Reliability of clinical judgment for evaluation of informed consent in mental health settings and the validation of the Evaluation of Informed Consent to Treatment (EICT) scale.

Introduction: The competence assessment to give informed consent in the legal and healthcare settings is often performed merely through clinical judgment. Given the acknowledged limited reliability of clinician-based evaluation in the mental health sector, particularly for the assessment of competence to consent, our objective was to ascertain the dependability of clinical judgment when evaluating the ability of schizophrenia patients to make choices about their health. Methods: The potential convergence between clinical evaluation and scores from a new standardized assessment (the "Evaluation of Informed Consent to Treatment" - "EICT" scale) was therefore tested. The scale assesses four dimensions of competence, specifically how patients normally understand information relating to care (Understanding); how they evaluate the choice of treatment in terms of risk/benefit ratio (Evaluating); how they reason coherently in the decision-making process (Reasoning); and, finally, their ability to make a choice between treatment alternatives (Expressing a choice). Thirty-four outpatients with schizophrenia were evaluated for their competence to consent by five referring clinicians with different backgrounds (psychiatrist, forensic psychiatrist, geriatrician, anesthetist, and medico-legal doctor). Inter-raters variability was tested through correlation analyses between the scores obtained by the clinicians on a modified version of the Global Assessment of Functioning scale (GAF) designed specifically to subjectively assess functioning in each of the four competence dimensions. Two validated competence scales (Mac-CAT-T, SICIATRI-R), and a neuropsychological battery were also administered along with scales for evaluating neuropsychiatric symptoms severity and side effects of medication. Results: Clinical judgments of the individual specialists showed great inter-rater variability. Likewise, only weak/non-significant correlations were found between the EICT subscales and the respective clinicians-rated GAF scales. Conversely, solid correlations were found between the EICT and MacCAT-T subscales. As expected, healthy controls performed better in the ability to give informed consent to treatment, as measured by the three scales (i.e., EICT, MacCAT-T, and SICIATRI-R), and neuropsychological test performance. In the comparisons between patients who, according to the administered EICT, were able or not able to give informed consent to treatment, significant differences emerged for the Phonemic verbal fluency task (p = 0.038), Verbal judgments (p = 0.048), MacCAT-T subscales, and SICIATRI-R total score. Moreover, EICT exhibited excellent internal consistency (Cronbach's alphas ranging from 0.96 to 0.98 for the four subscales) while the Item Analysis, by measuring the correlation between each item of the EICT and the total score, was excellent for all items of all subscales (alphas ranging from 0.86 to 0.98). Discussion: In conclusion, our findings highlighted that the assessment of competence exclusively through clinical judgment is not fully reliable and needs the support of standardized tools. The EICT scale could therefore be useful in assessing general competence to consent both in healthcare and legal contexts, where it might be necessary to evaluate the effective competence of patients with psychiatric disorders. Finally, this scale could serve as a valuable tool for decisions regarding whether and to what extent a patient needs support.

Parietal resting-state EEG alpha source connectivity is associated with subcortical white matter lesions in HIV-positive people.

OBJECTIVE: Parietal resting-state electroencephalographic (rsEEG) alpha (8-10 Hz) source connectivity is abnormal in HIV-positive persons. Here we tested whether this abnormality may be associated with subcortical white matter vascular lesions in the cerebral hemispheres. METHODS: Clinical, rsEEG, and magnetic resonance imaging (MRI) datasets in 38 HIV-positive persons and clinical and rsEEG datasets in 13 healthy controls were analyzed. Radiologists visually evaluated the subcortical white matter hyperintensities from T2-weighted FLAIR MRIs (i.e., Fazekas scale). In parallel, neurophysiologists estimated the eLORETA rsEEG source lagged linear connectivity from parietal cortical regions of interest. RESULTS: Compared to the HIV participants with no/negligible subcortical white matter hyperintensities, the HIV participants with mild/moderate subcortical white matter hyperintensities showed lower parietal interhemispheric rsEEG alpha lagged linear connectivity. This effect was also observed in HIV-positive persons with unimpaired cognition. This rsEEG marker allowed good discrimination (area under the receiver operating characteristic curve > 0.80) between the HIV-positive individuals with different amounts of subcortical white matter hyperintensities. CONCLUSIONS: The parietal rsEEG alpha source connectivity is associated with subcortical white matter vascular lesions in HIV-positive persons, even without neurocognitive disorders. SIGNIFICANCE: Those MRI-rsEEG markers may be used to screen HIV-positive persons at risk of neurocognitive disorders.

