Skip to main content
Top
Published in: Annals of General Psychiatry 1/2018

Open Access 01-12-2018 | Primary research

Exploring PTSD in emergency operators of a major University Hospital in Italy: a preliminary report on the role of gender, age, and education

Authors: Claudia Carmassi, Camilla Gesi, Martina Corsi, Ivan M. Cremone, Carlo A. Bertelloni, Enrico Massimetti, Maria Cristina Olivieri, Ciro Conversano, Massimo Santini, Liliana Dell’Osso

Published in: Annals of General Psychiatry | Issue 1/2018

Login to get access

Abstract

Background

Emergency services personnel face frequent exposure to potentially traumatic events, with the potential for chronic symptomatic distress. The DSM-5 recently recognized a particular risk for post-traumatic stress disorder (PTSD) among first responders (criterion A4) but data are still scarce on prevalence rates and correlates.

Objective

The aim of the present study was to explore the possible role of age, gender, and education training in a sample of emergency personnel diagnosed with DSM-5 PTSD.

Methods

The Trauma and Loss Spectrum-Self-Report (TALS-SR) and the Work and Social Adjustment Scale (WSAS) were administered to 42 between nurses and health care assistants, employed at the emergency room of a major University Hospital (Pisa) in Italy.

Results

21.4% of the sample reported DSM-5 PTSD with significantly higher scores in the TALS-SR domain exploring the acute reaction to trauma and losses among health care assistants, older, and non-graduated subjects. A significant correlation between the number of the TALS-SR symptoms endorsed, corresponding to DSM-5 PTSD diagnostic criteria emerged in health care assistants.

