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The ability to process sensory information is an essential adaptive function, and hyper- or hypo-sensitive maladaptive profiles of responses to environmental stimuli generate sensory processing disorders linked to cognitive, affective, and behavioral alterations. Consequently, assessing sensory processing profiles might help research the vulnerability and resilience to mental disorders. The research on neuroradiological correlates of the sensory processing profiles is mainly limited to the young-age population or neurodevelopmental disorders. So, this study aims to examine the structural MRI correlates of sensory profiles in a sample of typically developed adults. We investigated structural cortical thickness (CT) and white matter integrity, through Diffusion Tensor Imaging (DTI), correlates of Adolescent/Adult Sensory Profile (AASP) questionnaire subscales in 57 typical developing subjects (34F; mean age: 32.7 ± 9.3). We found significant results only for the sensation seeking (STS) subscale. Positive and negative correlations emerged with FA and RD in anterior thalamic radiation, optic radiation, superior longitudinal fasciculus, corpus callosum, and the cingulum bundle. Exploring correlation between sensation seeking and whole brain cortical thickness no correlations were found. Overall, our results suggest a positive correlation between sensation seeking and higher white matter structural integrity in those tracts mainly involved in visuospatial processing but no correlation with gray matter structure. The enhanced structural integrity associated with sensation seeking may reflect a neurobiological substrate linked to active research of sensory stimuli and resilience to major psychiatric disorders like schizophrenia, bipolar disorder, and depression.

IntroductionAlthough recent data show that SARS-CoV-2 infection seems to affect the central nervous system (CNS), little is known about the neuropsychiatric effects resulting from this condition. In addition to the well-known neurotrophism of coronaviruses, recent evidence shows also that the “cytokine storm” induced by the infection is at the basis of the neuroinflammation of the CNS. Furthermore, prolonged hospitalization, polypharmacotherapy, and isolation could be at the basis of the onset of delirium in hospitalized COVID patients. This multicentric observational study explores the incidence of the onset of delirium in an Italian cohort of SARS-CoV-2 positive inpatients.MethodsData were collected in the COVIDhospitals of Brescia, Bergamo, Chieti, and Genova. Different socio-demographic, medical, neurological, and pharmacological parameters were collected. As a rapid screening for delirium, the 4AT scale was used. Eighty COVID-19 inpatients (mean age 74.7 ± 14.5 years) met the inclusion criteria (confirmed positivity to the SARS-CoV-2 virus; the presence of delirium and/or psychomotor agitation and/or new onset of other neuropsychiatric symptoms during hospitalization).ResultsThe majority of these patients (68.8%) had “hyperactive delirium” subtype. Polypharmacotherapy, current treatment with corticosteroids, and higher age were associated with delirium severity.ConclusionThese data provide an insight into the onset of delirium among COVID-19 patients underlining the need for monitoring, especially in elderly patients, the neuropsychiatric symptoms, and the therapy in order to have shorter hospitalization times and better outcomes.

IntroductionLanguage is usually considered the social vehicle of thought in intersubjective communications. However, the relationship between language and high-order cognition seems to evade this canonical and unidirectional description (ie, the notion of language as a simple means of thought communication). In recent years, clinical high at-risk mental state (CHARMS) criteria (evolved from the Ultra-High-Risk paradigm) and the introduction of the Clinical Staging system have been proposed to address the dynamicity of early psychopathology. At the same time, natural language processing (NLP) techniques have greatly evolved and have been successfully applied to investigate different neuropsychiatric conditions. The combination of at-risk mental state paradigm, clinical staging system and automated NLP methods, the latter applied on spoken language transcripts, could represent a useful and convenient approach to the problem of early psychopathological distress within a transdiagnostic risk paradigm.Methods and analysisHelp-seeking young people presenting psychological distress (CHARMS+/− and Clinical Stage 1a or 1b; target sample size for both groups n=90) will be assessed through several psychometric tools and multiple speech analyses during an observational period of 1-year, in the context of an Italian multicentric study. Subjects will be enrolled in different contexts: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa—IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Mental Health Department—territorial mental services (ASL 3—Genoa), Genoa, Italy; and Mental Health Department—territorial mental services (AUSL—Piacenza), Piacenza, Italy. The conversion rate to full-blown psychopathology (CS 2) will be evaluated over 2 years of clinical observation, to further confirm the predictive and discriminative value of CHARMS criteria and to verify the possibility of enriching them with several linguistic features, derived from a fine-grained automated linguistic analysis of speech.Ethics and disseminationThe methodology described in this study adheres to ethical principles as formulated in the Declaration of Helsinki and is compatible with International Conference on Harmonization (ICH)-good clinical practice. The research protocol was reviewed and approved by two different ethics committees (CER Liguria approval code: 591/2020—id.10993; Comitato Etico dell’Area Vasta Emilia Nord approval code: 2022/0071963). Participants will provide their written informed consent prior to study enrolment and parental consent will be needed in the case of participants aged less than 18 years old. Experimental results will be carefully shared through publication in peer-reviewed journals, to ensure proper data reproducibility.Trial registration numberDOI:10.17605/OSF.IO/BQZTN.

