Maurizio Pompili

• M.D., Ph.D.
• Chair at Sapienza University of Rome

Background According to international guidelines, lithium treatment represents the gold standard for the appropriate management of persons with bipolar disorder. However, prescription rates in ordinary practice are not in line with clinical guidelines’ suggestions. Clinicians prefer to use drugs other than lithium, considering its low therapeutic w...

Background Suicide is a major and largely preventable public health issue, with rates increasing among people in later life. We aimed to describe global temporal and geographical patterns of suicide mortality among older adults. Methods Using the WHO mortality database (latest update: February 2024), we analysed suicide data for individuals aged 7...

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...

Globally, major depressive disorder, or MDD, is a leading cause of disability. It negatively impacts social interactions and significantly limits daily functioning, ultimately reducing life satisfaction. The prevalence rate is about twice as high in women as in males. It is believed that the genesis of major depressive disorder is complicated and i...

Background A suicide crisis represents a psychological state preceding a suicide behavior and occurs when an individual experiences intolerable emotions. Only a few instruments have been developed so far to assess cognitions and emotions associated with a specific interpretative model of the suicide crisis. Objectives We aimed to (1) evaluate the...

This study investigates treatment-resistant schizophrenia (TRS) by analysing genetic markers in dopamine and serotonin receptors. Conducted on a cohort of 221 patients with treatment-resistant mental disorders, the research focused on DRD2 and HTR2A gene variants—specifically, rs1801028, rs6314, rs7997012, and rs6311. The findings suggest specific...

Schizophrenia is a serious psychiatric condition requiring continuous treatment with antipsychotic medications available in different formulations, including oral antipsychotics (OAPs) and long-acting injectables (LAIs). This narrative review aims to comprehensively outline the advantages and disadvantages of OAPs and LAIs to support clinicians in...

Tardive dyskinesia (TD) is a chronic, often disabling hyperkinetic movement disorder associated with prolonged use of dopamine receptor blocking agents (DRBAs), particularly antipsychotics (APs) for psychiatric disorders such as schizophrenia and bipolar disorder. It manifests as abnormal, involuntary movements, often involving the orofacial region...

Suicide is a major public health concern; therefore, numerous factors have been investigated for their role in increasing suicide risk. Distal factors, such as attachment style, and proximal factors, like unmet interpersonal needs, interact with each other and may influence suicidal ideation. Understanding this interplay is crucial for developing e...

The association between inflammation with depression and suicide has prompted many investigations of the potential contributors to inflammatory pathology in these psychiatric illnesses. However, a distillation of diverse clinical findings into an integrated framework of the possible involvement of major physiological processes in the elicitation of...

Introduction: The COVID-19 pandemic had a negative impact on mental health in the general population. The fear, stress, and uncertainty surrounding that traumatic period could have contributed to the aggravation or possible new onset of obsessive–compulsive symptoms. Methods: The COvid Mental hEalth Trial (COMET) is a nationwide project organized b...

This systematic review investigates the association between the endocannabinoid, vanilloid, opioid, and galaninergic systems and suicide, focusing on post-mortem evidence. Findings indicate increased cannabinoid receptor 1 (CB1) densities in the prefrontal cortex, particularly in individuals with alcohol use disorder and mood disorders who died by...

Introduction COVID-19 pandemic had a negative impact on mental health in the general population. The fear, stress, and uncertainty surrounding that traumatic pe-riod could have contributed to the aggravation or possible new onset of obsessive-compulsive symptoms. Materials and Methods The COvid Mental hEalth Trial (COMET) is a nationwide project or...

Background: The psychiatric phenotype of the 22q11.2 deletion syndrome (22q11DS) has been largely described. Objectives: With a case-control study design, we now compared a sample of 22q11DS patients with a psychiatric diagnosis with a sample of psychiatric patients without 22q11DS to investigate possible differences between groups for depressio...

Suicide is a serious but preventable public health issue globally, with substantial geographical disparities. Although mortality from suicide is higher in older age groups, it ranks as the fourth leading cause of death among youth. This study analysed global suicide trends for the age group 10-24, from 1990 to 2020. Using data on certified deaths f...

The rising prevalence and legalisation of cannabis worldwide have underscored the need for a comprehensive understanding of its biological impact, particularly on mental health. Epigenetic mechanisms, specifically DNA methylation, have gained increasing recognition as vital factors in the interplay between risk factors and mental health. This study...

