RESUMO
BACKGROUND: Hikikomori (HK) is characterized by self-isolation and social refusal, being more likely also associated with affective disorders, including depression. This case-control study primarily aimed at identifying (if any) predominant affective temperaments are associated with HK in depressed versus not-depressed individuals. Secondary objectives comprise assessing which other psychopathological dimensions (e.g., boredom, anxiety) are associated with the HK specifier in depressed individuals. METHODS: From the larger SWATCH study, 687 Italian young people were screened for depression, as measured by 9 items-Patient Health Questionnaire (PHQ-9) and HK-like social withdrawal, through the Hikikomori Questionnaire-25 (HQ-25). All subjects were administered a brief-Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-M), the 7 items-Generalized Anxiety Disorder (GAD-7) and the Multidimensional State Boredom Scale (MSBS). RESULTS: Males reported significantly higher scores at HQ-25 total score than females (p = 0.026). In the total sample, HK social withdrawal is positively predicted by MSBS low arousal, disengagement, depressive levels, depressive and irritable affective temperaments, while negatively by anxiety (F(6, 680) = 82.336, p < 0.001, R2 = 0.421). By selecting only depressed sample, HQ-25 is positively predicted by MSBS total score, low arousal and depressive affective temperament, while negatively by MSBS high arousal (F(4, 383) = 48.544, p < 0.001, R2 = 0.336). The logistic regression model found that the likelihood of developing depression with the HK specifier is significantly predicted by depressive and cyclothymic affective temperaments. CONCLUSIONS: These preliminary findings could help in clinically characterizing the relationship between specific affective temperamental profiles among individuals with depression with/without HK specifier, in order to provide a more tailored and personalized therapeutic approach. Our Italian study should be extensively replicated in larger, longitudinal and multicentric pan-European studies, by specifically assessing the impact of these findings on depression clinical course, prognosis and treatment outcomes.
RESUMO
Digital therapeutics (DTx) offer evidence-based digitally-delivered high quality standards applications and/or softwares in the prevention, management and treatment of several medical conditions, including mood disorders. Nowadays, there are only three DTx officially approved by the Food and Drug Administration for mental conditions and there are still very few DTx developed in the context of mood disorders. The current comprehensive overview aims at providing a summary of currently published studies on DTx clinical applications in major depressive disorder (MDD), depressive symptomatology and bipolar disorder (BD), by using PubMed/MEDLINE and Scopus databases. Fifteen studies have been selected (10 on DTx in depressive symptomatology and/or MDD; 4 on BD; 1 on MDD and BD). Literature on DTx in mood disorders is still lacking, being mostly constituted by feasibility and acceptability rather than efficacy/effectiveness outcomes, particularly in BD. More studies focused on MDD compared to BD. Most DTx on MDD have been developed based on cognitive behaviour therapy interventions while on BD are based on psychoeducation. All studies assessing symptom severity improvement pre- vs. postinterventions demonstrated a significant postintervention improvement. Therefore, despite the preliminary encouraging results of studies here retrieved, their methodology is still too heterogeneous to allow comparisons and the generalizability of their findings. Further studies are warranted, in more larger samples involving multiple sites, including measures of both specific symptom effects as well as acceptability, feasibility and effectiveness in the real-world settings.
Assuntos
Transtorno Bipolar , Terapia Cognitivo-Comportamental , Transtorno Depressivo Maior , Humanos , Transtorno Bipolar/terapia , Transtorno Depressivo Maior/psicologia , Transtornos do Humor/terapia , Transtornos do Humor/psicologiaRESUMO
INTRODUCTION: Disruptive Mood Dysregulation Disorder (DMDD) was officially introduced as a new diagnostic entity in the Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-5), under the category of depressive disorders. AREAS COVERED: A comprehensive overview and a critical commentary on the currently investigated psychopharmacological approaches for the treatment of DMDD have been here provided. EXPERT OPINION: Behavioral and psychosocial interventions should be considered as first-line treatment strategies. When ineffective or partially effective, psychopharmacological strategy is recommended. Overall, pharmacological strategy should be preferred in those individuals with psychiatric comorbidities (e.g. ADHD). Indeed, so far published studies on pharmacological strategies in DMDD are scant and heterogeneous (i.e. age, assessment tools, symptomatology profile, comorbidity, and so forth). Therefore, DMDD psychopharmacological guidelines are needed, particularly to guide clinicians toward the patient's typical symptom profile who could benefit from psychopharmacological strategy.