Background: The aim of the present study is to identify the main sociodemographic and clinical correlates associated with frequent service users (FSUs) in an Italian psychiatric emergency department. Methods: This study is an observational and prospective clinical investigation. All subjects (N = 549) consecutively admitted to the Psychiatric Inpatient Unit of the IRCCS Ospedale Policlinico San Martino ((Genoa, Italy) were recruited over a period of 18 months. Results: On average, FSUs were more likely to be single (75.0% vs. 64.0, p = 0.001), younger (38.79 years ± 14.68 vs. 45.94 years ± 16.94, p = 0.028), with an earlier onset (20.15 years ± 7.22 vs. 29.33 years ± 15.96, p < 0.001), and longer length of hospitalisation (13.65 days ± 12.40 vs. 9.89 ± 10.15, p = 0.006) compared to non-FSUs. While bipolar disorder was the most common primary diagnosis in both FSUs and non-FSUs, cluster B personality disorder was particularly elevated in FSUs (30.3% vs. 10.4%, p < 0.001). Furthermore, FSUs were more prone to substance use disorder (63.6% vs. 40.0%, p < 0.001), particularly cannabis (45.5% vs. 15.3%, p < 0.001), cocaine (33.3% vs. 10.4%, p < 0.001), and heroin (19.7% vs. 5.8%, p < 0.001), and were more likely to have non-suicidal self-injuries (21.2% vs. 6.8%, p < 0.001). FSUs were significantly more likely to be discharged against medical advice (18.2% vs. 5.6%, p < 0.001) or to have at least one escape attempt from the psychiatric ward (12.1% vs. 0.8%, p < 0.001). Conclusions: Specific clinical and social profiles of patients who repeatedly utilised the services of a psychiatric emergency department have been identified. Our findings can be used to develop suitable structures to support and reintegrate FSUs into society and work life.

The study of Roy and colleagues recently accepted for publication in International Journal of Neuropsychopharmacology is a very interesting report investigating the role of specific microRNAs (miRNAs) in vulnerability or resistance to major depressive disorder in a specific brain region (e.g., amygdala). MiRNAs may act as a mega-controller of gene expression being involved in the pathogenesis of major neuropsychiatric conditions. Interestingly, some of the altered miRNAs (e.g., hsa-miR-425-3p, miR-425, miR-674-3p, and miR-873-3p) identified in this study were found to be dysregulated even in existing studies, but several methodological issues may hamper the translation of basic research findings in clinical studies. MiRNAs are proposed as possible biomarkers of disease and treatment response to disentangle the biological complexity underlying major affective disorders. The main implications regarding the present findings are discussed.

Time distortions characterise severe mental disorders, exhibiting different clinical and neurobiological manifestations. This systematic review aims to explore the existing literature encompassing experimental studies on time perception in patients with bipolar disorder (BD), considering psychopathological and cognitive correlates. Studies using an experimental paradigm to objectively measure the capacity to judge time have been searched for. Selected studies have been described based on whether i) explicit or implicit time perception was investigated, ii) the temporal intervals involved were sub-second or supra-second, and iii) a perceptual or motor timing paradigm was used. Only 11 met the criteria for inclusion in the review. The available literature shows that the performance of BD patients mostly aligns with controls within sub-second timeframes (six articles), while a different pattern emerges within supra-second intervals based on the clinical phase of the disease (seven articles). Specifically, for longer temporal spans, BD patients tend to overestimate the duration during manic states and underestimate it during depressive states. Notably, no studies have directly investigated the neurobiological mechanisms associated with time perception. This review indicates that BD patients exhibit time perception similar to controls within sub-second intervals, but tend to overestimate time and underestimate it based on the clinical phase within supra-second intervals. Expanding the understanding of time perception in BD, particularly in relation to clinical phases and cognitive function, is of great importance. Such insights could deepen our understanding of the disorder, refine diagnostic processes, and guide the development of innovative therapeutic interventions.

