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Hope, anxiety, PTSD and depression in COVID-19-bereaved family members
- F. Franza, A. Franza, A. De Paola, F. Papa, C. Esposito, B. Solomita
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S217
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Introduction
Sadness, nostalgia, deep discomfort, guilt and feelings of loss, hopelessness are just some of the emotions that overwhelm people who are experiencing the death of a loved one (Franza et al. Psychiatr Danub 2022; 34 (8) 60-63). The unusual mourning process in the time of COVID-19 challenges the usual process of coping with loss. The absence of the funeral rite and coping in time of COVID-19 affects the grieving process. The consequences of “bodiless” bereavement in survivors of people who died during the COVID-19 pandemic may be similar to Post Traumatic Stress Disorder (PTSD) (Spurio. Psychiatr Danub 2021; 33 (Suppl 9) 102-107).
ObjectivesTo evaluate the effects of the absence of the funeral rite on anxiety, depression, PTSD and hope in family members of people who have died from COVID-19.
MethodsIn our observational study, 23 family members (12 females; 11 males; mean age: 48.56 yrs) who experienced a bereavement of a loved one without participation in funeral rites due to COVID-19 restrictions were recruited. They had turned to mental health professionals (psychiatrists and psychologists) as suffering from anxiety and depressive disorders. The subjects interviewed between the months of May 2020 and July 2020 (T0) were administered the following evaluation scales: Beck Hopelessness Scale (BHS), Beck Depression Inventory -2 (BDI-II); Anxiety Zung, and PTSD Checklist for DSM-5 (PCL-5).
The same scales were administered after 1 year (T1) and after two years (T2).
All the relevant data were analysed using EZAnalyze Version 3.0, Microsoft Excel Add-ln. Repeated Measures ANOVA Variables used for analyzing scales scores.
ResultsThe main results are shown in Table 1. High values of hopelessness, anxiety and depressive symptoms were observed in T0. The score was reduced in the following times. In BHS the ANOVA results indicate that at least two of the repeated measures differed significantly (P – Unadjusted: T0 and T2: .003, T1 and T2: .009; P – Bonferroni: T0 and T1: .009, T1 and T2: 0.28). Similar results were highlighted in the Zung and DBI-II scales. These results indicate high levels of anxiety and depression at the beginning of the observation period (T0). The results for the assessment of PTSD indicate statistically significant differences (P. .000, Eta Squared: .378).
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ConclusionsOur little study evaluated some psychological factors in the emotional process of “normal” and complicated mourning. The loss of a loved one is inevitably an extremely painful event and is accompanied by a series of highly emotional experiential pathways. In the first months after death, family members have high levels of anxiety, depression, and hopelessness. There is a need to deepen the study with a higher number of participants and with a comparison with “normal” bereavement
Disclosure of InterestNone Declared
Episodes of aggression and psychomotor agitation in psychiatric inpatients during the period of Covid-19 pandemia
- F. Franza, B. Solomita
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S863
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Introduction
The COVID-19 pandemic has changed social, family, and interpersonal relationships and behaviors. Several studies have identified the increase in psychiatric disorders in the general population (Fountoulakis et al. Psychiatry Res 2022; 315 114702) and an increase in episodes of disease in people already affected by these diseases (Taquet et al. Lancet Psychiatry 2022; 9 815-827; Zhu et al. Adults Psychiatry Res 2021; 301 113959). These episodes were accentuated by the severe limitations that occurred during the greatest peaks of the pandemic. However, few studies have evaluated the effects of these restriction periods on the levels of hetero or self-directed aggression in patients staying in residential facilities.
ObjectivesTo evaluate the effects of the COVID-19 pandemic on aggression and psychomotor agitation crises in patients hospitalized in a psychiatric rehabilitation centre.Evaluate the differences in these behaviors in the different stages of external limitation in patients suffering from psychiatric disorders.
MethodsThis observational study was conducted in a residential psychiatric rehabilitation facility since the outbreak of the COVID-19 pandemic in Italy (March 2020 through September 2020). 354 patients were enrolled in the study. All guests had psychiatric disorders defined according to DSM-5 diagnostic criteria. Table 1 shows age mean and diagnosis at admission.
The several periods were recorded in the number of cases of psychomotor agitation and heterodirect aggression and an increase in emergency pharmacological interventions.
The following rating scales were administered in all patients: BPRS-18, BPRS Agitation (item item 6 tension + 10 hostility+ 17 excitement), GAF, and Epitrack.
The collected data were collected and statistically analyzed with the EZAanalyze 3.0 software in the Microsoft Excel Office.
ResultsIn tables 1 and 2 and in Graphics 1 and 2 the results obtained from our study are shown. We observed a reduction in the number of agitation and aggression episodes in periods 1, 3 and 6 (4, 12 and 5, respectively). In these same periods, the BPRS agit subscore score was also lower than in the other periods (7.92, 8.08, 7.42, respectively).
