BACKGROUND/OBJECTIVES:Lithium (Li), silicon (Si), and boron (B) are proposed nutritional trace elements with potential roles in metabolic, neurobiological, endocrine, inflammatory, and bone-related processes. This review provides a critical synthesis of data on Li-Si-B, emphasizing (i) physiological and mechanistic pathways, (ii) human clinical relevance, (iii) shared biological domains, and (iv) safety considerations. METHODS:A narrative review was conducted across PubMed, Scopus, and Web of Science from inception to January 2025. Predefined search strings targeted dietary, environmental, and supplemental exposures of lithium, silicon, or boron in relation to metabolism, endocrine function, neurobiology, inflammation, bone health, and the gut microbiome. Inclusion criteria required peer-reviewed studies in English. Data extraction followed a structured template, and evidence was stratified into human, animal, cellular, and ecological tiers. Methodological limitations were critically appraised. RESULTS:Li, Si, and B influence overlapping molecular pathways including oxidative stress modulation, mitochondrial stability, inflammatory signaling, endocrine regulation, and epithelial/gut barrier function. Human evidence remains limited: Li is supported primarily by small trials; Si by bone-related observational studies and biomarker-oriented interventions; and B by metabolic, inflammatory, and cognitive studies of modest sample size. Convergence across elements appears in redox control, barrier function, and neuroimmune interactions, but mechanistic synergism remains hypothetical. CONCLUSIONS:Although Li-Si-B display compelling mechanistic potential, current human data are insufficient to justify dietary recommendations or supplementation. Considerable research gaps-including exposure assessment, dose-response characterization, toxicity thresholds, and controlled human trials-must be addressed before translation into public health policy.

OBJECTIVE:Major depressive disorder (MDD) is a prevalent disabling condition, with psychotic features complicating its course and management. Purpose of the study is to identify clinical and biochemical factors differentiating psychotic from non-psychotic MDD. METHODS:This is a retrospective single-centre study conducted on patients hospitalised between 2002 and 2022 at Fondazione IRCCS Policlinico (Milan, Italy) with a diagnosis of MDD. A large set of clinical and biochemical variables was collected on the first day of hospitalisation. Patients were divided according to the presence or absence of lifetime psychotic symptoms and compared by Student's t-test for continuous variables and Chi-square tests for categorical ones. The statistically significant continuous variables were inserted in a binary logistic regression model as independent predictors of lifetime psychotic symptoms. RESULTS:No statistically significant differences in biochemical parameters (p > 0.05) were found in the two groups. The logistic regression model showed that depressed patients with lifetime psychotic symptoms had a significant longer duration of hospitalisation (p = 0.007), more lifetime suicide attempts (p = 0.035) and higher BPRS scores (p = 0.004) than the counterpart. CONCLUSIONS:Lifetime psychotic symptoms confer a more severe course of illness in patients with MDD. No biochemical parameter resulted as a biomarker of MDD psychotic subtype.

OBJECTIVE:Anorexia nervosa (AN) presents the highest rate of mortality among psychiatric disorders, making an early diagnosis and proper management essential. The purpose of the study was to investigate the role of duration of untreated illness (DUI) on the course and biochemical parameters in a sample of 76 female patients with AN. METHOD:Correlation analyses and one-way analyses of variance were performed to analyze the relation between DUI and quantitative and qualitative variables, respectively. Statistically significant factors from correlation analyses were inserted in a linear regression model as independent variables with the DUI as the dependent variable. RESULTS:A longer DUI was directly correlated with age (r = 0.35, p < 0.01), duration of illness (r = 0.61, p < 0.01), potassium (K) plasma levels (r = 0.47, p = 0.02), and platelet/lymphocyte ratio (PLR) (r = 0.25, p = 0.04). A longer DUI was inversely correlated with the sodium/potassium ratio (Na/K) (r = -0.42, p = 0.047). Linear regression analysis confirmed the direct association between a longer DUI with age (B = 0.12, p = 0.01) and K levels (B = 3.18, p = 0.017). DISCUSSION:The higher K plasma levels in patients with longer DUI may indicate an abuse of supplements and/or an alteration of the hypothalamus-pituitary-axis (HPA) or renin-angiotensin systems. In support of this hypothesis, alterations in PLR were identified in subjects with abnormal bone mineral density. Further research is needed to confirm the present findings.

