Parkinson's Disease, SARS-CoV-2, and Frailty: Is There a Vicious Cycle Related to Hypovitaminosis D?

The literature has long established the association between aging and frailty, with emerging evidence pointing to a relationship between frailty and SARS-CoV-2 contagion. The possible neurological consequences of SARS-CoV-2 infection, associated with physical and cognitive frailty, could lead to a worsening of Parkinson's disease (PD) in infected patients or-more rarely-to an increase in the Parkinsonian symptomatology. A possible link between those clinical pictures could be identified in vitamin D deficiency, while the whole process would appear to be associated with alterations in the microbiota-intestine-brain axis that fall within the α-Synuclein Origin site and Connectome (SOC) model, and allow for the identification of a body-first PD and a brain-first PD. The model of care for this condition must consider intrinsic and extrinsic variables so that care by a multidisciplinary team can be successfully predicted. A multidimensional screening protocol specifically designed to identify people at risk or in the early stages of the disease should begin with the investigation of indices of frailty and microbiota-intestine-brain axis alterations, with a new focus on cases of hypovitaminosis D.

The role of integrated psychological support in breast cancer patients: a randomized monocentric prospective study evaluating the Fil-Rouge Integrated Psycho-Oncological Support (FRIPOS) program.

PURPOSE: This study examined the effects of Fil-Rouge Integrated Psycho-Oncological Support (FRIPOS) in a group of women with breast cancer compared with a group receiving treatment as usual (TAU). METHODS: The research design was a randomized, monocentric, prospective study with three time points of data collection: after the preoperative phase (T0), in the initial phase of treatments (T1), and 3 months after the start of treatments (T2). The FRIPOS group (N = 103) and the TAU group (N = 79) completed a sociodemographic questionnaire, the Symptom Checklist-90-R (SCL-90-R) at T0; the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) C30 and EORTC QLQ-BR23 at T1; and SCL-90-R, EORTC QLQ-C30, and EORTC QLQ-BR23 at T2. RESULTS: A series of independent and paired t tests showed that patients in the FRIPOS group performed better on all scales related to symptomatic manifestations and on some quality of life scales (fatigue, dyspnea, and sleep disturbances) at T2. In addition, a series of ten multiple regressions were performed to predict each SCL subscale at T2 from the SCL score at T0 and the EORTC QLQ-C30 scores at T2. In nine of ten regression models (all except somatization), both FRIPOS group membership and QoL subscale contributed significantly to prediction. CONCLUSIONS: This study suggests that patients in the FRIPOS group have more benefits in emotional, psychological, and collateral symptoms than patients in the TAU group and that these improvements are due to integrated psycho-oncology care.

The psychological consequences of Sudden Infant Death Syndrome (SIDS) for the family system: A systematic review.

The Sudden Infant Death Syndrome (SIDS) is a tragic and difficult experience for families. It involves not only the death of the baby but also the loss of a future as a parent, sibling or grandparent. The subsequent grief is multifaceted and each family member has different needs and resources. Through a systematic review of literature, we identified 24 studies between 1982 and 2021: they dealt with individual, family and couple experience when a SIDS occurs; in addition, some studies compared perinatal loss and neonatal loss with SIDS loss. Our results point out the need for an intervention that focuses on the needs of each family member and tailored around the specifics of SIDS loss rather than general grief.

Brain Correlates of Eating Disorders in Response to Food Visual Stimuli: A Systematic Narrative Review of FMRI Studies.

This article summarizes the results of studies in which functional magnetic resonance imaging (fMRI) was performed to investigate the neurofunctional activations involved in processing visual stimuli from food in individuals with anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). A systematic review approach based on the PRISMA guidelines was used. Three databases-Scopus, PubMed and Web of Science (WoS)-were searched for brain correlates of each eating disorder. From an original pool of 688 articles, 30 articles were included and discussed. The selected studies did not always overlap in terms of research design and observed outcomes, but it was possible to identify some regularities that characterized each eating disorder. As if there were two complementary regulatory strategies, AN seems to be associated with general hyperactivity in brain regions involved in top-down control and emotional areas, such as the amygdala, insula and hypothalamus. The insula and striatum are hyperactive in BN patients and likely involved in abnormalities of impulsivity and emotion regulation. Finally, the temporal cortex and striatum appear to be involved in the neural correlates of BED, linking this condition to use of dissociative strategies and addictive aspects. Although further studies are needed, this review shows that there are specific activation pathways. Therefore, it is necessary to pay special attention to triggers, targets and maintenance processes in order to plan effective therapeutic interventions. Clinical implications are discussed.

