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Objective: To highlight the characteristics of eating disorders (ED) in males, with particular attention to sex-related clinical features and psychiatric co-morbidities. Method: Out of 280 persons, referred to our outpatients ED clinic between January 2011 and June 2014, 267 with complete information were included in this retrospective observational study. Results: The men/women ratio was one to five (male 16.5% vs female 83.5%) with an increasing proportion of male patients over the years. The most frequent ED in males was binge eating disorder, whereas in females anorexia nervosa and bulimia nervosa prevailed. Excessive exercising and fasting were the most common compensation behaviours in males; while self-induced vomiting and laxative–diuretic abuse were more typical in females. Among women, the most represented psychiatric co-morbidities were mood and somatoform disorders, whereas among men, anxiety and psychosis spectrum disorders were the most frequent ones. Borderline and histrionic personality disorders were prevalent in female ED, while narcissistic and antisocial personality disorders prevailed in males. Discussion: ED in men is a growing phenomenon. Male ED, compared to female ED, show differences in clinical presentation, symptoms and co-morbidities. Despite the use of clinical and psychometric evaluating tools targeting female patients, sex differences do exist and additional studies are required to investigate male specific issues in ED. Level of Evidence Level V, cross-sectional descriptive study.

Although in recent years substance addiction prevention programs and practices have increased, the majority of cases for these activities, in particular proximity interventions, lack the implementation of adequate assessment processes. This is also due to the absence of evaluation procedures and shared theoretical reference models. This study constitutes the first step of a larger research project aimed at assessing the effects of proximity interventions. In particular, the study describes the relationship among the frequency of substance intake or implementation of problem behaviour, stage of change as well as factors of vulnerability and protection. The study also demonstrates that the evaluation system adopted is able to detect the differences between various periods of change of course in which the frequency of problematic behaviour assumes significance in relation to psychological variables and context.

Adolescence is a hazardous bridge between childhood and adulthood representing one of the more complex phases of human development. During the “teen years” childhood experiences sediment to become the foundation of the adult identity. In this transitional period brains are particularly sensitive to surrounding influences. Digital natives, especially during adolescence, are in between new risks (hyper-connection and Internet addiction, Web-based unhealthy lifestyle promotion, cyberbullying, grooming) and new opportunities (Web-based professional help). Since the most of mental disorders start by the mid-teens and the mid-20s, and as less than half of adolescents with mental health problems receive an appropriate care, there’s a strong need for developing a proper digital education encompassing families, institutions, media, and therapists.

Objective Previous studies on cognitive deficits in acute and remitted states of old-age depression have shown mixed findings. The episodic nature of depression makes repeated assessment of cognitive performance important in order to address reversibility and stability of cognitive deficits. Methods Dementia-free older participants (≥60 years) from the population-based Swedish National Study on Aging and Care in Kungsholmen who completed neuropsychological testing at baseline (T1) and follow-up (T2) formed the basis of the study sample. Participants were grouped according to depression status at T1 and T2: depressed–remitted (n = 32), remitted–depressed (n = 45), and nondepressed–depressed (n = 29). These groups were compared with a group of randomly selected and matched (age, gender, education, and follow-up time) healthy controls (n = 106) over a period of maximum 6 years. Results Mixed ANCOVAs, controlling for age and gender, revealed depression-related deficits for processing speed, attention, executive function, and category fluency. In remitted states, only processing speed and attention were affected. However, these deficits were attenuated after exclusion of persons using benzodiazepine medications. A general pattern of cognitive decline was observed across all groups for processing speed, executive function, category fluency, and episodic and semantic memory; persons transitioning from a nondepressed to depressed state tended to show exacerbated cognitive decline. Conclusions The results support the notion that cognitive deficits in depression may be more transient than stable. Consequently, cognitive deficits in depression might be regarded as potential treatment targets rather than stable vulnerabilities. As such, repeated assessment of cognitive functioning may provide an additional marker of treatment response.

Background The purpose of the study was to evaluate in a sample of insulin-treated diabetic patients, with type 1 or type 2 diabetes, the psychometric characteristics of the Italian version of the DEPS-R scale, a diabetes-specific self-report questionnaire used to analyze disordered eating behaviors. Methods The study was performed on 211 consecutive insulin-treated diabetic patients attending two specialist centers. Lifetime prevalence of eating disorders (EDs) according to DSM-IV and DSM-5 criteria were assessed by means of the Module H of the Structured Clinical Interview for DSM IV Axis I Disorder and the Module H modified, according to DSM-5 criteria. The following questionnaires were administered: DEPS-R and the Eating Disorder Inventory – 3 (EDI-3). Test/retest reproducibility was assessed on a subgroup of 70 patients. The factorial structure, internal consistency, test-retest reliability and concurrent validity of DEPS-R were assessed. Results Overall, 21.8% of the sample met criteria for at least one DSM-5 diagnosis of ED. A “clinical risk” of ED was observed in 13.3% of the sample. Females displayed higher scores at DEPS-R, a higher percentage of at least one diagnosis of ED and a higher clinical risk for ED. A high level of reproducibility and homogeneity of the scale were revealed. A significant correlation was detected between DEPS-R and the 3 ED risk scales of EDI-3. Conclusions The data confirmed the overall reliability and validity of the scale. In view of the significance and implications of EDs in diabetic patients, it should be conducted a more extensive investigation of the phenomenon by means of evaluation instruments of demonstrated validity and reliability. Electronic supplementary material The online version of this article (doi:10.1186/s12888-017-1434-8) contains supplementary material, which is available to authorized users.

Objective The worldwide phenomenon of an aging population combined with the increasing prevalence of depression in late life are issues that need to be addressed. This study aims to estimate the frequency of depression and subthreshold depression occurring in a sample of cognitively well-functioning, community-dwelling, older Italian adults and to investigate sociodemographic and clinical correlates of depression, exploring gender differences. Methods We used a cross-sectional analyses of survivors in a population-based study (the Faenza Project) that included 359 subjects aged 74 years and older (49.3% women). A modified version of Cambridge Examination for Mental Disorders of Elderly Persons-Revised was administered to all participants. Prevalence rates of depression and 95% confidence intervals (CIs) were estimated according to International Classification of Diseases, Tenth Revision criteria. Statistical analyses were implemented to describe sociodemographic and clinical features associated with depression. Odds ratios were estimated by multivariate logistic regression, and the dependant variable was any type of depression. Results Overall prevalence of depression was 25.1% (95% CI: 20.6–29.6), with no evidence of gender difference. Prevalence of mild, moderate, and severe depression was 16.4% (95% CI: 12.6–20.2), 7.5% (95% CI: 4.8–10.2), and 1.1 (95% CI: –0.4–2.6), respectively. A rate of 5.6% of the population complained of subthreshold depressive symptoms. After age 81, depression occurrence decreased as age increased. The association between depression and functional measures, such as primary activity, mobility, and disability in performing household chores, were stronger in men than in women. Similarly, severely disabling conditions like stroke were more strongly associated with depression in men than in women. Conclusion Our data suggest a disparity between men and women regarding the impact of depression on everyday life. Specific gender differences need to be taken into account for the evaluation of the depression-related burden in late life.

