Lack of adherence to pharmacological treatment is considered a multifactorial phenomenon, remarkably frequent in clinical practice. Non-adherence is associated with increased number of relapses, poor clinical and functional outcomes, and worsening of patient health status, with a resulting increase in healthcare costs, particularly in people with severe mental disorders (SMD). Treatment adherence rates remain extremely low, highlighting the need to develop innovative and integrated strategies; one of these is represented by the promotion of healthy lifestyle behaviours, including regular physical activity.

The aim of this study is to assess how the rates of treatment adherence vary in patients with SMD after receiving a psychosocial intervention, focusing on the positive relationship between treatment adherence and physical activity.

LIFESTYLE is a randomized controlled trial comparing the efficacy of a structured psychosocial lifestyle intervention involving moderate physical activity exercises over a brief psychoeducational intervention. Levels of physical activity was assessed thorough the IPAQ scale, while treatment adherence was evaluated by the Morisky Medication Adherence Scale (MMAS).

The sample includes 401 patients, with a mean duration of illness was 16.3 (±17.8) years. All patients were receiving a pharmacological drug treatment; in particular, 59.6% (N=239) were treated with a second-generation antipsychotic and 54.9% (N=220) with a mood stabilizer. Our results show that moderate physical activity improves rates of treatment adherence. After 6 months, adherence to treatment increased from 35.8% at baseline to 47.6% at baseline in the experimental group, along with improvement in clinical health parameters (reduction in BMI, weight, and metabolic parameters). Another significant inverse correlation was found between adherence and quality of life (Rho di Person: -.140, p<.005). Furthermore, this study indicates that having a diagnosis of major depression, a better cognitive functioning, a shorter duration of illness and contact time with the local mental health centre are factors that positively influence treatment adherence. Remarkably, treatment adherence was not influenced by symptom severity and type of pharmacological treatment.

Moderate physical activity can represent a valid strategy to increase treatment adherence in patients with SMD. Therefore, promoting physical activity exercises in our clinical practice may be associated with better outcomes. However, further studies that evaluate patients with acute mental disorders are needed.

None Declared

The European Alliance for Sport and Mental Health (EASMH) is a partnership of scientific institutions, charity associations and sport organizations, funded by EU-Erasmus+. It aimed at developing good clinical practice in psychiatric rehabilitation through sport-based interventions as an integration of pharmacological and psychological therapies. Within the framework of the EASMH projects, several actions have been promoted including an assessment of the dissemination of sport-based interventions, a training course for specialized coaches and the implementation of pilot actions in four European Countries.

To briefly describe EASMH pilot actions performed in Finland, Italy, Romania and United Kingdom, where trained coaches delivered sport-based interventions to patients with severe mental disorders.

After completing pilot actions, charity associations and sport organizations belonging to EASMH network described general and specific aims, sport activities, composition of staff, timing and tools for assessing the outcomes.

In Italy, “Crazy for Rugby”, including adolescents and young patients, and “Not only headshots”, a football project for adults with severe mental disorders were performed. In UK, a football-based activity called “Imagine Your Goal” and a walking-football program for participants aged more than 40 were delivered. In Romania, two courses including gymnastics, yoga and pilates called “Get fit!” were provided. Different team sport-based activities were implemented in Finland, where “Multiple Sport Group” and “Rehabilitating Sports” aimed at increasing patients’ autonomy. Assessment of psychopathological, social, cognitive and sport/fitness outcomes confirmed the overall beneficial effects of sport on mental health.

Pilot actions represent the final step of EASMH project, which showed improvement of mental health outcomes by also delivering sport-based rehabilitation to patients with severe mental disorders. Institutions and stakeholders are now called to promote the implementation of such initiatives on a broader scale.

None Declared

The time period between the onset of a mental disorder and its first adequate treatment (duration of untreated illness - DUI) influence long-term prognosis and outcome in patients with severe mental disorders. The relationship between DUI and outcome was originally found in people affected by schizophrenia spectrum disorders, however in patients with Obsessive-Compulsive Disorder (OCD) DUI is significantly longer compared with that of patients with other severe mental disorders, such as schizophrenia and bipolar disorder.

Aims of the present study is to assess the impact of DUI on long-term outcomes in OCD patients across published studies.

A systematic review was carried out by selecting relevant articles on the topic present in three common on-line databases, such as PubMed, APA PsycInfo, and Scopus, up to June 2023.