State of Mind Assessment in Relation to Adult Attachment and Text Analysis of Adult Attachment Interviews in a Sample of Patients with Anorexia Nervosa.

BACKGROUND: Attachment theory represents one of the most important references for the study of the development of an individual throughout their life cycle and provides the clinician with a profound key for the purposes of understanding the suffering that underlies severe psychopathologies such as eating disorders. As such, we conducted a cross-sectional study with a mixed-methods analysis on a sample of 32 young women with anorexia nervosa (AN); this study was embedded in the utilized theoretical framework with the following aims: 1. to evaluate the state of mind (SoM) in relation to adult attachment, assuming a prevalence of the dismissing (DS) SoM and 2. to analyze the linguistic attachment profile emerging from the transcripts of the AAIs. METHODS: Interviews were transcribed verbatim, coded, and analyzed using the linguistic inquiry and word count (LIWC) method. RESULTS: The results were observed to be consistent with the referenced literature. The prevalence of a DS SoM (68.75%) is observed in the study sample, whereas the results of the lexical analysis of the stories deviate from expectations. Notably, the lexical results indicate the coexistence of the dismissing and entangled aspects at the representational level. CONCLUSIONS: The study results suggest a high level of specificity in the emotional functioning of patients with AN, with a focusing on a pervasive control of emotions that is well illustrated by the avoidant/ambivalent (A/C) strategy described in Crittenden's dynamic-maturational model. These findings and considerations have important implications for clinical work and treatment, which we believe must be structured on the basis of starting from a reappraisal of emotional content.

Sexual Harassment in the Workplace: Consequences and Perceived Self-Efficacy in Women and Men Witnesses and Non-Witnesses.

Despite the numerous advances made in Italy over the years in the study of sexual harassment in the workplace (SHW), research has focused exclusively on victims, perpetrators, and their relationships, and not on the consequences that the experience of sexual harassment can produce in witnesses. The present study aims to address this gap by examining how the indirect experience of SHW, in conjunction with variables such as gender, age, self-efficacy, and coping strategies, affects the mental health status of witnesses of SHW. A sample of 724 employees completed a questionnaire that included a modified version of the Sexual Experience Questionnaire (SEQ), the Oldenburg Burnout Inventory (OLBI), the General Health Questionnaire (GHQ), the Satisfaction With Life Scale (SWLS), and the Emotional Self-Efficacy Scale (RESE). Of the group, 321 participants reported witnessing sexual harassment in the workplace (28.2% of women and 16.2% of men). Results show that witnesses were younger than participants who described themselves as non-witnesses. Results also show that women and men who were witnesses were more likely to suffer the emotional and psychological consequences of the experience than non-witnesses. In addition, female witnesses expressed more positive emotions than men, which enabled them to manage their anxiety and emotional states when triggered in response to sexual harassment in the workplace. Finally, a significant association was found between perceptions of mental health and age, gender, experience with SHW, and self-efficacy strategies. The findings underscore the importance of sexual harassment intervention in the workplace, women and men who witness sexual harassment suffer vicarious experiences, psychological impact, exhaustion, disengagement, and negative feelings.

Hopelessness in Police Officers and Its Association with Depression and Burnout: A Pilot Study.

Hopelessness is a particularly critical condition and a risk factor for suicide. Many studies have reported that this condition is common in some occupations and is associated with high stress that is not properly managed. This study examined the prevalence of hopeless status (HS) in a sample of police officers (POs) and the association of hopelessness with depression, burnout, and suicidality. In total, 127 out of 231 POs participated in the survey; they were assessed with the Beck Hopelessness Scale, the Beck Depression Scale, and the Maslach Burnout Inventory. A total of 26.5% of POs reported hopelessness, and a significant association was found with depression and burnout; in individual cases, these conditions were associated with suicidal thoughts. In a multivariate logistic regression model adjusted for confounding variables, depression, emotional exhaustion, and reduction of personal accomplishment were significantly associated with HP status. Depression (OR = 3.02, 95% CI: 1-9.12) and emotional exhaustion (OR = 1.88, 95% CI: 1.06-3.32) significantly increased the risk of hopelessness, while personal accomplishment (OR = 0.57, 95% CI: 0.32-1) was a protective factor. Hopelessness appears to be a very important factor to consider when assessing POs' mental health.

Hospital-Based Healthcare Workers Victims of Workplace Violence in Italy: A Scoping Review.

