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Delirium is a phenomenon classified within neuro-cognitive disorders in the DSM-5. It has several etiologies and it is often lethal. This contribute aims at analyzing clinical characteristics and diagnostic possibilities of delirium in patients affected by covid-19. Furthermore, some preliminary recommendations on the use of psychopharmacological treatment of delirium and their interactions with main drugs used to treat covid-19 are given, with a special attention to comorbidities like in immunocompromised patients, in those affected by diabetes and cancer, in pregnant women or in addicted clients.

Introduction. Intimate partner violence (IPV) is a relevant public health issue due to its consequences on physical and mental health (mainly depression and post traumatic stress disorder) and then on the healthcare system. Aims. The main goal of this study is to evaluate the prevalence and consequences of IPV in a sample of women admitted to an outpatient clinic for anxiety and depression (VADEMECUM). Materials and methods. We conducted a cross-sectional study with 150 patients who entered the aforementioned outpatient clinic of the ASST San Gerardo Hospital in Monza (Italy) during the period October 2016-May 2017. All participants completed a screening questionnaire investigating IPV and the K6 questionnaire as index of psychological distress. Results. Among 150 women, 36 (24%) were victims of IPV: 35 with emotional abuse, 23 with physical abuse, and 7 with sexual abuse. In the "abused" group, 80% of women had psychic and physical health consequences, whilst 53% requested help from relatives/friends and/or healthcare staff. Conjugal status (p=0.024), voluntary pregnancy interruptions (p=0.015), anxiety episodes history (p=0.028), previous or current psychological treatment (p=0.001 and p=0.036, respectively), (K6) levels of psychological distress (p=0.0004) and child abuse (p=0.012) were significantly associated with IPV. Conclusions. "Abused" women have positive psychiatric history of anxiety, greater demand for psychological care, child abuse and worst psychological distress status compared to "not abused". This evidence as well as the high IPV prevalence found in our study suggest the need for appropriate screening and specific treatment pathways in psychiatric services.

Background: The current COVID-19 pandemic and the consequent containment measures are leading to increasing mental health issues both in psychiatric patients and general population. Objective: We aimed to compare the number and characteristics of emergency psychiatric consultations during the phase 1 of lockdown with respect to the same period in 2019 in a Department of Mental Health and Addiction (DMHA) located in Lombardy region. Methods: We conducted a cross-sectional study including subjects consecutively admitted to two psychiatric emergency rooms of DMHA in Monza, Lombardy, Italy. Sociodemographic data, clinical characteristics, referred symptoms, diagnosis and information on patients' illness course following the emergency consultations were collected. No subjects were excluded for the purposes of the study. Results: Between February 21st and May 3rd 2020, there was a marked reduction in the number of psychiatric emergency consultations, if compared to the same period of 2019. Subjects who were living in psychiatric residential treatment facilities, had cannabis addiction and a diagnosis of obsessive-compulsive disorder were significantly more likely to present to emergency psychiatric consultations during lockdown. Conclusions: COVID-19 epidemic may have a negative impact on more vulnerable individuals. Strategies to enhance relapse prevention and the use of alternative approaches as e-health technologies should be promoted.

AIMS: Longitudinal description of a clinical case of a woman with Chromosome 22 deletion syndrome (22q11.2DS), mild intellectual disability (ID) and associated psychiatric disorders, treated at "Adolescent Outpatient Service", at the ASST Monza DSMD from 2011 to 2017. METHODS: Assessment Test Tools. T0 (2011): WAIS-R; SCID-I; Vineland Scale; SPAIDD-G; SPAIDD-Follow-up. T1 (2013): SPAIDD-Follow-up. T2 (2015): SPAIDD-Follow-up. T3 (2017): SCID-I; Vineland Scale; SPAIDD-Follow up. Pharmacological psychiatric treatment: Shift from haloperidol 1 mg, sertraline 100 mg to aripiprazole 15 mg, venlafaxine 150 mg. Psychoeducational psychological treatment: 1 session every 15 days; support to family. RESULTS: (2011) WAIS-R: slight ID (total IQ 67, verbal IQ 73, performance IQ 67); SCID-I: subthreshold psychotic symptomatology, panic attack disorder with agoraphobia, obsessive-compulsive disorder (OCD) with trichotillomania; Vineland Scale: Communication 256/266, Daily Skills 267/402, Socialization 202/268, Motor skills 111/144; SPAIDD-G: OCD; SPAIDD-Follow up: aggression, psychomotor agitation, somatic complaints, impulsivity, oppositional behaviour, stereotypes, depressed mood, compulsions. (2017) SCID-I: OCD with trichotillomania; Vineland Scale: Communication 248/266, Daily Skills 312/402, Socialization 226/268, Motor skills 136/144; SPAIDD-Follow-up: stereotypes and compulsions persist. DISCUSSION AND CONCLUSIONS: There was no transition to psychosis in the follow-up; OCD and trichotillomania persists, probably related to neurodevelopmental alterations, that are difficult to be modified. In 22q11.2DS patients, standard non-pharmacological treatment strategies (CBT) are difficult to apply, but in the present case the combination of pharmacological and psychoeducational psychological treatment was effective, both for the reduction of symptoms and for the acceptance of ID by patient and family.