Among included studies, DUI ranged from 7,0±8,5 to 20,9±11,2 years. Patients reporting a longer DUI have a poor long-term outcome, in terms of greater symptom severity and lower level of treatment response, whether pharmacological treatment or psychotherapy or a combination of these two. This is particularly true when the onset of the disease is insidious and subthreshold. However, there are severe early-onset forms of OCD in which the request for help is anticipated due to the severity of the symptoms, the DUI is shorter, but the prognosis is still negative.

The present review confirms that longer DUI has a negative impact on the long-term outcome of patients with OCD. Furthermore, it is reasonable to hypothesize that cultural factors, such as the perception of the disease and the ability to access treatment, may result in a prolongation of the DUI. All these elements cannot be evaluated in our review due to the paucity of studies on the topic. Future studies could be useful to better understand the causes of a longer DUI, to guide and to promote the dissemination of early interventions with a specific focus on OCD symptoms.

None Declared

Workplaces can be source of significant stress for employees, leading to a series of mental health problems, such as burnout syndrome. Healthcare professionals and other helping professions are especially vulnerable to work-related stress.

The aim of the present review is to assess available intervention aiming at improving work-related stress symptoms.

We conducted a thorough search of relevant articles on PubMed, APA PsycInfo, and Scopus databases, using specific keywords such as “occupational stress,” “stress,” “anxiety,” “depression,” “health personnel,” “health care facilities, manpower and services,” “prevention,” and “control.”

Although significant methodological heterogeneity has been found among studies, regarding assessment tools, target population, and intervention types, we can still draw some satisfactory results. Healthcare professionals have access to various interventions to manage work-related stress symptoms, which can be classified into three categories: 1) individual cognitive-behavioral therapy approaches, 2) relaxation techniques at the individual level, and 3) organizational-level interventions. Mindfulness techniques, relaxation techniques, emotional freedom techniques, and integrated interventions have demonstrated effectiveness in alleviating work-related stress.

To prevent work-related stress among healthcare professionals, interventions should be targeted towards specific categories of healthcare workers based on factors such as age, tasks, and patient types. Well-structured and reliable randomized controlled trials focusing on the most promising interventions, such as mindfulness, need to be carried out in larger samples and with a solid methodology in order to confirm these evidences.

None Declared

An alteration of inflammatory indices has been reported in several major mental disorders. This alteration seems to be related to disease severity and treatment resistance, but its pathophysiological meaning remains to be established. Patients with severe mental disorders tend to have increased levels of circulating cytokines and increased microglial activity in the central nervous system, suggesting that inflammation may contribute to the onset, or chronicity, of mental disorders. Detecting inflammation‐relevant symptom clusters across mental disorders may represent an important step towards precision medicine in psychiatry.

The SMInflam project is a longitudinal, observational, real-world study which aims to: assess a set of inflammatory indices at baseline in a sample of patients with the diagnosis of a major mental disorder; identify inflammatory profiles of these patients using a latent class analysis approach; assess the response to pharmacological treatments of patients with different inflammatory profiles; re-assess the inflammatory indices and profiles at several times during follow-up and test their correlation with the evolution of psychopathology.

The sample will consist of 50 patients with a diagnosis of a major mental disorders consecutively enrolled at the outpatient unit of the Department of Psychiatry of University of Campania. All enrolled patients will be administered a set of reliable and validated psychopathological assessment tools. We will perform a complete physical evaluation, and a battery of laboratory tests. Peripheral markers of chronic inflammation will be assessed. Clinical and biological assessments will be performed at baseline (T0) and after 3 and 6 months (respectively, T1 and T2).

Expected results include the evaluation of the levels of inflammatory indices in a varied sample of patients with severe mental disorders. According to the pre-post design, these aspects will be evaluated before the start and at the follow-up. We will also take into consideration the role of confounding factors such as age and gender, which represent a critical biological variable influencing such inflammatory pathways.

Collected data will be used for having a more informative, reliable and valid characterization of psychopathology in a vast sample of patients with severe mental disorders. Our study may represent the first of a new wave of methodologically-sound studies on the role of inflammation and psychopathology in patients with severe mental disorders.

None Declared

Patients with severe mental disorders have a significantly reduced life expectancy than the general population, often resulting from the increased prevalence of cardiovascular and metabolic diseases. Reasons include unhealthy lifestyle behaviours, reduced access to screening programs and adverse effects of many psychotropic drugs.

