Publications by authors named "Stefano Barlati"

Mental health encompasses the ability to cope with important stresses of life and to realize one's abilities in the community, and the COVID-19 pandemic represented a very stressful event for people with mental illnesses. Our aim was to assess mental well-being in people living with different mental disorders, comparing results obtained in 2016 with those observed after the COVID-19 pandemic. Ninety-six participants were assessed using the Mental Health Continuum Short Form and classified as "flourishing," "moderately mentally healthy," and "languishing.

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In schizophrenia, it was suggested that an integrated and multimodal approach, combining pharmacological and non-pharmacological interventions, could improve functional outcomes and clinical features in patients living with schizophrenia (PLWS). Among these alternatives, evidence-based psychosocial interventions (EBPIs) and Non-Invasive Brain Stimulation (NIBS) represent feasible treatment options targeting the clinical features that are unmet needs of PLWS (especially negative and cognitive symptoms). As no clear evidence is available on the combination of these non-pharmacological approaches, this review aimed to collect the available literature on the combination of EBPIs and NIBS in the treatment of PLWS.

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The economic burden of schizophrenia amounts for 1.5-3 % of healthcare expenses in developed countries, and ∼50 % derives from direct costs: 81 % of these are due to hospitalization, residential facilities and semi-residential facilities. Therefore, a better characterization of variables that influence direct costs represents a relevant issue.

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Article Synopsis
  • Many people with schizophrenia do worse than average on memory and thinking tests, even if they seem fine to others.
  • Problems with thinking can happen before someone shows signs of schizophrenia and can still be present even when they’re feeling better.
  • A group of experts looked at the latest research about how to help people with these thinking problems and made suggestions to improve mental health care.
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  • "Revolving door patients" are people who keep going back to the hospital because they aren't getting better, often due to not taking their medicine or not having enough support.
  • The idea of a Mobile Delivery Program (MDP) is proposed, where healthcare workers bring medicines and help directly to these patients' homes to make it easier for them to stick to their treatment.
  • This program aims to help patients avoid going back to the hospital repeatedly, improve their overall health, and save a lot of money that is currently spent on hospital visits and other related costs.
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Background: Cognitive deficits are difficult to treat and negatively influence quality of life and functional outcomes of persons with schizophrenia. In the last twenty years, extensive literature demonstrated that persons with diabetes and insulin resistance (IR) also display cognitive deficits. Being type 2 diabetes (T2DM) and IR highly frequent in persons with schizophrenia, it is plausible to hypothesize that these conditions might play a role in determining dyscognition.

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  • Treatment-Resistant Depression (TRD) affects about 30% of people with Major Depressive Disorder, and a new nasal spray called Esketamine (ESK-NS) has been approved to help treat it when combined with certain medications.
  • Researchers wanted to see if combining Vortioxetine, another antidepressant, with ESK-NS was just as good or better than the usual treatment.
  • The results showed that the Vortioxetine and ESK-NS combo worked well to reduce depression and had fewer side effects, suggesting it could be a better option, but more research is needed to be sure.
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Cognitive impairment is a core feature of schizophrenia spectrum disorders (SSD). Violent and aggressive behavior represents a complex issue in psychiatry, and people with SSD have been shown to be at risk of being both victims and perpetrators of violence. In this review, the complex relationship between cognitive impairment and violent behavior is explored, also considering the usefulness of treating cognitive impairment to improve violence-related outcomes.

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Cognitive impairment associated with schizophrenia (CIAS) represents one of the core features of the disorder and has a significant impact on functional and rehabilitation outcomes of people living with schizophrenia spectrum disorders (SSD). The aim of this critical review is to highlight the most recent evidence on effective treatments available for CIAS, to discuss the current challenges in this field, and to present future perspectives that may help to overcome them. Concerning psychopharmacological approaches, among the most indicated strategies for the management and prevention of CIAS is to favor second-generation antipsychotic medications and avoid long-term and high-dose treatments with anticholinergic medications and benzodiazepines.

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Introduction: Neonatal intensive care unit (NICU) nurses play a crucial role in providing infant care, as well as in bridging the communication gap with parents.

Aim: Explore fathers' perceptions and interactions with nurses during their preterm infants' stay in a NICU.

Design: Qualitative study using ethnographic data collection techniques.

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Article Synopsis
  • - Cognitive Impairment Associated with Schizophrenia (CIAS) significantly affects those with Schizophrenia Spectrum Disorders, making it a crucial target for treatment to improve daily functioning.
  • - While existing medications like antipsychotics and benzodiazepines have limited benefits for CIAS, new experimental drugs are showing promise in early trials, but more research is needed for definitive recommendations.
  • - Effective management of current antipsychotic treatments is essential, as ongoing studies may lead to breakthroughs that could revolutionize pharmacological treatment for CIAS in the future.
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Cognitive impairment represents one of the core features of schizophrenia, involves both neurocognition and social cognition domains, and has a significant negative impact on real-world functioning. The present review provides a framework for the conceptualization and characterization of "primary" and "secondary" cognitive impairment in schizophrenia. In this conceptualization, primary cognitive impairment can be defined as a consequence of the neurobiological alterations that underlie psychopathological manifestations of the disorder, while secondary cognitive impairment can be defined as the results of a source issue that has a negative impact on cognitive performance.

