Cristina Crocamo | University of Pavia (original) (raw)

Papers by Cristina Crocamo

Substance Abuse, 2014

Most evidence about comorbid addiction and major mental illness comes from the USA, since this li... more Most evidence about comorbid addiction and major mental illness comes from the USA, since this literature remains relatively limited in many European countries. The purpose of this review was to examine prevalence, policies, and treatment systems of comorbid substance misuse and psychotic illness in Europe, illustrating differences and similarities with US findings. Based on computerized main databases searches, a narrative review was performed. The availability of substances but also the social contexts in terms of individual and local issues are factors likely to explain different dual diagnosis prevalence rates in Europe as compared with the USA. Integrated models implemented following US example might perform differently within the context of well-established European Union (EU) community mental health services. Such programs would require additional resources and radical redesign of service delivery systems.

Comprehensive psychiatry, Jan 28, 2014

Psychoneuroendocrinology, Jan 14, 2015

People with schizophrenia are more likely than general population to suffer from metabolic abnorm... more People with schizophrenia are more likely than general population to suffer from metabolic abnormalities, with second-generation antipsychotics (SGAs) increasing the risk. Low plasma adiponectin levels may lead to metabolic dysregulations but evidence in people with schizophrenia, especially for the role of SGAs, is still inconclusive. To compare plasma adiponectin levels between people with schizophrenia and healthy controls, and to estimate the relative effect of schizophrenia and SGAs on adiponectin. We performed a systematic review and meta-analysis of observational studies published up to 13 June 2014 in main electronic databases. Pooled standardized mean differences (SMDs) between index and control groups were generated. Appropriate subanalyses and additional subgroup analyses were carried out. Data from 2735 individuals, 1013 with and 1722 without schizophrenia, respectively, were analysed. Schizophrenia was not associated with lower adiponectin levels (SMD of -0.28, 95%CI: -0.59, 0.04; p=0.09). However, individuals with schizophrenia taking SGAs had plasma levels significantly lower than controls (p=0.002), which was not the case of drug free/drug naïve subjects (p=0.52). As regards single antipsychotic drugs clozapine (p<0.001) and olanzapine (p=0.04) - but not risperidone (p=0.88) - were associated with adiponectin levels lower than controls. People with schizophrenia per se may not have levels of adiponectin lower than controls, though treatment with SGAs is associated with this metabolic abnormality. This bears clinical significance because of hypoadiponectinemia involvement in cardiovascular diseases, even if mechanisms whereby SGAs affect adiponectin remain unexplained. Longitudinal studies evaluating long-term effects of SGAs on adiponectin are needed.

Substance Abuse, 2014

ABSTRACT Background: Binge drinking is common among young people but often relevant risk is not r... more ABSTRACT Background: Binge drinking is common among young people but often relevant risk is not recognized. eHealth apps, attractive for young people, may be useful to enhance awareness of this problem. We aimed at developing a current risk estimation model for binge drinking, incorporated into a eHealth app - D-ARIANNA - for young people. Methods: A longitudinal approach with phase 1 (risk estimation), phase 2 (design), phase 3 (feasibility) was followed. Risk/protective factors identified from the literature were used to develop a current risk estimation model for binge drinking. Relevant odds ratios, were subsequently pooled through meta-analytic techniques with random-effects model, deriving weighted estimates to be introduced in a final model. A set of questions, matching identified risk factors, were nested in a questionnaire, assessed for wording, content and acceptability, in focus groups involving 110 adolescents and young adults. Results: Ten risk (five modifiable), and two protective factors showed significant associations with binge drinking and were included into the model. Their weighted coefficients ranged between -0.71 (school proficiency) and 1.90 (cannabis use). The model, nested in an eHealth app questionnaire, provides in percent an overall current risk score, accompanied by appropriate images. Factors that mostly contribute are shown in summary messages. Minor changes have been realized after focus groups review. Most of the subjects (74%) regarded the eHealth app helpful to assess binge drinking risk. Conclusions: We could produce an evidence-based eHealth app for young people, evaluating current risk for binge drinking. Its effectiveness will be tested in a large trial.

