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Background: The aim was to assess the effects of a training program inclusive of contact sports and counseling on school dropout, quality of life (QoL) and psychopathologic symptoms in the youth with a history of school dropout and psychopathic personality traits., Methods: The Experimental Group (EG) consisted of 32 subjects (male 90.6%; age 19.6±4.3 years); the Control Group (CG) consisted of an equal number matched for gender and age with the same psychological features. At the beginning of the experimental Training Program (T0), both cohorts were assessed by a diagnostic psychiatric interview (SCID ANTAS), the Short Form Health Survey (SF-12) to evaluate QoL, the Psychopathy Checklist - Revised (PCL-R) for the assessment of psychopathic traits, the Self Reporting Questionnaire (SRQ) to measure general psychopathology. At the end of the program (T1), the coorths were evaluated by SF-12 and SRQ., Results: Twenty-seven subjects in the EG (84.4%) completed the course and underwent the evaluation at T1. The SF-12 score significantly increased from T0 to T1 in both groups, albeit this was more evident in the EG than in the CG, owing to an interaction between time and group. SRQ score significantly decreased in the EG from T0 to T1, while in the CG it did not, although the interaction between time and group was not significant., Conclusion: The experimental training program was effective in improving QoL and countering school dropout in young citizens with psychopathic traits. Further studies are needed to clarify if such results are due to a relationship between the practical tasks approach including contact sports and an improvement in mentalization processes.

Background: To compare the six-month outcome on mood, cognition and quality of life (QoL) in patients with severe carotid atherosclerosis (CA) who underwent carotid endarterectomy (CEA) with subjects who refused treatment., Methods: Cohort study on consecutive inpatients with CA (stenosis ≥ 50 %) (N = 46; age 72.56 ± 7.26; male 65.2 %). Intervention cohort: subjects who decided to undergo CEA (N = 35); Control cohort patients who refused CEA (N = 11). DSM-IV-Psychiatric diagnosis made by clinicians using interviews, QoL measured by Short Form Health Survey (SF-12); cognitive performance by WAIS Intelligent Coefficient (IC)., Results: The study showed a better improvement during six months in Overall IC, Performance IC and Verbal IC in the group that underwent CEA. QoL in the two cohorts did not reach statistical significance. Percentages of patients who improved in the CEA group were significantly higher with regard to Overall and Verbal IC scores, and at the limits of statistical significance in Performance IC. The differences of subject with improvement in SF-12 score in the two groups did not reach statistical significance. Ages below 68 were found to be determinant of a good outcome in Overall IC score. Limit: study conducted with a small sample size., Conclusions: Patients with severe carotid atherosclerosis who underwent CEA enhanced their cognitive performance.

Background: This study examines the psychosocial outcomes of women discharged from the Vlore Psychiatric Hospital in Albania., Methods: The study was designed as a controlled, not randomized, follow-up study. It included 16 women diagnosed with psychosis who were discharged from a psychiatric hospital to live in group homes in the community. The control group included 20 women diagnosed with psychosis who lived at the psychiatric hospital while awaiting discharge. All subjects were assessed twice using the HoNOS-Rome tool, at the start of the study (T0) and 12 months later (T1)., Results: Both groups showed an improvement in the HoNOS total score between T0 and T1 (p < .001). This improvement was significantly larger in the Home group compared to the Hospital group (p = .014). An item-level analysis indicated a significantly greater improvement in the Home group on items 11 (autonomy), 12 (work), 16 (family) and 18 (goals)., Conclusions: Projects for social inclusion of people suffering from psychosis must design living spaces that offer viable alternatives to psychiatric hospitals. This study also documents the efforts in the Vlore region of Albania to follow European standards of mental health care.

Background: The objective of the study was to determine if community surveys, conducted 3 times over a period of 20 years in a small district of Sardinia (Italy), confirm the increase in depressive disorders reported in the recent literature., Methods: Three community surveys were carried out on randomized samples of the same Sardinian mining area in 1988, 1998 and 2008. The surveys were conducted using the interview "Present State Examination" in 1988 (depression diagnosed with ICD-IX) and the CIDI-S in 1998 and 2008 (major depression diagnosed with ICD-X). The three surveys produced estimates of one-month prevalence and of lifetime prevalence in 1998 and 2008., Results: Our work found a substantial decrease in depressive disorders from the survey conducted in 1998 to the survey in 2008 using a similar methodology, except in the youngest age group, which showed an increase in the rate. A decrease in the frequency of depressive disorders compared to what was found 20 years ago was also observed. However, in this case the comparison is more problematic because of use of different diagnostic systems., Discussion: The research seems to show a decrease in depressive disorders over the past two decades. While the small population examined makes it difficult to generalize the overall findings, this study suggests that the hypothesis of an increase in the incidence of depressive disorders since the 1980s in western countries, should have exceptions. A complex interaction between socio-economic (mining closure and large migration) and biological factors (possible selective migration) is likely to influence changes in the prevalence of mood disorders. However, due to certain limitations of this study, this hypothesis may be considered from a heuristic perspective., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Background: The purpose of this population-based study is to examine the association between subjective quality of life and rural/urban residence in six Italian regions, including age and gender into the analysis., Study Design: community survey., Study Population: Samples stratified according to sex and age, drawn from municipal records., Sample Size: 4999 people 18 years and older, from seven communities within six regions of Italy., Tools: Ad-hoc form to assess basic demographic data; SF-12. Interviewers were trained psychologists or medical doctors., Results: 3398 subjects were interviewed (68% of recruited sample). The mean score of SF-12 in the overall sample was 38.4±6.1, SF-12 was higher in men than in in women (38.4±6.1 vs 37.5±5.9 F=99.18, df 1, 3396, 3397, p<0.0001); SF-12 score decreased from the youngest to the oldest age group, with significant differences between all ages groups; men showed higher scores in all age groups. The urban/rural difference of mean scores of SF-12 did not achieve statistical significance in women. Young men with urban residence had higher SF-12 scores than their counterparts with rural residence. Maen aged 65 years and older with rural residence showed, by contrast, higher scores than men from the same age group with urban residence., Conclusions: Men show a higher subjective quality of life than women. Subjective quality of life decreases with age in both genders.Men are more sensitive to urban/rural residence than women.Young men live better in cities, elderly men better in rural areas.