Machine Learning and Pharmacogenomics at the Time of Precision Psychiatry.

Traditional medicine and biomedical sciences are reaching a turning point because of the constantly growing impact and volume of Big Data. Machine Learning (ML) techniques and related algorithms play a central role as diagnostic, prognostic, and decision-making tools in this field. Another promising area becoming part of everyday clinical practice is personalized therapy and pharmacogenomics. Applying ML to pharmacogenomics opens new frontiers to tailored therapeutical strategies to help clinicians choose drugs with the best response and fewer side effects, operating with genetic information and combining it with the clinical profile. This systematic review aims to draw up the state-of-the-art ML applied to pharmacogenomics in psychiatry. Our research yielded fourteen papers; most were published in the last three years. The sample comprises 9,180 patients diagnosed with mood disorders, psychoses, or autism spectrum disorders. Prediction of drug response and prediction of side effects are the most frequently considered domains with the supervised ML technique, which first requires training and then testing. The random forest is the most used algorithm; it comprises several decision trees, reduces the training set's overfitting, and makes precise predictions. ML proved effective and reliable, especially when genetic and biodemographic information were integrated into the algorithm. Even though ML and pharmacogenomics are not part of everyday clinical practice yet, they will gain a unique role in the next future in improving personalized treatments in psychiatry.

Facing the Shadow Pandemic: Correlation and Trend Analyses of Violence Reports from Women to the Italian National Anti-Violence Number during 2021.

OBJECTIVES: To help to tackle gender-based violence against women in the aftermath of COVID-19 or other potential crisis situations, as recommended by the European Institute for Gender Equality, the present study aims to investigate the relationship between calls to the National Anti-violence Number (NAN) and the socio-sanitary pandemic factors during 2021, a period in which the scenario changed due to containment measures that gradually allowed women to emerge from the condition of isolation. In addition, the present work aims to identify significant changes in the number of calls to NAN during the progression of the pandemic in 2021. METHODS: Using Italian Civil Protection Department data on the socio-sanitary pandemic factors (defined by daily number of cases, swabs, deaths, hospitalizations, dismissions, intensive care unit hospitalizations, people isolated at home, and quarantine after 15 and 30 days) and NAN data. Correlation analyses, a joinpoint regression analysis, and Granger causality tests were performed. RESULTS: The number of calls correlated with the daily number of cases, swabs, deaths, hospitalizations, dismissions, intensive care unit hospitalizations, and quarantine after 15 and 30 days. The identified joinpoints showed significant changes in the number of daily anti-violence calls during the year. Furthermore, we found evidence of a significant causality between daily hospitalizations, daily home quarantined, daily dismissed patients, and calls to NAN. CONCLUSIONS: The results underline the influence of containment measures on the increased access to NAN, suggesting the need for a greater implementation of social and psychological support services in other potential crisis situations.

The ecological validity of the IOP-29: A follow-up study using the MMPI-2-RF and the SIMS as criterion variables.