According to the World Health Organization (WHO), more than 700,000 people take their own life every year globally. WHO also estimates that for every suicide, there are at least 10–20 acts of self-harm and about a hundred people have suicidal thoughts. Every suicide affects a large number of people in the victims immediate and extended circle of fa...

Introduction Peripartum mental disorders (PPMD) are characterized by heterogeneous psychopathological symptoms related to specific personality traits, which are only taken into account by a few preventive and therapeutic strategies. Traumatic experiences during childhood could predispose to develop those disorders during adulthood, especially in mo...

Introduction In patients affected by Schizophrenia and Bipolar Disorder disorders the use of antipsychotic drugs is essential in preventing the exacerbation of symptoms. The use of long-acting injectable (LAI) antipsychotics is considered an important treatment option. The aim of this study was to evaluate the incidence and predictors of relapse du...

Introduction Psychiatric Day Hospital (DH) constitutes an area of semiresidential care for short- and medium-term diagnostic and therapeutic-rehabilitative services. Through a descriptive analysis, we analyzed the clinical rationale and expected goals leading to an admission to the psychiatric day hospital service at St. Andrew’s Hospital in Rome,...

Introduction Suicide is one of the leading causes of death worldwide and scientific community investigates suicide risk factors relentlessly. Among these, anxiety symptoms were strongly related to suicidal ideation in several studies. Moreover, sleep and its disturbances are closely connected to mental well-being and psychiatric disorders in a bidi...

Introduction Suicide is a multifactorial phenomenon characterized by many biological, psychological, and social-cultural factors. The study of this phenomenon in migrants is complex, with no theoretical framework that can describe the available heterogeneous data. Although Italy has the fourth largest migrant population of EU, only few studies have...

Insomnia and anxiety symptoms are independent clinical variables involved in suicidal ideation in psychiatric inpatients. In this article, we investigated the relationship among insomnia severity, severity of anxiety symptoms, and suicidal ideation in a sample of psychiatric inpatients with severe mental disorders. We used a mediation model conside...

Introduction: The efficacy of trazodone for several psychopathologic dimensions of depression has been shown in the literature. Trazodone has been widely used in some clinical contexts (e.g. for insomnia and depression in the elderly). However, the role of trazodone in several aspects of depression is not well known. Area covered: Eight experts...

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 Although obsessive–compulsive disorder (OCD) is highly prevalent in schizophrenia, its relationship with patients’ real-life functioning is still controversial. Methods The present study aims at investigating the prevalence of OCD in a large cohort of non-preselected schizophrenia patients living in the community and verifying the relat...

Background Suicide is a serious but preventable public health concern at the global level, showing relevant geographical differences. This study aims to monitor global temporal and geographical patterns in suicide mortality in pre-adolescents, adolescents, and young adults (i.e., aged 10–24 years), from 1990 to 2020 or the most recent available yea...

Background: Schizophrenia is a severe mental disorder characterized by positive, negative, affective, and cognitive symptoms. Affective symptoms in patients with schizophrenia have traditionally been overlooked or even neglected because they are not considered as fundamental as positive and negative symptoms in the choice of medication. Methods:...

Long coronavirus disease 19 (COVID-19) is an emerging multifaceted illness with the pathological hallmarks of chronic inflammation and neuropsychiatric symptoms. These pathologies have also been implicated in developing suicidal behaviors and suicidal ideation (SI). However, research addressing suicide risk in long COVID-19 is limited. In this pros...

Background Severe mental disorders that require hospitalization are disabling conditions that contribute to the burden of mental diseases. They pose increased clinical challenges and highlight the need to thoroughly explore variables emerging from daily clinical practice. In this study, we assessed to what extent gender differences may characterize...

Facing suicide risk is probably the most difficult task for clinicians when dealing with patients in crisis. It requires professional, intellectual, and emotional efforts. Suicide risk assessment can sometimes be distressing for clinicians, and such a state may favour the avoidance of an in-depth exploration of suicidal thoughts and behaviour. Pati...

Suicide prevention represents a global imperative, and efforts to identify potential risk factors are intensifying. Among these, emotional regulation abilities represent a transdiagnostic component that may have an impactful influence on suicidal ideation and behavior. Therefore, the present systematic review aimed to investigate the association be...

Background A better characterization of educational processes during psychiatry training is needed, both to foster personal resilience and occupational proficiency. Methods An adequate coverage of medical residents at the national level was reached (41.86% of the total reference population, 29 out of 36 training centers—80.55%). Controls were recru...

