Chiara Buizza

Beliefs and attitudes among Italian high school students toward people with severe mental disorders.

Abstract The negative attitudes surrounding mental disorders and their treatment are a major obstacle to the correct identification and treatment of emerging psychopathologies. The purpose of this study was to investigate mental health literacy in a large and representative sample of high school students in Italy, via a booklet containing several questionnaires delivered to 1032 teenagers. The items in the questionnaires probed knowledge about mental health and illness, stigmatization, stereotypes, behaviors, opinions, and attitudes. In general, the students had a reasonable knowledge of mental disorders and were able to distinguish these from somatic disorders. However, a large portion of the students nourished some misconceptions about mental disorders and was also rather skeptical about the effectiveness of treatment or the chance of recovery for people with severe mental disorders. Nevertheless, roughly half of the students reported being willing to provide help to someone with a mental disorder when in need. Poor mental health literacy is a major barrier to seeking help and receiving effective treatment. Young people are the ideal target of raising awareness and antistigma campaigns because they are at a higher risk for developing a psychopathology.

INvolvement of breast CAncer patients during oncological consultations: A multicentre randomised controlled trial-the INCA study protocol

Introduction Studies on patient involvement show that physicians make few attempts to involve their patients who ask few questions if not facilitated. On the other hand, the patients who participate in the decision-making process show greater treatment adherence and have better health outcomes. Different methods to encourage the active participation during oncological consultation have been described; however, similar studies in Italy are lacking. The aims of the present study are to (1) assess the effects of a preconsultation intervention to increase the involvement of breast cancer patients during the consultation, and (2) explore the role of the attending companions in the information exchange during consultation. Methods and analysis All female patients with breast cancer who attend the Oncology Out-patient Services for the first time will provide an informed consent to participate in the study. They are randomly assigned to the intervention or to the control group. The intervention consists of the presentation of a list of relevant illness-related questions, called a question prompt sheet. The primary outcome measure of the efficacy of the intervention is the number of questions asked by patients during the consultation. Secondary outcomes are the involvement of the patient by the oncologist; the patients perceived achievement of her information needs; the patients satisfaction and ability to cope; the quality of the doctor–patient relationship in terms of patient-centeredness; and the number of questions asked by the patients companions and their involvement during the consultation. All outcome measures are supposed to significantly increase in the intervention group. Ethics and dissemination The study was approved by the local Ethics Committee of the Hospital Trust of Verona. Study findings will be disseminated through peer-reviewed publications and conference presentations. Trial registration ClinicalTrials.gov identifier: NCT01510964

Violent behavior of patients living in psychiatric residential facilities: a comparison of male patients with different violence histories.

People with severe mental disorders and a history of violence are often seen as a difficult-to-manage segment of the population. In addition, this group is usually characterized by a high risk of crime recidivism, and poor compliance with community and aftercare programs. To investigate a sample of male patients living in Residential Facilities (RFs) with a history of violent behavior against people and to compare their characteristics with those of never-violent residents; to analyze the associations between aggressive behaviors in the last two years and a history of previous violence; and, to assess the predictors of aggressive behaviors. This study is part of a prospective observational cohort study which involved 23 RFs in Northern Italy. A comprehensive set of sociodemographic, clinical, and treatment-related information was gathered, and standardized assessments were administered to each participant. Also a detailed assessment of aggressive behaviors in the past two years was carried out. The study involved 268 males: 81 violent and 187 never-violent. Compared to never-violent patients, violent patients were younger, with a higher proportion of personality disorders, and have displayed an increased number of aggressive behaviors in the last two years. The presence of a history of violent behavior in the past significantly increases the probability of committing aggressive acts in the future.

Monitoring and predicting the risk of violence in residential facilities. No difference between patients with history or with no history of violence.

