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Introduzione: L'apnea ostruttiva del sonno (OSA) è un comune disturbo cronico del sonno caratterizzato da ricorrenti ostruzioni delle vie respiratorie superiori, che causano interruzioni intermittenti della respirazione, influenzando significativamente la salute generale e la qualità della vita degli individui. L'OSA è accompagnata da sintomi quali forte russamento, risvegli frequenti, sonnolenza diurna, mal di testa, nicturia, irritabilità e compromissione della concentrazione, con un impatto notevole sulla qualità del sonno dei pazienti e dei loro partner. Nonostante la sua diffusione globale e i rischi per la salute associati, la sottodiagnosi e il trattamento insufficiente continuano a costituire un problema diffuso. In questo contesto, il ruolo dei partner diventa cruciale, poiché spesso motivano i pazienti a cercare una valutazione medica. La presente sistematica revisione della letteratura con meta-analisi ha l’obiettivo di indagare il potenziale miglioramento delle dinamiche psicologiche all’interno delle coppie nelle quali uno dei membri sia sottoposto a terapia con Pressione Positiva Continua (CPAP). Metodi: Da novembre 2023 a gennaio 2024, è stata condotta una revisione sistematica della letteratura seguendo la checklist PRISMA. Gli studi inclusi esplorano la relazione tra l'utilizzo della CPAP e la qualità della relazione di coppia, considerando la soddisfazione per la relazione, per la propria vita sessuale, il supporto e il conflitto, così come percepiti sia dai pazienti che dai loro bedpartner. La ricerca dei dati è stata eseguita attraverso database elettronici, tra cui PubMed, PsycINFO e Scopus, senza imposizione di restrizioni linguistiche o di data di pubblicazione. Inoltre, è stata condotta una meta-analisi al fine di osservare eventuali cambiamenti nelle disfunzioni sessuali maschili nei pazienti affetti da apnea ostruttiva del sonno (OSA) prima e dopo l'utilizzo della CPAP. Risultati e Conclusioni: La revisione della letteratura ha i

Background: Obstructive Sleep Apnea (OSA) impacts couple relationship quality between patients and bedpartners. Although Continuous Positive Airway Pressure (CPAP) is recognized as the gold standard treatment, adherence to it poses significant challenges, potentially influenced by illness perceptions (IP). Aims and Objectives: This study aims to investigate the association between CPAP adherence, patients' and bedpartners' IP, and couple relationship quality. Methods: A cross-sectional study is currently underway at the Sleep Center of Fondazione Don Gnocchi (Milan), involving OSA patient-bedpartner dyads, who completed medical and psychological assessments including questionnaires on IP, daytime sleepiness, sleep quality, and relationship quality. Results: The study involved 65 couples with OSA (average AHI=31.20). Patients, remotely monitored (CPAP hours/night: 4.64±2.55), were categorized based on CPAP adaptation stages: 12.3% not yet started, 43.1% within the first year, and 44.6% over a year. Patients' IP of severity decreased with longer adaptation [(t(62)=-2.52, p=.007], with similar trends in bedpartners [(t(62)=-1.71, p=.046]. A negative correlation was found between CPAP usage and patients’ IP (r=-.381; p=.004). However, a positive correlation was noted between patients' and bedpartners' IPs (r=.453; p=.001). Relationship quality improved with longer CPAP adaptation, in both patients [(t(60)=2.19, p=.016] and bedpartners [(t(52)= 2.67, p=.005], but was not significantly correlated with its usage. Conclusions: Considering IP in interventions to enhance CPAP adherence is crucial in OSA management.

Introduzione ad un testo significativo nel settore psicologia dell'emergenza

Separated from their ecological niche, refugees always experience multiple difficulties (Miller & Rasmussen, 2017). Language and culture of origin may prove insufficient to address the challenges posed by places of transit, temporary reception areas and communities that offer refuge (Mela, 2015). The conditions of daily life are often very demanding, sometimes seriously hindering even the possibility of responding to one’s basic needs. Staying united with a group of compatriots often represents a resource and a protective factor, since it makes personal drama a shared condition and allows for greater recognition and help at a social and political level. International research agrees in detecting a higher incidence among refugees (compared to host populations) of anxiety disorders, depression and disorders related to stress and trauma: adaptability disorders, acute stress disorders, PTSD and complex PTSD (Fazel et al., 2005; Lindert et al., 2009; Slewa-Younan et al., 2015). However, we must not make the mistake of thinking that psychological discomforts are all and only rooted in the experience of forced escape from the places of origin. The refugee condition is part of life paths that are sometimes already compromised by previous negative experiences, risk factors and consolidated vulnerabilities.

This study explores the details of cross-cultural hosting experiences, centering on the experiences and ideas of host families who welcomed Ukrainian refugees after the Russian full-scale aggression of Ukraine started in 2022. The research, carried out in different parts of Northern Italy, investigates both quantitative and qualitative aspects to discover the factors that mostly influence the hosting experience and the willingness of host families to host refugees once more.

Una buona consapevolezza dei pericoli che si intrecciano alle diverse attività umane potrebbe permettere una sensata valutazione dei rischi probabili, una prefigurazione dei danni plausibili e, di conseguenza, una pianificazione consapevole di azioni prudenti e protettive, una preparazione opportuna o una copertura assicurativa per le conseguenze irreparabili e probabili. Oppure, potrebbe suggerire un evitamento delle azioni troppo rischiose o, al contrario, una scelta di agire in modo coraggioso, con consapevole assunzione di responsabilità rispetto ad eventuali esiti nefasti dell’operazione intrapresa. Iniziamo dunque ad esaminare il tema della percezione delle minacce, cioè della consapevolezza che possono accadere quei cambiamenti rapidi e negativi che costituiscono il centro dei contesti emergenziali. Attraverso quali processi mentali si sviluppa la consapevolezza dei rischi?

Collocare l’adolescenza come una fase di vita risulta certamente appropriato, ma tale inquadramento, se non accompagnato da ulteriori considerazioni, potrebbe rivelarsi oltremodo riduttivo. L’adolescenza, infatti, non riguarda solamente un periodo che si interpone tra la pubertà e la vita adulta, ma un modus vivendi, connotato da precise esperienze capaci di presentarsi più volte nel corso della vita, anche quando da un punto di vista anagrafico si potrebbe pensare che tale fase risulti ormai compiuta. Ansia per il futuro e difficoltà di gestire desideri tra loro contrastanti rappresentano solo alcuni dei tratti che colorano il complesso mondo adolescenziale. Si potrebbe sostenere che la caratteristica distintiva dell’adolescenza riguarda il cambiamento. L’esser costantemente in trasformazione connota la vita dell’adolescente che, più dell’adulto, vive all’interno di una dimensione di indeterminatezza che lo incoraggia a sperimentarsi e a sperimentare le cose del mondo.

