Explore the vast range of titles available.

While a growing body of research highlights a bi-directional link between diabetes and mood disorders, little is known about the relationship between diabetes and obsessive-compulsive disorder (OCD). The aim of the present review is to investigate current evidence linking OCD, insulin-signaling and diabetes. A PubMed search was conducted to review all the available studies assessing diabetes, glucose metabolism and insulin-signaling in OCD patients and vice versa. Some clinical and epidemiological studies show a higher prevalence of diabetes in OCD and vice versa compared to the general population. Animal and genetic studies suggest a possible role of insulin-signaling in the pathophysiology of OCD. Deep brain stimulation (DBS) studies suggest that abnormal dopaminergic transmission in the striatum may contribute to impaired insulin sensitivity in OCD. While DBS seems to increase insulin sensitivity, a possible protective role of serotonin reuptake-inhibitors on diabetic risk needs further studies. Despite their preliminary nature, these data highlight the importance of further investigations aimed at assessing metabolic features in OCD patients and OCD symptoms in diabetes patients to understand the impact of each condition on the pathophysiology and course of the other. Understanding the role of insulin in the obsessive-compulsive brain could open new treatment pathways for OCD. •Some studies show a higher prevalence of diabetes in OCD and vice versa compared to the general population.•Animal and genetic studies suggest a possible role of insulin-signaling in the pathophysiology of OCD and DBS) studies suggest that abnormal dopaminergic transmission in the striatum may contribute to impaired insulin sensitivity in OCD.•While DBS seems to increase insulin sensitivity, a possible protective role of serotonin reuptake-inhibitors on diabetic risk need further studies.•These preliminary data highlight the importance of a deep clinical assessment and management of metabolic factors in OCD patients.

Immigration in Europe is a challenge for health care systems. Psychotic experiences are not uncommon in the community. Meta-analyses showed that immigrants are at higher risk of psychotic symptoms and experiences than natives. In the international literature, there is little knowledge about the psychological processes explaining the relationship between immigrant status and psychotic experiences. Aberrant salience, the biased assignment of significance to otherwise innocuous stimuli, and alexithymia (difficulty identifying/verbalizing feelings and concrete speech/thinking) have been found to be vulnerability/maintenance factors of psychotic symptoms. This report presents a study investigating whether: 1) adolescent immigrants in Italy report more intense psychotic experiences than natives; 2) aberrant salience and alexithymia predict more intense psychotic experiences; and 3) these psychological processes moderate the effect of immigrant status on psychotic experiences. Knowledge about the role of these processes in psychotic experiences may suggest early detection or prevention strategies. One hundred and forty-eight community adolescents were recruited (mean age =17.57 years, 47.30% females); of these, 75 were born in Italy (natives) and 73 were immigrants (born in countries other than Italy). The Aberrant Salience Inventory, the Toronto Alexithymia Scale-20, and the Screening for Psychotic Experiences were administered in classrooms. Immigrants had higher aberrant salience (F=4.38, <0.05), alexithymia (F=8.93, <0.01), and psychotic experiences (F=10.65, <0.01) than natives. Higher aberrant salience and alexithymia predicted more intense psychotic experiences. An interaction effect between immigrant status and alexithymia emerged: immigrants with higher alexithymia had more intense psychotic experiences (β=0.17, <0.001). Early detection or prevention programs should focus on aberrant salience in the adolescent population and should consider young immigrants with higher alexithymia as a subgroup with higher psychotic experiences. Mindfulness-based programs may be implemented for this adolescent subgroup to promote emotional intelligence.