Our goal is to assess the efficacy of a psychosocial group intervention promoting healthy lifestyle behaviors compared to a brief psychoeducational group intervention in terms of improvement of severity of psychiatric symptoms and perceived quality of life, and a series of anthropometric and hematological parameters.

This is a multicenter randomized controlled trial. Patients between 18 and 35 years of age with a diagnosis of schizophrenia and other primary psychotic disorders, unipolar depression and bipolar disorder were recruited. Exclusion criteria were inability to perform moderate physical activity, pregnancy and breastfeeding and impaired cognitive functions.

401 patients were recruited and randomly assigned to receive the experimental intervention (LIFESTYLE) or a behavioural control intervention. About 57% of the sample were female, with a mean age of 45.8±11.8, and BMI of 32.5±5.5. All of them were receiving almost one psychotropic drug. At one year, we observed a reduction in HOMA-IR index (from 4.3 ± 5.5 to 3.1 ± 2.9, p<0.01) and triglycerides (from 162.5 ± 78.1 mg/dL to 131.4 ± 76.0 mg/dL, p<0.001), as well as an increase in HDL (from 46.2± 14.6 mg/dL to 50.9±26.7 mg/dL, p<0.05). Moreover, a reduction in the values of BPRS “Affectivity” (from 8.7±3.0 to 7.2±2.5, p<0.001), “Activity” (from 4.7±1.9 to 4.2±1.3, p<0.01) and “Negative Symptoms” subscale (from 7.7±3.1 to 7.0±2.7, p<0.001) was also observed, along with an improvement in perceived quality of life (MANSA total score from 4.0 ± 1.0 to 5.3 ± 0.8, p<0.01).

The results support the evidence that the LIFESTYLE intervention has long-lasting positive effects on physical and mental health of people with mental disorders. More efforts need to be done in order to increase the availability of these treatments in routine clinical settings.

None Declared

The COVID-19 pandemic represents an unprecedented in health events that has had a negative impact on the mental health of the population in general as well as on specific categories, including patients with mental and physical disorders, and healthcare professionals. In particular, COVID-19 pandemic has produced extraordinary stress in healthcare workers, especially frontline physicians, nurses and healthcare professionals.

In the present study we aimed to evaluate levels of burnout, a clinical condition characterized by emotional, psychological and physical exhaustion, in a sample of health workers from the Campania region, Italy, during the first phase of the COVID-19 pandemic. Secondary objectives of the study include the assessment, in the same group, of levels of anxiety-depressive symptoms, insomnia, suicidal ideation and symptoms on the post-traumatic spectrum.

An online survey was released through the official website of the University of Campania “L. Vanvitelli” and social media. The Maslach Burnout Inventory was used to assess burnout in the healthcare professionals; Depression Anxiety Stress Scale-21 Short Version to measure levels of anxiety, depression and stress; the Insomnia Severity Index was used to identify insomnia-related symptoms; the Suicidal Ideation Attributes Scale was adopted to select individuals based on the presence of suicidal thoughts while the Impact of Event Scale-Revised was administered to evaluate trauma-related dimensions.

A total of 389 health workers was recruited. They were predominantly female, with an average age of 39.06 (± 11.85) years, working mainly in the second line hospitals during the COVID-19 emergency. During the pandemic, first- or second-line health workers reporting significant levels of emotional exhaustion are on average 23,89 (±4.22), those reporting feelings of depersonalization are on average 7.58 (±2.73), while those who report a good level of professional efficiency are on average 21.12 (±3.48).

Predictors of increased levels of depersonalization are being a first-line worker and the presence of traumatic event avoidance symptoms. Furthermore, levels of professional fulfillment are negatively affected by age, the presence of intrusive symptoms, the presence of sleep disorders, and being a frontline worker.

The impact of the COVID-19 pandemic on the mental health of healthcare professionals involved in the first and/or second line COVID hospitals is indisputable. Although burnout syndrome is not a new clinical condition, the COVID-19 pandemic may further worsen the magnitude of the problem. However, our results could be a starting point to promote a change in the way we perceive the mental health of healthcare professionals.

None Declared

Changes in physiological and hormonal balance occurring during pregnancy and post-partum period can have relevant implications on woman’s mental health. Up to 65% of pregnant women experience depressed mood, low self-esteem, cognitive impairment, fatigue, loss of appetite as well as suicidal ideation. Anxiety and depressive symptoms have been described as impactful on the newborn’s health at the time of delivery. Despite this, few evidence exist on this topic.

