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2. Young age and the risk of violent behaviour in people with severe mental disorders: Prospective, multicentre study

Author

Micciolo, R, Bianconi, G, Canal, L, Clerici, M, Ferla, M, Giugni, C, Iozzino, L, Sbravati, G, Tura, G, Vita, A, Zagarese, L, De Girolamo, G, Micciolo R., Bianconi G., Canal L., Clerici M., Ferla M. T., Giugni C., Iozzino L., Sbravati G., Tura G. B., Vita A., Zagarese L., De Girolamo G., Micciolo, R, Bianconi, G, Canal, L, Clerici, M, Ferla, M, Giugni, C, Iozzino, L, Sbravati, G, Tura, G, Vita, A, Zagarese, L, De Girolamo, G, Micciolo R., Bianconi G., Canal L., Clerici M., Ferla M. T., Giugni C., Iozzino L., Sbravati G., Tura G. B., Vita A., Zagarese L., and De Girolamo G.

Abstract

Background During adolescence and young adulthood people appear to be more prone to violent behaviour. A greater tendency to violent behaviour appears to be associated with hyperactivity, impulsivity and low tolerance for frustration and provocation in social settings. Aims This prospective cohort study aimed to evaluate rates of violent behaviour among young people with mental disorders, compared with older age groups. Method A total of 340 individuals with severe mental disorders (125 living in residential facilities and 215 out-patients) were evaluated at baseline with the SCID-I and II, Brief Psychiatric Rating Scale, Specific Level of Functioning scale, Brown-Goodwin Lifetime History of Aggression scale, Buss-Durkee Hostility Inventory, Barratt Impulsiveness Scale and State-Trait Anger Expression Inventory-2. Aggressive behaviour was rated every 15 days with the Modified Overt Aggression Scale (MOAS). Results The sample comprised 28 individuals aged 18-29 years, 202 aged 30-49 and 110 aged 50 and over. Younger age was associated with a personality disorder diagnosis, substance use disorder, being single and employed. These results were confirmed even controlling for the gender effect. The patterns of the cumulative MOAS mean scores showed that younger (18-29 years old) individuals were significantly more aggressive than older (≥50) ones (P < 0.001). Conclusions This study highlights how young age in people with severe mental disorders is correlated with higher levels of impulsivity, anger and hostility, confirming previous analyses. Our results may assist clinicians in implementing early interventions to improve anger and impulsivity control to reduce the risk of future aggressive behaviours.

Published
2022

3. Open science discovery of potent noncovalent SARS-CoV-2 main protease inhibitors.

Author

Boby, M.L., Fearon, D., Ferla, M., Filep, M., Koekemoer, L., Robinson, M.C., Chodera, J.D., Lee, A.A., London, N., Delft, A. von, Delft, F. von, Achdout, H., Aimon, A., Alonzi, D.S., Arbon, R., Aschenbrenner, J.C., Balcomb, B.H., Bar-David, E., Barr, H., Ben-Shmuel, A., Bennett, J., Bilenko, V.A., Borden, B., Boulet, P., Bowman, G.R., Brewitz, L., Brun, J., Bvnbs, S., Calmiano, M., Carbery, A., Carney, D.W., Cattermole, E., Chang, E., Chernyshenko, E., Clyde, A., Coffland, J.E., Cohen, G., Cole, J.C., Contini, A., Cox, L., Croll, T.I., Cvitkovic, M., Jonghe, S. De, Dias, A., Donckers, K., Dotson, D.L., Douangamath, A., Duberstein, S., Dudgeon, T., Dunnett, L.E., Eastman, P., Erez, N., Eyermann, C.J., Fairhead, M., Fate, G., Fedorov, O., Fernandes, R.S., Ferrins, L., Foster, R., Foster, H., Fraisse, L., Gabizon, R., García-Sastre, A., Gawriljuk, V.O., Gehrtz, P., Gileadi, C., Giroud, C., Glass, W.G., Glen, R.C., Glinert, I., Godoy, A.S., Gorichko, M., Gorrie-Stone, T., Griffen, E.J., Haneef, A., Hassell Hart, S, Heer, J., Henry, M., Hill, M., Horrell, S., Huang, Q.Y.J., Huliak, V.D., Hurley, M.F.D., Israely, T., Jajack, A., Jansen, J, Jnoff, E., Jochmans, D., John, T., Kaminow, B., Kang, L., Kantsadi, A.L., Kenny, P.W., Kiappes, J.L., Kinakh, S.O., Kovar, B., Krojer, T., La, V.N.T., Laghnimi-Hahn, S., Lefker, B.A., Levy, H., Lithgo, R.M., Logvinenko, I.G., Lukacik, P., Macdonald, H.B., MacLean, E.M., Makower, L.L., Malla, T.R., Marples, P.G., Matviiuk, T., McCorkindale, W., McGovern, B.L., Melamed, S., Melnykov, K.P., Michurin, O., Miesen, P., Mikolajek, H., Milne, B.F., Minh, D., Morris, A., Morris, G.M., Morwitzer, M.J., Moustakas, D., Mowbray, C.E., Nakamura, A.M., Neto, J.B., Neyts, J., Nguyen, L, Noske, G.D., Oleinikovas, V., Oliva, G., Overheul, G.J., Owen, C.D., Pai, R., Pan, J., Paran, N., Payne, A.M., Perry, B., Pingle, M., Pinjari, J., Politi, B., Powell, A., Pšenák, V., Pulido, I., Puni, R., Rangel, V.L., Reddi, R.N., Rees, P., Reid, S.P., Reid, L., Resnick, E., Ripka, E.G., Robinson, R.P., Rodriguez-Guerra, J., Rosales, R., Rufa, D.A., Saar, K., Saikatendu, K.S., Salah, E., Schaller, D., Scheen, J., Schiffer, C.A., Schofield, C.J., Shafeev, M., Shaikh, A., Shaqra, A.M., Shi, J., Shurrush, K., Singh, S., Sittner, A., Sjö, P., Skyner, R., Smalley, A., Smeets, B., Smilova, M.D., Solmesky, L.J., Spencer, J., Strain-Damerell, C., Swamy, V., Tamir, H., Taylor, J.C., Tennant, R.E., Thompson, W., Thompson, A., Tomásio, S., Tomlinson, C.W.E., Tsurupa, I.S., Tumber, A., Vakonakis, I., Rij, R.P. van, Vangeel, L., Varghese, F.S., Vaschetto, M., Vitner, E.B., Voelz, V., Volkamer, A., Walsh, M.A., Ward, W., Weatherall, C., Weiss, S., White, K.M., Wild, C.F., Witt, K.D., Wittmann, M., Wright, N., Yahalom-Ronen, Y., Yilmaz, N.K., Zaidmann, D., Zhang, I., Zidane, H., Zitzmann, N., Zvornicanin, S.N., Boby, M.L., Fearon, D., Ferla, M., Filep, M., Koekemoer, L., Robinson, M.C., Chodera, J.D., Lee, A.A., London, N., Delft, A. von, Delft, F. von, Achdout, H., Aimon, A., Alonzi, D.S., Arbon, R., Aschenbrenner, J.C., Balcomb, B.H., Bar-David, E., Barr, H., Ben-Shmuel, A., Bennett, J., Bilenko, V.A., Borden, B., Boulet, P., Bowman, G.R., Brewitz, L., Brun, J., Bvnbs, S., Calmiano, M., Carbery, A., Carney, D.W., Cattermole, E., Chang, E., Chernyshenko, E., Clyde, A., Coffland, J.E., Cohen, G., Cole, J.C., Contini, A., Cox, L., Croll, T.I., Cvitkovic, M., Jonghe, S. De, Dias, A., Donckers, K., Dotson, D.L., Douangamath, A., Duberstein, S., Dudgeon, T., Dunnett, L.E., Eastman, P., Erez, N., Eyermann, C.J., Fairhead, M., Fate, G., Fedorov, O., Fernandes, R.S., Ferrins, L., Foster, R., Foster, H., Fraisse, L., Gabizon, R., García-Sastre, A., Gawriljuk, V.O., Gehrtz, P., Gileadi, C., Giroud, C., Glass, W.G., Glen, R.C., Glinert, I., Godoy, A.S., Gorichko, M., Gorrie-Stone, T., Griffen, E.J., Haneef, A., Hassell Hart, S, Heer, J., Henry, M., Hill, M., Horrell, S., Huang, Q.Y.J., Huliak, V.D., Hurley, M.F.D., Israely, T., Jajack, A., Jansen, J, Jnoff, E., Jochmans, D., John, T., Kaminow, B., Kang, L., Kantsadi, A.L., Kenny, P.W., Kiappes, J.L., Kinakh, S.O., Kovar, B., Krojer, T., La, V.N.T., Laghnimi-Hahn, S., Lefker, B.A., Levy, H., Lithgo, R.M., Logvinenko, I.G., Lukacik, P., Macdonald, H.B., MacLean, E.M., Makower, L.L., Malla, T.R., Marples, P.G., Matviiuk, T., McCorkindale, W., McGovern, B.L., Melamed, S., Melnykov, K.P., Michurin, O., Miesen, P., Mikolajek, H., Milne, B.F., Minh, D., Morris, A., Morris, G.M., Morwitzer, M.J., Moustakas, D., Mowbray, C.E., Nakamura, A.M., Neto, J.B., Neyts, J., Nguyen, L, Noske, G.D., Oleinikovas, V., Oliva, G., Overheul, G.J., Owen, C.D., Pai, R., Pan, J., Paran, N., Payne, A.M., Perry, B., Pingle, M., Pinjari, J., Politi, B., Powell, A., Pšenák, V., Pulido, I., Puni, R., Rangel, V.L., Reddi, R.N., Rees, P., Reid, S.P., Reid, L., Resnick, E., Ripka, E.G., Robinson, R.P., Rodriguez-Guerra, J., Rosales, R., Rufa, D.A., Saar, K., Saikatendu, K.S., Salah, E., Schaller, D., Scheen, J., Schiffer, C.A., Schofield, C.J., Shafeev, M., Shaikh, A., Shaqra, A.M., Shi, J., Shurrush, K., Singh, S., Sittner, A., Sjö, P., Skyner, R., Smalley, A., Smeets, B., Smilova, M.D., Solmesky, L.J., Spencer, J., Strain-Damerell, C., Swamy, V., Tamir, H., Taylor, J.C., Tennant, R.E., Thompson, W., Thompson, A., Tomásio, S., Tomlinson, C.W.E., Tsurupa, I.S., Tumber, A., Vakonakis, I., Rij, R.P. van, Vangeel, L., Varghese, F.S., Vaschetto, M., Vitner, E.B., Voelz, V., Volkamer, A., Walsh, M.A., Ward, W., Weatherall, C., Weiss, S., White, K.M., Wild, C.F., Witt, K.D., Wittmann, M., Wright, N., Yahalom-Ronen, Y., Yilmaz, N.K., Zaidmann, D., Zhang, I., Zidane, H., Zitzmann, N., and Zvornicanin, S.N.