Background Bipolar disorder is one of the most burdensome severe mental disorders, characterized by high levels of personal and social disability. Patients often need an integrated pharmacological and non-pharmacological approach. Lithium is one of the most effective treatments available not only in psychiatry, but in the whole medicine, and its cl...

Suicidal ideation is a multifactorial phenomenon that is increasingly prevalent among adolescents, especially following the impact of Covid 19 pandemic on their mental health. Its analysis necessitates an interdisciplinary approach that simultaneously considers sociological and psychological perspectives, especially looking at the role of interpers...

Background The coronavirus disease of 2019 (COVID‐19) pandemic is an unprecedented traumatic event that has severely impacted social, economic, and health well‐being worldwide. The COvid Mental hEalth Trial was specifically designed to evaluate the impact of the COVID‐19 pandemic and its containment measures on the mental health of the Italian gene...

Suicide is a major public health issue worldwide, and scholars now recognise the multifactorial perspective of this phenomenon. However, psychiatric disorders are often considered the main determinant of suicide risk, and psychiatrists are commonly requested to assess and manage such a risk. The establishment of the medical model suggests that trea...

Professionals working with adolescents invest enormous resources and energies to find a tailored approach to improve patients' compliance and promote their access to care. As a re-sult, Panksepp's Primary Emotive Systems (PES) can be useful instruments to develop tai-lored treatment plans specific for this age. We aimed to find a PES specific for a...

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...

Neuropsychiatric disorders are common manifestations in 22q11.2 deletion syndrome (22q11.2DS-DiGeorge Syndrome). Although many patients with 22q11.2DS receive antipsychotic treatment for psychotic disorders, little is known about the safety and tolerability of antipsychotics in 22q11.2DS and resistant psychosis. The aim of this case series is to de...

Background: Major Depressive Disorder (MDD) with suicidal ideation, intent, or behavior is a psychiatric emergency with controversial care management. Our study describes the comprehensive treatment pathways of this population in Italian routine clinical practice. Methods: ARIANNA [NCT 04463108] is an observational prospective and retrospective coh...

Introduction Suicide is a leading cause of death worldwide and models may help the understanding of the phenomenon and ultimately reduce its burden through effective suicide prevention strategies. The Interpersonal Theory of Suicide and Shneidman’s Model have tried to describe different unmet needs related to suicidal ideation. The study aims to as...

The rising prevalence and legalization of cannabis worldwide have underscored the need for a comprehensive understanding of its biological impact, particularly on mental health. Epigenetic mechanisms, specifically DNA methylation, have gained increasing recognition as vital factors in the interplay between risk factors and mental health. This study...

Traditional medicine and biomedical sciences are reaching a turning point because of the constantly growing impact and volume of Big Data. Machine Learning (ML) techniques and related algorithms play a central role as diagnostic, prognostic, and decision-making tools in this field. Another promising area becoming part of everyday clinical practice...

Background: Recent literature has shown that a considerable percentage of patients with severe mental disorders can develop, over time, full-blown or subthreshold catatonia. Some studies corroborate the model of an illness trajectory in which different mental disorders would be arranged along a continuum of severity until the development of catato...

Background: Preventing hospitalization of major affective disorder patients is a fundamental clinical challenge for which lithium is expected to be helpful. Methods: We compared hospitalization rates and morbidity of 260 patients with DSM-5 bipolar or major depressive disorder in the 12 months before starting lithium versus 12 months of its use....

On January 30, 2020, the World Health Organization (WHO) declared the status of pandemic due to the COVID-19 infection. The initial phases of the pandemic were characterized by uncertainty and public fears. In order to cope with such unexpected conditions, people adopted different coping strategies, including search for information, accessing Inter...

Background: The objective of this study was to investigate the DRD2 rs1800497, rs1799732, rs1801028, DRD3 rs6280, and HTR2A rs6314, rs7997012, and rs6311 single-nucleotide polymorphism (SNP) correlations with resistance to second-generation antipsychotics (SGAs) in a real-world sample of patients with treatment-resistant mental disorders. Methods...

Background In the recent years, several studies have shown a correlation between autism spectrum disorder (ASD) and catatonia. It is also known that both conditions are found to be associated with mood disorders. This study aimed to investigate the relationship between autistic traits and catatonic symptoms, as well as the potential mediating role...

