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Almost half of the people with chronic obstructive pulmonary disease (COPD) do not adhere to the prescribed treatments and report anxiety and depression as comorbidities, resulting in higher rates of exacerbations, hospitalizations, and worse clinical outcomes. This systematic review provided a synthesis of studies about the relationships between anxiety, depression, and adherence in people affected by COPD. English language publications were searched in the PUBMED, SCOPUS, PsycInfo, Web of Science, PsycArticles, and Cochrane Library databases from December 2020 to March 2021, following PRISMA guidelines. The reference lists of eligible studies and other relevant systematic reviews were also searched. Data extraction and critical appraisal were undertaken by two reviewers working independently. The reference lists of eligible studies and other relevant systematic reviews were also searched. Data extraction and critical appraisal were undertaken by two reviewers working independently. A total of 34 studies (23 quantitative and 2 qualitative studies, 9 reviews) were included. The relationship between depression and treatment adherence was significant and negative. Adherence to both rehabilitation, psychological, and antidepressant pharmacological treatments in depressed patients was linked to a decreased risk of hospitalization. Moreover, depressed patients compliant with an antidepressant were more likely to adherent to COPD maintenance inhalers. On the other hand, the associations between anxiety and adherence were poorly investigated and high heterogeneity characterized the studies, leading to a weak and variable relationship as well as too few interventions. The systematic review highlights the variability in estimates of the relationship between depression, anxiety, and treatment adherence in COPD. It could be explained by methodological differences across the included studies. This suggests that standardization is critical to improving the precision of the estimates. Recommendations for future research include attention to causal inferences, an exploration of mechanisms to explain the relationships between both anxiety and depression and adherence in COPD, and a comprehensive, systematic approach.

To what extent can one’s mind promote direct changes to the body? Can one’s beliefs about the body become a physical reality, without mediating effects from behaviors? Specifically, can medical symptoms and the course of a disease be directly affected by a person’s mindset about the illness? There is a vast literature about placebo and nocebo effects, that promote physical changes by creating the expectation of a change through a primer (for example, a fake pill). Placebos, however, often imply deception, or at least ambiguity, to be effective. The concept of Illness Expectation describes the expectations, both implicit and explicit, that a person who has received a diagnosis makes about the course of the disease. It can be characterized by different degrees of rigidity, and it is argued here that these expectations can ultimately lead to changes in the disease progression. These changes may happen through behavior modifications, or through a non-behavioral pathway, which may deserve exploration efforts from the scientific literature.

ObjectivesThis review aimed to summarise the existing knowledge about placebo and nocebo effects associated with pharmacological interventions and their mechanisms.DesignUmbrella review, adopting the Assessment of Multiple Systematic Reviews 2 tool for critical appraisal.Data sourcesMEDLINE/PubMed, Scopus, Web of Science, PsycINFO, Cochrane Central Register of Controlled Trial were searched in September 2022, without any time restriction, for systematic reviews, narrative reviews, original articles. Results were summarised through narrative synthesis, tables, 95% CI.Outcome measuresMechanisms underlying placebo/nocebo effects and/or their effect sizes.ResultsThe databases search identified 372 studies, for a total of 158 312 participants, comprising 41 systematic reviews, 312 narrative reviews and 19 original articles. Seventy-three per cent of the examined systematic reviews were of high quality.Our findings revealed that mechanisms underlying placebo and/or nocebo effects have been characterised, at least in part, for: pain, non-noxious somatic sensation, Parkinson’s disease, migraine, sleep disorders, intellectual disability, depression, anxiety, dementia, addiction, gynaecological disorders, attention-deficit hyperactivity disorder, immune and endocrine systems, cardiovascular and respiratory systems, gastrointestinal disorders, skin diseases, influenza and related vaccines, oncology, obesity, physical and cognitive performance. Their magnitude ranged from 0.08 to 2.01 (95% CI 0.37 to 0.89) for placebo effects and from 0.32 to 0.90 (95% CI 0.24 to 1.00) for nocebo effects.ConclusionsThis study provides a valuable tool for clinicians and researchers, identifying both results ready for clinical practice and gaps to address in the near future.FundingUniversità Cattolica del Sacro Cuore, Milan, Italy with the ‘Finanziamento Ponte 2022’ grant.PROSPERO registration numberCRD42023392281.