Current guidelines for conducting symptom validity assessments require that professionals administer multiple symptom validity tests (SVTs) and that the SVTs selected for their evaluations provide nonredundant information. However, not many SVTs are currently available, and most of them rely on the same, (in)frequency-based, feigning detection strategy. In this context, the Inventory of Problems (IOP-29) could be a valuable addition to the assessor's toolbox because of its brevity (29 items) and its different approach to assessing the credibility of presented symptoms. As its ecological validity has been poorly investigated, the present study used a criterion groups design to examine the classification accuracy of the IOP-29 in a data set of 174 court-ordered psychological evaluations focused on psychological injury. The validity scales of the Minnesota Multiphasic Personality Inventory-2 Restructured Form and the total score of the Structured Inventory of Malingered Symptoms were used as criterion variables. Overall, the results of this study confirm that the IOP-29 is an effective measure (1.70 ≤ d ≤ 2.67) that provides valuable information when added to the multimethod assessment of symptom validity in civil forensic contexts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Decision-Making and Abuse, What Relationship in Victims of Violence?

Gender-Based violence is a worldwide persisting phenomenon: during their lifetime, 30% of women have experienced sexual and/or physical violence. The literature has investigated for several years the association between abuse and possible psychiatric and psychological consequences which may occur even after many years. The most common consequences involve mood and stress disorders (e.g., depression and PTSD). These disorders seem to have secondary long-term effects, such as decision-making and cognitive function impairments. Therefore, the present literature synthesis aimed to investigate whether and how the decision-making capacities of individuals experiencing violence can change because of abuse. We conducted a thematic synthesis using PRISMA guidelines: through a double-blind procedure, 4599 studies were screened; a total of 46 studies were selected for full-text reading, which was reduced to 13 by excluding papers with a wrong focus. To better understand the results of the thematic synthesis, two main focuses have been identified: "leave or stay decision making" and "multifactorial dimensions of decision making". Results showed that decision-making is an important process in avoiding secondary victimization.

Assisted Suicide and Euthanasia in Mental Disorders: Ethical Positions in the Debate between Proportionality, Dignity, and the Right to Die.

The admission of people suffering from psychiatric and neurocognitive disorders to euthanasia and physician-assisted suicide (E/PAS) in some European and non-European countries represents a controversial issue. In some countries, the initial limitation of E/PAS to cases of severe physical illness with poor prognosis in the short term has been overcome, as it was considered discriminatory; thus, E/PAS has also been made available to subjects suffering from mental disorders. This decision has raised significant ethical questions regarding the capacity and freedom of self-determination; the family, social, and economic contexts; the social consideration of the sense of dignity and the pressure on the judgment of one's personal value; the contextual therapeutic possibilities; the identification of figures involved in the validation and application; as well as the epistemological definitions of the clinical conditions in question. To these issues must be added the situation of legislative vacuum peculiar to different countries and the widespread lack of effective evaluation and control systems. Nonetheless, pessimistic indicators on global health status, availability of care and assistance, aging demographics, and socioeconomic levels suggest that there may be further pressure toward the expansion of such requests. The present paper aims to trace an international overview with the aim of providing ethical support to the debate on the matter. Precisely, the goal is the delimitation of foundations for clinical practice in the complex field of psychiatry between the recognition of the irreversibility of the disease, assessment of the state of physical and mental suffering, as well as the possibility of adopting free and informed choices.

Structured instruments for insanity defense evaluations: Opportunities and limitations.

Insanity evaluations are often criticized for their-alleged-lack of objectivity, reliability and transparency. Structured tools to guide and support forensic evaluators during these evaluations have been developed-but they are rarely employed in forensic practice. In the present article, we consider the value of these tools for forensic practice in terms of opportunities and limitations. First, we briefly describe different insanity criteria used in Western countries. Next, we will review five structured instruments to guide insanity assessment together with their performance measures. Finally, we draw conclusions on the value of such instruments for forensic practice.

The Relationship Between Childhood Trauma, Pathological Dissociation, and Behavioral Addictions in Young Adults: Findings from a Cross-Sectional Study.

