Paolo Stratta

• PhD, MD Psychiatrist
• Staff Psychiatrist at Mental Health Centre, ASL 1, L'Aquila

There is considerable interest in exploring effects of coronavirus disease 2019 (COVID-19) pandemic on mental health. Suicide is one of the leading causes of mortality worldwide and changes in daily life brought by the pandemic may be additional risk factors in people with pre-existing mental disorders. This rapid PRISMA-ScR (Preferred Reporting It...

Objectives This study assesses the psychopathological distress experienced by doctors working in an Intensive care unit (ICU) during the COVID-19 pandemic. These doctors were the same who faced the consequences of a previous natural disaster, a severe 6.3 magnitude earthquake. A second objective is to evaluate their current mental attitude, profess...

Background Psychotic‐like experiences (PLEs) index an increased risk for subsequent psychotic disorders. A risky family environment is a well‐established risk factor for PLEs; however, different contextual and personal resiliency factors may differentially mediate its effect on PLEs. Objective In this study, we propose a two‐dimensional model of r...

Introduction: Patients with severe mental disorders (namely schizophrenia, major depression and bipolar disorder) have a reduced life expectancy of at least 10 to 25 years compared with the general population. This mortality gap is due to the higher prevalence of comorbid physical disorders (such as diabetes, hypertension and cardiovascular disease...

Stress adjustment and resilience after multiple natural disaster exposure, specifically two successive earthquakes (i.e. 2009 and 2016 earthquakes) have been investigated in persons with mental disorder and compared to a clinical sample evaluated after the first seismic 2009 event. Seventy-one persons referred to the Mental Health Service of L’Aqui...

Personal values have increasingly become central in socio-psychological research. However, the relationships between values and psychopathological variables have been scarcely investigated, with mixed results. This study aimed to explore potential differences in value orientation in a sample of people with psychotic disorders and mood disorders com...

The relationship between subjective appraisal of cognitive deficits and symptom severity in schizophrenia is unclear. Insight reportedly affects both factors. Our aim is to further asses the relationship between subjective perception of cognitive deficits, symptom severity and lack of insight as a mediator variable. 109 subjects with schizophrenia...

Background: Several studies hypothesize emotional dysregulation in subjects with migraine related to a generalized hyperexcitability both to sensory and emotional stimuli, involving the cortical-limbic system. The aim of the study was to investigate Emotional Reactivity by means of the International Affective Picture System (IAPS), in a sample of m...

Purpose: The aim of the current study was to evaluate the construct validity and the internal consistence of the Italian version of the Psychological Maltreatment Review (PMR), and to assess the concurrent validity to provide adequate and reliable instruments to measure retrospectively child psychological maltreatment in the Italian population. M...

Background: Psychotic-like experiences index an increased risk for subsequent psychotic disorders. A risky family environment is a well-established risk factor for psychotic-like experiences, however different contextual and personal factors may differentially mediate their effect on psychotic-like experiences, including different aspects of resili...

Background: Interpersonal violence has increased as a health concern, especially in psychiatry practice, over the last decades. Nevertheless, most patients with stable mental disorders do not present an increased risk of violence, and mental disorder is not a necessary or sufficient cause of violent behaviours. People with mental disorders endorse...

Introduction Insecure attachment styles and immature or neurotic defense mechanisms are related to psychological distress. However, their mutual interaction in influencing psychological distress deserves further investigation. Methods One-thousand-one-hundred-twenty-nine University students were evaluated using the Global Severity Index of Symptom...

Introduction. Insecure attachment styles and immature or neurotic defense mechanisms are related to psychological distress. However, their mutual interaction in influencing psychological distress deserves further investigation. Methods. One-thousand-one-hundred-twenty-nine University students were evaluated using the Global Severity Index of Sympto...

SUMMARY. Background. Although cognitive deficit in persons with schizophrenia is well documented, the assessment of the patient’s perception of its own cognitive functioning is a relevant issue not adequately studied. Several evaluation tools have been elaborated, however none has been validated in Italian. The aim of the study is the validation of...

