Psychological Distress of Healthcare Workers in 4 Hospitals Compared to General Population During the First Italian Wave of COVID-19 Pandemic.

COVID-19 caused important consequences on public health, economy, physical, and mental health of people. The aim of this study was to evaluate the impact of COVID-19 on frontline workers, comparing them with their colleagues who had no contact with the patients and with the general population, by administering an online questionnaire based on the Distress Questionnaire-5 (DQ5). The study was carried out during the first Italian wave of COVID-19 pandemic from 1st to 30th of April. Participants were divided in 3 groups: group 1 is general population group that includes the general population which are quarantined but not isolated, group health care staff not working in COVID-19 hospitals, and group 3 healthcare staff group working in COVID-19 hospitals. The survey was carried with the Distress Questionnaire-5 (DQ5) as a tool to detect the psychological distress and mental health problems. A total of 2983 people participated in this survey. Seven hundred and twenty four out of 1123 (64%) were employers of the 4 hospitals included in this study. Particularly among the respondents, 2259 (75.7%) were general population, 502 (16.8%) were health care staff not working in COVID-19 hospitals, while 222 (7.4%) were health care staff working in covid-19 hospitals. Health care personnel working in COVID-19 hospitals (DQ-5 = 13, 10-16) had less psychological distress compared with health care staff not working in COVID-19 hospitals (DQ-5 = 14, 11-16) and general population (DQ-5 = 14, 11-17; P = .04). The regression model showed that people aged 26 to 35 (OR: 2.06, 95% CI: 1.21-3.48) and female (OR: 2.35, 95% CI: 1.95-2.83) were significantly at risk to develop a DQ-5 ≥ 11. During the first Italian wave of COVID-19 pandemic, healthcare personnel working in COVID-19 hospitals had less psychological distress compared with health care staff not working in COVID-19 hospitals and general population, probably because they were prepared to face situations like outbreak or emergencies.

Starting aripiprazole long-acting-once-a-month early in treatment: why, how and for whom? Expert consensus and practical recommendations by a panel of Italian clinicians.

INTRODUCTION: Aripiprazole long acting once-monthly (AOM) is approved for the treatment of schizophrenia in adults. Despite recent evidence of AOM efficacy in the acute treatment of schizophrenia, it is recommended that AOM should be started once the acute symptoms are controlled and patients are stabilized. However, there currently are no definitive guidelines exactly describing when a patient is to be considered stabilized enough to start AOM and which the patients are for whom an early AOM start is to be preferred. Areas covered: A panel of Italian clinicians experienced with real world use of AOM met to discuss the scenarios where an early (i.e., immediately after controlling the acute symptoms) start of AOM may be suggested. Real life clinical experiences were shared and a consensus was reached. Expert opinion: There are cases when the risks/benefits ratio suggests to start AOM early, i.e. immediately after the acute symptoms have been stabilized, as opposed to starting it several days/weeks after the stabilization of acute symptoms. Clinical pearls, guidelines and opinions are provided.

[Neuropsychological modifications at high altitude: from Pamir to Karakorum]. / Modificazioni neuropsicologiche da alta quota: dal Pamir al Karakorum.

AIM: Neuropsychological modifications and acclimatization processes at over 8000 without auxiliary oxygen were investigated in two climbers, evaluating attentive abilities and matching their performances. METHOD: During rest in base-camp (4800 m), at other three Resorts - Resort I (5800 m), Resort II (6400 m), Resort III (7200 m) -, and four months after the return at low altitude, were administered: Temporal Orientation Test (TOT), Trail Making Test (TMT), Animal Naming (AN), Verbal Fluency Test (VFT), Arithmetical Judgment Test (AJT), and Drawing Test (DT). Results. At TOT and at AJT, both the climbers demonstrated scores at higher normal levels (Eq = 4) in all the Resorts in which they were performed. They showed an impairment at AN test, especially at Resort III, showing sensitivity of animal naming to hypoxia. At the DT, human figures were reduced in their dimensions and details, as consequence of the tendency to self closure and introversion that occurs at higher altitudes. DISCUSSION: Neuropsychological functions concerning verbal fluency showed sensitivity to hypoxia, especially at higher altitudes. TMT demonstrated that attentive ability can be preserved if acclimatization is good. Sensitivity to hypoxia and acclimatization processes showed a significant subjective variability. CONCLUSIONS: The results of this study show that exposure to high altitude produces some significant neuropsychological changes.

Estudio mediante imagen funcional de resonancia magnética (fMRI) de las activaciones emotivas correlacionadas a la presentación de rostros extraños o del propio rostro en sujetos con personalidad inward y outward / Functional magnetic resonance imaging (fMRI) study of emotional expressions correlated to strange face expressions or of the itself in subjects with inward or outward personality

Introduction: Due to patterns ofreciprocity based on steady and coherent behaviours or, on the contrary, on articúlate and changing behaviours, attachment relationships produce personal meaning organizations respectively centred on inward or outward focus. In inward organizations, emotions are more distinct and reciprocity is more based on physical distance (protection, loneliness); in outward organizations, emotions are more blurred and reciprocity is more based on a semantic sight of relations (approval, rules). Thanks to the modern technologies of neuroimaging (especially functional magnetic resonance, flMR), a scientific, Uve study ofwhat happens when an emotion starts is now possible. Method: We studied in 10 healthy subjects the amygdala and other nervous system structures activations when the subject perceives emotional expressions by seeing an unknown face and his/her own face. Results were also matched with inward/outward organization (studied with clinical approach and MMPI2, QSP, MQOP). Results and Discussion: Our results proved that an unknown face produces higher activation on the subjects than their own face (surprise effect); the anger mostly activates the right amygdala, while the joy activates both the amygdalas or the left one (it produces a semantic decoding). Outward subjects, with respect to the inward ones, respond to the anger with a less intense and univocal pattern, actívate more cortical ßreas, not always respond to their own facial expressions and respond to the joy with an higher involvement ofthe left verbal hemisphere.

Introducción: Patrones de reciprocidad estable y coherente o, al contrario, no unívocos y cambiantes, permiten desarrollar organizaciones de significado personal con enfoque de la experiencia a lo interno (inward) o externo (outward). En los inward las emociones son más definidas y la reciprocidad es primordialmente física (protección, soledad); en los outward las emociones son más difuminadas y la reciprocidad es prevalentemente semántica (confirmación, reglas). Las modernas tecnologías de imágenes funcionales han permitido estudiar en vivo qué sucede cuando se experimenta una emoción. Método: Hemos estudiado, mediante imagen funcional de resonancia magnética (fMRI), las activaciones de la amígdalay de otras estructuras del SNCproducidas, en 10 voluntarios sanos, por estímulos emocionales externos estandarizados, tanto cuando el sujeto percibe expresiones emotivas relativas a un rostro extraño (tercera persona), como relativas al rostro propio (primera persona). Resultados y Discusión: Los resultados obtenidos han sido confrontados con las modalidades de enfoque inward o outward, atribuibles al funcionamiento de base de la personalidad individual. Tales modalidades han sido comprobadas mediante MMPI2, QSPyMQOP asociados a una evaluación clínica realizada por un psicoterapeuta experto. Los resultados indican que un rostro extraño produce activaciones mayores respecto al propio (efecto sorpresa), que la rabia activa mayormente la amígdala derecha, mientras que la alegría activa ambas amígdalas o la izquierda. Los outward, respecto a los inward, responden a la rabia de manera menos intensa y unívoca, activan más áreas corticales, pueden no responder a las emociones propias y tienen una mayor implicación del hemisferio verbal en la alegría.