Background/Objectives: Mediterranean diet (MD) adherence is associated with a lower risk of developing several chronic diseases, including cardiovascular and metabolic disorders, cancer, and mental health diseases. University students are vulnerable to mental disorders that considerably affect their well-being and quality of life, which may be ascribed to the stressful environment during their academic studies. This cross-sectional survey designed to explore the relationship between MD compliance and perceived stress levels as well as sleep quality in a representative sample of university students from Greece. Methods: This survey assigned 5433 university students from 10 Greek regions. We used qualified questionnaires to examine the socio-demographics of the assigned students. Anthropometrics were determined by qualified methods. Validated questionnaires were used to determine diverse lifestyle factors like physical activity, perceived stress, sleep quality and MD adherence. Results: Concerning the primary objectives of this study, greater MD compliance was independently and significantly related to lower incidence of perceived stress and poor sleep quality in university students. As far as the secondary objectives of this study concern, greater MD compliance was independently and significantly related to female gender, rural type of residence, living with family, smoking, biomedicine studies, being normal weight, and having enhanced physical activity. Conclusions: This study reinforces the idea that healthy dietary patterns like MD could be a significant modifiable factor against perceived stress and poor sleep quality of university students. Based on this evidence, longitudinal studies should be performed to confirm whether MD can exert a causal effect on perceived stress and sleep quality.

Background/Objectives: The COVID-19 pandemic has led to detrimental effects on diverse aspects of the mental and physical health of the general population worldwide. The elderly are more susceptible to COVID-19 infection compared to younger age groups. In this aspect, the purpose of the current survey is to evaluate the effect of the COVID-19 pandemic on the interrelationships among the sociodemographic and anthropometric characteristics, depressive behavior, quality of life, cognition status, physical activity and nutritional status of older adults. Methods: The present study constitutes a comparative, cross-sectional study of 4162 older adults (mean age ± standard deviation: 72.13 ± 8.1 years and 75.22 ± 8.2 years in the pre- and post-COVID-19 periods, respectively, and a male/female ratio of almost 1:1). We used validated questionnaires to assess depression, cognition function, quality of life, physical activity and nutritional status of the elderly in the pre-Covid and post-Covid periods. Relevant questionnaires were also used for collecting sociodemographic data, while anthropometric data were measured using standard protocols. Results: The present study finds that the COVID-19 pandemic influenced, in an independent manner, residence location, smoking status, overweight/obesity and abdominal obesity, depressive behavior, quality of life, cognition behavior, physical activity levels and nutritional status of the elderly. The COVID-19 pandemic was also related to employment and living status as well as family economic status. Nevertheless, the above three relationships were insignificant in the multivariate analysis. Conclusions: The COVID-19 pandemic exerted deleterious effects on several aspects of the mental and physical health of the elderly, which appeared to strongly persist in the post-Covid period. Future prospective population-based and well-organized surveys should be conducted to establish whether there is a causality long-term effect of the COVID-19 pandemic on diverse aspects of the mental and physical health of the elderly.

In the last few years, nutritional and lifestyle psychiatry has emerged as a novel scientific topic, highlighting the impact of nutrition and lifestyle in the onset, prevention and management of diverse mental diseases [...]

Background/Objectives: Emotional eating has been considered as a trend to consume energy concentrated and tasty foods in response to adverse emotions. Emotional eating may harmfully influence physical and mental health among university students, worsening their daily quality of life and their academic performance. The aim of the present study is to critically summarize and analyze the currently available clinical data concerning the impact of emotional eating among university students. Methods: Comprehensive exploration of the currently available scientific literature was performed in the most precise scientific databases, utilizing relevant and representative keywords. Results: More than a few interrelationships were found between emotional eating and body mass index, physical activity, depression, anxiety, stress, social media overuse, nutritional behaviors, and COVID-19 lockdown concerning university students. Conclusions: The currently available clinical studies support evidence that there are significant intercorrelations between emotional eating and several aspects of physical and mental health of university students. However, most of them have a cross-sectional design that cannot establish causality effects. In this respect, prospective surveys are strongly required to delineate the impact of emotional eating in the daily life of university students.

