Massimo Pasquini

• M.D., P.h.D.
• Professor (Full) at Sapienza University of Rome

Background The 22q11.2 deletion syndrome (22q11.2DS) represents a genetic condition at higher risk of transition to psychosis. Both self‐esteem (SE), intended as self‐evaluation based on cognitive and affective elements, and psychotic symptoms may be associated with patients' real‐life functioning. We investigated whether these variables differentl...

Abstract Background Mental pain represents a significant risk factor for suicidal behavior in severe mental disorders. The present study aims to investigate the interplay between childhood traumatic experiences, hopelessness, depressive symptoms and mental pain, using a network analysis approach in a large transdiagnostic sample of participants liv...

Background/Objectives: Hypermobile Ehlers-Danlos syndrome (hEDS) is the most common form of EDS, characterized by joint hypermobility, skin findings, and joint pains or recurrent dislocations that may also be associated with other several extra-articular symptoms. A deficit in the affect regulation represents a risk element in the development of bo...

Background: Hypermobility Ehlers–Danlos syndrome (hEDS) is a clinical condition characterized by hypermobility and tissue fragility and is associated with chronic pain. The present study aimed to investigate the associations between affect regulation, pain perception, and psychophysical dimensions as well as alexithymic characteristics in the patho...

Background: Hypermobility Ehlers Danlos syndrome (hEDS) is a clinical condition characterized by hypermobility and tissue fragility and associated to chronic pain. The present study aimed to investigate the associations between affect regulation, pain perception and psychophysical dimensions. Methods: Twenty-five hEDS patients completed tests asses...

Rationale Despite the growing scientific interest on mitragynine, the primary alkaloid in kratom (Mitragyna Speciosa), there is a lack of clinical trials in humans. Objectives This phase 1 study aimed to evaluate mitragynine’s safety profile and acute effects on subjective drug experience, neurocognition, and pain tolerance. Methods A placebo-con...

Background The 22q11.2 deletion syndrome (22q11.2DS) entails intellectual disabilities and higher risk of psychotic disorders. Neurocognitive deficits predict real‐life functioning of schizophrenic patients. We investigated real‐life functioning in 22q11.2DS, aiming at defining how neurocognitive profile and psychopathological variables impact on p...

Introduction Supraventricular tachyarrhythmias (ST) are the most common cardiac arrhythmias. Little is known about the potential impact of demoralization, which is considered as partially distinct from depression, on the course of ST. A correct assessment of both depressive symptoms and demoralization appears relevant for the treatment of these car...

Reciprocal connections exist between mental health and physical health, and conditions of cellular senescence/advanced biological age have been observed in association with certain psychiatric diseases. However, the construct of frailty has only preliminarily been explored in young adults and in relation to psychopathology so far. In the present st...

Objective Obsessive and compulsive symptoms (OCS) are cross-cutting psychopathological manifestations frequently detected in a variety of clinical and non-clinical samples. It has been suggested that impaired mentalization abilities and traumatic experiences during childhood may be relevant etiopathogenetic factors in the development of OCS. The pu...

Objective: The Psychological-Physical-Pain Visual Analogue Scale (PPP-VAS) was thought to probably help in identifying patients at risk of suicide. However, no data on its validity to measure psychological pain was available. Our main aim was to investigate the convergent validity of the PPP-VAS using two well-validated scales of psychological pain...

Background During the COVID-19 pandemic, the global population was exposed to a significant psychological distress, however, subgroups of vulnerable individuals proved resilient throughout the pandemic. This study aims to identify predictors of long-term, sustained resilience among people with a history of mental disorder during the first two years...

The term depression comes from the Latin “depressio” and indicates a state of dejection perceived by the subject accompanied by extreme suffering and discomfort. “Melancholia” (melas means black and cholé means bile), the term historically used to describe this condition, was first introduced by Hippocrates in the treatise On the Nature of Man [1]...

Background: Autistic symptoms represent a frequent feature in people with schizophrenia spectrum disorders (SSD), with a significant impact on clinical, cognitive and functional outcomes. However, the prevalence and the cognitive and functional correlates of autistic symptoms in unaffected first-degree relatives of people with SSD remain to be asse...

