identification of causes of mental disorders, (2) the refinement of diagnoses, (3) the social inclusion of patients, (4) the involvement of users and carers in mental health research and practice, and (5) the improvement of psychiatric treatments and services. This crisis should represent a stimulus for all psychiatrists and a reconceptualization of psychiatry as public health is not in question.
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http://dx.doi.org/10.3109/09540261.2014.931838DOI Listing
August 2014

Correlation of articular involvement, skin disfigurement and unemployment with depressive symptoms in patients with systemic sclerosis: a hospital sample.

Int J Rheum Dis 2014 Feb 29;17(2):186-94. Epub 2013 May 29.

Department of Mental Health, Azienda USL Modena, Modena, Italy.

Background: Systemic sclerosis (SSc) is a connective tissue disease associated with increased functional impairment, body image distress due to skin lesions, and psychosocial comorbidity, particularly depression. Prevalence of depressive symptoms in SSc patients ranges from 36% to 65% and it contributes to the worsening of any aspect of the disease. The aim of this study was to investigate the prevalence and clinical and non-clinical correlates of depressive symptoms in a sample of outpatients with SSc.

Methods: Seventy-eight consecutive SSc outpatients were recruited from February 2005 to July 2007. Socio-demographic and SSc-related clinical data were collected, including a modified Rodnan Skin Score, the Valentini Disease Activity Index and psycho-metric assessment of disability and pain. Depressive symptoms were assessed using the Beck Depression Inventory (BDI). Two questions on perception of support from relatives and impact of disfigurements were also directly addressed to subjects.

Results: The BDI mean score was 10.5 (± 8.3), with 36 subjects (46.2%) scoring above clinical significance. Unemployment, increased disability, pain, disease activity and articular involvement were significantly associated with more depressive symptoms. Older age, unemployment and more depressive symptoms were also related with complaints of disfigurements due to skin involvement.

Conclusions: Depression is an influential prognostic factor in SSc. The present study contributes to the knowledge of the relationship between depression and clinical features routinely collected in rheumatology settings in order to develop a standardized assessment of psychosocial distress in routine rheumatologic procedures.
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http://dx.doi.org/10.1111/1756-185X.12100DOI Listing
February 2014

Correlation of articular involvement, skin disfigurement and unemployment with depressive symptoms in patients with systemic sclerosis: a hospital sample.

Int J Rheum Dis 2014 Feb 29;17(2):186-94. Epub 2013 May 29.

Department of Mental Health, Azienda USL Modena, Modena, Italy.

Background: Systemic sclerosis (SSc) is a connective tissue disease associated with increased functional impairment, body image distress due to skin lesions, and psychosocial comorbidity, particularly depression. Prevalence of depressive symptoms in SSc patients ranges from 36% to 65% and it contributes to the worsening of any aspect of the disease. The aim of this study was to investigate the prevalence and clinical and non-clinical correlates of depressive symptoms in a sample of outpatients with SSc.

Methods: Seventy-eight consecutive SSc outpatients were recruited from February 2005 to July 2007. Socio-demographic and SSc-related clinical data were collected, including a modified Rodnan Skin Score, the Valentini Disease Activity Index and psycho-metric assessment of disability and pain. Depressive symptoms were assessed using the Beck Depression Inventory (BDI). Two questions on perception of support from relatives and impact of disfigurements were also directly addressed to subjects.

Results: The BDI mean score was 10.5 (± 8.3), with 36 subjects (46.2%) scoring above clinical significance. Unemployment, increased disability, pain, disease activity and articular involvement were significantly associated with more depressive symptoms. Older age, unemployment and more depressive symptoms were also related with complaints of disfigurements due to skin involvement.

Conclusions: Depression is an influential prognostic factor in SSc. The present study contributes to the knowledge of the relationship between depression and clinical features routinely collected in rheumatology settings in order to develop a standardized assessment of psychosocial distress in routine rheumatologic procedures.
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http://dx.doi.org/10.1111/1756-185X.12100DOI Listing
February 2014

Use of coercive measures in mental health practice and its impact on outcome: a critical review.

Expert Rev Neurother 2014 Feb 2;14(2):131-41. Epub 2014 Jan 2.

Department of Psychiatry, University of Naples SUN, Naples, Italy.