General Hospital Psychiatry, 2014

This study aimed to explore the prevalence of cardiovascular disease (CVD) risk factors in people... more This study aimed to explore the prevalence of cardiovascular disease (CVD) risk factors in people with severe mental illness (SMI), estimating its weight on related risks in Southern Europe, an area with distinct dietary traditions. People with SMI may be more likely than general population to have high prevalence of risk factors for CVDs, due to several reasons, including poor health behaviours and psychopharmacological medications. A cross-sectional study has been conducted, comparing inpatients with and without SMI. Univariate and multivariate analyses and logistic regression models have been carried out, exploring the effect of SMI on the prevalence of CVD risk factors. Although obesity and hypertriglyceridemia were more prevalent among people with SMI, controlling for relevant confounders in multivariate analyses we could not detect any significant difference. People with SMI may not necessarily have higher CVD risk, as compared with general population. Mediterranean healthy dietary habits, universal health coverage, families providing strong support, all are possible explanations for our findings. Further research is needed, exploring different mechanisms, with more detailed biological and genetics measures.

People with severe mental illness (SMI) generally have high rates of metabolic syndrome (MetS). P... more People with severe mental illness (SMI) generally have high rates of metabolic syndrome (MetS). Proposed explanations remain conjectural. Relatively little is known about Mets in SMI in Southern Europe, an area with generally healthy dietary traditions. To establish prevalence rates of MetS in an Italian sample, and testing hypotheses about putative reasons for the excess in the SMI group. We compared the prevalence and correlates of MetS in inpatients with SMI and controls randomly chosen from patients undergoing routine maxillofacial surgery. We employed formal tests of mediation. The MetS prevalence rate was 26.1 % in the SMI group and 15.9 % in the comparison group. After controlling for age, people with SMI were three times more likely to have MetS than their non-SMI counterparts. Smoking and a family history of cardiovascular disease were strongly related to MetS in both groups. However, these factors could not explain the excess of MetS in the SMI group, and we found no effect of antipsychotic dose. SMI remained prominent in increasing the likelihood of MetS in this low prevalence population, and putative determinants of MetS were common to people with SMI and to controls. Explanations for high MetS rates in SMI may lie in health behaviours other than smoking.

Biomed Res Int, 2014

Background. Although binge drinking prevalence and correlates among young people have been extens... more Background. Although binge drinking prevalence and correlates among young people have been extensively studied in the USA and Northern Europe, less is known for Southern Europe countries with relatively healthier drinking cultures. Objective. We aimed at analyzing prevalence and correlates of binge drinking in a representative sample of young adults in Italy. Methods. We conducted a cross-sectional survey among alcohol-consuming young adults. We carried out univariate and multivariate analyses to assess associations between recent binge drinking and candidate variables. Results. We selected 654 subjects, with 590 (mean age: 20.65 ± 1.90) meeting inclusion criteria. Prevalence for recent binge drinking was 38.0%, significantly higher for females than males. Multivariate analysis showed that high alcohol expectancies, large amount of money available during the weekend, interest for parties and discos, female gender, cannabis use, influence by peers, and electronic cigarettes smoking all were significantly associated with recent binge drinking, whereas living with parents appeared a significant protective factor. Conclusions. More than a third of young adults using alcohol are binge drinkers, and, in contrast with findings from Anglo-Saxon countries, females show higher risk as compared with males. These data suggest the increasing importance of primary and secondary prevention programmes for binge drinking.