In order to avoid that many senior citizens with Mild Cognitive Impairment (MCI) could become chronic patients with a low level of functioning in many cognitive, behavioral and emotional domains, some technological solutions have been improved to better enhance less compromised healthy lifestyle, providing real-time clinically-based suggestions and reducing some dysfunctional behaviors. Moreover another critical problem is the overweight and obesity that can affect many people in Western but also Eastern regions. In order to cope with MCI and obesity, mhealth monitor-ing solutions (smart-watches based and wearable based) have been devel-oped. The major aim of this paper is to show the rationale behind the SENIOR Project, a Cariplo funded project that will develop and deliver wearable monitoring solutions with tailored nudging feedbacks for patients with obesity an MCI. Scientific background, rationale, aims, outcomes measured and innovations are discussed.

Il volume vuole fornire una cornice di riferimento per la psicologia dell’invecchiamento che non approfondisca tanto le questioni teoriche sul “cosa accade al corpo e alla mente quando si invecchia”, ma fornisca strumenti operativi per superare lo stigma dell’invecchiare. Un testo pensato per psicologi, medici, infermieri, assistenti sociali e altri operatori socio-sanitari che esercitano la professione con persone anziane.

Objective: Food avoidance is central to patients with anorexia nervosa-restrictive type (AN-R). Competing accounts in experimental psychopathology research suggest that food avoidance may result from automatic, habitual responses or from elevated inhibitory control abilities. This study investigated behavioral trajectories of food avoidance in a novel virtual reality stopping task. Method: Sixty patients with AN-R and 29 healthy controls with normal weight were investigated using a novel, kinematic task in virtual reality. We recorded spatial displacement in stop- and go-trials to virtual food and control objects. Inhibitory control abilities were operationalized by the VR task in stopping performance (i.e., interrupted movement in stop-trials), whereas we also measured habitual avoidance of virtual food across both go- and stop-trials (i.e., delayed movement relative to nonfood objects). Results: In patients with AN-R, hand displacements were shorter to food versus nonfood across stop- and go-trials, reflected in a Stimulus × Group interaction. Healthy controls showed no differences. Importantly, the food-specific effect in AN-R was identical across stop- and go-trials, indicating habitual food avoidance. Moreover, stop error rates (i.e., stop-trials with response) were lower in patients with AN-R. Discussion: The findings suggest food-specific habitual avoidance and heightened generalized inhibitory control in AN-R. The continuously delayed displacements during active hand movements across stop- and go-trials indicated the persistence of patients' avoidance of food. Public Significance: Experimental research investigates the mechanisms underlying mental disorders such as anorexia nervosa. In this study, we measured interrupted hand movements in response to food pictures or neutral pictures (shoes) in patients with anorexia nervosa and healthy controls. A virtual reality scenario was used. Findings indicated that patients were slower at approaching food, interrupte

Objective: Individuals with fibromyalgia report alarming levels of suicidal ideation, and comorbidity with other chronic health conditions such as obesity—a risk factor for suicidal ideation per se—could further complicate the clinical picture. The aim of this study is to determine, in a sample of women with fibromyalgia and comorbid obesity, the prevalence of suicidal ideation and to evaluate clinical, pain-related and psychological factors associated with suicidal ideation. Methods: In total, 156 female individuals with fibromyalgia and obesity were recruited and completed a series of self-report measures that assessed (i) the level of pain intensity, (ii) depressive symptomatology, (iii) sleep quality, and (iv) pain catastrophizing. Suicidal ideation was evaluated by item #9 of the Beck Depression Inventory. In addition, information regarding previous suicide attempts and current opioid use was collected. Results: 3n sum, 7.8% of participants reported presence of suicidal ideation. According to the results of the multiple logistic regression, depressive symptomatology, sleep quality, and pain catastrophizing were associated with the presence of suicidal ideation. Discussion: The presence of suicidal ideation in our sample was significantly associated with depressive symptomatology, sleep quality, and pain catastrophizing. Our findings are the first to suggest a unique (ie, independent of depressive symptomatology, and sleep quality) association between pain catastrophizing and suicidal ideation in the context of fibromyalgia and comorbid obesity. In order to prevent and reduce suicidal ideation, these factors should be assessed and targeted in interventions for pain management. Future research should investigate the extent to which addressing depressive symptoms, sleep quality, and pain catastrophizing reduces suicidal ideation.

Background: The Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18) is an extensively used questionnaire to measure three transdiagnostic features of eating behavior: cognitive restraint, uncontrolled eating, and emotional eating. Objective: This research aims to investigate the psychometric properties of the Italian version of the TFEQ-R-18 in three large community samples. Method: Cross-sectional research designs were employed. In Study 1 (N = 537), an exploratory graph analysis (EGA) was used to examine item clustering within the TFEQ-R-18. In Study 2 (N = 645), a confirmatory factor analysis (CFA) was conducted to test its structural validity. In Study 3 (N = 346), a MANOVA was employed assessing mean differences across eating disorders (e.g., anorexia nervosa, bulimia nervosa, binge eating disorder). Results: In Study 1, the EGA accurately identified the three original dimensions of the TFEQ-R-18. Study 2 showed that the Italian TFEQ-R-18 has good fit indexes (CFI = 0.989, RMSEA = 0.064; 90% CI [0.058, 0.070], SRMR = 0.062), and possesses robust psychometric properties. Study 3 reveals distinct, statistically significant differences among eating disorders. Conclusion: The TFEQ-R-18 proves to be a concise and precise tool for measuring transdiagnostic eating behaviors. Its applicability in the Italian context, supported by robust psychometric properties, suggests its utility for both research and clinical purposes. The findings affirm its potential to inform interventions aimed at enhancing psychological health. Level of evidence: Level V, descriptive study.

Background: The ever-increasing spread of Internet-based systems for common mental disorders has generated the need for brief online screening methods. This study aims to test the psychometric properties of the Web Screening Questionnaire (WSQ) to examine its suitability for screening for common mental health problems among a community sample of Italian adults. Methods: A total of 1282 subjects (F = 819; mean age = 42.05) answered the WSQ. Its discriminant characteristics were examined with other validated selected scales for measuring mental health widely used in the Italian population using sensitivity, specificity, and area under the curve (AUC), as well as positive (PPV) and negative predictive values (NPV). Results: Most of the WSQ subscales exhibited moderate to high specificity values. Specifically, the scales of ‘agoraphobia’ (0.947; 95%CI [0.934, 0.960]), ‘anxiety’ (0.959; 95%CI [0.946, 0.970]), and ‘panic disorder’ (0.973; 95%CI [0.964, 0.981]) showed the highest values whilst the ‘obsessive-compulsive’ dimension had the lowest value at 0.838, 95%CI [0.815, 0.861]. With exceptions observed for ‘depression’ (0.716; 95%CI [642, 798]) and ‘alcohol abuse’ (0.760; 95%CI [560, 920]), instead, the WSQ demonstrated critical sensitivity values (<0.6) in all dimensions. Conclusions: The WSQ was appropriate for discriminating between people with and without a psychiatric condition, as it helps to confirm the absence of disorders. However, further diagnostic procedures are required, in case of a positive WSQ screening result.