The present paper aimed at assessing: 1) prevalence and risk factors of antenatal depression (AD); 2) the impact of AD on adverse obstetric outcomes and the onset of post-partum depression.

Pregnant outpatients attending the Department of Gynecology and Obstetrics of University of Campania “Luigi Vanvitelli” in Naples were asked to complete the Italian version of Edinburgh Postnatal Depression Scale (EPDS), a 10-item self-reported questionnaire developed as screening tool of postnatal depression up to one year after delivery. Sociodemographic, clinical and gestational information was collected at baseline.

A total of 268 pregnant women were recruited: 9.7% of them already suffered from depressive disorders and 22% from anxiety. EPDS mean total score was ≥10 in 36.2% of cases (97 out of 268). The presence of AD was longitudinally associated to a lower gestational age at the time of delivery and a higher 1 and 5 minutes APGAR scores. Moreover, AD was associated to a higher incidence of labor induction and the need of intensive care for the new-born. Finally, in our sample AD constituted a stable risk factor for EPDS scores within three days, one month and six months after delivery.

The presence of depressive symptoms during pregnancy should deserve a higher clinical attention by health professionals, given the correlations with adverse obstetric outcomes and post-partum mental health. Training programmes should be encouraged and digital psychiatry could represent a strategy to monitor pregnant women at risk.

None Declared

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.

to evaluate the perceived quality and utility of the EASMH training programme by sport coaches from different European countries (including Italy, UK, Romania, and Finland).

As 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.

The 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.

The 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.

None Declared

The impact of unhealthy lifestyle behaviors is significant in the general population, being associated with chronic physical conditions, reduced life expectancy and increased healthcare costs. This impact is higher in patients with severe mental disorders (SMD). In fact, SMD patients present higher rates of obesity, metabolic syndrome, diabetes, and cardiovascular diseases compared to the general population. The relationship between physical and mental health is multifactorial and includes side effects of many psychotropic drugs, sedentary behaviors, reduction of physical exercise, smoking, and substance abuse. Finally, illness-related factors, including cognitive impairment, reduced psychosocial functioning, social isolation, and self-stigma, can significantly impact on patients’ physical health.

This study, coordinated by the Department of Psychiatry of the University of Campania “L. Vanvitelli”, aims to test the efficacy of a lifestyle group intervention, compared to a brief psycho-educational intervention, in improving healthy habits in a real-world sample of patients with SMD.

401 patients were recruited and randomly allocated to receive the experimental or the control intervention. Inclusion criteria were age between 18 and 65 years; primary diagnosis of schizophrenia, schizoaffective disorder, delusional disorder, other psychotic disorders, major depressive disorder, or bipolar disorder according to the DSM-5; BMI≥ 25. At baseline and 6 months post-randomization all patients were administered: SCID-5, BPRS, MATRICS, MCCB, IPAQ and a questionnaire on lifestyle behaviors developed by the Italian National Institute of Health.

206 patients were allocated to the experimental group and 195 in the control one, of which 43.3% had a main diagnosis of bipolar disorder, 29.9% of psychosis and 26.9% of major depression. Patients were mainly female (57%), with a mean age of 45.6±11.8 years and with an educational level of 11.7±2.9 years. All patients were treated with at least one psychotropic drug. About 29.4% of patients reported performing physical activity regularly, while only 3.7% performed at least 75 min of vigorous physical activity per week. Patients practicing physical activity report higher levels of perceived satisfaction with the quality of life compared with non-active patients (p < 0.005). A general improvement in dietary patterns from T0 to T1 was found in patients receiving the experimental intervention. We found an increased weekly intake of fish (p < .001), vegetables (p < .05) and fresh fruit (p < .01). Moreover, we also found a reduction of junk food (p <.05) and of weekly consumption of cereals (p < .01).

Our findings show that patients with SMD can improve their lifestyle behaviors with appropriate support. There is the need to implement similar interventions clinical practice to reduce the mortality gap in patients with SMD.

