Borderline personality in patients with poly-diagnoses treated for a Bipolar Disorder

Some patients with dysphoria, explosive behaviour, or suicidal ideation, may receive a diagnosis of, and treatment for Bipolar Disorder (BD) and, not infrequently. The coexistence of these two diagnoses has been explained in different ways. Some authors include the BPD in the bipolar spectrum; others are sceptical about the existence of real comorbidity, suggesting a misdiagnosis. This study aimed to assess the personality of this group of poly-diagnosed patients (PolyD) and hypothesised they had a pathological borderline organisation. Via the administration of the Schedler Westen Assessment Procedure (SWAP-200), we compared PolyD patients with those suffering from BPD or BD only. We performed two different MANCOVAs to test PolyD, BPD and BD patients' differences in PD-factors, Q-traits and age. The sample comprised 45 patients (Mean age=43.3, SD=15.7; Females 57.7%, N=26). BD patients (N=15) did not present any personality disorder, they had a higher functioning and Obsessive Q-traits, and a lower Histrionic PD-factor than both PolyD (N=20) and BPD (N=10) patients. Compared to PolyD patients, BD had inferior PD-Borderline, PD-Antisocial factor and Dependent-Masochistic Q-traits, but there were no other differences with BPD patients. PolyD did not differ from BPD patients in any of the PD-factors and Q-traits. Our results suggest that PolyD patients are different from BD patients and propose to consider the pathological borderline personality as a central core of their disease

Effect of Glucose and Inactivated Yeast Additions on the Fermentation Performances of Lactiplantibacillus pentosus OM13 during the Production of Nocellara del Belice Table Olives

The use of selected strains of lactic acid bacteria is necessary to produce fermented table olives with high hygiene and quality standards at the industrial level. A current tendency is the use of fermentation adjuvants (nutrients and activators) that can satisfy the nutritional needs of starter strains. In this study, five experimental protocols, different for nutrient and activator presence and addition of Lactiplantibacillus pentosus OM13 in freeze-dried form and after acclimatisation, were tested with the aim of improving the fermentation performances of the commercial starter. The trial inoculated with the starter strain acclimatised in the presence of nutrients and activator showed the most rapid acidification during the first phase of fermentation (third to ninth day), registering a pH loss of 3.40 units. The addition of adjuvants positively influences starter dominance (>89%) and rapid colonisation (>7 Log CFU/mL from third d) by indirectly limiting the presence of undesirable microorganisms. The analysis of volatile organic compounds revealed the presence of 32 chemicals distributed differently in each trial. Sensory evaluation showed that table olives produced with the different treatments were characterised by low bitterness, acidity, and absence of unpleasant odours/flavours. Control production showed slower acidification kinetics and lower sensory pleasantness than the other trials

Latent burnout profiles in a sample of frontline healthcare professionals after the peak of the Italian COVID-19 pandemic

Background: In Italy since February 2020, the unexpected massive afflux of COVID-19 patients exposed healthcare professionals to high work-related stress, high time pressure and increased the risk of being infected. This is the first study that aimed to investigate the psychological impact of COVID-pandemic at the end of the peak, by identifying latent burnout profiles in a sample of front-line healthcare professionals that worked in Italy during the peak of the pandemic. Methods: A total of 589 subjects filled in an online ad-hoc questionnaire and the Italian version of Maslach Burnout Inventory - Human Services Survey. Results: A higher presence of burnout profile in healthcare professionals who worked in frontline during the peak of the COVID-19 pandemic was highlighted. Furthermore, those professionals showed significantly higher perceived stress levels, increase of worries, and sleep problems, they were more likely to underline the importance of team spirit and to consider asking for psychological support. A multiple regression analysis revealed that age, managing COVID-19 patients, perceived stress levels, adequacy of training, and considering to ask for psychological support significantly predicted latent burnout profiles. Moreover, perceived stress levels mediate the relationship between those profiles and managing COVID-19 patients. Conclusions: These findings highlight how stressful and damaging the pandemic has been, especially for people directly involved in the care of patients tested positive for COVID-19. Furthermore, it provides evidence for the importance of investing in wellness for healthcare professionals, in order to avoid shortage due to burnout and to guarantee optimal standards of care to all patient

Pathological gambling in adolescence: A narrative review

Pathological gambling is an emerging and increasing phenomenon in Western counties. This work is aimed at reviewing the existing literature on this topic, paying special attention to its development, course and outcome in adolescence. We will explore epidemiological data, the instruments for the diagnostic and clinical assessment, the course and the outcome of the disorder, the comorbidity with other psychiatric syndromes and disorders. The main risk factors will be described at individual, social and community level. We provide an overview of the available pharmacological and psychological treatments and we report a clinical vignette in order to describe the psychological and psychopathological features of pathological gambling in adolescence

Application of technological protocols on an industrial scale to improve Seville-style table olive production in Italy and Spain