Abstract

Item does not contain fulltext, We report the results of the COVID Moonshot, a fully open-science, crowdsourced, and structure-enabled drug discovery campaign targeting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) main protease. We discovered a noncovalent, nonpeptidic inhibitor scaffold with lead-like properties that is differentiated from current main protease inhibitors. Our approach leveraged crowdsourcing, machine learning, exascale molecular simulations, and high-throughput structural biology and chemistry. We generated a detailed map of the structural plasticity of the SARS-CoV-2 main protease, extensive structure-activity relationships for multiple chemotypes, and a wealth of biochemical activity data. All compound designs (>18,000 designs), crystallographic data (>490 ligand-bound x-ray structures), assay data (>10,000 measurements), and synthesized molecules (>2400 compounds) for this campaign were shared rapidly and openly, creating a rich, open, and intellectual property-free knowledge base for future anticoronavirus drug discovery.

Published
2023

7. Aggressive behavior and metacognitive functions: a longitudinal study on patients with mental disorders

Author

Candini, V., Ghisi, M., Bianconi, G., Bulgari, V., Carcione, A., Cavalera, C., Conte, G., Cricelli, M., Ferla, M. T., Ferrari, C., Iozzino, L., Macis, A., Nicolo, G., Stefana, A., De Girolamo, G., Barlati, Stefano, Assunta, Martinazzoli, Giuliana, Mina, Roberta, Paleari, Francesco, Restaino, Bruno, Travasso, and Vita, Antonio

Subjects
medicine.medical_specialty, Longitudinal study, lcsh:RC435-571, media_common.quotation_subject, Protective factor, Metacognition, Hostility, Settore M-PSI/08 - PSICOLOGIA CLINICA, Anger, Mental disorders, Internal mental states, lcsh:Psychiatry, medicine, Personality, Big Five personality traits, Psychiatry, media_common, Aggressive behavior, Risk of violence, Psychiatry and Mental health, Metacognition, Internal mental states, Aggressive behavior, Risk of violence, Mental disorders, medicine.symptom, Psychology, Primary Research, Geriatric psychiatry
Abstract

Background Metacognitive functions play a key role in understanding which psychological variables underlying the personality might lead a person with a severe mental disorder to commit violent acts against others. The aims of this study were to: (a) investigate the differences between patients with poor metacognitive functioning (PM group) and patients with good metacognitive functioning (GM group) in relation to a history of violence; (b) investigate the differences between the two groups in relation to aggressive behavior during a 1-year follow-up; and (c) analyze the predictors of aggressive behavior. Methods In a prospective cohort study, patients with severe mental disorders with and without a lifetime history of serious violence were assessed with a large set of standardized instruments and were evaluated bi-monthly with MOAS in order to monitor any aggressive behavior. The total sample included 180 patients: 56% outpatients and 44% inpatients, and the majority were male (75%) with a mean age of 44 (± 9.8) years, and half of them had a history of violence. The sample was split into two groups: poor metacognition (PM) group and good metacognition (GM) group, according to MAI evaluation scores. Results The PM patients reported a history of violence more frequently than GM patients, during the 1-year follow-up, but no differences between groups in aggressive and violent behavior were found. The strongest predictors of aggressive behavior were: borderline and passive–aggressive personality traits and a history of violence, anger, and hostility. The metacognitive functions alone did not predict aggressive behavior, but metacognitive functions interacted with hostility and angry reactions in predicting aggressive behavior. Conclusions This study led to some important conclusions: (a) some aspects closely related to violence are predictive of aggressive behavior only in patients with poor metacognition, thus good metacognition is a protective factor; (b) poor metacognition is associated with a history of violence, which in turn increases the risk of committing aggressive behavior.