BackgroundThere is substantial variability in the degree of cognitive impairment among older depressed persons. Inconsistencies in previous findings may be due to differences in clinical and demographic characteristics across study samples. We assessed the influence of unipolar depression and severity of depression on cognitive performance in a population-based sample of elderly persons aged ⩾60 years.MethodEighty-nine persons fulfilled ICD-10 criteria for unipolar depression (mild, n = 48; moderate, n = 38; severe, n = 3) after thorough screening for dementia (DSM-IV criteria), psychiatric co-morbidities and antidepressant pharmacotherapy. Participants (n = 2486) were administered an extensive cognitive test battery.ResultsModerate/severe unipolar depression was associated with poorer performance on tasks assessing processing speed, attention, executive function, verbal fluency, episodic memory and vocabulary. Mild depression was associated with poorer performance in processing speed, and few differences between mild and moderate/severe depression were observed. No association between depression and short-term memory, general knowledge or spatial ability was observed. Increasing age did not exacerbate the depression-related cognitive deficits, and the deficits remained largely unchanged after excluding persons in a preclinical phase of dementia. Furthermore, depression-related cognitive deficits were not associated with other pharmacological treatments that may affect cognitive performance.ConclusionsCognitive deficits in unipolar old-age depression involve a range of domains and the cognitive deficits seem to follow the spectrum of depression severity. The finding that mild depression was also associated with poorer cognitive functioning underscores the importance of detecting mild depression in elderly persons.

The KIBRA (rs17070145) C-allele and the CLSTN2 (rs6439886) T-allele have both been associated with poorer episodic memory performance. Given that episodic memory is affected in depression, we hypothesized that the combination of these risk alleles would be particularly detrimental to episodic memory performance in depressed persons. In the population-based SNAC-K study, 2170 participants (≥ 60 years) without dementia (DSM-IV criteria) and antidepressant pharmacotherapy were clinically examined and diagnosed following ICD-10 criteria for unipolar depression, and genotyped for KIBRA and CLSTN2. Participants were categorized according to unipolar depression status (yes, no) and genotype combinations (KIBRA: CC, any T; CLSTN2: TT, any C). Critically, a three-way interaction effect showed that the CC/TT genotype combination was associated with poorer episodic recall and recognition performance only in depressed elderly persons, with depressed CC/TT carriers consistently performing at the lowest level. This finding supports the view that effects of genetic polymorphisms on cognitive functioning may be most easily disclosed at suboptimal levels of cognitive ability, such as in old-age depression.

A recent population study has shown that among people manifesting a disorder related to alcohol and other substances, 28.6% and 47.7% respectively had at least one personality disorder (PD). Numerous sample studies have highlighted the presence of PDs in the drug-addicted population, estimating prevalence rates ranging from 44% to 79%. The most frequent PDs in the clinical sample were antisocial, borderline, avoidant, and paranoid PDs. Various types of relationship between addiction and PDs can be hypothesized: a common etiology (biological or psychic), an etiological relationship (predisposed personality or self-medication hypothesis), or one that is influenced reciprocally. PD comorbidity is associated with a spectrum of substance-correlated disorders, which are more chronic and severe and require many long-term therapeutic programs. Various psychotherapeutic treatments have proven to be efficacious with respect to reducing personality pathology and improving social functioning. This is especially true for cognitive-behaviorally or psychodynamically oriented individual psychotherapies. Considering the models of services organization, dual diagnosis patients can be better treated by using an integrated model with approaches that bridge the gap between the psychiatric and addiction services.

Aims: This article aims to (1) explore the levels of perceived insecurity in a sample of patients with mood or anxiety disorders and (2) assess whether living in ‘big cities’ can influence the levels of patients’ perceived insecurity and social contacts compared to living in a non-urbanized context. Methods: A total of 24 Italian mental health centers (MHCs) have been invited to participate. Twenty patients consecutively accessing the MHC have been recruited. All patients have been assessed using validated assessment tools. Results: The sample consisted of 426 patients, mostly female, with a mean age of 45 years. Globally, 52.2% of patients had a diagnosis of mood disorders, and 37.8% had anxiety disorders. Half of the sample declared that the main feeling toward life is uncertainty; higher levels of pessimistic views toward life have been detected in patients living in urban areas. A positive association between negative attitudes toward life and higher levels of depressive and anxiety symptoms, poor social functioning and higher levels of perceived psychological distress has been found. Conclusion: Our findings confirm the presence of a common sense of perceived uncertainty among our sample. Such attitude toward life can have a detrimental impact on patients’ psychological and physical well-being, contributing to high levels of distress.

