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This paper aims to examine the characteristics of students who withdrew from a university counselling service in northern Italy. Differences found in the socio-demographic characteristics of counse...

Medical students encounter specific stressors that can lead to higher levels of psychological distress compared to their similar aged counterparts who study other subjects. The Medical Student Stressor Questionnaire (MSSQ) was developed to specifically identify stressors among medical students as well as measure the intensity of stress caused by the stressors. However, no Italian version has been validated to date. The aim of this study was to develop an Italian version of the MSSQ (MSSQ-I) and to assess its psychometric properties. The MSSQ has been translated and culturally validated into Italian. All medical students from the University of Brescia were asked to participate in a web-survey in which they were asked to complete the MSSQ-I. For the analysis of the stability over time, participating students were asked to complete again the MSSQ-I after about one month. Among 1754 medical students, 964 completed the MSSQ-I for the validation analyses. A first Confirmatory Factor Analysis and a subsequent Explanatory Factor Analysis outlined a slightly modified factor structure of the scale with five factors instead of six as in the original scale. The internal consistency on the overall scale was high (α = 0.94), as well as the internal consistency of each of the new factors: (α > 0.83 for the first four factors and α = 0.67 for the fifth). External validity analysis confirmed moderate/high concurrent validity. These results suggest that the MSSQ-I can be used as a tool to identify stressors among Italian medical students, although further research is needed to confirm its individual test-retest reliability.

The objectives of this study are to identify all studies for stress-management carried out in medical students, in order to analyze their impact on psychological distress and on academic performance, and to assess how these interventions are incorporated into the medical education curriculum. For this purpose, a systematic narrative review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic search was performed in PubMed, Embase, and PsycInfo, using the following keywords: “stress” AND (“intervention” OR “treatment”) AND (“college” OR “university”) AND “medical” AND “student.” The quality of study was assessed using the Cochrane quality assessment tool and the Methodological Index for Nonrandomized Studies. Seventeen studies were included in the review: 3 randomized controlled trials and 14 non-randomized. The results have identified different stress-management interventions, mainly focused on mindfulness programs. Most studies were also carried out on the pre-clinical students in the first 2 years. Results showed that students who attended stress-management interventions had a decrease in their stress level; conversely, the data concerning the decrease in depression scores were contrasting. Findings suggest that stress-management programs may be helpful for medical students, but further studies are needed to assess a broader range of outcomes, including the correlation of stress-reduction with academic and health conditions. Prospective Registering of Systematic Reviews (PROSPERO). Identifier: CRD42019130789.

The aims of this study were to collect information about attitudes toward mental illness from the staff of Brescia University, and to detect predictors of issues regarding mental disorders and evaluate their relationship with public stigma. The study involved 1079 people and each participant received a letter explaining the purpose of the e-research. Four hundred and eighty-six people completed the questionnaires. The results showed that those who had a higher level of education, a personal life experience with mental disorders and a higher professional role were more likely to develop behaviours of acceptance toward the mentally ill. Factor analysis of the CAMI showed three main factors: Social distance and isolation, Social integration, Social responsibility and tolerance. Through the structural equation model it was found that the latent construct stigma was mainly defined by the first factor. From this study it emerged that education and personal contact were protective factors against public stigma.

Objective (1) To report the number and type of emotional expressions (cues/concerns) raised by breast cancer patients; (2) to identify the influence of setting, patient characteristics, and doctor-patient interaction on emotional expression. Methods 308 Italian-speaking female patients were recruited at their first breast cancer consultation. The visits were audio-recorded and analysed for number and type of emotional expressions (VR-CoDES). Oncologists’ interaction skills were rated by the VR-COPE. Socio-demographic, clinical and personality variables were gathered before the consultation. Clinical variables and oncologists’ evaluations of the patient were collected after. Results Breast cancer patients raised emotional issues mainly as cues. The setting (centre where the consultations took place), the oncologist’s attribution of anxiety, regardless of anxiety test screening (STAI-X1) score before the consultation, and the oncologist’s ability to pick up on patient’s worries, handle emotional needs or understand psychosocial condition were all positively related with the number of emotional expressions. More tightly structured consultations had fewer emotional expressions. Conclusion Both contextual and interactional aspects have an impact on patient emotional expressions. Practice implications Oncologists need to be trained to manage both the content and the process of medical consultation. Work organization of the consultation setting needs to be taken into account.

