Health Workers' Burnout and COVID-19 Pandemic: 1-Year after-Results from a Repeated Cross-Sectional Survey

: (1) Background: This study evaluates, one year later, the levels of burnout, anxious-depressive, and post-traumatic symptoms and the general health status in the Health Workers (HWs) involved in the SARS-COVID-19 pandemic in the Novara area. (2) Methods: The survey was sent via a link in an email to doctors, nurses, and other operators during the period between June and August 2021. The survey collected socio-demographic data and contained some self-administered questionnaires. (3) Results: A total of 688 HWs completed the survey, 53% were aged 30-49 years, 68% were female, 76% were cohabiting, 55% had children, 86% reported family habit changes, and 20% had non-COVID related health problems. Only a few of the respondents had a follow-up by a specialist (12%), of which there were even less in recent times (6%). It was observed that the respondents had undergone burnout; a poor state of general mental health (62%); depressive symptoms (70%); post-traumatic symptoms (29%); and less frequently, anxious symptoms (16%). The data of this study are in line with other studies in the literature. (4) Conclusions: The data indicate that psychological-based suffering was no longer markedly concentrated in some specific bands of HWs. In conclusion, it would be essential to enhance HW support strategies

Attempted Suicide in the Older Adults: A Case Series From the Psychiatry Ward of the University Hospital Maggiore Della Carità, Novara, Italy

: Introduction: As suicide rates increase with age, it is mandatory to carefully assess old age suicidal behaviors. Our aim was to describe the main socio-demographic and clinical features of a sample of suicide attempters aged 65 years and older, and to assess differences within the sample (men vs. women; patients with vs. without a previous history of suicide attempt; patients with vs. without a previous psychiatric history). Methods: Retrospective study conducted at the Maggiore della Carità University Hospital, Novara, Italy. Results: A higher percentage of female patients in our sample were treated by or referred to mental health services, while a greater percentage of male patients required a prolonged clinical observation in the Emergency Room (ER) or in non-psychiatric wards before psychiatric admission. The percentage of patients without previous psychiatric history taking anxiolytic and sedative medications was 25%. Conclusion: It is likely that different clusters and types of suicide attempters exist. Women in our sample appeared more proactive in asking for help, and more likely to be already treated by or referred to a psychiatric service, suggesting the need to facilitate the access to psychiatric services for the male population aged 65 years and older, or to offer support and care for the non-psychiatric reasons (comorbidities, pain, and loss of autonomy) possibly underlying suicidal behavior in this specific group. The use of medications deserves more attention considering the possible critical diagnostic issues in this age group

Asenapine in Clinical Practice: Responders Vs Non-responders

ntroduction Asenapine is a second-generation antipsychotic approved in Europe for the treatment of manic or mixed episodes. Objective To describe the clinical features of Asenapine responders and non-responders. Methods A naturalistic, observational study is ongoing in patients treated with Asenapine. We have already recruited 37 manic patients with a lifetime diagnosis of Bipolar I (BDI) or Schizoaffective Disorder referring to our Psychiatric Ward. Patients are assessed with the Young Mania Rating Scale (YMRS) at baseline (T0), and after 1 (T1) and 4 weeks (T2) of treatment. According to YMRS scores, patients are classified as responders and non-responders. Results The preliminary results highlight a significant improvement of the YMRS score from T0 to T2 in most patients. Asenapine seems particularly effective in patients with less severe manic symptoms, and responders are more likely to have lower baseline YMRS score. No correlation has currently emerged between responder status and diagnosis. Non-responders in our sample are females sharing some clinical features: early onset BDI diagnosis, several previous treatments (antipsychotics, mood stabilizers), initial cognitive impairment confirmed with the Mini Mental State Examination, Alzheimer Disease Assessment Scale and neuroimaging. Conclusions Elderly manic patients with neurological impairment and/or dementia may have poorer therapeutic outcomes and poorer response to pharmacological treatment, which may prove effective in reducing agitation but not mania ratings. Diagnosis (BDI or schizoaffective disorder) does not seem to have a significant impact on Asenapine efficacy. The further recruitment and assessment of patients is expected to support the results described above

Mental Health Impact and Burnout in Critical Care Staff During Coronavirus Disease 2019 Outbreak