Interactions between childhood trauma (CT) and dissociation can contribute to psychiatric disturbances. We explored this phenomenon in relation to behavioral addictions (BAs) in a sample (n = 633) of young adults (age: 18-34 years). Self-report measures investigating CT, dissociation, and symptoms related to gambling disorder, internet gaming disorder, problematic social media use, exercise dependence and compulsive buying were used. Scales related to BAs were summarized into a single measure ("Total Behavioral Addiction Index" - TBAI) for inferential analyses. A model analyzing the direct and indirect effects of CT on TBAI through the mediation of pathological dissociation was performed, controlling for confounding factors. Measures on CT, dissociation, and TBAI were significantly associated with each other (all p < .001). The total effect of CT on TBAI was significant (B = 0.063; CI: 0.045; 0.081); pathological dissociation significantly mediated such association (B = 0.023; CI: 0.013; 0.036). Our findings support the possibility that the interaction between CT and dissociation contributes to increase disturbances related to BAs.

Acquired Pedophilia: international Delphi-method-based consensus guidelines.

Idiopathic and acquired pedophilia are two different disorders with two different etiologies. However, the differential diagnosis is still very difficult, as the behavioral indicators used to discriminate the two forms of pedophilia are underexplored, and clinicians are still devoid of clear guidelines describing the clinical and neuroscientific investigations suggested to help them with this difficult task. Furthermore, the consequences of misdiagnosis are not known, and a consensus regarding the legal consequences for the two kinds of offenders is still lacking. The present study used the Delphi method to reach a global consensus on the following six topics: behavioral indicators/red flags helpful for differential diagnosis; neurological conditions potentially leading to acquired pedophilia; neuroscientific investigations important for a correct understanding of the case; consequences of misdiagnosis; legal consequences; and issues and future perspectives. An international and multidisciplinary board of scientists and clinicians took part in the consensus statements as Delphi members. The Delphi panel comprised 52 raters with interdisciplinary competencies, including neurologists, psychiatrists, neuropsychologists, forensic psychologists, expert in ethics, etc. The final recommendations consisted of 63 statements covering the six different topics. The current study is the first expert consensus on a delicate topic such as pedophilia. Important exploitable consensual recommendations that can ultimately be of immediate use by clinicians to help with differential diagnosis and plan and guide therapeutic interventions are described, as well as future perspectives for researchers.

A Medical-Legal and Psychological Systematic Review on Vitriolage Related to Gender-Based Violence.

Attacks perpetrated using acid are a particular form of interpersonal violence, possibly one of the most heinous manifestations of Intimate Partner Violence (IPV). Acid attacks are mainly motivated by extramarital cheating, marital conflicts, women's rejection of marriage proposals, and sexual advances. As these attacks are not well understood from a psychological perspective, we conducted a systematic review, following Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, of 284 articles identified, 13 were eligible for inclusion. Three main focuses were identified: "Risk and vulnerability factors," "Consequences and implications," and "Interventions and treatments." Acid attacks seem to be more frequent in countries where social and economic development leads to greater tensions over traditional gender roles like Bangladesh, Pakistan, and India. Identified risk factors were young age, low socioeconomic status, low educational attainment, ethnicity, unemployment status of the victim, alcohol, and drug use of the perpetrator. Among the main psychosocial consequences of acid attacks, isolation and social exclusion emerged. Additionally, the paper will discuss the role of mental health consequences and specific treatments from psychological, clinical, and medical-legal points of view.

The impact of machine learning in predicting risk of violence: A systematic review.

