Mario Miniati

Università di Pisa | UNIPI · Department of Clinical and Experimental Medicine

Suicidal risk in mothers is a public health priority. Risk factors include biological, psychological and psychosocial factors. Among the biological factors, the role of sleep disturbances as potential contributors to increased suicidal risk during the peripartum period is becoming apparent. To explore this further, we conducted a systematic review...

Psychological inflexibility is related to depressive symptoms through the ‘ruminative response style’ (RR) and ‘cognitive fusion’ (CF). We aimed at exploring whether university students were more exposed to CF, RR and depressive symptoms because of their intellectual performance than non-university students of the same age. We compared university s...

Insomnia is a stress-related sleep disorder conceptualised within a diathesis-stress framework, which it is thought to result from predisposing factors interacting with precipitating stressful events that trigger the development of insomnia. Among predisposing factors genetics and epigenetics may play a role. A systematic review of the current evid...

Insomnia disorder is considered as a stress-related disorder associated with hyperarousal, stress and emotion dysregulation and the instability of the 'flip-flop' switch system. The orexinergic system is well known for its key role in sleep and arousal processes but also in the allostatic system regulating stress and emotions and may thus be of maj...

Emotion regulation is an important aspect of psychological functioning that influences subjective experience and moderates emotional responses throughout the lifetime. Adaptive responses to stressful life events depend on the positive interaction between explicit and implicit emotion regulation strategies, such as mindfulness and defense mechanisms...

Objective: Alexithymia main features include deficits in empathy, emotion recognition and regulation. Alexithymia has been recently proposed as a potential key to explain the presence of the so-called 'autistic spectrum disorder' signs (ASD), in patients with Anorexia Nervosa (AN). Objective of this review is to summarize current knowledge on the...

Objective: The study aimed to investigate the possible impact of resilience and emotion dysregulation on the clinical manifestations of bipolar disorders (BDs) focusing on the possible role of circadian rhythm alterations. Method: A sample of 197 inpatients suffering from BD of type I (BDI) or II (BDII) were assessed during a major depressive ep...

Background Neuroleptics (NRL) and Tricyclic Antidepressants (TCA) could be related to the QT prolongation although the risk of ventricular arrhythmias and sudden death caused by these drugs was not clearly described in literature. Corrected QT (QTc), is the major marker of arrhythmic risk; Qt dispersion (QTd) is defined as the dispersion of the QT...

Distress associated with physical illness is a well‐known risk factor for adverse illness course in general hospitals. Understanding the factors contributing to it should be a priority and among them dysfunctional illness perception and poor sleep quality may contribute to it. As poor sleep quality is recognised as a major risk factor for health pr...

This study aims to evaluate clinical correlates of psychiatric comorbidity and length of hospitalization in patients admitted in a general hospital emergency medicine setting. Overall, 160 patients hospitalized for different acute medical pathologies were selected consecutively over 12 months. All subjects were evaluated with proper forms to collec...

Persisting limitations in respiratory function and gas exchange, cognitive impairment, and mental health deterioration have been observed weeks and months after acute SARS-CoV-2 (COVID-19). The present study aims at assessing the impairment at three-months in patients who successfully recovered from acute COVID-19. We collected data from May to Jul...

Abstract Aim: The study aimed to investigate resilience and its association with early exposure to stressful events on the clinical manifestations of bipolar disorders (BDs), such as severity of mood symptoms, suicidal ideation and behaviors focusing on the possible role of insomnia symptoms. Method: A sample of 188 adult participants with BD of...

Introduction Insomnia is emerging as a modifiable major risk factor for mental and physical problems, including cancer, and it may contribute to cancer-related fatigue and depression. Since both fatigue and depression may favor insomnia as well, we may hypothesize a self-reinforcing feedback loop among these factors in cancer. Methods With the aim...

Aim The study aimed to investigate resilience and its association with early exposure to stressful events on the clinical manifestations of bipolar disorders (BDs), such as severity of mood symptoms, suicidal ideation and behaviors focusing on the possible role of insomnia symptoms. Method A sample of 188 adult participants with BD of type I or II...

Background The aim of this paper is to review evidence on Interpersonal Psychotherapy (IPT) administered via telephone (IPT-T). Methods We conducted a systematic review of studies published between January 1, 1990 and June 30, 2020, assessing the efficacy of IPT administered by phone, using PubMed. Results Originally, we found 60 papers; the fina...

Ovarian cancer is the leading cause of gynaecological cancer deaths and the seventh most commonly diagnosed cancer among women worldwide, so that, as it is related to substantial and increasing disease burden, the management of ovarian cancer survivors should be a priority. Such issues involve prevention and management of emotional distress, anxiet...