Objective: The coronavirus disease 2019 outbreak exposed intensive care unit health care workers to a psychological burden. The aim of the study was to assess burnout, depression, anxiety, and post-traumatic stress symptoms in the intensive care unit staff during the pandemic period and to focus on the factors that contributed to psychological discomfort by using validated psychometric tools.Methods: This was a monocentric study developed at the end of the first emergency crisis period (May 2020). We used a custom-designed survey using SurveyMonkey. The first part of the online survey included 27 general questions (sociodemographic information, the professional role, and possible changes assigned in job tasks and duties), the second part included validated psychometric tools: Maslach Burnout Inventory, General Health Questionnaire-12 Items, Impact of Event Scale, Beck Anxiety Inventory, and Beck Depression Inventory-II. Factors independently associated with reported symptoms of mental health disorders were identified.Results: The response rate was 88%, with 95 respondents. Depressive and mild-moderate anxiety symptoms were reported in 20% and in 12% of health care workers, respectively, and half of the sample experienced moderate or severe post-traumatic stress symptoms. In total, 64% of health care workers reported high levels of burnout. General mental health problems were more frequently reported by women (P =.3), by those who were tested negative for the coronavirus disease 2019 buffer (P <.02), and by those who changed their family habits (P =.02) as a consequence of the pandemic. Being single or divorced (P =.04) was associated with the presence of depressive symptoms; vice versa, cohabiting with a partner or being married was associated with lower levels of depression. Anxious symptoms were reported in health care workers with no previous working experience in the intensive care unit.Conclusions: Health care workers experience high levels of psychological burden during the coronavirus disease 2019 pandemic. Knowing the risk factors can aid to develop strategies of observation and prevention and also strengthen the ability to be resilient to stressful situations

Suicidal Behaviors in Patients Admitted to Emergency Department for Psychiatric Consultation: A Comparison of the Migrant and Native Italian Populations Between 2008 and 2015

In recent decades, Italy has become a desirable destination for immigrants. In 2014, five million people (8.2% of the population) were migrants (regular/irregular, documented/undocumented). This study looks at psychiatric health, an important feature especially for first‐generation migrants and compares the new settlers with the native Italians. It should be noted that the organization of mental health services in Italy strongly relies on outpatient services, while the psychiatric wards, within the general hospitals, usually accommodate patients in acute phases of their disorder. Nonetheless, migrants’ first contact often happens in a psychiatry ward when they are in a severe and acute psychopathological condition. Research methods: Quantitative and qualitative; longitudinal research using official statistical and clinical data obtained from records of a public hospital as well as information obtained through professional interview. Results: In relation to mental health, we found that the migrant patients referred for psychiatric consultation to the emergency department (ED) setting were younger, less frequently treated by psychiatric outpatient services, more commonly going to the ED for self‐injury and presenting with symptoms of substance abuse and alcohol‐related disorders. The native Italian population was older, more frequently retired and/or invalid, more frequently already treated by psychiatric outpatient services for any kind of psychiatric symptoms. Conclusion: The comparison of the sociodemographic and clinical features of immigrants and Italians referred for psychiatric consultation in the ED highlighted some differences. Implications are discussed in the light of the existing literature

Asenapine Effects On Peroxidation and Calcium Movements in HL-1 Cells

Introduction Bipolar patients are at higher risk for cardiovascular morbidity and mortality than their counterparts in the general population. In a recent in vitro study, Asenapine, a new antipsychotic for the treatment of mania/mixed mania, was found to keep physiological endothelial function by activation of eNOS-related NO release and to protect endothelial cells against peroxidation by interference with mitochondria, apoptosis and cell survival. Objectives To examine the cardiac protective effects elicited by Asenapine against peroxidation and on the Ca2+ movements. Methods In HL-1 that had undergone oxidative stress by 20 min hydrogen peroxide the effects of 30 min pre-treatment with Asenapine on survival and proliferation will be examined. In Fura-2AM loaded HL-1 we will next analyze the effects of Asenapine on Ca2+ movements and the related involvement of cAMP/PKA and PLC pathways, CaMKII, L and T type Ca2+ channels and 5HT1A receptors. The role of 'capacitative” Ca2+ entry, plasma-membrane Ca2+ pump inhibitor (PMCA) and Na+/Ca2+ exchanger will be analyzed. Changes of membrane potential caused by interference with K+ channels will be examined, as well. Results We expect to find a proliferative and anti-peroxidative effect of Asenapine in HL-1 cells. Asenapine could also affect Ca2+ movements through cAMP/PKA and PLC-dependent signalling and the involvement of 5HT1A receptors. The effects of Asenapine could also be related to changes of plasma membrane by interference with K+ channels and the modulation of PMCA activity and Na+/Ca2+ exchanger. Conclusions We expect to further confirm the protective effect of Asenapine against peroxidative injuries.Implications will be discusse

Orthorexia nervosa, eating patterns and personality traits: a cross-cultural comparison of Italian, Polish and Spanish university students

