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Book: Multidimensional outcomes in "real world" mental health services

Lasalvia, Antonio

follow-up findings from the South Verona outcome project

(Acta psychiatrica Scandinavica : Supplementum ; 437)

2007

Author's details	guest ed.: Antonio Lasalvia
Series title	Acta psychiatrica Scandinavica : Supplementum ; 437 Acta psychiatrica Scandinavica Acta psychiatrica Scandinavica ; Supplementum
Collection	Acta psychiatrica Scandinavica Acta psychiatrica Scandinavica ; Supplementum
Language	English
Size	77 S.
Publisher	Blackwell Munksgaard
Publishing place	Oxford
Publishing country	Great Britain
Document type	Book
HBZ-ID	HT015366318
Database	Catalogue ZB MED Medicine, Health

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Shelf mark	Loan status	Location
Ui I Zs 141 -Suppl.437-	verfügbar in Königswinter	Königswinter

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Article ; Online: Emergenze epidemiche e stigma sociale. Quali insegnamenti trarre dalle precedenti epidemie di SARS ed Ebola da applicare nell’attuale pandemia CoViD-19?

Lasalvia, Antonio

Rivista di psichiatria

2020 Volume 55, Issue 4, Page(s) 250–253

Abstract: Scientific literature produced during the most recent international epidemic emergencies, such as SARS and Ebola, highlights that infected persons are often labeled, rejected, discriminated and subjected to loss of status due to their perceived link with ...

Title translation	Epidemic emergencies and social stigma. Which lessons should we learn from SARS and Ebola epidemics for the current CoViD-19 pandemics?
Abstract	Scientific literature produced during the most recent international epidemic emergencies, such as SARS and Ebola, highlights that infected persons are often labeled, rejected, discriminated and subjected to loss of status due to their perceived link with the disease. Such experiences of discrimination may have detrimental effects on both patients, their family members, friends and communities. It is also possible that those who have been infected with COVD-19 may experience shame, guilt and sense of isolation arising from social stigma. It is therefore important to take full advantage of experiences gained during past epidemic crises, in order to implement timely measures to tackle this further negative consequence of the pandemic.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Communication ; Coronavirus Infections/epidemiology ; Coronavirus Infections/psychology ; Emergencies ; Epidemics ; Family/psychology ; Hemorrhagic Fever, Ebola/epidemiology ; Hemorrhagic Fever, Ebola/psychology ; Humans ; Language ; Pandemics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/psychology ; SARS-CoV-2 ; Severe Acute Respiratory Syndrome/epidemiology ; Severe Acute Respiratory Syndrome/psychology ; Social Isolation/psychology ; Social Stigma
Keywords	covid19
Language	Italian
Publishing date	2020-07-22
Publishing country	Italy
Document type	Journal Article
ZDB-ID	205570-3
ISSN	2038-2502 ; 0035-6484
ISSN (online)	2038-2502
ISSN	0035-6484
DOI	10.1708/3417.34003
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Article: Emergenze epidemiche e stigma sociale. Quali insegnamenti trarre dalle precedenti epidemie di SARS ed Ebola da applicare nell'attuale pandemia CoViD-19?/ [Epidemic emergencies and social stigma. Which lessons should we learn from SARS and Ebola epidemics for the current CoViD-19 pandemics?]

Lasalvia, Antonio

Riv Psichiatr

Abstract	Scientific literature produced during the most recent international epidemic emergencies, such as SARS and Ebola, highlights that infected persons are often labeled, rejected, discriminated and subjected to loss of status due to their perceived link with the disease. Such experiences of discrimination may have detrimental effects on both patients, their family members, friends and communities. It is also possible that those who have been infected with COVD-19 may experience shame, guilt and sense of isolation arising from social stigma. It is therefore important to take full advantage of experiences gained during past epidemic crises, in order to implement timely measures to tackle this further negative consequence of the pandemic.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #690715
Database	COVID19

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Article ; Online: Advance statements in mental healthcare: time to close the evidence to practice gap.

Lasalvia, Antonio / Patuzzo, Sara / Braun, Esther / Henderson, Claire

Epidemiology and psychiatric sciences

2023 Volume 32, Page(s) e68

Abstract: This article discusses advance statements in mental health care, which allow individuals with mental disorders to express their preferences for treatment during mental health crises. Despite the evidence supporting their effectiveness, their ... ...

