7 results
Time Moderates the interplay between 5-HTTLPR and stress on depression risk: gene x environment interaction as dynamic process
- C. Delli Colli, S. Poggini, M. Borgi, B. Vai, F. Cirulli, B. W. J. H. Penninx, F. Benedetti, F. Chiarotti, I. Branchi
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S221
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Introduction
The role of the interaction between the serotonin-transporter-linked promoter region (5HTTLPR) and stressful condition in determining the vulnerability to depression has been widely investigated. Nevertheless, empirical research provides contrasting findings. Recently, the differential susceptibility to environment model proposed a conceptual shift respect to the classical interpretation of 5-HTTLPR: viewing the short (s) and the long (l) allele not as associated to different traits of vulnerability (respectively vulnerable or not), but determining different plasticity levels (respectively, more and less plasticity) and, thus, different susceptibilities to the environment (respectively, high and low susceptibility).
ObjectivesAs 5-HTTLPR is involved in plasticity, the main goal of the present study is to demonstrate that the interaction between the polymorphism and stress emerges when assessing its effects according to temporal factors in a dynamic process perspective.
MethodsWe explored our hypothesis, exploiting a meta analytic approach. We searched PubMed, PsychoINFO, Scopus and EMBASE databases and 1096 studies were identified and screened, resulting in 22 studies to be included in the meta-analyses. We applied the DerSimonian and Laird random-effects model to estimate crude odds ratios for risk of depression according to 5HTTLPR and we assessed heterogeneity using the I² and Cochran’s Q statistic. We stratified the staties according to (i) stress duration (i.e., chronic vs. acute stress) and (ii) time elapsed between the end of the stressful condition and the assessment of depression (i.e., within one year vs. more than one year).
ResultsWhen stratifying for the duration of stress, the effect of the 5-HTTLPR x stress interaction emerged only in the case of chronic stress (OR 1.43, 95%IC 1.16-1.77, I²= 52%, Q=25.25; Figure 1), with a significant subgroup difference (p=0.004). The stratification according to time interval revealed a significant interaction only for intervals within one year (OR 1.23, 95%IC 1.03-1-46, I²= 67%, Q=39.35), though no difference between subgroups was found. The critical role of time interval clearly emerged when considering only chronic stress: a significant effect of the 5-HTTLPR and stress interaction was confirmed exclusively within one year (OR 1.53, 95%IC 1.17-2.02, I²= 45%, Q=10.94; Figure 2) and a significant subgroup difference was found (p=0.01).
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ConclusionsOur results show that the 5-HTTLPR x stress interaction is a dynamic process, producing different effects at different time-points, and indirectly confirm that s-allele carriers are both at higher risk and more capable to recover from depression. Overall, these findings expand the current view of the interplay between 5-HTTLPR and stress adding the temporal dimension, resulting in a three-way interaction: gene x environment x time.
Disclosure of InterestNone Declared
Social connection and depression: an umbrella review of meta-analyses assessing the magnitude of risk and protection
- M. Pettorruso, R. Collevecchio, F. Zoratto, B. Collacchi, M. Boffa, M. Santorelli, M. Clerici, G. Martinotti, M. Borgi
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S415-S416
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Introduction
Depression is a severe mental disorder with an estimated 3.8% of the population affected, representing a leading cause of disability worldwide. Being linked to reduced quality of life and individual functioning, medical morbidity and mortality, depression has a huge social and economic impact. A wide range of potentially modifiable factors for depression has been identified. Among these, social factors (e.g. support/engagement) appear to play a major role in the emergence and severity of depression.
ObjectivesWe aimed at providing a quantitative synthesis of the consistency and magnitude of the association between measures of social connection and depression. Social connection included both quantitative (i.e. existence/absence of social relationships) and functional (i.e. support provided) measures of social relationships, as well as measures focusing on social inequalities related to participation in community spaces/activities (i.e. social discrimination).
MethodsWe searched PubMed, PsycINFO, Cochrane Library and EMBASE. The strength of the association between exposure factors (social measures) and depression was extracted and equivalent odds ratios were computed to compare the strength of the effect sizes among meta-analyses. The quality of each review was assessed using AMSTAR-2.
ResultsAs a result of the selection process 47 studies were included in the umbrella review. Social support was found to have a protective role on depression, with an observed moderate/strong effect in peripartum population and a weaker effect in clinical populations (e.g. AIDS/HIV patients). A moderate association between stigma/discrimination and depression emerged in clinical populations (e.g. epilepsy, mental illness, post-stroke), while a weaker effect was found in (ethnic) minorities. There are still few studies quantitatively investigating the link between depression and other social measures (e.g. community connectedness).