Several studies investigated the role of resilience as a mediating factor for psychopathological phenotypes. The aim of the current study is to explore the putative role of resilience as a mediator between different vulnerability factors and depressive symptoms. One hundred and fifty patients with a major depressive disorder diagnosis have been eva...

An earthquake hit the city of L’Aquila in central Italy in 2009, leaving the city completely destroyed and 309 casualties. Unexpectedly, lower rates of psychotic experiences in persons affected by the earthquake compared to non-affected persons were found 10 months after the earthquake. The very long-term impact of a natural disaster on the prevale...

Background: Brain-Derived Neurotrophic Factor (BDNF) modulates synaptic modifications that can constitute part of brain adaptive processes in the aftermath of trauma exposure. Thus, BDNF increase could be determined either in psychiatric patients or healthy subjects who, despite exposed to stressful events, did not develop stress-related symptoms....

Purpose. The aim of this research was to assess the prevalence of Night Eating Syndrome (NES) in a university student population and to clear up the relationship between NES, depression and chronotype. The relation between NES and seasonality was also investigated. Methods. The data were collected from a sample of 1136 students of the L’Aquila Univ...

Objectives Several studies have shown that survivors of natural disasters present high PTSD rates. On 6th April 2009, L'Aquila (Central Italy) was jolted by a 6.3 Richter scale magnitude earthquake causing a massive destruction of the town. More than 300 individuals died, 1,600 were injured and about 65,000 displaced. The aim of this paper is to re...

Introduction. Delusional symptoms are heterogeneous and differentially related to insight, depression and another psychological construct, such as deservedness. In this study we explore models of relationships among these constructs, by hypothesizing that lack of insight could predict depression or paranoia, representing these variables outcome or...

Background. Interpersonal violence has increased as a health concern, especially in psychiatry practice, over the last decades. Nevertheless, most patients with stable mental disorders do not present an increased risk of violence, and mental disorder is not a necessary or sufficient cause of violent behaviours. People with mental disorders endorse...

Il trauma collettivo conseguente a un disastro naturale si configura come una crisi di significato. Numerosi studi supportano la trasmissione transgenerazionale di esperienze traumatiche, come pure di modelli protettivi di resilienza. I numerosi eventi culturali e scientifici che si sono tenuti in occasione del decimo anniversario del sisma che ha...

Aim: Emotional reactivity (ER) and neuropsychological (Np) status were investigated in a case series of patients that underwent a surgical ablation of temporal lobe tumors (TLT). Methods: Ten patients (6 females, 4 males) who had undergone surgical ablation of TLT and 10 controls matched for age and gender were recruited. ER was tested using Intern...

Background. Interpersonal violence has increased as a health concern especially in the psychiatry practice over the last decades; nevertheless, most patients with stable mental illness do not present an increased risk of violence and a mental disorder is not a necessary or sufficient cause of violent behaviors. People with mental illness endorse mo...

Personal values are motivational constructs which guide behavior. Associations between values and risky behaviors have been reported in student and non-clinical samples. We investigated the relationship between human values and variables related to interpersonal violence and maltreatment in a sample of 160 consecutively admitted people with mental...

Background: The patients’ appraisal, satisfaction and attitude toward research is crucial to obtain reliable information, in psychiatry frequently not objective. Aim: We operationalised the information derived from studies on satisfaction and attitude towards research and developed a standardized measure, whose internal consistency and factor struc...

The epilepsy represents a challenge for life expectancy and quality of life either for social and relational consequences due to stigma and for the consequences of the disorder itself. Suicidal behaviors are more frequent in the persons with epilepsy than in the general population. In addition to those shared with other chronic diseases, the condit...