Background: Anorexia nervosa (AN) has the highest mortality rate among psychiatric disorders, making early diagnosis and tailored management crucial. This study aimed to evaluate the impact of age at onset (AAO)—childhood/adolescence versus adulthood—on the clinical course and associated biochemical parameters. Methods: Seventy-six female patients with AN were divided into two groups based on AAO (<18 years vs. ≥18 years). Group comparisons were performed using t-tests for continuous variables and χ2 tests for categorical variables. Correlation analyses assessed associations between AAO and continuous variables. Significant findings were entered into regression models, including a binary logistic regression with AAO as the dependent variable and a linear regression with significant correlations as predictors. Results: The early-onset group showed significantly higher potassium levels and a lower sodium/potassium ratio (Na+/K+) compared with the late-onset group (potassium: t = 0.93, p < 0.01; Na+/K+: t = 3.39, p < 0.01). AAO was strongly inversely correlated with potassium levels (r = −0.75, p < 0.01) and positively correlated with cholesterol (r = 0.574, p < 0.01) and Na+/K+ (r = 0.78, p = 0.01). Binary logistic regression correctly classified 87% of cases, showing that lower Na+/K+ was associated with earlier onset (OR = 2.23, p = 0.03). Linear regression confirmed significant associations of AAO with cholesterol levels (B = 0.07, p = 0.02) and Na+/K+ (B = 1.68, p < 0.01). Conclusions: AAO in AN is strongly associated with specific biochemical parameters. Early-onset patients exhibit more severe electrolyte imbalances, while late-onset cases show higher cholesterol levels, suggesting increased cardiovascular risk. These findings emphasize the importance of personalized treatment approaches according to AAO, although further studies are warranted to confirm these results.

Background: There has been recent evidence to suggest that people who suffer from eating disorders (EDs) or other eating behavior disturbances, such as emotional eating (EE), are particularly vulnerable post-COVID-19. This narrative literature review aims to comprehensively analyze and scrutinize the existing clinical studies regarding the effects of the COVID-19 pandemic on people with EDs or EE. Moreover, due to the COVID-19 pandemic, it is very important to find out whether a person’s emotional state may lead them to wrongly confront their emotional behavior with food consumption. Methods: A thorough search of several databases (PubMed, Scopus, Web of Science, Public Library of Science, Google Scholar, CINAHL Complete, PsycINFO, and Academic Search Complete) was performed to identify available clinical studies on the COVID-19 pandemic published between 2020 and 2024 using relevant keywords. Results: There is substantial evidence that the COVID-19 pandemic exerted negative effects on persons suffering from EDs, including those who are symptomatic, those who are in remission, and those with an EE behavior. Characteristically, people diagnosed with anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED) showed considerable symptomatic worsening after the first wave of the COVID-19 pandemic. Clinical studies investigating the effects of the COVID-19 pandemic on persons suffering from EE have also clearly demonstrated that their mood disturbances negatively affected their eating behaviors. These studies have also shown that vulnerable people were at greater risk of EE development and progression during the COVID-19 pandemic. Conclusion: The COVID-19 pandemic seems to have exerted a significant deleterious effect on people who have a history of suffering from EDs or EE. The COVID-19 pandemic has been related to the frequency of dysfunctional eating behaviors, thus decreasing therapeutic intervention efficiency in people with EDs as well as in those with disturbed eating behaviors such as EE. In this aspect, further clinical studies are strongly recommended to investigate the exact effects of the COVID-19 pandemic as well as to explore their potential long-term deleterious complications in the post-pandemic period. Public strategies and policies should be applied to provide special healthcare for this group of patients.

OBJECTIVE:To investigate demographic/cinical variables associated to dual diagnosis and the psychological reaction of dual-diagnosis patients to COVID-19 pandemic. METHODS:Information was collected at the Addiction Service of Monza, Italy. The Impact of Event Scale-Revised (IES-R), a self-report questionnaire measuring the subjective response to a traumatic event, was administered. Univariate analyses and binary logistic regression were performed. IES-R scores were compared between groups defined by qualitative variables through one-way analyses of variance (ANOVA). RESULTS:118 outpatients were included, 48.3% with dual diagnosis. Alcohol use disorder and being female were associated to dual diagnosis. IES-R scores were significantly higher in the dual-diagnosis group, especially for personality disorders (PDs). IES-R scores were higher in patients taking treatment for substance use disorder (SUD). CONCLUSIONS:Females and alcohol abusers were at-risk subjects for dual diagnosis. Patients with SUD and PDs may benefit from additional support, especially when traumatic life events occur. TRIAL REGISTRATION:ClinicalTrials.gov Identifier: NCT04694482.