IntroductionEating disorders (ED) and personality disorders (PD) are often interplayed in every-day clinical practice. Less is known on patient's emotional deregulation and impulsivity.AimsTo investigate whether clinical features of ED and PD correspond to a specific impulsivity and emotional background pattern.ObjectiveED, PD, impulsivity and emotional regulation.MethodsA group of outpatients with ED (n = 39) was compared to a group of healthy controls (n = 40) by means of semi-structured interviews and standardized questionnaires (BIS-11, DERS, Eat-26, SCID-II and STAI), in order to evaluate association between clinical features (ED and PD) and altered impulsivity or/and emotion regulation.ResultsSeventy-five percent of ED cases matched also diagnostic criteria for PD. Cluster B diagnoses occurred more frequently in Bulimia Nervosa (BN) and Binge eating disorders (BED) whereas Cluster C PD was strongly associated with restrictive anorexia (AN-R) (P < 0.001). BIS-11 scores were significantly higher in cluster B as compared to cluster C PD (P = 0.019). People with PD have a significantly higher DERS score compared to people without (P < 0.001). Mean DERS scores were similar in BN, BED and AN Binge purging (AN-BP) but lower in AN-R (P < 0.001).ConclusionsED is an iceberg top, of a three-step ladder. The intermediate step is built of personality traits and disorders forging the variety of ED clinical expressions. The hidden base of iceberg is represented by both the emotional (de)regulation and the level of impulsivity. Therapies focused on the base of this iceberg are needed for a clinical resolution of eating symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionGender is crucial in many aspects of life, including attitude towards body image perception. Although the well-known female preponderance, recent studies demonstrate an increasing Eating Disorders (EDs) incidence in males but scant literature attention.AimsThis study aims to highlight the growing phenomenon of EDs in males and shed light on sex-related clinical features and psychiatric comorbidities.MethodOut of 280 persons aged 18–74, consecutively referred to Bologna's outpatients EDs clinic, 267 were included in this retrospective observational study.ResultsThe men/women ratio was one to five. The most frequent EDs in males was Binge Eating Disorder, whereas in females Anorexia Nervosa and Bulimia Nervosa prevailed. Excessive exercising and fasting were the most common dysfunctional behaviors in men, while self-induced vomiting and laxative-diuretic abuse were more typical in women. Mood and Somatoform Disorders were more common in women, whereas Anxiety and Psychosis Disorders in males. Within personality disorders, borderline and histrionic prevailed in female, while narcissistic and anti-social in males.ConclusionsMale compared to female EDs, show differences in clinical presentation, symptoms and comorbidities. The increased proportion of affected men should alert general practitioners, clinicians and psychologists working in non-specialized settings to be more aware of the possibilities of encountering an ED in men and of the need of exploring the eating habits in all male patients. The finding of a more pronounced physical hyperactivity in men in order to achieve an ideal body shape which is muscular and athletic suggests the need of a deeper attention to sex-different symptoms and behaviors declination.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Background: This study aims to detect the impact of stroke on the occurrence of dementia and cognitive impairment/no dementia (CIND) in different age, sex, and education groups. Methods: Persons with dementia (DSM-III-R) or CIND were identified by a two-phase study design among 7,930 persons from the population-based Faenza Community Aging Study. Results: Subjects with a history of stroke had increased risk of both dementia [risk ratio (RR) = 3.7; 95% confidence interval (CI) = 3.1–4.4] and CIND (RR = 1.7, 95% CI = 1.4–2.2). These associations were stronger in the younger-old (61–74 years) than in the older-old (75+ years), and among higher-educated (4+ years) than lower-educated (0–3 years of schooling) persons. Dementia and CIND prevalence among stroke subjects was similar to the prevalence detected among subjects 10 years older but without a history of stroke. In stroke subjects, dementia prevalence became higher than CIND prevalence 10 years earlier than in non-stroke subjects. A combined effect for dementia due to a history of stroke, increasing age, and decreasing years of schooling was detected. Conclusions: Stroke is a strong risk factor for dementia among younger-old and higher-educated subjects; in the presence of a stroke, dementia onset might occur about 10 years earlier, possibly by accelerating the progression from CIND to dementia.

IntroductionStressful or traumatic events occurred during childhood do have a role in the genesis of personality disorders. Less is known about this remarkable association in people with addictive behaviors.AimsThis study aims to disentangle the relationship between childhood adverse experiences, personality disorders (PDs) and substance use disorders (SUDs).MethodsA cross-sectional naturalistic study of 320 consecutive SUDs outpatients attending an Italian addiction service. Participants were clinically evaluated by a semi-structured interview, the SCID-II (Structured Clinical Interview for DSM-IV Axis II PD), and the CECA-Q (Childhood Experience of Care and Abuse-questionnaire). Multivariate logistic regression analyses were used to estimate odds ratio (OR) and 95% confidence intervals (95% CI)ResultsThe prevalence rate of PDs in our sample of patients is 62.2%. PDs were associated with a history of physical punishment in childhood (OR = 1.82; CI 95%: 1.05–3.16; P = 0.034). Being exposed to three adverse events increases the risk of Cluster B PD (OR = 5.92; CI 95%: 2.21–15.92; P < 0.001). Heroin addiction increases the risk of Cluster B PD, both as previous (OR = 2.93; CI 95%: 1.49–5.75; P = 0.003) or current (OR = 4.34; IC 95%: 1.97–11.8; P = 0.004) consumption. Childhood institutionalization increases the probability of cluster B PD (OR: 2.15; CI 95%: 1.02–4.54; P = 0.041). Whereas being employed reduces the probability of both PDs and SUDs (OR = 0.54; CI 95%: 0.31–0.93; P = 0.027).ConclusionsPDs occurred in 62% of patients and were related to adverse childhood experiences and SUDs having detrimental effects on both social and occupational functioning. Being employed could be a protective factor on the development of PDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.

One of the most consistent findings in the biology of depression is an altered activity of the hypothalamic-pituitary-adrenal (HPA) axis. However, data concerning this issue have never been examined with a focus on the older population. Here we present a systematic review and meta-analysis, based on studies investigating levels of cortisol, adrenocorticotropic hormone (ACTH) and corticotropin-releasing hormone (CRH) in depressed participants older than 60 and compared with healthy controls. We found 20 studies, for a total of 43 comparisons on different indices of HPA axis functioning. Depression had a significant effect (Hedges' g) on basal cortisol levels measured in the morning (0.89), afternoon (0.83) and night (1.39), but a smaller effect on cortisol measured continuously (0.51). The effect of depression was even higher on post-dexamethasone cortisol levels (3.22), whereas it was non-significant on morning ACTH and CRH levels. Subgroup analyses indicated that various methodological and clinical factors can influence the study results. Overall, older participants suffering from depression show a high degree of dysregulation of HPA axis activity, with differences compared with younger adults. This might depend on several mechanisms, including physical illnesses, alterations in the CNS and immune-endocrinological alterations. Further studies are needed to clarify the implications of altered HPA axis activity in older patients suffering from depression. Novel pharmacological approaches might be effective in targeting this pathophysiological feature, thus improving the clinical outcomes.

The aim of this cross-sectional study is to investigate mild cognitive impairment (MCI) using the Mini-Mental State Examination in an Italian cohort (N = 6921; mean age 71.6 ± 7.5; 59.2% women). First, we applied psychometrically derived criteria for MCI regardless of presence/absence of subjective cognitive complaints (SCC); second, we implemented the analyses only on the SCC subsample. The estimated MCI prevalence was 6.0%. Amnestic- and non-amnestic MCI single domains accounted for 4.3% and 13.5% of the cases, respectively. Amnestic- and non-amnestic MCI multiple domains occurred in 2.0% and 4.5% of the cases, respectively. The 33.8% of the SCC subsample (6.0% of the cohort) had MCI. Stroke, diabetes and depressive symptoms were commonly associated to MCI suggesting that this common condition is associated with many correlates in Italian older persons. It deserves attention since it is early detectable and potentially preventable.