Background: Cognitive remediation therapy (CRT) for anorexia nervosa (AN) is an intervention specifically focused on addressing cognitive difficulties associated with the eating disorder. This systematic review of systematic reviews and meta-analysis aimed to provide a summary of the existing literature examining the efficacy of CRT in improving the neuropsychological, psychological, and clinical parameters of patients with AN. Methods: Systematic reviews and meta-analyses were sought in electronic databases, encompassing studies that explored the impact of CRT on AN. Three eligible reviews were identified based on the inclusion criteria. The Revised Assessment of Multiple SysTemAtic Reviews (R-AMSTAR) was employed to evaluate the methodological quality of the reviews, and all included reviews demonstrated satisfactory methodological quality with an R-AMSTAR score of >= 22. Relevant information was extracted from each review and qualitatively compiled. Results: Findings suggest that CRT can help people increase their awareness of cognitive styles and information processing and have a positive effect on patients' responses to treatment. Conclusions: Further research is required to better understand its impact on other relevant outcomes, including psychological variables, to optimize the treatment's benefits.

Background: Parent–child agreement regarding emotional and behavioral problems in adolescents with obesity was measured. Methods: One hundred Italian adolescents with obesity (36 males, 64 females, mean age ± SD: 15.3 ± 1.61 years, mean body mass index, BMI: 37.9 ± 5.48 kg/m2), hospitalized for a 3-week multidisciplinary body weight reduction program at Istituto Auxologico Italiano, Piancavallo-Verbania, Italy, and one of their parents (n = 100, 40 fathers, 60 mothers) participated in the study. Achenbach’s Child Behavior Checklist (CBCL) for parents and the Youth Self Report (YSR) for teens were administered. Results: Most of the CBCL and YSR scores were normal, with more borderline and clinical scores being found in CBCL (29% of borderline scores in attention problems, 28% in affective problems, and 26% in ADHD; 32% of clinical scores in affective problems, 23% in withdrawn/depressed, and 22% in anxiety problems and somatic complains subscales) than in YSR (19% of borderline scores in affective behaviors and 17% in somatic complains; 15% of clinical scores in anxiety problems and 17% in withdrawn/depressed subscale). Young females reported greater anxiety problems (p = 0.009), oppositional defiant problems (p = 0.029), anxiety/depressed (p = 0.030), and internalizing problems (p = 0.045) than males. Pearson’s coefficients ranged between 0.273 to 0.517. Conclusions: This study provides information on the cross-informant evaluation of psychological profiles with CBCL and YSR in a clinical sample of adolescents with obesity and their parents.

Background: Nordic walking (NW) has several potential benefits for individuals with cardiovascular disease (CV), type 2 diabetes, and obesity/overweight. It improves cardiovascular health, including exercise capacity and blood pressure control. It enhances glycemic control and insulin sensitivity in diabetes. It aids in weight management and body composition improvement. NW offers additional advantages such as improved muscular strength, joint mobility, physical activity levels, and psychological well-being. Methods: This open-label study with three arms will aim to evaluate the efficacy, safety, and adherence to exercise prescription in obese/overweight diabetic patients with CV complications. The primary objective will be to assess the CV performance of participants after a 6- and 12-month follow-up period, following a 3-month NW intervention, compared with standard rehabilitation (SR) and cardiological counseling (control group, CG) training lasting 3 months. Results: The results of the study will provide valuable insights into the comparative effectiveness of a NW intervention versus SR and CG training in improving cardiovascular performance in obese/overweight diabetic patients with CV complications. Additionally, safety and adherence data will help inform the feasibility and sustainability of the exercise prescription over an extended period. Conclusions: These findings may have implications for the development of tailored exercise programs for this specific patient population, with the aim of optimizing cardiovascular health outcomes.

Spatial navigation (SN) has been reported to be one of the first cognitive domains to be affected in Alzheimer's disease (AD), which occurs as a result of progressive neuropathology involving specific brain areas. Moreover, the epsilon 4 isoform of apolipoprotein-E (APOE-epsilon 4) has been associated with both sporadic and familial late-onset AD, and patients with mild cognitive impairment (MCI) due to AD are more likely to progressively deteriorate. Spatial navigation performance will be examined on a sample of 76 community-dwelling senior citizens (25 healthy controls; 25 individuals with subjective cognitive decline (SCD); and 26 patients with MCI due to AD) via a virtual computer-based task (i.e., the AppleGame) and a naturalistic task (i.e., the Detour Navigation Test-modified version) for which a wearable device with sensors will be used for recording gait data and revealing physiological parameters that may be associated with spatial disorientation. We expect that patients with MCI due to AD and APOE-epsilon 4 carriers will show altered SN performances compared to individuals with SCD and healthy controls in the experimental tasks, and that VR testing may predict ecological performance. Impaired SN performances in people at increased risk of developing AD may inform future cognitive rehabilitation protocols for counteracting spatial disorientation that may occur during elders' traveling to unfamiliar locations. The research protocol has been approved by the Ethics Committee of the Istituto Auxologico Italiano. Findings will be published in peer-reviewed medical journals and discussed in national and international congresses.

Scopo del presente intervento è quello di discutere le radici di queste violenze, le loro forme e il loro valore relazionale. Si tratta di descrizioni, concettualizzazioni ed ipotesi utili alla prevenzione e alla presa in carico delle sofferenze connesse a questi comportamenti. Innanzitutto, sarà necessario chiarire alcuni termini, che anche in letteratura sono a volte tra di loro confusi. Collera, ostilità, aggressività e violenza appartengono alla stessa area semantica, ma con sfumature diverse. Cercheremo in particolare di distinguere il concetto di aggressività da quello di violenza. Distingueremo dunque il comportamento aggressivo dal comportamento violento . Si tratta di concetti contigui, e a volte considerati sinonimi, ma che rappresentano fenomeni differenti.

In the past decade, Internet of Things (IoT) technologies have become more and more pervasive, allowing the development of Ambient Intelligence and Context Awareness applications. While the smart home is the chosen scenario for such technologies, a variety of environments could potentially benefit from the synergies between IoT and digital applications. Among them, the clinical waiting rooms is an environment facing several challenges, particularly after the COVID-19 pandemic. Clinical waiting rooms are crowded places associated with stress and anxiety, often linked to patients’ idling time. Nonetheless, the rise of IoT-enabled telehealth has focused attention on the possibility of changing the functions of clinical waiting rooms. In this work, we conducted a systematic literature review to identify the existing solutions for “smart waiting rooms”. The review process started with 278 works, and it identified 16 papers relevant to the topic of smart clinical waiting rooms. Moreover, the results of this review underlined that waiting rooms are a neglected research area that could take advantage of IoT and Artificial Intelligence (AI) technologies to enhance patients’ experience and support the diagnostic process. Leveraging the research directions identified in the review process, this work proposes a “Smart Waiting Room” that exploits virtual reality (VR), AI, and IoT technologies to support the diagnostic process (via a cognitive assessment) and the personalization of the patient’s context—taking into account the features of the physical environment. The prototypical smart waiting room constitutes an example of the potentialities of novel technologies applied to healthcare and can contribute to shaping the future of clinical waiting rooms.