Background: The amount of research about orthorexic attitudes and behaviours has increased in the last five years, but is still mainly based on descriptive and anecdotal data, yielding a variety of prevalence data and inconsistent results. The interplay between socio-cultural context and orthorexia has been poorly investigated and is still far from being understood. Method: Multicentre, cross-sectional study involving Italian (N = 216), Polish (N = 206) and Spanish (N = 242) university students, assessed through a protocol including informed consent, socio-demographic and anamnestic data sheet and self-administered questionnaires (ORTO-15, Eating Attitudes Test- 26 [EAT-26], Temperament and Character Inventory [TCI]). Results: Higher prevalence of orthorexia (as described by the ORTO-15 cutoff) was found in Poland. Female gender, Body Mass Index (BMI), current Eating Disorder, dieting, EAT-26 score ≥ 20 and low/medium Persistence were associated with orthorexia in the whole sample. The cross-cultural comparison showed several differences among the three subgroups of students. Conclusions: The associations found between orthorexic attitudes, self-reported current eating disorder, BMI and adherence to a dieting need to be supported by further research. The differences among students from the three countries seem to suggest a possible rolve for cultural elements in the construct of orthorexia

Outcomes of music therapy interventions in cancer patients. A review of the literature

Background: Effectiveness of music-based interventions (MI) on cancer patients\u2019 anxiety, depression, pain and quality of life (QoL) is a current research theme. MI are highly variable, making it challenging to compare studies. Objective and methods: To summarize the evidence on MI in cancer patients, 40 studies were reviewed following the PRISMA statement. Studies were included if assessing at least one outcome among anxiety, depression, QoL and pain in patients aged 65 18, with an active oncological/onco-haematological diagnosis, participating to any kind of MT, during/after surgery, chemotherapy or radiotherapy. Results: A positive effect of MI on the outcomes measured was supported. Greater reductions of anxiety and depression were observed in breast cancer patients. MI involving patients admitted to a hospital ward were less effective on QoL. Conclusion: The increasing evidence about MI effectiveness, tolerability, feasibility and appreciation, supports the need of MI implementation in Oncology, Radiotherapy and Surgery wards, and promotion of knowledge among health operators

Feeling Through the Body: Alexithymia and Eating Disorders

INTRODUCTION Alexithymia is characterized by difficulties identifying and communicating feelings, and problems differentiating between feelings and bodily sensations; its concrete cognitive style focused on the external environment is typical of psychosomatic patients. Patients with eating disorders (EDs) have high levels of alexithymia, particularly difficulties identifying and describing their feelings. OBJECTIVE The aims of our study are (1) to assess the alexythimia, emotional empathy, facial emotion identification skills and social inference abilities in a sample of ED patients; (2) to compare these variables between ED patients and healthy controls (HC); and (3) to correlate levels of alexithymia with the severity of the ED as measured by the Eating Disorder Inventory-3 (EDI-3) EDRC score in the ED group. METHODS ED (N=42) and HC (N=42) were tested with the Toronto Alexithymia Scale (TAS-20), Eating Disorder Inventory (EDI-3), Facial Emotion Identification Test (FEIT), The Awareness of Social Inference Test (TASIT) and Interpersonal Reactivity Index (IRI). RESULTS Data collection is being completed and the results’ analysis is ongoing. We expect the ED sample to show greater alexythimia and a poorer performance at FEIT and TASIT than HCs. We expect to find a linear correlation between the TAS-20 and EDRC score. CONCLUSION A better understanding of the role of alexithymia in ED etiology and maintenance might allow the development of targeted treatment approaches to help patients improve their skills in identifying and expressing emotions

Increased Risk of Metabolic Syndrome in Antidepressants Users: A Mini Review

Mounting evidence has shown that the risk of metabolic syndrome (MetS) is substantially overlapping in the diagnostic subgroups of psychiatric disorders. While it is widely acknowledged that patients receiving antipsychotic medications are at higher risk of MetS than antipsychotic-naive ones, the association between antidepressants and MetS is still debated. The goal of our mini review was to analyse the relationship among depressive symptoms, antidepressant use and the occurrence of MetS. Adhering to PRISMA guidelines, we searched MEDLINE, reference lists and journals, using the following search string: (((“Mental Disorders”[Mesh]) AND “Metabolic Syndrome”[Mesh]) AND “Antidepressive Agents”[Mesh]), and retrieved 36 records. Two reviewers independently assessed records and the mini review eventually included the data extracted from 8 studies. The Newcastle-Ottawa Scale was used to assess the quality of the selected studies. Overall, the results of the mini review seem to support the association among depressive symptoms, antidepressants therapy and MetS. Except for H1-R high-affinity ones, the relationship between antidepressants and MetS still needs to be clarified. Considering the widespread prescription of antidepressants, both on behalf of psychiatrists and primary care physicians, further research on this topic is recommended