Background After receiving a diagnosis, individuals often develop expectations about how their condition will evolve. This cognitive framework, known as ‘Illness Expectations’ (IEs), encompasses future‐oriented beliefs regarding the course of the illness and its symptoms. In chronic conditions such as asthma, IEs may play a critical role in shaping patient‐reported outcomes and clinical markers of disease progression. This study aims to empirically evaluate the impact of IEs on asthma symptoms and respiratory function. Methods A cohort of 310 individuals diagnosed with asthma was followed over a 6‐month period, with three assessment points. Asthma control was measured using the Asthma Control Test (ACT), while respiratory function was evaluated through forced expiratory volume in 1 s (FEV1) using spirometry. IEs were assessed using the validated ‘Illness Expectation Test’ (IET), which captures both explicit (conscious) and implicit (unconscious) expectations. Predictive analyses were conducted using latent growth modelling and linear regression to examine the influence of IEs on asthma symptoms and respiratory function over time. Results People with more negative explicit IEs about their asthma reported worse symptoms over time (β = −0.50, SE = 0.21, p = 0.01). Implicit IEs were not statistically significant (β = −0.014, SE = 0.008, p = 0.09). Explicit IEs about symptom progression were also associated with changes in lung function, with more negative expectations predicting greater declines in respiratory performance (β = 0.51, SE = 0.11, p = 0.001). Conclusions These findings suggest that IEs may be meaningfully associated with asthma outcomes, highlighting their potential relevance in understanding patient experiences and symptom perception. These results support further research into interventions targeting cognitive frameworks, with the aim of informing more personalised, patient‐centred approaches to asthma management. Patient or Public Contribution This study was developed in response to patient‐reported challenges in asthma management, particularly around understanding and managing IEs. Patients contributed to identifying key areas of concern, and their perspectives informed the choice of outcomes and tools. While direct involvement in recruitment and dissemination was limited due to the pandemic, the study's design and focus were guided by patient priorities, with potential applications in clinical consultations and future co‐designed interventions.

Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease characterized by persistent respiratory symptoms and airflow limitation. Besides its irreversibility, COPD is a treatable condition, and patients would strongly benefit from being adherent to their treatments. However, almost half of them are non-adherent, and, according to several recent studies, the way the patient perceives the disease might influence this variable. This systematic review provided a synthesis of studies about the relationships between illness perceptions (IP), cognitions, beliefs, and adherence in COPD. English language publications were searched in PubMed, Medline, Scopus, ResearchGate, PsycINFO, and Cochrane Library databases from November 2022 to February 2023, following PRISMA guidelines. The reference lists of eligible studies were also searched. Data extraction and critical appraisal were undertaken by two reviewers working independently. A total of 14 studies were included. Adherence to treatment in COPD is confirmed to be low, using both self-report questionnaires and objective assessment systems. Most studies concluded that COPD is perceived as a moderate threat destined to last forever, even if many participants referred to little disease knowledge. This perception did not change between adherent and non-adherent groups. Those who considered more necessary to take their medicines and had a caregiver were more adherent and less concerned about their future. On the other side, forgetfulness, lack of trust in medications, and difficulties in understanding how to take them were perceived as the main causes of non-adherence. Other predictors of non-adherence, like depression, low self-efficacy, and severity of disease were confirmed. The systematic review highlights the variability of the relationship between IP, cognitions and beliefs, and COPD treatment adherence. A new level of awareness of the relationship between patients' subjective point of view and treatment adherence may inform future treatment options and promote a more personalized intervention.

As space exploration missions move from low orbit to distant destinations, including the Moon and Mars, new psychological, behavioral, and team challenges will arise. This manuscript represents an up-to-date white paper developed by European experts invited by the European Space Agency (ESA), mapping unfilled research gaps related to the psychology of space exploration, considering the incoming human missions, and accounting for the available scientific knowledge. ESA created the expert team and facilitated its work, but the team was completely independent in terms of contents. The white paper considers basic issues of adaptation, pre-, during-, and post-mission experiences, and possible countermeasures to be developed and tested. The resulting integrative map provides a guide for researchers that are interested in conducting research in the support of future space exploration endeavors.