The aim of this scoping review is to synthesize the available evidence on the prevalence rates of healthcare workers being victims of violence perpetrated by patients and visitors in Italy. PubMed, Scopus, Web of Science and CINAHL were systematically searched from their inception to April 2021. Two authors independently assessed 1182 studies. All the scientific papers written in English or in Italian reporting primary quantitative and/or qualitative data on the prevalence of aggression or sexual harassment perpetrated by patients or visitors toward healthcare workers in Italy were included. Thirty-two papers were included in the review. The data extracted were summarized in a narrative synthesis organized in the following six thematic domains: (1). Methodology and study design; (2). Description of violent behavior; (3). Characteristics of health care staff involved in workplace violence (WPV); (4). Prevalence and form of WPV; (5). Context of WPV; and (6). Characteristics of violent patients and their relatives and/or visitors. The proportion of studies on WPV differed greatly across Italian regions, wards and professional roles of the healthcare workers. In general, the prevalence of WPV against healthcare workers in Italy is high, especially in psychiatric and emergency departments and among nurses and physicians, but further studies are needed in order to gather systematic evidence of this phenomenon. In Italy, and worldwide, there is an urgent need for governments, policy-makers and health institutions to prevent, monitor and manage WPV towards healthcare professionals.

Anxiety and Depression in Women Newly Diagnosed with Breast Cancer and Waiting for Surgery: Prevalence and Associations with Socio-Demographic Variables.

Background and Objectives: Cancer is a threatening-life disease with a significant psychological burden. The psychological morbidity varies according to the phases of the illness and is influenced by multiple socio-demographic factors, that are useful to consider in order to identify the categories of patients most at risk of developing psychiatric disorders. The present study analyzes, in a sample of women newly diagnosed with breast cancer, the relationships between their levels of anxiety and depression and several socio-demographic characteristics. The study was cross-sectional. Materials and Methods: Four hundred and seventy eight women newly diagnosed with breast cancer completed the Hospital Anxiety and Depression Scale during the pre-surgical phase. Results: Findings show that almost 40% of the sample had clinically relevant anxious symptoms and about a quarter of the sample had significant depressive symptoms. Their prevalence was higher in widows. Moreover, depressive symptoms were higher in older women and anxious symptoms were higher in patients with a lower educational level. In the pre-surgical phase, women can suffer from clinically relevant anxiety and depression, especially the widows, older women, and women with a lower educational level. Conclusions: Identifying the most psychologically vulnerable patients, due to specific socio-demographic characteristics, is essential in order to provide adequate psycho-oncological treatments to the categories of patients, who are most at risk of developing psychopathological concerns.

When Love Just Ends: An Investigation of the Relationship Between Dysfunctional Behaviors, Attachment Styles, Gender, and Education Shortly After a Relationship Dissolution.

Much information is known about the long-term consequences of separation and divorce, whereas there is a paucity of studies about the short-term consequences of such experiences. This study investigates the adoption of dysfunctional behaviors (e.g., insistent telephone calls and text messages, verbal threats, and sending unwanted objects) shortly after a relationship dissolution. A total of 136 participants who declared to have been left by their former partner in the previous 6 months were included in this study (i.e., females: n = 84; males: n = 52; mean age = 30.38; SD = 4.19). Attachment styles were evaluated as explanatory variables when facing a relationship dissolution, in connection with a set of (1) demographic variables (i.e., gender, education, and current marital/relationship status), (2) dysfunctional behaviors, and (3) motivations on the basis of those behaviors. Results showed that a secure or dismissing attachment style, a higher education, and currently married (but awaiting separation) status were the protective factors in adopting such dysfunctional behaviors, while the preoccupied and fearful-avoidant subjects, especially females, tended to adopt dysfunctional behaviors (i.e., communication attempts and defamation) and reported fear of abandonment and need for attention as underlying motivations. Future study on longitudinal aspects of the relationship dissolution processes is required to have deeper insights into this phenomenon. This study sheds light on the relationship between adult attachment styles and the motivations behind the adoption of dysfunctional behaviors after a relationship dissolution.

Trauma and Coping Strategies in Police Officers: A Quantitative-Qualitative Pilot Study.