ResumenLa estigmatización del paciente psiquiátrico es todavía una fuerte barrera para el proceso de integración de estos sujetos en nuestra sociedad. Por tanto, es necesario identificar qué tipos de prejuicios existen y los tipos de variables con los que se asocian, para planear estrategias para reducirlos. En este estudio exploratorio administramos una entrevista semiestructurada a 303 sujetos para examinar las relaciones entre las actitudes sociales hacia los trastornos mentales y algunas variables demográficas sociales, la información sobre los trastornos mentales y los “contactos” previos con los pacientes psiquiátricos. El análisis de datos muestra que hay una relación entre el conocimiento de los pacientes psiquiátricos y una actitud más positiva hacia ellos (es decir, menos temor, más integración y oportunidades laborales). Este estudio se debe considerar preliminar en lo que se refiere a las actitudes de las personas hacia los pacientes psiquiátricos. Este resultado anima a la planificación y puesta en práctica de programas de sensibilización e información con respecto a los trastornos mentales, en el sentido de que aumentar el conocimiento de los trastornos mentales podría llevar a logros significativos en la importante lucha contra el estigma que rodea a los pacientes psiquiátricos.

SummaryThe stigmatisation of the psychiatric patient is still a strong barrier to the integration process of these subjects in our society. Therefore, it is necessary to identify what types of prejudices exist and the types of variables with which they are linked, in order to plan strategies to reduce them. In this exploratory study we administered a semi-structured interview to 303 subjects in order to examine the relationships between social attitudes towards mental disorders and some social demographic variables, the information about mental disorders and the previous ‘contacts’ with psychiatric patients.The data analysis shows that there is a relationship between knowledge of psychiatric patients and a more positive attitude towards them (i.e., less fear, more integration and work opportunities). This study is to be considered preliminary as far as people’s attitudes towards psychiatric patients are concerned. This result encourages the planning and implementation of sensitisation and information programs concerning mental disorders, in the sense that increasing the knowledge of mental disorders could lead to significant achievements in the important fight against the stigma surrounding psychiatric patients.

The negative attitudes surrounding mental disorders and their treatment are a major obstacle to the correct identification and treatment of emerging psychopathologies. The purpose of this study was to investigate mental health literacy in a large and representative sample of high school students in Italy, via a booklet containing several questionnaires delivered to 1032 teenagers. The items in the questionnaires probed knowledge about mental health and illness, stigmatization, stereotypes, behaviors, opinions, and attitudes. In general, the students had a reasonable knowledge of mental disorders and were able to distinguish these from somatic disorders. However, a large portion of the students nourished some misconceptions about mental disorders and was also rather skeptical about the effectiveness of treatment or the chance of recovery for people with severe mental disorders. Nevertheless, roughly half of the students reported being willing to provide help to someone with a mental disorder when in need. Poor mental health literacy is a major barrier to seeking help and receiving effective treatment. Young people are the ideal target of raising awareness and antistigma campaigns because they are at a higher risk for developing a psychopathology.

Introduction: scientific evidences show that psychotic disorders come to the treatment a few years after their onset, when the symptoms have stabilized. There are many factors responsible for this delay, including the role played by stigma, which often hinders an early identification of symptoms. Materials and e methods: a study was conducted in two high schools in a northern Italian town, through a questionnaire that assesses the attitudes towards people suffering from psychosis. Results : 408 students were enrolled in the study: 57.8% male and 42.2% female. Only 8.6% of the students believe that effective therapies for the treatment of people with psychosis exist, and only 16.4% states that most of them can recover or improve. 61.3% report that people with psychosis should be treated in hospitals for a long time. Conclusions : the results show that students have negative attitudes towards people suffering from psychosis, in particular as regards the treatment. For this reason it’s important to promote public actions, of sensitization and information, in order to increase the knowledge about current model of community-based care for the treatment of these disorders and their possible positive outcome.