Assuntos
Prova Pericial , Humor Irritável , Humanos , Transtornos do Humor/diagnóstico , Transtornos do Humor/tratamento farmacológico , Transtornos do Humor/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo , ComorbidadeRESUMO
Introduction: Nonsuicidal-self-injury (NSSI)-related content recently emerged on social networking sites (SNS), despite its relationship with NSSI conducts is still unclear. Methods: Hence, the current population-based cross-sectional study investigated the interplay between SNS use, NSSI content engagement, risky social media challenges (RSMCs), in a sample of 404 young adults (aged 18-24), focusing on the influence of problematic social media use (PSMU) and fear of missing out (FoMO). Results: Around 51.5% of the samplewas engaged inNSSI-related contents on SNS, being mostly females (p<0.001), younger (p=0.005), transgender people and nonbinary people (p=0.030) and those who displayed higher PSMU (p<0.001) or FoMO (p=0.031). Around 66.2% of the sample currently practice NSSIs, predominantly among females (p<0.001), those using BeReal (p=0.012), actively looking for NSSIrelated contents on SNS (p<0.001) to be part of a group (p=0.0025) or learn how to practice NSSI (p=0.025). PSMU (p<0.001) and FoMO (p<0.001) emerged as significant predictors of NSSI content engagement, particularly among active seekers. NSSI conducts were significantly predicted by FoMO (p<0.001) and Snapchat (p=0.044), while negatively predicted by male sex (p<0.001), higher educational level (p=0.019) and age at which NSSI-related contents were firstly looked for (p=0.028). Discussion: These findings underline the need to implement preventivepolicies and targeted interventions to monitor NSSI-related contents on SNS, the impact of PSMU and FoMO on NSSI, particularly among youngsters.
RESUMO
A new postmodern depression type, named "Modern-Type Depression" (MTD), is emerging in Western countries. MTD is often underdiagnosed, mainly due to potentially higher comorbidity with technology-based addictions, including Internet Gaming Disorder (IGD). However, the definition of the relationship between MTD and IGD is still controversial, as few data have been published thus far. In particular, there are no data specifically investigating the prevalence of MTD within Italian young subjects with IGD, as well as their mutual association. Hence, within the SWATCH (Social Withdrawal and TeCno-mediated mental Health issues) project, our study aimed to identify the prevalence of MTD in a sample of Italian young adults who play video games by providing a clinical characterization of MTD within a group of IGD individuals (IGD+) versus a group without IGD (IGD-) who play video games. Our cross-sectional case-control study recruited a sample of 543 Italian young video-gaming players (aged 18-35) from the larger SWATCH database, stratified as IGD+ versus IGD-. Subjects were administered the 22-item Tarumi's Modern-Type Depression Trait Scale (TACS-22), the Motives for Online Gaming Questionnaire (MOGQ), and the Internet Gaming Disorder Scale-Short Form (IGDS9-SF). Around 21.7% of the total sample was represented by MTD individuals, while within the IGD sample, around 34% of subjects had MTD. Within the MTD group, significantly higher scores at IGDS-9SF (p < 0.001), MOGQ "Escape from reality" (p < 0.001), "Fantasy" (p < 0.001), and MOGQ total score (p = 0.003) were found compared to MTD-. According to the multivariate regression model, controlled for sex and age, higher scores in the TACS-22 were positively predicted by the total score of IGDS9-SF (p = 0.003), the MOGQ "Escape from Reality" subscale (p = 0.014), and MOGQ "Fantasy" (p = 0.011), and negatively predicted by the MOGQ "Competition" subscale (p = 0.035) [F (4538) = 17.265; p < 0.001]. Our findings suggested that MTD displays a strong association with IGD. Video-gaming players who do not have IGD appear to be less prone to MTD; this suggests that further studies could be carried out to specifically investigate whether pathological use of video games could also be determined by the presence of MTD.
