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Pompili M.,University of Rome La Sapienza | Pompili M.,Harvard University | Vichi M.,National Institute of Health ISS | Qin P.,University of Oslo | And 3 more authors.
Journal of Affective Disorders | Year: 2013

Objective: To evaluate whether education attainment was associated with completed suicide, a topic only marginally investigated in the literature. Methods: Data for the years between 2006 and 2008 were extracted from the Italian Mortality Database to include all deaths by suicide and natural causes and to obtain information on their education attainment. Results: We found significant differences in education attainment between suicide victims and individuals deceased by natural causes, stratified by sex and broken down by age bands. Of both males and females from 15 to 64 years old, suicide victims were significantly more often to have a higher education attainment compared with the same sex and age counterparts died from natural causes. Persons with higher school attainment, compared with those with a maximum primary school degree, had significantly increased odds ratios of dying from a suicide rather than a natural cause. For persons aged 65-74 years or above, however, the differences were not so much obvious. These observations remained almost the same after adjustment for marital status, region of residence and age. Conclusions: Individual with higher educational achievement may be more prone to suicide risk when facing failures, public shame, and high premorbid functioning. © 2012 Elsevier B.V. All rights reserved.


PubMed | Karolinska Institutet, Semmelweis University, University of Turku, University of Zürich and 30 more.
Type: | Journal: Annals of general psychiatry | Year: 2016

It is well known that suicidal rates vary considerably among European countries and the reasons for this are unknown, although several theories have been proposed. The effect of economic variables has been extensively studied but not that of climate.Data from 29 European countries covering the years 2000-2012 and concerning male and female standardized suicidal rates (according to WHO), economic variables (according World Bank) and climate variables were gathered. The statistical analysis included cluster and principal component analysis and categorical regression.The derived models explained 62.4% of the variability of male suicidal rates. Economic variables alone explained 26.9% and climate variables 37.6%. For females, the respective figures were 41.7, 11.5 and 28.1%. Male suicides correlated with high unemployment rate in the frame of high growth rate and high inflation and low GDP per capita, while female suicides correlated negatively with inflation. Both male and female suicides correlated with low temperature.The current study reports that the climatic effect (cold climate) is stronger than the economic one, but both are present. It seems that in Europe suicidality follows the climate/temperature cline which interestingly is not from south to north but from south to north-east. This raises concerns that climate change could lead to an increase in suicide rates. The current study is essentially the first successful attempt to explain the differences across countries in Europe; however, it is an observational analysis based on aggregate data and thus there is a lack of control for confounders.


Gabutti G.,Health-U | Rota M.C.,National Institute of Health ISS
International Journal of Environmental Research and Public Health | Year: 2012

Pertussis continues to be a relevant public-health issue. The high coverage rates achieved have decreased the spread of the pathogen, but the waning of immunity implies a relevant role of adolescents and adults in the infective dynamics as they may represent a significant source of infection for unvaccinated or incompletely immunized newborns. The passive surveillance system is affected by many limitations. The underestimation of pertussis in adolescents, young adults and adults is mainly related to the atypical clinical characteristics of cases and the lack of lab confirmation. The real epidemiological impact of pertussis is not always perceived, anyway, the unavailability of comprehensive data should not hamper the adoption of active prophylactic interventions aimed at preventing the impact of waning immunity on pertussis. To avoid an increase of the mean age of acquisition of the infection, a booster dose of low-antigen content combined vaccine should be adopted in adolescents and adults. A decreased risk of infection in newborns can be achieved with the cocoon strategy, although the debate on this aspect is still open and enhanced surveillance and further studies are needed to fine-tune the pertussis prevention strategy. © 2012 by the authors.


Pace G.,University of Tuscia | Pace G.,University of Barcelona | Della Bella V.,Environmental Protection Agency of Umbria Region | Barile M.,University of Tuscia | And 3 more authors.
Ecological Indicators | Year: 2012

The European Water Framework Directive (WFD 2000/60/CE) requires the use of different biological indicators, supporting physicochemical and hydromorphological elements, in the assessment of the ecological status of rivers: in each member state rivers should be at least in a good condition (or good ecological potential if heavily modified) by 2015, and those failing this criterion should be restored. Given that the need for restoration is primarily based on the results from ecological classifications, precision of these classifications is essential. The present study analyzed the relationships of two different biological communities (diatom and macroinvertebrate) when they are used to characterize a set of sites (from reference sites to human-impacted sites) within a single stream type (Mediterranean small sized volcanic-siliceous streams). In particular, we examine the issue of concordance among these communities and the anthropogenic stressors detected, using both multivariate and multimetric approach. Mantel test based on Bray-Curtis distance showed that assemblage dissimilarity between diatom and macroinvertebrate was weakly correlated, dissuading the use of one taxa group as surrogate of the other. The two biological indicators similarly reflected the overall river integrity, but provided complementary information on the specific stressors. Particularly, in accordance to previous studies, our results show that macroinvertebrate assemblage was influenced by water quality (nutrients enrichment and organic pollution) and habitat degradation. On the other hand, same as for benthos, diatom assemblage was regulated by chemical factors (especially nutrients), while did not show strong responses to morphological degradations. In addition, the ecological status of volcanic streams was evaluated by means of the two Intercalibration Common Metrics Indices (ICMi), based, respectively, on macroinvertebrate and diatom communities. The two ICM indices, developed for the Italian biomonitoring program (sensu WFD), were strongly correlated and provided a final classification mainly related to the water quality (nutrient enrichment and organic pollution). However, both indices were less sensitive to the hydromorphological alterations, highlighting the need for the development of stressor specific indices to achieve a complete evaluation of the anthropogenic stress present in the area. Studies of this kind across different disturbance gradients and focused on a particular river type (e.g. Mediterranean small-size volcanic-siliceous streams), will enable the relative merits of the indicators to become apparent and greatly facilitate their appropriate application. © 2012 Elsevier Ltd. All rights reserved.