ConclusionsOur findings align with the literature on social connection and mental health, confirming the role of social determinants in the emergence and severity of depression, particularly in the case of vulnerable populations. Social factors emerge as important modifiable targets in the context of depression prevention. Efforts to counteract disconnection at the societal and individual levels and to reduce stigma should be central to an effective depression prevention agenda.
Disclosure of InterestNone Declared
Improving sport-based psychosocial interventions in Europe: results from the EASMH training programme for professional sport coaches
- G. Sampogna, M. Di Vincenzo, M. Borgi, B. Collacchi, F. Cirulli, S. Cerino, S. Rullo, M. Luciano, V. Di Tommaso, S. Moliterni, A. Bichi, J. Garside, S. Kivistö, A. Iarion, A. Fiorillo
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S312-S313
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Introduction
In the framework of the EU-Erasmus+, the European Alliance for Sport and Mental Health (EASMH) project has been funded, aiming to promote the improvement of good clinical practice for sport-based psychosocial interventions throughout Europe. A specific training programme tailoring professional sport coaches has been developed in order to improve their skills in engaging and involving patients with severe mental disorders in sport-based rehabilitation activities.
Objectivesto evaluate the perceived quality and utility of the EASMH training programme by sport coaches from different European countries (including Italy, UK, Romania, and Finland).
MethodsAs part of the EASMH project, the University of Campania “L. Vanvitelli” has coordinated the development of training materials for professional sport coaches. The training programme has been tested in a pilot training programme. An ad-hoc questionnaire has been developed and administered at the end of the training, during a meeting held in Brussels in July 2022.
ResultsThe EASMH training programme consists of six modules, dealing with the following topics: definition of mental health/mental disorders; classification systems; essential clinical features of severe mental disorders; personal and social burden associated with severe mental disorders; how to build a therapeutic relationship with a patient with severe mental disorders; verbal and non-verbal communication; evaluation of patient’s preference in selecting sport activities; definition of a personalized plan; motivational interview/problem-solving strategy. A total of eight professional coaches involved in different sport coming from Italy, Romania, United Kingdom and Finland participated in the entire training, consisting of six 4hr training modules. Seven out the eight coaches compiled the questionnaire. The overall feedback has been extremely positive. Overall, coaches have judged the modules as very clear, useful and of high standing. Each question has been rated with an average of 4.35 related to the overall content.
ConclusionsThe present survey confirms that a short online training programme focused on professional sport coaches is well received by participants and can provide them with useful information on how to engage patients with severe mental disorders. The next step of the EASMH project foresees the implementation of several local pilot actions with the active involvement of patients with severe mental disorders.
Disclosure of InterestNone Declared
Dissemination of sport-based psychosocial interventions in Europe: results from the EASMH project
- G. Sampogna, M. Borgi, F. Cirulli, B. Collacchi, S. Cerino, V. Di Tommaso, S. Moliterni, A. Bichi, C. Barat, A. Pringle, S. Kivisto, I. Melenco, A. Oltean, J. Garside, A. Fiorillo
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S318
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Introduction
Among psychosocial interventions, recent studies have highlighted that sport-based interventions can positively impact on the long-term outcomes of patients with severe mental disorders, in terms of improving their quality of life and promoting social inclusion. Although sport-based interventions should be considered an effective strategy for promoting patients’ recovery, few data are available on their dissemination in the clinical routine care in Europe.
Objectivesto evaluate the availability of sport-based psychosocial interventions in European countries.
MethodsIn the framework of the EU-Erasmus+, the European Alliance for Sport and Mental Health (EASMH) project has been funded. In order to evaluate the availability of sport-based interventions, an ad-hoc online survey, sent to national mental health centres, has been developed.
Results103 responses were obtained (49 from Italy, 31 from UK, 17 from Finland and 12 from Romania). The respondents were mainly psychiatrists working in community mental health centers. Sport-based interventions were frequently provided by mental health services, in particular in Italy, UK and Finland. While in UK and Finland sport-based interventions are commonly offered to all patients, in the other countries these are provided only by patient’s request. The most frequent types of sport practised were: running, football, volleyball, tennis and table tennis and basketball. Almost all respondents reported to not use a dedicated monitoring tool for evaluating the efficacy of those interventions.
ConclusionsSport-based interventions are not frequently provided in the routine clinical settings, although no monitoring tools are routinely adopted. The EASMHaims to fill this gap by disseminating good clinical practice related to sport-based interventions.
DisclosureNo significant relationships.
Improving hospitalization in children and adolescents through animal assisted interventions (AAIS): A systematic review
- C. Correale, M. Borgi, B. Collacchi, T. Grimaldi Capitello, F. Vigevano, F. Cirulli, S. Cappelletti
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S465
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Introduction
Animal Assisted Interventions (AAIs) are increasingly introduced in pediatric care settings as a mean to promote the physical, mental, and emotional well-being of hospitalized children and adolescents and the humanization of the hospital environment.