Background: Inpatient violence in clinical and forensic settings is still an ongoing challenge to organizations and practitioners. Existing risk assessment instruments show only moderate benefits in clinical practice, are time consuming, and seem to scarcely generalize across different populations. In the last years, machine learning (ML) models have been applied in the study of risk factors for aggressive episodes. The objective of this systematic review is to investigate the potential of ML for identifying risk of violence in clinical and forensic populations. Methods: Following Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, a systematic review on the use of ML techniques in predicting risk of violence of psychiatric patients in clinical and forensic settings was performed. A systematic search was conducted on Medline/Pubmed, CINAHL, PsycINFO, Web of Science, and Scopus. Risk of bias and applicability assessment was performed using Prediction model Risk Of Bias ASsessment Tool (PROBAST). Results: We identified 182 potentially eligible studies from 2,259 records, and 8 papers were included in this systematic review. A wide variability in the experimental settings and characteristics of the enrolled samples emerged across studies, which probably represented the major cause for the absence of shared common predictors of violence found by the models learned. Nonetheless, a general trend toward a better performance of ML methods compared to structured violence risk assessment instruments in predicting risk of violent episodes emerged, with three out of eight studies with an AUC above 0.80. However, because of the varied experimental protocols, and heterogeneity in study populations, caution is needed when trying to quantitatively compare (e.g., in terms of AUC) and derive general conclusions from these approaches. Another limitation is represented by the overall quality of the included studies that suffer from objective limitations, difficult to overcome, such as the common use of retrospective data. Conclusion: Despite these limitations, ML models represent a promising approach in shedding light on predictive factors of violent episodes in clinical and forensic settings. Further research and more investments are required, preferably in large and prospective groups, to boost the application of ML models in clinical practice. Systematic review registration: [www.crd.york.ac.uk/prospero/], identifier [CRD42022310410].

When COVID-19 Is Not All: Femicide Conducted by a Murderer with a Narcissistic Personality "Masked" by a Brief Psychotic Disorder, with a Mini-Review.

Several cases of COVID-19-related mental disorders have emerged during the pandemic. In a case of femicide that occurred in Italy during the first phase of the pandemic, coinciding with a national lockdown, a discrepancy arose among forensic psychiatry experts, particularly toward the diagnosis of Brief Psychotic Disorder (BPD) related to COVID-19. We aimed to discuss the evaluation of the case through an integration of information and a literature review on comparable reported cases. An analysis of the diagnosis of brief acute psychosis was then performed, as well as a mini-review on cases of COVID-19-related psychosis. Results showed that psychotic symptomatology was characterized by polythematic delusions that always involved a SARS-CoV-2 infection. To a lesser extent, the delusions were accompanied by hallucinations, bizarre cognitive and associative alterations, insomnia, hyporexia, dysphoria, and suicidal behavior. No particularly violent acts with related injury or death of the victim were described. Finally, we could hypothesize that our case was better represented by a diagnosis of personality with predominantly narcissistic and partly psychopathic traits. The present case highlighted the importance, in the context of forensic psychiatry, of integrating assessments with the crime perpetrators, namely through accurate clinical interviews, neuropsychological tests, diachronic observations, and comparison with similar cases present in the literature. Such an integrated approach allows precise evaluation and reduces the odds of errors in a field, such as forensic psychiatry, where a diagnostic decision can be decisive in the judgment of criminal responsibility. Moreover, discerning forensics from health cases represents an important issue in risk management.

How the COVID-19 Pandemic Has Impacted Daily Life? Assessing the Use of Web Resources for Recreational Activities in the Italian Adult Population.

Restriction measures imposed during the COVID-19 pandemic led to changes in people's lives and behaviors. The aim of this paper is to assess the changes occurred in physical activity (PA), sleep, social and cultural activities and personal relationships of Italian adults during the pandemic and to evaluate the use of web-based resources to continue these activities. To this purpose, a cross-sectional study using a web-based questionnaire was carried out and both descriptive and regression analysis was performed. On a total of 1831 participants (61% females, age 18-93 years), the majority reported a decrease in PA, sleep, social and cultural activities and personal relationships, since the beginning of the pandemic. Sleep was notably affected by the use of new technologies. The regression analysis demonstrated that the use of web-based media for doing exercise was associated with being younger than 50 years and female; having a chronic condition was inversely related with the use of web resources for social and cultural activities and to maintain relationships; being employed was negatively related with the use of web media for continuing personal relationships and cultural activities; and being vaccinated against COVID-19 was positively associated with the use of the web for personal relationships. These findings confirm that the COVID-19 pandemic notably affected the daily life of Italian adults. Our results suggest that the use of technology to deal with these changes seems to be related with certain sociodemographic and health-related characteristics. These findings can be useful to identify those characteristics that can help people in copying with daily life modifications due to restriction measures.

