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Climate change is having significant impacts on health and mental health across Europe and globally. Such effects are likely to be more severe in climate change hotspots such as the Mediterranean region, including Italy. To review existing literature on the relationship between climate change and mental health in Italy, with a particular focus on trauma and PTSD. A scoping review methodology was used. We followed guidance for scoping reviews and the PRISMA Extension for Scoping Reviews (PRISMA-ScR) checklist. We searched for literature in MEDLINE, Global Health, Embase and PsycINFO. Following screening, data was extracted from individual papers and a quality assessment was conducted. Given the heterogeneity of studies, findings were summarized narratively. We identified 21 original research articles investigating the relationship between climate change and mental health in Italy. Climate change stressors (heat and heatwaves in particular) were found to have several negative effects on various mental health outcomes, such as a higher risk of mortality among people with mental health conditions, suicide and suicidal behaviour and psychiatric morbidity (e.g. psychiatric hospitalization and symptoms of mental health conditions). However, there is little research on the relationship between climate change and trauma or PTSD in the Italian context. More attention and resources should be directed towards understanding the mental health implications of climate change to prevent, promote, and respond to the mental health needs of Italy and the wider Mediterranean region. * Climate change stressors in Italy were found to have detrimental impacts on various mental health outcomes, such as psychiatric mortality and morbidity. * Little research on the relationship between climate change stressors and PTSD exists in Italy.

The COVID-19 pandemic has changed life in Europe and globally. The pandemic affects both individuals and the broader society across many domains, including physical and psychological health, the economy and general welfare. The measures taken to counteract the pandemic have significantly altered daily life and, along with the threat of contracting the coronavirus and uncertainties surrounding future developments, created a complex system of stressors with a negative impact on public mental health. This paper aims to outline the ESTSS strategy to address mental health issues related to COVID-19 and focuses on (1) trauma-informed policies, (2) capacity building, (3) collaborative research and (4) knowledge-exchange. To facilitate implementation of a trauma-informed approach and appropriate measures, ESTSS has developed a toolkit of recommendations on mental health and psychosocial assistance to be provided during the different phases of crisis and its aftermath. To promote capacity building, ESTSS offers a certification programme based on a curriculum in psychotraumatology and corresponding on-line training to the European community of mental health professionals. To assure evidence-based approaches and methods tailored to current circumstances, ESTSS has initiated a pan-European research project with international cooperation aimed at studying the mental health consequences of the pandemic, with a focus on psychological trauma and other stress-related reactions. To foster knowledge-exchange, the European Journal of Psychotraumatology (EJPT), the official journal of ESTSS, is publishing a special issue on COVID-19.

During the current COVID-19 pandemic, the people in Europe are exposed to self-isolation, quarantine, job loss, risk of contracting COVID-19, or grief of loved ones. Such a complex array of stressors may lead to symptoms of adjustment disorder or posttraumatic stress disorder. This research protocol describes a study launched by the European Society of Traumatic Stress Studies (ESTSS) to investigate the impact of the COVID-19 pandemic on symptoms of adjustment disorder across European countries. The longitudinal online cohort study aims (1) to explore psychosocial reactions to the COVID-19 pandemic across ten European countries; (2) to examine the relationships between risk and resilience factors, stressors and symptoms of adjustment disorder during the pandemic; and (3) to investigate whether these relationships are moderated by coping behaviours. In ten countries (Austria, Croatia, Georgia, Germany, Italy, Lithuania, Netherlands, Poland, Portugal, and Sweden), between 1,000 and 2,000 participants will be recruited, depending on the size of the country. Participants will be assessed at two timepoints with a six-month interval. Following a conceptual framework based on the WHO's social framework of health, an assessment of risk and resilience factors, COVID-19 related stressors and pandemic-specific coping behaviours will be measured to estimate their contribution to symptoms of adjustment disorder. The Adjustment Disorder New Module 8 (ADNM-8) will be used to assess symptoms of adjustment disorder. As a secondary measure, symptoms of posttraumatic stress disorder will be measure using the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). The relative contribution of risk factors, resilience factors, and stressors on symptoms of adjustment disorder or symptoms of posttraumatic stress disorder will be estimated using multilevel analysis. To determine the moderating effects of different types of coping behaviours on these relationships, a multilevel mediation analysis will be carried out.