Published
2020
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10. Facial emotion recognition in people with schizophrenia and a history of violence: a mediation analysis

Author

Bulgari, V, Bava, M, Gamba, G, Bartoli, F, Ornaghi, A, Candini, V, Ferla, M, Cricelli, M, Bianconi, G, Cavalera, C, Conte, G, Stefana, A, Picchioni, M, Iozzino, L, Crocamo, C, Carra, G, Bulgari V., Bava M., Gamba G., Bartoli F., Ornaghi A., Candini V., Ferla M. T., Cricelli M., Bianconi G., Cavalera C., CONTE, GEORGIA, Stefana A., Picchioni M., Iozzino L., Crocamo C., Carra G., Bulgari, V, Bava, M, Gamba, G, Bartoli, F, Ornaghi, A, Candini, V, Ferla, M, Cricelli, M, Bianconi, G, Cavalera, C, Conte, G, Stefana, A, Picchioni, M, Iozzino, L, Crocamo, C, Carra, G, Bulgari V., Bava M., Gamba G., Bartoli F., Ornaghi A., Candini V., Ferla M. T., Cricelli M., Bianconi G., Cavalera C., CONTE, GEORGIA, Stefana A., Picchioni M., Iozzino L., Crocamo C., and Carra G.

Abstract

Evidence for an association between impaired facial emotion recognition and violence in people with schizophrenia is inconclusive. In particular, the role of misidentification patterns involving specific emotions such as anger and the influence of clinical characteristics on this association remain unclear. In this study, we compared facial emotion recognition performance in age- and gender-matched schizophrenia spectrum disorders subjects with (N = 52) and without (N = 52) a history of violence. Data on current symptom severity, Cluster B personality status, past victimization, and alcohol and substance misuse were also collected. Compared to those without, subjects with a history of violence showed worse facial emotion recognition performances, involving anger, fear, disgust, sadness, and happiness. When formally testing the reporting of angry faces, evidence of enhanced sensitivity to anger was not supported. Finally, when the impact of current symptoms was assessed, higher severity of activation symptoms, including motor hyperactivity, elevated mood, excitement and distractibility, mediated the relationship between history of violence and poor facial emotion recognition performance. As a whole, our findings seem to support the role of perceptual deficits involving different emotions as well as of a mediation played by activation symptoms. Facial emotion recognition deficits associated with the propensity to violence, as well certain symptoms mediating their relationship, should be targeted by specific treatment approaches.

Published
2020

11. Substance use disorders and violent behaviour in patients with severe mental disorders: A prospective, multicentre study

Author

Cavalera, C, Ferrari, C, Bianconi, G, Bulgari, V, Candini, V, Carrà, G, Clerici, M, Conte, G, Cricelli, M, Ferla, M, Iozzino, L, Macis, A, Stefana, A, Ornaghi, A, de Girolamo, G, Cavalera C., Ferrari C., Bianconi G., Bulgari V., Candini V., Carrà Giuseppe., Clerici M., Conte G., Cricelli M., Ferla M. T., Iozzino L., Macis A., Stefana A., Ornaghi A., de Girolamo G., Cavalera, C, Ferrari, C, Bianconi, G, Bulgari, V, Candini, V, Carrà, G, Clerici, M, Conte, G, Cricelli, M, Ferla, M, Iozzino, L, Macis, A, Stefana, A, Ornaghi, A, de Girolamo, G, Cavalera C., Ferrari C., Bianconi G., Bulgari V., Candini V., Carrà Giuseppe., Clerici M., Conte G., Cricelli M., Ferla M. T., Iozzino L., Macis A., Stefana A., Ornaghi A., and de Girolamo G.

Abstract

Objective: The relationship between alcohol and substance use and the risk of violence exhibited by patients with mental disorders is under-researched. This prospective cohort study aims to compare patients with severe mental disorders and with different substance use behaviors in terms of sociodemographic and clinical characteristics, hostility, impulsivity and aggressive behaviors. Furthermore, this study aims to assess differences in violent behaviors during a 1-year monitoring follow-up. Methods: A total of 378 participants with severe mental disorders from Italian residential facilities and from four Departments of Mental Health (244 outpatients and 134 residential patients) were enrolled. Participants were categorized as Persons with Current Substance Use, Persons with Former Substance Use and Persons with Non-Substance Use. All these patients underwent a complex multidimensional assessment, including the lifetime and current substance use; a subsample of outpatients was also assessed with a laboratory substance assay including the testing for specific substances. We assessed the differences among these three groups in hostility, impulsivity and aggressive behaviors. Results: The results of the close 1-year monitoring show a significantly higher risk of violence for patients with severe mental disorders Persons with Current Substance Use compared to Persons with Former Substance Use and Persons with Non-Substance Use. Persons with Current Substance Use showed significantly higher scores for irritability, negativism and verbal assault compared to Persons with Non-Substance Use. Persons with Former Substance Use showed significantly higher scores for lifetime history of aggressive behaviors compared with patients with Persons with Non-Substance Use. Conclusion: These findings suggest that patients with comorbid mental illness and substance use disorders should be referred for specific interventions to reduce aggressive behavior and ensure patient well-being and

Published
2020

12. Prescribing Patterns of Psychotropic drugs and Risk of violent behaviour: A Prospective, multicentre study in Italy

Author

di Giacomo, E, Stefana, A, Candini, V, Bianconi, G, Canal, L, Clerici, M, Conte, G, Ferla, M, Iozzino, L, Sbravati, G, Tura, G, Micciolo, R, de Girolamo, G, Ferla, M T, di Giacomo, E, Stefana, A, Candini, V, Bianconi, G, Canal, L, Clerici, M, Conte, G, Ferla, M, Iozzino, L, Sbravati, G, Tura, G, Micciolo, R, de Girolamo, G, and Ferla, M T

Abstract

BACKGROUND: This prospective cohort study aimed at evaluating patterns of polypharmacy and aggressive and violent behavior during a 1-year follow-up in patients with severe mental disorders. METHODS: A total of 340 patients (125 inpatients from residential facilities and 215 outpatients) were evaluated at baseline with the Structured Clinical Interview for DSM-IV Axis I and II, Brief Psychiatric Rating Scale, Specific Levels of Functioning scale, Brown-Goodwin Lifetime History of Aggression, Buss-Durkee Hostility Inventory, Barratt Impulsiveness Scale, and State-Trait Anger Expression Inventory-2. Aggressive behavior was rated every 15 days with the Modified Overt Aggression Scale and treatment compliance with the Medication Adherence Rating Scale. RESULTS: The whole sample was prescribed mainly antipsychotics with high levels of polypharmacy. Clozapine prescription and higher compliance were associated with lower levels of aggressive and violent behavior. Patients with a history of violence who took clozapine were prescribed the highest number of drugs. The patterns of cumulative Modified Overt Aggression Scale mean scores of patients taking clozapine (n = 46), other antipsychotics (n = 257), and no antipsychotics (n = 37) were significantly different (P = .001). Patients taking clozapine showed a time trend at 1-year follow-up (24 evaluations) indicating a significantly lower level of aggressive behavior. Patient higher compliance was also associated with lower Modified Overt Aggression Scale ratings during the 1-year follow-up. CONCLUSION: Both inpatients and outpatients showed high levels of polypharmacy. Clozapine prescription was associated with lower Modified Overt Aggression Scale ratings compared with any other antipsychotics or other psychotropic drugs. Higher compliance was associated with lower levels of aggressive and violent behavior.