Background: Several data suggest that coronavirus disease 2019 (COVID-19) pandemic may exacerbate or trigger eating disorders (EDs). The aim of this paper was to summarize current literature studies on COVID pandemic and EDs. Methods: Literature search, study selection, methods, and quality evaluation were performed according to the preferred repor...

Objectives: In the present study we investigate the putative differences in pain catastrophising (PC), pain perception (PP), sexual functioning (SF), satisfaction (SS), and overall quality of life between fibromyalgia (FM) and rheumatoid arthritis (RA) patients as compared to healthy controls (HC). Methods: Fifty-seven native Italian-speaking fe...

Objective: Interpersonal Psychotherapy (IPT) model, with its four problematic areas of grief, deficit, role transition and role dispute, provides a useful frame of reference for a quick case formulation. We aimed at applying the IPT problematic areas assessment in a sample of patients from a liaison psychiatry setting. Methods: One-hundred and twen...

Background: Several data suggest that COVID-19 pandemic might exacerbate or trigger Eating Disorders (EDs). The aim of this paper was to summarize present literature on COVID pandemic and EDs. Methods: Literature search, study selection, methods, and quality evaluation were performed following PRISMA Guidelines. Results: The systematic search permi...

The study aimed at investigating the potential impact of early stressful events on the clinical manifestations of bipolar disorder (BD). A sample of 162 adult individuals with BD was assessed using the Structural Clinical Interview for DSM-5, the Beck Depression Inventory-II, the Young Mania Rating Scale, the Early Trauma Inventory Self Report-Shor...

Background: The clinical presentation of Eating Disorders (EDs) is often characterized by a great phenotypic variability and by a substantial instability over time of diagnostic categories. For these reasons, it has been proposed a different approach to EDs, encompassing both their dimensional and categorical descriptions, in a lifetime perspective...

Objective: To examine the role of chronobiological dysrhythmicity in suicidal ideation and behaviors and its relation with hopelessness. Methods: One hundred twenty-seven patients (77 females, mean age of 47.4 ± 12.5 years) with a major depressive episode and bipolar disorder (BD) type I or II (according to Structured Clinical Interview for DSM-...

The present paper aims at reviewing and commenting on the relationships between sleep and circadian phasing alterations and neurodegenerative/neuroprogressive processes in mood disorder. We carried out a systematic review, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, in PubMed, PsycINFO, and Embase ele...

Objectives: Fibromyalgia (FM) is highly prevalent in female gender. Scarce attention has been given to the exploration and description of this syndrome, from a psychological point of view, when occurring in males. The aim of the present study is to develop further knowledge, and to summarise the literature regarding subjective psychological experi...

Aim The study aimed to investigate the potential pathways mediating early exposure to stressful events and the clinical manifestations of bipolar disorder (BD), such as severity of mood symptoms, hopelessness and suicidal ideation, focusing on the potential role of insomnia symptoms. Method A sample of 162 adult participants with BD I or II were a...

Objective: We reviewed literature on drugs for bipolar disorders (BD), utilized in ovarian cancer (OC). Method: We adhered to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines in completion of this systematic review. Results: We identified 73 papers. Thirty-two studies were finally included. BD is rarely...

Objective: To explore decision-making, impulsiveness and temperamental traits in patients suffering from eating disorders (EDs), as compared with healthy controls (HC). Method: Fifty-one patients affected by ED (fourteen with anorexia restricting subtype, AN-R; fourteen with bulimia, BN; thirteen with anorexia bingeing/purging subtype, AN-BP; te...

Background. To explore relationships among post-traumatic stress disorder (PTSD), depres- sive spectrum symptoms, and intrusiveness in subjects who survived the crash of a train derailed carrying liquefied petroleum gas and exploded causing a fire. Methods. A sample of 111 subjects was enrolled in Viareggio, Italy. AMOS version 21 (IBM Corp, 2012)...

Clinical Neuropsychiatry (2020) 17, 2, 94-96 Citation: Conversano, C., Marchi, L., Miniati, M. (2020). Psychological distress among healthcare professionals involved in the Covid-19 emergency: vulnerability and resilience factors. Clinical Neuropsychiatry, 17 (2), 94-96. Open Access the aim of this paper is to outline some considerations about the...

Objectives: Stressful life events (SLEs) are common in patients who developed both physical and psychological syndromes. Research shown the role of psychological defense mechanisms in cancer progression and survival probability. The present study analyzed recent SLEs and defense mechanisms as characteristic of cancer patients and tested their role...