Aim: This review aims to examine the recent literature on the topic of intimate partner violence (IPV) in order to provide definitions, Italian and international prevalence data, prevalence data in special populations (such as patients with severe mental illness), investigations into risk factors (alcohol, substances, child abuse) and the consequences on general and mental health. Methods: Free search has been used in Medline/PubMed with key words ((“Mental Disorders” [Majr]) AND “Crime Victims” [Majr: NoExp]) AND ((“Domestic Violence” [Majr]) OR “Intimate Partner Violence” [Majr]) and in PsychInfo with MJSUB.EXACT.EXPLODE (“Victimization”) AND MJSUB.EXACT.EXPLODE (“Mental Disorders”) AND (MJSUB.EXACT.EXPLODE (“Intimate Partner Violence”) OR MJSUB. EXACT.EXPLODE (“Domestic Violence”)). Results: 219 publications in PubMed (during the last 10 years) and 48 in PsychInfo concerning IPV and mental disorders; National websites (e.g. ISTAT, Office for National Statistics) have provided updated epidemiological data. Discussion: In many countries, IPV and domestic violence are subject to national surveys, but scientific research on the topic mainly involves England and the United States, in order to establish the possible correlations between IPV, mental disorders and risk factors. Alcohol and substance use disorders and childhood abuse are the most risk factors related to IPV. This type of violence is a major public health problem, also in economic terms, for its consequences on physical and mental health. The WHO in 2011 developed some guidelines for health professionals on how to respond adequately to violence from an intimate partner and to sexual violence against women. Conclusions: In the light of the importance of violence between partners, the health and academic institutions have the task of framing the phenomenon in epidemiological and clinical terms, providing updated research data to the stakeholders, in order to improve the treatment and prevention practices.

L’11 marzo 2020 l’Organizzazione Mondiale della Sanità (OMS) dichiara la malattia da nuovo coronavirus 2019 (COVID-19) una pandemia globale e la Lombardia risulta fin da subito la regione italiana più drammaticamente colpita. L’impatto della pandemia e del lockdown, in termini di conseguenze sulla salute mentale di pazienti, cittadini e operatori sanitari è ormai noto, ampiamente discusso e universalmente descritto, anche in luoghi e Paesi culturalmente e socialmente molto diversi tra di loro. Tutto ciò ha condotto a profondi cambiamenti nell’organizzazione dei Servizi ad opera dei Dipartimenti di Salute Mentale e Dipendenze (DSMD) e si è globalmente assistito, soprattutto in una fase iniziale, ad una contrazione delle prestazioni erogate (sia ospedaliere che territoriali) e ad un incremento degli interventi erogati in modalità telematica, con la definizione di procedure, linee guida e modalità operative alternative nei diversi Servizi afferenti ai DSMD. In questo lavoro vengono descritti alcuni esempi dei cambiamenti avvenuti all’interno del DSMD dell’ASST di Monza nel periodo marzo-maggio 2020. La ricaduta sul lungo periodo in termini psicopatologici e psicosociali di un evento di tale portata rimane complessa e, ad ora, solo in parte prevedibile in relazione alla sua evoluzione nel prossimo futuro: tale esperienza porrà nuove e fondamentali sfide ai Dipartimenti di Salute Mentale e, più in generale, ai Servizi sanitari, che si troveranno a ridefinire priorità e a rimodulare piani di intervento che consentano una rapida riorganizzazione in caso di nuove circostanze emergenziali ed il reperimento di risorse in grado di garantire interventi più rapidi, appropriati ed efficaci.