Published
2020

13. Prescribing Patterns of Psychotropic Drugs and Risk of Violent Behavior: A Prospective, Multicenter Study in Italy

Author

di Giacomo, E., Stefana, A., Candini, V., Bianconi, G., Canal, L., Clerici, M., Conte, G., Ferla, M. T., Iozzino, L., Sbravati, G., Tura, G., Micciolo, R., VIORMED GROUP: Mattia Bava, de Girolamo G., Giuseppe, Carrà, Giulia Gamba: Assunta Martinazzoli, Giuliana, Mina, Alessandra, Ornaghi, Bruno, Travasso, Vita, Antonio, di Giacomo, E, Stefana, A, Candini, V, Bianconi, G, Canal, L, Clerici, M, Conte, G, Ferla, M, Iozzino, L, Sbravati, G, Tura, G, Micciolo, R, and de Girolamo, G

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, AcademicSubjects/MED00415, Adolescent, Hostility, Regular Research Articles, Drug Prescriptions, Medication Adherence, Young Adult, violence, Barratt Impulsiveness Scale, severe mental illne, Rating scale, severe mental illness, Brief Psychiatric Rating Scale, medicine, Humans, Pharmacology (medical), Prospective Studies, Practice Patterns, Physicians', polypharmacy, Psychiatry, aggressive behavior, Modified Overt Aggression Scale, Clozapine, Pharmacology, Polypharmacy, Psychotropic Drugs, clozapine, AcademicSubjects/SCI01870, business.industry, Aggression, Mental Disorders, Middle Aged, Drug Utilization, Psychiatry and Mental health, Cross-Sectional Studies, Italy, Female, medicine.symptom, business, medicine.drug
Abstract

Background This prospective cohort study aimed at evaluating patterns of polypharmacy and aggressive and violent behavior during a 1-year follow-up in patients with severe mental disorders. Methods A total of 340 patients (125 inpatients from residential facilities and 215 outpatients) were evaluated at baseline with the Structured Clinical Interview for DSM-IV Axis I and II, Brief Psychiatric Rating Scale, Specific Levels of Functioning scale, Brown-Goodwin Lifetime History of Aggression, Buss-Durkee Hostility Inventory, Barratt Impulsiveness Scale, and State-Trait Anger Expression Inventory-2. Aggressive behavior was rated every 15 days with the Modified Overt Aggression Scale and treatment compliance with the Medication Adherence Rating Scale. Results The whole sample was prescribed mainly antipsychotics with high levels of polypharmacy. Clozapine prescription and higher compliance were associated with lower levels of aggressive and violent behavior. Patients with a history of violence who took clozapine were prescribed the highest number of drugs. The patterns of cumulative Modified Overt Aggression Scale mean scores of patients taking clozapine (n = 46), other antipsychotics (n = 257), and no antipsychotics (n = 37) were significantly different (P = .001). Patients taking clozapine showed a time trend at 1-year follow-up (24 evaluations) indicating a significantly lower level of aggressive behavior. Patient higher compliance was also associated with lower Modified Overt Aggression Scale ratings during the 1-year follow-up. Conclusion Both inpatients and outpatients showed high levels of polypharmacy. Clozapine prescription was associated with lower Modified Overt Aggression Scale ratings compared with any other antipsychotics or other psychotropic drugs. Higher compliance was associated with lower levels of aggressive and violent behavior.

Published
2020

14. Publisher Correction: Self-harm behaviour and externally-directed aggression in psychiatric outpatients: a multicentre, prospective study (viormed-2 study) (Scientific Reports, (2019), 9, 1, (17857), 10.1038/s41598-019-53993-7)

Author

Scocco, P, Macis, A, Ferrari, C, Bava, M, Bianconi, G, Bulgari, V, Candini, V, Carra, G, Cavalera, C, Clerici, M, Conte, G, Cricelli, M, Ferla, M, Iozzino, L, Stefana, A, de Girolamo, G, Scocco P., Macis A., Ferrari C., Bava M., Bianconi G., Bulgari V., Candini V., Carra G., Cavalera C., Clerici M., Conte G., Cricelli M., Ferla M. T., Iozzino L., Stefana A., de Girolamo G., Scocco, P, Macis, A, Ferrari, C, Bava, M, Bianconi, G, Bulgari, V, Candini, V, Carra, G, Cavalera, C, Clerici, M, Conte, G, Cricelli, M, Ferla, M, Iozzino, L, Stefana, A, de Girolamo, G, Scocco P., Macis A., Ferrari C., Bava M., Bianconi G., Bulgari V., Candini V., Carra G., Cavalera C., Clerici M., Conte G., Cricelli M., Ferla M. T., Iozzino L., Stefana A., and de Girolamo G.

Abstract

The original version of this Article contained errors. In the title of the paper, the word “in” was incorrectly given as “In”. In the original Table 1, cells in column six were not merged correctly and the table has been replaced. Finally, the original Figures 1 and 2 have been replaced with higher resolution images. These errors have now been corrected in the PDF and HTML versions of the Article. The accompanying Supplementary Information file was correct at the time of publication.

Published
2019

15. Self-harm behaviour and externally-directed aggression In psychiatric outpatients: a multicentre, prospective study (viormed-2 study)

Author

Scocco, P, Macis, A, Ferrari, C, Bava, M, Bianconi, G, Bulgari, V, Candini, V, Carra, G, Cavalera, C, Clerici, M, Conte, G, Cricelli, M, Teresa Ferla, M, Iozzino, L, Stefana, A, de Girolamo, G, Scocco P., Macis A., Ferrari C., Bava M., Bianconi G., Bulgari V., Candini V., Carra G., Cavalera C., Clerici M., Conte G., Cricelli M., Teresa Ferla M., Iozzino L., Stefana A., de Girolamo G., Scocco, P, Macis, A, Ferrari, C, Bava, M, Bianconi, G, Bulgari, V, Candini, V, Carra, G, Cavalera, C, Clerici, M, Conte, G, Cricelli, M, Teresa Ferla, M, Iozzino, L, Stefana, A, de Girolamo, G, Scocco P., Macis A., Ferrari C., Bava M., Bianconi G., Bulgari V., Candini V., Carra G., Cavalera C., Clerici M., Conte G., Cricelli M., Teresa Ferla M., Iozzino L., Stefana A., and de Girolamo G.

