Ilaria Lega - Academia.edu (original) (raw)
Papers by Ilaria Lega
International Journal of Environmental Research and Public Health, Mar 28, 2023
Inserto BEN - Bollettino Epidemiologico Nazionale, 2019
MALTRATTAMENTO E ABUSO ALL'INFANZIA
This review examines the association between the perinatal period and thoughts and behaviours of ... more This review examines the association between the perinatal period and thoughts and behaviours of neonaticide, infanticide, and filicide, highlighting mothers' risk factors. A literature search was conducted on PubMed, PsycINFO, and ScienceDirect, with 2,957 articles screened and 13 determined as eligible for inclusion. Inclusion criteria were: 1) studies on neonaticide, infanticide and filicide; 2) studies conducted on women; 3) studies with perinatal population; 4) original, peer-reviewed studies; 5) studies written in English or Italian language. Single-case reports and qualitative studies were excluded, as were those studies written in any other language, and any studies for which the full-text version could not be obtained (i.e. conference abstracts). Two reviewers independently reviewed titles and abstracts, reviewed relevant articles' full text, and extracted the data. Several individuals and socio-environmental risk factors were identified for neonaticide, infanticide...
The Lancet Regional Health - Europe
Summary Background Mental health is a public health issue for European young people, with great h... more Summary Background Mental health is a public health issue for European young people, with great heterogeneity in resource allocation. Representative population-based studies are needed. The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time. Methods Prevalence, incidence, Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) from mental disorders (MDs), substance use disorders (SUDs) and self-harm were estimated for young people aged 10-24 years in 31 European countries. Rates per 100,000 population, percentage changes in 1990-2019, 95% Uncertainty Intervals (UIs), and correlations with Sociodemographic Index (SDI), were estimated. Findings In 2019, rates per 100,000 population were 16,983 (95% UI 12,823 – 21,630) for MDs, 3,891 (3,020 - 4,905) for SUDs, and 89·1 (63·8 - 123·1) for self-harm. In terms of disability, anxiety contributed to 647·3 (432–912·3) YLDs, while in terms of premature death, self-harm contributed to 319·6 (248·9–412·8) YLLs, per 100,000 population. Over the 30 years studied, YLDs increased in eating disorders (14·9%;9·4-20·1) and drug use disorders (16·9%;8·9-26·3), and decreased in idiopathic developmental intellectual disability (–29·1%;23·8-38·5). YLLs decreased in self-harm (–27·9%;38·3-18·7). Variations were found by sex, age-group and country. The burden of SUDs and self-harm was higher in countries with lower SDI, MDs were associated with SUDs. Interpretation Mental health conditions represent an important burden among young people living in Europe. National policies should strengthen mental health, with a specific focus on young people. Funding The Bill and Melinda Gates Foundation
Annali dell'Istituto superiore di sanita, 2020
With the exception of a few countries that chose a different approach, the worldwide reaction to ... more With the exception of a few countries that chose a different approach, the worldwide reaction to the COVID-19 pandemic was a (longer or shorter) period of national lockdown. While the economic consequences of shutting down national economies were immediately evident, the sociopsychiatric implications of the social confinement of the entire population remain hidden and not fully understood. Italy has been the first European country to be severely impacted by the COVID-19 pandemic, to which it responded through strict lockdown measurements. The results of a timely survey on mental and social health, carried out by students and teachers of a middle school in Rome, might help identify the most vulnerable groups of the population. This evidence could be crucial in conceiving and enacting targeted public health policies to mitigate the consequences of the pandemic on mental health and to prevent intolerance to containment measures in some population segments, which could hamper worldwide ...
Antimicrobial Resistance and Infection Control, May 21, 2022
Long-Term Forensic Psychiatric Care, 2019
This chapter describes the legislative, organizational, and clinical innovations supporting the n... more This chapter describes the legislative, organizational, and clinical innovations supporting the national and regional plan of closing the six Italian forensic hospitals. We illustrate the historical determinants of the contemporary situation, shedding light on the cultural heritage that has preserved the previous hospital-based system. The asylum organization had remained unchanged throughout the reformist period in the last decades, as correctional and general mental health sectors were totally separated in their organization.