Background: The COVID-19 pandemic exposes individuals to multiple stressors, such as quarantine, physical distancing, job loss, risk of infection, and loss of loved ones. Such a complex array of stressors potentially lead to symptoms of adjustment disorder. Objective: This cross-sectional exploratory study examined relationships between risk and protective factors, stressors, and symptoms of adjustment disorder during the first year of the COVID-19 pandemic. Methods: Data from the first wave of the European Society of Traumatic Stress Studies (ESTSS) longitudinal ADJUST Study were used. N = 15,563 participants aged 18 years and above were recruited in eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. Associations between risk and protective factors (e.g. gender, diagnosis of a mental health disorder), stressors (e.g. fear of infection, restricted face-to-face contact), and symptoms of adjustment disorder (ADNM-8) were examined using multivariate linear regression. Results: The prevalence of self-reported probable adjustment disorder was 18.2%. Risk factors associated with higher levels of symptoms of adjustment disorder were female gender, older age, being at risk for severe COVID-19 illness, poorer general health status, current or previous trauma exposure, a current or previous mental health disorder, and longer exposure to COVID-19 news. Protective factors related to lower levels of symptoms of adjustment disorder were higher income, being retired, and having more face-to-face contact with loved ones or friends. Pandemic-related stressors associated with higher levels of symptoms of adjustment disorder included fear of infection, governmental crisis management, restricted social contact, work-related problems, restricted activity, and difficult housing conditions. Conclusions: We identified stressors, risk, and protective factors that may help identify individuals at higher risk for adjustment disorder. We examined symptoms of adjustment disorder in 15,563 adults during the COVID-19 pandemic. The prevalence of probable adjustment disorder was 18.2%. We identified stressors, risk, and protective factors that may help identify individuals at higher risk for adjustment disorder.

Communication may be an influential determinant of inequality of access to, engagement with and benefit from psychiatric services. To review the evidence on interventions designed to improve therapeutic communications between Black and minority ethnic patients and clinicians who provide care in psychiatric services. Systematic review and evidence synthesis (PROSPERO registration: CRD42011001661). Data sources included the published and the 'grey' literature. A survey of experts and a consultation with patients and carers all contributed to the evidence synthesis, interpretation and recommendations. Twenty-one studies were included in our analysis. The trials showed benefits mainly for depressive symptoms, experiences of care, knowledge, stigma, adherence to prescribed medication, insight and alliance. The effect sizes were smaller for better-quality trials (range of d 0.18-0.75) than for moderate- or lower-quality studies (range of d 0.18-4.3). The review found only two studies offering weak economic evidence. Culturally adapted psychotherapies, and ethnographic and motivational assessment leading to psychotherapies were effective and favoured by patients and carers. Further trials are needed from outside of the UK and USA, as are economic evaluations and studies of routine psychiatric care practices.

Background: The COVID-19 pandemic is a health emergency resulting in multiple stressors that may be related to posttraumatic stress disorder (PTSD). Objective: This study examined relationships between risk and protective factors, pandemic-related stressors, and PTSD during the COVID-19 pandemic. Methods: Data from the European Society of Traumatic Stress Studies (ESTSS) ADJUST Study were used. N = 4,607 trauma-exposed participants aged 18 years and above were recruited from the general populations of eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. We assessed sociodemographic (e.g. gender), pandemic-related (e.g. news consumption), and health-related (e.g. general health condition) risk and protective factors, pandemic-related stressors (e.g. fear of infection), and probable PTSD (PC-PTSD-5). The relationships between these variables were examined using logistic regression on multiple imputed data sets. Results: The prevalence of probable PTSD was 17.7%. Factors associated with an increased risk for PTSD were younger age, female gender, more than 3 h of daily pandemic-related news consumption (vs. no consumption), a satisfactory, poor, or very poor health condition (vs. a very good condition), a current or previous diagnosis of a mental disorder, and trauma exposure during the COVID-19 pandemic. Factors associated with a reduced risk for PTSD included a medium and high income (vs. very low income), face-to-face contact less than once a week or 3-7 times a week (vs. no contact), and digital social contact less than once a week or 1-7 days a week (vs. no contact). Pandemic-related stressors associated with an increased risk for PTSD included governmental crisis management and communication, restricted resources, restricted social contact, and difficult housing conditions. Conclusion: We identified risk and protective factors as well as stressors that may help identify trauma-exposed individuals at risk for PTSD, enabling more efficient and rapid access to care. N =  4,607 trauma-exposed adult participants were recruited from the general population during the first year of the COVID-19 pandemic. The prevalence for probable posttraumatic stress disorder was 17.7%. We identified risk factors (e.g. poor health condition) and protective factors (e.g. social contact) associated with posttraumatic stress disorder.