Introduction Pregnancy is an important life event, involving body and mind transformation as well as brain reorganization. ADHD dimension is an additional aggravating factor, albeit poorly studied in the literature, in patients with mental health disorders in the peripartum. Objectives The purpose of this study was to evaluate the correlation amon...

Introduction Only a few studies analyse the clinical and psychopathological characteristics of first-admitted inpatients regardless of diagnosis. Objectives Describing the psychopathological, demographic, and clinical characteristics of inpatients with acute symptomatology identifying groups with common features using factors extracted from the Br...

Campaigns have been launched to make sense of what makes a specific individual suicidal. We know that suicidal individuals give definite warning signs, mainly from their ambivalence about ending their own lives. Classical suicidology posited that the suicidal individual experiences unbearable psychological pain ( psychache ) or suffering and that s...

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...

Background: The affective, cognitive, and behavioral aspects of impulsivity involved in suicide-related outcomes can be investigated through the UPPS model, which conceptualizes these facets in multidimensional terms related to negative and positive urgency, lack of premeditation and perseverance, and sensation seeking. This systematic review and...

Background Sunlight contains ultraviolet B (UVB) radiation that triggers the production of vitamin D by skin. Vitamin D has widespread effects on brain function in both developing and adult brains. However, many people live at latitudes (about > 40 N or S) that do not receive enough UVB in winter to produce vitamin D. This exploratory study investi...

Background Recent literature has highlighted that catatonia may be more prevalent among psychiatric patients than previously thought, beginning from autism spectrum disorders (ASD), for which it has been suggested to represent a severe late consequence, but also among individuals with mood disorders and borderline personality disorder (BPD). Intere...

Background: While cannabis use is a well-established risk factor for psychosis, little is known about any association between reasons for first using cannabis (RFUC) and later patterns of use and risk of psychosis. Methods: We used data from 11 sites of the multicentre European Gene-Environment Interaction (EU-GEI) case-control study. 558 first-...

Purpose To examine efficacy and safety of paliperidone palmitate (PP) 6-month (PP6M) vs PP3-month (PP3M) long acting injectable (LAI) in patients with schizophrenia from European sites previously stabilized on PP3M or PP1-month (PP1M). Methods This post-hoc subgroup analysis used data from a global phase-3 double-blind (DB) randomized non-inferior...

The impact of suicide on our societies, mental healthcare, and public health is beyond questionable. Every year approximately 700 000 lives are lost due to suicide around the world (WHO, 2021); more people die by suicide than by homicide and war. Although suicide is a key issue and reducing suicide mortality is a global imperative, suicide is a hig...

Italy has the third-largest immigrant population of European Union countries, but only a few research papers have examined suicide risk in immigrant psychiatric patients in Italy. The main aim of this paper was to compare suicidal ideation and suicide attempts in a sample of 304 psychiatric patients. We included 152 immigrant patients matched with...

Background Deficits in social cognition (SC) are significantly related to community functioning in schizophrenia (SZ). Few studies investigated longitudinal changes in SC and its impact on recovery. In the present study, we aimed: (a) to estimate the magnitude and clinical significance of SC change in outpatients with stable SZ who were assessed at...

Recently, esketamine became availableas an intranasal formulation, proposed for treatment-resistant depression (TRD). Three cases of TRD are presented, two with features of a psychiatric emergency. The first case is a 35-year-old man with MDD onset at the age of 27 years, with five previous failed therapies. The second patient is a middle-aged man...

Gender differences in clinical and psychosocial aspects of schizophrenia have been widely reported. Findings have not always been consistent, and some of them need further research. In a large sample of community dwelling persons with schizophrenia, we investigated gender differences in clinical, cognitive and functional indices, as well as their c...

Introduction Interest in identifying the clinical implications of the neuropathophysiological background of schizophrenia is rising, including changes in cortical gyrification that may be due to neurodevelopmental abnormalities. Inpatients with schizophrenia can show abnormal gyrification of cortical regions correlated with the symptom severity. M...

The potentially traumatic impact of the COVID-19 pandemic in subjects with pre-existing mental disorders is still unclear, especially regarding its long-term consequences. The aim of this study was to prospectively assess post-traumatic stress disorder (PTSD) and post-traumatic stress symptoms (PTSS) in patients with mental disorders, during the 3r...