Official Journal of the Italian Society of Psychopathology, 2003
Epidemiologia e prevenzione, 2021
INTRODUCTION in 2017, the Italian Ministry of Health funded the project "Analysis of the act... more INTRODUCTION in 2017, the Italian Ministry of Health funded the project "Analysis of the activities of the network of the Family Care Centers (FCCs) to relaunch their role" aimed at updating the state of the art of the national FCCs. The project was coordinated by the Italian National Institute of Health (INIH). The present paper focuses on a selection of the project's results. OBJECTIVES to describe some characteristics of the regional and Local Health Unit governance of the FCCs, and the care offered by the FCCs in different fields of activity. DESIGN online census survey on three organizational levels of the FCCs: regional governance, coordination at the Local Health Unit level, and at the single FCC level. Data were collected through dedicated web forms via a national network of reference professionals. SETTING AND PARTICIPANTS all the Italian Regions and Autonomous Provinces, 207 Local Health Unit coordinators, and 1,859 FCC's professionals were involved. Nine...
Biology of Sex Differences, 2020
Background Among the unknowns posed by the coronavirus disease 2019 (COVID-19) outbreak, the role... more Background Among the unknowns posed by the coronavirus disease 2019 (COVID-19) outbreak, the role of biological sex to explain disease susceptibility and progression is still a matter of debate, with limited sex-disaggregated data available. Methods A retrospective analysis was performed to assess if sex differences exist in the clinical manifestations and transitions of care among hospitalized individuals dying with laboratory-confirmed SARS-CoV-2 infection in Italy (February 27–June 11, 2020). Clinical characteristics and the times from symptoms’ onset to admission, nasopharyngeal swab, and death were compared between sexes. Adjusted multivariate analysis was performed to identify the clinical features associated with male sex. Results Of the 32,938 COVID-19-related deaths that occurred in Italy, 3517 hospitalized and deceased individuals with COVID-19 (mean 78 ± 12 years, 33% women) were analyzed. At admission, men had a higher prevalence of ischemic heart disease (adj-OR = 1.76,...
Journal of Psychosomatic Research, 2004
Clinical Microbiology and Infection
International Journal of Environmental Research and Public Health
There has been concern about the impact of the COVID-19 outbreak on women’s mental health during ... more There has been concern about the impact of the COVID-19 outbreak on women’s mental health during the perinatal period. We conducted a cross-sectional web-based study aimed at evaluating the psychological impact (BSI-18) of the COVID-19 pandemic on this population and collecting information on the perinatal experiences (COPE-IS) during the second Italian wave. Overall, 1168 pregnant women, and 940 within the first six months after childbirth, were recruited in selected Italian Family Care Centers from October 2020 to May 2021. The prevalence of psychological distress symptoms during pregnancy was 12.1% and 9.3% in the postnatal group. Financial difficulties, a previous mood or anxiety disorder and lack of perceived social support and of support provided by health professionals were associated to psychological distress symptoms in both groups. A third of the women felt unsupported by their social network; 61.7% of the pregnant women experienced changes in antenatal care; 21.2% of thos...
Annali dell'Istituto superiore di sanita, 2019
OBJECTIVE To describe the Italian Obstetric Surveillance System (ItOSS) investigating maternal de... more OBJECTIVE To describe the Italian Obstetric Surveillance System (ItOSS) investigating maternal death through incident case reporting and confidential enquiries. METHODS All maternal deaths occurred in any public and private health facility in 8 Italian regions covering 73% of national births have been notified to the ItOSS. Every incident case is confidentially reviewed to assess quality of care and establish the cause and avoidability of the death. FINDINGS A total of 106 maternal deaths among 1 455 545 live births have been notified to the surveillance system in 2013-17. Haemorrhage, sepsis and hypertensive disorders of pregnancy are the leading causes of direct maternal deaths due to obstetric causes. CONCLUSIONS A maternal mortality surveillance system, including incidence reporting and confidential enquiries along with a retrospective analysis of administrative data sources, emerged as the best option for case ascertainment and for preventing avoidable maternal deaths.
Epidemiologia e prevenzione, 2020
THE CONTEXT: among the community health services representing a resource to face the COVID-19 eme... more THE CONTEXT: among the community health services representing a resource to face the COVID-19 emergency, there are the Family Care Centres (FCCs). A national study coordinated by the Italian National Institute of Health (ISS) and funded by the Italian Ministry of Health, recently described their activities and needs, highlighting a large interregional variability in the number of centres and staff availability. Ante and post-natal care, cervical cancer screening and actions addressed at teenagers are the FCCs strategic activities. THE CF IN FRONT OF COVID-19: despite the need to limit the offer of care to the services that cannot be postponed during the lockdown, many FCCs have been exemplary in promptly reorganizing activities in the new context. The paper presents a selection of experiences carried out from March to June 2020 by some FCCs in different Italian Regions concerning FCCs strategic activities. CONCLUSIONS: the combined reading of some of the results of the ISS study and...
