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Article ; Online: Mental health interventions in Italian prisons: are we ready for a new model? Suggestions from the Parma experience.

Pelizza, Lorenzo / Pupo, Simona

2024 Volume 59, Issue 1, Page(s) 35–42

Abstract: Mental health interventions for Italian prisoners with mental disorder remain a problematic issue, despite radical changes in psychiatric care and a 2008 major government reform transferring mental health care in prison to the National Health Service. ... ...

Abstract	Mental health interventions for Italian prisoners with mental disorder remain a problematic issue, despite radical changes in psychiatric care and a 2008 major government reform transferring mental health care in prison to the National Health Service. Indeed, prison has increasingly become a place of severe psychological distress, where also serious mental illnesses sometimes occur. In this contribution, we commented on the recommendations recently proposed by the Emilia-Romagna Region on how structuring mental healthcare interventions in all regional jails. Moreover, starting from the findings reported in recent epidemiological studies examining the prevalence of mental disorders in Emilia-Romagna prisons, we proposed a new treatment model for mental health and pathological addictions in jail, which took into account the current incidence of inmates with severe mental illness, psychological distress due to incarceration, and substance use disorder. Perhaps, this new intervention model (specifically centered on clinical psychology and case management by intramural mental health professionals) requires a vision able to overcome the classical "medical-centered" approach, which still too often permeates many sectors of public mental healthcare services. In our opinion, if we decide to look at the moon, we shouldn't dwell too much on the finger pointing to it.
MeSH term(s)	Humans ; Prisons ; Mental Health ; State Medicine ; Prisoners/psychology ; Mental Disorders/epidemiology ; Mental Disorders/therapy ; Italy/epidemiology
Language	English
Publishing date	2024-02-16
Publishing country	Italy
Document type	Journal Article
ZDB-ID	205570-3
ISSN	2038-2502 ; 0035-6484
ISSN (online)	2038-2502
ISSN	0035-6484
DOI	10.1708/4205.41947
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Article: Borderline personality disorder and early psychosis: a narrative review.

Biancalani, Arianna / Pelizza, Lorenzo / Menchetti, Marco

Annals of general psychiatry

2023 Volume 22, Issue 1, Page(s) 44

Abstract: Background: The purpose of the present review was to summarize the main literature contribution on the relationship between borderline personality disorder (BPD) and early psychosis. While retracing the historical path of the term "borderline", specific ...

Abstract	Background: The purpose of the present review was to summarize the main literature contribution on the relationship between borderline personality disorder (BPD) and early psychosis. While retracing the historical path of the term "borderline", specific attention was paid to psychotic and psychotic-like symptoms in BPD. Its relationship with At Risk Mental State was evaluated, as well. Methods: This search was conducted on PUBMED/MEDLINE and PsycInfo, looking for "Borderline personality disorder, First Episode Psychosis, Early Psychosis, Ultra-High Risk AND/OR Clinical High Risk" for psychosis. Results: Eight pertinent papers were identified on this topic. Their main findings were then discussed. The term "borderline" has undergone different changes in meaning and use, despite always referring to states considered on the fence between neurosis and psychosis. However, considering the history of psychopathology and its relationship with diagnostic manuals, little attention has been given to its psychotic features. Being those symptoms highly burdensome, this neglect has often led to misdiagnosis and under-treatment. Conclusions: Psychotic symptoms in BPD can be severe and distressing. Nonetheless they can be easily neglected, and when found they challenge clinicians in defining a differential diagnosis to distinguish between BPD and Psychosis Spectrum Disorders. Given specific needs and interventions for these different conditions, a dimensional, rather than categorical, approach should be considered, as well as specific care pathways and monitoring should be advised.
Language	English
Publishing date	2023-11-02
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2090401-0
ISSN	1744-859X ; 1475-2832
ISSN	1744-859X ; 1475-2832
DOI	10.1186/s12991-023-00475-w
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Article ; Online: The times they are a-changin: implementing new psychiatric rehabilitation models within a community care in the post COVID-19 era.