BACKGROUND Most people with mental disorders are not violent. However, the lack of specific studies in this area and recent radical changes in Italy, including the closure of six Forensic Mental Hospitals, has prompted a more detailed investigation of patients with aggressive behaviour. AIMS To compare socio-demographic, clinical and treatment-related characteristics of long-term inpatients with a lifetime history of serious violence with controls; to identify predictors of verbal and physical aggressive behaviour during 1-year follow-up. METHODS In a prospective cohort study, patients living in Residential Facilities (RFs) with a lifetime history of serious violence were assessed with a large set of standardized instruments and compared to patients with no violent history. Patients were evaluated bi-monthly with MOAS in order to monitor any aggressive behaviour. RESULTS The sample included 139 inpatients, 82 violent and 57 control subjects; most patients were male. The bi-monthly monitoring during the 1-year follow-up did not show any statistically significant differences in aggressive behaviour rates between the two groups. The subscale explaining most of the MOAS total score was aggression against objects, although verbal aggression was the most common pattern. Furthermore, verbal aggression was significantly associated with aggression against objects and physical aggression. CONCLUSIONS Patients with a history of violence in RFs, where treatment and clinical supervision are available, do not show higher rates of aggressiveness compared to patients with no lifetime history of violence. Since verbal aggression is associated with more severe forms of aggression, prompt intervention is warranted to reduce the risk of escalation.

Patterns of experienced and anticipated discrimination in patients with schizophremia. Italian results from the INDIGO international multisite project

AIMS To describe patterns of experienced and anticipated discrimination in a sample of schizophrenic patients recruited in Italy in the context of the International Study of Discrimination and Stigma Outcomes (INDIGO). METHODS Cross-sectional survey on a sample of 50 people with clinical diagnosis of schizophrenia recruited in the Italian INDIGO sites of Verona and Brescia. The 41-item interview-based Discrimination and Stigma Scale (DISC-10), which assesses how experienced and anticipated discrimination affects the life of people with schizophrenia, was used. RESULTS The most frequently occurring areas of experienced discrimination were discrimination by family members (44%), making and keeping friends (33%), keeping (36%) and finding a job (34%), getting or keeping a driving licence (32%). Anticipated discrimination was common in applying for work, training or education (58%), looking for close relationships (50%) and doing something important (48%); 68% felt the need to conceal their diagnosis. Positive experiences were rare, and getting welfare benefits/disability pensions was the only area where participants reported being treated with advantage (34%) more commonly than with disadvantage (8%). Overall, experienced discrimination reported by Italian patients was in the intermediate position of the score range of all INDIGO sites, whereas anticipated discrimination was lower than that reported in the other countries. CONCLUSIONS Interventions to reduce discrimination against people with schizophrenia may need to address both actual and anticipated discrimination. Targeted therapeutic strategies aiming to improve self-esteem of people with schizophrenia may be useful to facilitate their social participation and full inclusion in the community.

A follow-up study on students attending a university counselling service in Northern Italy

ABSTRACT The aims of this study were to evaluate the effectiveness of a university counselling service in Northern Italy, to assess the sociodemographic and clinical characteristics of students who used counselling service, and to assess the psychological conditions of the students who ended the counselling after a 4 month follow-up period. The study involved 100 students, who filled out the General Health Questionnaire (GHQ-12), the Brief COPE Inventory, and the Symptom Checklist-90-Revised (SCL-90-R). The results showed that who received counselling were positively affected by this experience. The areas of benefit were psychological well-being, coping behaviours, ability to positively reframe problems and less sense of guilt. Additional studies are needed to identify which factors influence the outcomes of university counselling services in Italy. These studies would be important to evaluate the services rendered, upgrade the skills of counsellors and visualise priority areas of need.

Beliefs and Prejudices Versus Knowledge and Awareness: How to Cope Stigma Against Mental Illness. A College Staff E-survey

The aims of this study were to collect information about attitudes toward mental illness from the staff of Brescia University, and to detect predictors of issues regarding mental disorders and evaluate their relationship with public stigma. The study involved 1079 people and each participant received a letter explaining the purpose of the e-research. Four hundred and eighty-six people completed the questionnaires. The results showed that those who had a higher level of education, a personal life experience with mental disorders and a higher professional role were more likely to develop behaviours of acceptance toward the mentally ill. Factor analysis of the CAMI showed three main factors: Social distance and isolation, Social integration, Social responsibility and tolerance. Through the structural equation model it was found that the latent construct stigma was mainly defined by the first factor. From this study it emerged that education and personal contact were protective factors against public stigma.