OBJECTIVE: The aim of this study was to evaluate the association between vision and hearing impairment and depressive-anxiety syndrome in a large population participating in the Faenza Project, Northern Italy. METHOD: The study population consisted of 7389 participants not affected by dementia, 4408 (59.7%), of whom were women, mean age ± standard deviation (±SD) 71.9 (±7.7) years. Information about previous or current psychiatric symptoms, including sleeping and eating habits, non-verbal language and ability in activity of daily living was used to investigate depressive and anxiety syndrome. A semi-structured interview was administered to survey the presence of sensory impairment. Logistic regression analyses were used to evaluate the association between sensory impairment and depressive-anxiety syndrome estimating Odds ratio (OR) and 95% confidence interval (95% CI). RESULTS: The prevalence of vision and hearing impairment was 1.4% and 0.2%, respectively, with an increasing trend in people aged 75+ years (p < 0.001). The prevalence of depressive syndrome was higher among vision-impaired participants (20.2% vs. 9.3%, p < 0.001), especially women (22.9%) and persons aged 75+ years (22.1%). The prevalence of anxiety syndrome was higher in the hearing-impaired group (25.0% vs. 11.0%, p = 0.09). Vision-impaired participants, especially women and participants aged 75+ years had have a twofold higher probability to have depressive syndrome (OR = 2.03, 95% CI = 1.21-3.38), and hearing-impaired individuals showed an increased probability of presenting anxiety syndrome (OR = 2.71, 95% CI = 0.86-8.55), although these results were not statistically significant. CONCLUSION: This study's findings suggest that sensory impairment in older adults can increase their probability of experiencing depressive and anxiety syndrome. Correction of these deficits could improve the quality of life in this population.

Aims:To evaluate the prevalence of MCI and its subtypes in the Faenza Project, using the Mini-Mental State Examination (MMSE).Methods:Subjects living in the municipality of Faenza were clinically assessed. The diagnosis of MCI was achieved according to international criteria using a double-step procedure: first, we excluded subjects with dementia, functional impairment and MMSE< 24, leaving 6,745 persons. Then, the performance in different cognitive domains was considered and scores less than 1.5 standard deviations below the age- and education-adjusted norms on MMSE were settled as cut-offs. Four subtypes were identified: amnestic MCI, single non-memory MCI, multidomains non-amnestic, multidomains amnestic MCI.Results:2,720 (40.3%) participants met MCI criteria. Prevalence were 4% (amnestic MCI), 26.5% (single non-memory MCI), 4.4% (multidomains amnestic MCI), and 5.4% (multidomains non-amnestic MCI).Conclusions:MCI is common among Italian elderly. In our study prevalence are higher than reported in other population-based studies. The use of MMSE with different operational criteria, diverse sampling and assessment procedure might explain such discrepancy. The role of MMSE to identify persons with mild cognitive deficits deserves concerns. However, MMSE is largely used in both clinical practice and research and has been suggested as a useful screening tool for assessing the degree of cognitive impairment in the guidelines for the Report of the Quality Standards Subcommittee of the American Academy of Neurology.

In older individuals, inflammatory mechanisms have been linked to the pathogenesis of both dementia and functional impairment. In this cross-sectional study we have investigated the possible association between some markers of systemic inflammation and functional status, in a sample of one hundred and forty older demented patients including 60 patients with late onset Alzheimer's disease (LOAD) and 80 with vascular dementia (VD). Functional status was evaluated by Barthel Index (BI); the total score ranged from 0 (total dependency) to 20 (total autonomy). Interleukin-1beta, Tumor Necrosis Factor-alpha, Interleukin- 6, Interleukin- 8, and Transforming Grow Factor beta were quantified by ELISA. Among the cytokines evaluated, only IL-6 was correlated with the BI (r: -0.32, p < 0.001). The mean levels of IL-6 progressively decreased from I (9.50 pg/mL), to II (6.40 pg/mL), to III BI tertile (4.80 pg/mL) (p < 0.02). At multiple regression analysis, IL-6 was associated with BI in the whole sample and in VD, but not in LOAD, independent of age, gender, smoking, alcohol consumption, hypertension, diabetes, coronary heart disease, previous stroke, and mini mental state examination score. Our study suggests the existence of an independent and negative relationship between IL-6 plasma levels and functional status in older individuals with vascular dementia. This finding might contribute to explain the 'excess of disability' phenomenon described in older demented patients.

Introduction Cognitive symptoms in depression are associated with high distress, poor functional outcome and more relapses. Variability in cognitive deficits in depression is often reported, and may originate from numerous factors; one rarely examined factor is psychiatric history. Objectives To assess the effects of depression and severe psychiatric history on old-age cognitive performance. Methods From a sample of non-demented participants (60+ years) in a population-based study receiving neuropsychological testing, three groups were formed based on information from the Swedish national inpatient register (1969-2005): current unipolar depression (ICD-10)/no psychiatric history (n=49), current unipolar depression/psychiatric history (n=16; F10-F45, F31-31.9 excluded), remission/history of mood disorders (n=35, F31-31.9 excluded). In addition, a group of healthy controls (n=98) was randomly selected. Results Currently depressed participants without psychiatric history performed at a lower level compared to healthy controls in processing speed, attention, executive function, verbal fluency, episodic free recall and vocabulary. However, remitted participants performed at the same level as healthy controls, and outperformed currently depressed with psychiatric history in verbal fluency. No group differences were observed for short term memory, episodic recognition, general knowledge or spatial ability. Conclusions Currently depressed without psychiatric history consistently performed at the lowest level. The proportion receiving psychopharmacological treatment in this group was low, 6.1% compared to 56.2% and 37.1%, which may partially account for this finding. Additional factors potentially explaining why remitted participants and healthy controls perform at the same level cognitively will be examined. These findings may have important implications for preventing residual cognitive deficits in depression.