Pace G.,University of Tuscia | Andreani P.,Province of Viterbo | Barile M.,University of Tuscia | Buffagni A.,CNR Institute of Neuroscience | And 3 more authors.
Ecological Indicators | Year: 2011

According to the guidelines of the European Water Framework Directive, assessment of the ecological quality of streams and rivers should be based on type-specific reference conditions. Moreover to support biological indicators an hydromorphological analysisis also requested for each rivertype. The rationalefor including an habitat assessment in biomonitoring study is that a biological community can be influenced by habitat quality just as water chemistry. In the present work benthic macroinvertebrates were analysed in a specific river type of Central Italy (small-sized streams, volcanic-siliceous), to identify taxa assemblages at the mesohabitat scale and to test how common measures of benthic community used in biomonitoring differ between riffles and pools in order to evaluate if differences may influence water quality classification. Macroinvertebrates were collected in 10 selected streams, covering the whole quality range present in the geographic areafrom 'reference sites'tohuman-impacted sites, alongapool-riffle sequence following a multihabitat sampling protocol. We compared assemblage of macroinvertebrates found in different mesohabitats using principal component analysis (PCA). Similar site grouping was obtained in riffle, pool and abiotic analysis. The measures of diversity and abundance were used as replicates in ANOVA analysis to test differences between pools and riffles within the groups of sites. There were no significant differences in terms of taxa richness and total abundance. When we compared the abundance of each taxon we found significant differences only in the group of reference sites with 18 taxa (about 25%) that showed a significant habitat preference. Our findings support that macroinvertebrates assemblages reflected primarily the environmental conditions and differences at mesohabitat scale are strongly correlated to hydromorphological condition and are maximized in reference sites. However such differences do not influence the ecological status assessment in this typology. © 2010 Elsevier Ltd. All rights reserved.


PubMed | University of Rome La Sapienza, University of Genoa, National Institute of Health ISS and Kyung Hee University
Type: | Journal: Psychiatry research | Year: 2016

People seeking information and news regarding suicide are likely to use the Internet. However, evidence of the relationship between suicide-related search volumes and national suicide-rates in different countries can be strikingly different. We aimed to investigate the relationship between suicide-rates and Google suicide-related search volumes in the Italian population (2008-2012) using the Italian mortality database that provided monthly national data concerning suicides (2008-2012). Moreover, this study aimedto identify future trends of national suicide rates on the basis of the results we obtained concerning the period 2013-14. Google Trends provided data of online monthly search-volumes of the term suicide, commit suicide and how to commit suicide in Google Search and Google News (2008-2014). Google Search volumes for the term suicide lags suicide by three months (=0.482, p-value<0.001), whereas no correlation was found between search volumes for commit suicide and how to commit suicide and national suicide rates. Google News search volumes for the three terms resulted in white noise. Apparently, online searches for suicide-related terms in Italy are more likely to be linked to factors other than suicidiality such as personal interest and suicide bereavement.


Pompili M.,University of Rome La Sapienza | Vichi M.,National Institute of Health ISS | Innamorati M.,University of Rome La Sapienza | Lester D.,The Richard Stockton College of New Jersey | And 3 more authors.
Health and Social Care in the Community | Year: 2014

Previous research reported that economic crises may have important implications for increasing suicide rates. We investigated official data on completed suicide in Italy during the recent economic crisis as related to age and gender. Data were extracted from the Italian Mortality Database. The trend in suicide rates from 1980 to 2010 (the most recent year available) was analysed by joinpoint regression analysis. Rate ratios were calculated to compare suicide rates before and after the present economic crisis. Suicide rates for men 25-64 years of age (those involved in the labour force) started to increase in 2008 after a period of a statistically significant decrease from 1994 to 2007 and their suicide rate was 12% higher in 2010 compared with that in 2006. In contrast, suicide rates declined for women of all ages and for men younger than 25 and older than 65 years of age. After 2007, there was a noticeable increase in suicide rates among Italian men involved in the labour force. © 2013 John Wiley & Sons Ltd.