Improving the fermentation performance of starter strains used in the fermentation of table olives is a biotechnological solution of current interest to improve the quality characteristics of the final product. The aim of this study was to evaluate the use of Lactiplantibacillus pentosus OM13 as a starter culture for the fermentation of Seville-type table olives in two different production areas: Italy and Spain. The starter strain L. pentosus OM13 was inoculated into two different table olive varieties: Nocellara del Belice in Italy and Manzanilla in Spain. Lactiplantibacillus plantarum Vege-Start 60 was used as a commercial control, while an additional control pro- duction was carried out by spontaneous fermentation. The industrial productions consisted of three different protocols, differing in the type of nutrient and the presence/absence of acclimatisation of the starter strain. All trials were subjected to microbiological monitoring, evaluation of acidification dynamics and sensory analysis of the final product. After 90 days, the pH reached values below 5 in the different treatments. The LAB reached microbial loads varying between 6.5 and 8.7 log CFU/mL throughout the monitoring period. The microbial populations of spoilage and/or potential pathogenic microorganisms were variable depending on the microbial group monitored. However, after 12 days of fermentation, Enterobacteriaceae showed values below the detection limit. In contrast, a fluctuating trend was observed for yeasts, Pseudomonadaceae and Staphylococcaceae. Sensory analyses showed variable differences depending on the technological protocol used. Table olives ob- tained with L. pentosus OM13 in the presence of nutrient, activator and acclimatisation period achieved higher overall acceptability values compared to the other trials. The use of adjuvants (nutrients and activators) is a strategy used in the production of table olives fermented with L. pentosus OM13 to improve the sensory char- acteristics of table olives

Children and Families' mental health during the first COVID-19 lockdown in Italy

Background: This study aimed to screen a wide range of emotional and behavioural variables emerging during the first COVID-19 pandemic-lockdown in a sample of parents and children, residents in the southern part of Italy, and explore which variables could predict children's wellbeing. We hypothesised that difficulties in adapting routines to pandemic restrictions, parents' emotional wellbeing, and attitude towards the pandemic could influence the children's behavioural attitudes. Methods: 221 parents completed the survey and gave information about 246 children. Ad hoc questionnaires were created and then exploratory reduced in factors. Strengths and Difficulties Questionnaire (SDQ) for parents assessed positive and negative behavioural attitudes in children. Depression Anxiety Stress Scale (Italian DASS-21) scored depression, anxiety and stress in parents. Results: Children presented higher emotional distress (Mean difference (Mdiff)=0.6, 95% C.I. 0.2, 0.9, p=0.013) and better prosocial behaviour (Mdiff=0.5, 95% C.I. 0.1, 0.9, p=0.011) than the Italian normative sample. Parents were more depressed than expected in the general population (Mdiff=1.0, 95% C.I. 0.3, 1.6, p=0.005). Having developed a morbid attachment to an adult (B=0.37, 95% CI 0.05, 0.69, p=0.024), a higher parental depression (B=0.1, 95% CI 0.02, 0.18, p=0.014), and children's suffering from nightmares (B=0.35, 95% CI 0.03, 0.67, p=0.032) explained the 31.9% of the total variance in children's emotional distress. Children's anxiety was related to parents' fear of the pandemic effects (r=0.32, p=0.001) and avoiding communicative approach (r=0.24, p=0.011). Conclusion: The first lockdown determined emotional distress and regressive mechanisms in children in the contest of higher parental discomfort, fear of the infection and avoidant communication. Following parents' indications, it could be helpful to provide families with informative and age-appropriate support

Working Memory, Jumping to Conclusions and Emotion Recognition: a Possible Link in First Episode Psychosis (Fep)

Introduction A large body of literature has demonstrated that people affected by psychotic disorders show deficits in working memory, in Emotion Recognition (ER) and in data-gathering to reach a decision (Jumping To Conclusions - JTC). Aims To investigate a possible correlation between working memory, JTC and ER in FEP. Methods 41 patients and 89 healthy controls completed assessments of working memory using WAIS shortened version, JTC using the 60:40 Beads Task and ER using Degraded Facial Affect Recognition Task. Results According to the literature, cases had poorer performance in working memory tasks (Digit Span: \u3bc7,72 [ds=2,98] vs \u3bc10,14 [ds=3,10], U=865,00, p=0,00; Digit Symbol: \u3bc5,36 [ds=2,43] vs \u3bc10,05 [ds=3,10], U=455,50, p=0,00; Arithmetic: \u3bc5,46 [ds=2,76] vs \u3bc8,74 [ds=3,24], U=865,50, p=0,00; Block Design: \u3bc4,82 [ds=2,72] vs \u3bc7,60 [ds=3,18], U=912,00, p=0,00), in Beads Task (81,6% vs 51,1%, \u3c72=10,27, p=0,001, \u3bc2,53 [ds=3,57] vs \u3bc4,23 [ds=4,77], U=1171,00, p=0,006) and in DFAR (total errors: \u3bc21,62 [ds=7,43] vs \u3bc16,58 [ds=8,69], U=554,50, p=0,002). Furthermore working memory tasks in cases group correlated significantly with JTC (Digit Span: rrho=0,276, p=0,003; Digit Symbol: rrho=0,275, p=0,002; Arithmetic: rrho=0,265, p=0,003; Block Design: rrho=0,292, p=0,001), but only Digit Span with ER (rrho=-0,239; p=0,021). In addition, we found that JTC and ER were significantly associated (rrho=-0,281; p=0,004). Conclusions Data show that working memory impairments, JTC style and dysfunctions in the facial emotions recognition are phenomena strongly correlated in the group of patients. Preliminary results suggest the importance of early rehabilitation as the impairments detected may lead to difficulties in social and relational adaptation in psychotic patients