Introduction The Rorschach is a projective test frequently used in the forensic ambit for the information it can give in both the cognitive and affective areas. The purpose of our work is to identify the traits recurring in perpetrators of the “crime of impetus” through the examination of the psychometric indices of the Rorschach. Method 15 male subjects between 22 and 60 years (mean age = 43.2 ± 10.96 years) authors of murders, without previous psychiatric disorders, were tested; the control group was represented by 15 subjects without history of crimes. All protocols were collected and signed through the method “Scuola Romana Rorschach” and the scores of psychometric indices were compared between and within groups by Student's t-test. Results From the cognitive point of view there were no significant differences concerning the sense of reality between the murderers and control samples (R+% = 75,87 vs 70,73; p = 0,241. F+% = 75,47 vs 76,93; p = 0,653), but the number of responses was lower than average (16,67 vs 25,27; p Conclusions According to the most recent literature the Rorschach indices showed in the perpetrators of the “crime of impetus” the absence of mental disorders; however, the disproportion of the Index G/M and Impulsivity Index may indicate a “vulnerable anthropology” as a risk factor for impulsive crime in the presence of emotional stress.

Introduction Recognition of cognitive deficits in old-age depression is especially important since they contribute to poor function outcome, have strong implications for coping abilities and treatment compliance. However, substantial variability in cognitive deficits among older depressed persons has been reported. Clinical and demographic characteristics are likely to have contributed to inconsistencies in previous findings. Objective To assess effects of unipolar depression on cognitive performance in a population-based sample of elderly persons (60+ years). Methods An extensive cognitive test battery was administered. Eighty-nine persons fulfilled ICD-10 criteria for unipolar depression (mild, n=48; moderate; n=38, severe; n=3) after thorough screening for dementia (DSM-IV criteria), psychiatric comorbidities, antidepressant pharmacotherapy, and lastly preclinical dementia. Results Unipolar old-age depression was associated with deficits in processing speed, attention, executive function, verbal fluency, and episodic free recall. No depression-related deficits were observed in short-term memory, semantic memory, or spatial ability. Increasing age did not exacerbate the cognitive deficits in old-age depression. The cognitive deficits remained significant after exclusion of persons with preclinical dementia, except free recall, where performance differences were at trend level. Conclusions Cognitive deficits in unipolar old-age depression involve a number of cognitive domains, and are also present among persons with mild depression. Importantly, no statistically significant performance differences between mild and moderate/severe depression were observed. Given the prevalence of depression in older populations, the impact of this disorder on cognitive functioning may be relatively large at the population level.

Introduction Low assertiveness and difficulties in emotion's regulation can perpetuate symptoms and worsen the outcome in patients with eating disorders (ED). Objectives Cognitive-behavioral-therapy (CBT) is the most effective treatment for bulimia nervosa (BN) and binge eating disorders (BED). Group training helps patients to cope with interpersonal difficulties. Aims To examine the effects of a CBT-group-training on assertiveness, emotion's regulation and binge behaviors in patients with ED. Methods Scale for Interpersonal Behavior (Arrindell et al, 1984; Sanavio, 2002), Difficulties in Emotion Regulation Scale (Gratz et al, 2004; Sighinolfi et al, 2010), Bulimic Investigatory Test of Edinburgh (BITE) were administered at baseline and one and three months after a CBT-training to 20 patients with ED (BED, NES, BN, EDNOS) (90% women, age 25-69 years). Results Patients who took part in the training improves assertiveness and emotion's regulation. Download : Download full-size image [SIB] Download : Download full-size image [DERS] Conclusions CBT-group-training increases assertiveness, improves emotion's regulation, has little effects on binge behaviors severity.

Introduction Drop-out is a serious problem in ED which remains poorly understood. Aims To describe socio-demographic and clinical factors associated with drop-out in order to prevent this phenomenon with individualized strategies. Methods A semi-structured clinical interview was administered to 92 adult out-patients attending a third level centre for ED. Measures of psychopathology (EDE12th, BDI, STAI, MINI, SCID-II) were collected to achieve diagnoses. The study population included completers (CO) and drop-outs (DO) which consist of patients that did not complete the baseline assessment Failing in Alliance (FA) and persons who Failed in Treatment (FT). Results The drop-out rate is 34,8%, including 17,4% of FA and 17,4% of FT. DO were less likely to have Anorexia Nervosa at Onset and Obsessive-Compulsive Personality Disorder, while serious Depressive Symptoms, Borderline Personality Disorder and Bulimia Nervosa predicted premature attrition. After multivariate analysis only the last three remain statistically significantly. Considering the period of drop out, we found that Bulimia Nervosa and Borderline Personality Disorder were independent correlated with FA respectively (OR=5,800; 95%CI 1,574–21,368) and (OR=5,782; 95%CI 1,135–29,449). Conversely FT had a higher probability to have serious Depressive Symptoms (OR= 12,289; 95%CI 1,187–127,207). Conclusions Drop-outs in ED include two different subpopulations: failure in alliance (FA) and failure in treatment (FT) characterized by different clinical characteristics. Bulimia Nervosa and Borderline Personality Disorder were predictors of FA, whereas serious Depressive Symptoms were predictors of FT.

Background Technological and medical progresses stimulated a worldwide demographic transition with a high socio-economic impact. The Mental Health in Older People Consensus suggests that elderly mental health deserve attention from a research and a public health perspective. Aims To investigate mental disorders in a population-based sample of persons aged 75+ living in Faenza (Northern Italy). Methods The Cambridge Mental Disorders of the Elderly Examination (CAMDEX) (Roth, 1986) was administered to 462 elderly (or/and their proxies/informants). Cognitive functions were tested using CAMDEX-Cognitive section (CAMCOG) and dementia diagnoses were achieved according to DSM-IV criteria. Among cognitively intact individuals, depression was diagnosed based on DSM-IV and ICD-10 criteria. Presence of general anxiety disorder was evaluated using the Geriatric Anxiety Inventory Short Form (GAI-sf) (Byrne, 2011). Results Dementia prevalence was 19.1% (95% Confidence Intervals: 16–23%). Even if only eight (2.2%) participants were affected by a major depressive episode (DSM-IV criteria), one out of four participants was clinically diagnosed as being depressed when ICD-10 criteria were applied: mildmoderate- and severe-depression prevalence was 16.4% (95%CI: 12.6–20.2%); 7.5% (95%CI: 4.8–10.2%); 1.1 (95%CI: 0.04–2.2%) respectively. Furthermore 20 (5.4%) participants complained sub-threshold depressive symptoms. Three persons had psychotics’ symptoms (two were depressed). Fifty-one participants (11.0%) felt that living was not worthy (95%CI: 8.0–14.0%) and 29 (7.0%) had suicidal thoughts (95%CI: 4.0–8.0%). Anxiety affected the 18.6% of the sample (95%CI: 14.0–22.0%). Depression and anxiety co-occurred in 36 persons (10.2% of the total population). Conclusions At least one mental disorder is diagnosable in one out of two community-dwelling elderly.