None Declared

Bipolar disorder (BD) is a psychiatric disease whose heterogeneity in phenotypic manifestations and disease severity hampers the diagnosis and the achievement of adequate therapeutic management. Increased pro-inflammatory cytokines and cortisol levels (CORT) have been observed in BD patients that might affect brain plasticity by decreasing Brain-Derived-Neurotrophic Factor (BDNF) levels. However, BD etiopathological mechanisms are still largely unclear and little is known about the interaction among these biomarkers and affective episodes.

To assess changes in peripheral endocrine and inflammatory markers, CORT awakening response, BDNF and cytokines levels during an acute phase of the disease and during euthymia and to evaluate whether these changes might be exploited as a biosignature of the disease.

The study will be carried out on BD patients aged 18-65 who will be recruited during affective episodes (depressive, manic/hypomanic phase). In addition, a control group of 40 healthy subjects, age- and sex-matched will be also enrolled. All assessments will be carried out at the time of recruitment and after 3 and 6 months. Blood samples will be collected to evaluate cytokines (IL-1, IL-2, IL-6, IL-10, TNF-alpha, IFN-gamma) and BDNF. Hypothalamic-pituitary-adrenal (HPA) axis response will be assessed by measuring salivary cortisol levels upon awakening (cortisol awakening response – CAR). The psychopathological assessment will include the use of MADRS, YMRS and HAM-A for the assessment of psychiatric symptoms; PSP and C-SSRS for the assessment of global functioning and suicidal risk; IPSS and SRRS for the assessment of stress levels; CIRS for the evaluation of physical comorbidities.

We expect that 1) changes in inflammatory markers can predict the onset of acute phases of BD; 2) to observe significant differences in the levels of pro-inflammatory cytokines, CORT and BDNF between BD patients (during euthymia) and control subjects.

Using a longitudinal approach, we will be able to evaluate whether the presence of affective symptoms in the BD patient is correlated with fluctuations in the levels of pro-inflammatory cytokines and chemokines, salivary cortisol and BDNF. Furthermore, the enrolment of control subjects will allow to evaluate if the inflammatory state and the activation of the HPA axis are steadily elevated in BD patients.

“Funded by: Bando Ricerca Indipendente ISS 2021-2023 to A. Berry project code ISS20-9286e4091f8e”

None Declared

The COVID-19 pandemic represents a new form of trauma, which is impacting on the mental health of the general population. However, the effects of this new trauma are variable, being mediated by individual factors such as the levels of resilience and the coping strategies.

The aims of the present study are: 1) describe the levels of resilience and the type of coping strategies adopted by the Italian general adult population during the first wave of the pandemic; 2) evaluate the protective role of coping strategies and resilience on the levels of depressive, anxiety and stress symptoms.

An online survey has been developed, which includes several validated self-reported questionnaires for the evaluation of participants’ mental health condition, coping strategies and levels of resilience. The main outcome measure is the Depression Anxiety and Stress Scale-21 (DASS-21).

The finale sample consists of 20,720 participants, more than half reported low levels of resilience, which were not associated with age or gender. The levels of resilience did not differ among the general population, patients with pre-existing mental disorders and those infected by COVID-19. People with low levels of resilience rarely used adaptive coping strategies. The levels of resilience did not have any influence on stress, depressive or anxiety symptoms.

The presence of low levels of resilience in the general population may be the missing link between the pandemic and increasing concerns on mental health problems. This could be important for the development of ad-hoc supportive and preventive psychosocial interventions.

No significant relationships.

Vitamin D modulates the biosynthesis of neurotransmitters and neurotrophic factors and it is involved in the modulation of inflammatory responses, with a potential impact on clinical status of patients with severe mental disorders. Moreover, available evidences report that decreased blood levels of Vitamin D are associated to a worse course of psychotic and affective disorders.

We assessed calcium homeostasis imbalance in a sample of inpatients and outpatients, referring to the Department of Psychiatry of University of Campania “Luigi Vanvitelli” in order to explore levels of Calcium, PTH and Vitamin D and their influence in clinical severity among this different subgroups.

All patients were administered The Brief Psychiatric Rating Scale (BPRS) to assess different domains of psychopathology. Vitamin D, Calcium and PTH levels were assessed in all patients. An-ad hoc schedule was administered for socio-demographic and clinical characteristics.

The total sample consisted of 152 patients (75 males and 77 females with 47.3 ± 14.4 age at admission, 74 inpatients and 78 outpatients). Patients with lower level of Vitamin D are more likely to present higher number of relapses (p<0.05) and to be inpatients (<0.01). Finally, serum levels of Vitamin D were negatively correlated with all the BPRS subscales (p < 0.01).