Both individuals with bipolar (BD) and those with alcohol (AUD) and other substance (SUD) use dis... more Both individuals with bipolar (BD) and those with alcohol (AUD) and other substance (SUD) use disorders are likely to attempt suicide. Comorbidity of BD and AUD/SUD may increase the likelihood of suicide attempts. We conducted a meta-analysis to estimate the association of comorbid AUD/SUD and suicide attempts in subjects with BD in the literature to date. Electronic databases through January 2013 were searched. Studies reporting rates of suicide attempts in people with co-occurring BD and AUD/SUD were retrieved. Comorbid AUD and SUD and suicide attempts rates as well as demographic, clinical, and methodological variables were extracted from each publication or obtained directly from its authors. Twenty-nine of 222 studies assessed for eligibility met the inclusion criteria, comprising a total of 31,294 individuals with BD, of whom 6308 (20.1%) had documented suicide attempts. There were consistent findings across the studies included. As compared to controls, subjects with BD and comorbid AUD/SUD were more likely to attempt suicide. The cross-sectional association estimates showed random-effects pooled crude ORs of 1.96 (95% CI=1.56-2.47; p<0.01), 1.72 (95% CI=1.52-1.95; p<0.01), and 1.77 (95% CI=1.49-2.10; p<0.01), for combined AUD/SUD, AUD, and SUD. There was no publication bias and sensitivity analyses based on the highest quality studies confirmed core results. The effects of the number and the type of suicide attempts could not be investigated due to insufficient information. Comorbid AUD and SUD in individuals with BD are significantly associated with suicide attempts. Individuals with this comorbidity should be targeted for intensive suicide prevention efforts.

Journal of affective disorders, Jan 22, 2014

This study assessed the efficacy of the Falloon model of psychoeducational family intervention (P... more This study assessed the efficacy of the Falloon model of psychoeducational family intervention (PFI), originally developed for schizophrenia management and adapted to bipolar I disorder. The efficacy of the intervention was evaluated in terms of improvement of patients׳ social functioning and reduction of family burden. This was a multicentre, real-world, controlled, outpatient trial carried out in 11 randomly recruited Italian mental health centres. Enroled patients and key-relatives were consecutively allocated either to receive PFI and Treatment As Usual (TAU) or to a waiting list receiving TAU alone. The efficacy of the intervention was evaluated in terms of improvement in patients׳ social functioning (primary outcome) and reduction of family burden (secondary outcome). Of the 137 recruited families, 70 were allocated to the experimental group and 67 to the control group. At the end of the intervention, significant improvements in patients׳ social functioning and in relatives׳ burden were found in the treated group compared to TAU. This effect of the intervention remained also after controlling for several confounding patient׳s socio-demographic and clinical factors. The experimental intervention had an impact also on other outcome measures, such as patients׳ clinical status and personal burden. Lack of an active control group. The results of this study clearly show that the psychoeducational family intervention according to the Falloon model is effective in improving the social outcome of patients with bipolar I disorder.

Addictive Behaviors

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has made s... more The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has made several changes to criteria for alcohol use disorder (AUD). The objective of this systematic review is to assess if new DSM-5 diagnostic criteria will increase the prevalence rates of AUD in clinical and non-clinical samples as compared with DSM-IV criteria. We searched PubMed, Scopus, and PsycINFO (via ProQuest) electronic databases, with no language restrictions. We included studies with data available on both DSM-IV (and DSM-IV-TR) and DSM-5 AUD in samples of adults, estimating from each study an expected increase in prevalence rates with relevant 95% confidence intervals (CIs). Twelve studies were included in this review. Seven studies showed an increase, two no substantial difference, and three a decrease in AUD prevalence according to DSM-5 diagnostic criteria, with differences in rates (95% CIs) varying between -12.4% (-27.4 to +5.6%) and +61.3% (+46.7 to +77.3%). Additional analyses provided confirmatory results. DSM-5 diagnostic criteria seem to inflate prevalence rates of AUD as compared with DSM-IV. The increasing likelihood of a DSM-5 AUD diagnosis may be explained by the amount of DSM-IV 'diagnostic orphans' which are more prevalent than DSM-IV single-criterion alcohol abuse individuals. Further research should be aimed to study if similar trends are detectable also for other substance use disorders that experienced similar changes in DSM-5 diagnostic criteria.

