Search

Current pharmacological treatments for major depressive disorder (MDD) are often only partially effective, with many patients experiencing no significant benefit, leading to treatment-resistant depression (TRD). Psilocybin, a classical serotonergic psychedelic, has emerged as a notable emerging treatment for such disorders. The aim of this systematic review and meta-analysis is to summarize and discuss the most recent evidence about the therapeutic effects of single-dose and two-dose psilocybin administration on the severity of depressive symptoms, as well as compare the efficacy of these interventions among patients with a primary diagnosis of MDD or TRD. Articles were collected from EBSCOhost and PubMed following the PRISMA guidelines, yielding 425 articles with 138 duplicates. After screening 287 records, 12 studies met the eligibility criteria and were included in the review. A quantitative analysis of the studies indicates that psilocybin is highly effective in reducing depressive symptoms severity among patients with primary MDD or TRD. Both single-dose and two-dose psilocybin treatments significantly reduced depressive symptoms severity, with two-dose administration sometimes yielding more pronounced and lasting effects. However, it is unclear if this was solely due to dosage or other factors. Future research should include standardized trials comparing these dosing strategies to better inform clinical practice. [ABSTRACT FROM AUTHOR]

The utilization of non-invasive neurostimulation techniques, such as transcranial magnetic stimulation (TMS), is increasingly prevalent in psychiatry due to their efficacy and safety. Although the precise therapeutic mechanisms remain partially unclear, repetitive TMS, particularly high-frequency stimulation, may enhance cognitive functions, contributing to therapeutic benefits. This within-subjects study examined the impact of TMS on cognitive and symptomatic outcomes in patients with obsessive–compulsive disorder (OCD), substance use disorder (SUD), and major depressive disorder (MDD). A total of 44 patients underwent cognitive tests and symptom assessments before and after an intensive four-week TMS treatment phase, followed by a four-week maintenance phase. Cognitive assessments included Raven's matrices, verbal fluency, and digit span tests, while symptom severity was measured using the Italian version of the SCL-90-R. Decision-making performance was also evaluated by administering a delay discounting (DD) test. Principal component analysis was used to generate a dimensional characterization of subjects along cognitive and symptom-related axes before and after treatment. The results indicated that TMS significantly improved symptom scores, but no significant cognitive enhancement was observed. Statistical analysis based on linear mixed-effects models confirmed these findings, showing a significant fixed effect of TMS treatment on symptoms but not on cognitive performance. DD metrics remained unchanged. These findings suggest that while TMS effectively alleviates clinical symptoms, it does not produce consistent or appreciable enhancement of cognitive functions in these protocols. This study highlights the need for more personalized and combined therapeutic approaches to maximize the benefits of TMS, potentially incorporating cognitive enhancement strategies. Future studies will be useful to explore whether the results we obtained are valid for other pathologies, cognitive tests, and stimulation protocols. [ABSTRACT FROM AUTHOR]

A PTSD subtype with dissociative symptoms (D-PTSD) was included in the DSM-5 recognizing the existence of a more severe form of PTSD, associated to past trauma, high comorbidity, and complex clinical management. As research is rapidly growing and results are inconsistent, a better investigation of this subtype is of primary importance. We conducted a systematic review of studies using Latent Profile Analysis to investigate the existence of a D-PTSD subtype. Covariates of D-PTSD were included, to understand additional symptoms, risk factors and comorbidities. The search was performed on PubMed, EBSCOHost, and PTSDPubs according to 2020 PRISMA guidelines. Eligible articles assessed trauma exposure, PTSD symptoms and diagnosis, and dissociation, in adult samples. 13 of 165 articles met the inclusion criteria. All identified a dissociative subtype of PTSD, mainly characterized by higher levels of depersonalization and derealization. D-PTSD profile sometimes presented other dissociative symptoms, such as gaps in awareness and memory, other comorbid disorders, and a history of abuse. Despite some limitations, this review supports the existence of a dissociative subgroup of individuals among those with PTSD. More rigorous studies are needed to clarify these findings and their clinical implications. [ABSTRACT FROM AUTHOR]

First-line treatments for post-traumatic stress disorder (PTSD) encompass a wide range of pharmacotherapies and psychotherapies. However, many patients fail to respond to such interventions, highlighting the need for novel approaches. Due to its ability to modulate cortical activity, non-invasive brain stimulation (NIBS) could represent a valuable therapeutic tool. Therefore, the aim of this systematic review is to summarize and discuss the existing evidence on the ameliorative effects of NIBS on PTSD and comorbid anxiety and depressive symptoms. Our goal is also to debate the effectiveness of an integrated approach characterized by the combination of NIBS and psychotherapy. This search was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines in the PubMed, PsycINFO, PsycARTICLES, PSYINDEX, MEDLINE, and ERIC databases. Overall, 31 studies met the eligibility criteria, yielding a total of 26 clinical trials employing transcranial magnetic stimulation (TMS) and 5 making use of transcranial direct-current stimulation (tDCS). From these studies, it emerged that NIBS consistently reduced overall PTSD symptoms' severity as well as comorbid anxiety and depressive symptoms. Moreover, we speculate that combining NIBS with prolonged exposure or cognitive processing therapy might represent a promising therapeutic approach for consistently ameliorating subjects' clinical conditions. [ABSTRACT FROM AUTHOR]

Sustainability rating systems for the built environment involve a multitude of indicators that are based on different types of data. This work capitalizes on an existing multicriteria assessment method and supporting decision-making tool at building and neighbourhood scale, to develop an enhanced method and tool at city scale. The main sustainability issues at building and city scales include site and infrastructure, energy and resources consumption, environmental loadings, climate change, environmental quality, water, waste, transportation, services, social aspects, economy and governance. Approximately 300 indicators distributed among the different scales are used to describe and quantify the various facets of sustainability. Specifically, the building scale includes a pool of 80 indicators of which 17 are key performance indicators (KPIs), the neighbourhood scale has 133 indicators of which 14 are KPIs and the city scale has a total of 99 indicators of which 10 are KPIs that were new additions to the existing method. The emphasis in this paper is given on elaborating the key performance indicators for cities and demonstrating their applicability through a case study. The common method and tools provide a flexible assessment system for local authorities and stakeholders to develop and assess sustainability plans. [ABSTRACT FROM AUTHOR]

Our research explores the causes of Twitter activity in highly technological start‐ups that finance their activities via initial coin offerings (ICOs). By relying on weekly data of 297 ICOs for the period 2015–2020 (35,459 observations), we examine how major exogenous events affect the number of tweets issued by the start‐up. Then, we explore how the community of followers reacts to the tweets. We discover that events external to firms reduce ICOs' tweeting activity. Moreover, our evidence indicates that the followers' reaction is positively related to the tweets issued by the firm and negatively related to major events unrelated to the firm. Interestingly, followers' reaction has an inverted U‐shaped relation with the firm's Twitter volume, suggesting that excessive Twitter activity can harm the further dissemination of tweets. Our results, robust to alternative estimation techniques, emphasize the important role of Twitter as an information disseminator, legitimizer, and endorser for highly opaque firms. [ABSTRACT FROM AUTHOR]

An editorial is presented on the implications of nursing work organization in Italian hospitals on job satisfaction, nurse well-being, and patient safety. Topics include the nurse-to-patient ratio, the impact of functional nursing care delivery models, missed nursing care and efforts to improve working conditions and patients' outcomes through person-centered care models and nursing-sensitive outcomes.