IntroductionThe ‘Hikikomori’ syndrome (HS) consists of prolonged and severe social withdrawal. It has been studied first in Japan and recently has increasingly drawn the attention of researchers and clinicians all over the world. It is unclear whether it exists in other cultural contexts than Asia. The existing systematic reviews did not provide a quantitative synthesis on its prevalence. In addition, a summary of the co-occurring rates of psychiatric disorders is lacking. To provide a more comprehensive understanding of the clinical picture, it seems important to investigate which psychiatric disorders listed in the classification systems are most frequently associated with this psychological condition affecting young people. This paper describes a systematic review and meta-analysis protocol summarising worldwide prevalence of the HS in general population and clinical samples with psychiatric disorders. The review will also assess the co-occurrence between HS and each psychiatric disorder defined by any version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD) in any clinical samples with psychiatric disorders.Methods and analysisA systematic review will be conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies will be included if they use youth aged 12–35 years, recruited from general population or population with psychiatric disorders, if they use international criteria to diagnose HS. No restriction about design or language will be applied. The search will be conducted during the first week of November 2019 by two independent reviewers through the databases Scopus, PubMed, PsycINFO, Web of Science, by examining study references, by looking for conference proceedings/dissertations/theses, by contacting study corresponding authors. Random-effect meta-analysis will be performed by computing effect sizes as logit event rates. Study quality will be assessed through the Newcastle-Ottawa Scale.Ethics and disseminationThe current review does not require ethics approval. The results will be disseminated through conference presentations and publications in peer-reviewed journals.PROSPERO registration numberCRD 42018098747.

Obsessive-compulsive disorder (OCD) is a seriously impairing psychiatric condition that affects 1%-3% of youth. Investigating the quality of life (QOL) is an important issue for treatment planning of this disorder, as targeting symptoms without taking it into account may bias assessment and prognosis when the patient presents with reduced symptoms that do not correspond to improved QOL. However, QOL in young individuals with OCD has been understudied. This meta-analysis summarized current evidence that assessed differences in global, social and school QOL dimensions, between children/adolescents with OCD and screened controls. Age, sex and OCD severity were examined as moderators. Case-control studies were included if children/adolescents with primary OCD were compared with screened controls on validated self-reported QOL outcomes. Online databases (January 1966-January 2016) were searched. Five case-control studies were included (n=543, 17 effect sizes overall). On global QOL, a large effect size emerged ( =-1.16, <0.001), suggesting that individuals with OCD had lower global QOL than controls. Moderate effect sizes emerged for school ( =-0.61, <0.01) and social QOL ( =-0.54, <0.01), respectively, indicating worse QOL on these domains for individuals with OCD. For samples with higher OCD severity, global QOL of individuals with OCD was lower than that for controls ( =-0.02, <0.05). For samples with lower percentages of females, global QOL of individuals with OCD was more impaired ( =0.02, <0.001). Age was not correlated with effect sizes. Assessment and treatment should target QOL for young males suffering from more severe OCD. The small number of included studies highlighted that QOL is under-recognized. Future research should focus on additional QOL domains and compare which ones are impaired among individuals with OCD compared with other psychiatric conditions. Overall, the results pointed out the importance of addressing QOL in both practice and research on assessment and treatment of children/adolescents with this condition.

Objectives Mindfulness, positive self-related attitudes and secure attachment have been shown to protect against psychopathology during adolescence, but it is unknown how these factors are related to each other and which are most strongly linked to psychopathology symptoms. Methods A cross-sectional research design was used with a large sample of adolescents (aged 14 to 18 years; n  = 1660) that completed validated measures of mindfulness, self-related attitudes, attachment, depression, anxiety and anger. We employed network analytic methods in order to better understand associations among these variables. Results Mindfulness was linked to lower levels of depression and anxiety while self-reassurance was linked to lower levels of anxiety and higher levels of anger. Self-hate was linked to depression. In turn, self-reassurance and self-hate were differentially linked to facets of attachment, particularly trust in parents. Conclusions Interventions combining mindfulness practice and clinical techniques based on attachment theory, which operate on different psychological levels, may improve self-related attitudes, which in turn can help ameliorate depression and anxiety in adolescents. Alternatively, interventions directly targeting self-related attitudes, particularly self-reassurance and self-inadequacy, hold promise to achieve positive effects on mental health among adolescents.