BACKGROUND: Because of their work, emergency workers, such as police officers (POs), are exposed to traumatic events on a daily basis. These experiences can have consequences in terms of physical and emotional stress. Primary attachment relationships affect the development of coping strategies for dealing with stressful events (primarily hyperactivating strategies in entangled adults and hypo-activating strategies in dismissing adults). In this study, we explored how POs describe the experience of traumatic accidents, the effects they reported and their coping strategies related to their attachment style. METHODS: We used a quantitative-qualitative method. Thirty-nine POs were administered the Beck Depression Inventory, the Maslach Burnout Inventory and a semi-structured interview about traumatic events and reactions. Interviews were analyzed using Interpretative Phenomenological Analysis. RESULTS: Traumatic events at work predominantly concerned aggressions, witnessing deaths, forced hospitalizations, and domestic violence involving children. POs with a responsible role were more likely than POs to use security-based strategies. Most POs narrated overactivation and deactivation strategies, which were associated with depressive symptoms, emotional exhaustion, and depersonalization. CONCLUSIONS: These results can be useful to improve trauma-informed interventions for POs based on their different attachment styles and coping strategies.

Data on work-related consequences of COVID-19 pandemic for employees across Europe.

The COVID-19 pandemic influenced the work of employees across all continents. This article presents raw data that may be used to describe how the pandemic affected the work of employees in four European countries and how it influenced their job attitudes, feelings and work performance. In total, 726 respondents from Germany, the Czech Republic, Slovakia and Italy filled out an extensive online survey and provided information about changes in their workload, work difficulty, income, social contact, work from home, task performance and organizational commitment during the pandemic, and about the risk of being infected by COVID-19 during their workday. The employees also reported their actual work performance, organizational commitment, job satisfaction, intention to leave and irritation in the time of the pandemic. To reveal factors that might help employees cope with pandemic, the respondents filled out established questionnaires measuring servant leadership of their supervisor, perceived organizational support, social support provided by colleagues, their own occupational self-efficacy, resilience, job crafting and readiness for change. The data is unique as it was collected in a specific situation during the pandemic, when the work of employees was affected by security measures and lockdown introduced by governments in countries where they worked.

The use of the Distress Thermometer and the Hospital Anxiety and Depression Scale for screening of anxiety and depression in Italian women newly diagnosed with breast cancer.

PURPOSE: Distress is a factor that can adversely affect quality of life in breast cancer patients. A rapid and non-invasive tool to accurately detect distress is therefore important. The aims of the study were (1) to describe the women's experiences after having received a breast cancer diagnosis and while awaiting primary surgery, in terms of anxiety and depression, (2) to evaluate the use of the Distress Thermometer (DT) in newly diagnosed breast cancer patients, and (3) to define an optimal cutoff score for the DT for this population. METHOD: This study involved 436 newly diagnosed patients in the pre-surgery phase. Consent forms and questionnaires were delivered by nurses during the pre-surgery check-ups, in the time between the 4 weeks post-diagnosis and the 2 weeks before surgery. Receiver operating characteristic analysis was used to evaluate the diagnostic accuracy of the DT compared to the Hospital Anxiety and Depression Scale (HADS) and to define an optimal cutoff score for the DT in this specific population. RESULTS: The results showed that the DT is a fast, easy, and well-accepted screening tool in the Italian context of women newly diagnosed with breast cancer, performing well in relation to the HADS. The proposed cutoff score for DT screening in the clinical setting is 4 versus 5. CONCLUSION: The DT is recommended as a first step in screening, always followed by a more detailed evaluation of psychological functioning.

Body image, personality profiles and alexithymia in patients with polycystic ovary syndrome (PCOS).

Aim: Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic disorder. It affects women's physical well-being and leads to great psychological distress. Indeed, women with PCOS show a compromised quality of life as well as impaired emotional well-being. The aim of this study is to assess personality characteristics, body image and alexithymia in women with PCOS. Materials and methods: A total of 59 women with PCOS and 38 healthy controls were administered the Toronto Alexithymia Scale (TAS), the Body Uneasiness Test (BUT) and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Results: The PCOS group showed higher values of alexithymia and a higher body uneasiness. They also showed higher values on many clinical, content and supplementary scales of the MMPI-2. Discussion: It seems that physical appearance and bodily function have a central place in the minds of women with PCOS, as well as in their relationships. However, it is a body they find it hard to feel and with which they mostly feel uncomfortable. Their approach to the outside world seems to be characterized by a certain degree of immaturity, anger, hostility and distrust. Low self-esteem also seems to be connected to a certain tendency toward introversion and withdrawal. This leads to problems in social, professional and intimate relationships.

Italian adaptation of the brief modified experiences in close relationships scale in a sample of cancer patients: factor analysis and clinical implications.