Abstract

The aim of the project was to investigate differences between outpatients with Severe Mental Disorders (SMDs) with and without a history of Self-Harm behaviour (SHb) and/or Violent behaviour against other people (Vb) in relation to: (a) socio-demographic and clinical characteristics, (b) violent behaviour during a 1-year FU, (c) predictors of SHb and Vb during the FU. Outpatients with SMDs, with and without a history of Vb were enrolled. They were divided in four groups: patients with lifetime Vb (V), patients with both Vb and SHb (V-SH), patients with only SHb (SH) and patients with no history of SHb and Vb (control group, CONT). The frequency and severity of SHb and Vb during the FU were assessed every two weeks by the MOAS. Overall 246 patients were enrolled. BPRS-E Depression item, the SLOF Social acceptability, the BDHI Indirect Aggression, the BIS Motor Impulsiveness and the STAXI-2 Control-Out showed significant correlations with all the four groups (p < 0.030). V and V-SH patient groups reached higher scores in all MOAS sub-scales. Age among the SH group and BPRS-E affect-anxiety subscale among the V group significantly predicted aggression against people. In people with SMDs a history of SHb or Vb is associated with different medium-term outcomes.

Published
2019

16. Personality, Schizophrenia, and Violence: A Longitudinal Study: The Second Wave of the VIORMED Project

Author

Bottesi, G, Candini, V, Ghisi, M, Bava, M, Bianconi, G, Bulgari, V, Carrà, G, Cavalera, C, Conte, G, Cricelli, M, Ferla, M, Iozzino, L, Macis, A, Stefana, A, de Girolamo, G, Bottesi, Gioia, Candini, Valentina, Ghisi, Marta, BAVA, MATTIA, Bianconi, Giorgio, Bulgari, Viola, Carrà, Giuseppe, CAVALERA, CESARE MASSIMO, Conte, Giovanni, Cricelli, Marta, Ferla, Maria Teresa, Iozzino, Laura, Macis, Ambra, Stefana, Alberto, de Girolamo, Giovanni, Bottesi, G, Candini, V, Ghisi, M, Bava, M, Bianconi, G, Bulgari, V, Carrà, G, Cavalera, C, Conte, G, Cricelli, M, Ferla, M, Iozzino, L, Macis, A, Stefana, A, de Girolamo, G, Bottesi, Gioia, Candini, Valentina, Ghisi, Marta, BAVA, MATTIA, Bianconi, Giorgio, Bulgari, Viola, Carrà, Giuseppe, CAVALERA, CESARE MASSIMO, Conte, Giovanni, Cricelli, Marta, Ferla, Maria Teresa, Iozzino, Laura, Macis, Ambra, Stefana, Alberto, and de Girolamo, Giovanni

Abstract

This study investigated the association between maladaptive personality traits, personality disorders (PDs), schizophrenia, and the risk of aggressive behavior. Ninety-four patients with a history of violence and 92 patients with no history of violence underwent a multidimensional baseline assessment. Aggressive behavior was monitored during a 1-year follow-up through the Modified Overt Aggression Scale. The Violent group scored significantly higher than the Control group on the Millon Clinical Multiaxial Inventory (MCMI-III) Antisocial, Sadistic, Borderline, and Paranoid personality scales. Irrespective of any history of violence, patients with PD as a primary diagnosis displayed more aggressive behaviors than those with a primary diagnosis of schizophrenia during the follow-up. Furthermore, the most significant predictor of aggressive behaviors over time was endorsing a primary diagnosis of PD. Identifying the crucial risk factors for violent recidivism would contribute to reducing aggressive behavior in this population.

Published
2021

18. Publisher Correction: Self-harm behaviour and externally-directed aggression in psychiatric outpatients: a multicentre, prospective study (viormed-2 study) (Scientific Reports, (2019), 9, 1, (17857), 10.1038/s41598-019-53993-7)

Author

Scocco P., Macis A., Ferrari C., Bava M., Bianconi G., Bulgari V., Candini V., Carra G., Cavalera C., Clerici M., Conte G., Cricelli M., Ferla M. T., Iozzino L., Stefana A., de Girolamo G., Scocco, P, Macis, A, Ferrari, C, Bava, M, Bianconi, G, Bulgari, V, Candini, V, Carra, G, Cavalera, C, Clerici, M, Conte, G, Cricelli, M, Ferla, M, Iozzino, L, Stefana, A, and de Girolamo, G

Subjects
violence
Abstract

The original version of this Article contained errors. In the title of the paper, the word “in” was incorrectly given as “In”. In the original Table 1, cells in column six were not merged correctly and the table has been replaced. Finally, the original Figures 1 and 2 have been replaced with higher resolution images. These errors have now been corrected in the PDF and HTML versions of the Article. The accompanying Supplementary Information file was correct at the time of publication.

Published
2019

19. Delineation of dominant and recessive forms of LZTR1‐associated Noonan syndrome

Author

Pagnamenta, A, Kaisaki, P, Bennett, F, Burkitt-Wright, E, Martin, H, Ferla, M, Taylor, J, Gompertz, L, Lahiri, N, Tatton-Brown, K, Newbury-Ecob, R, Henderson, A, Joss, S, Weber, A, Carmichael, J, Turnpenny, P, McKee, S, Forzano, F, Ashraf, T, Bradbury, K, Shears, D, Kini, U, De Burca, A, Study, The DDD, Blair, E, and Stewart, H

Subjects
Male, Heterozygote, Adolescent, Infant, Genes, Recessive, Original Articles, Pedigree, Cohort Studies, Gene Ontology, Phenotype, Child, Preschool, Mutation, RAS‐MAPK signalling, Humans, Noonan syndrome, Female, Original Article, Exome, LZTR1, Child, Alleles, developmental disorder, Transcription Factors, Genes, Dominant
Abstract

Noonan syndrome (NS) is characterised by distinctive facial features, heart defects, variable degrees of intellectual disability and other phenotypic manifestations. Although the mode of inheritance is typically dominant, recent studies indicate LZTR1 may be associated with both dominant and recessive forms. Seeking to describe the phenotypic characteristics of LZTR1‐associated NS, we searched for likely pathogenic variants using two approaches. First, scrutiny of exomes from 9624 patients recruited by the Deciphering Developmental Disorders (DDDs) study uncovered six dominantly‐acting mutations (p.R97L; p.Y136C; p.Y136H, p.N145I, p.S244C; p.G248R) of which five arose de novo, and three patients with compound‐heterozygous variants (p.R210*/p.V579M; p.R210*/p.D531N; c.1149+1G>T/p.R688C). One patient also had biallelic loss‐of‐function mutations in NEB, consistent with a composite phenotype. After removing this complex case, analysis of human phenotype ontology terms indicated significant phenotypic similarities (P = 0.0005), supporting a causal role for LZTR1. Second, targeted sequencing of eight unsolved NS‐like cases identified biallelic LZTR1 variants in three further subjects (p.W469*/p.Y749C, p.W437*/c.‐38T>A and p.A461D/p.I462T). Our study strengthens the association of LZTR1 with NS, with de novo mutations clustering around the KT1‐4 domains. Although LZTR1 variants explain ~0.1% of cases across the DDD cohort, the gene is a relatively common cause of unsolved NS cases where recessive inheritance is suspected.

