Social connection (SC) is a multi-dimensional concept capturing both the structural–quantitative (e.g., number of social relations, social contact frequency, network structure) and the functional–qualitative dimension (e.g., social support) of social relationships. Although empirical evidence of the association between SC measures and depression has increased significantly in recent years (De Risio et al, J Affect Disord 2024; 345 358–368), very little is known about the extent to which interventions that build SC are effective in improving depressive symptoms.

This umbrella review of systematic reviews/meta-analyses aims to synthesize evidence regarding the effectiveness of SC interventions on depression. Our primary focus is on interventions directly acting upon the natural social network, while indirect interventions that aim to improve social skills, or those that provide professional (formal) or semi-professional support through health services, were excluded.

We provide a synthesis of the consistency and magnitude of the effectiveness of SC interventions on depression. We searched PubMed, PsycINFO, Cochrane Library, and EMBASE and 16 reviews/meta-analyses were included. Information on the effectiveness of SC interventions on depression were compared among different populations. The quality/certainty of evidence was assessed using AMSTAR-2 and GRADE tools.

Included interventions were categorized into the following domains: social support (interventions increasing both perceived and enacted social support from family, friends, and others); social engagement (interventions aimed at strengthening social networks and contrasting social isolation); social inclusion (interventions promoting social integration and access to social capital); social identification (interventions enhancing participants’ identification with a group). Overall, the evidence is rather mixed with some SC interventions resulting in little to no difference in depressive symptoms compared to usual care/other interventions. The most promising interventions appear to be those contrasting social disengagement and reducing social isolation in older individuals and in patients with depression, as well as social inclusion interventions for adolescents and young adults.

The broader implications of SC as a key determinant of depression call for a deep examination of the impact of interventions/preventive programs on the evolving psychopathology of depressive trajectories and inform on which targeted interventions are more effective, thus guiding public health policies.

None Declared

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.

We 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).

We 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.

As 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).

Our 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.

None Declared

In this review, we aimed to evaluate the association between language proficiency (LP) and the prevalence and severity of mental disorders in migrants. Secondarily, we aimed to consider whether sociodemographic and migration-related factors may affect the correlation between LP and mental disorders.

MEDLINE, PsycArticles, EMBASE, and PsycInfo were systematically searched in April 2020 to identify original studies reporting prevalence of psychiatric symptoms or disorders among migrants and taking into account linguistic factors.

The search of electronic databases initially yielded 1,944 citations. Of the 197 full texts assessed for eligibility, 41 studies were selected for inclusion in the systematic review. Thirty-five of the papers included reported a significant negative association between low LP and prevalence and/or severity of psychiatric symptoms or disorders, whereas only two records found the opposite relationship and four papers reported no association between them. Inadequate LP was consistently associated with several mental disorders in migrants, including psychotic, mood, anxiety, and post-traumatic stress disorders. Notably, all the four longitudinal studies that met inclusion criteria for this review reported a positive effect of LP acquisition over time on prevalence or symptom severity of mental disorders.

Even though larger prospective studies are needed to better evaluate the relationship between LP and psychiatric disorders among migrants, we believe that the present findings could be inspiring for authorities to provide support and courses to improve migrants’ language proficiency upon arrival.

Our study aims to assess the prevalence of behavioural addictions in an adolescent populations, evaluating the effects of gender and age, and to assess the correlations and associations between different behavioural addictions.

A population of 2853 students (1142 F and 1711 M, mean age 16.7± 1.9) was assessed in order to evaluate the prevalence of behavioural dependences such as Pathological Gambling (PG), Compulsive Buying (CB), Exercise Addiction (EA), Internet Addiction (IA), and Work Addiction (WA). The South Oaks Gambling Screen-Revised Adolescent, the Compulsive Buying Scale, the Exercise Addiction Inventory, the Internet Addiction Test, and the Work Addiction Risk Test, were compiled anonymously by the students.

Overall prevalence was 7.0% for PG, 11.3% for CB, 1.2% for IA, 7.6% for WA, 8.5% for EA. PG, and EA were more common among boys, while gender had no effect on the other conditions. CB was more common among younger (< 18 years old) students. Each of these conditions showed a strong association with others, and the scores of all of these scales were correlated.

In line with previous studies our results indicate that behavioural addictions are quite common among adolescents. The strong association between behavioural addictions stresses the concept that treatment for one of these conditions should involve assessment and treatment for the others.