Background Training in Psychiatry is especially debated since the biological, psychological and social perspectives need to be integrated in the education of Early-Career Psychiatrists (ECP). Aims To describe the opinion of ECP about the training received and to evaluate their self-confidence in therapeutic interventions. Methods A training event for ECP from all over Italy takes place in Rome yearly. A 30-item ad hoc questionnaire with both yes/no and rating scale answers has been administered to all the participants in the event. Results Over the past three years 224 questionnaires were collected from 216 last-year trainees and 8 recently qualified psychiatrists (68.5% women, mean age 30.5 ± 3.5). Only 13% of participants was globally satisfied with his/her training program in psychiatry, the most of them were only partially or a little satisfied (51.4% and 32.0% respectively). The most critical training areas were Forensic Psychiatry and Psychotherapy followed by Psychiatric Rehabilitation. Conversely, Clinical Psychiatry and Psychopharmacology were the most satisfying areas of training. Likewise, ECP felt themselves most confident in Clinical Psychiatry (87.9%) and Psychopharmacology (48.7%); whereas the most uncomfortable areas were Forensic Psychiatry (62.5%), Child and Adolescent Psychiatry (37.2%), and Dual Diagnosis/Substance-Abuse Related Disorders (33.9%). The 45% of ECP complained that Psychotherapy is a critical issue. Despite the 46.4% of participants had supervision within the training program (less than two hours per week), the 87.4% seek help from external psychotherapeutic training programs. Conclusions To achieve a satisfactory educational standard and an adequate self confidence, network programs (within Italy and/or Europe) might be helpful.

Introduction Erectile dysfunction (ED) and premature ejaculation (PE) are common disorders among italian male population aged between 18 and 65 years old (prevalence rate: 20–25%). Several studies demonstrate that the early treatment of the psychological conditions, frequently associated to ED and PE, can positively influence the prognosis. Aim To evaluate the psychological correlates of sexual dysfunction using a standardized instruments.Methods. 46 male patients aged between 18 and 65 years old affected by EP (60,87%) and DE (47,83%) were administered the Cognitive Behavioural Assessment (CBA 2.0). Analysis of data was carried out using an automatic scoring and creating a graphic profile. Results The 28,26% of the participants showed an high score (> 95th percentile) at the STAI X-1 suggesting the presence of trait anxiety; the 39.16% of the subjects reported experiences of social and emotional maladjustment and concomitant introversive personality traits at EPQ schedule (85–@95th percentile at subscales E and P) and depressive mood at scale 8 (questionnaire D). Finally, the 32.60% did not present psychological conditions. Conclusions According to the literature, our findings demonstrates an high frequency of psychological distress in patients affected by sexual dysfunction (67%). The use of CBA 2.0 migth represent an useful tool for the diagnosis and early treatment of this kind of population.

Introduction The KIBRA rs17070145 “CC” and the CLSTN2 rs6439886 “TT” genotypes have been associated with poor episodic memory performance in healthy persons. Episodic memory is also impaired in depression. Therefore, we hypothesized that depressed persons with the “CC/TT” genotype combination would perform worse in comparison to other KIBRA and CLSTN2 combinations. Objectives To examine the effects of KIBRA and CLSTN2 on episodic memory performance in nondepressed and depressed elderly persons (60+). Methods Genotyping from peripheral blood samples and episodic memory testing were performed in the population-based SNAC-K study. All non-demented participants (n = 2332) were categorized according to depression status (nondepressed/depressed) following ICD-10 criteria. Dichotomous variables were used for KIBRA (any T/CC) and CLSTN2 (any C/TT). Results A three-factor MANCOVA revealed no main effects, but two significant interaction effects for episodic memory performance. Post hoc test for KIBRA × CLSTN2 revealed that persons with the “CC/TT” genotype exhibited poorer performance on free recall and recognition. Further, the three-way interaction (KIBRA × CLSTN2 × depression) showed that the negative effect of the “CC/TT” genotype was most pronounced among depressed persons Depressed “CC/TT” consistently performed at the lowest level. Conclusions The combination of the KIBRA “CC” and the CLSTN2 “TT” genotypes was associated with poorer episodic memory performance in both nondepressed and depressed persons. Depression in combination with the “CC/TT” genotype was especially disadvantageous for episodic memory performance. This supports the view that effects of specific SNPs on performance may be most easily disclosed at suboptimal levels of cognitive ability, e.g. in depression.

Introduction The Rorschach is a projective test frequently used in the forensic ambit for the information it can give in both the cognitive and affective area. The purpose of our work is to identify the personality traits recurring in killings through the examination of the psychometric major indices of the Rorschach. Method 20 male subjects, authors of murders, between 20 and 50 years were tested (average age, 29); the control group was represented by 20 male subjects aged between 20 and 50 years without history of crimes. All protocols were collected and signed through the method “Scuola Romana Rorschach” and processed by information systems RORCOMP. Results From the cognitive point of view there were no significant differences concerning the sense of reality between the murderers and control samples (R +%, F +%: 70–80), but the number of responses was lower than average (80% of subjects R = 20) as well as the number of M (75% of subjects M FC; then 78% of the subjects showed an average value of the Impulsivity Index equivalent to 0.85. Conclusions Despite the availability of a limited number of cases, the Rorschach indices, in concordance with literature data, showed in the murderers the presence of affective lability and immature object relations, lack of interest in the object, impulsivity, egotism and mild empathy, that identify the cluster B personality traits.

IntroductionThe use of standardized and objective instruments constitutes a support to the clinical observation in order to evaluate particular and general aspects of an individual's psychic life, and it can represent a valid aid in the evaluation and prediction of aggressivity. Our aim is the assessment of the MMPI-2 ‘s predictive capacity, a self-report personality test, constituted of 567 items, evaluating possible aggressive acts.Method20 subjects with a history of aggressivity, in the absence of major psychiatric disorders, were examined. The MMPI-2 test was administered to them, so as to assess their profile with reference to the aggressivity's indicators. It was also administered to a control group of subjects without a history of aggressivity.ResultsIn all the examined offenders, unlike the control group, were observed low T values in the K scale (< 40), an increase in the Pd base scale (>65) and supplemental scale O-H (>65); with respect to the derivative indexes, it was noticed a scarce adaptive capacity (Hy< Pa), a low tendency to the tolerance of frustrations and a negative value at T points in the PAI (Hy+100)-(Pd+2Pa).ConclusionIn concordance with the literature data, the MMPI-2 can be a useful support in evaluating the risk of aggressivity. Subjects at risk of acting out show low values in the K scale (< 40), high values in the Pd scale (>65). Other particularly important risk indicators are: code types 4/6, 4/8, 468, a scarce adaptive capacity (Hy< Pa) and a scarce tolerance to frustrations.

