Interplay between negative symptoms, time spent doing nothing, and negative emotions in patients with schizophrenia spectrum disorders: results from a 37-site study.

This study evaluated the relationship between negative symptoms, daily time use (productive/non-productive activities, PA/NPA), and negative emotions in schizophrenia-spectrum disorders (SSDs): 618 individuals with SSDs (311 residential care patients [RCPs], 307 outpatients) were surveyed about socio-demographic, clinical (BPRS, BNSS) and daily time use (paper-and-pencil Time Use Survey completed twice/week) characteristics. Among them 57 RCPs and 46 outpatients, matched to 112 healthy controls, also underwent ecological monitoring of emotions (8 times/day for a week) through Experience Sampling Method (ESM). RCPs spent significantly less time in PA than outpatients. Patients with more negative symptomatology spent more time in NPA and less in PA compared to patients with milder symptoms. Higher time spent in NPA was associated with negative emotions (p < 0.001 during workdays) even when correcting for BNSS total and antipsychotic polypharmacy (p = 0.002 for workdays, p = 0.006 for Sundays). Future studies are needed to explore in more detail the relationship between negative emotions, negative symptoms, time use, and functioning in individuals with SSDs, providing opportunities for more informed and personalised clinical treatment planning and research into interactions between different motivational, saliency and behavioural aspects in individuals with SSDs.

First access to mental health services during COVID-19 pandemic: A multicenter study.

BACKGROUND: The impact of the COVID-19 pandemic on mental health is complex and affects a broad segment of the population. Several studies indicate that depressive, anxious and post-traumatic symptoms are common in people exposed to SARS-Cov2. METHODS: 458 subjects were recruited during their first consultation in outpatient psychiatric services between June 2020 and October 2021. Post-traumatic, depressive and anxious symptoms were assessed using the Impact of Event Scale-Revised (IES-R), the Beck Depression Inventory Scale-second edition (BDI-II), and  the Self Rating Anxiety Scale (SAS). A specific set of questions was developed, with the aim of evaluating socio-demographic variables and work, environmental and personal characteristics related to the pandemic. RESULTS: Prevalence rates of clinically significant depressive, anxious and post-traumatic symptoms were 57.6%, 63.5% and 54.8%, respectively. Female gender, worsening of relationship status and financial consequences due to the pandemic were the conditions most strongly associated with the presence of psychopathology. LIMITATION: The cross-sectional design of the study doesn't allow an evaluation over time of the sample. No assumption of causality can be made due to the lack of pre-pandemic assessments for the investigated variables. CONCLUSIONS: The impact of the pandemic involves depressive, anxious and post-traumatic dimensions. The investigated psychopathology correlates with several variables expressing the personal and environmental changes that occurred in the population due to the COVID-19 emergency. The study is multicentric and the recruitment of participants was held in a clinical setting, providing a realistic picture of the consequences of the pandemic in clinical practice within mental health services.

[The first access to Mental Health Services in a multi-ethnic city: diagnostic and therapeutic differences in the population of Prato, Italy.] / Il primo contatto con i Servizi di Salute Mentale in una città multietnica: differenze diagnostiche e terapeutiche nella popolazione di Prato.

AIM: In urban contexts, Mental Health Services are increasingly involved in the assessment of users with a heterogeneous ethnic and cultural background. These characteristics of migrants can exert an influence on access to healthcare, diagnostic evaluation, and use of therapeutic resources. The present work aimed to compare these differences among individuals who received their first clinical evaluation at the Mental Health Outpatient Service of Prato in 2019-2021, exploring variations across time, among the entire non-native population, and based on their continent of origin. METHODS: In the abovementioned clinical population, socio-demographic data, the type of evaluation received, and the primary diagnostic classification were retrieved. Their absolute and relative frequencies were registered, and differences based on the origin of migrants were explored. RESULTS: Of 3,992 assessments, 485 (12.1%) involved non-natives from 60 different countries, with a lower mean age as compared to the Italian counterpart, and a heterogeneous gender prevalence based on the continent of origin. The percentage of migrants increased from 11.8% to 14.2% across time, with a higher proportion of psychiatric evaluations and a lower implementation of multi-professional interventions. As compared to native individuals, a higher proportion of adjustment, psychotic, substance-related, somatic, conversive, dissociative, and post-traumatic disorders was observed. DISCUSSION AND CONCLUSIONS: The access of migrants to the Public Mental Health outpatient facility proved to be remarkably lower than expected, based on the composition of the general population. Given the proportional increase in the requested evaluations, it is necessary to promote a reflexion on the specificity of the emergent psychopathology, and on difficulties in access to psychotherapy: a trans-cultural approach to mental health may require adequate resources for the management of these distinctive needs.

[The integration between Primary Care and Mental Health Services: review of the scientific literature and on-field experience in three Italian regions]. / L'integrazione tra medicina generale e servizi pubblici di salute mentale: rassegna della letteratura e dell'esperienza sul campo in tre Regioni italiane.

This paper focuses on the integration between Mental Health Services and Primary Care in Italy, a topic that has been discussed for many years but still remains to be achieved nationwide. After a brief review of the scientific literature considering different models of integration, the experiences of three Italian Regions (Lombardy, Emilia-Romagna and Tuscany) are described and discussed, in order to detect different options to fulfill the needs of an adequate cooperation in this field of public health.

Suicide Risk among Immigrants and Ethnic Minorities: A Literature Overview.

Recent studies have demonstrated that immigrants and ethnic minorities may be at higher risk of suicidal behaviour as compared to the general population. We conducted a literature search to identify studies in English from 1980 to 2017 related to suicide risk among immigrants and ethnic minorities. Six hundred and seventy-eight reports were screened, and 43 articles were included in the qualitative synthesis of the review. Some studies reported lower rates of suicide attempts, while other findings suggested higher rates of suicidal behaviour and deaths among immigrants as compared to the native population. Also, a positive correlation was found between suicidal behaviour and specific countries of origin. Non-European immigrant women were at the highest risk for suicide attempts, a group which included young women of South Asian and black African origin. Risk factors among migrants and ethnic minorities were found to be: language barriers, worrying about family back home, and separation from family. The lack of information on health care system, loss of status, loss of social network, and acculturation were identified as possible triggers for suicidal behaviour. Overall, results suggest that specific migrant populations and ethnic minorities present a higher risk of suicidal behaviour than native populations, as well as a higher risk of death by suicide.

Emotion recognition impairment in traumatic brain injury compared with schizophrenia spectrum: similar deficits with different origins.

The aim of our study was to identify the common and separate mechanisms that might underpin emotion recognition impairment in patients with traumatic brain injury (TBI) and schizophrenia (Sz) compared with healthy controls (HCs). We recruited 21 Sz outpatients, 24 severe TBI outpatients, and 38 HCs, and we used eye-tracking to compare facial emotion processing performance. Both Sz and TBI patients were significantly poorer at recognizing facial emotions compared with HC. Sz patients showed a different way of exploring the Pictures of Facial Affects stimuli and were significantly worse in recognition of neutral expressions. Selective or sustained attention deficits in TBI may reduce efficient emotion recognition, whereas in Sz, there is a more strategic deficit underlying the observed problem. There would seem to be scope for adjustment of effective rehabilitative training focused on emotion recognition.