Topiramate (up to 300 mg per day) is more efficacious than placebo as an adjunct to standardised medication compliance management in treatment of alcohol dependence. However, adverse events can limit its use in different clinical situation. In this randomised, double-blind, placebo controlled trial we aimed to investigate the efficacy of low-dosage topiramate on alcohol drinking indices. Craving and psychiatric symptoms improvements were the secondary endpoints.

Forty alcohol dependent subjects where detoxified and subsequently randomised into two groups, respectively receiving topiramate (100mg/die) or Placebo. The level of craving for alcohol was evaluated by a 10-cm Visual Analogue Scale (VAS) and the Italian -version of the Obsessive and Compulsive Drinking Scale (OCDS). Psychiatric symptomatology was evaluated by the Symptom Check List 90 Revised (SCL-90 R).

The improvement of alcohol drinking indices and craving scores was higher in the topiramate group than placebo. The survival function showed that patients treated with topiramate remained abstinent from any alcohol amount for a longer time with respect to placebo (Z= -2.197; P< 0.05). The SCL-90-R general index of “Positive Symptom Total” significantly reduced in the topiramate group (F= 3.41, p< 0.05). The number of patients dropped-out from the study for adverse events was not different between groups.

To our knowledge, this is the first randomised, parallel group trial to evaluate the efficacy of topiramate at low dosage for alcohol dependence. The use of topiramate at low dosage could increase the number of subjects in treatment, given the reduced possibility of adverse events.

The purpose of this study is to contribute to the knowledge of the clinical characteristics of the bipolar spectrum by examining factors associated to course of symptoms in BP patients. We evaluated differences between acutely depressed versus subthreshold mixed patients.

90 depressed patients (Group 1, HDRS: 18.2±4.6, YMRS: 1.4±2.9) and 41 patients presenting a mixed subthreshold symptomathology (Group 2, HDRS: 9.1±3.2, YMRS: 9.6±6.4) were included in the study. All patients underwent structured diagnostic interviews for axis I and axis II disorders (SCID-I, SCID-II) and have been submitted to psychometric assessment with Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Young Mania Rating Scale (YMRS), Global Assessment Scale (GAS), Social Adjustment Self-reported Scale (SASS), Quality of Life Scale (QoL), at baseline and repeated follow-up (1, 3, 6, 12 months). Personality dimensions were evaluated by Temperament and Character Inventory (TCI-R).

The most important result is the slight increase in depressive symptoms in subthreshold mixed patients after 3 months of treatment. These patients were more likely diagnosed as BP-I, were non-SUD patients and/or non-comorbid for axis II personality disorders and had a shorter duration of current episode prior intake. Measures of social and functional adjustment were not different in the two groups, though a slight trend for depressed patients to report a poorer quality of life. No difference in personality traits were observed among the two samples.

Our study confirms the importance of considering subthreshold symptoms in the evaluation and treatment of patients with Bipolar Disorder.

Behavioural addictions (BAs) can be understood as disorders characterized by repetitive occurrence of impulsive and uncontrolled behaviours. Very few studies have investigated their association with mood disorders. The present study was undertaken to determine the prevalence of the main behavioural addictions in a sample of bipolar outpatients in euthymic phase or stabilised by medications and to investigate the role of impulsivity and temperamental and character dimensions.

One-hundred-fifty-eight Bipolar Disorder (BD) (DSM-IV) outpatients were assessed with tests designed to screen the main behavioural addictions: pathological gambling (SOGS), compulsive shopping (CBS), sexual (SAST), internet (IAD), work (WART) and physical exercise (EAI) addictions. TCI-R and BIS-11 were administered to investigate impulsivity and personality dimensions mainly associated with BAs. The clinical sample has been compared with 200 matched healthy control subjects.

In bipolar patients, 33% presented at least one BA respect to the 13% of controls. Significantly higher scores at the scales for pathological gambling (p< .001), compulsive buying (p< .05), sexual (p< .001) and work addictions (p< .05) have been found. Self-Directness (p=.007) and Cooperativeness (p=.014) scores were significantly lower while impulsivity level was significantly higher (p=.007) in bipolar patients with BA than those without BA.

To our knowledge, this is the first study investigating the prevalence of behavioural addictions in BD showing a significant association of these disorders. BAs are more frequent in bipolar patients than in healthy controls and are related to higher impulsivity levels and character immaturity.

The aim of our study was to evaluate the relationships between alexithymia and suicidal ideation in a sample of adult outpatients with obsessive-compulsive disorder (OCD).