RESUMO
Non-suicidal self-injury (NSSI) can both precede and co-occur with suicidal attempts (SA). Underlying mechanisms/factors leading to the transition to SA in NSSI youths have been proposed (including the role of social cognition), despite they should be yet confirmed. Therefore, the study aims at exploring the role of the Theory of Mind in the differentiation of a sample of NSSI youngsters (aged 15-24) according to the presence of SA. We divided the sample into 4 groups using the Deliberate Self Harm Inventory (DSHI) and Columbia Suicide Severity Rating Scale (C-SSRS): control group (notNSSInotSA), NSSI without SA (NSSInotSA), NSSI with SA (NSSIplusSA), and SA without NSSI (SAonly). NSSIplusSA patients displayed higher Reading the Mind in the Eyes Test (RMET) scores (indicative of ToM abilities) than both the NSSInotSA (p=0.0016) and SAonly groups (p=0.0198), while SAonly patients showed lower RMET scores compared to the control group (p=0.0214). Multiple regression models used to differentiate NSSInotSA and NSSIplusSA found a significant association between RMET and LOSCS-CSC (Level Of Self-Criticism Scale-Comparative Self-Criticism) (pC=0.0802, pD=0.0016, pG=0.0053). Our findings supported the hypothesis that a hypertrophic affective ToM may possibly be associated with the occurrence of SA in youth NSSI. Further larger and longitudinal studies should confirm these preliminary findings, by exploring all social cognition dimensions.
RESUMO
INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) in adults could be frequently underdiagnosed due to concomitant psychiatric disorders, including depressive symptomatology, which could determine inappropriate treatments. Our study aims at clinically characterizing adult ADHD with or without depressive symptomatology in order to identify the relationship with specific affective temperamental profiles and coping strategies. METHODS: A total of 225 outpatients consecutively afferent to our outpatient adult ADHD service since September 2019 were retrospectively screened for eligibility and administered Beck Depression Inventory-II (BDI-II), Coping Orientation to Problems Experienced Inventory (COPE-NV) and Temperament Evaluation of the Memphis, Pisa, Paris and San Diego (TEMPS-M). RESULTS: 64.7 % of patients displayed a significant comorbid depressive symptomatology. According to the multivariate linear regression model, depressive levels were positively predicted by TEMPS-M cyclothymic subscale (B = 0.567, p = 0.004) and negatively predicted by COPE-NVI "positive attitude" subscale (B = -0.438, p = 0.024) (R = 0.496, R2 = 0.246, F(2,66) = 10.747, p < 0.001). LIMITATION: While considering the results, it should be taken in consideration that: the assessment was carried out only at baseline, our sample is constituted only by adult ADHD patients and mostly without a previous ADHD diagnosis, the presence of a discrepancy between the rates of ADHD subtypes, the absence of a healthy control group and emotional dysregulation was not directly assessed. CONCLUSION: Affective temperamental profiles and coping strategies could help in clinically characterizing and personalizing treatment in adult comorbid ADHD-depressive symptomatology patients. Further research is warranted to explore the efficacy of targeted psychotherapeutic and pharmacological interventions within this ADHD sub-sample.