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Psychosocial functioning represents a core treatment target of Schizophrenia Spectrum Disorders (SSD), and several clinical and cognitive factors contribute to its impairment. However, determinants of psychosocial functioning in people living with SSD that committed violent offences remain to be more thoroughly explored. This study aims to separately assess and compare predictors of psychosocial functioning in people with SSD that did and that did not commit violent offences considering several clinical, cognitive and violence-related parameters.

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Introduction: The Patient Journey Project aimed to analyze the scenario among Italian Mental Health Services (MHS) to understand the clinical interventions that are properly implemented and the ones deserving further implementation to design an effective treatment plan for patients living with schizophrenia (PLWS).

Methods: The 60-items survey was co-designed with all the stakeholders (clinicians, expert patients and caregivers) involved in the Patient Journey and focused on three phases of schizophrenia course: early detection and management, acute phase management, long-term management/continuity of care. Respondents were Heads of the Mental Health Departments and Addiction Services (MHDAS) or facilities directors throughout Italian MHS.

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Traumatic events increase risk of mental illnesses, but childhood neglect prevalence in psychiatric disorders is understudied. This systematic review and meta-analysis assessed neglect prevalence, including emotional neglect (EN) and physical neglect (PN), among adults with psychiatric disorders. We conducted a systematic search and meta-analysis in 122 studies assessing different psychiatric disorders.

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Objective: Cognitive remediation provides substantial improvements in cognitive performance and real-world functioning for people living with schizophrenia, but the durability of these benefits needs to be reassessed and better defined. The aims of this study were to provide a comprehensive assessment of the durability of the benefits of cognitive remediation for cognition and functioning in people living with schizophrenia and evaluating potential moderators of effects.

Methods: A systematic search was conducted in PubMed, Scopus, and PsycINFO, and reference lists of included articles and Google Scholar were inspected.

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Purpose Of Review: Schizophrenia Spectrum Disorders (SSD) are severe conditions that frequently produce significant impairment in cognitive performance, social skills and psychosocial functioning. As pharmacological treatment alone often provides only limited improvements on these outcomes, several psychosocial interventions are employed in psychiatric rehabilitation practice to improve of real-world outcomes of people living with SSD: the present review aims to provide a critical overview of these treatments, focusing on those that show consistent evidence of effectiveness.

Recent Findings: Several recent systematic reviews and meta-analyses have investigated in detail the acceptability, the effectiveness on several specific outcomes and moderators of response of different psychosocial interventions, and several individual studies have provided novel insight on their implementation and combination in rehabilitation practice.

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Background: Treating depressive symptoms in patients with schizophrenia is challenging. While transcranical Dicrect Current Stimulation (tDCS) improved other core symptoms of schizophrenia, conflicting results have been obtained on depressive symptoms. Thus, we aimed to expand current evidence on tDCS efficacy to improve depressive symptoms in patients with schizophrenia.

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Purpose: People with schizophrenia in Sub-Saharan Africa often live in very difficult conditions, suffer important social isolation and usually do not receive any kind of treatment. In this context, some non-governmental initiatives have come to light, providing accommodation, food, primary healthcare, medications and, in some cases, education and rehabilitation. The aims of this study were to assess feasibility, effects, and acceptability of a Cognitive Remediation Therapy (CRT) intervention in the particular context of psychiatric rehabilitation in Togo and Benin.

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Background: A better characterization of educational processes during psychiatry training is needed, both to foster personal resilience and occupational proficiency.

Methods: An adequate coverage of medical residents at the national level was reached (41.86% of the total reference population, 29 out of 36 training centers-80.

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Introduction: Intravenous ketamine (KET-IV) and intranasal esketamine (ESK-NS) are effective in the acute treatment of Treatment-Resistant Depression (TRD). Studies comparing KET-IV and ESK-NS concerning their action, safety, and tolerability are currently lacking.

Materials And Methods: We combined patients' data from two unipolar TRD cohorts that received KET-IV (n = 171) at the Canadian Rapid Treatment Center of Excellence in Toronto, Canada, or ESK-NS (n = 140) at several TRD clinics in Italy.

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Article Synopsis
  • * The study involved 736 participants screened, with 402 completing detailed cognitive and clinical assessments, revealing that those with CI experienced more severe mental health issues and poorer overall functioning compared to those without cognitive impairment.
  • * Additionally, 45% of participants demonstrated cognitive deficits in areas like attention and memory, and worse cognitive functioning was associated with higher LDH blood levels, suggesting the need for regular cognitive assessments and possible training programs for affected individuals.
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