Many previous studies have indicated that the attachment pattern developed during infancy shapes the adult attachment style, which in turn affects responses to stress and help-seeking behaviors. It may be relevant within clinical contexts to have easy-to-administer and rapid tools aimed to investigate attachment dimensions. The current study presents the Italian adaptation of the Brief Modified Experiences in Close Relationships (ECR-M16) - a self-reported measure of the attachment-style dimensions with reference to close others - and assesses its factorial structure. The questionnaire was administered to cancer outpatients. The number of factors to be extracted was calculated via parallel analysis. Subsequently, an exploratory factor analysis was run to calculate the first-order factor structure, which was compared to the original one via Procrustes rotation and Tucker's coefficient. Finally, a second-order factor structure was calculated by factor analyzing the first-order factor scores. The Italian adaptation of the ECR-M16 is characterized by a first-order factor structure comprising four factors, like the original. The degree of similarity between the two ranges between fair and dissimilar. The second-order factor structure comprises two higher order dimensions, like in the original study. Although partially similar, the two second-order factor structures show relevant differences. A clinically oriented discussion centered on the similarities and differences between the two factor structures is provided, along with indications for future studies.

The Effectiveness of Eye Movement Desensitization and Reprocessing Integrative Group Protocol with Adolescent Survivors of the Central Italy Earthquake.

Earthquakes, which can cause widespread territorial and socio-economic destruction, are life-threatening, unexpected, unpredictable, and uncontrollable events caused by the shaking of the surface of the earth. The psychological consequences, such as PTSD, anxiety, depression, and suicidal ideation, are well-known to clinicians and researchers. This study was conducted with the aim of evaluating the use of the Eye Movement Desensitization and Reprocessing (EMDR) Integrative Group Treatment Protocol on a sample of adolescents, after the earthquake in Central Italy on 24 August 2016. The objective of the EMDR intervention was to reduce PTSD symptoms. Before and after EMDR, specific assessment to find changes in PTSD symptoms was made using the Impact of Event Scale-Revised and through the analyses of the Subjective Units of Disturbance. The EMDR treatment was given in three sessions (T1, T2, and T3), each lasting 90 min, and the results at follow-up phase (T4) were also monitored. The results are very encouraging, showing significantly reduced PTSD symptoms in the majority of the subjects. The clinical implications and limitations will be discussed.

Dissociative symptomatology in cancer patients.

INTRODUCTION: The utilization of the post-traumatic stress disorder (PTSD) diagnostic spectrum is currently being debated to categorize psychological adjustment in cancer patients. The aims of this study were to: (1) evaluate the presence of cancer-related traumatic dissociative symptomatology in a sample of cancer patients; (2) examine the correlation of cancer-related dissociation and sociodemographic and medical variables, anxiety, depression, and post-traumatic stress symptomatology; (3) investigate the predictors of cancer-related dissociation. METHODS: Ninety-two mixed cancer patients (mean age: 58.94, ds = 10.13) recruited from two hospitals in northern Italy were administered a questionnaire on sociodemographic and medical characteristics, the Karnofsky Scale to measure the level of patient activity and medical care requirements, the Hospital Anxiety and Depression Scale (HADS) to evaluate the presence of anxiety and depression, the Impact of Event Scale Revised (IES-R) to assess the severity of intrusion, avoidance, and hypervigilance, and the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) to quantify the traumatic dissociative symptomatology. RESULTS: 31.5% of participants report a PDEQ score above the cutoff. The results indicated that dissociative symptomatology was positively correlated with HADS scores (HADS-Anxiety: r = 0.476, p < 0.001; HADS-Depression: r = 0.364, p < 0.001) and with IES-R scores (IES-R-Intrusion: r = 0.698, p < 0.001; IES-R-Avoidance: r = 0.619, p < 0.001; IES-R- Hypervigilance: r = 0.681, p < 0.001). A stepwise regression analysis was performed in order to find the predictors of cancer-related traumatic dissociative symptomatology. The results converged on a three predictor model revealing that IES-R-Intrusion, IES-R-Avoidance, and IES-R-Hyperarousal accounted for 53.9% of the explained variance. CONCLUSION: These findings allow us to hypothesize a specific psychological reaction which may be ascribed to the traumatic spectrum within the context of cancer, emphasizing the close relationship between the origin of dissociative constituents which, according to the scientific literature, compose the traumatic experience. Our results have implications for understanding dissociative symptomatology in a cancer population and can help develop clinical programs of prevention and support for patients.