Danilo Carrozzino

Mental Pain and Suicide: A Systematic Review of the Literature

Background Mental pain, defined as a subjective experience characterized by perception of strong negative feelings and changes in the self and its function, is no less real than other types of grief. Mental pain has been considered to be a distinct entity from depression. We have performed a systematic review analyzing the relationship between mental pain and suicide by providing a qualitative data synthesis of the studies. Methods We have conducted, in accordance with PRISMA guidelines, a systematic search for the literature in PubMed, Web Of Science, and Scopus. Search terms were “mental pain” “OR” “psychological pain” OR “psychache” combined with the Boolean “AND” operator with “suicid*.” In addition, a manual search of the literature, only including the term “psychache,” was performed on Google Scholar for further studies not yet identified. Results Initial search identified 1450 citations. A total of 42 research reports met the predefined inclusion criteria and were analyzed. Mental pain was found to be a significant predictive factor of suicide risk, even in the absence of a diagnosed mental disorder. Specifically, mental pain is a stronger factor of vulnerability of suicidal ideation than depression. Conclusion Mental pain is a core clinical factor for understanding suicide, both in the context of mood disorders and independently from depression. Health care professionals need to be aware of the higher suicidal risk in patients reporting mental pain. In this regard, psychological assessment should include a clinimetric evaluation of mental pain in order to further detect its contribution to suicidal tendency.

A clinimetric analysis of the Hopkins Symptom Checklist (SCL-90-R) in general population studies (Denmark, Norway, and Italy)

Abstract Background: Although the Symptom Checklist (SCL-90-R) is one of the most widely used self-reported scales covering several psychopathological states, the scalability of the SCL-90-R has been found to be very problematic. Aims: We have performed a clinimetric analysis of the SCL-90-R, taking both its factor structure and scalability (i.e. total scale score a sufficient statistic) into account. Methods: The applicability of the SCL-90-R has been found acceptable in general population studies from Denmark, Norway and Italy. These studies were examined with principal component analysis (PCA) to identify the factor structure. The scalability of the traditional SCL-90-R subscales (i.e. somatization, hostility, and interpersonal sensitivity) as well as the affective subscales (i.e. depression and anxiety and ADHD), were tested by Mokken’s item response theory model. Results: Across the three general population studies the traditional scaled SCL-90-R factor including 83 items was identified by PCA. The Mokken analysis accepted the scalability of both the general factor and the clinical SCL-90-R subscales under examination. Conclusion: The traditional, scaled, general 83 item SCL-90-R scale is a valid measure of general psychopathology. The SCL-90-R subscales of somatization, hostility, and interpersonal sensitivity as well as the affective subscales of depression, anxiety, and ADHD were all accepted by the Mokken test for scalability, i.e. their total scores are sufficient statistics.

Anxiety in adolescent epilepsy. A clinimetric analysis

Abstract Background Anxiety and depression have been considered to be neglected disorders in epilepsy. Because panic disorder is one of the most important anxiety disorders, it has been problematic to use very comprehensive anxiety questionnaires in epilepsy patients, as panic attacks and epileptic seizures, although two distinct clinical entities from a diagnostic point of view, show a significant overlap of symptoms. Aims We have focused on single items for anxiety and depression as screening candidates in adolescent epilepsy. Methods The individual panic attack item in the Screen for Children Anxiety Related Emotional Disorders Scale (SCARED) and the single depression item in the Kellner Symptom Questionnaire were tested. Our samples consisted of adolescent patients with epilepsy and a matched control group with healthy participants, as well as two numerical groups acting as controls. Results The single panic attack item identified panic anxiety in 24.1% in the group of patients with epilepsy and 0.0% in the matched control group (p = 0.01). The single depression item identified 52.2% with depression in the epilepsy group and 6.2% in the matched control group (p = 0.001). Conclusion As screening instruments, single items of panic attack and depression are sufficient to screen for these affective states in adolescent epilepsy. The clinical implications are that it is important to be quite specific when screening for depression and panic attacks in adolescent patients with epilepsy.