Introduction According to the gender paradox,in suicidology an important sex difference has been reported with a preponderance of females in nonfatal suicidal behavior and a preponderance of males in completed suicide.The lethality of suicidal behavior in females is lower most likely because males choose more violent suicide methods.Furthermore,wom...

Ehlers–Danlos syndromes are a heterogeneous group of Heritable Connective Tissue Disorders characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. Among the different types, the hypermobile Ehlers–Danlos syndrome is the most frequent and includes generalized joint hypermobility as the major diagnostic criterion. Joint h...

Ehlers–Danlos syndromes (EDS) are a heterogeneous group of heritable connective tissue disorders (HCTDs) characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. Among the different types, the hypermobile EDS (hEDS) is the most frequent, and includes generalized joint hypermobility as the major diagnostic criterion. Join...

Purpose of review: This work aims to provide an up-to-date review of the preclinical and clinical scientific literature on the therapeutic value of kratom to better understand the underlying mechanisms related to its use and inform future therapeutic applications. Recent findings: A growing number of studies, mainly of cross-sectional nature, de...

Patients with the 22q11.2 deletion syndrome (DS) show an increased risk of developing a psychotic illness lifetime. 22q11.2DS may represent a reliable model for studying the neurobiological underpinnings of schizophrenia. The study of social inference abilities in a genetic condition at high risk for psychosis, like 22q11.2DS, may shed light on the...

Background In asylum seekers and refugees, the frequency of mental disorders, such as depression, anxiety and post-traumatic stress disorder, is higher than the general population, but there is a lack of data on risk factors for the development of mental disorders in this population. Aim This study investigated the risk factors for mental disorder...

Background. The 22q11.2 Deletion Syndrome (22q11.2DS) is a genetic condition at high risk of developing both psychosis and motor disorders. Social Cognition (SC) deficits have been associated not only with schizophrenia but also with Parkinson’s disease (PD). The present study assessed SC deficits in 22q11.2DS and investigated the interaction betwe...

Purpose Studies have shown significant associations of dissociative symptoms with both eating and addictive disorders; however, the different forms of dissociation have been relatively understudied in relation to food addiction (FA). The main aim of this study was to investigate the association of certain forms of dissociative experiences (i.e., ab...

Interactions between childhood trauma (CT) and dissociation can contribute to psychiatric disturbances. We explored this phenomenon in relation to behavioral addictions (BAs) in a sample (n = 633) of young adults (age: 18-34 years). Self-report measures investigating CT, dissociation, and symptoms related to gambling disorder, internet gaming disor...

Background: Insomnia is commonly reported by cancer patients. Its multifaceted pathophysiology makes this symptom a complex challenge for the clinician, who should bear in mind the manifold world of causes and consequences of sleep disturbances in these patients and the importance of accurate treatment that should consider the frequent co-prescrip...

Background: The 22q11.2 Deletion Syndrome (22q11.2DS) is considered the most reliable biological model to study genetic vulnerability to schizophrenia. It appears useful to investigate neuroanatomical characteristics of people with 22q11.2DS compared to chronic schizophrenia and healthy controls. Methods: The sample consisted of 16 individuals w...

Background: Insufficient effectiveness and a difficult tolerability profile of antidepressant drugs for the treatment of major depressive disorder (MDD) have been reported, and polyunsaturated fatty acids (PUFAs) have been posited as reliable therapeutic alternatives. The present study investigated the efficacy of omega-3 PUFAs as monotherapy for...

According to the gender paradox in suicidology, an important sex difference has been reported with a preponderance of females in nonfatal suicidal behavior and a preponderance of males in completed suicide. Furthermore, females and males present different risk factors for suicide. The present study explored possible clinical differences between mal...

Backgrounds Individuals with chronic medical conditions are considered highly exposed to COVID-19 pandemic stress, but emerging evidence is demonstrating that resilience is common even among them. We aimed at identifying sustained resilient outcomes and their predictors in chronically ill people during the first year of the pandemic. Methods This...

Background Symptoms of depression are transdiagnostic heterogenous features frequently assessed in psychiatric disorders, that impact the response to first-line treatment and are associated with higher suicide risk. This study assessed whether severe mental pain could characterize a specific phenotype of severely depressed high-risk psychiatric pat...