Background The reduction of multiple psychiatric hospitalizations is an important clinical challenge in mental health care. In fact, psychiatric re-hospitalization negatively affects the quality of life and the life expectancy of patients with psychiatric disorders. For these reasons, identifying predictors of re-hospitalization is important for be...

Russia’s military assault on Ukraine has caused Europe’s largest civilian refugee crisis since World War II, displacing more than 10 million Ukrainians (mostly women, children, elderly, and other vulnerable populations) either internally or internationally. These individuals urgently need comprehensive mental and psychosocial assistance that integr...

Lo stato di gravidanza determina nella donna quasi sempre sentimenti di gioia, di benessere, di speranza, ma anche nuove preoccupazioni, ed è causa talvolta di malessere e sofferenza. Oscillazioni del tono dell'umore, fasi di stanchezza e preoccupazioni quali quelle inerenti alle modificazioni del proprio corpo, le paure legate all'esito della grav...

Since the outbreak of the COVID-19 pandemic, the consequences on mental health have been found to be considerable, with potential effects on the general population and in high-risk groups, with a variety of physiopathological mechanisms [...]

Introduction Lurasidone is an atypical antipsychotic agent approved in the European Union for the treatment of schizophrenia in adults and adolescents (13–17 years). Clinical trials have shown a generally favorable balance between efficacy and tolerability. Areas covered This paper provides a review and commentary regarding the use of lurasidone i...

Background Use of social media (SM) has exponentially grown particularly among youths in the past two years, due to COVID-19-related changing lifestyles. Based on the Italian COvid Mental hEalth Trial (COMET), we investigated the association between SM use and depressive symptoms among Italian young adults (aged 18–24). Methods The COMET is a nati...

Background In recent years, numerous studies have highlighted the overlap between autism spectrum disorder (ASD) and catatonia, both from a clinical and pathophysiological perspective. This study aimed to investigate the relationship between the autism spectrum (autistic traits and ASD signs, symptoms, and behavioral manifestation) and Catatonia Sp...

Background A "suicide pact" is a joint and actively induced death of two individuals with the essential and unavoidable characteristic of a mutual consent. One of the partners (dominant in the relationship, commonly male) usually induces the action and in most cases, it is the one who actively carries it out. Undiagnosed psychopathological dimensio...

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...

Background: Resilience is defined as the ability to modify thoughts to cope with stressful events. Patients with schizophrenia (SCZ) having higher resilience (HR) levels show less severe symptoms and better real-life functioning. However, the clinical factors contributing to determine resilience levels in patients remain unclear. Thus, based on ps...

Individuals with different personality traits, temperaments, and psychological symptoms have different attitudes toward the pandemic experiences and restrictive measures. The aim of the present study was to evaluate the associations between the psychological factors and the attitudes toward COVID-19, experienced during the third pandemic wave in It...

Objective: This research aimed to investigate the experience of major depression by integrating the perspectives of patients, caregivers and healthcare providers through narrative-based medicine (NBM) to provide new insights to improve care relationships. Design and setting: The research was conducted in 2019 and involved five Italian psychiatri...

Previous studies have shown, although not consistently, that first generation antipsychotics (FGA) are associated with a prevalence of extrapyramidal symptoms (EPS) higher than second generation antipsychotics (SGA). We assessed the prevalence and the incidence of antipsychotic-induced EPS in a large sample of community-dwelling Italian persons wit...

Although suicide is a major public health issue worldwide, mental health professionals and lay-people struggle to cope with suicide. Part of the problem comes from the myths, obsolete paradigms, and stigma associated with suicide, which results in anxiety and fear. However, most suicidal individuals want to live even when facing serious suicidal st...

Background Research on the influence of neurocognitive factors on suicide risk, regardless of the diagnosis, is inconsistent. Recently, suicide risk studies propose applying a trans-diagnostic framework in line with the launch of the Research Domain Criteria Cognitive Systems model. In the present study, we highlight the extent of cognitive impairm...

Suicide risk is a multifaceted phenomenon, and many risk factors are involved in its complexity. In the last few decades, mental health apps have spread, providing economic and affordable strategies to prevent suicide. Therefore, the aim of this review is to identify original studies on mobile apps that target suicidal crises. The review follows PR...

Lithium salts are widely used clinically, mainly for treatment of bipolar disorder, in which it is highly effective. Various preparations have been developed and tested, including older immediate-release (IR) forms of lithium carbonate and other salts and formulations with slow-release (SR) properties, developed in hopes of increasing the tolerabil...