IntroductionThe delusional misidentification syndromes (syndromes of Frégoli, Intermetamorphosis, Subjective Doubles and Capgras) are characterized by delusions of misidentification of other persons or of one-self. Aggressive ideas or behaviours often go with these delusions, but the problem received relatively little attention. Capgras’ Syndrome is characterized by the delusional belief that a well-known person has been replaced by a double. The delusion frequently involves significant others and takes place in a paranoid atmosphere with feelings of strangeness and unreality. We stress the importance of considering the potential dangerousness and homicidal acts directed towards family members of patients with Capgras’ Syndrome.MethodsWe report a case with histories of paranoid schizophrenia and alcohol and cannabis intoxications who developed a Capgras’ Syndrome associated with homicidal behaviours toward his wife.ResultsOur case met DSM IV-TR diagnostic criteria for paranoid schizophrenia, according to previous studies which show that paranoid schizophrenia is the most frequent mental disorder associated with delusional misidentification. The psychopathological analysis show that homicidal acts are connected to anguish of the ego disintegration and failure of defense mechanisms.ConclusionsAccording to the most recent literature, our findings suggest that Capgras’ Syndrome may be linked to a genesis of aggressive behaviours; alcohol and substance intoxications facilitates impulsivity and dissociation. The patients’ acting out directed toward family members occurs during a psychotic breakdown. Capgras’ Syndrome should always be evaluated in order to prevent violent acts.

IntroductionThe longevity of population is an evidence over the past decades. Elderly physical and mental health are imperative. Despite anxiety is common and has adverse consequences, literature is meagre.ObjectivesTo estimate the prevalence of generalized anxiety disorder (GAD) in elderly and to investigate the association with physical comorbidity, depression, daily habits.Methods426 subjects from the population-based Faenza Community Aging Study (De Ronchi et al 2005), mean age 85,1 (Standard Deviation = 6,9). The Geriatric Anxiety Inventory short-form (GAI-sf) was utilized to define GAD (score ≥ 3). Logistic-regression were used to estimated odds ratio and 95%Confidence Intervals (CI).ResultSubjects with anxiety were 84 (21,2%), 63,1% were women. For age < 80 the prevalence of GAD was 38,1% while for age> 95 was 4,8%. When we compared elderly with GAD to elderly not affected we found the following results: no hobbies (83,3% vs 79,6%) p = 0,124, no friendship (21,8% vs 15,8%) p = 0,425, they don’t make physical activity (53,7% vs 45,6%) p = 0,214 than subjects without anxiety. To have comorbidity was associated with anxiety: one disease OR (CI95%) = 2,71 (1,15–6,24), two or three OR (CI95%) = 2,57 (1,07–6,16) and > three OR (CI95%) = 7,5 (1,81–31,05). Hypertension was positively associated with anxiety OR (CI95%) = 1,94 (1,04-3,62). Depression was highly correlated with anxiety OR (CI 95%) = 5,82 (3,39–9,98). Moderate alcohol consumption was negative associated with anxiety OR(CI 95%) = 0,49 (0,25–0,95).ConclusionAnxiety in elderly is frequent and should be actively investigated especially in elderly with comorbidity.

IntroductionThe cognitive profile of the older depressed person includes impairments in executive functioning, episodic memory and processing speed. When in remission, executive functioning impairment may still remain. It is not known whether these impairments also exist in self-reported depression and if so, whether there are any performance differences between currently and remitted depression.ObjectivesTo examine differences in cognitive functioning between self-reported nondepressed, depressed, and remitted persons in young and older old.MethodsData were collected using interviews and cognitive testing (executive functioning, episodic memory, and processing speed) in the Swedish National study of Aging and Care in Kungsholmen (SNAC-K). All non-demented participants (n = 2727) were categorized according to age (60–77 years, n = 1626, and +78 years, n = 1101), and depression status, 1) never depressed (n = 2200), 2) current depression (n = 214), and 3) remitted depression (n = 313).ResultsA 2 (age) × 3 (depression) MANOVA showed significant main effects of age, depression and a significant interaction effect. Younger outperformed older on all tests. Depression showed an effect on Trail Making Test B, where nondepressed outperformed currently depressed, and the remitted outperformed the currently depressed on free recall. Furthermore, an interaction effect was found for recognition, suggesting that decline in episodic memory is more pronounced in persons with self-reported depression when aging.ConclusionsSelf-reported depression in an older population affects executive functioning and episodic memory, but not processing speed. For persons in remission, we found remaining deficits in episodic memory, rather than executive functioning.

IntroductionThe role of cognitive complaints has recently received increasing attention in dementia research.AimTo investigate whether the subjective perception of cognitive deficits is related to multi-morbidity in an old Italian cohort.MethodsThe study population(N = 6,825) included persons who did not receive a diagnosis of dementia(DSM-IIIR criteria), were not cognitively impaired and scored < 4 at the Global Deterioration Scale(GDS). On GDS stage one, Individuals with GDS score equal to one do not report memory problems and no deficits are detected during the interview. In subjects with GDS score = 2, a very mild cognitive decline is appreciable. On GDS score = 3,deficiencies begin to be noted. The examining physicians diagnosed the somatic disorders according to the International Classification Disease version 10 (ICD-10). Mental health was clinically assessed by the examining physicians with semi-structured questions. A multimorbidity index was created based on the number of co-occurring chronic disorders. Binary logistic regression analyses were used to estimate multiadjusted Odds ratio (aOR) and 95% Confidence Intervals (CI).ResultsAccording to GDS, 28.4% (N = 1,940) of participants reported some degree of perceived cognitive decline. Cognitive complaints were associated with increasing age, low education, and multimorbidity. Stroke (aOR,95%CI 1.6;1.3–1.9),diabetes(aOR,95%CI 1.4;1.1–1.7),depressive(aOR,95%CI 2.2;1.8–2.7) and anxiety symptoms(aOR, 95%CI 1.5;1.3–1.8) were significantly associated with perceived cognitive decline. When performances at MMSE were taken into account, cardiovascular(aOR,95%CI 2.3;1.3–4.1) and respiratory diseases(aOR,95%CI 1.9;1.0–3.6) were associated with self-perceived cognitive decline in absence of observable cognitive deficits.ConclusionsCognitive complaints have many somatic correlates and some of them may account for the discrepancy between perceived cognitive decline and cognitive assessment.