Detecting and Managing Mental Health Issues within Young Adults. A Systematic Review on College Counselling in Italy

Background: College counselling can be considered as a front-line service in detecting and managing mental health issues within young adults. In this sense, it is important to investigate the effectiveness of counselling interventions. Objective: To provide a systematic review about college counselling in Italy; to assess which psychological interventions really meet student needs, and their effectiveness; to focus on the level of cohesion between Italian counselling services and the international guidelines about college counselling. Method: A systematic review about college counselling through PsycInfo and PubMed was carried out. Because of the scarceness of pertinent available articles, the survey was extended to Google Scholar and Riviste Web. Keywords: counselling, mental health, wellbeing, psychological support, university, students, Italy. Results: Out of thirty-four articles retrieved, 16 are relevant to academic counselling, the other 18 have been considered not pertinent to the aim of the present review. Data show a lack of homogeneity in methodology and organization between each University: different approaches towards students’ needs. Furthermore, no follow-up studies or measurement of effectiveness were found. Conclusion: This review is a contribution to disseminate the results of counselling experiences in Italy and represents an effort to encourage colleagues working in a web environment to share results and methods for a more organized protocol application.

The involvement of early stage breast cancer patients during oncology consultations in Italy: a multi-centred, randomized controlled trial of a question prompt sheet versus question listing

Objectives To investigate, prior to an oncology consultation, the use of a pre-prepared list of evidence based questions, Question Prompt Sheet (QPS), compared with a Question List (QL), a patient self-generated list of questions. Design Multi-centred, randomised controlled trial. Setting Secondary-care patients attending three outpatient oncology clinics in Northern Italy. Participants 308 women completed the study. Inclusion criteria were an age between 18 and 75 years, a recent diagnosis of early stage, non-metastatic breast cancer, adequate Italian language skills, no previous oncology visits and no evidence of cognitive impairment. Intervention Patients received the QPS or the QL prior to the consultation, completed it without suggestion or coaching session and delivered back before the visit.The consultations were audio-recorded and analysed for the number and content of questions. Multilevel linear models were used to compare the two groups. Outcome measures The primary outcome was the comparison of questions asked between QPS and QL group. Secondary outcomes included satisfaction about questions asked, satisfaction with decision, and level of anxiety. Results Patients in the QPS and QL group asked 13 and 16 questions respectively. The difference was not significant (b=1.7, CI –0.3 to 3.6, p=0.10). A mean of 22 questions was selected in the QPS, while a mean of 2 questions was written in the QL. Patients in the QPS group were significantly less satisfied (t=3.60, p<0.01) with questions asked but wanted less additional information (t=2.20, p<0.05). Levels of patient decisional satisfaction were equivalent between groups. Similarly, anxiety levels were equal between groups prior to the consultation and decreased in similar way after the consultation. Conclusions Both interventions have similar impact on patients’ participation in terms of question asking during the consultation. Future research is needed in order to explore which components of the interventions are really useful and efficacious. Trial registration ClinicalTrials.gov NCT01510964

La valutazione dell’attrazione sessuale, tipologie di attrazione e variabilità inter-individuale

L’attrazione sessuale, da sempre considerata sinonimo dell’orientamento sessuale, raramente e stata trattata come un fenomeno che meritasse di essere studiato in modo indipendente. Questo studio parte dalla considerazione che attrazione sessuale e orientamento sessuale sono costrutti autonomi e che, di conseguenza, la valutazione separata dell’attrazione sessuale potrebbe avere importanti ricadute sia in ambito clinico che di ricerca. Per indagare l’attrazione sessuale e stato utilizzato un questionario multidimensionale - il Questionario sull’Attrazione Sessuale - di cui si propone l’adattamento italiano su una popolazione adulta. I risultati di questo studio mostrano che il questionario gode di buone qualita psicometriche e che risulta essere un utile strumento in grado di promuovere una maggiore comprensione scientifica e una piu profonda valutazione clinica dei processi individuali coinvolti nell’attrazione sessuale.