Rivista di psichiatria, 2003, 38, 6 323 RIASSUNTO. Introduzione. I disturbi depressivi sono frequ... more Rivista di psichiatria, 2003, 38, 6 323 RIASSUNTO. Introduzione. I disturbi depressivi sono frequenti e si associano a elevati livelli di mortalità, disabilità, e morbilità secondaria. Tuttavia, spesso questi disturbi non vengono riconosciuti e trattati adeguatamente. È necessario disporre di strumenti di screening validi e adatti all’uso di routine. L’obiettivo di questo studio è stato mettere a punto la versione italiana del questionario Primary Care Screener for Affective Disorders (PC-SAD), e di testarne la validità nei confronti della SCID-I. Metodi. Sono stati studiati pazienti ricoverati di età 18-65 anni, non affetti da compromissione cognitiva o demenza. Poco dopo l’ingresso in reparto, i pazienti hanno compilato il PC-SAD, ed entro 48 ore è stata loro somministrata la SCID-I da parte di un medico addestrato, che ignorava i risultati del questionario. Sono state calcolate la sensibilità e la specificità del PC-SAD, con la SCID-I come standard di riferimento. Risultati. l’an...
PLOS ONE
In this before and after cross-sectional analysis, the authors aim to assess the impact of the bu... more In this before and after cross-sectional analysis, the authors aim to assess the impact of the bundle of research and training initiatives implemented between 2013 and 2018, and coordinated by the Italian Obstetric Surveillance System (ItOSS) to reduce obstetric haemorrhagic emergencies in five selected Italian Regions. To this purpose, the haemorrhagic Maternal Mortality Ratios (MMR) per 100,000 live births were estimated before and after implementing the bundle, through the ItOSS’s vital statistic linkage procedures and incident reporting and Confidential Enquiries. The research and training bundle was offered to all health professionals involved in pregnancy and birth care in the selected regions, representing 40% of national live births, and participating in the ItOSS audit cycle since its institution. The haemorrhagic MMR significantly decreased from 2.49/100,000 live births [95% CI 1.75 to 3.43] in the years 2007–2013 prior to the bundle implementation, to 0.77/100,000 live bi...
International Journal of Environmental Research and Public Health, Mar 28, 2023
Inserto BEN - Bollettino Epidemiologico Nazionale, 2019
MALTRATTAMENTO E ABUSO ALL'INFANZIA
This review examines the association between the perinatal period and thoughts and behaviours of ... more This review examines the association between the perinatal period and thoughts and behaviours of neonaticide, infanticide, and filicide, highlighting mothers' risk factors. A literature search was conducted on PubMed, PsycINFO, and ScienceDirect, with 2,957 articles screened and 13 determined as eligible for inclusion. Inclusion criteria were: 1) studies on neonaticide, infanticide and filicide; 2) studies conducted on women; 3) studies with perinatal population; 4) original, peer-reviewed studies; 5) studies written in English or Italian language. Single-case reports and qualitative studies were excluded, as were those studies written in any other language, and any studies for which the full-text version could not be obtained (i.e. conference abstracts). Two reviewers independently reviewed titles and abstracts, reviewed relevant articles' full text, and extracted the data. Several individuals and socio-environmental risk factors were identified for neonaticide, infanticide...
