Background: Italy was one of the first European countries adopting the need for treatment criteria for compulsory admission (CA). The aim of the present study was to confirm whether CA in an urban setting in Italy was compliant with the requested clinical criteria.Methods: In this retrospective observational study, we retrieved all collected information regarding CA in Turin (Italy) from January 2006 to December 2013. All content and data reported in the CA forms, including diagnosis and clinical details, were gathered and analyzed. Comparisons between CA with and without a diagnosis of DSM-IV psychiatric disorders and between different diagnoses were performed using either parametric or non-parametric tests, depending on variable distribution.Results: Three hundred and two (10.5%) of 2,870 consecutive CAs made in Turin during a lag time of 8 years were due to unknown psychiatric diagnoses (113; 3.9%) or to psychomotor agitation (189; 6.6%). The most prevalent psychiatric disorders leading to CA were schizophrenia (729; 25.4%), brief psychotic disorder (627; 21.8%), bipolar disorder episode (396; 13.8%), delusional disorder (292; 10.2%), and personality disorder (237; 8.3%). The CAs due to psychiatric disorder were longer (U = 328,875.0; p < 0.001) and involved patients who were more likely to be compulsorily admitted during the study period (U = 357,012.5; p = 0.003), to have had prior contact with a psychiatrist [χ(2)2 = 28.34; p < 0.001], to have had previous admissions to a psychiatric ward [χ(2)2 = 33.06; p < 0.001], to be under the care of psychiatric services [χ(3)2 = 87.01; p < 0.001], and not to have concurrent alcohol [χ(1)2 = 23.06; p < 0.001] and/or drug use [χ(1)2 = 12.97; p < 0.001] than those due to psychomotor agitation/unspecified diagnoses.Conclusion: Despite a history of 35 years of CA made according to a strict need for treatment criteria, the evaluation of CA records shows that a certain proportion of CAs appears to have been due to brief, not psychiatric, alcohol/drug related behavioral conditions. Further studies should confirm the need for law reform leading to the integration between the need for treatment and the danger criteria for CAs.

Background: Psychological distress is common among patients with cancer, with severe consequences on their quality of life. Anxiety and depression are the most common clinical presentation of psychological distress in cancer patients, but in some cases cancer may represent a traumatic event resulting in posttraumatic stress disorder (PTSD). Currently, Eye Movement Desensitization and Reprocessing (EMDR) therapy is considered an evidence-based treatment for PTSD, but recent studies also showed its effectiveness for anxiety and depression. The aim of the present systematic review is to summarize the current literature on the effect of EMDR on cancer-related psychological distress.Methods: A literature search was conducted for peer-reviewed articles about “EMDR” and “cancer patients” in the following electronic databases: PubMed, MEDLINE, Science Direct, Google Scholar, and Cochrane library.Results: Our search identified 7 studies in which EMDR was used with a total of 140 cancer patients. The psychiatric diagnosis was PTSD in 3 studies. Otherwise, the diagnosis concerned the anxious and depressive disorder spectrum. Overall, EMDR treatment schedules used were highly heterogeneous, with a different number of sessions (from 2 to 12) and a different duration of therapy (up to 4 months). However, across all studies analyzed EMDR therapy was judged to be adequate in reducing symptoms of psychological distress in this population.Conclusions: According to the results of our analysis, the level of evidence regarding EMDR efficacy in cancer patients is limited by the scarcity of studies and their low methodological quality. Although better quality research is needed, available data suggest that EMDR could be a promising treatment for psychological distress in patients with cancer.

High prevalence of PDs among adult ADHD patients was confirmed. The personality profiles seemed to reflect the persistence of ADHD and related childhood comorbidities in adulthood.

BackgroundHigh prevalence of Metabolic Syndrome (MS) was found in patients with schizophrenia and bipolar disorders. Insulin Resistance (IR) seems to mediate MS role in developing cardiometabolic consequences.AimsTo investigate the prevalence of MS, and the role of MS components and IR surrogate indexes in determining MS in adult ADHD outpatients.MethodsIn the present cross-sectional study, MS, defined according to the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATP III), and IR surrogate indexes were assessed on a consecutive sample of adult ADHD outpatients. Logistic regression analysis was performed to evaluate the effect of each ATP III component and IR surrogate index in determining MS.ResultsSeventeen out of 158 patients (10.8%, 95%CI = 0.064/0.167) fulfilled the ATP-III criteria for MS. A comprehensive comparison with prevalence in the reference population was hindered by the lack of patients over 60 in the study sample, however under this age no significant differences were found. Among MS components, blood triglycerides level (OR = 1.02, 95%CI=1.01/1.03, p = 0.001) was the main predictor for MS, followed by diastolic blood pressure (OR = 1.08, 95%CI=1.01/1.16, p = 0.024) and waist circumference (OR = 1.06, 95%CI=1.01/1.13, p = 0.029). Lipid Accumulation Product (LAP, OR = 1.0006, 95%CI=1.0003/1.0009, p &lt; 0.001) outperformed Triglyceride-Waist Circumference (TG-WC, OR=1.03, 95%CI=1.01/1.04, p &lt; 0.001) in predicting MS.ConclusionsMore attention should be paid not only to MS but also to each ATP III component of MS and LAP in ADHD patients both at first assessment and during follow-up process.

IntroductionPatients with Attention Deficit/Hyperactivity Disorder (ADHD) have shown a high risk to develop a DSM cluster B (i.e., Borderline, OR = 13.16; Antisocial, OR = 3.03; Narcissistic, OR = 8.69) and DSM Avoidant personality disorder (OR = 9.77). Similarly, higher rates of DSM cluster B personality disorder were found among adult ADHD patients (6-25%) than general population. Although some authors investigated the prevalence of personality traits and disorders among adult ADHD patients, no studies have been yet reported about the assessment of Millon's Evolution-Based Personality profiles in adult ADHD patients.AimsTo explore the prevalence of personality traits and disorders among adult ADHD patients.MethodsMillon's personality traits and disorders were assessed in a consecutive sample of 35 adult ADHD outpatients accessing the Service for Adult ADHD of the AOU San Luigi Gonzaga (Orbassano, TO) using the Millon Clinical Multiaxial Inventory–III (MCMI-III).ResultsAccording to the MCMI-III manual, ADHD patients in our sample showed more frequently both Cluster C and Cluster A traits and disorders, with a high prevalence of avoidant/depressive (8.6%/14.3%) and negativistic/self-defeating (20%/5.7%) personality disorders. Conversely, we found a low prevalence of Narcissistic (5.7%) and Histrionic (5.7%) traits, and no patient showed Borderline personality traits or disorder.ConclusionsUnexpectedly, the dimensional assessment of adult ADHD personality reveals a high prevalence of cluster C and cluster A personality traits and disorders, and a low prevalence of cluster B personality disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.