IntroductionObsessive-compulsive disorder (OCD) is a mental health condition associated with severe impairment in a variety of quality of life domains, an increased physical health burden, and a higher risk of general medical conditions and mortality compared with the general population. While there is a large amount of literature on psychological quality of life, a systematic review of perceived physical health in OCD is lacking. A quantitative summary might suggest that policy makers also focus the evaluation on perceived physical health and develop new strategies also aimed at this outcome. The current paper presents a protocol for the first systematic review and meta-analysis aimed at summarising perceived physical health in OCD by specifically examining perceived physical health status, bodily pain and role limitations due to physical problems in patients with OCD compared with controls. The review will also investigate potential demographic and clinical moderators of perceived physical health status (age, gender, OCD severity, publication date, methodological quality).Methods and analysisA systematic review and meta-analysis will be conducted according to PRISMA guidelines. Studies will be included if using a clinical group with a current primary diagnosis of OCD established by international standardised criteria, if measuring perceived physical health status, and if using screened or community participants as controls. No publication date or language restriction will be applied. An online systematic search of electronic databases (Scopus, PubMed, PsycINFO, EMBASE, Cochrane Library), and examination of conference proceedings and theses/dissertations will be conducted by independent reviewers. Risk of bias will be assessed through the Newcastle-Ottawa Scale.Ethics and disseminationThe current review does not require ethics approval. The results will be disseminated through publications in peer-reviewed journals.PROSPERO registration number2018 CRD42018106194.

Background In the last decade, the number of patients supported by informal caregivers has substantially increased. In the Italian healthcare context, informal caregivers’ experience of care is a new under-recognized construct, and no assessment tool is available. Measuring caregivers’ experience is important since in Italy the relationship between doctors and patients/relatives is still considered asymmetrical. The current study presented development and initial psychometric properties of the Health Services and Caregiver Experience questionnaire (HSCE), a self-report tool of caregivers’ global experience for inpatient clinical care, including factor structure, reliability and its relations with measures of coping strategies and family strain. Methods The HSCE was administered to a total of 503 informal caregivers of inpatients admitted at an Italian University Hospital (mean age = 48.08 years, SD = 14.82, females = 61.40%). Family Strain Questionnaire-Short Form (FSQ-SF) and Coping Orientations to Problems Experience-New Italian Version (COPE-NVI) were administered to a subgroup of participants. First-grade relatives were 73.10%, whereas 13.20% were second-grade relatives and 13.70% were home-watch caregivers. Results Exploratory and confirmatory factor analyses showed a structure with a single factor, which explained 64.80% of the total variance. All the items had salient loadings. In the two subsamples, HSCE had excellent internal consistency (Cronbach’s alpha = 0.95–0.97). Positive moderate correlations were found between HSCE and FSQ-SF scores ( r  = 0.45, p  < .05), between HSCE and COPE-NVI scale scores, including COPE-NVI positive attitude and COPE-NVI problem solving scores (rs’ range = 0.51–0.57, p  < .05). Moreover, a positive large correlation between HSCE and COPE-NVI social support scores emerged ( r  = 0.72, p  < .05). Correlations were not significant between HSCE scores and COPE-NVI turning to religion and avoidance strategies. Conclusions The HSCE resulted to have good psychometric properties. Better caregivers’ experience correlated with stronger family strain but also with better problem solving and social support. The study expanded knowledge on caregiver’s experience in Italy and indicated that HSCE is a valid and reliable tool to measure this under-recognized construct in Italy.