PurposeThis research aims to analyze the relationship between emotional regulation and the symbolic process in autobiographical narratives of a group of individuals diagnosed with restrictive anorexia nervosa (AN), compared to a non-clinical group. The study is framed within multiple code theory (MCT) (Bucci, 1997; 2021), which considers mind–body...

Objective: Mental pain and exposure to maltreatment are significant risk factors for suicidal behavior. This study aimed to investigate whether mental pain could be associated with a recent suicide attempt and whether it could mediate the relationship between childhood traumatic experiences and suicide risk in psychiatric patients. Methods: A multi...

Objective: Mental pain and exposure to maltreatment are significant risk factors for suicidal behavior. This study aimed to investigate whether mental pain could be associated with a recent suicide attempt and whether it could mediate the relationship between childhood traumatic experiences and suicide risk in psychiatric patients. Methods: A mult...

Objectives Moving to a foreign country, whether out of necessity, seeking refuge, opportunity or mere curiosity, makes the individual more vulnerable to mental disorders. Even in the same conditions , many factors contribute to make migrants more susceptible to this risk than the natives. Among many, these include linguistic and cultural difference...

Suicide is a major public health problem, and it is urgent to investigate its underlying clinical and psychological concomitants. It has been suggested that low mentalization skills and problematic use of the internet (PUI) are factors that can play a role in suicidal behaviors. It is possible that poor mentalization skills contribute to leading to...

Purpose: This research aims to analyze the relationship between emotional regulation and the symbolic process in autobiographical narratives in a group of individuals diagnosed with restrictive Anorexia Nervosa (AN), compared to a non-clinical group. The study is framed within Multiple Code Theory MCT (Bucci, 1997; 2021) which considers mind-body i...

BACKGROUND Background: Obsessive-compulsive disorder (OCD) is a psychiatric syndrome characterized by unwanted and repetitive thoughts and repeated ritualistic compulsions aimed to decrease the distress. Symptoms can cause severe distress and functional impairment. OCD affects 2-3% of the population and is ranked within the ten leading neuropsychia...

Background: Obsessive-compulsive disorder (OCD) is a psychiatric syndrome characterized by unwanted and repetitive thoughts and repeated ritualistic compulsions for decreasing distress. Symptoms can cause severe distress and functional impairment. OCD affects 2% to 3% of the population and is ranked within the 10 leading neuropsychiatric causes of...

Numerous studies addressed the topic of behavioral and symptomatic changes in eating disorders. Rates of transition vary widely across studies, ranging from 0 to 70.8%, depending on the diagnoses taken into account and the study design. Evidence shows that the specific transition from restrictive-type anorexia nervosa (AN-R) to disorders involving...

Purpose Although the association between problematic use of the internet and eating disorders (EDs) in young adults has been previously established, its underlying mechanisms have not been completely clarified. It has been suggested that exposure to idealized very thin and toned body images (e.g., “thinspiration” and “fitspiration” trends) on socia...

Background Immigrants in Europe appear to be at higher risk of psychiatric coercive interventions. Involuntary psychiatric hospitalization poses significant ethical and clinical challenges. Nonetheless, reasons for migration and other risk factors for involuntary treatment were rarely addressed in previous studies. The aims of this study are to cla...

Background: Social cognition (SC) deficits and of its facial emotion expression (FEE) component have been described in 22q11.2 Deletion Syndrome (22q11.2DS), a high-risk for schizophrenia (SCZ) systemic genetic syndrome. Correlations between deficits in FEE skills and visual-spatial abilities in people with 22q11.2DS warrant investigation. Method...

Neuropsychiatry mainly deals with processes of the mind related to neurological diseases. Only secondarily, it deal with depressive and anxiety syndromes, as reactions to the presence of an acute, chronic, or degenerative neurological disease. This review illustrate the most frequent neuropsychiatric disorders in the context of the main neurologica...

Background: There is a growing body of literature on the association between psychosis and sexual dysfunction. However, most studies have focused on sexual dysfunction and have not investigated the sexual lives of patients with psychosis across a broader range. Material and methods: Consecutive patients with a diagnosis of acute psychosis or sch...