Drug and Alcohol Dependence, 2014

Background: Assessing factors associated with non-fatal overdose is important as these could be u... more Background: Assessing factors associated with non-fatal overdose is important as these could be useful to identify individuals with substance use disorders at high risk of adverse outcomes and consequences. Depression may play an important role in terms of overdose risk. We aimed to test if drug users suffering from a depressive disorder might have significantly higher risk of non-fatal overdose as compared with drug users without depression. Methods: We conducted a systematic review and meta-analysis. PubMed, Embase and Web of Knowledge were searched. The pooled analyses were based on prevalence rates, risk difference (RD) and odds ratio (OR), reporting 95% confidence intervals (CIs). The combined estimates were obtained weighting each study according to random effects model for meta-analysis. Results: Seven articles, involving 12,019 individuals, and run in the US, Canada, Sweden, Norway, and Australia, were included. Pooled analyses comparing depressed with not depressed individuals highlighted a RD (95% CIs) for non-fatal overdose of 7.3% (4.8-9.7%) and an OR (95% CIs) of 1.45 (1.17-1.79). The subgroups analyses based on specific characteristics of included studies confirmed the association between depression and overdose. Conclusions: Depressive disorders seem to be important factors associated to the risk of non-fatal overdose. Longitudinal studies might appropriately clarify causal inference issues. Future research should address the role of depressive disorders as predictors of subsequent non-fatal overdoses.

Award => app FeelEat by Cristina Crocamo

Knowledge and curiosity. Evidence-based FeelEat app is a practical and concrete tool, aimed at ex... more Knowledge and curiosity. Evidence-based FeelEat app is a practical and concrete tool, aimed at exploring and discovering the relationship between food and emotional and psychological well-being. Psychological well-being is related to many aspects that affect the daily life: lifestyle, relationships, dietary habits, episodes of stress, work status, but also the role of social networks and the Internet, especially in younger people. Science and everyday life together in an extraordinary discovery.
The starting point is nutrition and emotions. Dietary habits are frequently characterized and influenced by stereotypes and beliefs that are also suggestive for our feelings.
The project proposes a thematic itinerary that is as stimulus for our knowledge, suggesting to reflect on the two-way relationship between dietary habits and psychological well-being through interactive sections. In English, Italian, and French.

FeelEat is available on Google Play store, App store, and also in a web version
https://play.google.com/store/apps/details?id=com.phonegap.appfood&hl=en
https://itunes.apple.com/en/app/id980220440?mt=8

*developed for Fondazione Varenna for Expo Milano 2015 (Food&Mood contest)
*IT Consulting-App programming Marco Cinquegrani (https://it.linkedin.com/pub/marco-cinquegrani/a2/b17/517)

Substance Abuse, 2014

Most evidence about comorbid addiction and major mental illness comes from the USA, since this li... more Most evidence about comorbid addiction and major mental illness comes from the USA, since this literature remains relatively limited in many European countries. The purpose of this review was to examine prevalence, policies, and treatment systems of comorbid substance misuse and psychotic illness in Europe, illustrating differences and similarities with US findings. Based on computerized main databases searches, a narrative review was performed. The availability of substances but also the social contexts in terms of individual and local issues are factors likely to explain different dual diagnosis prevalence rates in Europe as compared with the USA. Integrated models implemented following US example might perform differently within the context of well-established European Union (EU) community mental health services. Such programs would require additional resources and radical redesign of service delivery systems.

Comprehensive psychiatry, Jan 28, 2014

Psychoneuroendocrinology, Jan 14, 2015

People with schizophrenia are more likely than general population to suffer from metabolic abnorm... more People with schizophrenia are more likely than general population to suffer from metabolic abnormalities, with second-generation antipsychotics (SGAs) increasing the risk. Low plasma adiponectin levels may lead to metabolic dysregulations but evidence in people with schizophrenia, especially for the role of SGAs, is still inconclusive. To compare plasma adiponectin levels between people with schizophrenia and healthy controls, and to estimate the relative effect of schizophrenia and SGAs on adiponectin. We performed a systematic review and meta-analysis of observational studies published up to 13 June 2014 in main electronic databases. Pooled standardized mean differences (SMDs) between index and control groups were generated. Appropriate subanalyses and additional subgroup analyses were carried out. Data from 2735 individuals, 1013 with and 1722 without schizophrenia, respectively, were analysed. Schizophrenia was not associated with lower adiponectin levels (SMD of -0.28, 95%CI: -0.59, 0.04; p=0.09). However, individuals with schizophrenia taking SGAs had plasma levels significantly lower than controls (p=0.002), which was not the case of drug free/drug naïve subjects (p=0.52). As regards single antipsychotic drugs clozapine (p<0.001) and olanzapine (p=0.04) - but not risperidone (p=0.88) - were associated with adiponectin levels lower than controls. People with schizophrenia per se may not have levels of adiponectin lower than controls, though treatment with SGAs is associated with this metabolic abnormality. This bears clinical significance because of hypoadiponectinemia involvement in cardiovascular diseases, even if mechanisms whereby SGAs affect adiponectin remain unexplained. Longitudinal studies evaluating long-term effects of SGAs on adiponectin are needed.