Deficits in social cognition (SC) are significantly related to community functioning in schizophrenia (SZ). Few studies investigated longitudinal changes in SC and its impact on recovery. In the present study, we aimed: (a) to estimate the magnitude and clinical significance of SC change in outpatients with stable SZ who were assessed at baseline and after 4 years, (b) to identify predictors of reliable and clinically significant change (RCSC), and (c) to determine whether changes in SC over 4 years predicted patient recovery at follow-up. The reliable change index was used to estimate the proportion of true change in SC, not attributable to measurement error. Stepwise multiple logistic regression models were used to identify the predictors of RCSC in a SC domain (The Awareness of Social Inference Test [TASIT]) and the effect of change in TASIT on recovery at follow-up. In 548 participants, statistically significant improvements were found for the simple and paradoxical sarcasm of TASIT scale, and for the total score of section 2. The reliable change index was 9.8. A cut-off of 45 identified patients showing clinically significant change. Reliable change was achieved by 12.6% and RCSC by 8% of participants. Lower baseline TASIT sect. 2 score predicted reliable improvement on TASIT sect. 2. Improvement in TASIT sect. 2 scores predicted functional recovery, with a 10-point change predicting 40% increase in the probability of recovery. The RCSC index provides a conservative way to assess the improvement in the ability to grasp sarcasm in SZ, and is associated with recovery.

The aim of this paper was to survey the current management of the problem of smoking in our Mental Health Units, the structural characteristics of the units and how a total smoking ban would be perceived by doctors and nurses.AimThe aim of this paper was to survey the current management of the problem of smoking in our Mental Health Units, the structural characteristics of the units and how a total smoking ban would be perceived by doctors and nurses.An 18 items survey about smoking habits of inpatients and department inner regulations was sent to the Head Physician and the Charge Nurse of all the Intensive Psychiatric Care General Hospital Units in Italy (228 units), in order to increase the answer rate and to investigate if the perception of the problem is eventually different between the two groups.MethodAn 18 items survey about smoking habits of inpatients and department inner regulations was sent to the Head Physician and the Charge Nurse of all the Intensive Psychiatric Care General Hospital Units in Italy (228 units), in order to increase the answer rate and to investigate if the perception of the problem is eventually different between the two groups.We collected 65 answers from Head Physician and 79 from Nurses. Both groups think that the smoking rates for inpatients are between 50-100%. Most of the units is locked, with or without an external space, so that a total smoking ban is considered difficult to achieve by both groups. A very high rate of units has no specific rooms for smokers. In most cases the issue management is solved by a self-regulation, based on collecting cigarettes and lighters and granting a limited number of cigarettes per day. Anyway, an institutional intervention would be appreciated especially by nurses, who seem to be even more involved in the issue management and both of groups seem to badly judge the lack of sources to face the eventual ban: particularly the possibility to offer nicotine replacement therapy, a cognitive-behavioural support and providing more staff education would all be considered useful to implement the success rate of the ban. By the way, both of groups seem skeptical about the possibility of a total smoking-free policy in Acute Psychiatric Hospital Units. Though, a difference in the problem’s perception between the two groups has been noticed.ResultsWe collected 65 answers from Head Physician and 79 from Nurses. Both groups think that the smoking rates for inpatients are between 50-100%. Most of the units is locked, with or without an external space, so that a total smoking ban is considered difficult to achieve by both groups. A very high rate of units has no specific rooms for smokers. In most cases the issue management is solved by a self-regulation, based on collecting cigarettes and lighters and granting a limited number of cigarettes per day. Anyway, an institutional intervention would be appreciated especially by nurses, who seem to be even more involved in the issue management and both of groups seem to badly judge the lack of sources to face the eventual ban: particularly the possibility to offer nicotine replacement therapy, a cognitive-behavioural support and providing more staff education would all be considered useful to implement the success rate of the ban. By the way, both of groups seem skeptical about the possibility of a total smoking-free policy in Acute Psychiatric Hospital Units. Though, a difference in the problem’s perception between the two groups has been noticed.Smoking cessation remains a neglected area in psychiatry, in part due to misconceptions about smoking in the mentally ill, i.e. the idea that smoking cessation will exacerbate mental illness, aggression and suicide risk, even though these believes are not supported by evidence; in part due to the lack of institutional intervention and the structural deficiencies of the units.DiscussionSmoking cessation remains a neglected area in psychiatry, in part due to misconceptions about smoking in the mentally ill, i.e. the idea that smoking cessation will exacerbate mental illness, aggression and suicide risk, even though these believes are not supported by evidence; in part due to the lack of institutional intervention and the structural deficiencies of the units.