Views of Schizophrenia Among Future Healthcare Professionals: Differences in Relation to Diagnostic Labelling, Causal Explanations, and Type of Academic Degree Program

Objective: Stereotyped beliefs about schizophrenia are well-established in the society and relatively common among healthcare professionals and students. The aim of this study was to investigate the opinions about the causes, treatment, and outcome of schizophrenia among healthcare students. Method: Undergraduate nursing and psychology students completed selected items of the Opinion on Mental Illness Questionnaire after reading a clinical vignette of undiagnosed schizophrenia. Results: Students who labelled the description as schizophrenia were more pessimistic regarding full recovery from the disorder. Those who acknowledged greater relevance to biogenetic risk factors were more convinced of the efficacy of medications. Respondents’ opinions on the efficacy of psychological interventions were more positive among psychology students than among nursing students. Conclusions: The study confirmed the associations of schizophrenia labelling with prognostic pessimism and beliefs about the efficacy of pharmacological treatment among future healthcare professionals. Students’ opinions were less influenced by differences between academic degree programs. Information about current recovery rate and comprehensive care for schizophrenia may support future healthcare professionals in the relationship and the clinical management of PWS

The role of different game-genres in predicting internet gaming disorder (IGD)

Introduction: Internet gaming disorder (IGD) is a new diagnosis in DSM 5 worth of research. New potentially addictive features are emerging in pay- and free-to-play videogames, involving different at-risk populations of gamers. However, few studies have examined whether and how different game-genres can contribute to the risk of IGD. Objectives: This study aimed to investigate how game-genres can predict IGD, accounting for alexithymia scores, time-related play- ing habits, and other predictors. Methods: Participants were gamers joining online communities, surveyed about which games they played more than 20 hours in their lifetime, time-variables, other stressors and alexithymia scores. A six-steps linear regression with IGD scores and a post hoc logistic regression (outcome: IGD>=21) were performed. Results: 5,979 subjects (88.7% males, 14-18 years), playing at different games (Figure-1). The game-genre explained the 1% of variation only. WoW and similar MMORPGs confirmed their potentiality in promoting IGD, regardless of alexithymia features (B=0.50, p=0.005). However, time-variables completely absorbed the WoW effect (B=0.01, p=0.951). LoL resulted addictive, even if considering time-variables and alexithymia (B=0.88, p<0.001). Minecraft emerged when time-variables were inserted (B=0.359, p=0.041) and stayed significant if removing alexithymia scores (B=0.48, p=0.010). Playing at Diablo3 and similar RPG did not increase IGD (B=-0.99, p>0.001). None of the different game- genres was able to push the subject over the threshold of IGD, because other characteristics interacted as additive risk-factors. Conclusions: Alexithymia traits and time-related playing habits mostly moderated the effect of different games in increasing IGD risk. A videogame could engage people with specific characteristics that may, in turn, differentially predispose to IGD

Perceived public stigma towards schizophrenia among healthcare students: The relationship with diagnostic labelling and contact with people with schizophrenia

Objectives This study aimed at investigating the relationship between perceived public stigma towards people with schizophrenia (PWS) and their family members in a large sample of medical and psychology students. We hypothesised that: a) schizophrenia labelling would be related to greater perceived public stigma; b) contact with PWS would be related with lower perceived stigma; c) perceived public stigma would be similar between medical and psychology students and would be higher among students attending the clinical stage compared to their pre-clinical colleagues. Methods Participants were 592 students attending either the pre-clinical or clinical stage of coursework in Medicine and Psychology, at the University of Palermo (Italy) (Tab. I). Study measures included a short socio-demographic questionnaire, the Devaluation of Consumers Scale (DCS), and the Devaluation Consumers Families Scale (DCFS). Results Students who identified schizophrenia in an unlabelled clinical description expressed greater perceived public stigma towards PWS (t = -2.895, p = 0.004) and their family members (t = -2.389, p = 0.017). A trend-level association was found between previous contact with PWS and lower perceived public stigma (t = 1.903, p = 0.058), which became significant for those students who had a more extensive contact (Mann-Whitney z = 2.063, p = 0.039). Compared to medical students, psychology students perceived greater public stigma towards PWS. No difference was observed between students at different stages of their academic coursework (Tab. II). In a multivariate linear regression model, schizophrenia labelling and degree course predicted perceived public stigma towards severe mental disorders. Conclusions This study replicated previous findings on the relationship between public stigma towards PWS, schizophrenia labelling, and contact with PWS. Perception of public stigma was similar among pre-clinical and clinical students and greater among psychology students. The findings suggest the importance of promoting a critical awareness of negative stereotypes towards schizophrenia among healthcare students, since the beginning of their coursework. In addition to correct information about schizophrenia, anti-stigma intervention should include contact with PWS who live in the community