Background Endometriosis presents diagnostic challenges and has profound impacts, encompassing physical and psychological symptoms, relationship difficulties, and disruptions in daily life. The emotional burden is pervasive, intensified by feelings of anxiety, depression, guilt, and shame. Despite extensive exploration of risk factors such as pelvic pain, knowledge about protective factors for mental health in this population is limited. Thus, this study aims to investigate whether self-compassion and mindfulness are associated with enhanced psychological wellbeing in individuals with endometriosis. Methods This cross-sectional study involved 653 participants aged 18 years or older, self-reporting a clinical or surgical diagnosis of endometriosis. Data collection occurred online via Qualtrics from May 11 to August 24, 2022. Sociodemographic and endometriosis-related data were collected using a researcher-made questionnaire. Psychological wellbeing, self-compassion, and mindfulness were assessed using validated self-report questionnaires. Results Out of 1,153 survey accesses, 653 participants (75%) provided complete responses and were included. Self-compassion and mindfulness exhibited a positive correlation with psychological wellbeing. In a hierarchical multiple regression model, controlling for confounding factors, both variables significantly increased the explained variance ( ΔR 2  = 0.315). However, only the association between psychological wellbeing and self-compassion remained statistically significant. Conclusions Self-compassion emerges as an important protective factor for psychological wellbeing in the context of endometriosis. These findings, coupled with recent studies, emphasize the significance of promoting self-compassion in the psychological treatment of individuals with endometriosis, especially among the young and recently diagnosed.

Background Noticing new things, accepting the continuously changing nature of circumstances, and flexibly shifting perspectives in concert with changing contexts constitute the essential features of Langerian mindfulness. This contrasts with a “mindless” approach in which one remains fixed in a singular mindset and is closed off to new possibilities. Despite potentially important clinical applications for this construct, few studies have explored them. The instrument developed to measure Langerian mindfulness is the Langer Mindfulness Scale (LMS), although this tool has been limited primarily to English-speaking populations. The study aimed to test LMS validity in the Italian language and to analyze the relationships between Langerian mindfulness and well-being. Methods We translated the LMS into Italian, analyzed its factor structure, and investigated the correlation between mindfulness and quality of life and psychological well-being in a sample of 248 Italian students (88.7% females, mean age 20.05). A confirmatory factor analysis confirmed the tri-dimensional structure of the English LMS in the Italian version. Results The primary analysis found a significant negative correlation between mindfulness and psychological symptoms including obsessive-compulsive tendencies, depression, anxiety, and paranoid ideation. There was also a positive correlation between mindfulness and reports of quality of life. Conclusions The Italian LMS appears reliable and it shows relevant correlations with well-being.

Ochratoxin A (OTA) is a powerful mycotoxin found in various foods and feedstuff, responsible for subchronic and chronic toxicity, such as nephrotoxicity, hepatotoxicity, teratogenicity, and immunotoxicity to both humans and several animal species. The severity of the liver damage caused depends on both dose and duration of exposure. Several studies have suggested that oxidative stress might contribute to increasing the hepatotoxicity of OTA, and several antioxidants, including curcumin (CURC), have been tested to counteract the toxic hepatic action of OTA in various classes of animals. Therefore, the present study was designed to evaluate the protective effect of CURC, a bioactive compound with different therapeutic properties on hepatic injuries caused by OTA in rat animal models. CURC effects were examined in Sprague Dawley rats treated with CURC (100 mg/kg), alone or in combination with OTA (0.5 mg/kg), by gavage daily for 14 days. At the end of the experiment, rats treated with OTA showed alterations in biochemical parameters and oxidative stress in the liver. CURC dosing significantly attenuated oxidative stress and lipid peroxidation versus the OTA group. Furthermore, liver histological tests showed that CURC reduced the multifocal lymphoplasmacellular hepatitis, the periportal fibrosis, and the necrosis observed in the OTA group. This study provides evidence that CURC can preserve OTA-induced oxidative damage in the liver of rats.

Chronic myeloid leukemia (CML) is a myeloproliferative disease that activates multiple signaling pathways, causing cells to produce higher levels of reactive oxygen species (ROS). Nicotinamide adenine dinucleotide phosphate (NADPH) oxidases (NOXs) are a major generator of ROS in leukemia, and marine natural products have shown promising activities for the treatment of hematopoietic malignancies. In the present study, we investigated the effect of the marine microalga Skeletonema marinoi (S.M.), a ubiquitous diatom that forms massive blooms in the oceans, on the human leukemia cell line K562. The effects of S.M. extract on cell viability, production of ROS, nitric oxide (NO), and apoptosis were examined. In this preliminary work, S.M. was able to decrease cell viability (p < 0.05) and increase apoptosis levels (p < 0.05) in K562 cells after 48 h of treatment. In addition, the levels of NOX, NO, and malondialdehyde (MDA) were reduced in K562-treated cells (p < 0.05), whereas the levels of SOD, CAT, and GPx increased during treatment (p < 0.05). Finally, analyzing Bax and Bcl-2 expression, we found a significant increase in the proapoptotic protein Bax and a sustained decrease in the antiapoptotic protein Bcl-2 (p < 0.05) in the K562-treated cells.