Objectives It has been well documented that metacognition is compromised in people with a diagnosis of schizophrenia. Recent theories, concerning the roots of poor insight in schizophrenia, have proposed that it may result, in part, from impairments in metacognition, the capacity to think about thinking. Metacognition is a complex construct includi...

Purpose: Emotional reactivity (ER) is the early rapidly evoked response to a salient emotional stimulus which influences an individual's coping mechanisms, eliciting adaptive responses. We investigated ER in patients with mesial temporal lobe epilepsy (MTLE) in order to obtain an emotion-processing measure that can be related to behavioral regulat...

Objectives To achieve a validation of the Persecution and Deservedness Scale (PaDS) in an Italian convenience sample from general population. To catch the link between paranoia, self-esteem, depressive symptoms and aberrant salience assuming that these constructs could be related to paranoia. Methods 312 individuals provided complete data on Persec...

Objectives Variants appearing de novo in genes regulating key neurodevelopmental processes and/or in noncoding cis-regulatory elements (CREs), as enhancers, may increase the risk for schizophrenia. However, CREs involvement in schizophrenia needs to be explored more deeply. Methods We investigated de novo copy number variations (CNVs) in the whole...

Background The increased use of the MATRICS Consensus Cognitive Battery (MCCB) to investigate cognitive dysfunctions in schizophrenia fostered interest in its sensitivity in the context of family studies. As various measures of the same cognitive domains may have different power to distinguish between unaffected relatives of patients and controls,...

Depression in schizophrenia represents a challenge from a diagnostic, psychopathological and therapeutic perspective. The objective of this study is to test the hypothesis that resilience and self-stigma affect depression severity and to evaluate the strength of their relations in 921 patients with schizophrenia. A structural equation model was tes...

Objective: Suicidal ideation is modulated by several risk and protective factors. The aim of this study was to evaluate differences between patients with a history of suicide attempt and those with no such history, with special attention to depression, interpersonal sensitivity, humiliation, and resilience. Methods: One hundred consecutively admit...

Self-reported ‘personal recovery’ and clinical recovery in schizophrenia (SRPR and CR, respectively) reflect different perspectives in schizophrenia outcome, not necessarily concordant with each other and usually representing the consumer's or the therapist's point of view. By means of a cluster analysis on SRPR-related variables, we identified thr...

Important changes were introduced concerning posttraumatic-stress disorder (PTSD) by the DSM-5 recognizing the role of negative emotions such as guilt and shame, but little evidence is yet available on their prevalence in population assessed by means of DSM-5 criteria. In this study we explored the rates of guilt and shame DSM-5 PTSD diagnostic sym...

In our recently published article, we investigated the behavioral addiction model of obsessive-compulsive disorder (OCD), by assessing three core dimensions of addiction in patients with OCD healthy participants. Similar to the common findings in addiction, OCD patients demonstrated increased impulsivity, risky decision-making, and biased probabili...

The relationships of personal resources with symptom severity and psychosocial functioning have never been tested systematically in a large sample of people with schizophrenia. We applied structural equation models to a sample of 921 patients with schizophrenia collected in a nationwide Italian study, with the aim to identify, among a large set of...

Clinical correlates of plasma Brain-Derived Neurotrophic Factor (BDNF) have been investigated in a clinical population with Post Traumatic Stress Disorder (PTSD) symptoms and healthy control subjects who survived to the L'Aquila 2009 earthquake. Twenty-six outpatients and 14 control subjects were recruited. Assessments included: Structured Clinical...

Rationale: Variables influencing real-life functioning have repeatedly been modeled in schizophrenia subjects but not systematically investigated in their unaffected first-degree relatives (SRs), in whom milder forms of deficits reported in schizophrenia have been observed, but confounders of clinical cohorts are not in play. Demonstrating that pa...

Background: an earthquake of 6.3 magnitude struck the town and province of L'Aquila on 6th April 2009. About 100,000 buildings were damaged, 1,600 people remained injured and 309 deceased; 66,000 people were left homeless by the disaster. The studies performed on the consequences of this seismic event have been numerous, more than those published...