Published
2019
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20. Neuropsychological features in patients with severe mental disorders and risk of violence: a prospective multicenter study in Italy

Author

Gobbi, E., Cotelli, Maria, Manenti, Rosa, Ferrari, C., Macis, A., Bianconi, G., Candini, V., Clerici, M., Ferla, M. T., Iozzino, L., Vita, A., de Girolamo, G., Cotelli Maria, Gobbi, E., Cotelli, Maria, Manenti, Rosa, Ferrari, C., Macis, A., Bianconi, G., Candini, V., Clerici, M., Ferla, M. T., Iozzino, L., Vita, A., de Girolamo, G., and Cotelli Maria

Abstract

In Severe Mental Disorders (SMDs) the most important cognitive deficits involve the Executive Functions (EFs). In this study we examined the association between EFs and aggressive behaviour in outpatients with SMDs. We included a total of 247 outpatients divided into two groups: ‘cases’, patients with a history of violence (N=126) and ‘non-violent’ (N=121). We compared their EFs score and then categorized the participants into four groups (Pathological Non-Violent comparison group; Non-Pathological Non-Violent comparison group; Pathological Violent cases and Non-Pathological Violent cases), based on the scores of a subtest assessing processing speed (i.e., Symbol-coding task) of the Brief Assessment of Cognition in Schizophrenia (BACS). We followed the 4 groups during a 1-year follow-up (FU) monitoring violent behaviour with the Modified Overt Aggression Scale (MOAS). According to the classification based on the BACS-Symbol Coding Task we found no statistically significant differences between subgroups in MOAS scores. We only found that the trend curve for PV was almost consistently over the other group curves in the MOAS ‘aggression against people’. Our results suggested a worse performance in the violent compared to non-violent group in EFs. Despite this evidence, the score on the processing speed task was not associated with aggressive behaviour during FU.

Published
2020

21. Substance use disorders and violent behaviour in patients with severe mental disorders: A prospective, multicentre study

Author

Cavalera, Cesare Massimo, Ferrari, C., Bianconi, G., Bulgari, Viola, Candini, V., Carra, Giovanni, Clerici, Anna Marina, Conte, Gianluigi, Cricelli, M., Ferla, M. T., Iozzino, L., Macis, A., Stefana, A., Ornaghi, A., De Girolamo, Giovanni, Cavalera C. (ORCID:0000-0001-9309-0874), Bulgari V., Carra G., Clerici M., Conte G. (ORCID:0000-0002-8541-6923), de Girolamo G., Cavalera, Cesare Massimo, Ferrari, C., Bianconi, G., Bulgari, Viola, Candini, V., Carra, Giovanni, Clerici, Anna Marina, Conte, Gianluigi, Cricelli, M., Ferla, M. T., Iozzino, L., Macis, A., Stefana, A., Ornaghi, A., De Girolamo, Giovanni, Cavalera C. (ORCID:0000-0001-9309-0874), Bulgari V., Carra G., Clerici M., Conte G. (ORCID:0000-0002-8541-6923), and de Girolamo G.

Abstract

Objective: The relationship between alcohol and substance use and the risk of violence exhibited by patients with mental disorders is under-researched. This prospective cohort study aims to compare patients with severe mental disorders and with different substance use behaviors in terms of sociodemographic and clinical characteristics, hostility, impulsivity and aggressive behaviors. Furthermore, this study aims to assess differences in violent behaviors during a 1-year monitoring follow-up. Methods: A total of 378 participants with severe mental disorders from Italian residential facilities and from four Departments of Mental Health (244 outpatients and 134 residential patients) were enrolled. Participants were categorized as Persons with Current Substance Use, Persons with Former Substance Use and Persons with Non-Substance Use. All these patients underwent a complex multidimensional assessment, including the lifetime and current substance use; a subsample of outpatients was also assessed with a laboratory substance assay including the testing for specific substances. We assessed the differences among these three groups in hostility, impulsivity and aggressive behaviors. Results: The results of the close 1-year monitoring show a significantly higher risk of violence for patients with severe mental disorders Persons with Current Substance Use compared to Persons with Former Substance Use and Persons with Non-Substance Use. Persons with Current Substance Use showed significantly higher scores for irritability, negativism and verbal assault compared to Persons with Non-Substance Use. Persons with Former Substance Use showed significantly higher scores for lifetime history of aggressive behaviors compared with patients with Persons with Non-Substance Use. Conclusion: These findings suggest that patients with comorbid mental illness and substance use disorders should be referred for specific interventions to reduce aggressive behavior and ensure patient well-being and

Published
2020

22. Facial emotion recognition in people with schizophrenia and a history of violence: a mediation analysis

Author

Bulgari, Viola, Bava, M., Gamba, G., Bartoli, F., Ornaghi, A., Candini, V., Ferla, Mariateresa, Cricelli, M., Bianconi, G., Cavalera, Cesare Massimo, Conte, G., Stefana, A., Picchioni, M., Iozzino, L., Crocamo, C., Carra, G., Bulgari V., Ferla M. T., Cavalera C. (ORCID:0000-0001-9309-0874), Bulgari, Viola, Bava, M., Gamba, G., Bartoli, F., Ornaghi, A., Candini, V., Ferla, Mariateresa, Cricelli, M., Bianconi, G., Cavalera, Cesare Massimo, Conte, G., Stefana, A., Picchioni, M., Iozzino, L., Crocamo, C., Carra, G., Bulgari V., Ferla M. T., and Cavalera C. (ORCID:0000-0001-9309-0874)

Abstract

Evidence for an association between impaired facial emotion recognition and violence in people with schizophrenia is inconclusive. In particular, the role of misidentification patterns involving specific emotions such as anger and the influence of clinical characteristics on this association remain unclear. In this study, we compared facial emotion recognition performance in age- and gender-matched schizophrenia spectrum disorders subjects with (N = 52) and without (N = 52) a history of violence. Data on current symptom severity, Cluster B personality status, past victimization, and alcohol and substance misuse were also collected. Compared to those without, subjects with a history of violence showed worse facial emotion recognition performances, involving anger, fear, disgust, sadness, and happiness. When formally testing the reporting of angry faces, evidence of enhanced sensitivity to anger was not supported. Finally, when the impact of current symptoms was assessed, higher severity of activation symptoms, including motor hyperactivity, elevated mood, excitement and distractibility, mediated the relationship between history of violence and poor facial emotion recognition performance. As a whole, our findings seem to support the role of perceptual deficits involving different emotions as well as of a mediation played by activation symptoms. Facial emotion recognition deficits associated with the propensity to violence, as well certain symptoms mediating their relationship, should be targeted by specific treatment approaches.

Published
2020

23. Women slowly taking off: An investigation on female underrepresentation in commercial aviation

Author

Ferla, M. and Graham, A.

Subjects
Women, commercial aviation, gender, discrimination, CSR
Abstract

The purpose of this research is to explore the lack of female representation in commercial aviation, one of the most male-dominated fields in which women still do not benefit from the same professional opportunities as men. This issue constitutes a crucial challenge for the sector, as the inability to attract, recruit and retain women inhibits their professional development, limits growth and profitability, and results in a waste of female talent and skills. This is particularly significant and relevant with regards to the shortage of workforce that the industry will need to face in the next few decades due to the continuous growth of air travel demand and retiring aviation population. Qualitative interviews to female members of the sectors have been employed to distinguish and understand the main challenges and issues concerning women’s participation in commercial aviation and to identify and analyse the causes behind the lack of female representation in the industry. Through the interviews and a qualitative content review of the CSR agenda of different airlines, the research also offers some recommendations to the industry to actively promote the representation of women across different departments and to achieve gender equality and diversity in its workforce.