Abstract	This article discusses advance statements in mental health care, which allow individuals with mental disorders to express their preferences for treatment during mental health crises. Despite the evidence supporting their effectiveness, their implementation in clinical practice remains limited. This article explores variations among advance statements, such as psychiatric advance directives (PADs), joint crisis plans (JCPs) and self-binding directives (SBDs), highlighting their content, development process and legal status. We outline the benefits of advance statements, including empowerment, early intervention, improved therapeutic relationships and reduced compulsory admissions. We then draw attention to the challenges that may contribute to their lack of implementation, including legal complexities, communication issues, cultural factors, potential inequities, healthcare provider knowledge, changing preferences, resource constraints, crisis responses, data privacy, family involvement, and long-term evaluation. In conclusion, advance statements offer significant benefits but require addressing these critical aspects to ensure ethical and effective use. Bridging the evidence-to-practice gap is essential, with a focus on implementation science. Integrating these tools into routine clinical practice can significantly benefit individuals with severe mental disorders and mental health systems.
MeSH term(s)	Humans ; Professional Practice Gaps ; Mental Disorders/therapy ; Mental Disorders/psychology ; Advance Directives/psychology ; Mental Health Services ; Mental Health
Language	English
Publishing date	2023-12-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2607964-1
ISSN	2045-7979 ; 2045-7960
ISSN (online)	2045-7979
ISSN	2045-7960
DOI	10.1017/S2045796023000835
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Article ; Online: Behind the screen of voluntary psychiatric hospital admissions: A qualitative exploration of treatment pressures and informal coercion in experiences of patients in Italy, Poland and the United Kingdom.

Klingemann, Justyna / Świtaj, Piotr / Lasalvia, Antonio / Priebe, Stefan

The International journal of social psychiatry

2021 Volume 68, Issue 2, Page(s) 457–464

Abstract: Background: Despite the extensive research and intense debate on coercion in psychiatry we have seen in recent years, little is still known about formally voluntarily admitted patients, who experience high levels of perceived coercion during their ... ...

Abstract	Background: Despite the extensive research and intense debate on coercion in psychiatry we have seen in recent years, little is still known about formally voluntarily admitted patients, who experience high levels of perceived coercion during their admission to a psychiatric hospital. Aims: The purpose of the present research was to explore forms of treatment pressure put on patients, not only by clinicians, but also by patients' relatives, during admission to psychiatric hospitals in Italy, Poland and the United Kingdom. Methods: Data were obtained via in-depth, semi-structured interviews with patients ( Results: The results of the analysis confirm that the legal classifications of involuntary and voluntary hospitalisation do not capture the fundamental distinctions between patients who are and are not coerced into treatment. Our findings show that the level of perceived coercion in voluntary patients ranges from 'persuasion' and 'interpersonal leverage' (categorised as treatment pressures) to 'threat', 'someone else's decisions' and 'violence' (categorised as informal coercion). Conclusion: We suggest that the term 'treatment pressures' be applied to techniques for convincing patients to follow a suggested course of treatment by offering advice and support in getting professional help, as well as using emotional arguments based on the personal relationship with the patient. In turn, we propose to reserve the term 'informal coercion' to describe practices for pressuring patients into treatment by threatening them, by making them believe that they have no choice, and by taking away their power to make autonomous decisions.
MeSH term(s)	Coercion ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Mental Disorders/psychology ; Mental Disorders/therapy ; Poland ; United Kingdom
Language	English
Publishing date	2021-04-15
Publishing country	England
Document type	Journal Article
ZDB-ID	3062-4
ISSN	1741-2854 ; 0020-7640
ISSN (online)	1741-2854
ISSN	0020-7640
DOI	10.1177/00207640211003942
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Article ; Online: Renaming schizophrenia: benefits, challenges and barriers.

Lasalvia, Antonio / Ruggeri, Mirella

Epidemiology and psychiatric sciences

2018 Volume 28, Issue 3, Page(s) 251–253

MeSH term(s)	Humans ; Psychotic Disorders/diagnosis ; Psychotic Disorders/psychology ; Schizophrenia/diagnosis ; Schizophrenic Psychology ; Social Stigma
Language	English
Publishing date	2018-11-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2607964-1
ISSN	2045-7979 ; 2045-7960
ISSN (online)	2045-7979
ISSN	2045-7960
DOI	10.1017/S2045796018000677
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Article ; Online: Should we be concerned about stigma and discrimination in people at risk for psychosis? A systematic review.

Colizzi, Marco / Ruggeri, Mirella / Lasalvia, Antonio

Psychological medicine

2020 Volume 50, Issue 5, Page(s) 705–726

Abstract: Background: Previous studies have provided initial evidence that people at risk for psychosis (PR) suffer from stigma and discrimination related to their condition. However, no study has systematically reviewed stigma and discrimination associated with ... ...