Introduction: The metabolic syndrome (MS) is an area of interest for mental health research because individuals with mental illnesses have an increased risk of medical morbidity and mortality compared with the general population. This cross-sectional study is aimed to estimate the prevalence of metabolic syndrome in an Italian psychiatric sample,...

The aim of this study was to explore the relationships among empathy processes in terms of self-report empathy evaluation and recognition of emotional cues and Theory of Mind components. We used the Empathy Quotient - short form (EQ-s), the Pictures of Facial Affect (POFA) system, a (ToM) Irony appreciation task and the Wisconsin Card Sorting Test...

Background. Symptoms of PTSD denote alterations in several neurobiological systems, including the opioid system. In a previous study on methadone-treated heroin use disorder (HUD) patients, we demonstrated strong correlations between the severity and progression of HUD and the subsequently greater severity of PTSD spectrum symptoms, so suggesting a...

Background and Aims Recent studies have challenged the anxiety-avoidance model of obsessive–compulsive disorder (OCD), linking OCD to impulsivity, risky-decision-making and reward-system dysfunction, which can also be found in addiction and might support the conceptualization of OCD as a behavioral addiction. Here, we conducted an exploratory inves...

The aim of this study is to investigate the relationship between resilience, risky family and psychiatric symptoms in order to understand which role resilience may have. 608 post-doc course students (323 males and 285 females) were recruited and evaluated through the Resilience Scale for Adult, the Risky Family Questionnaire and the Brief Symptom I...

We report a case of a 17-year-old man presenting with new onset psychiatric symptoms. Magnetic resonance imaging (MRI) and proton magnetic resonance (MR) spectroscopy revealed some lesions in the right cerebellar hemisphere and ipsilateral cerebellar tonsil suggestive of encephalitis. An extensive workup was negative for both infectious and neoplas...

Background: Decision making (DM) consists of a number of complex processes involving higher-order cognitive functions involved in outcome evaluation. Problems in DM may have significant negative repercussions on community functioning. We hypothesise in individuals with schizophrenia difficulties in community functioning will be associated with DM...

Objective We aimed to deepen the clinical utility of humiliation assessment in the study of depression. Method We performed a correlational analysis of the relationship between humiliation, depression, resilience, and negative primary familial environment in 80 clinically depressed subjects (41 men and 39 women; mean age = 40.71, standard deviation...

The aim of the present study was to explore the correlations between Spirituality/Mysticism/Psychoticism symptoms and suicidality in young adult survivors of the L'Aquila earthquake. The sample included 475 subjects recruited among high school seniors who had experienced the April 6, 2009, earthquake. Assessments included: Trauma and Loss Spectrum-...

The paper describes the current status of the new interdisciplinary research field of neuroeconomics in relation to psychopathology, giving an account of possible clinical implications for social dysfunction. This is achievable because neuroeconomics join economics, psychology, neuroscience and computational science in order to gain a greater under...

Resilience is increasingly recognized as a relevant factor in shaping psychological response to natural disasters. Aim of the study is to examine in the context of a natural disaster the potential effects of resilience on the relation between coping and trauma spectrum symptoms, using structural equation modeling. A sample of 371 students who survi...

Introduction Non-adherence to therapy is a significant problem in treatment of patients with a diagnosis of schizophrenia; the rate of non-adherence in psychiatric patients varies from 24% to 90%, with average of about 60%. This may be due to the lack of awareness of the disorder, weak conviction of the utility of therapy by the patient or family,...

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...

Research on resilience showed its substantive role as buffer against mental differing but the difficulty to find a valid and reliable measurement instrument represents a limit for the improvement of the knowledge on this topic. In this study we examined the psychometric properties of the Italian version of the Resilience Scale for Adults (RSA). RSA...

This study investigated the use of the facilities for the mental health by the population affected by the L'Aquila (Italy) 2009 earthquake. The data about the activities of the Mental Health Centre of L'Aquila during the years from 2008 to 2010 were obtained by the service Information System. In the months following the event the percentage of refe...