The aim of the present study was to investigate the potential associations between clinical/socio-demographic variables and the presence of purging/binge-eating episodes in eating disorders (EDs). Clinical/socio-demographic variables and psychometric scores were collected. Groups of patients were identified according to the presence or absence of purging or objective binge-eating episodes (OBEs) and compared through t-test and chi-square tests. Binary logistic regression analyses were run. A sample of 51 ED outpatients was recruited. Patients with purging behaviors had a longer duration of untreated illness (DUI) (t = 1.672; p = 0.019) and smoked a higher number of cigarettes/day (t = 1.061; p = 0.030) compared to their counterparts. A lower BMI was associated with purging (OR = 0.881; p = 0.035), and an older age at onset showed a trend towards statistical significance (OR = 1.153; p = 0.061). Patients with OBEs, compared to their counterparts, were older (t = 0.095; p < 0.001), more frequently presented a diagnosis of bulimia or binge-eating disorder (χ2 = 26.693; p < 0.001), a longer duration of illness (t = 2.162; p = 0.019), a higher number of hospitalizations (t = 1.301; p = 0.012), and more often received a prescription for pharmacological treatment (χ2 = 7.864; OR = 6.000; p = 0.005). A longer duration of the last pharmacological treatment was associated with OBE (OR = 1.569; p = 0.046). In contrast to purging, OBE was associated with a more complicated and severe presentation of ED. A lower BMI and a later age at onset, as well as long-lasting previous pharmacological treatments, may predict the presence of purging/binging. Further research is needed to thoroughly characterize ED features and corroborate our preliminary findings.

The COVID-19 pandemic has been a pivotal event, reshaping many aspects of daily life and public health across the globe [...]

Alcohol use disorder’s complexity arises from genetic and environmental factors, with alcohol metabolism genes and neurotransmitter pathways being critical. This study aims to analyze synaptic plasticity gene expression changes in individuals with AUD in order to study their contribution to AUD development and to identify potential biomarkers of treatment response. RNA was extracted from whole peripheral blood (20 patients, 10 healthy controls), before and after treatment (Qiagen AllPrep RNA/DNA Mini Kit), and the gene expression of 84 genes related to neuroplasticity was studied using the RT2 Profiler for Human Synaptic Plasticity RT-PCR Array (PAHS-126ZA, Qiagen), comparing AUD patients to control and responders to non-responders. The potential prognostic/predictive biomarkers were searched using machine learning models. A total of 35 dysregulated genes were found in AUD patients. EPHB2, EGR, and AKT1 were increased, while TIMP1, NCAM1, and GRM2 were decreased. Responders showed distinct gene expression profiles at baseline. After treatment, the expression of 57 genes was normalized, while NCAM1, GRM2, and BDNF showed the most significant recovery. EGR4, INHBA, and NCAM1 emerged as potential biomarkers to predict treatment success. These results indicate that gene profiles in peripheral blood can serve as prognostic markers for the prognosis and treatment of AUD, although further validation is required.

Background: The ketogenic diet (KD) has been highly developed in the past for the treatment of epileptic pathological states in children and adults. Recently, the current re-emergence in its popularity mainly focuses on the therapy of cardiometabolic diseases. The KD can also have anti-inflammatory and neuroprotective activities which may be applied to the prevention and/or co-treatment of a diverse range of psychiatric disorders. Purpose: This is a comprehensive literature review that intends to critically collect and scrutinize the pre-existing research basis and clinical data of the potential advantageous impacts of a KD on stress, anxiety, depression, schizophrenia and bipolar disorder. Methods: This literature review was performed to thoroughly represent the existing research in this topic, as well as to find gaps in the international scientific community. In this aspect, we carefully investigated the ultimate scientific web databases, e.g., PubMed, Scopus, and Web of Science, to derive the currently available animal and clinical human surveys by using efficient and representative keywords. Results: Just in recent years, an increasing amount of animal and clinical human surveys have focused on investigating the possible impacts of the KD in the prevention and co-treatment of depression, anxiety, stress, schizophrenia, and bipolar disorder. Pre-existing basic research with animal studies has consistently demonstrated promising results of the KD, showing a propensity to ameliorate symptoms of depression, anxiety, stress, schizophrenia, and bipolar disorder. However, the translation of these findings to clinical settings presents a more complex issue. The majority of the currently available clinical surveys seem to be moderate, usually not controlled, and have mainly assessed the short-term effects of a KD. In addition, some clinical surveys appear to be characterized by enormous dropout rates and significant absence of compliance measurement, as well as an elevated amount of heterogeneity in their methodological design. Conclusions: Although the currently available evidence seems promising, it is highly recommended to accomplish larger, long-term, randomized, double-blind, controlled clinical trials with a prospective design, in order to derive conclusive results as to whether KD could act as a potential preventative factor or even a co-treatment agent against stress, anxiety, depression, schizophrenia, and bipolar disorder. Basic research with animal studies is also recommended to examine the molecular mechanisms of KD against the above psychiatric diseases.

