Federica Ricci

Insomnia as a predictor of high-lethality suicide attempts.

Research has demonstrated that patients with insomnia are at an increased risk of experiencing suicidal ideation and/or making a suicide attempt.

Bereavement after the suicide of a significant other

Context: It is estimated that approximately one in four people know someone who has taken their own life and that one suicide death leaves six or more suicide survivors. Aims: The aim of this paper was to review the literature regarding the association between suicide and bereavement, focusing also on the supportive and therapeutic resources available for survivors. Materials and Methods: Careful MedLine and PsycINFO searches for the period 1980-2013. Results: The review of the literature indicates that emotional turmoil in suicide survivors may last a long time and, in some cases, may end with their own suicide. Conclusion: Future research should evaluate the efficacy of professional treatments and of support groups targeting suicide survivors. Practice Implications: It is crucial to understand the bereavement process after the suicide of a significant other in order to provide proper care, reduce stigma, and improve the outcomes of related psychiatric conditions.

Psychometric properties of the stagnation scale in medication overuse headache patients.

BackgroundMedication-overuse headache (MOH) is often comorbid with emotional disturbances, contributing to poorer outcomes. The aims of the present study were to assess the psychometric properties of the Stagnation Scale in a sample of MOH patients, and to compare two factor models: a three-factor model reported in previous studies and a proposed bi-factor model.MethodsConsecutive adult outpatients (N = 310) admitted to the Regional Referral Headache Centre of the Sant’Andrea Hospital in Rome (Italy) were administered the Stagnation Scale and two questionnaires measuring depression and perceived disability.ResultsThe original three-factor model demonstrated an adequate fit to the data (χ2101 = 238.70; p < 0.001; Root Mean Square Error of Approximation [RMSEA] = 0.07; 90% CI of RMSEA = 0.06 / 0.08; Comparative Fit Index [CFI] = 0.98; Weighted Root Mean Square Residual [WRMR] = 0.75). However, the bi-factor model had a comparable or even better fit, with a RMSEA of 0.05 (90% CI: 0.04 / 0.07), providing strong evidence for an absolute fit to the data (χ288 = 161.43; p < 0.001; RMSEA = 0.05; 90% CI of RMSEA = 0.04 / 0.07; CFI = 0.99; WRMR = 0.56). The stagnation general factor and all the group factors correlated significantly and positively with convergent measures.ConclusionsThere is support for the use of the Stagnation Scale in MOH patients, with the goal of better understanding the role of psychological factors in the evolution and course of the disorder.

Pharmacotherapy in bipolar disorders during hospitalization and at discharge predicts clinical and psychosocial functioning at follow-up.

Individuals with bipolar disorder (BD) usually report significant disability and psychosocial impairment. Both the nature and causes associated with this impairment are poorly understood. In particular, research examining the impact of pharmacotherapy on the different aspects of psychosocial functioning in bipolar patients is currently lacking. The aim of this study was to assess to what extent the psychotropic medications used during psychiatric hospitalization and at discharge can predict clinical psychosocial functioning and the severity of the illness at follow‐up in inpatients with bipolar disorder (BD).

Factorial validity of the Childhood Trauma Questionnaire in Italian psychiatric patients

Early adverse experiences are associated with neurobiological changes and these may underlie the increased risk of psychopathology. The Childhood Trauma Questionnaire (CTQ-SF) is the most commonly used instrument for assessing childhood maltreatment. Thus, the aim of our study was to investigate the factorial validity of an Italian version of the CTQ-SF in a sample of psychiatric inpatients by means of confirmatory and exploratory factor analyses. The sample was composed of 471 psychiatric in-patients and out-patients (206 males and 265 females) aged 16-80 years (mean age=34.4 years [SD=16.3]) consecutively admitted to two psychiatric departments. All patients were administered the Italian version of the CTQ-SF. We tested five different factor models which lacked good fit, while the exploratory factor analysis supported the adequacy of a solution with three factors (Emotional Neglect/Abuse, Sexual Abuse, Physical Neglect/Abuse). The three factors had satisfactory internal consistency (ordinal Cronbach alphas >0.90). Our study supports results from previous research indicating the lack of structural invariance of the CTQ-SF in cross-cultural adaptations of the test, and the fact that, when measuring different types of childhood maltreatment, the difference between abuse and neglect may be not valid.

Depression and insomnia are independently associated with satisfaction and enjoyment of life in medication-overuse headache patients

Objective Medication-overuse headache is often comorbid with emotional disturbances and disordered personality traits. The aim of the present study was to determine whether depression and insomnia complaints were associated with satisfaction and enjoyment with one’s own life in medication-overuse headache patients, and whether insomnia complaints were able to explain part of the variance of Quality of Life explained by depression. Methods Participants were 187 consecutive adult outpatients admitted to the Regional Referral Headache Centre of the Sant’Andrea Hospital in Rome, Italy. Patients were administered the Quality of Life Enjoyment and Satisfaction Questionnaire, the Beck Depression Inventory – II, and the Athens Insomnia Scale. Results The Beck Depression Inventory was associated with all the dimensions of the Quality of Life Enjoyment and Satisfaction Questionnaire, with more severe depression being associated independently with lower satisfaction and enjoyment with one’s own life. The Athens Insomnia Scale was independently and significantly associated only with physical health, such that patients with more insomnia complaints were 3.1 times (p < 0.001) more likely to report lower physical health satisfaction. Conclusions Our findings confirmed that medication-overuse headache patients has a negative impact on quality of life and suggested that depression and insomnia were independently associated with satisfaction and enjoyment of life in medication-overuse headache patients. The early recognition and appropriate treatment of comorbid psychopathological symptoms are crucial to improve satisfaction and enjoyment of life in medication-overuse headache patients.

