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The current study aimed at increasing our understanding of the psychological impact of the COVID-19 lockdown on undergraduate students, particularly with respect to the association between personality traits; defense mechanisms (DMs); depression, anxiety, and stress symptoms (DASSs); and compliance with the government recommended health measures. A sample of 1,427 Italian undergraduate students were administered the Personality Inventory for the DSM-5-Brief Form; the Defense Style Questionnaire-40; and the Depression, Anxiety and Stress Scale-21. Compliance with the COVID-19 behavioral recommendations was measured through a 10-item survey measure. Results showed that immature DMs and internalizing personality traits (i.e., detachment, negative affect, psychoticism) were risk factors of DASSs. Furthermore, subjects with higher levels of DASSs appeared less compliant with the health measures recommended by the Italian government. Experts may use these results to identify and subsequently support ( via the Internet) young subjects at greater risk of mental health problems as a result of the COVID-19 pandemic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Biondi, Casale, Burrai, Mazza, Cavaggioni, Ferracuti, Giannini and Roma.)

Background: Psychic euosmia (PE) has been described as a supposed psychological predisposition for which pleasant smells elicit an immediate sense of pleasure, order and calmness in obsessive-compulsive personality disorder (OCPD). In this study we tried to verify the interpretation that PE is the counterpart of disgust that has been associated to contamination and moral purity. Disgust and morality are significantly associated in people with obsessive-compulsive personality traits. We expected that OCPD patients would experience higher levels of PE., Aim: To investigate the PE frequency in OCPD patients and healthy controls (HC) and to evaluate the relationship between PE and disgust., Methods: A single-center, case-control study was conducted in an outpatient service for obsessive-compulsive and related disorders. The sample consisted of 129 subjects: 45 OCPD patients and 84 HC. In both groups we submitted the Disgust Scale Revised (DS-R) and the self-report Structured Clinical Interview for DSM-5 Screening Personality Questionnaire to which we added an additional yes or no question to investigate the presence of PE. In order to verify differences between groups, t -test was employed for continuous variables and 2 test for categorical variable; odds ratio was employed to analyze group differences in the PE survey. Correlation was explored with Pearson r correlations., Results: No differences were observed between groups in gender composition or education. A slight significant difference was found in mean age ( t = 1.988; P = 0.049). The present study revealed significantly higher proportions of PE among OCPD patients when compared to HC (OR: 5.3, 2.28-12.46). Patients with OCPD were more likely to report PE ( n = 36; 80%) whereas a much lower proportion endorsed PE in the HC group ( n = 36; 42.9%). Interestingly, no differences were observed between groups in mean score for the Disgust Scale. There was also no difference between the two groups in any of the Disgust Scale Revised subscales. Moreover, no significant correlations were observed in the OCPD group between PE and Disgust Scale Revised subscales., Conclusion: Results suggested that PE might be part of the clinical spectrum of OCPD, and it does not reflect the counterpart of disgust. This could also indicate that this phenomenon is a manifestation of orderliness or incompleteness. Further studies will need to be undertaken to better understand PE and its significance in OCPD., Competing Interests: Conflict-of-interest statement: All authors declare the absence of conflict of interests related to the present study., (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)

Studies have suggested a relationship between low circulating levels of Vitamin D and depression. Vitamin D deficiency may be a consequence of depression-related factors, such as reduced sun exposure, decreased outdoor activity, and dietary changes, but it can also play a role in the pathophysiology of depressive conditions through a range of molecular mechanisms. In the present manuscript, findings related to prospective longitudinal studies on the relationship between Vitamin D levels and depressive symptoms and to randomized controlled trials on Vitamin D supplementation for depressive disorders are reviewed.