La psicologia dell’emergenza si occupa di tutti i processi psichici che preparano, accompagnano e riparano i danni causati da eventi improvvisi e lesivi. Per questo si occupa delle persone colpite da incidenti (di trasporto, domestici, sul lavoro) oltre che delle organizzazioni e delle comunità ferite da disastri, catastrofi e crisi (Sbattella 2020). Per quanto riguarda la prevenzione degli incidenti, in particolare, la psicologia dell’emergenza si interessa della percezione dei rischi e dei comportamenti che aumentano la sicurezza e la protezione dei singoli e delle collettività. E non lo fa studiando solo la psicologia individuale. Lo studio dell’incidentalità sui luoghi di lavoro, ad esempio, obbliga ad allargare l’orizzonte delle osservazioni alle dinamiche dei sistemi sociotecnici, alle logiche organizzative e alle culture connesse agli incidenti stessi. In queste pagine cercheremo di riflettere su un aspetto puntuale della cultura che promuove la sicurezza nei luoghi di lavoro oggi in Italia. Concentreremo la nostra attenzione sui Dispositivi di protezione individuale, strumenti a cui è data ampia attenzione in questo settore. Rifletteremo su questi strumenti e sulla loro diffusione considerandoli degli artefatti, cioè degli oggetti in grado di influenzare pensieri ed azioni, poiché portatori impliciti della cultura che li ha prodotti (Vygotzskij, 1934). Cercheremo in queste righe di evidenziare come la decisione di chiamare questi strumenti dispositivi non sia neutrale e porti con sé, implicitamente, alcune visioni del mondo che poi dirigono atteggiamenti e comportamenti personali e collettivi. Vedremo come l’introduzione dell’acronimo DPI (Dispositivo di Protezione individuale), usato per descrivere strumenti di lavoro usati da secoli e conosciuti con altri nomi, sia motivato dalla connessione esistente tra questi oggetti e alcune istituzioni, leggi e poteri che li hanno concepiti e prescritti, come teorizzato da M. Foucault (1976) e da G. Agamben (20

Background: Orthorexia Nervosa (ON) is a condition characterized by an obsessive focus on healthy eating, inflexible dietary rules, and persistent preoccupations with food. Despite it has been recently the subject of increasingly relevant studies, little is known about the mechanisms that might foster ON symptoms. Objective: This study used a structural equation modeling approach to test the mediating effect of thoughts, worries, and preoccupations about food on the relationship that eating disorders (EDs) attitudes (e.g., dieting) and obsessive-compulsive thoughts and symptoms have with ON in a large community sample. It was hypothesized that the effect of dieting and obsessive-compulsive thoughts and symptoms on ON would be partially mediated by the presence of thoughts, worries, and preoccupations about food. Methods: Data from a cross-sectional sample of 1328 participants (females = 976) recruited from the general population were asked to fill in an online survey comprising the Eating Attitude Test-26 (EAT-26), the Obsessive-compulsive subscale of the Symptom Checklist-90 Revised (SCL-90R–OC) and the Orthorexia Scale-15 (ORTO-15). Results: Structural equation models indicated that both obsessive-compulsive thoughts and symptoms and dieting had a direct effect on ON and that food preoccupation partially mediated these relationships. Conclusion: These findings provide novel insight into the nature of ON that could aid its conceptualization and treatment.

L’Associazione internazionale per lo studio del dolore (Aisd) ha definito il dolore cronico come «un’esperienza sensoriale ed emozionale spiacevole, associata o meno ad un danno tessutale, in atto o potenziale, o descritta in termini di un simile danno». Tale definizione di dolore cronico ha introdotto un’evoluzione del concetto di dolore cronico, riconoscendo la centralità della valenza soggettiva e multidimensionale, che coinvolge aspetti biologici, psicologici e sociali. Da qui la necessità di introdurre la medicina centrata sul paziente e di ampliare le modalità di gestione del dolore cronico. L’obiettivo clinico primario non si esaurisce con la dimensione biologica e nel trattamento del dolore, ma deve includere l’esperienza individuale del paziente e deve mantenere un valore interdisciplinare, includendo la terapia farmacologica, l’assistenza psicologica e gli interventi integrativi. Ne consegue la necessità di istituire un’équipe multidisciplinare con il coinvolgimento di più professionisti, come il fisiatra e lo psicologo, ai fini di un’adeguata diagnosi e gestione clinica. Queste prospettive hanno fornito il razionale teorico per l’organizzazione dell’Ambulatorio del dolore dell’Asst Santi Paolo e Carlo di Milano. Il presente contributo illustra il caso di un paziente (di 56 anni) con lombalgia cronica seguito clinicamente presso tale Ambulatorio.

(1) Background: Spatial cognition (SC) is one of the earliest cognitive domains to be impaired in the course of Alzheimer’s disease (AD), resulting in spatial disorientation and becoming lost even in familiar surroundings as later dementia symptoms. To date, few studies have identified initial alterations of spatial navigation (SN) in the premorbid AD phase by real-world paradigms, and none have adopted an innovative technological apparatus to better detect gait alterations as well as physiological aspects correlated to spatial disorientation (SD). The present study aimed at exploring initial SN defects in patients with prodromal AD via a naturalistic task by using a sensory garment. (2) Methods: 20 community-dwelling patients with Mild Cognitive Impairment (MCI) due to AD and 20 age/education controls were assessed on their sequential egocentric and allocentric navigation abilities by using a modified version of the Detour Navigation Test (DNT-mv). (3) Results: When compared to controls, patients with MCI due to AD exhibited higher wrong turns (WT) and moments of hesitation (MsH) in the DNT-mv, reflecting difficulties both in sequential egocentric and allocentric navigation, depending on hippocampal deterioration. Moreover, they reported more complaints about their SN competencies and lower long-term visuospatial memory abilities than controls. Remarkably, WTs and MsH manifested in the allocentric naturalistic task of the DNT-mv were associated with autonomic nervous system alteration pertaining to cardiac functioning in the whole sample. (4) Conclusions: Naturalistic navigation tests of hippocampal function using a continuous non-invasive monitoring device can provide early markers of spatial disorientation in patients with MCI due to AD. Future studies should develop cognitive remediation techniques able to enhance SC residual abilities in patients at high risk of conversion into dementia and ecological paradigms to be replicated on a large scale.

Given the prevalence of risky behaviors during adolescence, it is imperative to employ innovative methods to prevent psychopathological experiences. Recognizing the challenges and opportunities within high school environments, the need for cutting-edge prevention strategies becomes paramount. Harnessing innovative approaches, such as virtual reality (VR), can prove instrumental in navigating the complexities of adolescent development and promoting mental well-being. In this context, the VR-MEM project explores the potential impact of VR technology on adolescents' autobiographical memories, examining its efficacy as a preventive tool in the dynamic landscape of high school environments.