Substance Abuse, 2014

ABSTRACT Background: Binge drinking is common among young people but often relevant risk is not r... more ABSTRACT Background: Binge drinking is common among young people but often relevant risk is not recognized. eHealth apps, attractive for young people, may be useful to enhance awareness of this problem. We aimed at developing a current risk estimation model for binge drinking, incorporated into a eHealth app - D-ARIANNA - for young people. Methods: A longitudinal approach with phase 1 (risk estimation), phase 2 (design), phase 3 (feasibility) was followed. Risk/protective factors identified from the literature were used to develop a current risk estimation model for binge drinking. Relevant odds ratios, were subsequently pooled through meta-analytic techniques with random-effects model, deriving weighted estimates to be introduced in a final model. A set of questions, matching identified risk factors, were nested in a questionnaire, assessed for wording, content and acceptability, in focus groups involving 110 adolescents and young adults. Results: Ten risk (five modifiable), and two protective factors showed significant associations with binge drinking and were included into the model. Their weighted coefficients ranged between -0.71 (school proficiency) and 1.90 (cannabis use). The model, nested in an eHealth app questionnaire, provides in percent an overall current risk score, accompanied by appropriate images. Factors that mostly contribute are shown in summary messages. Minor changes have been realized after focus groups review. Most of the subjects (74%) regarded the eHealth app helpful to assess binge drinking risk. Conclusions: We could produce an evidence-based eHealth app for young people, evaluating current risk for binge drinking. Its effectiveness will be tested in a large trial.

General Hospital Psychiatry, 2014

This study aimed to explore the prevalence of cardiovascular disease (CVD) risk factors in people... more This study aimed to explore the prevalence of cardiovascular disease (CVD) risk factors in people with severe mental illness (SMI), estimating its weight on related risks in Southern Europe, an area with distinct dietary traditions. People with SMI may be more likely than general population to have high prevalence of risk factors for CVDs, due to several reasons, including poor health behaviours and psychopharmacological medications. A cross-sectional study has been conducted, comparing inpatients with and without SMI. Univariate and multivariate analyses and logistic regression models have been carried out, exploring the effect of SMI on the prevalence of CVD risk factors. Although obesity and hypertriglyceridemia were more prevalent among people with SMI, controlling for relevant confounders in multivariate analyses we could not detect any significant difference. People with SMI may not necessarily have higher CVD risk, as compared with general population. Mediterranean healthy dietary habits, universal health coverage, families providing strong support, all are possible explanations for our findings. Further research is needed, exploring different mechanisms, with more detailed biological and genetics measures.

People with severe mental illness (SMI) generally have high rates of metabolic syndrome (MetS). P... more People with severe mental illness (SMI) generally have high rates of metabolic syndrome (MetS). Proposed explanations remain conjectural. Relatively little is known about Mets in SMI in Southern Europe, an area with generally healthy dietary traditions. To establish prevalence rates of MetS in an Italian sample, and testing hypotheses about putative reasons for the excess in the SMI group. We compared the prevalence and correlates of MetS in inpatients with SMI and controls randomly chosen from patients undergoing routine maxillofacial surgery. We employed formal tests of mediation. The MetS prevalence rate was 26.1 % in the SMI group and 15.9 % in the comparison group. After controlling for age, people with SMI were three times more likely to have MetS than their non-SMI counterparts. Smoking and a family history of cardiovascular disease were strongly related to MetS in both groups. However, these factors could not explain the excess of MetS in the SMI group, and we found no effect of antipsychotic dose. SMI remained prominent in increasing the likelihood of MetS in this low prevalence population, and putative determinants of MetS were common to people with SMI and to controls. Explanations for high MetS rates in SMI may lie in health behaviours other than smoking.

