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AIM: The aim of this work was to validate the Italian version of GAI (GAI-It) and its short form (GAI-It SF) in an over 65-population. METHODS: In 3 recruitment areas across Italy, two raters reciprocally blind to results assessed eligible subjects; a semi-structured diagnostic clinical interview was performed by a psychiatrist. RESULTS: Among the 76 enrolled subjects (mean age 72.7±6.8 years), anxiety symptoms were very common: 69.7% (moderate/ severe HADS-Anxiety), 76.3% (moderate/severe STAI-state), 71.0% (moderate/severe STAI-trait), 61.8% (GAI), 55.3% (GAI-SF). Sensitivity, specificity and positive predictive value of GAI confirmed a good reliability of the Italian version, with Cronbach's Alpha equal to 0.93 for GAI-It and to 0.77 for GAI-It SF, indicating a very good and good construct validity, respectively, of the scales. The Pearson correlation index demonstrated a moderately positive correlation among GAI, GAI-SF and STAI. CONCLUSIONS: Our data confirm the validity of GAI-It as a valuable instrument to assess anxiety in an elderly population, for clinical and research purposes.

Obiettivo: descrivere l’utilizzo di psicofarmaci in una popolazione ultrasettantacinquenne, mettendolo poi in relazione ai principali disturbi psichiatrici dell’età senile. Metodi: Il Cambridge-Mental-Disorders of the Elderly-Examination (CAMDEX) è stato somministrato a 462 anziani (età media 85.09±6.86 anni, 53.2% donne) arruolati nello studio di popolazione di Faenza. Informazioni riguardo all’uso di farmaci al momento dell’intervista sono state raccolte direttamente dagli intervistati e dai rispettivi care-giver nonché dalla documentazione medica disponibile. Le diagnosi di demenza, disturbi affettivi ed ansiosi sono state fatte sulla scorta dell’intervista e della valutazione clinica in base ai criteri del DSM-IV ed ICD-10. Risultati: Il 32.6% degli intervistati assume 5 farmaci o più rappresentati principalmente da anti-ipertensivi, anti-aggreganti piastrinici ed inibitori della pompa protonica. Le Benzodiazepine sono assunte dal 14% dei partecipanti allo studio, e si trovano così al primo posto tra gli psicofarmaci, e al quarto tra i farmaci di uso comune. Il 26.1% della popolazione assume almeno 1 psicofarmaco, di questi l’1.1% ne assume 3 o più. Tra gli psicofarmaci, gli Ipnoinducenti e gli Antidepressivi sono quelli più utilizzati. Conclusioni: Dallo studio emerge un largo utilizzo di psicofarmaci, tuttavia il trattamento non è sempre adeguato in quanto pazienti affetti da disturbi affettivi e da demenza sono sottotrattati. Grande cautela si osserva nell’utilizzo degli antipsicotici atipici, e sufficiente attenzione nella prescrizione di Benzodiazepine.

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

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