Background: Bipolar disorders are complex disorders involving the interaction of multiple factors. Affective temperaments, insomnia, and chronobiological rhythms desynchronization may all contribute to bipolar disorder. Since there is a paucity of research examining this topic we aimed to study how they are interrelated and collectively associated...

Background Over the course of the 20th century, Neurology and Psychiatry diverged and became two separate disciplines. Subsequently, the continuous progress of Neurosciences confused their boundaries. However, both with ‘the splitting’ and ‘the lumping’ approaches relevant difficulties remain in targeting clinical and therapeutic goals, when psychi...

Eating and Feeding Disorders are heterogeneous clinical conditions characterized by cognitive, interpersonal, and behavioural features. They might spread across a spectrum of severity, from mild or sub-threshold conditions, belonging to the realm of altered eating habits or body dysmorphic features, to severe disorders. The Anorexia-Bulimia Spectru...

Summary The use of dietary supplements and herbal medicines is spreading across many developed countries. Although patients without specific problems can administer most, relevant toxic- ities might occur with a reckless use of dietary supplements, especially when psychiatric or medical comorbidities are present. Limited research is available on th...

Objective To investigate if sleep disturbances may affect treatment outcomes of patients with panic disorder (PD). Methods Eighty-five PD outpatients with no Axis I comorbidity for mood disorders completed a baseline assessment (T1) and were evaluated after 3 (T2), 6 (T3) and 12 months (T4), with the Panic Disorder Severity Scale (PDSS) total scor...

Background: Interpersonal psychotherapy (IPT) is a time-limited and affect-, life-event-, and present-focused psychotherapy originally conceptualized for unipolar depression, and then adapted to the treatment of other disorders, including eating disorders (EDs). The purpose of this paper is to conduct a systematic review of studies on IPT for EDs....

Purpose: To investigate the presence of mood spectrum signs and symptoms in patients with anorexia nervosa, restricting subtype (AN-R) or bulimia nervosa (BN). Method: 55 consecutive female patients meeting DSM-IV criteria for eating disorders (EDs) not satisfying DSM-IV criteria for Axis I mood disorders were evaluated with the Lifetime Mood Sp...

The aim is to summarize current knowledge on both QoL and depressive/anxious symptoms in patients with UM, including studies on the effect on QoL and psychological status of genetic testing related to the risk of metastatic disease. A review from the last 25 years by using the databases “PsycInfo,” “Medline,” and “Science Direct” was performed. As...

Autism Spectrum Disorder (ASD) has been recently highlighted as potentially related to a higher risk for suicide. ASD features are often under-recognized, especially in subjects with high level of functioning. We present the case of a 21-year-old man who attempted suicide jumping from the third floor of his home. The patient had been treated during...

Delirious mania is a severe but often underrecognized syndrome characterized by rapid onset of delirium, mania, and psychosis, not associated with a prior toxicity, physical illness, or mental disorder. We discuss the case of a delirious mania potentially triggered and maintained by a systemic hypotension induced by antihypertensive drugs. Symptoms...

Background: The aim of this study was to assess the treatment benefit and patterns of recurrence for patients with high-risk vulvar squamous cell carcinoma treated with surgery followed by adjuvant radiotherapy (RT). Patients and methods: From January 1999 to June 2016, 51 patients underwent total or partial deep vulvectomy with inguinofemoral l...

Psychopharmacological options for adult patients with anorexia nervosa: the patients’ and carers’ perspectives integrated by the spectrum model - Mario Miniati, Donatella Marazziti

Background: There is evidence in the literature that adverse early attachment experiences and subsequent attachment insecurities during adulthood would lead to pessimism, low self-esteem, hopelessness and, ultimately, to suicide risk. Subjects and methods: This paper aims to review finding on the link between attachment style and suicidality. We...

Background: Starvation symptoms are common in patients with anorexia nervosa, and according to the transdiagnostic cognitive behavioural theory for eating disorders, they contribute to maintaining the eating disorder psychopathology. The aim of this study was therefore to describe the design and validation of the Starvation Symptoms Inventory (SSI)...

Objective We explored the potential association between antipsychotics and QT/QTc duration changes in hospitalized male patients with psychotic disorders. Methods The chart review was conducted on 184 male patients hospitalized between 2013 and 2015 at the Psychiatric Clinic of Pisa, Italy. Patients who were treated with one atypical antipsychotic...

