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Summary: Narcolepsy type 1 is a chronic central disorder of hypersomnolence, and it is frequently accompanied by overweight, but the association between narcolepsy type 1 and eating disorders is controversial. Our study aims to compare patients with narcolepsy type 1 and controls on the symptomatology of eating disorders and to evaluate the association between clinical factors. This is a cross‐sectional study, with consecutive recruitment of patients with narcolepsy type 1 attending the Outpatient Clinic for Narcolepsy at the IRCCS Istituto delle Scienze Neurologiche di Bologna (Italy) for routine follow‐up visits. Healthy subjects from general populations were recruited as controls. Patients underwent a questionnaire‐based assessment using the Eating Disorder Examination Questionnaire (EDE‐Q), Binge Eating Scale (BES), Italian Night Eating Questionnaire (I‐NEQ), Epworth Sleepiness Scale (ESS), and Narcolepsy Severity Scale (NSS). One hundred and thirty‐eight patients with narcolepsy type 1 and 162 controls were enrolled. This study showed that individuals with narcolepsy type 1 reported higher scores on the EDE‐Q, I‐NEQ, and a higher body mass index (BMI) than the controls. The logistic regression analysis results, with EDE‐Q positivity as a dependent variable, demonstrate a significant association with antidepressant drugs, female sex, and the use of sodium oxybate. We found an association between antidepressant drug consumption, the NSS total score, and female sex with BES positivity as the dependent variable. The logistic regression analysis for I‐NEQ positivity found an association with antidepressant drug use. This study shows that patients with narcolepsy type 1 frequently present with comorbid eating disorder symptomatology, mainly night eating syndrome. Investigating the possible presence of eating disorders symptomatology through questionnaires is fundamental during the assessment of patients with narcolepsy type 1. [ABSTRACT FROM AUTHOR]

Objective: Healthcare workers (HCWs) were considered a population at risk for developing psychiatric symptoms during the COVID-19 pandemic, such as anxiety, depression, and post-traumatic stress disorder (PTSD). Peritraumatic distress is associated with post-traumatic psychopathological symptoms; however, little is known about how it may affect functioning. The study aimed at evaluating the level of peritraumatic distress in a sample of HCWs during the first wave of the COVID-19 pandemic and at examining the relationship between peritraumatic distress, mental health symptoms, and functioning impairment. Methods: A sample of 554 frontline HCWs were consecutively enrolled in major university hospitals and community services in Italy. The PDI, IES-R, PHQ-9, and GAD-7 were used to assess peritraumatic distress, symptoms of PTSD, depression, and anxiety, respectively, and the WSAS to investigate functioning impairment. PDI scores were higher among females, community services, physicians, and nurses. Furthermore, the PDI correlated significantly with the GAD-7, PHQ-9, IES-R, and WSAS. Results: In a mediation analysis, the direct effect of PDI on WSAS and the indirect effects through the PHQ-9 and IES-R were statistically significant (P < .001). Conclusion: Peritraumatic distress reported by HCWs was associated with symptoms of PTSD, depression, and anxiety, but the association with reduced functioning may be only partially mediated through symptoms of depression and PTSD. [ABSTRACT FROM AUTHOR]

Background: Few studies, so far, have been specifically designed to highlight the features related to Compulsory Admissions (CA) and Voluntary Admissions (VA) in Italian psychiatric emergency wards. Aims: The main purpose of this observational study was to compare the sociodemographic and clinical characteristics of VA and CA and to explore possible predictors of re-admissions. Methods: During a 6-month Index Period (February, the 1st–July, the 31st 2008) all psychiatric admissions were documented and then followed-up through all available informatic systems for the next 9 years. Results: Out of 390 hospitalizations, 101 (25.9%) were compulsory (CA rate was 2.79 per 10,000 inhabitants per year, mean duration of hospitalizations of 7.33 ± 7.84 days). Diagnoses were recorded for the 325 patients who had been hospitalized during index period: schizophrenic psychoses ([ p =.042], in particular schizophrenia [ p =.027]), manic episode (p =.044), and delusional disorders (p =.009) were associated with CA; conversely, the diagnosis of unipolar major depression (p =.005) and personality disorders (p =.048) were significantly more frequent in VA. The 325 admitted patients were followed up for 1,801 person-years. No significant differences were found in terms of drop-outs, transferring, and discharge rates, and mortality rates due to both natural causes and suicides. Factors associated with at least one compulsory readmission were younger age and having had a previous CA (p =.011); conversely having been engaged with psychiatric services for over 1 year prior to index hospitalization was protective for a subsequent CA (p =.013). Conclusions: After a 40-year old political reform, the current study shows that, in a context of integrated outpatient and inpatient services, engagement with outpatient care may be protective for compulsory rehospitalization. [ABSTRACT FROM AUTHOR]