A sample of 90 adult outpatients with DSM-IV diagnosis of OCD were tested with tested with the Yale-Brown Obsessive Compulsive Scale, Toronto Alexithymia Scale (TAS-20), Scale for Suicide Ideation (SSI) and Montgomery-Asberg Depression Rating Scale (MADRS).

35 subjects were categorized as alexithymics and showed earlier onset, longer duration of illness and more likelihood to have a chronic course than nonalexithymics; they also scored higher on the MADRS and SSI. Results of a linear regression showed that chronic OCD course together with Difficulty in Identifying Feelings dimension of TAS-20 and higher MADRS scores were significantly associated with higher scores on the SSI.

Suicidal ideation is frequent among adult outpatients with OCD and is strongly related to the presence of alexithymia and depressive symptoms. Implications are discussed.

To evaluate relationships between alexithymia, somatic complaints and depressive symptoms in a non-clinical sample of school-aged Italian adolescents.

A mixed male-female sample of 168 school-aged adolescents with a mean age of 15.8 years was investigated with self-reported rating scales. Scales were: Toronto Alexithymia Scale (TAS-20), Beck Depression Inventory (BDI), Symptom Checklist 90 - Somatization Subscale (SCL-90-SOM), State-Trait Anxiety Inventory (STAI), Rosemberg Self Esteem Scale (RSES). Subjects were evaluated at three times: at the beginning (T0), at the middle (T1) and at the end (T2) of the scholastic year.

30 subjects (17.9%) were categorized as alexithymics and, overall, showed greater psychological distress than non-alexithymics. Alexithymia levels remained stable during the time as well as the number of alexithymics. Alexithymics were more suitable to develop more severe depressive symptoms. Results of a linear regression supported the notion that depressive symptoms at endpoint were significantly associated with female sex, DIF subscale of TAS-20 and higher SCL-90-SOM scores.

Alexithymia, depressive symptoms and somatic complaints appeared to be highly correlated in adolescence.

Outpatient treatment may be as effective as inpatient treatment if clients are retained, especially in the early phase. On the contrary, dropping out from treatment predicts relapse in alcohol dependence. We investigate early predictors of retention in a cohort of alcoholics undergoing a day-hospital rehabilitation programme.

A consecutive sample of 85 patients entered this prospective study by completing an intensive start-up phase. The main characteristics of the sample were: mean age 43.1± 10.7; 65% male; 68% employed; 27% polyabuser; 76% ongoing psychopharmacological therapy. Clients were assessed (AWRS, VAS for alcohol craving, OCDS, SCL-90-R) at baseline, T30, T60, T120 and T180. The statistical significance of comparisons was tested by Chi square and Mann-Whitney.

The overall retention rate was: 60 pts (70%) at T30, 54 pts (63%) at T60, 42 pts (49%) at T120, 35 pts (41%) at T180. The following comparisons reached statistical significance: the VAS score for craving at baseline was lower among retained clients at T30 (p=0.01) and T60 (P=0.02), and so was the OCDS compulsion score at baseline among retained clients at T30 (p=0.04); those receiving a psychopharmacological therapy after the start-up phase showed a better retention at T30 (p=0.01) and at T60 (p=0.04).

According to this preliminary analysis, alcohol-related symptom distress at baseline and lack of psychiatric medication after the intensive treatment phase are more frequently observed in early drop-out. Further analysis is necessary to identify true predictors of retention in a multivariate model.

Pregabalin is a new anxiolytic that acts as a presynaptic inhibitor of the release of excessive levels of excitatory neurotransmitters. To the best of our knowledge pregabalin has not been investigated in alcohol dependence, a disorder frequently characterized by high levels of anxiety, panic attacks, and unsteadiness.

Twenty detoxified alcohol dependent subjects meeting clinical criteria for Alcohol Dependence were consecutively recruited, after a short detoxification period, and then orally treated with flexible doses of pregabalin (mean dosage = 260.5 mg/day) for 6 monthss. The level of craving for alcohol was evaluated through a Visual Analogue Scale (VAS) and the Obsessive-Compulsive Drinking Scale (OCDS). Psychiatric symptomatology was evaluated through the Symptom Check List 90 Revised (SCL-90 R). Effectiveness measures included the Clinical Global Impressions scale (CGI) and the Quality of Life Index (QOL).

eleven patients (55%) maintained an alcohol free condition for all the study period. Subjects experienced a reduction of craving in both OCDS (F=13.2; p<.001) and VAS (F=11.2; p<.001), a decrease of the SCL-90 subscore of ostility-aggression (F=8.1; p<.05). At the end of the study improvements were evidenced on both CGI (p<.001) and QOL (p<.001).

the data of this pilot clinical study, suggest a possible role for this drug in the treatment of individuals with alcohol problems. If it could be demonstrated in controlled randomised trials that pregabalin is efficacious in decreasing alcohol use, lessening craving, and attenuating psychopathological symptom severity, we will have gained a powerful agent for the treatment of alcohol dependent subjects.