Summary Objectives Herein the authors review the literature on humiliation, focusing on the relationship with psychopathology and neuroscience. Methods A literature search was conducted on Pubmed and Google Scholar using “humiliation”, “psychopathology”, “social neuroscience” and “social neurobiology” as key words. Results Twenty-nine international...

Gender differences in post-traumatic stress disorder (PTSD) rates were confirmed across different DSM editions as well as the role of bipolar disorder (BD) comorbidity on prevalence and course, but little data is available upon new DSM-5 criteria, including maladaptive behaviors. The aim of this study was to investigate gender differences in DSM-5...

In people suffering from schizophrenia, major areas of everyday life are impaired, including independent living, productive activities and social relationships. Enhanced understanding of factors that hinder real-life functioning is vital for treatments to translate into more positive outcomes. The goal of the present study was to identify predictor...

Emotional reactivity in bipolar affective disorders has received increased attention as a relevant issue with regard to the ability to respond to emotional external stimuli for individual real world adaptation. We investigated emotional reactivity using the International Affective Picture System (IAPS) paradigm in bipolar patients during the depres...

RIASSUNTO. Studi precedenti hanno ampiamente documentato una compromissione della capacità di riconoscimento degli stimoli emotivi nei pazienti affetti da schizofrenia. In questo studio con potenziali evento-correlati sono state utilizzate alcune immagini di volti tratte da Ekman e Friesen per valutare i correlati neurofisiologici del processa ment...

The study aims to investigate the relationship of suicidal ideation with coping and resilience in a sample of adolescents who survived an earthquake. Three hundred forty-three adolescents who had experienced the L'Aquila earthquake were investigated for a screening distinguishing Suicidal Screen-Negative (SSN) from the Positive (SSP) subjects. Resi...

Previous studies extensively reported an impaired ability to recognize emotional stimuli in patients with schizophrenia. We used pictures from Ekman and Friesen in an event-related potentials study to investigate the neurophysiological correlates of the fear emotional processing compared with happiness in patients with schizophrenia versus healthy...

Bipolar patients seem to be at high risk of trauma exposure and, when exposed, of PTSD. When comorbid, PTSD has shown a negative impact on the course of the bipolar illness. Conversely, a correlation between even manic symptoms and an increased risk for suicide has also been reported in PTSD patients. The aim of this study was to investigate the re...

Objectves: Considering social variables influencing psychological well-being and protecting from development of mental disease, social support received great attention. In recent years the focus shifted toward more general constructs that can account for stability and coherence of the scheme that each person applies to relate to the social word as...

Religiousness and spirituality are increasingly being investigated in relation with physical and mental health. The aims of this study are to investigate the factor structure of the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) and analyze the relations of BMMRS factors with personality, well-being, and perceived stress const...

Objectives Research following disasters allows for exploration of the effects of severe stress on mental health, as trauma is likely to increase the risk of psychosis. The aim of this study was to investigate the relationship between post-earthquake symptom distress and subclinical psychological symptoms on 512 young students, one year after the ea...

Clinical, cognitive, metabolic and functioning variables have been evaluated in patients with schizophrenia in an 8-week trial with Ziprasidone. The aim of this post-hoc analysis is to investigate how these variables interact in determining short-term remission. Baseline values or the variation from baseline to endpoint were considered predictors....

The aim of this study was to evaluate the impact of L’Aquila earthquake (Italy) on Resilience and Coping 2 years after the earthquake in a high school sample. Three hundred and twenty-four male and female students exposed to the earthquake and 147 not-exposed have been assessed with the Resilience Scale for Adolescents (READ) and the Brief COPE. Th...

Background: Post-traumatic stress disorder (PTSD) represents one of the most frequently psychiatric sequelae to earthquake exposure. Increasing evidence suggests the onset of maladaptive behaviors among veterans and adolescents with PTSD, with specific gender differences emerging in the latter. Aims of the present study were to investigate the rela...