Published
2019
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24. Correction to: Whole exome sequencing in familial isolated primary hyperparathyroidism

Author

Cetani, F., primary, Pardi, E., additional, Aretini, P., additional, Saponaro, F., additional, Borsari, S., additional, Mazoni, L., additional, Apicella, M., additional, Civita, P., additional, La Ferla, M., additional, Caligo, M. A., additional, Lessi, F., additional, Mazzanti, C. M., additional, Torregrossa, L., additional, Oppo, A., additional, and Marcocci, C., additional

Published
2019
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25. Whole exome sequencing in familial isolated primary hyperparathyroidism

Author

Cetani, F., primary, Pardi, E., additional, Aretini, P., additional, Saponaro, F., additional, Borsari, S., additional, Mazoni, L., additional, Apicella, M., additional, Civita, P., additional, La Ferla, M., additional, Caligo, M. A., additional, Lessi, F., additional, Mazzanti, C. M., additional, Torregossa, L., additional, Oppo, A., additional, and Marcocci, C., additional

Published
2019
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26. Self-harm behaviour and externally-directed aggression In psychiatric outpatients: a multicentre, prospective study (viormed-2 study)

Author

Scocco, P., Macis, A., Ferrari, C., Bava, M., Bianconi, G., Bulgari, V., Candini, V., Carra, G., Cavalera, C., Clerici, M., Conte, G., Cricelli, M., Teresa Ferla, M., Iozzino, L., Stefana, A., de Girolamo, G., Bulgari V., Carra G., Cavalera C. (ORCID:0000-0001-9309-0874), Clerici M., Conte G. (ORCID:0000-0002-8541-6923), de Girolamo G., Scocco, P., Macis, A., Ferrari, C., Bava, M., Bianconi, G., Bulgari, V., Candini, V., Carra, G., Cavalera, C., Clerici, M., Conte, G., Cricelli, M., Teresa Ferla, M., Iozzino, L., Stefana, A., de Girolamo, G., Bulgari V., Carra G., Cavalera C. (ORCID:0000-0001-9309-0874), Clerici M., Conte G. (ORCID:0000-0002-8541-6923), and de Girolamo G.

Abstract

The aim of the project was to investigate differences between outpatients with Severe Mental Disorders (SMDs) with and without a history of Self-Harm behaviour (SHb) and/or Violent behaviour against other people (Vb) in relation to: (a) socio-demographic and clinical characteristics, (b) violent behaviour during a 1-year FU, (c) predictors of SHb and Vb during the FU. Outpatients with SMDs, with and without a history of Vb were enrolled. They were divided in four groups: patients with lifetime Vb (V), patients with both Vb and SHb (V-SH), patients with only SHb (SH) and patients with no history of SHb and Vb (control group, CONT). The frequency and severity of SHb and Vb during the FU were assessed every two weeks by the MOAS. Overall 246 patients were enrolled. BPRS-E Depression item, the SLOF Social acceptability, the BDHI Indirect Aggression, the BIS Motor Impulsiveness and the STAXI-2 Control-Out showed significant correlations with all the four groups (p < 0.030). V and V-SH patient groups reached higher scores in all MOAS sub-scales. Age among the SH group and BPRS-E affect-anxiety subscale among the V group significantly predicted aggression against people. In people with SMDs a history of SHb or Vb is associated with different medium-term outcomes.

Published
2019

27. Violence risk and mental disorders (VIORMED-2): A prospective multicenter study in Italy

Author

Barlati, S, Stefana, A, Bartoli, F, Bianconi, G, Bulgari, V, Candini, V, Carrà, G, Cavalera, C, Clerici, M, Cricelli, M, Ferla, M, Ferrari, C, Iozzino, L, Macis, A, Vita, A, de Girolamo, G, Barlati, Stefano, Stefana, Alberto, Bartoli, Francesco, Bianconi, Giorgio, Bulgari, Viola, Candini, Valentina, Carrà, Giuseppe, Cavalera, Cesare, Clerici, Massimo, Cricelli, Marta, Ferla, Maria Teresa, Ferrari, Clarissa, Iozzino, Laura, Macis, Ambra, Vita, Antonio, de Girolamo, Giovanni, Barlati, S, Stefana, A, Bartoli, F, Bianconi, G, Bulgari, V, Candini, V, Carrà, G, Cavalera, C, Clerici, M, Cricelli, M, Ferla, M, Ferrari, C, Iozzino, L, Macis, A, Vita, A, de Girolamo, G, Barlati, Stefano, Stefana, Alberto, Bartoli, Francesco, Bianconi, Giorgio, Bulgari, Viola, Candini, Valentina, Carrà, Giuseppe, Cavalera, Cesare, Clerici, Massimo, Cricelli, Marta, Ferla, Maria Teresa, Ferrari, Clarissa, Iozzino, Laura, Macis, Ambra, Vita, Antonio, and de Girolamo, Giovanni

Abstract

Background The management of mentally ill offenders in the community is one of the great challenges imposed on community psychiatry. Aim The aim of this study was to analyze the association between sociodemographic, clinical, and psychosocial factors and violent behavior in a sample of outpatients with severe mental disorders. Method This was a prospective cohort study with a baseline cross-sectional design used to provide a detailed analysis of patients’ profiles, followed by a longitudinal design to measure aggressive and violent behavior during a 1-year follow-up. Patients with severe mental disorders, with or without a history of violence, were enrolled in four Italian Departments of Mental Health and underwent a comprehensive multidimensional assessment. Results The sample included 247 outpatients, for a total of 126 cases and 121 controls. Compared to controls, patients with a history of violence had a greater frequency of lifetime domestic violence, a greater lifetime propensity to misuse substances, and a higher number of compulsory admissions. The forthnightly monitoring during the 1-year follow-up did show statistically significant differences in aggressive and violent behavior rates between the two groups. Verbal aggression was significantly associated with aggression against objects and physical aggression. Moreover, outpatients with an history of violence showed statistically significant higher MOAS scores compared to both residential patients with an history of violence, assessed in the first wave of this project, and all controls. Conclusions Patients with a history of violence had specific characteristics and showed a greater occurrence of additional community violence during a 1-year observation period. Our results may assist clinicians in implementing standardized methods of patient assessment and violence monitoring in outpatient mental health services and may prompt improved collaboration between different community services.

Published
2019

28. Violence risk and mental disorders (VIORMED-2): A prospective multicenter study in Italy

Author

Barlati, S., Stefana, A., Bartoli, F., Bianconi, G., Bulgari, Viola, Candini, V., Carra, G., Cavalera, Cesare Massimo, Clerici, M., Cricelli, M., Ferla, Mariateresa, Ferrari, C., Iozzino, L., Macis, A., Vita, A., De Girolamo, Giovanni, Bulgari V., Cavalera C. (ORCID:0000-0001-9309-0874), Ferla M. T., de Girolamo G., Barlati, S., Stefana, A., Bartoli, F., Bianconi, G., Bulgari, Viola, Candini, V., Carra, G., Cavalera, Cesare Massimo, Clerici, M., Cricelli, M., Ferla, Mariateresa, Ferrari, C., Iozzino, L., Macis, A., Vita, A., De Girolamo, Giovanni, Bulgari V., Cavalera C. (ORCID:0000-0001-9309-0874), Ferla M. T., and de Girolamo G.