This document is an editorial published in the journal Frontiers in Psychiatry. It explores the association between metabolism and psychiatric disorders. The editorial emphasizes the need for multidisciplinary research and collaborative care to improve patients' quality of life. The document summarizes four studies included in the research topic, which highlight the prevalence of folate deficiency, vitamin B12 deficiency, and hyperhomocysteinemia in patients with psychotic disorders, the potential benefits of a ketogenic diet in alleviating neuropsychiatric symptoms, and the role of mitochondrial dysfunction in metabolic dysregulation induced by antipsychotics. The editorial concludes by calling for further research to understand the mechanisms linking metabolic dysregulation and psychiatric conditions and to develop targeted interventions. [Extracted from the article]

Background and aims: Social exclusion and reduced access to community health services can lead to urgent health problems among immigrants; this may explain their increasing rate of admittance to psychiatric inpatient units. This cross-sectional study aims to evaluate the prevalence of psychotic symptoms among Romanian immigrants living in very poor conditions at an abandoned hotel in Bologna and to highlight the possible correlation with general health status, distress and socio-demographic characteristics. Methods: The Psychosis Screening Questionnaire (PSQ) and General Health Questionnaire-12 (GHQ-12) were administered to all immigrants residing at the hotel during two index days with the help of a cultural mediator. Socio-demographic, migration and health characteristics were also collected. Results: Sixty eight subjects were evaluated. More than 80% had left Romania for economic reasons. Of immigrants, 57% exceeded the four-point GHQ-12 threshold of potential mental disorder and 19% scored positively at the PSQ. Immigrants with positive PSQ showed higher mean GHQ-12 scores (5.9 [+ or -] 3.5 vs. 3.8 [+ or -] 2.75; p = 0.02).The development of post-migration health problems significantly predicts positive PSQ cases even after adjusting for age, sex and GHQ-12 dichotomized score (OR = 21.2, CI = 1.1-169.4). Conclusion: This community of immigrants living in deprived conditions showed a high prevalence of distress and psychotic symptoms, related to health problems. Preventing excess of psychosis among immigrants and ethnic minorities in critical socio-economic conditions should mean, first and foremost, facilitating social integration and access to primary care. Key words: migration, social distress, psychic morbidity, psychotic symptoms, physical health

Background. The possible relationship between serum total cholesterol (TC) levels and outcome following ischemic stroke is still controversial. We evaluated the association between TC levels and 30-day mortality in a sample of older patients with acute ischemic stroke. Methods. We enrolled 490 older patients with severe ischemic stroke consecutively admitted to University Hospital's Internal Medicine or Geriatrics Department. Stroke type was classified according to the Oxfordshire Community Stroke Project. The data recorded included clinical features, medical history, electrocardiogram, and blood analyses. Patients were divided into three groups by TC levels: group I (TC < 4.1 retool/L), group II (TC 4.1-5.2 mmol/L), and group I[I (TC > 5.2 mmol/L). Results. The overall mortality was 27.7%. Mortality was higher in patients with low TC levels (47.4%) compared with those with normal and high TC levels (23.0% and 24.1%, respectively). The odds ratio (OR) for short-term death was 2.17 (95% confidence interval [CI] 1,22-3.85) in group I compared with group III, after adjustment for age and gender. This result did not change after adjustment for possible confounders (OR 2.87; 95% CI 1.23-6.68). A similar trend was observed after adjustment for the Oxfordshire classification, age, and gender (OR 1.67; 95% CI 0,83-3.33). Conclusions. Short-term mortality following ischemic stroke is higher in older participants with low TC levels, independent of a large number of factors. Low TC levels might be useful in identifying frail older participants at high risk of stroke short-term mortality.