Biomed Res Int, 2014

Background. Although binge drinking prevalence and correlates among young people have been extens... more Background. Although binge drinking prevalence and correlates among young people have been extensively studied in the USA and Northern Europe, less is known for Southern Europe countries with relatively healthier drinking cultures. Objective. We aimed at analyzing prevalence and correlates of binge drinking in a representative sample of young adults in Italy. Methods. We conducted a cross-sectional survey among alcohol-consuming young adults. We carried out univariate and multivariate analyses to assess associations between recent binge drinking and candidate variables. Results. We selected 654 subjects, with 590 (mean age: 20.65 ± 1.90) meeting inclusion criteria. Prevalence for recent binge drinking was 38.0%, significantly higher for females than males. Multivariate analysis showed that high alcohol expectancies, large amount of money available during the weekend, interest for parties and discos, female gender, cannabis use, influence by peers, and electronic cigarettes smoking all were significantly associated with recent binge drinking, whereas living with parents appeared a significant protective factor. Conclusions. More than a third of young adults using alcohol are binge drinkers, and, in contrast with findings from Anglo-Saxon countries, females show higher risk as compared with males. These data suggest the increasing importance of primary and secondary prevention programmes for binge drinking.

Both individuals with bipolar (BD) and those with alcohol (AUD) and other substance (SUD) use dis... more Both individuals with bipolar (BD) and those with alcohol (AUD) and other substance (SUD) use disorders are likely to attempt suicide. Comorbidity of BD and AUD/SUD may increase the likelihood of suicide attempts. We conducted a meta-analysis to estimate the association of comorbid AUD/SUD and suicide attempts in subjects with BD in the literature to date. Electronic databases through January 2013 were searched. Studies reporting rates of suicide attempts in people with co-occurring BD and AUD/SUD were retrieved. Comorbid AUD and SUD and suicide attempts rates as well as demographic, clinical, and methodological variables were extracted from each publication or obtained directly from its authors. Twenty-nine of 222 studies assessed for eligibility met the inclusion criteria, comprising a total of 31,294 individuals with BD, of whom 6308 (20.1%) had documented suicide attempts. There were consistent findings across the studies included. As compared to controls, subjects with BD and comorbid AUD/SUD were more likely to attempt suicide. The cross-sectional association estimates showed random-effects pooled crude ORs of 1.96 (95% CI=1.56-2.47; p<0.01), 1.72 (95% CI=1.52-1.95; p<0.01), and 1.77 (95% CI=1.49-2.10; p<0.01), for combined AUD/SUD, AUD, and SUD. There was no publication bias and sensitivity analyses based on the highest quality studies confirmed core results. The effects of the number and the type of suicide attempts could not be investigated due to insufficient information. Comorbid AUD and SUD in individuals with BD are significantly associated with suicide attempts. Individuals with this comorbidity should be targeted for intensive suicide prevention efforts.

Journal of affective disorders, Jan 22, 2014

This study assessed the efficacy of the Falloon model of psychoeducational family intervention (P... more This study assessed the efficacy of the Falloon model of psychoeducational family intervention (PFI), originally developed for schizophrenia management and adapted to bipolar I disorder. The efficacy of the intervention was evaluated in terms of improvement of patients׳ social functioning and reduction of family burden. This was a multicentre, real-world, controlled, outpatient trial carried out in 11 randomly recruited Italian mental health centres. Enroled patients and key-relatives were consecutively allocated either to receive PFI and Treatment As Usual (TAU) or to a waiting list receiving TAU alone. The efficacy of the intervention was evaluated in terms of improvement in patients׳ social functioning (primary outcome) and reduction of family burden (secondary outcome). Of the 137 recruited families, 70 were allocated to the experimental group and 67 to the control group. At the end of the intervention, significant improvements in patients׳ social functioning and in relatives׳ burden were found in the treated group compared to TAU. This effect of the intervention remained also after controlling for several confounding patient׳s socio-demographic and clinical factors. The experimental intervention had an impact also on other outcome measures, such as patients׳ clinical status and personal burden. Lack of an active control group. The results of this study clearly show that the psychoeducational family intervention according to the Falloon model is effective in improving the social outcome of patients with bipolar I disorder.