Objective: aim of this study is to assess the tendency to make decisions extremely hastily and on the basis of little evidence, and decision making in relation to impulsiveness and personality dimensions in abstinent alcohol-dependent subjects (AADS). Methods: eighteen AADS were evaluated using Beads Test, Iowa Gambling Task, Barratt Impulsiveness...

PTSD and post-traumatic spectrum symptoms represent the most frequently reported psychiatric sequelae of earthquakes and several studies have investigated the role of risk factors1,2. Aim of the present study was to explore PTSD and post-traumatic spectrum symptoms in L’Aquila (Italy) 2009 earthquake survivors and their correlations with age, gende...

Background: Given the well-documented acute increase in psychopathology after disasters as well as the greater likelihood of suicide among persons with psychopathology, it may be expected that suicide rates also rise after such events. Aim: To investigate the suicide rate 1 year after the April 2009 earthquake that struck L'Aquila (Italy). Meth...

PTSD is one of the most frequently occurring sequelae in earthquake survivors and increasing literature has been focused on its potential risk factors. More recently increasing evidence has highlighted the onset of maladaptive behaviours in the same populations. The aim of the present study was to explore: 1) the role of degree of exposure ("direct...

Objective: Given the complex nature and frequent comorbidities of bipolar disorder (BD), polypharmacy is often used to achieve and maintain remission. In clinical practice, this is frequently the rule rather than the exception. Although research on BD uncommonly involves controlled clinical studies for combination therapies, clinicians nonetheless...

BACKGROUND: Earthquakes are among the most frequently occurring natural disasters affecting the general population and inducing Post-Traumatic Stress Disorder (PTSD). Thus, increasing effort has been devoted to explore risk factors for PTSD onset after exposure. The aim of the present study was to investigate the impact of gender, degree of exposur...

Objective The aim of this study was to investigate full blown and partial post-traumatic-stress disorder (PTSD), besides post-traumatic stress symptoms, in a selected group of young and middle-age subjects who survived to the 2009 L'Aquila (Italy) earthquake, with a particular focus on the impact of age, gender and of their possible interaction. Me...

In the present work we describe the mental health condition of L'Aquila population in the aftermath of the earthquake in terms of structural, process and outcome perspectives. Literature revision of the published reports on the L'Aquila earthquake has been performed. Although important psychological distress has been reported by the population, cap...

This study evaluated the correspondence between measures of two competing theories of personality, the five-factor model as measured by the Big Five Questionnaire (BFQ), and Cloninger's psychobiological theory measured by the Temperament and Character Inventory-Revised (TCI-R). A sample of 900 Italian participants, balanced with respect to sex (393...

Recibido: XX de XX del 2012 | Aceptado: XX de XX del 2012 PAOLO STRATTA2-3; STEFANO DE CATALDO2; ROBERTO BONANNI2; ANNAMARIA ALLEGRO2; MARCO VALENTI4; FRANCESCO MASEDU4; ILARIA RICCARDI5; ALESSANDRO ROSSI5 (NATIONAL MENTAL HEALTH CARE SERVICE, L´Aquila, Italy). ABSTRACT The authors describe the psychological consequences of the April 2009 earthquak...

The aim of the study was to assess the relationship among decision-making (DM) ability (as measured by the Iowa Gambling Task [IGT]), impulsivity, and temperament and character traits in a long-term abstinent alcohol-dependent sample. Twenty-six abstinent alcohol-dependent subjects, referred to a Drug Addiction Unit of the National Health Service o...

The validity of the Italian version of the 28-items Resilience Scale for Adolescents (READ) was examined. A sample of 472 senior high school students between 18 and 20 years of age were used for this purpose. Reliability and validity were investigated by means of Cronbach's alpha, exploratory factor analysis, and confirmatory factor analysis. The r...