Abstract	Background: Previous studies have provided initial evidence that people at risk for psychosis (PR) suffer from stigma and discrimination related to their condition. However, no study has systematically reviewed stigma and discrimination associated with being at PR and the potential underlying mechanisms. Methods: This work aimed to systematically review all studies addressing stigma and discrimination in PR people in order to assess: (1) the occurrence of this phenomenon and its different components (public, internalized, perceived, and labeling-related), (2) whether stigma affects outcomes of the PR state, and (3) whether other factors modulate stigma among PR individuals. Results: The reviewed studies (n = 38) widely differ in their design, methodological quality, and populations under investigation, thus limiting direct comparison of findings. However, converging evidence suggests that the general public endorses stigmatizing attitudes towards PR individuals, and that this is more frequent in people with a low educational level or with no direct experience of the PR state. PR individuals experience more internalized stigma and perceive more discrimination than healthy subjects or patients with non-psychotic disorders. Further, PR labeling is equally associated with both positive (e.g. validation and relief) and negative effects (e.g. status loss and discrimination). Moreover, stigma increases the likelihood of poor outcome, transition to full-psychosis, disengagement from services, and family stigma among PR individuals. Finally, very limited evidence awaiting replication supports the efficacy of cognitive therapies in mitigating the negative effects of stigma. Conclusions: Evidence confirms previous concerns about stigma and its negative consequences for PR individuals, thus having important public health implications.
MeSH term(s)	Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Male ; Middle Aged ; Psychotic Disorders/psychology ; Social Stigma ; Stereotyping ; Young Adult
Language	English
Publishing date	2020-02-17
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	217420-0
ISSN	1469-8978 ; 0033-2917
ISSN (online)	1469-8978
ISSN	0033-2917
DOI	10.1017/S0033291720000148
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Article: Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care?

Colizzi, Marco / Lasalvia, Antonio / Ruggeri, Mirella

International journal of mental health systems

2020 Volume 14, Page(s) 23

Abstract: Background: Similar to other health care sectors, mental health has moved towards the secondary prevention, with the effort to detect and treat mental disorders as early as possible. However, converging evidence sheds new light on the potential of ... ...

Abstract	Background: Similar to other health care sectors, mental health has moved towards the secondary prevention, with the effort to detect and treat mental disorders as early as possible. However, converging evidence sheds new light on the potential of primary preventive and promotion strategies for mental health of young people. We aimed to reappraise such evidence. Methods: We reviewed the current state of knowledge on delivering promotion and preventive interventions addressing youth mental health. Results: Half of all mental disorders start by 14 years and are usually preceded by non-specific psychosocial disturbances potentially evolving in any major mental disorder and accounting for 45% of the global burden of disease across the 0-25 age span. While some action has been taken to promote the implementation of services dedicated to young people, mental health needs during this critical period are still largely unmet. This urges redesigning preventive strategies in a youth-focused multidisciplinary and trans-diagnostic framework which might early modify possible psychopathological trajectories. Conclusions: Evidence suggests that it would be unrealistic to consider promotion and prevention in mental health responsibility of mental health professionals alone. Integrated and multidisciplinary services are needed to increase the range of possible interventions and limit the risk of poor long-term outcome, with also potential benefits in terms of healthcare system costs. However, mental health professionals have the scientific, ethical, and moral responsibility to indicate the direction to all social, political, and other health care bodies involved in the process of meeting mental health needs during youth years.
Language	English
Publishing date	2020-03-24
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2382266-1
ISSN	1752-4458
ISSN	1752-4458
DOI	10.1186/s13033-020-00356-9
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Article ; Online: Development and psychometric validation of new questionnaires assessing experienced discrimination and internalised stigma among people with Covid-19.

Bonetto, Chiara / Pace, Davide / Bodini, Luca / Colombi, Morena / Van Bortel, Tine / Lasalvia, Antonio

Epidemiology and psychiatric sciences

2022 Volume 31, Page(s) e37

Abstract: Aims: To develop and validate two new standardised measures assessing, respectively, experienced discrimination (Covid-19 Experienced DISCrimination scale, CEDISC) and internalised stigma (COvid-19 INternalised Stigma scale, COINS) in people who had ... ...

