RESUMO
Schizophrenia is among the fifteen most disabling diseases worldwide. Negative symptoms (NS) are highly prevalent in schizophrenia, negatively affect the functional outcome of the disorder, and their treatment is difficult and rarely specifically investigated. Serotonin-dopamine activity modulators (SDAMs), of which aripiprazole, cariprazine, brexpiprazole, and lumateperone were approved for schizophrenia treatment, represent a possible therapy to reduce NS. The aim of this rapid review is to summarize the evidence on this topic to make it readily available for psychiatrists treating NS and for further research. We searched the PubMed database for original studies using SDAM, aripiprazole, cariprazine, brexpiprazole, lumateperone, schizophrenia, and NS as keywords. We included four mega-analyses, eight meta-analyses, two post hoc analyses, and 20 clinical trials. Aripiprazole, cariprazine, and brexpiprazole were more effective than placebo in reducing NS. Only six studies compared SDAMs with other classes of antipsychotics, demonstrating a superiority in the treatment of NS mainly for cariprazine. The lack of specific research and various methodological issues, related to the study population and the assessment of NS, may have led to these partial results. Here, we highlight the need to conduct new methodologically robust investigations with head-to-head treatment comparisons and long-term observational studies on homogeneous groups of patients evaluating persistent NS with first- and second-generation scales, namely the Brief Negative Symptom Scale and the Clinical Assessment Interview for Negative Symptoms. This rapid review can expand research on NS therapeutic strategies in schizophrenia, which is fundamental for the long-term improvement of patients' quality of life.
RESUMO
Cyberaggression (CyA) embraces a broad spectrum of hostile behaviors through electronic means. This cross-sectional study aimed to evaluate features and outcomes of this phenomenon among Italian adults. A nationwide survey was distributed on social media platforms. Being victim and being perpetrator of CyA were the primary outcomes; positive scores for GAD-2 (generalized anxiety disorder) and PHQ-2 (depressive symptoms) scales were the secondary outcomes. In total, 446 surveys were collected. Considering the primary outcomes, 46.3% and 13.5% reported having been victims and perpetrators of CyA, respectively. Politics, ethnic minority, and sexual orientation were main subjects triggering CyA. A higher likelihood of being cyber-victims was observed for women and the LGBTQA+ group. Women were less likely to be CyA perpetrators. There was an association between being a CyA victim and a CyA perpetrator. A total of 22.4% and 34.0% respondents scored positive for PHQ-2 and GAD-2, respectively. The main mental health consequences after CyA exposure were anger and sadness, whereas sleep alterations and stomach ache were the most experienced psychosomatics symptoms. No significant relationships between PHQ-2/GAD-2 and CyA emerged. CyA also represents a crucial public health issue among Italian adults. Further investigations are needed to better define the phenomenon and to study the potential consequences on mental health.