Pelizza, Lorenzo / Pupo, Simona

Acta bio-medica : Atenei Parmensis

2021 Volume 92, Issue 2, Page(s) e2021222

Abstract: During the COVID-19 pandemic, community healthcare treatments have played a crucial role in early detection and intervention against the epidemic spreading (as most of the infected individuals were at home). For the national policy on mental health ... ...

Abstract	During the COVID-19 pandemic, community healthcare treatments have played a crucial role in early detection and intervention against the epidemic spreading (as most of the infected individuals were at home). For the national policy on mental health services in Italy, "the person as a community resource within a caring community" is still a crucial idea that the COVID-19 era helped to revive, together with the supremacy of the public healthcare pathway over the private one. In this article, new mental health rehabilitation models (such as the Personal Health Budget and the Individual Placement and Support) are suggested as useful intervention approaches on which to base psychiatric care within a community care in the post COVID-19 era.
MeSH term(s)	COVID-19 ; Humans ; Italy/epidemiology ; Pandemics ; Psychiatric Rehabilitation ; SARS-CoV-2
Language	English
Publishing date	2021-05-12
Publishing country	Italy
Document type	Letter
ZDB-ID	2114240-3
ISSN	2531-6745 ; 0392-4203
ISSN (online)	2531-6745
ISSN	0392-4203
DOI	10.23750/abm.v92i2.11043
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Article ; Online: Borderline personality disorder vs. schizophrenia spectrum disorders in young people recruited within an "Early Intervention in Psychosis" service: clinical and outcome comparisons.

Pelizza, Lorenzo / Leuci, Emanuela / Quattrone, Emanuela / Azzali, Silvia / Paulillo, Giuseppina / Pupo, Simona / Pellegrini, Pietro / Gammino, Lorenzo / Biancalani, Arianna / Menchetti, Marco

European archives of psychiatry and clinical neuroscience

2024

Abstract: Borderline Personality Disorder (BPD) is under-recognized in First-Episode Psychosis (FEP) and its psychotic manifestations are difficult to differentiate from Schizophrenia Spectrum Disorders (SSD). The aim of this investigation was to compare clinical, ...

Abstract	Borderline Personality Disorder (BPD) is under-recognized in First-Episode Psychosis (FEP) and its psychotic manifestations are difficult to differentiate from Schizophrenia Spectrum Disorders (SSD). The aim of this investigation was to compare clinical, sociodemographic, and outcome characteristics between FEP patients with BPD vs. FEP subjects with SSD both at baseline and across a 2-year follow-up period. Participants completed the Health of the Nation Outcome Scale (HoNOS), the Positive And Negative Syndrome Scale (PANSS), and the Global Assessment of Functioning (GAF) scale both at entry and every 12 months during the follow-up. A mixed-design ANOVA model was conducted to investigate the temporal stability of clinical scores within and between the two subgroups. Among 356 FEP participants, 49 had a BPD diagnosis. Compared to FEP/SSD (n = 307), FEP/BPD patients showed higher prevalence of employment, current substance use, and past attempted suicide. They had a lower equivalent dose of antipsychotic medication at entry and lower levels of negative symptoms. Finally, they had a higher 2-year drop-out rate and a significant improvement in psychopathological scores limited to the first year of treatment. BPD as categorical entity represents a FEP subgroup with specific clinical challenges. Appropriate treatment guidelines for this FEP subgroup are thus needed.
Language	English
Publishing date	2024-03-12
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1045583-8
ISSN	1433-8491 ; 0175-758X ; 0940-1334
ISSN (online)	1433-8491
ISSN	0175-758X ; 0940-1334
DOI	10.1007/s00406-024-01772-5
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Article ; Online: COVID-19 epidemic and public mental health care in Italy: ethical considerations.

Pelizza, Lorenzo / Pupo, Simona

Social psychiatry and psychiatric epidemiology

2020 Volume 55, Issue 8, Page(s) 1093–1094

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus ; Coronavirus Infections ; Humans ; Italy ; Mental Health ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-07-04
Publishing country	Germany
Document type	Letter ; Comment
ZDB-ID	623071-4
ISSN	1433-9285 ; 0037-7813 ; 0933-7954
ISSN (online)	1433-9285
ISSN	0037-7813 ; 0933-7954
DOI	10.1007/s00127-020-01907-8
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Article ; Online: The 'Parma At-Risk mental states' (PARMS) program: General description and process analysis after 5 years of clinical activity.