Somatization in Parkinson's Disease: A systematic review

ABSTRACT The current systematic review study is aimed at critically analyzing from a clinimetric viewpoint the clinical consequence of somatization in Parkinsons Disease (PD). By focusing on the International Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, we conducted a comprehensive electronic literature research strategy on ISI Web‐of‐Science, PsychINFO, PubMed, EBSCO, ScienceDirect, MEDLINE, Scopus, and Google Scholar databases. Out of 2.926 initial records, only a total of 9 studies were identified as clearly relevant and analyzed in this systematic review. The prevalence of somatization in PD has been found to range between 7.0% and 66.7%, with somatoform disorders acting as clinical factor significantly contributing to predict a progressive cognitive impairment. We highlighted that somatization is a highly prevalent comorbidity affecting PD. However, the clinical consequence of such psychiatric symptom should be further evaluated by replacing the clinically inadequate diagnostic label of psychogenic parkinsonism with the psychosomatic concept of persistent somatization as conceived by the Diagnostic Criteria for Psychosomatic Research (DCPR). HIGHLIGHTSSomatization is a highly prevalent comorbidity in Parkinsons Disease.Somatization significantly influences Parkinsons Disease prognosis.A clinimetric reappraisal of the somatization concept is proposed.Clinimetrics provides a clinically based method for evaluating somatization.

Quality of Life in Women with Gestational Diabetes Mellitus: A Systematic Review

Background and Objective. Diagnosis of Gestational Diabetes Mellitus (GDM) could significantly increase the likelihood of health problems concerning both potential risks for the mother, fetus, and childs development and negative effects on maternal mental health above all in terms of a diminished Quality of Life (QoL). The current systematic review study is aimed at further contributing to an advancement of knowledge about the clinical link between GDM and QoL. Methods. According to PRISMA guidelines, PubMed, Web of Science, Scopus, and Cochrane databases were searched for studies aimed at evaluating and/or improving levels of QoL in women diagnosed with GDM. Results. Fifteen research studies were identified and qualitatively analyzed by summarizing results according to the following two topics: GDM and QoL and interventions on QoL in patients with GDM. Studies showed that, in women with GDM, QoL is significantly worse in both the short term and long term. However, improvements on QoL can be achieved through different intervention programs by enhancing positive diabetes-related self-management behaviors. Conclusion. Future studies are strongly recommended to further examine the impact of integrative programs, including telemedicine and educational interventions, on QoL of GDM patients by promoting their illness acceptance and healthy lifestyle behaviors.

Evaluating psychiatric symptoms in Parkinson's Disease by a clinimetric analysis of the Hopkins Symptom Checklist (SCL-90-R)

&NA; Although psychiatric comorbidity in Parkinsons Disease (PD) has often been studied, the individual psychiatric symptoms have rarely been evaluated from a clinimetric point of view in an attempt to measure how much the symptoms have been bothering or distressing the PD patients. The current study is therefore aimed at evaluating from a clinimetric viewpoint the severity of psychiatric symptoms affecting PD patients by using the Hopkins Symptom Checklist (SCL‐90‐R) to show its measurement‐driven construct validity (scalability). The conventional nine SCL‐90‐R subscales (somatization, obsessive‐compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideas, and psychoticism), as well as the clinical most valid subscales from the SCL‐28 version (depression, anxiety, interpersonal sensitivity, and neurasthenia) were analysed according to a clinimetric approach by comparing PD patients with a control group from a general population study. Scalability was tested by the non‐parametric item response theory model by use of a Mokken analysis. Among the various SCL‐90‐R or SCL‐28 subscales we identified from the clinimetric analysis that the somatization, anxiety, phobic anxiety, psychoticism, and neurasthenia (apathy), as well as the SCL‐90‐R GSI, were the most impaired psychiatric syndromes reaching a clinically significant effect size above 0.80, whereas the total SCL‐28 GSI obtained an effect size of just 0.80. Our clinimetric analysis has shown that patients with PD not only are bothered with diverse somatic symptoms, but also with specific secondary psychiatric comorbidities which are clinically severe markers of impairment in the day‐to‐day function implying a negative cooping approach. HighlightsThe SCL‐90‐R and SCL‐28 are statistically sufficient self‐rating scales.Somatization is the most severe psychiatric symptom in Parkinsons disease.Neurasthenia is the most prevalent psychiatric symptom in Parkinsons disease.Anxiety and phobic anxiety symptoms are clinically elevated in Parkinsons Disease.Psychoticism is a clinically significant comorbidity in Parkinsons Disease.