Background: To determine the use of antidepressants (ADs) in people with sub-threshold depression (SD); the lifetime prevalence of mania and hypomania in SD and the link between ADs use, bipolarity and anxiety disorders in SD., Study Design: community survey., Study Population: samples randomly drawn, after stratification from the adult population of municipal records., Sample Size: 4999 people from seven areas within six Italian regions. Tools: Questionnaire on psychotropic drug consumption, prescription; Structured Clinical Interview NP for DSM-IV modified (ANTAS); Hamilton Depression Rating Scale (HAM-D); Mood Disorder Questionnaire (MDQ); Short Form Health Survey (SF-12). SD definition: HAM-D > 10 without lifetime diagnosis of Depressive Episode (DE)., Results: SD point prevalence is 5.0%. The lifetime prevalence of mania and hypomania episodes in SD is 7.3%. Benzodiazepines (BDZ) consumption in SD is 24.1%, followed by ADs (19.7%). In SD, positive for MDQ and comorbidity with Panic Disorder (PD) or Generalized Anxiety Disorders (GAD) are associated with ADs use, whereas the association between a positive MDQ and ADs use, without a diagnosis of PD or GAD, is not significant. Only in people with DE the well-being (SF-12) is higher among those using first-line antidepressants compared to those not using any medication. In people with SD no significant differences were found in terms of SF-12 score according to drug use., Conclusions: This study suggests caution in prescribing ADs to people with SD. In people with concomitant anxiety disorders and SD, it should be mandatory to perform a well-designed assessment and evaluate the presence of previous manic or hypomanic symptoms prior to prescribing ADs.

The present study is aimed at evaluating the efficacy of an introductory mini tennis programme as a therapeutic aid in the psychosocial rehabilitation of participants affected by mild/moderate intellectual disability in semi-residential care.Two groups (N=12) of participants diagnosed with intellectual disability, one of which followed the mini tennis rehabilitation programme, were compared at time t0, t1 (after 2 months) and t2 (after 6 months).Psychopathological status was assessed by means of the Italian version of the Assessment and Information Rating Profile (AIRP). Motor coordination, lateral dominance and body scheme were assessed by means of structured tools.Psychopathological total scores showed a statistically significant decrease in the experimental group in comparison with the control group. A statistical decrease in the group with the mini tennis rehabilitation programme was found also in the anxiety sub-scale while the sub-scales schizophrenia, depression, adjustment disorder, personality problems, somatoform disorders and psychosexual disorders did not reach any statistical difference between groups.A statistically significant increase in the visuo manual coordination was highlighted in the experimental versus the control group. No statistically significant differences were reported with regard to general movement skills, dynamic balance and coordination.In spite of the limitations of this study, the results obtained are encouraging and suggest the potential efficacy of mini tennis as an auxiliary aid in rehabilitation programmes, particularly to improve visuo manual coordination skills and to boost the patient/participants' self esteem. These findings warrant confirmation by further research studies.

Background: The increased use of antidepressant drugs (ADs) improved the response to the needs of care although some community surveys have shown that subjects without lifetime psychiatric diagnosis (anxiety/depression) used ADs., Objectives: To evaluate the appropriateness and amount of prescription of psychotropic drugs in people with lifetime diagnosis of Major Depressive Disorder (MDD) by means of community survey with a semi-structured interview as a diagnostic instrument, administered by clinicians., Study Design: community survey., Study Population: samples randomly drawn, after stratification from the adult population of municipal records., Sample Size: 4.999 people were drawn in 7 centres of 6 Italian regions., Tools: questionnaire on psychotropic drug consumption, prescription, health services utilization; Structured Clinical Interview for DSM-IV modified (ANTAS); Training: interviewers were trained psychologists or medical doctors., Results: 3.398 subjects were interviewed (68% of the recruited sample). The lifetime prevalence of DSM-IV MDD was 4.3% in males and 11.5% in females; antidepressant drugs were taken by 4.7% of subjects, 2.9% male and 5.9% female. 38% of males and 57% of females with lifetime diagnosis of MDD were taking ADs., Conclusions: Compared with studies using lay interviewers and structured tools the prevalence of the MDD was quite lower; ADs use was higher and tallied well with the data regarding antidepressant sales in Italy; the correspondence between lifetime diagnosis of MDD and ADs use was closer.