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ConclusionsDifferently to expected data, the number of episodes of psychomotor agitation and heterodirect aggression proved to be reduced in the periods of greater restraint and limitation. Instead, the levels increased in the month following the reduction of such restrictions characterized by visits with family members, planned outings. it is difficult to give a reliable and definitive explanation to these results. However, the feeling of protection, risk reduction and potentially dangerous stimuli could guide the explanation of the results obtained.
Disclosure of InterestNone Declared
“Family Burnout” of psychiatric patients: its role during the COVID-19 pandemic
- F. Franza, A. Vacca, M.V. Minò, B. Solomita, F. Papa, A. De Paola, A. Franza
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S190
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Introduction
Family members caregivers (FMCs) of patients with severe psychiatric disorders (SMPD) are subjected to a complex system of fatigue and stress. FMCs can be subjected to a care burden defined as “Family Burnout”. Caring of family members of patients affected by psychiatric disorder suffered an additional burden during the pandemic period.
ObjectivesTo investigate the stress, burnout and compassion fatigue in FMCs during the pandemic vs non-pandemic period.
MethodsIn our observational study we recruited family members (FMCs) of SMPDs (DSM-5). The severity was assessed with BPRS > 31; from March 2021 to July 2021 (T1), in 66 FMCs (38 females, 28 men) that completed following questionnaires: CBI (Caregiver Burden Inventory), ProQOL (compassion satisfaction and compassion fatigue (burnout and secondary trauma) subscales]. These data (T1) were compared with the scores obtained in the same family members in 2019 (T0) in a pre-pandemic period.
ResultsProQOL data /T1) have a higher total score than those observed in a previous study (T0). They show a lower main score in Compassion Satisfaction (CS) subscale [T1 vs T0; 34.27 vs 38.89 (p < .00.5). CS subscale T0 vs T1= 34.84% vs 12.12%). High levels of burnout were found in 28.79% (T1) vs 13.64% (T0) of FMCs group. Similar results showed in the Secondary Trauma subscale and CBI with higher scores in T1 vs T0.
ConclusionsThe comparative mean results (2019 vs 2021) showed that in the same group of FMCs, the mean values obtained with same scales were higher during the lockdown. During health crisis, FMCs of psychiatric patients are subjected to high levels of stress.
DisclosureNo significant relationships.
Emotional blunting and cognitive profile in elderly depressed patients in treatment with vortioxetine
- F. Franza, B. Solomita, A. Colucci, M. Perito, F. Pellegrino, G. Del Buono, G. Tavormina
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S326
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Introduction
Antidepressants in older people have experienced their increase in medical prescriptions in recent decades whit comorbidity with other pathologies and drug polytherapies. With the use of antidepressants, can be observed side and unwanted effects (e.g. emotional blunting). Vortioxetine is a new antidepressant agent which promises fewer side effects.
ObjectivesTo evaluate the clinical efficacy, safety, side effects (e.g emotional blunting) and cognitive profile
Methods45 elderly patients affected by MDD (DSM-5) were recruited in our observational study. All patients were treated with vortioxetine for 12 months. Physiological and pathological parameters were collected at baseline (T0), after 3 months (T1), 6 months (T2); 12 months (T3). All patients were administered the following scales: GDS; MMSE; QLi; ODQ. The statistical data were processed with EZAnalyze.
Results33.33% of patients had a score in the “unlikely depression” GDS group. The ANOVA ODQ “Total” results indicate that at least two of the repeated measures differ significantly. Data of the “antidepressant as cause” dimension are interesting [T0 vs T3 (P-Unadjusted .000; P-Bonferroni .000; T-value 5.687. MMSE scores are indicative of one small but not significant difference. Mean QLIndex scores did not show statistically significant changes, but are indicative of positive changes from the baseline score
ConclusionsVortioxetine resulted in partial reduction of depression. There was a moderate non-statistically significant increase in body weight, glycidic and lipid profiles. Overall data highlight the importance and role that vortioxetine can have in the management of depressive symptoms in elderly subjects. The handling, effectiveness and reduced side effects of the molecule are emphasized.
EPA-0395 – Metabolic Alterations Associated with First and Second Generation Antipsychotics: an Twenty-years Open Study
- F. Franza, A. Cervone, A. Battista, L. Calabrese, V. Fasano, N. Fiorentino, M. Iandoli, R. Mazziotti di Celso, A. Soddu, B. Solomita
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- Journal:
- European Psychiatry / Volume 29 / Issue S1 / 2014
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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Introduction:
The use of atypical antipsychotics (SGAs) is hindered by the frequent occurrence of metabolic side effects, resulting in worsened quality of life and greater mortality as a result of increased risk factors for metabolic syndrome [2] [3] in schizophrenic patients compared with general population [1].