Aim. The aim of this paper was to survey the current management of the problem of smoking in our Mental Health Units, the structural characteristics of the units and how a total smoking ban would be perceived by doctors and nurses. Method. An 18 items survey about smoking habits of inpatients and department inner regulations was sent to the Head Physician and the Charge Nurse of all the Intensive Psychiatric Care General Hospital Units in Italy (228 units), in order to increase the answer rate and to investigate if the perception of the problem is eventually different between the two groups. Results. We collected 65 answers from Head Physician and 79 from Nurses. Both groups think that the smoking rates for inpatients are between 50-100%. Most of the units is locked, with or without an external space, so that a total smoking ban is considered difficult to achieve by both groups. A very high rate of units has no specific rooms for smokers. In most cases the issue management is solved by a self-regulation, based on collecting cigarettes and lighters and granting a limited number of cigarettes per day. Anyway, an institutional intervention would be appreciated especially by nurses, who seem to be even more involved in the issue management and both of groups seem to badly judge the lack of sources to face the eventual ban: particularly the possibility to offer nicotine replacement therapy, a cognitive-behavioural support and providing more staff education would all be considered useful to implement the success rate of the ban. By the way, both of groups seem skeptical about the possibility of a total smoking-free policy in Acute Psychiatric Hospital Units. Though, a difference in the problem’s perception between the two groups has been noticed. Discussion. Smoking cessation remains a neglected area in psychiatry, in part due to misconceptions about smoking in the mentally ill, i.e. the idea that smoking cessation will exacerbate mental illness, aggression and suicide risk, even though these believes are not supported by evidence; in part due to the lack of institutional intervention and the structural deficiencies of the units.

Obiettivo. L'obiettivo di questo studio è stato valutare la gestione del problema del tabagismo nei Servizi Psichiatrici di Diagnosi e Cura (SPDC), le caratteristiche strutturali dei reparti ospedalieri e come un divieto totale di fumo sarebbe eventualmente accolto da medici e infermieri. Metodo. È stato inviato un questionario di 18 quesiti a risposta multipla, inerente le abitudini dei ricoverati fumatori e i regolamenti interni del reparto, al direttore e al coordinatore infermieristico di tutti gli SPDC italiani (228) al fine di incrementare il tasso di risposta e valutare se il problema fosse percepito diversamente dai due gruppi. Risultati. Hanno risposto 65 direttori e 79 coordinatori infermieristici. A giudizio di entrambi i gruppi, i pazienti fumatori sono compresi tra il 50 e il 100%. La maggior parte dei reparti è chiusa e non tutti dispongono di uno spazio esterno accessibile: anche per questo motivo un divieto di fumo assoluto in reparto è considerato, da entrambi i gruppi, di difficile attuazione. Una percentuale elevata di reparti, almeno il 30%, è risultata sprovvista di una stanza specifica per il fumo. In molti casi il problema è gestito per mezzo di un'autoregolamentazione, principalmente prendendo in custodia sigarette e accendini e concedendo ai pazienti un numero limitato di sigarette giornaliere. Sarebbe tuttavia apprezzato, soprattutto dagli infermieri, un aumento dell'attenzione e delle risorse dedicate a questo problema: vengono citati come provvedimenti utili la possibilità di garantire ai pazienti la terapia nicotinica sostitutiva, il supporto cognitivo-comportamentale, nonché l'organizzazione di eventi e corsi formativi per gli operatori. Nonostante ciò, entrambi i gruppi intervistati rimangono scettici riguardo alla possibilità di applicare un totale divieto di fumo in SPDC. Esiste tuttavia una differenza nella percezione del problema fra direttori e coordinatori. Discussione. L'idea di una politica antifumo in SPDC è ancora rifiutata, in parte a causa del timore non confermato da recenti studi che l'astinenza dal fumo possa peggiorare i sintomi psichiatrici, esacerbare comportamenti violenti o idee e tentativi suicidari, in parte a causa del mancato intervento istituzionale, in parte a causa delle carenze strutturali dei reparti.