Aim:To evaluate the relationship between depression, somatic symptoms, cognitive impairment and disability in an elderly population.Methods:216 subjects (65-84 years) were clinically examined for somatic symptoms, and underwent a mental health examination. Depression was defined by Geriatric Depression Scale scores >11/30; cognitive impairment by Mini-Mental State Examination scores < 24/30; functional status by Instrumental Activities of Daily Living Scale. Associations between depression, cognitive impairment or somatic symptoms and disability were evaluated by logistic regression analyses, estimating Odds Ratios (ORs) and 95% confidence intervals (95%CI) adjusted by sex, age, education.Results:Disability was common among depressed individuals (OR(95%CI)=3.60(1.63-7.96)) and among cognitively impaired subjects (OR(95%CI)=7.35(3.07-17.60)). An increasing number of somatic complaints increased the probability of functional impairment: compared with presence of 1-2 somatic symptoms, complaint of 3-6 and 7-12 symptoms were related to disability with OR(95%CI)=3.30(1.11-9.80) and OR (95%CI)=4.20 (1.17-15.09) respectively. Distinguishing pain, gastrointestinal, pseudo-neurological and general symptoms, only general somatic symptoms (palpitations, fatigue, sleep disturbances) were associated with disability (OR(95%CI)=1.81(1.25-2.62), independently by medical conditions (OR(95%CI)=1.57(0.98-2.52)). An additive effect toward disability was observed when general somatic complaints and cognitive impairment were co-existing (OR(95%CI)=23.68(5.50-101.86)). Including simultaneously cognitive impairment, somatic complaints and depression in the model, only cognitive impairment was still significantly related (OR(95%CI)=5.87(2.66-12.96)).Conclusions:Among many possible causes of disability in the elderly, an important role could be attributed to cognitive deficits.

Aims:To evaluate prevalence rate of suicidal ideation among Italian elderly and to investigate possible socio-demographic and psychopathological features of suicide attempters in a population-based study.Methods:461 subjects (mean age 85 years; 52.9% women; 49.2% widow) were interviewed using the Revised Cambridge Examination for Mental Disorders in the Elderly. the presence of suicidal ideation was assessed by the Scale for Suicide Ideation. the association between suicidal ideation and its correlates was analysed by Logistic Regression Model estimating Odds Ratios and 95% Confidence Intervals (OR, 95%CI).Results:Eighteen (3,8%) persons refused to answer to questions concerning suicide thoughts. Only one participant declared to have attempted suicide (a 92 years-old men, widow, living on his own and complaining about depressive feelings). Overall suicidal ideation prevalence was 7.3%: wish to die (3.8%) and not worth living (13%). Gender, age, education, marital and socio-economic status were similar in subjects with and without suicidal ideation. Subjects with suicidal ideation had fewer family contacts, were less satisfied of their general health status and had a higher number of depressive and anxiety symptoms. However, when all these conditions were tested in the same model, only depressive symptoms were still significantly associated with suicidal ideation (OR, 95%CI=9.6, 3.3-27.9).Conclusion:The worldwide aging of the population deserves attention to psycho-geriatric medicine. Study on suicide in late-life are of interest to detect elderly at risk and to emphasize this increasing phenomenon.

Dementia is one of the most pressing public health problems with social and economic implication. The form called cognitive impairment non-dementia (CIND)represents a subclinical phase of dementia. Different studies have shown a possible effect of micro- and macro-nutrients on cognitive function. Trace elements, being involved in metabolic processes and redox reactions in the central nervous system (CNS), could influence the cognitive functions. This study evaluated the presence of an eventual correlation between serum trace element concentrations and cognitive function in a group of subjects with CIND and manifest dementia (Alzheimer dementia = AD, and vascular dementia = VaD), and compared them with a control group. Thirty -five patients were enrolled in this study. Each patient underwent a clinical and biochemical examination. We also performed a neuropsychological and functional assessment (the Milan overall dementia assessment = MODA, activities of daily living = ADL, and instrumental activities of daily living = IADL), and a computerized tomographic (CT) cerebral scan. Patients were than divided in 4 groups according to the obtained diagnosis (Controls, CIND, AD, VaD). The presence of any acute or chronic conditions, affecting cognitive functions, was considered as exclusion criteria. A blood sample was collected to determine iron (Fe), zinc (Zn), manganese (Mn), selenium (Se), cobalt (Co), chromium (Cr), copper (Cu),molybdenum (Mo) and aluminium (Al) serum concentrations (chromatographic,spectrophotometric methods). In our cohort we found a positive correlation between cognitive function, expressed as the MODA score, and Se, Cr, Co and Fe serum levels,while a negative correlation was observed between MODA score, Cu and Al serum levels.Moreover, some statistically significant differences in Se, Cr, Co, Cu and Al concentrations were found among the groups. According to these results, we may suppose that Se, Cr and Co protect cognitive function, Cu influences the evolution of cognitive impairment, while Al contributes to the pathogenesis of AD.

Cognitive deficits in old-age depression vary as a function of multiple factors; one rarely examined factor is long-term psychiatric history. We investigated effects of psychiatric history on cognitive performance in old-age depression and in remitted persons. In the population-based Swedish National Study on Aging and Care in Kungsholmen study, older persons (≥60 years) without dementia were tested with a cognitive battery and matched to the Swedish National Inpatient Register (starting 1969). Participants were grouped according to current depression status and psychiatric history and compared to healthy controls (n = 96). Group differences were observed for processing speed, attention, executive functions, and verbal fluency. Persons with depression and psychiatric inpatient history (n = 20) and late-onset depression (n = 49) performed at the lowest levels, whereas cognitive performance in persons with self-reported recurrent unipolar depression (n = 52) was intermediate. Remitted persons with inpatient history of unipolar depression (n = 38) exhibited no cognitive deficits. Heart disease burden, physical inactivity, and cumulative inpatient days modulated the observed group differences in cognitive performance. Among currently depressed persons, those with inpatient history, and late onset performed at the lowest levels. Importantly, remitted persons showed no cognitive deficits, possibly reflecting the extended time since the last admission (m = 15.6 years). Thus, the present data suggest that cognitive deficits in unipolar depression may be more state- than trait-related. Information on profiles of cognitive performance, psychiatric history, and health behaviors may be useful in tailoring individualized treatment.