Abstract

Background The management of mentally ill offenders in the community is one of the great challenges imposed on community psychiatry. Aim The aim of this study was to analyze the association between sociodemographic, clinical, and psychosocial factors and violent behavior in a sample of outpatients with severe mental disorders. Method This was a prospective cohort study with a baseline cross-sectional design used to provide a detailed analysis of patients’ profiles, followed by a longitudinal design to measure aggressive and violent behavior during a 1-year follow-up. Patients with severe mental disorders, with or without a history of violence, were enrolled in four Italian Departments of Mental Health and underwent a comprehensive multidimensional assessment. Results The sample included 247 outpatients, for a total of 126 cases and 121 controls. Compared to controls, patients with a history of violence had a greater frequency of lifetime domestic violence, a greater lifetime propensity to misuse substances, and a higher number of compulsory admissions. The forthnightly monitoring during the 1-year follow-up did show statistically significant differences in aggressive and violent behavior rates between the two groups. Verbal aggression was significantly associated with aggression against objects and physical aggression. Moreover, outpatients with an history of violence showed statistically significant higher MOAS scores compared to both residential patients with an history of violence, assessed in the first wave of this project, and all controls. Conclusions Patients with a history of violence had specific characteristics and showed a greater occurrence of additional community violence during a 1-year observation period. Our results may assist clinicians in implementing standardized methods of patient assessment and violence monitoring in outpatient mental health services and may prompt improved collaboration between different community services.

Published
2019

29. Publisher Correction: Self-harm behaviour and externally-directed aggression in psychiatric outpatients: a multicentre, prospective study (viormed-2 study) (Scientific Reports, (2019), 9, 1, (17857), 10.1038/s41598-019-53993-7)

Author

Scocco, P., Macis, A., Ferrari, C., Bava, M., Bianconi, G., Bulgari, Viola, Candini, V., Carra, Giovanni, Cavalera, Cesare Massimo, Clerici, Anna Marina, Conte, Gianluigi, Cricelli, M., Ferla, M. T., Iozzino, L., Stefana, A., De Girolamo, Giovanni, Bulgari V., Carra G., Cavalera C. (ORCID:0000-0001-9309-0874), Clerici M., Conte G. (ORCID:0000-0002-8541-6923), de Girolamo G., Scocco, P., Macis, A., Ferrari, C., Bava, M., Bianconi, G., Bulgari, Viola, Candini, V., Carra, Giovanni, Cavalera, Cesare Massimo, Clerici, Anna Marina, Conte, Gianluigi, Cricelli, M., Ferla, M. T., Iozzino, L., Stefana, A., De Girolamo, Giovanni, Bulgari V., Carra G., Cavalera C. (ORCID:0000-0001-9309-0874), Clerici M., Conte G. (ORCID:0000-0002-8541-6923), and de Girolamo G.

Abstract

The original version of this Article contained errors. In the title of the paper, the word “in” was incorrectly given as “In”. In the original Table 1, cells in column six were not merged correctly and the table has been replaced. Finally, the original Figures 1 and 2 have been replaced with higher resolution images. These errors have now been corrected in the PDF and HTML versions of the Article. The accompanying Supplementary Information file was correct at the time of publication.

Published
2019

33. Prescribing Patterns of Psychotropic Drugs and Risk of Violent Behavior: A Prospective, Multicenter Study in Italy.

Author

Giacomo, E di, Stefana, A, Candini, V, Bianconi, G, Canal, L, Clerici, M, Conte, G, Ferla, M T, Iozzino, L, Sbravati, G, Tura, G, Micciolo, R, Girolamo, G de, and Group, VIORMED-2

Subjects
VIOLENCE, AT-risk behavior, PSYCHIATRIC drugs, PSYCHIATRIC rating scales, AGGRESSION (Psychology), ARIPIPRAZOLE
Abstract

Background This prospective cohort study aimed at evaluating patterns of polypharmacy and aggressive and violent behavior during a 1-year follow-up in patients with severe mental disorders. Methods A total of 340 patients (125 inpatients from residential facilities and 215 outpatients) were evaluated at baseline with the Structured Clinical Interview for DSM-IV Axis I and II, Brief Psychiatric Rating Scale, Specific Levels of Functioning scale, Brown-Goodwin Lifetime History of Aggression, Buss-Durkee Hostility Inventory, Barratt Impulsiveness Scale, and State-Trait Anger Expression Inventory-2. Aggressive behavior was rated every 15 days with the Modified Overt Aggression Scale and treatment compliance with the Medication Adherence Rating Scale. Results The whole sample was prescribed mainly antipsychotics with high levels of polypharmacy. Clozapine prescription and higher compliance were associated with lower levels of aggressive and violent behavior. Patients with a history of violence who took clozapine were prescribed the highest number of drugs. The patterns of cumulative Modified Overt Aggression Scale mean scores of patients taking clozapine (n = 46), other antipsychotics (n = 257), and no antipsychotics (n = 37) were significantly different (P = . 001). Patients taking clozapine showed a time trend at 1-year follow-up (24 evaluations) indicating a significantly lower level of aggressive behavior. Patient higher compliance was also associated with lower Modified Overt Aggression Scale ratings during the 1-year follow-up. Conclusion Both inpatients and outpatients showed high levels of polypharmacy. Clozapine prescription was associated with lower Modified Overt Aggression Scale ratings compared with any other antipsychotics or other psychotropic drugs. Higher compliance was associated with lower levels of aggressive and violent behavior. [ABSTRACT FROM AUTHOR]

Published
2020
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43. Whole-exome sequencing of HER-2 positive human breast cancers: potential molecular mechanisms of response to neoadjuvant chemotherapy plus trastuzumab

Author

La Ferla, M., primary, Cantini, L., additional, Aretini, P., additional, Scatena, C., additional, Bertolini, I., additional, Fancelli, S., additional, Ferrarini, I., additional, De Angelis, C., additional, Salvadori, B., additional, Michelotti, A., additional, Landucci, E., additional, Ghilli, M., additional, Fustaino, L., additional, Lo Russo, M., additional, Roncella, M., additional, Falcone, A., additional, Bevilacqua, G., additional, Naccarato, G.A., additional, Mazzanti, C.M., additional, and Fontana, A., additional

Published
2015
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46. Estimating suspended sediments concentrations from Acoustic Doppler Current Profiler data in the Venice Lagoon inlets, Italy

Author

Costa F. (1), Zaggia L. (1), Simionato F. (1), Kovacevic V. (2), Gacic M. (2), Arena F. (2), Mancero Mosquera I. (2), Mazzoldi A. (1), Ferla M. (3), and Defendi V. (1)

Subjects
sediment, acoustic doppler current profiler, Venice Lagoon
Abstract

The feasibility of monitoring the suspended particle concentration (SPC) and fluxes (PF) with Acoustic Doppler Current Profilers (ADCP) was tested in the Venice Lagoon inlets. The backscatter recorded by boat- and bottom-mounted instruments was converted into SPC estimates with a calibration procedure based on multiple water sample collection and ADCP transects. Time series of PF across the inlets were derived from discharge and SPC data allowing for the calculation of a preliminary budget of the exchanges between the lagoon and the open sea.

Published
2007

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