Introduction Mood, anxiety and sleep disorders have a very complex relationship: it has a negative impact on therapeutic strategies. The aim was to evaluate the effect of mood and sleep deregulation on treatment outcome in Panic Disorder by adopting a dimensional perspective and using the Mood Spectrum Self-Report Questionnaire (MOODS-SR). It has b...

Objectives: To explore the presence of PTSD and the potential correlations between the risk of developing PTSD and the lifetime mood spectrum signs and symptoms, as assessed with the Mood Spectrum Questionnaire Lifetime Version (MOODS-SR), in a sample of survivors of a liquid gas train crash in Italy, in 2009. Methods: One hundred eleven subjects w...

Background Conflicting evidence exists about the relationship between psychotic symptoms and suicidality in mood disorders. We aimed to investigate the lifetime suicidality and its relationship with dimensions of the psychotic spectrum over the lifespan among subjects with bipolar I (BD I) or major depressive disorder (MDD). Methods 147 Consecutiv...

Objectives: This study evaluates the validity and reliability of a new self-report instrument that assess GAD spectrum symptoms: the WORRY-SR. Methods: Participants included 120 patients with mood and anxiety disorders recruited at the Department of Psychiatry of the University of Pisa and two comparison groups included 47 participants recruited at...

Childbearing is one of the most complex periods of human experience, and pregnancy is not a protective factor against perinatal depression. Pregnant women and mothers who have recently delivered are vulnerable to the entire spectrum of psychiatric disorders. The cumulative point-prevalence rates of major and minor depression range from 8.5% to 11%...

The aim of this review was to summarize evidence from research on psychopharmacological options for adult patients with anorexia nervosa (AN). Database searches of MEDLINE and PsycINFO (from January 1966 to January 2014) were performed, and original articles published as full papers, brief reports, case reports, or case series were included. Forty-...

Objectives: To compare predictive formulae commonly used to calculate resting energy expenditure (REE) with the indirect calorimetry (IC) in a sample of female outpatients with bipolar I disorder, stabilised with long-term psychopharmacological treatment. Methods: Seventeen female patients with bipolar I disorder were evaluated with an IC instrumen...

to investigate studies conducted with the Mood Spectrum Structured Interviews and Self-Report versions (SCI-MOODS and MOODS-SR). We conducted a review of studies published between 1997 and August 2014. The search was performed using Pubmed and PsycINFO databases. Analysis of the papers followed the inclusion and exclusion criteria recommended by th...

The authors comment on the recently proposed food addiction spectrum that represents a theoretical model to understand the continuum between several conditions ranging from normality to pathological states, including eating disorders and obesity, as well as why some individuals show a peculiar attachment to food that can become an addiction. Furthe...

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced noteworthy revisions to Post-Traumatic Stress Disorder (PTSD) criteria, including a four-factor model and some new symptomatic criteria. To date, only a limited number of studies investigated the impact of such changes on the prevalence rates of the di...

We present a case report of a young man who attempted suicide during a mixed episode with psychotic symptoms.The patient’s history revealed the lifetime presence of signs and features belonging to the autism spectrum realm that had been completely overlooked.We believe that this case is representative of an important and barely researched topic: wh...

We present a case report of a young man who attempted suicide during a mixed episode with psychotic symptoms. The patient's history revealed the lifetime presence of signs and features belonging to the autism spectrum realm that had been completely overlooked. We believe that this case is representative of an important and barely researched topic:...

Interpersonal psychotherapy (IPT) is a dynamically informed and present-focused psychotherapy originally conceived for patients with unipolar depression and subsequently modified for other disorders, including postpartum depression (PPD). The aim of this paper is to review the evidence on the efficacy of IPT for PPD. We conducted a systematic revie...

This study aimed to explore predictors of remission to electroconvulsive therapy (ECT) in a sample of depressive patients resistant to pharmacological treatments. Two hundred eight patients, 31 of whom had major depressive disorder, 101 had bipolar disorder II (BP II), and 76 had bipolar disorder I (BP I), diagnosed according to the Diagnostic and...

We present a case report of a woman hospitalized for a ventricular-peritoneal shunting replacement, who developed a manic episode with psychotic symptoms after hydrocephalus resolution. We have no knowledge of cases of manic episodes due to hydrocephalus resolution by ventricular-peritoneal shunt replacement, although previous case reports have sug...

RIASSUNTO L’importanza clinica di un metodo di valutazione del disturbo di panico (DP) esteso a un più ampio numero di segni e sintomi rispetto a quanto descritto nei sistemi categoriali è una diretta conseguenza della ridotta sensibilità delle scale di valutazione comunemente utilizzate. L’occorrenza di una fenomenica residua, di manifestazioni su...