"Monkeypox: What Do You Know about That?" Italian Adults' Awareness of a New Epidemic.

In the course of 2022, an epidemic of monkeypox (MPX) arose worldwide. In order to assess the level of knowledge of the Italian adults regarding the new emerging disease, its prevention and their level of worrying and the acceptance of a possible vaccination, a web questionnaire was spread nationwide. A total of 1352 individuals (mean age 54.5 ± 13.4, 52.4% males) completed the questionnaire. Only 26. 7% of the sample wereaware of the burden of the epidemic at the moment of the investigation; 47.1% were not able to identify the transmission route, nor the main symptoms (48.9%); and 54.2% were hesitant toward a possible MPXV vaccination, mainly because of a lack of confident in vaccines (38.5%). A low level of worrying about the disease was registered (mean score 2.3 ± 1.2 on a 5-point scale). In the regression analysis performed considering MPX knowledge as outcome, a lower level of knowledge was associated with higher age (OR 1.378, CI95% 0.998-1.904), working or studying in a nonhealthcare setting (OR 0.046, CI95% 0.033-0.066), being single (OR 0.624, CI95% 0.455-0.856) and having mass media as the main source of information (OR 0.332, CI95% 0.158-0.696). These findings indicate as of the time of this investigation, the communication about the MPXV epidemic was not effective in determining a good level of knowledge about the disease and its transmission among Italian adults. This highlights the need to improve risk communication strategies.

High Expressed Emotion (HEE), Assessed Using the Five-Minute Speech Sample (FMSS), as a Predictor of Psychiatric Relapse in Patients with Schizophrenia and Major Depressive Disorder: A Meta-Analysis and Meta-Regression.

Expressed Emotion (EE) describes the tone of a caregiver's response to a patient with a mental disorder, and it is used to predict relapse. The Five-Minute Speech Sample (FMSS) is a 5-min interview with a caregiver that evaluates only two EE dimensions. The present study aimed at evaluating HEE (High Expressed Emotion) as a predictor of relapse in patients with schizophrenia and major depressive disorder. Six studies were selected for the meta-analysis. In total, the studies included 297 subjects. The analyses included a random effects model; a meta-analysis excluding the study with the smallest sample; a cumulative meta-analysis; a meta-regression with random effects, using patient age and duration of illness as moderators; a leave-one-out meta-analysis; and a funnel plot to estimate publication bias. The FMSS emerged as a valid and reliable tool for measuring EE as a predictor of relapse in patients with schizophrenia and major depressive disorder. Patient age and duration of illness had no significant effect on the results. Future meta-analyses should include more studies to reduce publication bias. EE may be a good predictor of relapse when examined through a fast measurement technique such as the FMSS, which may also be useful to analyze the psychopathological structure of caregivers.

Climate Changes, Natural Resources Depletion, COVID-19 Pandemic, and Russian-Ukrainian War: What Is the Impact on Habits Change and Mental Health?

Climate Change, Natural Resources Depletion, COVID-19, and Wars are some of the great challenges of our time. The consequences will affect psychological well-being and could have a harmful impact on mental health. This study aimed to assess the level of preoccupation and fears surrounding issues of the 21st-century and the implication for psychological well-being of the general population from Central/Southern Italy among different age groups. A questionnaire that included sociodemographic characteristics, topics formulated ad-hoc about preoccupation, fears, habits, and willingness to change habits in the future related to the 21st-century challenges, and the Depression Anxiety Stress Scales 21 (DASS-21) was administered online. A sample of 1831 participants (61% F; mean age 47.71 ± 17.30) was obtained. Results showed that young adults and older adults, respectively, reported greater and less psychological well-being. Young adults reported higher scores for preoccupation, changing habits, and willingness to change habits in the future, while older adults reported the lowest scores except for changing habits, also controlling for gender. Results for this variable, as well as correlations between the many variables described, rely on the specificity of age, and 21st-century challenges. Moreover, the main fears related to the 21st-century concerns were different based on both age and gender. In conclusion, the various stresses of the 21st-century discussed in this study have a relationship with personal well-being, and it is important to consider potential global mental health issues resulting from these stressors.