Psychopathological symptoms and reduced health related quality of life (HRQoL) are frequent in cirrhotics, but no data on their association with cirrhosis prognosis assessed by the MELDNa score are available. Prospective data on the long-term effect of deceased donor liver transplantation (LT) on psychopathological symptoms are needed. Before entering the LT waiting list, 44 consecutive LT cirrhotic candidates without a major psychiatric disorder underwent a psychopathological assessment, including Symptom Checklist-90-revised (SCL-90-R) and Defense Style Questionnaire (DSQ). HRQoL was measured by Short Form 36 Health Survey (SF-36). Abnormal performance at each questionnaire was defined by using 44 age, gender, BMI and education-matched healthy subjects. Separate binary logistic regression models were used to test the association of the Child-Pugh, MELD and MELDNa scores with abnormal performance at each questionnaire. Fourteen patients repeated the battery tests 3 years after LT. Before LT, increasing MELDNa was the only prognostic score independently associated with an abnormal SCL-90-R global psychopathological score index (OR: 1.207; 95% CI: 1.026-1.420; P = 0.02) and the best independent predictor of reduced HRQoL. After LT, compared to status prior to LT, performance at SF-36 general health perception scale ameliorated (P = 0.02), performance at SCL-90-R somatization scale (P = 0.001) and global psychopathological score index (P < 0.001) worsened and the negative correlation between the psychopathological global score index and HRQoL disappeared. The severity of cirrhosis in LT candidates should be monitored by the MELDNa score to better establish the right psychological counselling. Psychopathology, and in particular somatization, worsens after LT and should be carefully investigated.

Background: The aim of this study was to determine whether the serotonin transporter gene (5-HTT), a key component in the control of the serotonergic system, is associated with endometriosis in an Italian population., Findings: A case-control study, comprising 137 Italian patients with surgically confirmed endometriosis and 120 healthy controls, was carried out. 5-HTT genotypes (LL, SL and SS) were obtained by polymerase chain reaction and gel electrophoresis analysis. We found no overall difference in genotypic and allelic distributions of the 5-HTT gene between cases and controls., Conclusions: Our results suggest that the 5-HTT L/S promoter polymorphism is not associated with susceptibility to endometriosis in the studied Italian patients.

Objective: The aim of this preliminary study was to determine whether psychiatric disorders, psychopathological symptoms, and alexithymia are associated with endometriosis in an Italian population., Study Design: A preliminary study comprising 37 Italian patients with surgically confirmed endometriosis and 43 controls, without clinical and ultrasound signs of endometriosis, was carried out. Both patients and controls were evaluated for the presence/absence of psychiatric disorders, psychopathological symptoms, alexithymia, and pain symptoms (nonmenstrual pelvic pain, dysmenorrhea, and dyspareunia)., Results: Statistically significant differences were found between cases and controls for prevalence of mood and anxiety disorders, malfunctioning on obsessive-compulsive subscale (P < 0.01) and depression subscale (P < 0.05) of the Symptom Checklist-90-Revisited (SCL-90-R), and higher alexithymia levels (P < 0.01). Patients with endometriosis-associated pain showed greater prevalence of psychiatric disorders compared to pain-free patients but that difference was not significant. Significant correlation was found between malfunctioning in some SCL-90-R dimensions and pelvic pain, dysmenorrhea, and dyspareunia scores at the visual analog score (VAS)., Conclusion: Some psychopathological aspects, such as psychoemotional distress and alexithymia, are more frequent in women with endometriosis and might amplify pain symptoms in these patients.

Introduction: During the last years, in Italy as well abroad, psychological counseling has been spreading through university environment, offering a range of opportunities, from individual settings to post-counseling group psychotherapies. Medical students, on the basis of data from several works within international literature, would represent a population particularly exposed to stressors., Materials and Methods: In our study we have recruited a sample of 44 medical students at Sapienza University of Rome. As evaluation tools we have used: a gathering card of socio-demographic variables, the Structured Clinical Interview for DSM-IV Axis I Disorders Clinical Version (SCID-I CV) and a satisfaction card of the service. RESULTS; Fourteen students showed one or more diagnosis in Axis 1 of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Frequency analysis through χ2 test has underlined statistically significant differences relative to geographic origin variable. The service has been evaluated as alright., Discussion: Although the data presented need deeper and more extensive verifications, our study supports the need of a service of psychological counseling devoted to university population and, even more, to medical students.

In almost all the universities worldwide, the admission to the Faculty of Medicine is subject to a specific selection process. In most cases tests are used to assess the cognitive abilities of the candidates. However, a growing number of universities (particularly American and Canadian) is using a set of instruments to evaluate non-cognitive skills in addition to these tests. Among the most commonly used tools are included personal interviews, Multiple Mini Interview (MMI), Personal Quality Assessment (PQA). In Italy in the last decade increasing emphasis was placed on assessing students' attitudes through the use of orientation tests (given in classrooms or online fillable), as part of several projects that involve collaboration between secondary school and university. Nevertheless, the admission to the Faculty of Medicine does not yet provide a psychological and aptitude assessment, but relies exclusively on cognitive features. In a similar way to what is already the case with the selection of personnel in law enforcement agency, we propose a selection model that includes an assessment of psychological features and aptitudes of the candidates, as well as cognitive skills.