Pelizza, Lorenzo / Leuci, Emanuela / Quattrone, Emanuela / Paulillo, Giuseppina / Pellegrini, Pietro

Early intervention in psychiatry

2023 Volume 17, Issue 6, Page(s) 625–635

Abstract: Aim: From January 2016, the Parma Department of Mental Health developed a specialized care protocol - the 'Parma At-Risk Mental States' (PARMS) program - as a diffused service for early intervention in individuals at Clinical High Risk for Psychosis ( ... ...

Abstract	Aim: From January 2016, the Parma Department of Mental Health developed a specialized care protocol - the 'Parma At-Risk Mental States' (PARMS) program - as a diffused service for early intervention in individuals at Clinical High Risk for Psychosis (CHR-P). The aims of this investigation were (1) to describe the PARMS structural organization and (2) to examine specific process indicators during the first 5 years of its clinical activity. Methods: All participants were adolescent and young adult help-seekers (aged 12-25 years) at CHR-P in accordance with well-defined psychometric criteria. Results: At entry, 52 subjects were provided with a dedicated protocol of care and only 14 dropped out during the first year of treatment. The Duration of Untreated Illness (DUI) overall decreased over time. Most of CHR-P participants suffered from 'Attenuated Psychotic Symptoms' and 'Brief, Limited, Intermittent Psychotic Symptoms' in the same percentage (48.1% [n = 25]). The most common DSM-IV-TR diagnosis was schizotypal personality disorder, followed by borderline personality disorder and brief psychotic disorder. Conclusions: A specialized, evidence-based care protocol for CHR-P individuals within Italian adult and child/adolescent psychiatric services is feasible, also in adolescents, who have a high risk of falling through the child/adult service gap.
MeSH term(s)	Adolescent ; Young Adult ; Child ; Humans ; Psychotic Disorders/diagnosis ; Psychotic Disorders/therapy ; Psychotic Disorders/psychology ; Schizotypal Personality Disorder/diagnosis ; Borderline Personality Disorder ; Italy
Language	English
Publishing date	2023-01-13
Publishing country	Australia
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2272425-4
ISSN	1751-7893 ; 1751-7885
ISSN (online)	1751-7893
ISSN	1751-7885
DOI	10.1111/eip.13399
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Article ; Online: Future psychiatric services in Italy: lesson from the COVID-19 pandemic.

Pelizza, Lorenzo / Pupo, Simona

Acta bio-medica : Atenei Parmensis

2020 Volume 91, Issue 3, Page(s) e2020011

Abstract: During the COVID-19 epidemic, home care and remote working showed important technological innovations, leading to review all public mental health policies. In this article, some considerations based on the Italian COVID-19 experience in order to plan ... ...

Abstract	During the COVID-19 epidemic, home care and remote working showed important technological innovations, leading to review all public mental health policies. In this article, some considerations based on the Italian COVID-19 experience in order to plan post-COVID psychiatric interventions are reported.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/epidemiology ; Coronavirus Infections/psychology ; Emergency Services, Psychiatric/organization & administration ; Humans ; Italy/epidemiology ; Mental Disorders/epidemiology ; Mental Disorders/etiology ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/psychology ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-09-07
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	2114240-3
ISSN	2531-6745 ; 0392-4203
ISSN (online)	2531-6745
ISSN	0392-4203
DOI	10.23750/abm.v91i3.10170
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Article: The COVID-19 Pandemic and Italian Public Mental Health Services: Experience and Future Directions.

Pelizza, Lorenzo / Pupo, Simona

Journal of patient experience

2020 Volume 7, Issue 5, Page(s) 642–644

Abstract: The COVID-19 pandemic has crosses every health care area (from primary care to specialist ones), leading to a review of all public health policies. The use of smart working allows important technological innovations, but it must be accompanied by a ... ...