The primary objective of this study is to assess the efficacy of a Virtual Reality (VR) intervention when compared to an integrated multimodal medically managed Inpatient Program (IP) in a cohort of 24 female patients diagnosed with Bulimia Nervosa (BN). Psychological measures (i.e., EDI-2) were assessed at three points: pre-treatment, post-treatment, and at 1-month follow-up. Behavioral measures (i.e., BMI) were evaluated at 6 different time points, instead (i.e., pre-treatment, post-treatment, 3, 6, 9, and 12 months from the discharge date). The VR treatment was more effective in improving the EDI subscales EDI-DT (i.e., drive for thinness) and EDI-BU (i.e., binging-purging behaviors). In particular, patients in the VR condition showed a reduced EDI-BU score at 1-month follow-up and post-test in comparison to the pre-test, as well as a lower EDI-DT score at 1-month follow-up compared to the pre-test. Conversely, no significant changes were noted in the IP group for either subscale. Regarding the behavioral measures, the group undergoing the VR condition reported the maintenance of the BMI in the long term compared to the IP. Specifically, in the VR group BMI decreased from the pre- to post-test, and from the pre-test to the 12-month follow-up. In the IP group, BMI improved from the pre- to the post-test, and from the pre-test to the 12-month follow-up. However, a relapse pattern was observed in the IP condition during the follow-up period, with a significant BMI increase from the post-test to the 9-month follow-up, from the 3 to the 9-month follow-up, from the 6 to the 9-month follow-up, and a decrease of BMI between the 9 and the 12-month follow-up. In conclusion, these results suggest that integrating VR treatment into the care of individuals with BN could enhance both immediate and sustained treatment outcomes.

Food addiction (FA) and disordered eating behaviors related to obesity are gaining attention in clinical and research fields. The modified Yale Food Addiction Scale 2.0 (mYFAS2.0) is the gold standard questionnaire to measure FA, while another tool is the Measure of Eating Compulsivity 10 (MEC10). Discriminant validity is present when two measures of similar but distinct constructs show a correlation that is low enough for the factors to be regarded as distinct. However, the discriminant validity of these measures has never been tested. Through a cross-sectional study design, 717 inpatients (females: 56.20%, age: 53.681 ± 12.74) with severe obesity completed the MEC10, Binge Eating Scale (BES), and mYFAS2.0. A structural equation model (SEM) was fitted, freely estimating latent correlations with 95% confidence intervals (95% CI). The results confirmed the scales’ excellent psychometric properties. Importantly, latent factor correlations between MEC10 and mYFAS2.0 (est = 0.783, 95% CI [0.76, 0.80]) supported their discriminant validity. In contrast, the latent correlation of MEC10 and BES (est = 0.86, 95% CI [0.84, 0.87]) exceeded the recommended thresholds, indicating the absence of discriminant validity and suggesting a potential overlap, consistent with previous evidence. In conclusion, MEC10 demonstrates excellent psychometric properties but is more a measure of BED and not FA.

Background: This study aimed to examine whether dyadic coping (DC) is associated with relationship satisfaction (RS) among couples facing cardiac diseases. Furthermore, the moderating role of both partners’ anxiety and depression was tested. Methods: One hundred cardiac patients (81.5% men) and their partners (81.5% women) completed a self-report questionnaire during hospitalization. The Actor–Partner Interdependence Model (APIM) and moderation analyses were used to assess the above associations. Results: Results showed that positive DC was significantly related to higher levels of RS, and negative DC was related to lower levels of RS. Furthermore, patient and partner psychological distress significantly moderated the link between DC and RS: patient-perceived positive DC was associated with higher partner RS when partner depression was high; partner-perceived positive DC was associated with higher patient RS when patient anxiety was low; patient-perceived negative DC has associated with lower patient RS when patient anxiety and depression were high. Conclusion: This study showed that positive DC is associated with a more satisfying relationship and identified under what conditions of cardiac-related distress this can happen. Furthermore, this study underlined the importance of examining DC in addition to the individual coping skills as a process pertaining to personal well-being and couple’s outcomes.

The study of autobiographical memories (AMs)—that are intimately tied to one’s personal history—has been explored in populations suffering from addiction. Existing research suggests that individuals with addiction face similar challenges to those with other mental disorders when attempting to retrieve their AMs, often encountering memories that are uncomfortable.1 In particular, patients in drug rehabilitation centers are reluctant to share their memories, in part due to fear of stigma and potential legal repercussions. This concern fosters a heightened state of vigilance that inhibits the spontaneous sharing of personal experiences. In addition, a pervasive distrust of psychotherapists and caregivers, especially at the beginning of the rehabilitation journey, further hinders the development of autobiographical awareness—a key element for mental health improvement.

Background: Multiple studies have highlighted elevated rates of depression among individuals with Multiple Sclerosis (MS), with its associated symptoms posing a significant threat to overall well-being. Moreover, existing literature suggests a potential interconnection between depressive manifestations and the decline of physical functionalities in the context of MS.Objective: to examine the viability of the Eye Movement Desensitization Reprocessing (EMDR) therapy protocol for the treatment of depressive disorders (DeprEND) for alleviating depression in individuals with MS.Methods: We conducted a process-outcome study to examine the feasibilty and effectiveness DeprEND enrolling 13 individuals with MS and depressive symtpoms. Psychological and physical assessment pre-, post-intervention and 3-month follow-up were included. Pre- and post-magnetic resonance imaging (MRI) scans were conducted to analyze potential alterations in brain function.Results: The EMDR DeprEND treatment showed a high level of adherence and feasibility. Significant reductions in depressive symptoms were found at post-intervention and at 3 months follow-up. No significant differences were observed in terms of physical symptoms. A significant modulation observed in parietal and premotor areas when examining negative valence stimuli post-treatment was found.Conclusion: for The EMDR DeprEND protocol may represent a feasible and cost-effective treatment for reducing depressive symptoms in MS patients and improving their mental well-being.

Background: Providing informal care can be experienced as stressful and lead to caregiver burden. Internet-based interventions, a specific form of eHealth, have proven to be a good option to support informal caregivers. SOSteniamoci, an internetbased intervention already tested in Lithuania, was translated and adapted for Italian caregivers.Objective: As many novel eHealth solutions have been rejected by end-users due to usability problems, we aimed to evaluate the usability of the adapted platform, using a computer-based prototype.Methods: The following methods and metrics were applied: 1. task analysis, using audio and video recordings that included three usability metrics: task completion rate, frequency of errors, and frequency of help requests; 2. the system usability scale (SUS); and 3. a semi-structured interview to collect additional data about the system's design and overall satisfaction.Results: Ten informal caregivers (60% female; age M= 47.8, SD = 15.21) provided insights and suggestions for increasing the usability of the platform. The platform was considered satisfactory, with a mean score on the SUS of 75 (SD = 13.07) out of 100. The task analysis measurements highlighted difficulties in how to log in to the platform, understanding what the intervention is about, and texting the therapist. The same difficulties were also mentioned during the post-experience interview. Thus, improvements were subsequently made to enhance users' experience when navigating the platform. Finally, the platform overall was found to be intuitive and friendly, and the contents were appreciated.Conclusion: To maintain participants' engagement and prevent drop-out, it is crucial to test the usability of internet-based interventions. Even though the platform proved to be user-friendly, intuitive and easy to use, several enhancements were implemented based on participants' feedback. Thus, the usability of internet-based interventions should be tested, and end-users must be involv