Addictive Behaviors

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has made s... more The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has made several changes to criteria for alcohol use disorder (AUD). The objective of this systematic review is to assess if new DSM-5 diagnostic criteria will increase the prevalence rates of AUD in clinical and non-clinical samples as compared with DSM-IV criteria. We searched PubMed, Scopus, and PsycINFO (via ProQuest) electronic databases, with no language restrictions. We included studies with data available on both DSM-IV (and DSM-IV-TR) and DSM-5 AUD in samples of adults, estimating from each study an expected increase in prevalence rates with relevant 95% confidence intervals (CIs). Twelve studies were included in this review. Seven studies showed an increase, two no substantial difference, and three a decrease in AUD prevalence according to DSM-5 diagnostic criteria, with differences in rates (95% CIs) varying between -12.4% (-27.4 to +5.6%) and +61.3% (+46.7 to +77.3%). Additional analyses provided confirmatory results. DSM-5 diagnostic criteria seem to inflate prevalence rates of AUD as compared with DSM-IV. The increasing likelihood of a DSM-5 AUD diagnosis may be explained by the amount of DSM-IV 'diagnostic orphans' which are more prevalent than DSM-IV single-criterion alcohol abuse individuals. Further research should be aimed to study if similar trends are detectable also for other substance use disorders that experienced similar changes in DSM-5 diagnostic criteria.

Drug and Alcohol Dependence, 2014

Background: Assessing factors associated with non-fatal overdose is important as these could be u... more Background: Assessing factors associated with non-fatal overdose is important as these could be useful to identify individuals with substance use disorders at high risk of adverse outcomes and consequences. Depression may play an important role in terms of overdose risk. We aimed to test if drug users suffering from a depressive disorder might have significantly higher risk of non-fatal overdose as compared with drug users without depression. Methods: We conducted a systematic review and meta-analysis. PubMed, Embase and Web of Knowledge were searched. The pooled analyses were based on prevalence rates, risk difference (RD) and odds ratio (OR), reporting 95% confidence intervals (CIs). The combined estimates were obtained weighting each study according to random effects model for meta-analysis. Results: Seven articles, involving 12,019 individuals, and run in the US, Canada, Sweden, Norway, and Australia, were included. Pooled analyses comparing depressed with not depressed individuals highlighted a RD (95% CIs) for non-fatal overdose of 7.3% (4.8-9.7%) and an OR (95% CIs) of 1.45 (1.17-1.79). The subgroups analyses based on specific characteristics of included studies confirmed the association between depression and overdose. Conclusions: Depressive disorders seem to be important factors associated to the risk of non-fatal overdose. Longitudinal studies might appropriately clarify causal inference issues. Future research should address the role of depressive disorders as predictors of subsequent non-fatal overdoses.

Knowledge and curiosity. Evidence-based FeelEat app is a practical and concrete tool, aimed at ex... more Knowledge and curiosity. Evidence-based FeelEat app is a practical and concrete tool, aimed at exploring and discovering the relationship between food and emotional and psychological well-being. Psychological well-being is related to many aspects that affect the daily life: lifestyle, relationships, dietary habits, episodes of stress, work status, but also the role of social networks and the Internet, especially in younger people. Science and everyday life together in an extraordinary discovery.
The starting point is nutrition and emotions. Dietary habits are frequently characterized and influenced by stereotypes and beliefs that are also suggestive for our feelings.
The project proposes a thematic itinerary that is as stimulus for our knowledge, suggesting to reflect on the two-way relationship between dietary habits and psychological well-being through interactive sections. In English, Italian, and French.

FeelEat is available on Google Play store, App store, and also in a web version
https://play.google.com/store/apps/details?id=com.phonegap.appfood&hl=en
https://itunes.apple.com/en/app/id980220440?mt=8

*developed for Fondazione Varenna for Expo Milano 2015 (Food&Mood contest)
*IT Consulting-App programming Marco Cinquegrani (https://it.linkedin.com/pub/marco-cinquegrani/a2/b17/517)