O070. The association between temperament, depression, hopelessness and quality of life in medication-overuse headache patients

of life (-.282 -.105; p <0.01) and with the risk of suicide (r: -.36; p: < .05). Particularly, subjects with suicide ideation showed higher scores on the level of depression, (t= -4.823; p: 001) hopelessness, (t= -4.261; p: 001) and emotional abuse (t= -3.526; p: 001). Conclusions Our data confirm that patients with MOH showed an anxiety-related temperament associated with high levels of depression, hopelessness and suicide risk. Suicide attempts seem to be more frequent in patients suffering from migraine than in the general population, especially in females. Suicidal ideation was associated with higher headache frequency and headache-related disability. The evidence of a possible link between chronic headache and psychiatric disorder is not a recent finding. Back in 1895, the occurring depressive mood, irritability, and anxiety in these patients [4] was described. Our findings indicate that patients with a diagnosis of MOH and migraine have severe hopelessness, and suicide risk. This evidence suggests that psychologic assessment is necessary in patients with MOH, and also that the presence of headache has to be carefully monitored in patients with mental illness. Written informed consent to publication was obtained from the patient(s).

Prognostic value of pulmonary blood volume by first-pass contrast-enhanced CMR in heart failure outpatients: the PROVE-HF study

Aims Pulmonary blood volume (PBV) is a novel clinical application of cardiovascular magnetic resonance (CMR) imaging for the quantitative grading of haemodynamic congestion. In this study, we aimed to assess the prognostic value of PBV in a cohort of outpatients with chronic heart failure (HF). Methods and results One hundred and twelve consecutive patients (91 men, 67 ± 12 years) and 53 age- and sex-matched healthy controls underwent echocardiography and contrast-enhanced CMR. PBV was calculated as the product of stroke volume and the number of cardiac cycles for an intravenous bolus of gadolinium contrast to pass through the pulmonary circulation determined by first-pass perfusion imaging. Compared with healthy controls, HF outpatients showed significantly higher PBV index (PBVI, 308 ± 92 vs. 373 ± 175, mL/m2, P = 0.012) and pulmonary transit time (6.8 ± 1.8 vs. 9.5 ± 4 s, P ≤0.001). During a median follow-up of 26 ± 17 months, 27 patients (24%) reached the composite end point of cardiovascular death, HF hospitalization, or sustained ventricular arrhythmias/appropriate implantable cardioverter-defibrillator intervention. Using a cut-off point of PBVI >492 mL/m2, corresponding to two standard deviations above the mean of healthy controls, event-free survival was significantly lower in patients with higher PBVI (P < 0.001). At multivariable-adjusted Cox regression analysis, PBVI was an independent predictor of the composite cardiovascular end point (per 10% increase hazard ratio 1.31, 95% confidence interval: 1.02-1.69, P = 0.03). Conclusions PBVI is a novel application of perfusion CMR potentially useful to quantitatively determine haemodynamic congestion as a surrogate marker of left ventricular diastolic dysfunction. PBVI might prove to be helpful in stratifying the prognosis of asymptomatic or mildly symptomatic patients with left ventricular dysfunction.

Psychopathology and Suicide Risk in Patients Suffering From Psoriasis and Other Dermatological Diseases

Introduction Psoriasis has a significant impact on the mental and emotional functioning. It has been shown that the risk of psychiatric comorbidity as well as suicide risk increases with the severity of the disease. Objectives To analyze the association between psoriasis, mental disorders and suicidal ideation in a sample of patients affected by psoriasis. Aims To analyze the differences between patients affected by psoriasis and patients with other dermatologic diseases. Methods we enrolled 157 consecutive patients (90 women and 67 men), mean age 50,15 years (±16,21); 91 affected by psoriasis (58.0 %), 35 by melanoma (22.3 %) and 31 with atopic dermatitis (19.7%). All participants completed a structured sociodemographic interview. We also administered the following rating scale: Hamilton Rating Scale for Depression (HAM- D) and the Hamilton Rating Scale for Anxiety (HAM -A). We assessed current and prior suicidal ideation and the number of previous suicide attempts. Results Patients with psoriasis, more frequently had a comorbid psychiatric disorder (38.5% vs 16.7 %, p Conclusions The clinical evaluation of patients with psoriasis should include the assessment of psychiatric comorbidities and the routine assessment of suicide risk.

EPA-1202 – The role of a telephone helpline in the prevention of suicide during economic crisis in italy

Introduction The Lifeline’Talk With Us’ was founded in 2008 by Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Italy, to provide free and confidential emotional support to people in suicidal crisis. Objective In this study we evaluated the socio demographic profile of individuals who used the helpline during last year (2012–2013) and callers intent to die at the end of the call. Aim To investigate suicide risk factors among the callers and the association with the socio-economic status. Method Using a standardized form, we assessed suicide risk in a sample of 228 callers (120 female) focusing on Suicidal Desire, Suicidal Capability, Suicidal Intent. Results The mean age of our sample was 41±14,8; most callers (52%) were female from north and central of Italy. Suicide risk factors in our sample were the following: feeling alone, loss of a significant relationship, economic problems, loss of a significant loved one by suicide. Suicide attempts were reported by 27% of participants whereas 16,8% of them referred suicidal ideation. Unemployment was found in 22% of the callers whereas 42% of them referred suicide attempts, and 25% suicidal ideation. Conclusion This study shows the importance to provide an accessible volunteer service for people who are in crisis, present suicidal ideation or reported prior suicide attempts. In particular, our service was very important for those who were in economic crisis, as demonstrated by our data. Improving the quality of the existing services, and promoting awareness that suicide prevention is possible are highly recommended.