Predictors of stigma in a sample of mental health professionals: Network and moderator analysis on gender, years of experience, personality traits, and levels of burnout.

BACKGROUND: Stigma is one of the most important barriers to help-seeking and to personal recovery for people suffering from mental disorders. Stigmatizing attitudes are present among mental health professionals with negative effects on the quality of health care. METHODS: Network and moderator analysis were used to identify what path determines stigma, considering demographic and professional variables, personality traits, and burnout dimensions in a sample of mental health professionals (n = 318) from six Community Mental Health Services. The survey included the Attribution Questionnaire-9, the Maslach Burnout Inventory, and the Ten-Item Personality Inventory. RESULTS: The personality trait of openness to new experiences resulted to determine lower levels of stigma. Burnout (personal accomplishment) interacted with emotional stability in predicting stigma, and specifically, for subjects with lower emotional stability lower levels of personal accomplishment were associated with higher levels of stigma. CONCLUSIONS: Some personality traits may be accompanied by better empathic and communication skills, and may have a protective role against stigma. Moreover, burnout can increase stigma, in particular in subjects with specific personality traits. Assessing personality and burnout levels could help in identifying mental health professionals at higher risk of developing stigma. Future studies should determine whether targeted interventions in mental health professionals at risk of developing stigma may be effective in stigma prevention.

Pandemic COVID-19: the residents' resilience.

BACKGROUND AND AIM OF THE WORK: Healthcare workers are often exposed to secondary traumatic stress. The SARS-CoV-2 outbreak caused intense psychological pressure in various healthcare professionals, with increased risk of post-traumatic stress disorder. Objective of our study was to evaluate the incidence of post-traumatic stress disorder in italian residents in Intensive Care and Emergency Departments facing COVID-19 emergency. METHODS: We developed a short, anonymous web-questionnaire to obtain data regarding sociodemographic, professional characteristics, history of psychological trauma, psychotherapy, use of psychiatric medications and the presence of symptoms of post-traumatic stress disorder. Primary outcome was the incidence of post-traumatic stress disorder. Secondary endpoint was to identify possible risk factors associated with the development of post-traumatic stress disorder.  Post-traumatic stress disorder symptoms were assessed by the Impact of Event Scale-Revised.  A cut-off of 33 identified a probable diagnosis of post-traumatic stress disorder while a cut-off of 22 identified subclinical post-traumatic stress disorder. RESULTS: 503 residents completed the questionnaire. Among residents who were directly involved in the clinical assistance of COVID-19 patients, 34.3% presented a probable diagnosis of post-traumatic stress disorder, while 21.5% presented subclinical post-traumatic stress disorder. Female gender and history of psychological trauma were significantly associated with the development of post-traumatic stress symptoms. CONCLUSIONS: Our data suggest a high incidence of post-traumatic stress disorder in Italian residents working in Intensive Care Units and Emergency Departments during the SARS-CoV-2 outbreak. This finding supports the importance of promptly implementing any strategy that might preserve staff mental health.

Exploring the relationships among personality traits, burnout dimensions and stigma in a sample of mental health professionals.

A sample of mental health professionals (n = 215) from six Community Mental Health Services was examined using a short version of the Attribution Questionnaire-27, the Maslach Burnout Inventory and the Ten Items Personality Inventory to detect possible associations among stigma, burnout dimensions and personality traits. The role of demographic and professional variables was also explored. Perception of workplace safety resulted to significantly affect attitudes toward patients. The concern about being assaulted and a low level of Personal Accomplishment were both related to avoidant attitudes, while the presence of procedures for managing the violent patient was associated with a higher level of Personal Accomplishment. Conversely, Emotional Stability and Openness to new experiences were inversely correlated with burnout dimensions and avoidant attitudes, respectively. Overall, our study supports the view of a significant association among some dimensions of stigma, burnout and personality factors. In particular, avoidant attitudes toward patients may be influenced by Personal Accomplishment and Openness to new experiences.

Alexithymia in juvenile primary headache sufferers: a pilot study.

Starting in the 1990s, there has been accumulating evidence of alexithymic characteristics in adult patients with primary headache. Little research has been conducted, however, on the relationship between alexithymia and primary headache in developmental age. In their research on alexithymia in the formative years, the authors identified one of the most promising prospects for research, as discussed here. The aim of this study was to verify whether there is: (a) a link between tension-type headache and alexithymia in childhood and early adolescence; and (b) a correlation between alexithymia in children/preadolescents and their mothers. This study was based on an experimental group of 32 patients (26 females and 6 males, aged from 8 to 15 years, mean 11.2 ± 2.0) suffering from tension-type headache and 32 control subjects (26 females and 6 males, aged from 8 to 15 years, mean 11.8 ± 1.6). Tension-type headache was diagnosed by applying the International Headache Classification (ICHD-II, 2004). The alexithymic construct was measured using an Italian version of the Alexithymia Questionnaire for Children in the case of the juvenile patients and the Toronto Alexithymia Scale (TAS-20) for their mothers. Higher rates of alexithymia were observed in the children/preadolescents in the experimental group (EG) than in the control group; in the EG there was no significant correlation between the alexithymia rates in the children/preadolescents and in their mothers.

Cost-benefit analysis of influenza vaccination in a public healthcare unit.

OBJECTIVE: Estimate the costs and benefits of influenza vaccination in a group of employees of an Italian District Health Authority, Unità Locale Socio Sanitaria (ULSS), to define a scheme of an economic evaluation to be used for other vaccination strategies. DESIGN: In an observational study conducted from December 2002 to April 2003, 107 ULSS employees, voluntarily vaccinated, were compared with 107 nonvaccinated ULSS employees matched for age, sex, and job category. The outcome of cost-benefit analysis was evaluated by checking personnel department records about absences from work and their causes, including influenza. Costs and benefits of the influenza vaccination from the ULSS point of view were calculated. RESULTS: The influenza vaccination strategy reduced absences from work by 23% and decreased the loss of working days by 30% and related cost. This difference is not significative. The ratio vaccination benefits/cost was euro4.2. The advantage of vaccination is confirmed by sensitivity analysis performed on the mean cost of a working day, which showed that the benefit-cost ratio ranged from euro4.5 to euro11.7. CONCLUSIONS: The results suggest that the influenza vaccination strategy in our sample of people was cost-saving. The economic evaluation used in this study could also be used for other vaccination strategies and in other settings.