Objectives: The dimensional approach to psychopathology has been proposed to reliably evaluate suicidality. Potential gender modulation of psychopathological dimensions associated to suicide attempts was investigated. Methods: 91 subjects who committed a near-lethal suicide (SA group) and 374 who did not (nSA group) were recruited in a Psychiatr...

One of the worrying concomitants of problematic use of Internet (PUI) is aggression. Although the mechanisms underlying such link have not been completely clarified, it has been suggested that problematic use of social media and online videogames (i.e., two common forms of PUI among young adults) lead to increased sleep disturbances which, in turn,...

Background 22q11.2 Deletion Syndrome (22q11DS) represents one of the most important genetic risk factors for schizophrenia (SCZ) and a reliable biological model to study endophenotypic characters of SCZ. The aim of the study was to investigate Social Cognition impairments in subjects with 22q11.2DS compared to a considerable sample of schizophrenic...

Recent data suggest that obsessive-compulsive disorder (OCD) is driven by an imbalance among the habit learning system and the goal-directed system. The frontostriatal loop termed cortico-striatal-thalamo-cortical (CSTC) circuitry loop is involved in habits and their dysfunction plays an important role in OCD. Glutamatergic neurotransmission is the...

Patients with cervical dystonia (CD) may display non-motor symptoms, including psychiatric disturbances, pain, and sleep disorders. Intramuscular injection of botulinum toxin type A (BoNT-A) is the most efficacious treatment for motor symptoms in CD, but little is known about its effects on non-motor manifestations. The aim of the present study was...

Objective Neurofibromatosis 1 (NF1) is a chronic medical disease that often presents with psychiatric disorders. We investigated suicidal ideation in NF1 patients compared to healthy controls. We also evaluated whether hopelessness, depressive symptoms and perceived disability may mediate suicidal ideation in patients with NF1. Methods We enrolled...

Background Studies increasingly suggest that chronic exposure to psychological stress can lead to health deterioration and accelerated ageing, thus possibly contributing to the development of frailty. Recent approaches based on the deficit accumulation model measure frailty on a continuous grading through the “Frailty Index” (FI), i.e. a macroscopi...

Introduction Cervical dystonia (CD) is a heterogeneous condition. However, while motor subtypes of CD have recently been identified, it is still unknown whether and how non-motor symptoms contribute to CD heterogeneity. In the present cross-sectional study, we aimed to identify clinical CD subtypes on the basis of motor and non-motor symptoms by us...

Despite entailing more severe and uncommon side effects in 22q11.2DS compared to idiopathic schizophrenia, we strongly believe that clozapine should continue to be considered the gold standard for all treatment‐resistant schizophrenia, even in 22qDS. Despite entailing more severe and uncommon side effects in 22q11.2DS compared to idiopathic schizop...

Introduction: Several features contribute to determining suicide risk. This study was designed with the aim of evaluating whether insight into illness and demoralization are involved in suicide risk (active suicidal ideation or behavior). Methods: For this purpose, in a sample of 100 adult psychiatric inpatients, we used the Columbia Suicide Sev...

Introduction Although several authors have investigated the relationship between demoralization, insight, and suicide risk, the role of these factors in determining suicide risk in patients with psychiatric disorders is still unclear [Berardelli et al., 2019; Costanza et al., 2020]. Objectives The main aim of this study was therefore to determine...

Background: Psychic euosmia (PE) has been described as a supposed psychological predisposition for which pleasant smells elicit an immediate sense of pleasure, order and calmness in obsessive-compulsive personality disorder (OCPD). In this study we tried to verify the interpretation that PE is the counterpart of disgust that has been associated to...

Empathic communication represents the first step of the “END” Communication procedure, which is followed by normalization and de-escalation communication. In this chapter, our view of empathy is conceived not only as an ability of inferring and representing the other one’s mental state but also all the interpersonal procedures and expressions given...

This book describes theory and techniques of empathic communication, normalization and de-escalation procedures for the management of aggressive or violent patients in clinical critical settings'. Consisting of 9 chapters, it discusses in detail the self-regulation of empathy in potential dangerous interactions, as well as common mistakes and nonpr...