Lower levels of Vitamin D correlate with a worse clinical outcome of patients with different psychiatric diagnosis. Our results highlight the importance to routinely assess PTH, Vit D and calcium levels, especially in inpatients. Moreover, Vitamin D may represent a valid add-on treatment for these patients.

No significant relationships.

The period after delivery is characterised by physical, hormonal and psychological changes. Up to 20% of women can present depressive and anxiety symptoms and difficulties in the interaction with the newborn, emotional lability. This condition is also called “Maternity Blues (MB)”.

To: 1) assess the frequency of MB presentation of depressive symptoms immediately after the delivery; 2) identify those characteristics more frequently associated to the onset of depressive symptoms after the delivery; and 3) verify the hypothesis that the presence of maternity blues is a risk factor for the onset of a depressive episode in the 12 months after the delivery.

From December 2019 to February 2021 all women who gave birth at the University of Campania “Vanvitelli” were enrolled. Upon acceptance, they filled in the EPDS Scale. Sociodemographic, gynaecological, peripartum and psychiatric anamnesis was collected at baseline. Women have been reassessed after 1, 3, 6 and 12 months.

359 women were recruited, with a mean EPDS score of 5.51. Among these, 83 reported the presence of MB (EPDS score≥10; 23.12%). Anxiety disorders with onset prior to pregnancy (p<.000), preeclampsia (p<.01), increased foetal health rate (p<.01), conflicts with relatives (p<.001) and anxiety disorders the partner (p<.01) emerged as predictors of Mb. The presence of MB increase 7 time the risk to have higher EPDS score at follow-up assessments (p<.000).

The presence of MB should always be assessed in the immediate post-partum and psychosocial interventions should be provided to women with MB to reduce its potential negative effect on mental health.

No significant relationships.

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.

to evaluate the availability of sport-based psychosocial interventions in European countries.

In 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.

103 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.

Sport-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.

No significant relationships.

Bipolar disorder (BD) is associated to high personal and social burden, impaired social functioning and high levels of disability. Recent studies have showed that relapse rates are significantly reduced in those patients whose families receive psychoeducational interventions. Even though most of available evidences are related to the short-term efficacy of psychoeducational family interventions (PFI). No evidence is available on medium and long-term efficacy.

This study aims to assess the efficacy after one and five years of PFI in BD in terms of: 1) improvement of patients’ symptoms and global functioning; 2) improvement of relatives’ objective and subjective burden and coping strategies.

A multicenter, controlled, outpatient trial has been conducted in BD patients and their key relatives, recruited in 11 Italian mental health centers. Patient’s clinical status, social and personal functioning, burden of illness, and relative’s burden and coping strategies were assessed with specific instruments at baseline, after 1 year and after 5 years.

137 families were recruited, 70 allocated to the experimental intervention. After one year, an increasing positive effect on patients’ clinical status, global functioning and objective and subjective burden was found. Moreover, were observed a reduced number of relapses and of hospitalizations after five years, compared to the control group. A reduction in the levels of family burden and an improvement of their coping strategies were also observed.

Positive effects of the experimental intervention persist over the mid and long-term period. PFI should be provided in mental health centres to patients with BD and their relatives.

No significant relationships.

The sudden changes in daily routine due to the containment measures adopted for facing the COVID-19 pandemic have had an impact on the mental health of the general population. In particular, young adults are exposed to a higher risk compared to the general population to suffer from the consequences of the pandemic, in terms of anger and irritability, depressive symptoms and somatic complaints, insomnia, lack of motivation and loneliness. In particular, loneliness can be particularly pronounced during young adulthood.

This study aimed to describe the levels of loneliness in a sample of Italian young people during the national lockdown in 2020, evaluating clinical and socio-demographic differences and the role of coping strategies and levels of resilience.

A sub-analysis of a sample of adults aged 18-34 years has been drawn on a larger cross-sectional observational national trial (COMET, 2020) in which, among other psychopathological dimensions, the levels of loneliness have been assessed by the UCLA scale short version.

Levels of loneliness were particularly severe in a third of cases (risk factors: unemployment, low income and vulnerability in mental health), in association with depression, anxiety, stress, OCD symptoms, higher rates of suicidal ideation, sleep disturbance and excessive use of Internet. Levels of loneliness tended to increase over time.