Starting from the escalating global burden of mental health disorders, exacerbated by the COVID-19 pandemic, the article examines the potential of artificial intelligence (AI) to revolutionize mental health care. With nearly one in five adults facing mental health issues and suicide ranking as a leading cause of death among the young, the strained mental health system seeks innovative solutions. The text discusses the rapid evolution of AI, particularly in image analysis for early physical health diagnoses, and its promising applications in mental health, including predictive analytics for various disorders. AI's ability to analyze written language, speech characteristics, and physiological signals from wearables offers avenues for remote monitoring and early prognosis. Despite the need to address ethical considerations, particularly biases in data sets and concerns about potential patient detachment, the article advocates for AI as a complementary tool rather than a replacement for human involvement in mental health services. Overall, the article emphasizes the transformative potential of AI in enhancing diagnostics, monitoring, and treatment strategies for mental health disorders.

Background: Positivity (POS) indicates the proclivity to see life and experiences in a positive light. There is limited research on its effects on individuals with Schizophrenia Spectrum Disorders (SSD). Very little is known about the relationship between POS and daily activities in people with SSD. Aim: The study aims to compare the POS rated by patients with SSD with those obtained in an Italian normative sample matched by age and sex and to use the Ecological Momentary Assessment (EMA) to investigate the association between POS and daily time use (i.e. productive activities, leisure activities), functioning and mood in individuals with SSD. Method: 620 SSD patients were recruited from mental health services in Italy as part of the DiAPAson project. POS, symptom severity, functioning, and quality of life (QoL) were assessed. POS scores were compared to a normative sample of 5,002 Italian citizens. Additionally, a subset of 102 patients underwent 7-day assessments using mobile EMA. Results: People with SSD did not significantly differ from the Italian normative sample in POS levels (0.035, p =.190). POS showed a significant inverse association with support network (−0.586, p =.036) and symptomatology (BPRS −0.101; 95% p <.001; BNSS B = −0.113, p <.001). A significant direct association was found between POS and QoL (B = 0.310, p <.001) and functioning (B = 0.058, p <.001). In the subsample using EMA, POS ratings showed significant associations with Positive Emotions (B = 0.167, p <.001) and Negative Emotions (B = −0.201, p <.001). Conclusion: People with SSD exhibited comparable levels of POS to the normative sample. Higher POS was linked to better functioning, QoL, fewer severe symptoms, and increased positive emotions. However, it did not relate to increased productivity or engagement in leisure activities. Further research is needed to understand the relationship between POS and time use in individuals with SSD.

Le famiglie migranti spesso presentano condizioni di salute peggiori rispetto a quelle degli autoctoni, a causa delle difficoltà di accesso e di engagement nei servizi sanitari. I bambini provenienti da contesti migratori che presentano un disturbo dello spettro autistico (ASD) sono in genere diagnosticati in età più avanzata rispetto ai bambini autoctoni e quelli i cui genitori non parlano adeguatamente la lingua del Paese ospitante ricevono meno attenzione e meno possibilità di cura. Lo studio mira a identificare gli ostacoli principali che impediscono alle famiglie immigrate con un bambino autistico di accedere ai servizi sanitari. Sono stati intervistati 36 genitori di bambini con ASD, immigrati in Italia da più di 8 anni. Le principali difficoltà rilevate includono la mancata conoscenza della lingua italiana, una limitata alfabetizzazione sanitaria e incomprensioni nell’implementazione di pratiche educative utili al figlio, a causa della diversa tradizione culturale di appartenenza., Migrant families often have worse health conditions due to difficulties in access and engagement in healthcare services. Children from migrant backgrounds with autism spectrum disorder (ASD) are typically diagnosed at a later age than non-migrante children, and those whose parents do not adequately speak the language of the host country receive less attention and fewer treatment options. The study aims to identify the main barriers that prevent immigrant families with an autistic child from accessing health services. We interviewed 36 parents of children with ASD who have been living in Italy for more than 8 years. The main difficulties noted include lack of knowledge of the Italian language, limited health literacy, and misunderstandings in the implementation of educational practices that are useful to their child, due to their different cultural backgrounds.

La guerra è un fenomeno umano che per sua natura evolve e assume diverse forme. In queste pagine vengono richiamate alcune di queste forme: la guerra convenzionale e quella non convenzionale (UW; unconventional warfare), la guerra ibrida e quella cognitiva. L’autore mostra come la conoscenza della psiche umana possa aiutare a comprendere e gestire questo fenomeno ed in particolare come la psicologia sia coinvolta nelle forme più recenti di guerra globale. Un coinvolgimento che si realizza a posteriori, nella cura dei danni psichici causati dalla guerra, ma anche durante il conflitto, attraverso il sostegno alle strategie delle parti combattenti. La psicologia, infine, ha oggi uno un ruolo cruciale nel tempo che precede ogni guerra, perché conosce le dinamiche umane che portano ai conflitti violenti e che possono prevenirli., War is a human phenomenon that by its nature evolves and takes different forms. Some of these forms are recalled in these pages: conventional and unconventional warfare (UW), hybrid warfare and cognitive warfare. The author shows how knowledge of the human psyche can help to understand and manage this phenomenon and in particular how psychology is involved in the most recent forms of global warfare. An involvement that is realized a posteriori, in the treatment of the psychic damage caused by the war, but also during the conflict, through the support to the strategies of fighting parts. Finally, psychology plays a crucial role today in the time before any war because it knows the human dynamics that lead to and can prevent violent conflicts.

Objective: The objective of this study was to produce a cross-cultural adaptation in Italian of the Agitated Behavior Scale (ABS), originally developed in English, as the first of two stages that also include cross-cultural validation and allow a clinical scale to be used in the proper setting such as rehabilitation units. Methods: In order to adapt the ABS scale to a different cultural environment, five consecutive steps were performed: (1) forward translations (n = 8), (2) synthesis of the 8 forward translations to obtain a first shared italian version (ABS_I_trial), (3) back translations (n = 3), (4) creation of an expert committee to evaluate forward and back translations and finally (5) the cognitive debriefing. Results: After the five steps, including forward translations and back translations, the process of committee verification and judgement and the evaluative step of cognitive debriefing, high comprehensibility of all items was found, resulting in an Italian translation version of ABS suitable for application in a clinical setting. Conclusion: ABS translation was produced by means of a standardized procedure aimed at minimizing cross-cultural gaps. The expert committee evaluated the version produced as highly understandable in Italian. Further steps, such as the subsequent validation of its psychometric properties, are needed to employ this translation in a clinical setting.

