Suchergebnisse

Introduction: Hikikomori is a Japanese term etymologically derived from ' hiku' (i.e. ' to pull back') and ' komoru' (i.e. ' seclude oneself'), which identifies those subjects who deliberately withdraw themselves by social life, remaining confined into their own home/room. The phenomenon is widely diffused in Japan, even though it is currently spread outside the Japanese culture. However, a universally shared and cross-cultural adaptation of Hikikomori definition, phenomenological and psychopathological characterization is still missing. Methodology: An expert-guided opinion paper was here provided to clinical characterize the Hikikomori-like social withdrawal in the Italian context, by considering the transformation from a family-based society to a 'fluid' digital-structured culture, also discussing the concept of modern-type depression. This was provided deepening the principal current studies available in literature and giving an interpretation based on clinical experience in the Italian society. The work was supervised through a consensus by the most international expert of Japanese Hikikomori syndrome. Results: Current individual, family and social trajectories may potentially act as a mediator in favouring the occurrence of Hikikomori-like social withdrawal also in western countries, including Italy. Despite the differences between Japanese and Italian society and culture, the recent shaping of family structure and intra-familial dynamics, typical of the current post-modern society, may potentially influence the emergence of psychopathologies not typical of Italian culture. Unemployment and 'Not in Employment Education or Training' (NEET) conditions may represent another potential risk factor for economical/social marginalization of youngsters, together with the recent dramatic emergence of web-based psychopathologies. Conclusion: A diagnostic culturally-adapted flow-chart is proposed for clinical characterizing Hikikomori in Italian context, which may help in proposing preventive strategies, ensuring early identification and prompt therapeutic interventions, particularly among youngsters.

The COVID-19 pandemic represents an unprecedented public health emergency, with consequences at the political, social, and economic levels. Mental health services have been called to play a key role in facing the impact of the pandemic on the mental health of the general population. In the period March–May 2020, an online survey was implemented as part of the Covid Mental Health Trial (COMET), a multicentric collaborative study carried out in Italy, one of the Western countries most severely hit by the pandemic. The present study aims to investigate the use of mental health resources during the first wave of the pandemic. The final sample consisted of 20,712 participants, mainly females (N = 14,712, 71%) with a mean age of 40.4 ± 14.3 years. Access to mental health services was reported in 7.7% of cases. Among those referred to mental health services, in 93.9% of cases (N = 1503 subjects) a psychological assessment was requested and in 15.7% of cases (N = 252) a psychiatric consultation. People reporting higher levels of perceived loneliness (OR 1.079, 95% CI 1.056–1.101, p < 0.001), practicing smart-working (OR 1.122, 95% CI 0.980–1.285, p = 0.095), using avoidant (OR 1.586, 95% CI 1.458–1.725, p < 0.001) and approach (OR 1.215, 95% CI 1.138–1.299, p < 0.001) coping strategies more frequently accessed mental health services. On the other hand, having higher levels of perceived social support (OR 0.833, 95% CI 0.795–0.873, p < 0.001) was associated with a reduced probability to access mental health services. The COVID-19 pandemic represents a new threat to the mental health and well-being of the general population, therefore specific strategies should be implemented to promote access to mental healthcare during the pandemic and afterwards.

Background and aims: In Italy, the reform of the mental health system in 1978 should have drastically changed the provision of care and pathways of patients seeking to obtain it. The aim of this article is to examine the current pathways to psychiatric care in Italy. Methods: We used a method developed in the World Health Organization international collaborative studies to investigate pathways to care in 15 Italian mental health centers. We recruited 420 patients with a psychiatric illness and explored the care pathways they took to reach to psychiatric services and the delays from the onset of illness to reaching psychiatric care. Results: The majority of patients (33.8%) had direct access to mental health care, whereas the others arrived to a specialist in psychiatry through general hospitals (20.3%), general practitioners (33.0%) or private practitioners (9.8%). The main diagnosis for referral was neurotic disorder (36.6%), followed by affective disorder (35.4%) and psychotic disorder (11.5%). The delay from onset of illness to psychiatric care was greater for patients with psychotic disorders than for those with affective and neurotic disorders. The most frequently prescribed treatments were pharmacotherapy (56%), psychological support (8%), and psychotherapy (7.0%); 15% of the patients received no treatment. Conclusions: Our multicenter study shows that although general practitioners and hospital doctors are still the main referral point for mental health care, a greater proportion of patients are first seen in private settings or directly reach mental health centers, compared to previous surveys conducted in Italy. However, a stronger collaboration of psychiatrists with general practitioners and psychologists is still needed.