The Lancet Regional Health - Europe
Summary Background Mental health is a public health issue for European young people, with great h... more Summary Background Mental health is a public health issue for European young people, with great heterogeneity in resource allocation. Representative population-based studies are needed. The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time. Methods Prevalence, incidence, Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) from mental disorders (MDs), substance use disorders (SUDs) and self-harm were estimated for young people aged 10-24 years in 31 European countries. Rates per 100,000 population, percentage changes in 1990-2019, 95% Uncertainty Intervals (UIs), and correlations with Sociodemographic Index (SDI), were estimated. Findings In 2019, rates per 100,000 population were 16,983 (95% UI 12,823 – 21,630) for MDs, 3,891 (3,020 - 4,905) for SUDs, and 89·1 (63·8 - 123·1) for self-harm. In terms of disability, anxiety contributed to 647·3 (432–912·3) YLDs, while in terms of premature death, self-harm contributed to 319·6 (248·9–412·8) YLLs, per 100,000 population. Over the 30 years studied, YLDs increased in eating disorders (14·9%;9·4-20·1) and drug use disorders (16·9%;8·9-26·3), and decreased in idiopathic developmental intellectual disability (–29·1%;23·8-38·5). YLLs decreased in self-harm (–27·9%;38·3-18·7). Variations were found by sex, age-group and country. The burden of SUDs and self-harm was higher in countries with lower SDI, MDs were associated with SUDs. Interpretation Mental health conditions represent an important burden among young people living in Europe. National policies should strengthen mental health, with a specific focus on young people. Funding The Bill and Melinda Gates Foundation
Annali dell'Istituto superiore di sanita, 2020
With the exception of a few countries that chose a different approach, the worldwide reaction to ... more With the exception of a few countries that chose a different approach, the worldwide reaction to the COVID-19 pandemic was a (longer or shorter) period of national lockdown. While the economic consequences of shutting down national economies were immediately evident, the sociopsychiatric implications of the social confinement of the entire population remain hidden and not fully understood. Italy has been the first European country to be severely impacted by the COVID-19 pandemic, to which it responded through strict lockdown measurements. The results of a timely survey on mental and social health, carried out by students and teachers of a middle school in Rome, might help identify the most vulnerable groups of the population. This evidence could be crucial in conceiving and enacting targeted public health policies to mitigate the consequences of the pandemic on mental health and to prevent intolerance to containment measures in some population segments, which could hamper worldwide ...
Antimicrobial Resistance and Infection Control, May 21, 2022
Long-Term Forensic Psychiatric Care, 2019
This chapter describes the legislative, organizational, and clinical innovations supporting the n... more This chapter describes the legislative, organizational, and clinical innovations supporting the national and regional plan of closing the six Italian forensic hospitals. We illustrate the historical determinants of the contemporary situation, shedding light on the cultural heritage that has preserved the previous hospital-based system. The asylum organization had remained unchanged throughout the reformist period in the last decades, as correctional and general mental health sectors were totally separated in their organization.
Official Journal of the Italian Society of Psychopathology, 2003
Epidemiologia e prevenzione, 2021
INTRODUCTION in 2017, the Italian Ministry of Health funded the project "Analysis of the act... more INTRODUCTION in 2017, the Italian Ministry of Health funded the project "Analysis of the activities of the network of the Family Care Centers (FCCs) to relaunch their role" aimed at updating the state of the art of the national FCCs. The project was coordinated by the Italian National Institute of Health (INIH). The present paper focuses on a selection of the project's results. OBJECTIVES to describe some characteristics of the regional and Local Health Unit governance of the FCCs, and the care offered by the FCCs in different fields of activity. DESIGN online census survey on three organizational levels of the FCCs: regional governance, coordination at the Local Health Unit level, and at the single FCC level. Data were collected through dedicated web forms via a national network of reference professionals. SETTING AND PARTICIPANTS all the Italian Regions and Autonomous Provinces, 207 Local Health Unit coordinators, and 1,859 FCC's professionals were involved. Nine...
Biology of Sex Differences, 2020
Background Among the unknowns posed by the coronavirus disease 2019 (COVID-19) outbreak, the role... more Background Among the unknowns posed by the coronavirus disease 2019 (COVID-19) outbreak, the role of biological sex to explain disease susceptibility and progression is still a matter of debate, with limited sex-disaggregated data available. Methods A retrospective analysis was performed to assess if sex differences exist in the clinical manifestations and transitions of care among hospitalized individuals dying with laboratory-confirmed SARS-CoV-2 infection in Italy (February 27–June 11, 2020). Clinical characteristics and the times from symptoms’ onset to admission, nasopharyngeal swab, and death were compared between sexes. Adjusted multivariate analysis was performed to identify the clinical features associated with male sex. Results Of the 32,938 COVID-19-related deaths that occurred in Italy, 3517 hospitalized and deceased individuals with COVID-19 (mean 78 ± 12 years, 33% women) were analyzed. At admission, men had a higher prevalence of ischemic heart disease (adj-OR = 1.76,...
Journal of Psychosomatic Research, 2004
Clinical Microbiology and Infection
International Journal of Environmental Research and Public Health
There has been concern about the impact of the COVID-19 outbreak on women’s mental health during ... more There has been concern about the impact of the COVID-19 outbreak on women’s mental health during the perinatal period. We conducted a cross-sectional web-based study aimed at evaluating the psychological impact (BSI-18) of the COVID-19 pandemic on this population and collecting information on the perinatal experiences (COPE-IS) during the second Italian wave. Overall, 1168 pregnant women, and 940 within the first six months after childbirth, were recruited in selected Italian Family Care Centers from October 2020 to May 2021. The prevalence of psychological distress symptoms during pregnancy was 12.1% and 9.3% in the postnatal group. Financial difficulties, a previous mood or anxiety disorder and lack of perceived social support and of support provided by health professionals were associated to psychological distress symptoms in both groups. A third of the women felt unsupported by their social network; 61.7% of the pregnant women experienced changes in antenatal care; 21.2% of thos...