In the last decades there was an increasing interest in early detection of prodromal symptoms in schizophrenia and, more specifically, in detecting subjects at high risk for psychosis. However, especially in case of childhood-onset schizophrenia (COS), sometimes it is possible to don't recognize its early symptoms and to ascribe the observed clinical picture to other diseases, with consequent delay in diagnosis and treatment of these patients. In this case report we want to underline the importance of an early detection of schizophrenia, with a focus on differential diagnosis between Attention Deficit/Hyperactivity Disorder and schizophrenia.

Aims: The aims of the study are to evaluate, in the Italian context, the presence and clinical features of early prodromal symptoms before the psychotic onset and, most of all, the duration of the period between the first onset of any psychiatric symptom and the psychotic onset (Duration of Untreated Illness)., Materials and Methods: The study was carried out on a sample of 296 inpatients with a diagnosis of "non-affective psychosis" enrolled in "Villa dei Fiori" inpatients Clinic in Rome. The retrospective analysis was developed using clinical records and clinical interview with patients and their parents. The evaluation of the psychotic onset and of DUI was assessed with the PANSS (Positive and Negative Symptoms Scale)., Results: The mean DUI is 4.7 ± 4.4 years. We found a connection between DUI and early symptoms of psycosis: depressive symptoms (4.9; DS=5.0) were most frequently observed, followed by anxiety symptoms (5.1; DS=4.8), eating disorders (5.7; DS=3.0); obsessive symptoms (4.5; DS=3.6); social withdrawal (5.9; DS=4.9); psychotic like symptoms (2.6; DS=1.3). DUI resulted lower in psychotic like symptoms than in the depressive ones., Conclusion: In Italy DUI turn out to be much longer than in other Country where do exists specialized services for early intervention. For this reason seem to be necessary to explore the opportunity to develop also in Italy specialized services for adolescents and young adults at risk and at their psychotic onset.

Aims: To evaluate (i) the incidence of psychiatric disorders and (ii) the frequency of Mood Disorders diagnoses in a sample of 115 university students afferent to Sportello Counseling-Accoglienza Studenti "Fatti vivo!" of "Sapienza" University of Rome, between November 2008 and December 2010; to point out correlations with socio-demographic variables., Materials and Methods: The prevalence of Mood Disorders was evaluated with the Structured Clinical Interview for DSM IV Axis I Disorders Clinical Version (SCID-I cv), drawn up by the counselor at first meeting. Each student completed a data collection from which investigates socio-demographic characteristics. A descriptive analysis was conducted and the associations between variables and Axis I diagnoses were investigated., Results: The overall mean age is 24.7 years. A DSM IV-TR Axis I Disorder was diagnosed in 26.9%, of which 45.2% is constituted by Mood Disorders (mean age of 25.7 years). Male students, the highest family members' mean age and the lowest regular studies (64% pursue a course of regular studies) seem to be characteristics of the subgroup of students with Mood Disorders diagnoses compared to the subgroups with other Axis I Disorders diagnoses. Moreover, the same subgroup most frequently recognizes as pathological its condition (78.6%) compared to the subgroup with other Axis I Disorders diagnoses (53.3%). Those differences, however, aren't statistically significant., Conclusions: The discovered percentage of Axis I diagnoses in general and Mood Disorders in particular could be considered representative of perceived unease degree in a population of university students. At the same time, the difficulty in identifying the early signs of uneasiness and in recognizing as pathological own condition interferes with and delays the awareness of the need of a psychological/psychiatric support and the expression of the help-seek.