The COVID-19 pandemic caused multiple stressors that may lead to symptoms of adjustment disorder. We longitudinally examined relationships between risk and protective factors, pandemic-related stressors and symptoms of adjustment disorder during the COVID-19 pandemic, as well as whether these relationships differed by the time of assessment. The European Society for Traumatic Stress Studies (ESTSS) ADJUST Study included = 15,169 participants aged 18 years and above. Participants from 11 European countries were recruited and screened three times at 6-month intervals from June 2020 to January 2022. Associations between risk and protective factors (e.g. gender), stressors (e.g. fear of infection), and symptoms of adjustment disorder (AjD, ADNM-8) and their interaction with time of assessment were examined using mixed linear regression. The following predictors were significantly associated with higher AjD symptom levels: female or diverse gender; older age; pandemic-related news consumption >30 min a day; a current or previous mental health disorder; trauma exposure before or during the pandemic; a good, satisfactory or poor health status (vs. very good); burden related to governmental crisis management and communication; fear of infection; restricted social contact; work-related problems; restricted activity; and difficult housing conditions. The following predictors were associated with lower AjD levels: self-employment or retirement; working in healthcare; and face-to-face contact ≥ once a week with loved ones or friends. The effects of the following predictors on AjD symptoms differed by the time of assessment in the course of the pandemic: a current or previous mental disorder; burden related to governmental crisis management; income reduction; and a current trauma exposure. We identified risk factors and stressors predicting AjD symptom levels at different stages of the pandemic. For some predictors, the effects on mental health may change at different stages of a pandemic.

The COVID-19 pandemic is a manifestation of trauma exposure that could eventuate in psychological distress, anxiety, depression, and various mental health disturbances, especially in people who have experienced an additional stressor such as a traumatic event. This cross-sectional study assessed the relationship between pandemic-related stressors, post-traumatic stress disorder (PTSD), the risk for severe or life-threatening symptoms, and resilience among individuals with a traumatic history amidst the coronavirus disease. This study is part of a longitudinal pan-European research, the ADJUST study. The present study consisted of 14.106 participants. The questionnaires utilized included: sociodemographics, health aspects, the Criterion A section of the PTSD Checklist for DSM-5 (PCL-5), the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), the Pandemic Stressor Scale (PaSS), and the Resilience Evaluation Scale (RES). For the analysis, descriptive statistics and logistic regression analysis were applied. 29% of the respondents reported a traumatic history. Fear of infection, burden of infection, crisis management and communication, restricted activity, risk for severe or life-threatening symptoms of the coronavirus disease, PTSD, and resilience were the predictive factors in the trauma-exposed population. This research provides insights into the stressors that individuals with a traumatic background might experience through the COVID-19 pandemic. Future interventions and worldwide health policies should target trauma-exposed populations to enhance psychological health amidst COVID-19 and other stressful events.

The European countries have a long history of exposure to large-scale trauma. In the early 1990s the increasing awareness of the consequences of trauma within the mental health community led to the foundation of local societies for psychotraumatology across Europe and the European Society of Traumatic Stress Studies (ESTSS), which celebrated its 25th anniversary in 2018. The focus of this article is to describe the current state of care for survivors of trauma in the 15 European countries where ESTSS member societies have been established. Brief descriptions on the historical burden of trauma in each country are followed by an overview of the care system for trauma survivors in the countries, the state-of-the-art of interventions, current challenges in caring for survivors and the topics that need to be most urgently addressed in the future. The reports from the different countries demonstrate how important steps towards a better provision of care for survivors of trauma have been made in Europe. Given the cultural and economic diversity of the continent, there are also differences between the European countries, for instance with regard to the use of evidence-based treatments. Strategies to overcome these differences, like the new ESTSS training curricula for care-providers across Europe, are briefly discussed.

This book offers a comprehensive overview of up-to-date research and intervention techniques for traumatized youth highlighting uncharted territories in the field of developmental trauma and related post-traumatic reactions.