Background Three distinct subtypes of Skin Picking (SP) have been identified in previous research: Focused, Automatic and Mixed. Early Maladaptive Schemas (EMS) were not investigated across the subtypes. Understanding which EMS are associated with the subtypes might suggest the evaluation of Schema Therapy for SP and guide clinicians using it according to subtypes. The current study explored the relationship between EMS and SP subtypes in community adults. Methods Five hundred ninety-six adults [mean age = 35.23 years, 66% females] self-reporting SP behaviours completed the Milwaukee Inventory for Dimensions of Adult Skin Picking and the Young Schema Questionnaire-Long form third version (YSQ-L3). Results Higher Dependence/Incompetence EMS was a common predictor of both Focused and Automatic subtypes, while lower Emotional Deprivation EMS and younger age predicted all three subtypes. Higher Approval/Recognition Seeking, Mistrust/Abuse and Failure to Achieve were specific predictors of Automatic, Focused and Mixed subtypes, respectively. Lower Social Isolation/Alienation and Enmeshment/Undeveloped Self were specific predictors of Focused subtype. Male gender was a specific predictor of Mixed subtype. Conclusions The assessment and psychological treatment of individuals with SP behaviour may focus on specific EMS. Future longitudinal studies using clinical samples may clarify this association.

Obsessive-compulsive disorder (OCD) is one of the leading causes of disability and reduced quality of life (QOL), with impairment in a number of domains. However, there is a paucity of literature on the association between severity of OCD symptoms and QOL, and the data that do exist are inconsistent. In addition, the role of severity in QOL has not been summarized as yet from a cross-generational perspective (ie, across childhood/adolescence and adulthood). Through meta-regression techniques, the current study summarized evidence about the moderator role of severity of OCD symptoms on differences in global QOL between individuals with OCD and controls. Online databases were searched, and cross-sectional case-control studies comparing participants of all ages with OCD with controls on self-report QOL measures were included. Random-effect meta-regression techniques were used to comment on the role of illness severity in global QOL in individuals with OCD. Thirteen studies were included. A positive significant association emerged between OCD severity and effect sizes on global QOL: in samples with higher severity, there were narrower differences in QOL between patients with OCD and controls than in samples with lower severity. Such positive association was confirmed by a sensitivity analysis conducted on studies including only adults, where the difference in QOL ratings between patients and controls was significantly narrower when OCD severity was higher. Conversely, a negative association between severity and QOL was found in those studies including only children/adolescents, where the difference in QOL was significantly larger between patients and controls when OCD severity was higher. QOL remains an important issue to address in the management of OCD in all age groups, irrespective of illness severity. Even in those with lower severity ratings, QOL may be considered as an important marker of treatment response.

Background Obsessive compulsive disorder (OCD) is a chronic mental health condition recognized as one of the most serious causes of disability and impaired quality of life. In the literature, there is no review about sexual dysfunction and satisfaction in OCD. The current paper presents the protocol for a systematic review and meta-analysis aimed to summarize data (1) comparing the presence of sexual dysfunction between groups with OCD and non-clinical groups, (2) investigating prevalence of each one of the sexual dysfunctions in patients with OCD, (3) comparing risk for sexual dysfunction in OCD groups with the prevalence in control groups, (4) comparing sexual satisfaction between OCD groups and non-clinical groups, and (5) investigating moderators of sexual dysfunction in OCD groups as compared with control groups. Gender, age, marital status, OCD symptom severity and subtypes, comorbid depressive disorders, comorbid anxiety disorders, concurrent psychiatric medications, comorbid general medical disease, and study quality will be investigated as moderators. Methods The protocol is reported according to PRISMA-P guidelines. The search will be conducted by independent reviewers during the second week of December 2019 by using electronic databases (Scopus, PubMed, EMBASE, PsycINFO, CINAHL, and the Cochrane Library), by contacting the authors of the included studies to identify further data, by examining the references of the included studies, and by handsearching conference proceedings and theses/doctoral dissertations. The study quality will be independently evaluated using the Newcastle-Ottawa Quality Assessment Scale. Random-effect meta-analyses will be computed. If there is insufficient data for a specific outcome, only a systematic review will be performed. Discussion This review may support clinical practice highlighting the importance of the assessment of sexuality in patients with OCD and suggesting the use of therapeutic strategies dedicated to sexuality in this clinical population with the aim of improving patients’ quality of life. Potential limitations will regard the heterogeneity of the studies in terms of the instruments used to assess sexual dysfunction/satisfaction and of the definitions used to conceptualize sexual dysfunction. Systematic review registration Prospero CRD42019132264