RESUMO
In recent years, there has been a gradual digitalization of our society, resulting in intensified technology use for daily life activities, including the emergence of problematic Internet use (PIU). Few studies specifically addressed the boredom and loneliness dimensions in mediating the association between depression, anxiety, and stress levels and the onset of PIU. A nationwide population-based cross-sectional case-control study was carried out by recruiting a sample of Italian young people (aged 18-35). Only 1643 participants were selected for the analyses based on the age and the presence versus absence of PIU. Participants were mainly females (68.7%), with a mean age of 21.8 (SD = 1.7). Non-PIU individuals had significantly stable relationships (p = 0.012), siblings (p = 0.044) and lived with their family (p = 0.010), compared to PIU. PIU individuals displayed significantly higher depression, anxiety, and stress, as well as higher loneliness and boredom levels (all p < 0.001), compared to non-PIU. Depressive symptomatology predicted PIU and that their interaction is positively double mediated by boredom and loneliness (ß = 0.3829 (0.0245), 95%CI = 0.3349-0.4309). Our findings suggested that boredom and loneliness dimensions could act as mediators in the association between depressive symptomatology and the likelihood of PIU onset and maintenance.
Assuntos
Comportamento Aditivo , Feminino , Humanos , Adolescente , Adulto Jovem , Adulto , Masculino , Solidão , Estudos Transversais , Tédio , Estudos de Casos e Controles , Uso da Internet , InternetRESUMO
Lumateperone (also known as ITI-007 or ITI-722) represents a novel second-generation medication characterized by a favorable safety and tolerability profile. This is attributed to its notable selectivity for D2 receptors within specific regions of the brain. The U.S. Food and Drug Administration (FDA) granted approval for the treatment of schizophrenia in adults in December 2019. Additionally, it gained approval for addressing depressive episodes associated with bipolar I and II disorders in adults, either as a standalone therapy or in conjunction with lithium or valproate, in December 2021. The objective of this investigation is to systematically review the existing literature to assess the safety, tolerability, and efficacy of lumateperone in the treatment of schizophrenia. Lumateperone has demonstrated effectiveness in addressing positive, negative, and cognitive symptoms associated with schizophrenia. The evaluation of safety indicators in the reviewed studies indicates that lumateperone is deemed to be a well-tolerated and safe antipsychotic. Additional research is warranted to explore lumateperone's efficacy in managing major depressive disorders, behavioral issues in Alzheimer's disease and dementia, sleep maintenance insomnia, bipolar disorders, and personality disorders.
RESUMO
BACKGROUND: Despite a confirmed association between Problematic Internet use (PIU) and hikikomori-like social withdrawal, few studies investigated differences between sexes. Hence, the main objective was identifying psychopathological predictors (including hikikomori-like traits) associated with PIU (vs. non-PIU) across both sexes. METHODS: A total of 1141 Italian university students were assessed with the Hikikomori Questionnaire-11 (HQ-11), Toronto Alexithymia Scale (TAS-20), Internet Addiction Test (IAT) and Depression Anxiety Stress Scale-21 (DASS-21). Student's T-test, bivariate Person's correlations, linear regression and a stepwise binary logistic regression analysis were post-hoc run. CHERRIES guidelines were followed for data reporting. RESULTS: PIU university students, independently of sex, had greater psychological problems (p < 0.001) and greater hikikomori traits, compared to non-PIU (respectively, p = 0.010 and p < 0.001). PIU females had a better social quality of life (p = 0.007), and higher anxiety (p = 0.013) and stress (p = 0.051) levels, compared to PIU males. Linear regression analysis showed that depressive (p = 0.001) and stress levels (p = 0.003) as well as Hikikomori traits (p < 0.001) significantly predicted IAT total score in females (p < 0.001). Sex-specific binary logistic analyses showed that hikikomori, psychological distress, alexithymia, and compromised social quality of life predicted PIU in females. In males, PIU is predicted by family annual income, psychopathological distress, alexithymia, and compromised social quality of life, but not by Hikikomori traits. CONCLUSION: Main psychopathological predictors of PIU in Italian university students showed differences across sexes, as hikikomori-like traits are predictors of the emergence of a PIU only in the female sample. Further research studies should better investigate whether female Hikikomori-like young people may display better functioning compared to their male counterparts.