Background: There is growing support for considering Dance Movement Therapy (DMT) as an effective approach to improving physical and psychological symptoms in eating disorders (ED), but additional evidence is needed. The current study aims to investigate the effectiveness of a DMT intervention for inpatients with ED during an in-hospital rehabilitation program for ED in reducing emotion dysregulation and alexithymia and improving interoceptive awareness. Methods: Forty-nine consecutive inpatient young women with ED (aged between 18 and 34 years) recruited from a clinical center for the rehabilitation of obesity and ED received four group sessions of DMT intervention. All participants completed the Difficulties in Emotion Regulation Scale (DERS), the Toronto Alexithymia Scale (TAS), and the Multidimensional Assessment of Interoceptive Awareness Scale (MAIA) before (Time 0) and after the intervention (Time 1). Paired-sample t-tests were run to assess differences between Time 0 to Time 1. Results: From pre-to-post interventions, there was a significant reduction in the means of all of the subscales of DERS, suggesting an improvement in emotion regulation competencies, with the only exception for difficulties in awareness that increased (p = 0.016). We also found a significant reduction in alexithymia, as proved by significant differences in all of the subscales and the total score of TAS (p < 0.001), and significant improvements in interoceptive awareness as suggested by increased scores of the noticing (p = 0.043), emotional awareness (p < 0.001), body listening (p < 0.001), and trusting (p < 0.001) subscales of MAIA. Conclusion: Overall, our results point towards the efficacy of dance/movement in reducing symptoms of eating disorders. Our findings also suggest that dancing can be considered a useful intervention to increase emotional regulation, reduce alexithymia, and enhance interoceptive awareness.

Gli stadi più precoci dello sviluppo risultano caratterizzati dal bisogno preriflessivo di costituire una matrice intersoggettiva primaria. L’apparato motorio e il sistema motivazionale del neonato sembrano, infatti, configurarsi come modalità atte a soddisfare esigenze di natura relazionale. Poter contare sui legami di attaccamento e sulla consapevolezza di far parte di un mondo in cui emozioni e sensazioni provate vengono condivise appare la conditio sine qua non per la nostra sopravvivenza, a tal punto che si potrebbe dire che l’Altro risulta determinante per la costituzione di noi stessi. Prima ancora di un Io emerge una dinamica relazionale Io-Tu, che gioca un ruolo decisivo per tutte le fasi successive di sviluppo. La comunicazione che caratterizza la dinamica relazionale primaria tra madre e bambino poggia su codici comunicativi preverbali, la cui decodifica risente del linguaggio emotivo più di ogni altra cosa. Tale contatto trae origine da una sintonizzazione intercorporea tanto evidente quanto il fatto di cominciare la vita abitando proprio nel corpo di un altro, cioè quello della madre (Gallese & Ammaniti, 2014). È a partire da questa vita prima della vita che si affinano le abilità di sintonizzazione emotiva decisive per la sopravvivenza. Emerge una motivazione intrinseca che porta a stabilire un contatto reciproco, indispensabile per la tutela dello sviluppo.

Introduction. The project aims at identifying, among the group rehabilitation activities offered by Fondazione Adele Bonolis - As.Fra., a psychiatric residential facility accredited with the Italian National Health Service in Lombardy region, the specific process indicators of a good functioning of group activities, according to PREM (patient reported experience measure) approach. Methods. In order to do this, a Grounded Theory method will be adopted, whereby staff and patients will be interviewed about their experiences of group rehabilitation activities; from these interviews, the aim will be to bring out a poll of specific indicators of a "good functioning" of group rehabilitation activities, taking into account the differences between the activities belonging to the different typologies and the adopted intervention methodologies, identifying the processes of construction of the "therapeutic nature" of group activities. Results. Therefore, starting from the unique experiences of the patients who participate in these activities and the practitioners who conduct them, the aim is to identify elements that hinder and promote these activities in a transversal sense. We expect to be able to extract around 10-15 indicators of the elements considered by patients and clinicians as useful for the treatment process of group rehabilitation activities. Discussion. The first and most direct gain of the present study is to come up with a questionnaire that can be used in the evaluation of group rehabilitation activities, regardless of the area to which they pertain. In fact, there does not seem to be such a wide-ranging instrument in the literature, which can also allow a comparison between different group rehabilitation activities. Furthermore, but primarily with respect to the first point, the study will make it possible to focus on which elements are subjectively experienced by patients as useful for them in such group rehabilitation contexts. Similarly, it will make it poss

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The aim of this study was to examine workers’ psychological distress during the COVID-19 pandemic as a function of their individual coping, dyadic coping, and work-family conflict. We also tested the moderating role of gender and culture in these associations. To achieve this aim, we run HLM analyses on data from 1521 workers cohabiting with a partner, coming from six countries (Italy, Spain, Malta, Cyprus, Greece, and Russia) characterized by various degrees of country-level individualism/collectivism. Across all six countries, findings highlighted that work-family conflict as well as the individual coping strategy social support seeking were associated with higher psychological distress for workers, while the individual coping strategy positive attitude and common dyadic coping were found to be protective against workers’ psychological distress. This latter association, moreover, was stronger in more individualistic countries.

Introduction: The main aim was to gain insight into the experience of adult people with a diagnosis of at least 6-months of mild or moderate persistent asthma according to the Global Initiative for Asthma (GINA), and their emotions, beliefs, and expectations during the first wave of COVID-19. Methods: Qualitative semi-structured interviews using the Interpretative Phenomenological Analysis (IPA) were carried out by phone involving 31 people (mean age=58.2; SD=16.2). Interviews were audio recording, transcribed verbatim and analysed through thematic analysis. Results: Five superordinate themes and themes were dedicated to illness (symptoms of asthma; difficulties related to COVID-19), experienced emotions (lockdown period; medical changes; emotions COVID-19 related), beliefs (about asthma; about COVID-19), expectations (related to asthma; related to COVID-19) and behaviours (to protect; risk taken; adherence; contacts with General Practitioners; support). The prevalence of emotions such as fear, worry and anxiety emerged in the participants’ narratives. All are accompanied by a preference for action and problem solving. A sense of protection, connection to self and other, and commitment to life were revealed as central concepts for enhancing well-being even at a time of deterring. Discussion: The common threads of the presence of uncertainty and vulnerability open the outlook of a treatment that ensures greater continuity and ownership of care in the patient, preserving the sense of self-efficacy even in times of greater instability.