Objectives:To establish the relationship between antipsychotic efficacy and side effects, especially the impact of various antipsychotics on metabolic parameters after 20-year treatment with atypical (SGAs) and typical antipsychotics (FGAs)
Aims:To identify advantages and disvantages of SGAs in terms of quality of life, costs and benefits.
Methods:Forty-five psychiatric inpatients diagnosed with schizophrenia or schizoaffective disorder (DSM-IV-TR diagnosis), treated with typical (haloperidol) and atypical (clozapine, risperidone, olanzapine, quetiapine, aripiprazole) antipyschotics, were studied retrospectively during 20 years. We use data at baseline, follow-up: 1, 5, 10, 20 years. Rating scales administered: CGI-I, SAPS, SANS, PANSS.
Results:The results have underlined a statistically significant variations(p value <.05) of the lipidic and glicidic profile. We have also found a reduction of the recorded values at endpoint vs baseline in aripiprazole and haloperidol groups. The glicemic values, were not statistically different in quetiapine, aripiprazole, risperidone and haloperidol groups. No significant statistical variations were observed in complete blood count, electrocardiogram, liver enzymes blood pressure and body weight.
Conclusions:The results confirm studies on efficacy and effectiveness of both SGAs and FGAs, and their influence on metabolic profile and other biological parameters. These data can represent a’real world’ study in patients observed during our daily out-patient practice.
Migrants and Psychosomatic Symptoms: An Evaluation in an Emergency Centre
- M. Perito, R.M. Calia, G. Carpentieri, S. De Guglielmo, G. Del Buono, V. Fasano, N. Fiorentino, R. Napolitano, M. Forgione, D. Scotti, B. Solomita, F. Franza
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- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. S621
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Introduction
In recent years, there has been an increase in migration in Europe. Particularly, Italy has been one of the most important landing place. Currently, migrants in the province of Avellino, South Italy city, amount to about 1400, housed in 40 facilities in 23 municipalities. Psychological interest on migration and its impact on lifestyle patterns has increased in recent years.
ObjectivesThere are few studies that evaluated the frequent psychosomatic symptoms in these populations. Despite the trauma experienced, they are not able to give a name to the suffered and somatized pain.
AimAssessment of somatic symptoms reported by the immigrant cohort after a three-month observation period.
MethodsWe included 50 migrants (21.3 mean years) hosted in emergency centre in Avellino, Italy. All guests have conducted psychological clinical interviews. At baseline, were administered following scales: the patient health questionnaire (PHQ-9); Illness Behaviour Inventory (IBI); Symptoms checklist-90-Revised (SCL-90-R) scale. Same data was collected after three months.
ResultsThe migrant group was a heterogeneous group. Overall data on IBI and PHQ-9 scale indicate a statistically significant variation baseline vs deadline Data of IBI scale is statistically significant [T-Score: 3,921; P: 003]; also with PHQ-9 [T0 vs. T1: T-Score: 3,986; P: .003]. Similar results have been found with SCL-90-R.
ConclusionsIn their vocabulary, terms such as anxiety, sadness, fear exist hardly. They tend to minimize the psychological pain, not because I do not feel, but because move it on the body. They have difficulty to talk about emotions, not just a matter of culture and language, but also because they are ashamed.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Screening for metabolic syndrome in older patients with severe mental illness: Two-years observational study
- F. Franza, K. Aquino, L. Calabrese, A. Cervone, N. Fiorentino, S. De Guglielmo, M. Iandoli, A. Soddu, B. Solomita, V. Fasano
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- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S185
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Introduction
Patients with serious psychiatric illness (SMI) have a reduced quality of life and life expectancy than the general population. Metabolic syndrome (MS) is a clinical aspect determining who should be considered to reduce the risk of serious and chronic organic factors, even more significant in the elderly.
ObjectivesTo evaluate metabolic screening of elderly patients with severe mental illness (SMI).
AimsTo evaluate the importance of routine screening of metabolic parameters in elderly guests of residential facilities with or without SMI; metabolic screening at baseline and after two of hospitalization.
MethodsElderly inpatients (44 Tot) with Severe Mental Illness (SMI: bipolar disorder: 34%; schizophrenia: 46%; other: 20%) vs elderly inpatients (78 Tot). Data collected at baseline: psychiatric diagnosis; any previous diagnosis of hypertension, diabetes, dyslipidemia; ECG. At baseline and for two years were administered following scale: BPRS; PANSS; Qli; MMSE, ADL.
ResultsAfter two years metabolic screening has recorded at least one of the new interactions between the five factors of MS (ATP III) in 50% of patients with: one (34%); two (21%); three (11%); four (3%) new altered parameters. In MS inpatients, 53% of new metabolic alterations were recorded in 53% (MS inpatients) vs 23% without MS after two years.
ConclusionsOur results showed a higher frequency of MS in patients with SMI than comparison subjects. Haloperidol was the antipsychotic medication that caused minor impact on the development of metabolic disorders.
Disclosure of interestThe authors have not supplied their declaration of competing interest.