Long term directional wave recording in the Northern Adriatic Sea

We report on the instrumental system used on an oceanographic tower for the directional measurement of wind waves. The associated time series is one of the longest ones in the world. After a compact description of the instrumental part, we present some long term statistics of the wave conditions in the Northern Adriatic Sea. Then we discuss the applications of the results and the possible evolution of the system

A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services

Analysis of psychiatric consultations in patients with HIV infection and related syndromes.

All the requests transmitted to the Service of Consultation-Liaison Psychiatry (C-LPS) of the University of Ferrara for patients admitted to the S.Anna Hospital, Ferrara, Italy, during a period of one year (january-december 1993) were gathered. S.Anna Hospital is a large city hospital with 1235 beds and over 30,000 admissions per year. Psychiatric diagnoses, following DSM-III-R criteria, as registered by the consultant, the rate of consultation for each patient (total number of consultations/number of patients) and the time spent per patient were also taken into account for analysis. A comparison between requests and subsequent psychiatric diagnosis for HIV-infected patients with respect to non-HIV patients was made. Analysis was performed on 571 requests. Seventy-five requests (13.13%) regarded HIV infected patients (41 males and 34 females) admitted to the Division of Infectious Disease and the remaining 496 physically ill and HIV-negative patients (296 females and 200 males) admitted to the other medical or surgical divisions of S.Anna Hospital. 28 HIV+ subjects were in CDC group III and 47 in CDC group IV (AIDS). A significant difference was found between HIV and non-HIV patients as regard age (32.4 yrs. ± 7.8 vs 49.7 ± 18.8, p < ). The most frequent reason for referral both in HIV and non-HIV groups was the presence of psychiatric symptoms (anxiety, depression, behavioural disroders, confusional state, psychiotic symptoms). Requests for HIV-positive patients differed from those of uninfected patients in reporting a lower suspected presence of functional symptoms (16% vs. 35.9%, p < 0.001) and higher presences of maladaptive psychological reactions (56% vs. 25.35% p < 0.01) and patient’s requests (17.33% vs. 2.83%, p < 0.0001). No difference was found in the categories Urgency (within one hour/within 24 hours/routine) and Type of treatment (psychotropic intervention/psychological counseling/family counseling/meeting with the staff/transfer to psychiatric ward), as requested by the referring doctor. With regard to DSM-III-R psychiatric diagnoses, as evaluated by the consultant, HIV+ patients were found to have a significantly higher rate of psychoactive substance abuse disorder, organic mental disorders, particularly dementia (13.79% vs. 1.99%, p < 0.0001) and a depressive disorder NOS (10.3% vs. 3.56% p < 0.05). The number of consultations per patient was higher in AIDS patients than in other conditions (4.8 vs. 2.3), as well as the mean total time dedicated to each patient (7.3 hours vs. 3.4 hours)

Human immunodeficiency virus-related risk behavior among Italian psychiatric inpatients

This study evaluated at-risk behavior for HIV infection among Italian psychiatric inpatients. One hundred patients with mental disorders consecutively admitted to an acute psychiatric unit over a one-year period were studied using a self-report questionnaire. 53.1% of the patients reported sex with multiple partners, 35.4% with occasional partners, 57% had sex with prostitutes, 6.7% with IV drug users. Forty-three percent had never used condoms during sexual intercourse; 23% had used drugs intravenously; 20% had shared needles. Only one-third of the patients were tested for HIV, and 2 tested seropositive (prevalence 5.8%). Most patients (62%) reported no concern about the risk of HIV infection. The rate of HIV risk behaviors was higher among psychiatric patients than a control group of 90 healthy people. These findings indicate an alarming rate of HIV risk behavior among Italian psychiatric inpatients and the need for closer attention to HIV assessment and education in mental health settings

Depression or hypoactive delirium? A report of ciprofloxacin-induced mental disorder in a patient with chronic obstructive pulmonary disease.

Medically ill patients are at high risk for developing psychiatric disorders, especially major depression and depressive disorders due to a general medical condition, including depression induced by drugs (e.g. corticosteroids, digoxin, ß-blockers, calcium channel blockers, diuretics, hormonal agents, antibiotics). Differential diagnosis, however, is not always easy because of the multiple interactions between the psychosocial impact of the medical illness and the direct consequences of the illness itself and the drugs on the central nervous system (CNS). Hypoactive delirium shares with depression due to a general medical condition certain symptoms (e.g. psychomotor retardation, apathy, sad appearance and depressed mood) and etiologic causes (e.g. delirium secondary to anti-hypertensives, corticosteroids, antiarrhythmic agents and antibiotics). This makes the problem of accurate diagnosis, by medical staff, of psychiatric comorbidity among physically ill patients complex. We report a case of a 64 year old woman affected by chronic obstructive pulmonary disease (COPD) who developed delirium (hypoactive type) caused by ciprofloxacin therapy 250 mg t.i.d. per os. Although patients with COPD seem to be at high risk of depression because of the effects of the disease and multiple drugs (e.g. steroids, digoxin, diuretics), used to treat the medical condition and its complications, attention should be exerted towards other significant disorders that, at first glance, may resemble depression, such as hypoactive delirium

HIV-risk behaviour and knowledge about HIV/AIDS among patients with schizophrenia.

BACKGROUND. Recent literature have demonstrated that psychiatric patients, particularly those with a diagnosis of schizophrenia, may be at high risk for HIV infection. In fact, HIV risk behaviour, such as intravenous drug with sharing needles, promiscuity associated with unprotected sex and high-risk sexual activity after using drugs has been reported by a substantial proportion of mentally ill patients. METHODS. In order to examine this problem in Italy, HIV-risk taking behaviour and knowledge about HIV/AIDS was investigated among 91 schizophrenic patients by using two self-report questionnaires (HIV-Risk Behaviour Questionnaire; AIDS Risk Behavior Knowledge Test). RESULTS. One-third of the patients reported having been tested for HIV infection and one tested seropositive (prevalence 3.4%). A high proportion of patients reported HIV-risk behaviour, such as injected drugs use (22.4%) and engaging in high risk sexual activity (e.g. multiple partners, 58%; prostitutes, 45%; occasional partners, 37%). Condoms were ‘never used’ by 41% of the patients and ‘almost never used’ by another 25%. In spite of these behaviours, 65% reported no concern of HIV infection. Knowledge about AIDS was lower among psychiatric patients than a healthy control group. Patients with long-lasting illness and numerous psychiatric admissions were less acknowledgeable about HIV infection. Certain misconceptions on HIV transmission were related to HIV risk behaviour. CONCLUSIONS. These results indicate the urgent need for HIV educational programs within mental health community-care settings