Viene chiarito il ruolo della mente in emergenza

Dopo la stesura in Italia del Piano Nazionale Emergenza Nucleare, abbiamo sperimentato un percorso di formazione alla comunicazione del rischio nucleare rivolto a giovani psicologi. Avendo constatato che la conoscenza teorica degli scenari di rischio e dei bisogni informativi in questi contesti non è sufficiente per formare dei buoni comunicatori, abbiamo voluto verificare l’ipotesi che un’esperienza immersiva potesse aumentare le competenze comunicative del personale chiamato a gestire e prevenire l’emergenza nucleare e radioattiva. Il percorso si è sviluppato in più fasi tra di loro collegate: (1) lavoro preparatorio: analisi del contesto di rischio nucleare e radioattivo in Italia; analisi del Piano Nazionale; analisi del rischio infodemia in emergenza; individuazione dei target a cui rivolgere azioni informative in fase di prevenzione, dei contenuti e delle metodologie; (2) formazione immersiva: all’interno di un rifugio antiatomico, simulazione delle azioni di fronteggiamento dell’emergenza nucleare e dei bisogni comunicativi dei diversi target; (3) messa a punto di azioni comunicative e contenuti informativi utili alla prevenzione del rischio radioattivo e alla gestione di una eventuale crisi da fall-out nucleare. Venti psicologi con laurea triennale, hanno partecipato al percorso, rimanendo per tre giorni all’interno di un rifugio antiatomico, nelle condizioni che avrebbero dovuto proporre alla popolazione, in caso di necessità. Provando in prima persona le condizioni di vita nel contesto di protezione dalle radiazioni, è stato poi proposto loro di progettare azioni di comunicazione opportune, rivolte a vari target. I professionisti hanno così generato proposte narrative per i minori, video pillole da condividere nei social, messaggi specifici per diversi target. La verifica effettuata a termine della formazione ha permesso di evidenziare come la simulazione immersiva del contesto emergenziale abbia saputo stimolare la creatività dei professionisti coi

Pregnancy represents a critical and potentially stressful event that can negatively impact on prospective mothers’ psychological well-being. Indeed, a growing body of studies reported high rates of clinical conditions such as anxiety, depression, and severe fear of childbirth during pregnancy across countries. Several variables, both at an individual and interpersonal level, have been found to be associated with pregnant women’s mental health, representing important risk or protective factors. Specifically, many studies have progressively highlighted the association between expectant mothers’ psychological well-being and practical and emotional social support, both from the partner, the extended formal, and informal network. The Covid-19 pandemic and the restrictive measures adopted to contain the virus’ spread may act as additional stressor on pregnant women, thus increasing the physiological vulnerability of an already fragile population and causing disruptive effects on both pregnancy outcomes as well as expectant mothers’ mental health. In particular, the outbreak shrunk women’s social and support networks and hindered their access to both pregnancy as well as mental health care facilities. Moreover, both care provision and care seeking behaviors have changed dramatically, for example leading to an increase in telehealth consultations and to the exclusion of birth companions from maternal units. In this chapter, after summarizing the state of the art regarding mental health in pregnant women and outlining the main effects of the pandemic on expectant mothers’ psychological well-being, we discuss the changes in maternal settings and the consequent behaviors adopted by prospective mothers. The final paragraph of the chapter is devoted to the discussion of guidelines and implications for clinical practice and mainly provides guidance of four areas: information, promotion, care, and coordination.

Background: Using Non-Invasive Ventilation (NIV) in an acute setting for COVID-19-related acute hypoxic respiratory failure (AHRF) can be a stressful and anxiety-inducing experience for patients in the Respiratory and Intensive Care Units (RICU and ICU). Aims and objectives: This study aimed to investigate the presence of anxiety, symptoms related to Post Traumatic Stress Disorder (PTSD), psychological distress, and depression about the perception of one's disease state in people with COVID-19-related AHRF undergoing NIV during their stay at RICU/ICU and after rehabilitation. Methods: Fifty-two people with COVID-19 (M=66.9; SD=9.17) were evaluated during hospitalization in the RICU/ICU, and at 6 months, after rehabilitation, for symptoms of anxiety, psychological distress, Post Traumatic Stress Disorder (PTSD), and depression, in relation to the perceived severity of illness and NIV’s usage. Results: Patients with COVID-19 experienced increased fear and anxiety due to the severity of their illness and the uncertainty surrounding the disease in the acute setting. The need for NIV indicated more severe COVID-19 disease, which significantly increased fear and anxiety [(t(14)= 2.79, p=.014] compared to the remission period, leading to feelings of loss of control and a decreased psychological well-being [(t(17)= 2.35, p=.031]. Resilience significantly improved over time [(t(16)= -4.78, p<.001]. Conclusions: Healthcare professionals need to supply more attention and support, such as offering reassurance, providing information, and addressing any concerns or fears.

Background: Patients with Chronic Obstructive Pulmonary Disease (COPD) who received supplemental oxygen reported improved symptoms such as increased energy, less breathlessness, and improved quality of life, even though the oxygen therapy was not actually providing any additional therapeutic benefit beyond maintaining adequate oxygen levels. Aims and objectives: To investigate the impact of the placebo effect on oxygen therapy during the 6-Minute Walking Test (6MWT) in patients with COPD. Methods: A randomized crossover two-arm study was conducted with 95 patients with COPD (68.4% male, average age 67). All participants underwent baseline assessments, including the Mini-Mental Status Examination, the Modified British Medical Research Council Questionnaire, the Fatigue Severity Scale, and Simple Spirometry. All participants underwent 6MWT, using one medical oxygen (O2) concentrator and another whose molecular filters (MF) had been removed, so patients believed the concentrator was delivering oxygen. The sequence of the first group was ABC (A = Baseline, B =MF, C = O2), while the sequence of the second was ACB. Saturation, heart rate and blood pressure were measured at baseline, at 3’:30’’ and after 6MWT. Results: A repeated measures ANOVA was performed to compare the effect of oxygen usage on the 6MWT. There was no statistically significant difference in the 6MWT between the two groups (F(2, 1) = 0.113, p = 0.888). Conclusions: Although the use of oxygen remains an important and effective treatment for maintaining adequate oxygen levels, specific treatments based on beliefs and patients' expectations can improve the healthcare process in COPD.

Transition to parenthood represents a critical experience as it entails profound changes, which, in turn, can lead to negative consequences on the individual and relational well-being of new parents. The COVID-19 pandemic has been an additional stressful event that can exacerbate the potentially negative effects of such transition. During the first lockdown (March-May 2020), 575 pregnant women or new mothers completed an online survey with the aim of investigating their psychological well-being. Both the new and the expectant mothers were administered a series of questionnaires to investigate anxiety (state and trait) and depression. In addition, pregnant women completed a questionnaire assessing fear of childbirth. Childbirth experience and Postpartum Traumatic Disorder, on the other end, were only assessed with regards to the new mothers’ subsample. Results show that the presence of certain stressful variables can affect the well-being of pregnant and postpartum women and have an impact on their subjective experience of childbirth. More specifically, having had previous pregnancies as well as having suffered from one or more clinical disorders in the past proved to have a negative impact on both new and expectant mothers’ well-being, especially with regards to measures of anxiety and depression. Giving birth during the COVID-19 outbreak meant, for the women, experiencing an additional stress during a particularly delicate time; in this respect, the likelihood of their partners not being allowed to assist them during labor and delivery caused an increase in both anxiety and fear of childbirth scores. Overall, this study clearly highlights how the presence of support (either formal or informal) in the immediate postpartum and during labor and delivery is a crucial protective factor in preventing women from developing anxious or posttraumatic symptoms. We believe these findings may prove particularly useful, especially in informing clinical practice and formalizing c