Although coercive measures have always been part of the psychiatric armamentarium, the ethical dilemma between the use of a "therapeutic" coercion and the loss of patients' dignity is one of the major controversial issues in mental health research and practice. The aims of the present review are to explore the existing literature on predictors of use of coercive measures and to explore the relationship between coercive measures and patient outcome. A literature search was conducted using MEDLINE, PsychyINFO, Scopus, Web of Knowledge and the Cochrane Database. In all selected papers, references were cross-checked to identify other possible eligible papers. The use of coercive measures was predicted by patients' clinical and socio-demographic features, staff characteristics and ward-related factors. Coercive measures have only a limited impact on patients' clinical and social outcome. At the current level of knowledge, coercion is still a controversial issue in mental health practice. Only few studies with a solid methodology have been carried out. Large multicenter and rigorous studies, with long-term follow-ups, are highly needed.
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http://dx.doi.org/10.1586/14737175.2014.874286DOI Listing
February 2014

International study of student career choice in psychiatry (ISoSCCiP): results from Modena, Italy.

Int Rev Psychiatry 2013 Aug;25(4):450-9

Department of Diagnostic-Clinical Medicine and Public Health, section of Psychiatry, University of Modena & Reggio Emilia , Modena , Italy.

Italy was one of the 16 countries to take part in the International Study of Student Career Choice in Psychiatry (ISoSCCiP). This paper reports and comments on the IsoSCCiP data on Italian medical students. Italian final year medical students from the University of Modena and Reggio Emilia were asked to fill in an on-line questionnaire during the first semester of two consecutive academic years (2009-2010, 2010-2011). Step-wise logistic regressions were performed. Of the 231 students invited, 106 returned completed questionnaires (response rate = 46.7%). Women constituted 66%, and mean age was 25.14 (SD = 1.15). Psychiatry was the second most common choice of possible career by students (5.7%, n = 6). Choosing psychiatry was predicted by having volunteered for further clinical/research activities in psychiatry (p = 0.01), believing that 'the problems presented by psychiatric patients are often particularly interesting and challenging' (p < 0.01), and by accounts of personal/family experience with physical illness (p < 0.01). Both personal factors and factors related to training may be involved in the choice of psychiatry among Italian medical students. Cultural and organizational specificities of Italian mental healthcare may be involved, particularly the strong tradition of social psychiatry.
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http://dx.doi.org/10.3109/09540261.2013.804402DOI Listing
August 2013

Vertigo "in the pink": The impact of female gender on psychiatric-psychosomatic comorbidity in benign paroxysmal positional vertigo patients.

Psychosomatics 2014 May-Jun;55(3):280-8. Epub 2013 Jun 4.

Human Resources, AUSL, Reggio Emilia, Reggio Emilia, Italy; International PhD School in Clinical and Experimental Medicine, University of Modena, Reggio Emilia, Modena, Italy.

Background: Comorbidity between vestibular and psychiatric disorders in predisposed individuals is underestimated, untreated, and may result in chronicization and poor quality of life. There are few studies concerning the type and the prevalence of psychiatric-psychosomatic distress in patients with benign paroxysmal positional vertigo (BPPV).

Objective: The aim of this study was to evaluate psychiatric-psychosomatic comorbidities, in particular anxiety, depression, somatization symptoms, and alexithymia, in a group of BPPV patients compared with healthy subjects, and according to gender.

Methods: Case-control study comparing 92 BPPV patients recruited at the ENT Unit of Modena General Hospital between November 2007 and December 2010, and 141 healthy controls. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Diagnostic Criteria for Psychosomatic Research (DCPR), Brief Symptom Inventory (BSI), and Toronto Alexithymia Scale (TAS-20) were used to perform psychometric assessment.

Results: BPPV patients scored higher than controls, with statistical significance, at BDI, BSI somatization, anxiety, and phobic anxiety subscales, and STAI state anxiety; a larger proportion of BPPV patients suffered from clinically significant BDI depressive symptomatology; DCPR disease phobia, functional somatic symptoms secondary to a psychiatric disorder, and demoralization were more common among BPPV subjects. High levels of symptomatology were still found among BPPV female patients, but not among males, even after controlling for symptom severity.

Conclusions: Affective symptomatology, such as depression, demoralization, phobia and anxiety, and somatization, were significantly prevalent in BPPV patients, and female gender may be a predisposing factor.
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http://dx.doi.org/10.1016/j.psym.2013.02.005DOI Listing
June 2015
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