Dans les cas des troubles bipolaires, les taux de comorbidité avec un TDAH peut varier entre 9,5 % et 27 % [1]. Ces patients présentent un début de trouble plus précoce, avec plus d’épisodes dépressifs et des épisodes mixtes. Il existe peu d’étude sur le lien entre ces deux pathologies et les différentes dimensions de personnalité selon le modèle de Big Five.

Notre étude comporte 106 patients souffrant de dépression, 102 patients bipolaires et 120 témoins, tous homogènes vis-à-vis de leurs caractéristiques démographiques. Le diagnostic de TDAH se basait sur les critères DSM-IV-TR. Les traits de TDAH étaient autoévalués avec la Wender Utah Rating Scale (WURS), la Adult ADHD Self-rating Scale (ASRS) et la Brown Attention Déficit Disorder Scale (ADD). L’Inventaire de Personnalité-Révisé, le NEO PI-R, servait également à évaluer les dimensions de la personnalité au sein des groupes cliniques.

15,7 % des adultes souffrant d’un trouble bipolaire et 7,5 % souffrant d’une dépression sévère manifestaient une comorbidité d’un TDAH en comparaison avec seulement 3,3 % des témoins. Il existe des corrélations significatives entre des traits de personnalité et la présence d’un TDAH. Une analyse de régression logistique de l’ensemble des 208 sujets cliniques a montré que ceux avec des faibles niveaux de névrosisme manifestaient un taux moins important de comorbidité avec un TDAH.

Notre étude souligne le lien entre des troubles de l’humeur, notamment les troubles bipolaires, et la présence d’un TDAH chez des adultes. Nos résultats soutiennent la nécessité d’évaluer les sujets souffrant des troubles d’humeur sur une éventuelle comorbidité de TDAH en milieu clinique. Il faudra étudier d’une façon plus approfondie ces traits de personnalité et les liens entre des troubles de l’humeur et un TDAH afin de pouvoir adapter la prise en charge.

Our study aims to assess the prevalence of behavioural addictions in an adolescent populations, evaluating the effects of gender and age, and to assess the correlations and associations between different behavioural addictions.

A population of 2853 students (1142 F and 1711 M, mean age 16.7± 1.9) was assessed in order to evaluate the prevalence of behavioural dependences such as Pathological Gambling (PG), Compulsive Buying (CB), Exercise Addiction (EA), Internet Addiction (IA), and Work Addiction (WA). The South Oaks Gambling Screen-Revised Adolescent, the Compulsive Buying Scale, the Exercise Addiction Inventory, the Internet Addiction Test, and the Work Addiction Risk Test, were compiled anonymously by the students.

Overall prevalence was 7.0% for PG, 11.3% for CB, 1.2% for IA, 7.6% for WA, 8.5% for EA. PG, and EA were more common among boys, while gender had no effect on the other conditions. CB was more common among younger ( < 18 years old) students. Each of these conditions showed a strong association with others, and the scores of all of these scales were correlated.

In line with previous studies our results indicate that behavioural addictions are quite common among adolescents. The strong association between behavioural addictions stresses the concept that treatment for one of these conditions should involve assessment and treatment for the others.

Aim of this randomised, parallel, placebo-controlled group trial was to compare oxcarbazepina and topiramate with placebo on alcohol drinking indices. Craving and psychiatric simptomatology have also been investigated.

This randomised, parallel, placebo-controlled psychopharmacology trial studied 60 patients, consecutively recruited, meeting clinical criteria for Alcohol Dependence (DSM-IV). After detoxification, subjects were assigned to flexible doses of oxcarbazepine (n=20), or topiramate (n=20) or placebo (n=20). Withdrawal symptomatology was determined by the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) and the level of craving for alcohol was evaluated by a 10-cm Visual Analogue Scale (VAS) and the Italian -version of the Obsessive and Compulsive Drinking Scale (OCDS). Psychiatric symptoms were evaluated with the Symptom Check List 90 Revised (SCL-90 R).