Aims: To evaluate: (i) self-perceived stress, depressive and anxiety symptoms in a community sample of young adults; (ii) which elements have most impact on the development of mental disease; (iii) if high levels of mental disease are related to help-seeking behavior., Materials and Methods: The study was carried out on a sample of 1660 university students. The evaluation of the perceived stress was conducted using the Stress-Related Vulnerability Scale (SVS), the evaluation of depressive and anxiety symptoms with Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI). A descriptive analysis of all the data collected was carried out and the principal links between variables and level of mental disease were detected. Finally the reasons for the failure to seek help were investigated., Results: Mean scores of BDI-II and BAI were respectively 10.9 (sigma = 8.3) and 11.4 (sigma = 9.4) and about 4% of the sample showed a pathological level of stress with the SVS. Female sex, non resident status and conflictual family climate were found to be more related with more severe anxious and depressive symptoms. Moreover, the latter ones were found to be strongly related with help-seeking behavior., Conclusion: In this sample mental disease associated with distress show a significant percentage. Higher level of anxiety and depressive symptoms are more related to perceived need for help and help-seeking behavior. Nevertheless the level of unexpressed help-seeking turn out to be high for multiple reason.

Aims: The principal aim of this study is: (i) to assess the rate of depressive disorders in a sample of patient in a psychotherapy service of the Department of Psychiatric Sciences and Psychological Medicine at the Sapienza University, Roma; (ii) to focus the psychopathological features of depressive patient through the SCL-90R scale; (iii) to evaluate the correlation between SCL-90R score and categorical diagnosis., Materials and Methods: The sample of this study includes 178 patients, who came to our service for a psychotherapy. The anamnestic and clinical information were collected for each patient. Each patient is submitted to the multidimensional scale SCL-90R in the curse of the first interview. A descriptive analysis of all the data collected was made and the principal links between SCL-90 R score and categorical diagnosis were detected., Results: About 46% of the patients were depressive disorders following the DSM-IVTR diagnostic criteria. About 70% of depressive patients have psychoticism pathological scores, 60% have paranoic pathological scores, 70% anxiety pathological scores and 60% interpersonal sensibility pathological scores. The depressive dimension was pathological in about 77% of anxious patient and in 87% of patient with personality disorders., Conclusions: The DSM.IVTR categorical psychiatric diagnosis might underestimate important psychopathological dimensions which are underline through a dimensional scale as the SCL-90R and through a psychodynamic diagnostic instrument.

Aims: The association between pharmacological treatment and psychotherapy is frequent. However doesn't exist any agreement or guide-line about the management of this combined therapy. Therefore we considered useful to evaluate which were the most frequent way of management of the combined therapy in a sample of 120 psychiatrists., Materials and Methods: A 10-items questionnaire finalized to explore the management way of the combined therapy was administered to a sample of 120 psychiatrists. A descriptive analysis of the data was made and the association between different variables was explored. The statistical analysis was performed using SPSS 13.0., Results: 35% of the sample work as a private practitioner, 19.17% is involved in public health (CMHT'S). More than 50% of the sample consider the combined therapy as a effective. In the public field the combined treatment turn out to be the most utilized, opposite than in private practice. 75% of the sample manage alone the combined therapy, while 25% work in team with a colleague. 85% of the pharmacotherapy is utilized in psychosis with positive symptoms, followed by the mood disorder with psychotic symptoms. Neuroleptics are the most frequently prescribed drug., Conclusions: The combined therapy seems to be useful when coherently with the psychotherapy theory model. The pharmacological treatment should be utilized when strictly necessary and, if is possible, the combined therapy should be managed by one psychiatrist.

Aims: The depersonalization is a clinical condition of frequent observation that occurs often in the late adolescence and among the young adults. This condition most of the time causes anguish justified from the gravity of the symptomatic perception, involving consequently a series of clinical problems, not last the answer that such condition generates in the observer: answer not only aware, that influences strongly the diagnostic interpretation and the therapeutic approach., Materials and Methods: We tried to investigate this clinical condition within a sample of 267 subjects, 120 of them examinated in our outpatients ambulatory of psychotherapy and 147 examinated in E.R. and in inpatients unit., Results: The percentage of patients with depersonalization, similarly to other studies, is quantitatively different in the two samples. However, what seems obvious is that if the differences for what concerns the frequency and the symptomatic intensity are rather marked, otherwise for what concerns the psychodinamic aspect the differences appears less sharp., Conclusions: This observation puts in evidence, on the model of many international studies about the latent psychosis, that in psychiatry at the seriousness of the psychodynamic and prognostic aspects not always corresponds the seriousness of the symptomatic aspects.