ObjectivesThe aim of this work was to review published studies implementing AAIs in hospital settings and to assess their effectiveness in reducing stress and pain, ameliorating social behavior, quality of life, and mood in pediatric patients. Reviewed interventions were also evaluated for their effects on caregiver’s stress and burden, as well as on perception of the work environment in hospital staff.
MethodsStudies were systematically searched using PubMed, Scopus, ProQuest and Web of Science databases in accordance with PRISMA guidelines. The search was aimed at identifying studies examining the effects of AAIs on behavioral and physiological response to stress in children and adolescents (0-18 years) formally admitted to a hospital for a stay, as well as in those undergoing a visit for treatments or medical examinations.
ResultsOf 350 studies screened, 17 were eligible for inclusion. Most of them focused on stress, pain and anxiety reduction in pediatric patients, and used both physiological parameters and behavioral observations/scales. The vast majority of the studies employed dogs. Results show the potential of AAIs to reduce anxiety and behavioral distress in pediatric patients, while acting on physiological measures associated with arousal.
ConclusionsAlthough further studies of better quality are still needed, the findings of this review may have implications for clinical practices suggesting appropriate planning of AAIs by pediatric healthcare professionals.
Equestrian vaulting as an innovative complementary intervention in eating disorders: A pilot study
- B. Collacchi, F. Cirulli, M. Borgi, I. Monaci, A. Piccotti, S. Renga, L. Dalla Ragione, M. Ettorre, G. Biccheri, F. Rossetti, S. Cerino
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S352
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Introduction
Anorexia is a disorder associated with severe disturbances in eating behaviors and related thoughts and emotions (distorted weight perception, body dissatisfaction). Multidimensional integrative treatment approaches are needed to act both on intrapersonal (e.g. nutritional and psychological) and interpersonal (e.g. behavioral and affective) processes.
ObjectivesAim of this pilot project was to develop a 3-months horse-assisted intervention based on Equestrian Vaulting (EV) and tests its suitability and acceptability in patients with anorexia nervosa. Preliminary observations were carried out to assess the effectiveness of this program on body image, interpersonal relationships and communication and in managing anxiety.
MethodsSeven patients in charge of public service specialized in eating disorder participated in the study. EV activities were performed in an Equestrian Centre included horse grooming, gym exercises and horseback sessions.Clinical and psychological tests (SF 36, IPAQ, EDI3, STAI, SCL90) were administered at baseline and at the end of the program.
ResultsIncreases in body fat and decreases in lean muscle mass were observed. These were accompained by an improvement in participants’ anxiety and relational skills and in the specific disease related symptoms.
ConclusionsResults indicate the potential of EV to help patients with eating disorder regaining awareness of themselves and their body, a critical element for their future reintegration in the contexts of everyday life and society. Although this is a pilot, the protocol developed represents an initial step to promote the application of EV in persons with eating disorders, informing feasibility in the design of larger controlled studies and suggesting critical variables to be targeted.
10 - Macro-economic consequences of demographic uncertainty in world regions
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- By Vladimir Borgy, Centre d'Etudes Prospectives et d'Informations Internationales (CEPII), France, Juha M. Alho, Professor of Statistics University of Joensuu, Finland
- Edited by Juha M. Alho, University of Joensuu, Finland, Svend E. Hougaard Jensen, Odense Universitet, Denmark, Jukka Lassila
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- Uncertain Demographics and Fiscal Sustainability
- Published online:
- 22 September 2009
- Print publication:
- 13 March 2008, pp 195-218
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Summary
Introduction
Demographic projections suggest that the OECD countries (notably the European countries and Japan) are expected to have large increases in their old-age dependency ratios. The other regions of the world are expected to have relatively low ratios, and their working-age populations are expected to increase. This differential timing of ageing may induce international flows of ‘excess’ saving from the ageing industrialized regions to the younger developing regions during the next decades. We expect such macro-economic dynamics – more precisely the saving-investment equilibrium – to be reflected in the world financial markets, in particular in the evolution of world interest rates.
While demographics have long been identified as a key variable in long-term macro-economic analysis, most previous analyses have relied on deterministic population forecasts. But, as contributions in this volume testify (e.g. Keilman, Cruijsen and Alho, chap. 2; Alho, Cruijsen and Keilman, chap. 3), demographic developments are uncertain, and attempts at describing this via scenario-based variants have serious shortcomings. As far as we know, the macro-economic consequences of demographic uncertainty have not been explored in the multi-regional setting of the world economy, but they can be of considerable interest. The asynchronous nature of the ageing process is expected to influence macro-economic trends, but it is also of interest that the uncertainty of population forecasts differs across world regions (National Research Council, 2000).
In this chapter, we investigate the impact of demographic uncertainty in a multi-regional general equilibrium, overlapping-generations model.