Non-benzodiazepine anticonvulsants have been shown to be efficacious treatments for the prevention of alcohol relapse although the FDA has yet approved none of these agents. During the congress the main results of this study will be presented.

To our knowledge, this is the first randomised, parallel, placebo-controlled group study to evaluate the efficacy of oxcarbazepine and topiramate compared in alcohol dependent patients. The data of this pilot clinical study suggest and investigate a possible role for the anticonvulsants agents in the treatment of alcohol dependent patients.

There is an increasing focus on the impact of psychosocial factors and stressors on the course of Alcohol Use Disorders. Exposure to traumatic events is common among individuals with substance use disorders. PTSD symptoms were associated with greater risk of relapse in intrapersonal and negative physiological contexts. Causative chains are multifactorial and complex, and genetic factors can influence life event exposure. The purpose of this study is to describe the relationships stressful life events and alcohol relapse in a clinical sample of Alcohol Dependent Subjects.

Seventy detoxified alcoholics meeting clinical criteria for Alcohol Dependence were consecutively recruited, after a short detoxification period, and then regularly followed for a period of one year. In the occurrence of alcohol relapse, patients were evaluated by the Paykel Interview for Recent Life Events. All patients were assessed by the Global Assessment of Functioning, the Quality of Life Index, and the Social Adaptation Self-evaluation Scale.

Forty-six subjects were still in treatment at the end of the study period. Stressful life events, did not determine an increased relapse rata and were not associated with alcohol relapse.

This study suggests that the role of psychosocial risk factors should be reconsidered toward a better understand of the factors implicated in alcohol relapse. Other aspects, such as the psychological functioning, the family environment, the peer relationships, and biological and genetic characteristics are further aspect to investigate.

Aims of this study were to investigate alexithymic traits and dissociative experiences in a sample of patients with Alcohol Use Disorders, the significance of this association and the possible correlation with temperamental and character personality traits.

Eighty patients with diagnosis of Alcohol Use Disorder (DSM-IV) were consecutively recruited and assessed with the Toronto Alexithymia Scale-20 (TAS-20), to evaluate the alexithymic traits, the Dissociative Experience Scale II (DES II), to investigate the possible presence of dissociative experiences, and the Temperament and Character Inventory - Revised (TCI-R) in order to define a personality profile.

The mean scores obtained by the experimental group in both the TAS-20 and DES II do not differ from those estimated during the validation procedure. Pearson's linear correlation between scores was found statistically significant (p < .05). Significant correlations with some personality dimensions have also been found.

According to some authors substances related disorders could be classified as “disturbs of emotional regulation”, an active process in which neurophysiological, motor-behavioural and cognitive-experiential systems are involved. The lack of connection or an inadequate development of these systems would result in the malfunction of the symbolic function and then in the inability for the subject to contain the tensions generated by internal needs and/or by environmental stimulations. Both alexithymia and dissociation may assume the form of defence mechanisms against the unbearable emotions. Finally, some personality factors may be involved both in the rise of dissociative states and in the alexithymic traits.

Adolescence seems to be a critical period of addiction vulnerability, based on both neurobiological, social, and familiar factors. The earlier onset of behavioural/substance dependence seems to predict greater addiction severity, morbidity, and multiple addictive disorders. The aim of this study was to assess the presence of multiple addictions in an Italian adolescent high-school population.

Data were collected from a sample of 2907 high school students recruited in the area of Barletta (Puglia) and Latina (Lazio). The sample had an average age of 16.69+/-1.89 years. Through different multi-item scales we evaluated different behavioural addictions: Pathological Gambling, Internet Addiction, Compulsive Buying, Sexual Addiction, Relationship Addiction, Mobile Phone Addiction, Exercise Addiction, Work Addiction.

the presence of pathological gambling was found in 4.4%, compulsive buying in 8.3%, internet addiction in 1.1%, work addiction in 7.2%, exercise addiction in 6.7% of the subjects. Males showed higher scores (p<.001) for pathological gambling, internet and exercise addiction, whereas females showed an higher score (p<.001) for mobile phone addiction. A positive correlation (p<.001) was found between all the scale employed, apart from the Compulsive Buying Scale, which was negatively correlated (p<.001) with the other scales.

The high number of subjects reporting a behavioural dependence is an unexpected data, which creates concern, and need an adequate analysis. It should be valued if these typologies of “addiction without the substance” are a temporary phenomenon occurring in adolescents or if they are a stable trait, and a consequent risk factor for a substance misuse.