SUMMARYAims— To describe patterns of experienced andanticipated discrimination in a sample of schizophrenic patients recruited in Italy in the context of the International Study of Discrimination and Stigma Outcomes (INDIGO).Methods— Cross-sectional survey on a sample of 50 people with clinical diagnosis of schizophrenia recruited in the Italian INDIGO sites of Verona and Brescia. The 41-item interview-based Discrimination and Stigma Scale (DISC-10), which assesses how experienced and anticipated discrimination affects the life of people with schizophrenia, was used.Results— The most frequently occurring areas of experienced discrimination were discrimination by family members (44%), making and keeping friends (33%), keeping (36%) and finding a job (34%), getting or keeping a driving licence (32%). Anticipated discrimination was common in applying for work, training or education (58%), lookingfor close relationships (50%) and doing something important (48%); 68% felt the need to conceal their diagnosis. Positive experiences were rare, and getting welfare benefits/disability pensions was the only area where participants reported being treated with advantage (34%) more commonly than with disadvantage (8%). Overall, experienced discrimination reported by Italian patients was in the intermediate position of the score range of all INDIGO sites, whereas anticipated discrimination was lower than that reported in the other countries.Conclusions— Interventions to reduce discrimination against people with schizophrenia may need to address both actual and anticipated discrimination. Targeted therapeutic strategies aiming to improve self-esteem of people with schizophrenia may be usefulto facilitate their social participation and full inclusion in the community.Declaration of Interest: The authors declare they have not competing interests.

The Sexual Attraction Questionnaire (SAQ) was designed to measure sexual attraction (Fernández, Quiroga, & Rodríguez, 2006), because the current questionnaires were considered inadequate. The purpose of this research was to test whether the SAQ factors remain meaningful after several years (stability) and whether the Italian version is equivalent to the Spanish one (consistency). Three groups of university students participated: two from Spain (n = 182 and 255, respectively) and one from Italy (n = 293). The Spanish groups were tested with a 7-year interval (2001-2008). The Italian group was tested in 2008. The main hypotheses were to test, across time interval and countries: (a) factor congruence, (b) predictive power of factors (proportion of variance accounted for), and (c) scale reliability. Sexual attraction typology also was analyzed, within and between countries, to test the validity of the underlying theoretical model. The results obtained show that the SAQ factor structure remains the same, the resulting factors have high predictive power, and the SAQ scales are highly reliable. Sexual dimorphism and sexual attraction typology are highly associated, thus validating the underlying theoretical model.

Structured group psychoeducation for bipolar patients: a study of effectiveness in Italy V. Candini, C. Buizza, G. de Girolamo, C. Ferrari, M.T. Caldera, R. Ermentini, G. Nobili, R. Pioli, M. Sabaudo, E. Sacchetti, F. M. Saviotti, G. Seggioli, A. Zanini IRCCS St. John of God Fatebenefratelli, Brescia, Italy MHD of Desenzano del Garda, Desenzano del Garda, Italy MHD of Brescia, Brescia, Italy University of Brescia, Brescia, Italy

Introduction Persons with severe mental disorders and a history of violent offending are usually seen as a difficult-tomanage population: most have schizophrenia or severe affective disorders, while some suffer from severe personality disorders. Aims To investigate the sociodemographic, clinical, and treatment-related characteristics of a sample of patients living in RFs with a history of antisocial behaviour (‘violent’ group); to compare the characteristics of the ‘violent’ group with residents never violent; and to compare the rate of violent behaviour in the two groups over two years and to assess the likelihood of discharge in the two groups. Methods This is prospective observational cohort study involved 23 RFs of the St John of God Order in Northern Italy. The sample was divided into two groups: non-violent patients and ‘violent’ patients. The last included patients at last one time admitted in FMH or arrested for violent crimes or acted violent behaviors against people. For each inpatient was filled out a “Patient Schedule”: socio-demographic and clinical data were collected, including a specific session to assess aggressive behavior lifetime and in the last year. Results The study involved 403 patients: 89 ‘violents’ and 314 non-violent. ‘Violent’ group was mainly male, younger, with a prevalence of personality disorders. Coherently, in the group of ‘violent’ there were more people lifetime arrested and admitted to a FMH. Discussion There are some differences in the monitoring of violent behavior in the two years of assessment. We observed more threatening, slap, punch, inappropriate sexual harassment, etc. in the ‘violents’ group.