Annali dell'Istituto superiore di sanita, 2019
OBJECTIVE To describe the Italian Obstetric Surveillance System (ItOSS) investigating maternal de... more OBJECTIVE To describe the Italian Obstetric Surveillance System (ItOSS) investigating maternal death through incident case reporting and confidential enquiries. METHODS All maternal deaths occurred in any public and private health facility in 8 Italian regions covering 73% of national births have been notified to the ItOSS. Every incident case is confidentially reviewed to assess quality of care and establish the cause and avoidability of the death. FINDINGS A total of 106 maternal deaths among 1 455 545 live births have been notified to the surveillance system in 2013-17. Haemorrhage, sepsis and hypertensive disorders of pregnancy are the leading causes of direct maternal deaths due to obstetric causes. CONCLUSIONS A maternal mortality surveillance system, including incidence reporting and confidential enquiries along with a retrospective analysis of administrative data sources, emerged as the best option for case ascertainment and for preventing avoidable maternal deaths.
Epidemiologia e prevenzione, 2020
THE CONTEXT: among the community health services representing a resource to face the COVID-19 eme... more THE CONTEXT: among the community health services representing a resource to face the COVID-19 emergency, there are the Family Care Centres (FCCs). A national study coordinated by the Italian National Institute of Health (ISS) and funded by the Italian Ministry of Health, recently described their activities and needs, highlighting a large interregional variability in the number of centres and staff availability. Ante and post-natal care, cervical cancer screening and actions addressed at teenagers are the FCCs strategic activities. THE CF IN FRONT OF COVID-19: despite the need to limit the offer of care to the services that cannot be postponed during the lockdown, many FCCs have been exemplary in promptly reorganizing activities in the new context. The paper presents a selection of experiences carried out from March to June 2020 by some FCCs in different Italian Regions concerning FCCs strategic activities. CONCLUSIONS: the combined reading of some of the results of the ISS study and...
Rivista di psichiatria, 2003, 38, 6 323 RIASSUNTO. Introduzione. I disturbi depressivi sono frequ... more Rivista di psichiatria, 2003, 38, 6 323 RIASSUNTO. Introduzione. I disturbi depressivi sono frequenti e si associano a elevati livelli di mortalità, disabilità, e morbilità secondaria. Tuttavia, spesso questi disturbi non vengono riconosciuti e trattati adeguatamente. È necessario disporre di strumenti di screening validi e adatti all’uso di routine. L’obiettivo di questo studio è stato mettere a punto la versione italiana del questionario Primary Care Screener for Affective Disorders (PC-SAD), e di testarne la validità nei confronti della SCID-I. Metodi. Sono stati studiati pazienti ricoverati di età 18-65 anni, non affetti da compromissione cognitiva o demenza. Poco dopo l’ingresso in reparto, i pazienti hanno compilato il PC-SAD, ed entro 48 ore è stata loro somministrata la SCID-I da parte di un medico addestrato, che ignorava i risultati del questionario. Sono state calcolate la sensibilità e la specificità del PC-SAD, con la SCID-I come standard di riferimento. Risultati. l’an...
PLOS ONE
In this before and after cross-sectional analysis, the authors aim to assess the impact of the bu... more In this before and after cross-sectional analysis, the authors aim to assess the impact of the bundle of research and training initiatives implemented between 2013 and 2018, and coordinated by the Italian Obstetric Surveillance System (ItOSS) to reduce obstetric haemorrhagic emergencies in five selected Italian Regions. To this purpose, the haemorrhagic Maternal Mortality Ratios (MMR) per 100,000 live births were estimated before and after implementing the bundle, through the ItOSS’s vital statistic linkage procedures and incident reporting and Confidential Enquiries. The research and training bundle was offered to all health professionals involved in pregnancy and birth care in the selected regions, representing 40% of national live births, and participating in the ItOSS audit cycle since its institution. The haemorrhagic MMR significantly decreased from 2.49/100,000 live births [95% CI 1.75 to 3.43] in the years 2007–2013 prior to the bundle implementation, to 0.77/100,000 live bi...