I disturbi depressivi rappresentano una delle principali cause di disabilità a livello mondiale. I meccanismi eziopatogenetici non sono ancora del tutto chiariti, pur essendo stati individuati fattori psicosociali e biologici di vulnerabilità. Le molteplici presentazioni cliniche, oltre alla variabilità di decorso e di risposta ai trattamenti, rend...

Background: Alcohol is one of the most widely used drugs among adolescents and young people, and problematic alcohol use (PAU) is related to significant long-term biological, clinical, and psychosocial sequelae. Although preliminary reports have linked deficits in mentalization to increased vulnerability to addiction, no studies have specifically e...

Riv Psichiatr 2020; 55(5): 262-268 262 IINTRODUCTION People suffering from psychiatric disorders and emotional difficulties may turn to various providers to ask for help, especially mental health specialists 1. In mental health settings , psychotherapy is one of the main therapeutic options available for patients suffering from a variety of common...

Studies conducted in primary care as well as in psychiatric settings show that more than half of patients suffering from major depressive disorder (MDD) have poor adherence to antidepressants. Patients prematurely discontinue antidepressant therapy for various reasons, including patient-related (e.g., misperceptions about antidepressants, side-effe...

Background: Preliminary studies have tested nicotine as a novel treatment for OCD patients who respond partially/incompletely or not at all to first and second-line treatment strategies, with the former represented by SSRIs or clomipramine, and the latter by switching to another SSRI, or augmentation with atypical antipsychotics, and/or combinatio...

This narrative review addresses the interconnections among stress, mental disorders and migraine with a specific focus on non-pharmacological interventions that may be effective in improving both migraine and the psychiatric comorbidity. Migraine is often comorbid with depression, anxiety, personality disorders, and sleep disorders. Subjective stre...

Introduction. 22q11DS represents the most important known genetic risk factor for psychosis: 25-28% of 22q11DS adults are affected by a psychotic disorder. Social cognition is impaired in people with 22q11.2DS. Few data are available regarding functioning in 22q11DS, meanwhile there are several evidence about significant functional impairments inv...

Purpose: One of the most consistent models investigating the relationship between premorbid personality and depression was described by Tellenbach. According to this model, concern with orderliness, conscientiousness, hyper/hetereonomia and intolerance of ambiguity are the core features of Typus Melancholicus (TM). Previous studies showed a relati...

Background 22q11DS is the most important genetic risk factor for schizophrenia: up to 28% of these subjects develop psychosis in adulthood. At present this syndrome represents the strongest biological model to investigate neurobiological underpinnings of schizophrenia. We expected Theory of Mind impairments in subjects at risk for psychosis (22q11D...

Background 22q11DS is the most common microdeletion with an incidence of 1:4000 live births. It is considered a genetic biological model for psychosis vulnerability: 25–28% of 22q11DS adults is affected by a psychotic disorder. Few data are available regarding functioning in 22q11DS. Our aim was to test the hypothesis that functioning is similar in...

Background Demoralization, as assessed through the Diagnostic Criteria for Psychosomatic Research–Demoralization (DCPR/D) interview or the Demoralization Scale (DS), has been found to affect about 30% of patients with medical disorders, while few studies have been done in patients with psychiatric disorders. Methods A convenience sample of 377 pat...

Background : Serious mental illnesses may be characterized by accelerated biological aging, and over the last years the research on the topic has been stimulated by studies exploring the molecular underpinnings of senescence. Methods : In the present manuscript we propose that measuring frailty, a general product of organismal ageing, through the...

Objectives: To assess the rates of co-occurring putative ‘behavioural addictions’ in patients with obsessive-compulsive disorder (OCD). Methods: Twenty-three international centres specialising in the treatment of OCD were invited to participate in a survey of the rates of behavioural addictions and other relevant comorbidity within their samples. R...

Introduction: 22q11.2 microdeletion syndrome (22q11DS) is associated with a 25% risk of psychotic onset. Materials and methods: The sample consist of 120 subjects: 39 schizophrenics (SCZ); 20 siblings of schizophrenic patients (SIB); 34 22q11DS non-psychotic patients (DEL); 17 22q11DS psychotic patients (DEL_scz); 30 control subjects (CS). Socia...