Abstract	The COVID-19 pandemic has crosses every health care area (from primary care to specialist ones), leading to a review of all public health policies. The use of smart working allows important technological innovations, but it must be accompanied by a review of hospital and residential programs and locations. Since many institution are talking about economic investments for mental health (a crucial area for a full recovery of the society), specific funds are needed in mental health professionals (eg, psychologists), skills, and innovation of locations and technology, such as the conversion of psychiatric wards to community services that carefully must consider the patient experience and clinician's point of view. Some considerations on the COVID-19 experience in Italy are reported, and suggestions on future directions for public mental health service organization are hypothesized.
Language	English
Publishing date	2020-10-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2857285-3
ISSN	2374-3743 ; 2374-3735
ISSN (online)	2374-3743
ISSN	2374-3735
DOI	10.1177/2374373520956857
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Article: The COVID-19 Pandemic and Italian Public Mental Health Services: Experience and Future Directions

Pelizza, Lorenzo Pupo Simona

Journal of Patient Experience

Abstract: The COVID-19 pandemic has crosses every health care area (from primary care to specialist ones), leading to a review of all public health policies The use of smart working allows important technological innovations, but it must be accompanied by a review ...

Abstract	The COVID-19 pandemic has crosses every health care area (from primary care to specialist ones), leading to a review of all public health policies The use of smart working allows important technological innovations, but it must be accompanied by a review of hospital and residential programs and locations Since many institution are talking about economic investments for mental health (a crucial area for a full recovery of the society), specific funds are needed in mental health professionals (eg, psychologists), skills, and innovation of locations and technology, such as the conversion of psychiatric wards to community services that carefully must consider the patient experience and clinician?s point of view Some considerations on the COVID-19 experience in Italy are reported, and suggestions on future directions for public mental health service organization are hypothesized
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #883549
Database	COVID19

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Article ; Online: Persistent negative symptoms in young people at clinical high risk of psychosis treated with an Italian early intervention program: a longitudinal study.

Ricci, Camilla / Leuci, Emanuela / Quattrone, Emanuela / Palmisano, Derna / Pellegrini, Pietro / Menchetti, Marco / Pupo, Simona / Pelizza, Lorenzo

European archives of psychiatry and clinical neuroscience

2024

Abstract: Negative symptoms in CHR-P people are generally not responsive to treatments and commonly related to poorer functional outcome. However, less research attention has been dedicated to Persistent Negative Symptoms (PNS), defined as clinically stable ... ...

Abstract	Negative symptoms in CHR-P people are generally not responsive to treatments and commonly related to poorer functional outcome. However, less research attention has been dedicated to Persistent Negative Symptoms (PNS), defined as clinically stable negative symptoms of moderate severity evident for at least 6 months. This study aims to (a) determine the prevalence of PNS in a sample of young people at CHR-P; (b) investigate any association of PNS with functioning and clinical features; (c) examine longitudinal course of PNS across 2 years of follow-up and changes in PNS severity levels with specialized treatments. One Hundred Eighty CHR-P participants were recruited and were divided into CHR-P/PNS + and CHR-P/PNS- subgroups. The clinical assessments were based on the PANSS and the GAF and were conducted at baseline and every 12 months during the follow-up. Twenty four participants showed PNS at entry. Of them, 21 concluded the 2-year follow-up period. At baseline, the CHR-P/PNS + participants showed more educational and employment deficits, and more social and functioning impairment. During the follow-up, the CHR-P/PNS + subgroup had a significant longitudinal decrease in negative symptoms, which was specifically related to antidepressant treatment. CHR-P/PNS + subjects also showed a higher incidence of new hospitalization and a lower functional recovery over time. Our findings support that the persistence of negative symptoms in CHR-P people is longitudinally related to worse daily functioning and more severe clinical conditions that are at higher risk of hospitalization and are less responsive to specialized treatments.
Language	English
Publishing date	2024-04-26
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1045583-8
ISSN	1433-8491 ; 0175-758X ; 0940-1334
ISSN (online)	1433-8491
ISSN	0175-758X ; 0940-1334
DOI	10.1007/s00406-024-01808-w
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