Pompili M.,SantAndrea Hospital | Pompili M.,Harvard University | Pompili M.,University of Rome La Sapienza | Vichi M.,National Institute of Health ISS | And 3 more authors.
European Child and Adolescent Psychiatry | Year: 2012

The objective of the study is to evaluate temporal trends, gender effects and methods of completed suicide amongst children and adolescent (aged 10-17) when compared with temporal trends of deaths from other causes. Data were extracted from the Italian Mortality Database, which is collected by the Italian National Census Bureau (ISTAT) and processed by the Statistics Unit of National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS) at the National Institute of Health (Istituto Superiore di Sanita). A total of 1,871 children and adolescents, age 10-17 years, committed suicide in Italy from 1971 to 2003 and 109 died by suicide during the last 3-year period of observation (2006-2008). The average suicide rate over the entire period of observation was 0.91 per 100,000; the rate was 1.21 for males and 0.59 for females. During the study period, the general mortality of children and adolescents, age 10-17 years, decreased dramatically, the average annual percentage change decrease was of -3.3% (95% CI -4.4 to -1.9) for males and -2.9% (95% IC -4.4 to -2.5) for females. The decrease was observed, for both genders, for all causes of deaths except suicide. For males, the most frequent method was hanging (54.5%), followed by shooting/fire arms (19.6%), falls/jumping from high places (12.7%); for females, the most frequent method, jumping from high places/falls, accounted for 35.7% of suicides during the whole study period. In conclusion, this study highlights that over the course of several decades suicide is a far less preventable cause of death as compared to other causes of death amongst children and adolescents. Our study demonstrated that suicide rates in adolescents are not a stable phenomenon over the 40 years period of study. It suggested that rates for males and females differed and varied in different ways during specific time periods of this study. National suicide prevention actions should parallel prevention measures implemented to reduce other causes of death. © 2012 Springer-Verlag.


Mannarelli D.,University of Rome La Sapienza | Pauletti C.,University of Rome La Sapienza | Locuratolo N.,University of Rome La Sapienza | Vanacore N.,National Institute of Health ISS | And 4 more authors.
Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration | Year: 2014

Our objective was to evaluate attentional processing with respect to the clinical-onset subtype in amyotrophic lateral sclerosis (ALS) using event-related potentials (ERPs). Thirty-three non-demented ALS patients (22 spinal onset, 11 bulbar onset) and 32 age- and gender-matched controls underwent a psychophysiological evaluation. Mismatch Negativity (MMN), P300 components and Contingent Negative Variation (CNV) were obtained. Latencies and amplitudes of the MMN, P3a and P3b waves and CNV amplitude were then evaluated. Clinical parameters were correlated with ERP data. No differences emerged between ALS patients and controls with regard to the MMN and P3b components. N1-P3a inter-peak latency (Fz, p = 0.003; Cz, p = 0.001; Pz, p = 0.002) was longer in ALS-b than in ALS-s. Total CNV area (Cz, p = 0.01) and W1-CNV area were significantly reduced (Cz, p = 0.05; Pz, p = 0.03) in ALS-b with respect to the one of the controls, while no differences were found between ALS-s patients and controls. In conclusion, automatic pre-attentive processing of stimuli seems to be preserved in ALS. However, a significant delay in the time-course of selective attentive processing and a difficulty in initiating and sustaining attention may be present in ALS-b, which points to a possible dysfunction in the frontal neural network that responds to novelty and to abnormal integration of associative functions. This attentional impairment should be taken in account while developing alternative communicative strategies in ALS patients. © 2014 Informa Healthcare.


Pauletti C.,University of Rome La Sapienza | Mannarelli D.,University of Rome La Sapienza | Locuratolo N.,University of Rome La Sapienza | Vanacore N.,National Institute of Health ISS | And 2 more authors.
Clinical Neurophysiology | Year: 2014

Objective: To investigate whether pre-attentive auditory discrimination is impaired in patients with essential tremor (ET) and to evaluate the role of age at onset in this function. Methods: Seventeen non-demented patients with ET and seventeen age- and sex-matched healthy controls underwent an EEG recording during a classical auditory MMN paradigm. Results: MMN latency was significantly prolonged in patients with elderly-onset ET (>65. years) (p= 0.046), while no differences emerged in either latency or amplitude between young-onset ET patients and controls. Conclusions: This study represents a tentative indication of a dysfunction of auditory automatic change detection in elderly-onset ET patients, pointing to a selective attentive deficit in this subgroup of ET patients. Significance: The delay in pre-attentive auditory discrimination, which affects elderly-onset ET patients alone, further supports the hypothesis that ET represents a heterogeneous family of diseases united by tremor; these diseases are characterized by cognitive differences that may range from a disturbance in a selective cognitive function, such as the automatic part of the orienting response, to more widespread and complex cognitive dysfunctions. © 2013 International Federation of Clinical Neurophysiology.

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