Psychosis in parkinsonism: an unorthodox approach

Psychosis in Parkinson’s disease (PD) is currently considered as the occurrence of hallucinations and delusions. The historical meaning of the term psychosis was, however, broader, encompassing a disorganization of both consciousness and personality, including behavior abnormalities, such as impulsive overactivity and catatonia, in complete definitions by the International Classification of Diseases-10 (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Our review is aimed at reminding that complex psychotic symptoms, including impulsive overactivity and somatoform disorders (the last being a recent controversial entity in PD), were carefully described in postencephalitic parkinsonism (PEP), many decades before dopaminergic treatment era, and are now described in other parkinsonisms than PD. Eminent neuropsychiatrists of the past century speculated that studying psychosis in PEP might highlight its mechanisms in other conditions. Yet, functional assessments were unavailable at the time. Therefore, the second part of our article reviews the studies of neural correlates of psychosis in parkinsonisms, by taking into account both theories on the narrative functions of the default mode network (DMN) and hypotheses on DMN modulation.

The Italian version of the Depressive Experiences Questionnaire: psychometric properties and validation in students, community, and clinical groups

The current study evaluated the psychometric properties of the Italian validation of the Depressive Experiences Questionnaire (DEQ), conceived as a measure of self-criticism and dependency, i.e. two personality factors acting, according to Blatt (2004), as risk factors for depression in particular and psychopathology in general. A series of standardized measures [Beck Depression Inventory-II (BDI-II), DEQ, Symptom Checklist-90-R (SCL-90-R), Millon Clinical Multiaxial Inventory, 3rd edition (MCMI-III)] was administered to three samples (i.e., students, community and clinical). Factorial validity was evaluated along with convergent and predictive validity. In order to evaluate the reliability and internal consistency, a specific subgroup of participants was retested on the DEQ and BDI-II. Results showed correlations between DEQ dimensions and some personality traits of the MCMI-III. The traditional three-factor model of the DEQ structure as identified by principal component analysis appears to be as stable factors as typically found in American samples, although some items showed elevated cross-loading or low loadings on any factor. Clinical and diagnostic implications of the findings will be discussed.

The clinical consequence of positive mental health in psychotherapy

The current commentary is aimed at critically analyzing the document Psychotherapies for Anxiety and Depression: benefits and costs by focusing on specific theoretical concepts and empirical evidences arising from research studies fulfilled in the area of study of Clinical and Health Psychology. Specifically, the following were the main topics on which we are focused on: i) the clinical consequence potentially resulting from considering the psychological well-being and the euthymia condition as the main targets of a psychotherapeutic treatment; ii) a critical reappraisal of the clinical inadequacy of the evidence based model in psychotherapy; iii) clinimetrics as a clinically based measurement method for evaluating the psychological well-being of a patient after a psychotherapeutic intervention.

The prevalence of psychological distress in Parkinson's disease patients: The brief symptom inventory (BSI-18) versus the Hopkins symptom checklist (SCL-90-R)

Abstract The prevalence of psychological distress in Parkinsons disease (PD) patients has been evaluated by many different assessment instruments and with diverse control groups. The most frequently used distress symptom scale has been the Hopkins Symptom Checklist (SCL‐90‐R), although it contains many symptoms with problematic validity clinically. The 18‐item subscale of the SCL‐90‐R, the Brief Symptom Inventory (BSI‐18) has recently been shown to have a sufficient validity to screen for the prevalence of psychological distress (somatization) in PD patients. We have performed a clinimetric analysis by comparing the BSI‐18 with SCL‐90‐R relevant subscales in PD patients. Our micro‐analysis has focused on the Mokken model to test the scalability of the subscales. The macro‐analysis has focused both on effect size statistics and the normative level of psychological distress with reference to the Italian general population data using T‐score metric. The Mokken analysis indicated acceptable scalability for all the subscales of BSI‐18. The effect size statistics identified somatization in both BSI‐18 and SCL‐90‐R as the most prevalent and intense symptom of psychological distress. The T‐score metric identified the phobic anxiety subscale of SCL‐90‐R to be clinically much more important than the BSI‐18 anxiety subscale in the PD patients. We have found the SCL‐90‐R subscale of phobic anxiety and the BSI‐18 somatization subscale most clinically valid when measuring psychological distress in PD patients. HighlightsSomatization was the most intense symptom of psychological distress.Phobic anxiety is a clinically significant consequence of Parkinsons disease.Psychological distress reached a prevalence of 36.4% in Parkinsons disease.The somatization subscales in the BSI‐18 and SCL‐90‐R were both clinically valid.The SCL‐90‐R phobic anxiety subscale is more valid than the BSI‐18 anxiety factor.