Depressive disorders represent a major cause of disability worldwide, but their etiopathogenetic mechanisms have not yet been fully explained. The interaction between psychosocial and biological vulnerability factors however plays a major role in determining depression. The multiple and variable clinical characteristics of depression, as well as it...

Studies have suggested a relationship between low circulating levels of Vitamin D and depression. Vitamin D deficiency may be a consequence of depression-related factors, such as reduced sun exposure, decreased outdoor activity, and dietary changes, but it can also play a role in the pathophysiology of depressive conditions through a range of molec...

Introduction: reviewed studies that assessed the treatment of psychiatric disturbances in Parkinson’s disease and atypical parkinsonisms. Neuropsychiatric disturbances in these conditions are frequent and have a profound impact on quality of life of patients and of their caregivers. It is therefore important to be familiar with the appropriate phar...

Atrial fibrillation (AF) is the most widely recognized arrhythmia. Systemic arterial hypertension, diabetes, obesity, heart failure, and valvular heart diseases are major risk factors for the onset and progression of AF. Various studies have emphasized the augmented anxiety rate among AF patients due to the poor quality of life; however, little inf...

This brief review deals with the various issues that contributed to the creation of the new Diagnostic and Statistical Manual condition of hoarding disorder (HD) and attempts at reviewing its pharmacotherapy. It appears that after the newly founded diagnosis appeared in the literature as an autonomous entity, distinct from obsessive-compulsive diso...

Based on the evidence that there can be no health without mental health, psychosomatic medicine recognizes the complexity of the interface between psychiatry, lifestyle and medicine. At the clinical level, psychosomatic medicine integrates interdisciplinary evaluation and management involving diverse specialties including psychiatry, psychology, ne...

Introduction: This paper reviews studies that have assessed the treatment of psychiatric disturbances in dystonia, tic disorders, Tourette syndrome, Huntington’s disease and essential tremor. Areas covered: We searched for papers in English in Pubmed using the following keywords: blepharospasm, cervical dystonia, arm dystonia, laryngeal dystonia, s...

Multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD) are the most common atypical parkinsonisms. These disorders are characterized by varying combinations of autonomic, cerebellar and pyramidal system, and cognitive dysfunctions. In this paper, we reviewed the evidence available on the presence an...

Patients with obsessive compulsive personality disorder (OCPD) often refer to a prompt mood improvement upon encountering good scents in general, or fresh laundry borax on their clothes, pillows or home settings. The Authors propose the new term psychic euosmia in the mean of an overstated psychological predisposition for a real pleasant smell that...

The SVARAD can be successfully adopted in routine clinical practice; it is easy to learn, quick to use (about 3–5 min for each patient), optimised for a busy clinical setting, and well accepted by clinicians, as it requires minimal effort for data interpretation.

Psychiatric diagnosis is a complex and difficult issue. Ontological and epistemological questions permeate the nosological literature, with innumerable considerations about the uncertain ontological status of psychiatric disorders and the difficulties in providing irreproachable definitions for them. These considerations help to place the issue of...

The “outer” SVARAD dimensions, impulsivity, anger/aggressiveness, and activation, represent trans-diagnostic psychological and behavioural domains that span traditional categorical boundaries. At the neurobiological level, the fronto-limbic and the fronto-cerebellar circuitry, as well as molecular pathways involving dopamine, serotonin, testosteron...

Obsessive-compulsive disorder (OCD) is a clinical syndrome characterised by recurrent intrusive thoughts (obsessions) and repetitive mental or behavioural acts (compulsions), typically performed in response to obsessions or related anxiety. OCD generally has a stable symptom pattern throughout life but nevertheless is well known for its heterogenei...

This book presents an innovative approach to clinical assessment in psychiatry based on a number of psychopathological dimensions with a presumed underlying pathophysiology, that are related to fundamental phenomenological aspects and lie on a continuum from normality to pathology. It is described how the evaluation of these dimensions with a speci...

Deep brain stimulation (DBS) has proved useful for several movement disorders (Parkinson’s disease, essential tremor, dystonia), in which first and/or second line pharmacological treatments were inefficacious. Initial evidence of DBS efficacy exists for refractory obsessive-compulsive disorder, treatment-resistant major depressive disorder, and imp...