Abstract	Aims: To develop and validate two new standardised measures assessing, respectively, experienced discrimination (Covid-19 Experienced DISCrimination scale, CEDISC) and internalised stigma (COvid-19 INternalised Stigma scale, COINS) in people who had been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or had developed coronavirus disease 2019 (Covid-19) disease. Methods: Both the CEDISC and the COINS were developed in Italian and tested for ease of use, comprehension, acceptability, the relevance of items and response options within a focus group session. Online cross-sectional validation survey was conducted among adults infected with SARS-CoV-2 or who developed Covid-19 disease, members of a closed Facebook discussion group in Italy. Exploratory factor analysis (EFA) with Promax oblique rotation; the Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy and the Bartlett's test of sphericity were used to assess the suitability of the sample for factor analysis. Reliability was assessed as internal consistency using Cronbach's alpha and as test-retest reliability using weighted kappa and intraclass correlation coefficient (ICC). Precision was examined by Kendall's tau-b coefficient. Results: Overall, 579 participants completed the CEDISC, 519 also completed the COINS, 155 completed the retest for both scales after two weeks. The 12 items of the CEDISC converged over a 2-factor solution ('social life' and 'close relations') accounting for 49.2% of the variance (KMO = 0.894; Bartlett's test p < 0.001); the 13 items of the COINS converged over a 3-factor solution ('self-perception', 'close relations' and 'social life') accounting for 67.7% (KMO = 0.827; Bartlett's test p < 0.001). Cronbach's α was 0.848 for the CEDISC, and 0.837 for the COINS. The CEDISC showed three items (25%) with kappa between 0.61 and 0.80 and seven (58.4%) between 0.41 and 0.60, with only two items scoring 0.21 and 0.40; the COINS had ten items (76.9%) with kappa ranging from 0.41 to 0.60, and three items below 0.31. ICC was 0.906 (95% CI, 0.871-0.932) for the, CEDISC and 0.860 (95% CI, 0.808-0.898) for the COINS. Kendall's tau-b ranged from 0.360 to 0.556 (p < 0.001) for the CEDISC and from 0.290 to 0.606 (p < 0.001) for the COINS. Conclusions: Both the CEDISC and the COINS are two valid and reliable scales to be used in studies examining the role of stigma and discrimination of people infected with SARS-CoV-2 and Covid-19 patients, and in research evaluating interventions designed to mitigate stigma in this population.
MeSH term(s)	Adult ; COVID-19 ; Cross-Sectional Studies ; Humans ; Psychometrics ; Reproducibility of Results ; SARS-CoV-2 ; Surveys and Questionnaires
Language	English
Publishing date	2022-05-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2607964-1
ISSN	2045-7979 ; 2045-7960
ISSN (online)	2045-7979
ISSN	2045-7960
DOI	10.1017/S204579602200021X
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Article: Psychiatrists' attitudes towards functional neurological disorders: results from a national survey.

Marotta, Angela / Lasalvia, Antonio / Fiorio, Mirta / Zanalda, Enrico / Di Sciascio, Guido / Palumbo, Claudia / Papola, Davide / Barbui, Corrado / Tinazzi, Michele

Frontiers in psychiatry

2023 Volume 14, Page(s) 1216756

Abstract: Introduction: Functional neurological disorder (FND) presents motor, sensory, and cognitive symptoms characterized by clinical signs incongruent with known neurological disease. Together with other health professionals, like neurologists, psychiatrists ... ...

Abstract	Introduction: Functional neurological disorder (FND) presents motor, sensory, and cognitive symptoms characterized by clinical signs incongruent with known neurological disease. Together with other health professionals, like neurologists, psychiatrists can play an essential role in diagnosing and managing these disorders. Hence, understanding their opinion and clinical experience with FND is of utmost importance to catch potential educational needs and improve healthcare services for patients. This study aims at assessing the knowledge, opinion, and clinical approach of Italian psychiatrists to FND. Methods: Members of the Italian Society of Psychiatry completed a 14-item web-based survey investigating their approach to FND. Results. Overall, 174 questionnaires were completed. Our main findings suggest that Italian psychiatrists have a psychogenetic conceptualization of FND. "Conversion disorders", in fact, is the term most frequently used by Italian psychiatrists to refer to FND, thus implying a psychological etiology of these disorders. Congruently with this view, psychotherapy associated with pharmacological therapy is considered the most appropriate treatment by psychiatrists, while physiotherapy is an under-recognized treatment option for FND. Discussion: The present study highlights that a psychogenetic view of FND dominates among Italian psychiatrists. This could be due to out-of-date knowledge about the pathophysiology of this group of disorders. Promoting education about novel approaches to FND would be of crucial importance to improving care for patients suffering from this condition.
Language	English
Publishing date	2023-07-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2023.1216756
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