Overall, during the Italian COVID-19 lockdown young people have experienced quite high levels of loneliness: this dimension could represent a useful domain to assess in routine clinical practice.

No significant relationships.

Perinatal depression is a severe and disabling condition, which affects negatively both mothers’ and children’s mental health and well-being. About 12.8% of pregnant women report depressive symptoms in the perinatal period.

The aims of the present study are to: 1) identify factors (socio-demographic and clinical) associated with an increased risk of developing PD; 2) promote a screening program on PD.

All pregnant women were assessed at each trimester of pregnancy, three days after the childbirth and after 1, 3, 6 and 12 months, with the Edinburgh Postpartum Depression Scale (EPDS). Women scoring ≥10 on the EPDS were invited to receive a full psychiatric evaluation to confirm the diagnosis.

420 women were recruited. 52.9%, 27.6% and 31.6% of participants presented an EPDS≥ 10 score at The I, II and III trimester of pregnancy, respectively. The percentage of patients with and EPS score ≥19 is 16.6%, 6.8%, 6.8%, 11.3% and 7.8% in 3 days following the childbirth and after 3, 6, 9 and 12 months, respectively. Higher EPDS scores are predicted by the presence of anxiety symptoms before pregnancy and of depressive and anxiety symptoms in previous pregnancies (p<0.05). Women with family conflicts and with anxiety symptoms in the partner are more likely to report higher EPDS scores (p<0.001).

Our results confirm that perinatal depression is a highly prevalent condition. An early identification of depressive symptoms during this period is crucial in order to reduce the long-term negative impact on the mothers, the newborn and other family members.

No significant relationships.

Severe mental disorders (SMD) are associated with higher morbidity rates and poorer health outcomes compared to the general population. They are more likely to be overweight, to be affected by cardiovascular diseases, and to have higher risk factors for chronic diseases.

To assess physical health in a sample of patients with SMD and to investigate which mental health-related factors and other psychosocial outcomes could be considered predictors of poor physical health.

Patients referring to the psychiatric outpatients unit of the University of Campania “L. Vanvitelli” were recruited, and were assessed through validated assessment instruments exploring psychopathological status, global functioning and stigma. Physical health was assessed with an ad-hoc anthropometric schedule. A blood sample has been collected to assess levels of cholesterol, blood glucose, triglycerides, and blood insulin.

75 patients have been recruited, with a mean age of 45.63±11.84 years. 30% of the sample had a diagnosis of psychosis, 27% of depression and 43% of bipolar disorder. A higher BMI is predicted by higher number of hospitalizations, a reduced score at MANSA (p<.000), and PSP (p<.05), and higher score at ISMI and BPRS (p<.05). A higher cardiovascular risk is predicted by a reduced MANSA score (p<.000), a higher ISMI score and a poorer adherence to pharmacological treatments (p<.05). Higher ISMI score (p<.0001) and number of hospitalizations (p<.05) are predictors of insulin-resistance.

Our study shows that psychosocial domains negatively influence physical health outcome. It is necessary to disseminate an integrated psychosocial intervention in order to improve patients’ physical health.

No significant relationships.

Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a negative long-term outcome and high suicide rate. Although affective temperaments are considered possible mediators of outcome, their role on the course and outcome of BD remains poorly studied.

The aims of the present study are to describe the clinical characteristics of patients with BD more frequently associated with the different affective temperaments and to verify which affective temperaments are associated with a more severe clinical picture in a sample of patients with BD.

All patients with BD referring to the outpatient units of two Italian university sites have been recruited. Patients’ psychiatric symptoms, affective temperaments, and quality of life were investigated through validated assessment instruments.

199 patients were recruited. 54.8% of patients had a diagnosis of bipolar I disorder. 56.8% of the sample reported at least one episode of aggressive behaviours and 30.2% of suicidal attempt. Predominant cyclothymic and irritable temperaments predicted more frequent relapses, a poorer quality of life (p<;0.05), more aggressive behaviours and suicide attempts (p<;0.01). The predominant hyperthymic disposition was a protective factor for several outcome measures, including relapses and suicidality (p<;0.01), and was correlated with a less severity of psychiatric symptoms and later age at onset (p<;0.05).

Early identification of affective temperaments in BD patients can help clinicians to identify those who could show a worse prognosis. A screening of affective temperaments can be useful to develop early targeted integrated pharmacological and psychosocial interventions.

No significant relationships.