No systematic review has been conducted to provide an overview of the effectiveness of psychoanalysis for treatment outcomes in bipolar depression and mania. The present study undertakes a scoping review of the effectiveness of psychoanalysis for bipolar disorder (BD), provides a summary of the evidence base, and identifies issues for future research in this area. A thorough search of journal articles in MEDLINE, PEP-Web, PsycINFO, Scopus, and the Web of Science was carried out to obtain available studies on psychoanalytic treatment for BD published from 1990 to 2021. We searched for either quantitative or single-case studies. Twenty-six single-case reports from 21 articles and no quantitative studies met the inclusion criteria. A qualitative analysis suggests efficacy and cost-effectiveness but thus far there is no scientific evidence in support of psychoanalysis. Although these pilot findings suggest that psychoanalysis may impact symptoms and global functioning in individuals with BD, the underlying evidence is poor and should be confirmed by experimental studies.

A strong interplay exists between sleep and dietary habits, and sleep disturbances have been repeatedly documented in individuals with eating disorders (EDs). The orexin system – implicated in sleep regulation, energy homeostasis, and food reward - may represent a mechanist link between sleep alterations and disordered eating behaviors. Daridorexant is a dual orexin receptor antagonist (DORA) recently approved for the treatment of insomnia, with demonstrated efficacy and tolerability. Owing to its action on orexin neurons, the compound represents an intriguing option for addressing both sleep-related and core symptoms of EDs. By inhibiting motor hyperactivity, daridorexant may reduce excessive physical exercise in individuals with anorexia nervosa (AN) restricting type. Additionally, the compound may exert anti-binge effects, suggesting broad applicability in binge ED, bulimia nervosa, and binge/purging AN. In this framework, daridorexant emerges as a promising therapeutic option, offering a multifaceted approach to improving circadian rhythms, energy balance, and overall quality of life in individuals with diverse ED subtypes.

Background: The Mediterranean diet (MD) is well-known as a diet which may exert a protective effect against neurodegenerative diseases, including multiple sclerosis (MS). To date, only a few clinical surveys have assessed the potential effects of the MD in patients with MS. The purpose of the present study is to evaluate the potential effects of MD compliance on disease disability, quality of life, physical activity, depressive symptomatology, and blood biochemical parameters related to nutritional status in MS patients, considering several socio-demographic, anthropometric, and lifestyle characteristics. Methods: This is a cross-sectional study conducted on 558 adults with MS aged 18–64 years. Relevant questionnaires were utilized to evaluate socio-demographic and anthropometric parameters, disease disability (Expanded Disability Status Scale, EDSS), multidimensional health-related quality (MS Quality of Life-54, MSQOL-54), physical activity levels (International Physical Activity Questionnaire, IPAQ), depression (Beck Depression Inventory II, BDI-II), and MD adherence (MedDietScore), while several blood biochemical parameters were retrieved from the patients’ medical records. Results: Enhanced MD compliance was independently associated with a decreased frequency of overweight/obesity, as well as abdominal obesity, in patients suffering from MS. Elevated MD compliance was also independently associated with a decreased incidence of advanced disease disability, a higher prevalence of elevated physical activity, an improved quality of life, and lower depressive symptoms, as well as higher levels of certain blood biochemical parameters, which are effective indicators of iron deficiency and malnutrition. Conclusions: The present study found that higher MD adherence may slow down disease disability, promoting a better quality of life and mental health in adults with MS. Future prospective surveys are required to obtain conclusive results.