Calls to the anti-violence number in Italy during COVID-19 pandemic: correlation and trend analyses of violence reports during 2020.

PURPOSE: We hypothesized that during the 2020 pandemic there has been a significant change along the year, depending on the SARS-CoV-2 impact on the population and varying difficulties implied in the norms that were adopted to embank the pandemic. Our objectives were to verify how the phenomenon of domestic violence has evolved and changed along 2020, and to clarify if these changes were correlated to the evolution of the pandemic. METHODS: Though the analysis of the number of daily calls from women to the national anti-violence number and the parameters related to COVID-19 pandemic (daily cases, deaths, hospitalizations, and admissions in ICU), a positive correlation was found between daily deaths due to COVID-19 and the number of calls to the anti-violence number, while daily hospitalizations and admissions in ICU negatively correlated with calls of women reporting at the national anti-violence number. RESULTS: The number of daily calls from women reporting at the national anti-violence number positively correlated with the number of quarantined people shifted of 30 days from the beginning of isolation at home, as well. We also analyzed temporal trends of daily calls from women to the national anti-violence number from 25th of February 2020 to 31st of December 2020. CONCLUSIONS: These findings demonstrate the importance of an active anti-violence telephone service and may help in developing a strategy to improve anti-violence facilities, especially during crises, such as specific sources of psychological support for women who have survived violence episodes.

Neuroanatomical correlates of autism spectrum disorders: A meta-analysis of structural magnetic resonance imaging (MRI) studies.

Autism spectrum disorders (ASD) are neurodevelopmental disorders correlated to various neuroanatomical modifications. We aimed to identify neuroanatomical changes assessed in magnetic resonance imaging (MRI) studies of autism spectrum disorder (ASD) through Activation Likelihood Estimate (ALE) meta-analysis. We included 19 peer-reviewed magnetic resonance imaging (MRI) studies that analyzed cortical volume in patients with ASD compared to healthy control subjects (HCs). The between-group analyses comparing subjects with ASD to HCs showed a volumetric reduction of a large cluster in the right brain, including the uncus/amygdala, parahippocampal gyrus, and entorhinal cortex, and putamen. The anomalies are primarily found in the right hemisphere, involved in social cognitive function, particularly impaired in ASD. These results correlate with several clinical aspects of ASD. These volumetric alterations can be considered a major correlate of disease in the context of multifactorial etiology. Further studies on brain lateralization in ASD are needed, considering the clinical phenotype variability of these disorders.

Capturing the Features of Physical Activity in Old Adults during the COVID-19 Pandemic: Results of an Italian Survey.

The restriction measures adopted to control the COVID-19 pandemic had significant consequences on individuals' lifestyles. This study is aimed at assessing the amount and type of habitual physical activity (PA) in older adults during the advanced phase of the pandemic and their possible relationships with sociodemographic aspects. A questionnaire that included sociodemographic characteristics and the Physical Activity Scale for the Elderly (PASE) was administered online to elderly subjects living in the Apulia region, South Italy. A sample of 939 participants (57.1% F; mean age 75.9 ± 6.3) was obtained. In total, 68.8% of female respondents reported a decrease in PA during the pandemic, while 55.1% of men maintained their previous levels (<0.001). The total PASE score did not differ between gender groups (median value 91.7 in males vs. 90.0 in females; p = 0.067). However, differences were registered in leisure activities, particularly regarding walking (23.8 ± 14.8 in males vs. 20.2 ± 14.6 in females; p = 0.001). Higher PA levels were related with lower age (OR 0.253; 95% CI 0.192−0.333; p = 0.001). Since inactivity can affect elderly health and wellbeing, and considering the impact of the COVID-19 lockdown on this habit, health promotion strategies to counteract the negative effects of the pandemic should include interventions aimed at increasing PA in this sub-group of the population, especially among women and elderly subjects.