RIASSUNTO Negli ultimi decenni diversi autori hanno proposto un approccio dimensionale ai disturbi dell’umore. Il concetto di spettro dei disturbi dell’umore configura un approccio di tipo dimensionale nato dalla collaborazione di un gruppo di ricercatori e clinici delle università di Pittsburgh, New York, San Diego e Pisa. Lo spectrum model ipotiz...

Aims and background: To summarize current knowledge on psychopharmacological and psychotherapeutic options for patients with breast cancer and comorbid depression, starting from the psychiatric viewpoint. Issues on diagnostic boundaries of depression and outcome measures are raised. Methods: We completed a literature review from the last 30 year...

Aims and background. To summarize current knowledge on psychopharmacological and psychotherapeutic options for patients with breast cancer and comorbid depression, starting from the psychiatric viewpoint. Issues on diagnostic boundaries of depression and outcome measures are raised. Methods. We completed a literature review from the last 30 years (...

Aims and background To summarize current knowledge on psychopharmacological and psychotherapeutic options for patients with breast cancer and comorbid depression, starting from the psychiatric viewpoint. Issues on diagnostic boundaries of depression and outcome measures are raised. Methods We completed a literature review from the last 30 years (u...

Here we report on a case series chart review conducted on nine severe and treatment-resistant patients with anorexia nervosa, body mass index <13 kg/m(2), and a delusional body image disturbance. Patients received low doses of haloperidol during hospitalization. Haloperidol was well tolerated. The delusional body image disturbance and the drive for...

The aim of the present study was to evaluate the long-term outcome in a sample of patients with bipolar disorder with severe depression or mixed-state resistant to pharmacological treatment who have responded to electroconvulsive therapy (ECT). The study involved 36 patients with major depression (5 patients with bipolar I depression, and 14 patien...

Objective: The aim of this paper is to provide an overview of the self-report and interview-based instruments to assess mania/hypomania symptoms and related features, with a focus on 7 selected instruments in widespread use to illustrate their psychometric properties, comparative performance and pros and cons. Methods: A systematic search strategy...

Multiple studies indicate that bipolar disorders are often underrecognized, misdiagnosed, and incorrectly treated. The aim of the present report is to determine which combination of clinical, demographic, and psychopathological factors and corresponding cutoff scores best discriminate patients with unipolar disorder from those with bipolar disorder...

Efficacy of treatments for panic disorder is well established, but not all patients respond. Adult separation anxiety has been found to predict poorer response to CBT, but its effect on response to medication has not been previously explored. The aim of this study is to investigate if panic-agoraphobic spectrum factors, including 'separation anxiet...

Background: Despite the availability of many effective treatments, patients with major depression remain at risk for relapse following remission of a depressive episode. The aims of this report are to estimate the relapse rates associated with the acute treatment strategies employed in this study and to investigate demographic and clinical predicto...

Despite the availability of many effective treatments, patients with major depression remain at risk for relapse following remission of a depressive episode. The aims of this report are to estimate the relapse rates associated with the acute treatment strategies employed in this study and to investigate demographic and clinical predictors of relaps...

To date, few randomized controlled trials (RCTs) of major depression have examined suicidal ideation as an outcome measure. Our aim is to determine the incidence of treatment-emergent suicidal ideation (ESI) and behaviors during the acute phase of treatment with an SSRI antidepressant or interpersonal psychotherapy (IPT) in patients with unipolar m...

The recognition and assessment of psychomotor retardation may have implications for better definition of the clinical phenotypes of depression. The aim of this study was to assess the clinical correlates of psychomotor retardation endorsed at any time during the patients' lifetime (LPR). The study sample included 291 patients with non-psychotic maj...

The aim of this study was to analyze the relationship of residual mood and panic-agoraphobic spectrum phenomenology to functional impairment and quality of life in 226 adult outpatients who had remitted from a major depressive episode. Quality of life and functioning were assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire a...

The short (s) variant of the serotonin transporter gene linked functional polymorphic region (5-HTTLPR) is associated with depression. Stressful life events, gender, and race have been shown to moderate this association. Because features of mania/hypomania seem to constitute an indicator of higher severity of depression, we examined the relationshi...

Clinical features and treatment outcome were compared in depressed outpatients with and without a history of emotional and physical abuse (EPA), including childhood maltreatment. Patients were initially randomized to IPT or SSRI and then augmented with the second treatment if they did not remit with monotherapy. Assessments included the SCID-I, the...