Conclusions

Despite further studies are needed in larger samples, our data suggest a high risk for PTSD and post-traumatic stress spectrum symptoms in nurses and health care workers operating in an emergency department, particularly among health care assistants, women, older, and non-graduated operators.
Literature
1.
go back to reference Papathanasiou IV, Damigos D, Mavreas V. Higher levels of psychiatric symptomatology reported by health professionals working in medical settings in Greece. Ann Gen Psychiatry. 2011;10(1):28.CrossRefPubMedPubMedCentral Papathanasiou IV, Damigos D, Mavreas V. Higher levels of psychiatric symptomatology reported by health professionals working in medical settings in Greece. Ann Gen Psychiatry. 2011;10(1):28.CrossRefPubMedPubMedCentral
2.
go back to reference Embriaco N, Papazian L, Kentish-Barnes N, Pochard F, Azoulay E. Burnout syndrome among critical care healthcare workers. Curr Opin Crit Care. 2007;13(5):482–8.CrossRefPubMed Embriaco N, Papazian L, Kentish-Barnes N, Pochard F, Azoulay E. Burnout syndrome among critical care healthcare workers. Curr Opin Crit Care. 2007;13(5):482–8.CrossRefPubMed
3.
go back to reference Mealer M, Burnham EL, Goode CJ, Rothbaum B, Moss M. The prevalence and impact of post traumatic stress disorder and burnout syndrome in nurses. Depress Anxiety. 2009;26(12):1118–26.CrossRefPubMedPubMedCentral Mealer M, Burnham EL, Goode CJ, Rothbaum B, Moss M. The prevalence and impact of post traumatic stress disorder and burnout syndrome in nurses. Depress Anxiety. 2009;26(12):1118–26.CrossRefPubMedPubMedCentral
4.
go back to reference Berger W, Coutinho ES, Figueira I, Marques-Portella C, Luz MP, Neylan TC, Marmar CR, Mendlowicz MV. Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Soc Psychiatry Psychiatr Epidemiol. 2012;47(6):1001–11.CrossRefPubMed Berger W, Coutinho ES, Figueira I, Marques-Portella C, Luz MP, Neylan TC, Marmar CR, Mendlowicz MV. Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Soc Psychiatry Psychiatr Epidemiol. 2012;47(6):1001–11.CrossRefPubMed
5.
go back to reference Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):617–27.CrossRefPubMedPubMedCentral Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):617–27.CrossRefPubMedPubMedCentral
6.
go back to reference Carmassi C, Dell’Osso L, Manni C, Candini V, Dagani J, Iozzino L, Koenen KC, de Girolamo G. Frequency of trauma exposure and post-traumatic stress disorder in Italy: analysis from the World Mental Health Survey Initiative. J Psychiatr Res. 2014;59:77–84.CrossRefPubMedPubMedCentral Carmassi C, Dell’Osso L, Manni C, Candini V, Dagani J, Iozzino L, Koenen KC, de Girolamo G. Frequency of trauma exposure and post-traumatic stress disorder in Italy: analysis from the World Mental Health Survey Initiative. J Psychiatr Res. 2014;59:77–84.CrossRefPubMedPubMedCentral
7.
go back to reference Helzer JE, Robins LN, McEvoy L. Post-traumatic stress disorder in the general population. Findings of the epidemiologic catchment area survey. N Engl J Med. 1987;317(26):1630–4.CrossRefPubMed Helzer JE, Robins LN, McEvoy L. Post-traumatic stress disorder in the general population. Findings of the epidemiologic catchment area survey. N Engl J Med. 1987;317(26):1630–4.CrossRefPubMed
8.
go back to reference Clohessy S, Ehlers A. PTSD symptoms, response to intrusive memories and coping in ambulance service workers. Br J Clin Psychol. 1999;38(Pt 3):251–65.CrossRefPubMed Clohessy S, Ehlers A. PTSD symptoms, response to intrusive memories and coping in ambulance service workers. Br J Clin Psychol. 1999;38(Pt 3):251–65.CrossRefPubMed
9.
go back to reference Grevin F. Posttraumatic stress disorder, ego defense mechanisms, and empathy among urban paramedics. Psychol Rep. 1996;79(2):483–95.CrossRefPubMed Grevin F. Posttraumatic stress disorder, ego defense mechanisms, and empathy among urban paramedics. Psychol Rep. 1996;79(2):483–95.CrossRefPubMed
10.
go back to reference Hegg-Deloye S, Brassard P, Jauvin N, Prairie J, Larouche D, Poirier P, Tremblay A, Corbeil P. Current state of knowledge of post-traumatic stress, sleeping problems, obesity and cardiovascular disease in paramedics. Emerg Med J. 2014;31(3):242–7.CrossRefPubMed Hegg-Deloye S, Brassard P, Jauvin N, Prairie J, Larouche D, Poirier P, Tremblay A, Corbeil P. Current state of knowledge of post-traumatic stress, sleeping problems, obesity and cardiovascular disease in paramedics. Emerg Med J. 2014;31(3):242–7.CrossRefPubMed
11.
go back to reference Mealer M, Conrad D, Evans J, Jooste K, Solyntjes J, Rothbaum B, Moss M. Feasibility and acceptability of a resilience training program for intensive care unit nurses. Am J Crit Care. 2014;23(6):e97–105.CrossRefPubMed Mealer M, Conrad D, Evans J, Jooste K, Solyntjes J, Rothbaum B, Moss M. Feasibility and acceptability of a resilience training program for intensive care unit nurses. Am J Crit Care. 2014;23(6):e97–105.CrossRefPubMed
12.
go back to reference Ward CL, Lombard CJ, Gwebushe N. Critical incident exposure in South African emergency services personnel: prevalence and associated mental health issues. Emerg Med J. 2006;23(3):226–31.CrossRefPubMedPubMedCentral Ward CL, Lombard CJ, Gwebushe N. Critical incident exposure in South African emergency services personnel: prevalence and associated mental health issues. Emerg Med J. 2006;23(3):226–31.CrossRefPubMedPubMedCentral
13.
go back to reference Donnelly E, Siebert D. Occupational risk factors in the emergency medical services. Prehosp Disaster Med. 2009;24(5):422–9.CrossRefPubMed Donnelly E, Siebert D. Occupational risk factors in the emergency medical services. Prehosp Disaster Med. 2009;24(5):422–9.CrossRefPubMed
14.
go back to reference Fjeldheim CB, Nothling J, Pretorius K, Basson M, Ganasen K, Heneke R, Cloete KJ, Seedat S. Trauma exposure, posttraumatic stress disorder and the effect of explanatory variables in paramedic trainees. BMC Emerg Med. 2014;14:11.CrossRefPubMedPubMedCentral Fjeldheim CB, Nothling J, Pretorius K, Basson M, Ganasen K, Heneke R, Cloete KJ, Seedat S. Trauma exposure, posttraumatic stress disorder and the effect of explanatory variables in paramedic trainees. BMC Emerg Med. 2014;14:11.CrossRefPubMedPubMedCentral
15.
go back to reference Lowery K, Stokes MA. Role of peer support and emotional expression on posttraumatic stress disorder in student paramedics. J Trauma Stress. 2005;18(2):171–9.CrossRefPubMed Lowery K, Stokes MA. Role of peer support and emotional expression on posttraumatic stress disorder in student paramedics. J Trauma Stress. 2005;18(2):171–9.CrossRefPubMed
16.
go back to reference Maia AC, Ribeiro E. The psychological impact of motor vehicle accidents on emergency service workers. Eur J Emerg Med. 2010;17(5):296–301.CrossRefPubMed Maia AC, Ribeiro E. The psychological impact of motor vehicle accidents on emergency service workers. Eur J Emerg Med. 2010;17(5):296–301.CrossRefPubMed
17.
go back to reference Jonsson A, Segesten K. Daily stress and concept of self in Swedish ambulance personnel. Prehosp Disaster Med. 2004;19(3):226–34.CrossRefPubMed Jonsson A, Segesten K. Daily stress and concept of self in Swedish ambulance personnel. Prehosp Disaster Med. 2004;19(3):226–34.CrossRefPubMed
18.
go back to reference Dell’Osso L, Carmassi C, Rucci P, Conversano C, Shear MK, Calugi S, Maser JD, Endicott J, Fagiolini A, Cassano GB. A multidimensional spectrum approach to post-traumatic stress disorder: comparison between the Structured Clinical Interview for Trauma and Loss Spectrum (SCI-TALS) and the Self-Report instrument (TALS-SR). Compr Psychiatry. 2009;50(5):485–90.CrossRefPubMed Dell’Osso L, Carmassi C, Rucci P, Conversano C, Shear MK, Calugi S, Maser JD, Endicott J, Fagiolini A, Cassano GB. A multidimensional spectrum approach to post-traumatic stress disorder: comparison between the Structured Clinical Interview for Trauma and Loss Spectrum (SCI-TALS) and the Self-Report instrument (TALS-SR). Compr Psychiatry. 2009;50(5):485–90.CrossRefPubMed
19.
go back to reference Dell’Osso L, Shear MK, Carmassi C, Rucci P, Maser JD, Frank E, Endicott J, Lorettu L, Altamura CA, Carpiniello B, et al. Validity and reliability of the Structured Clinical Interview for the Trauma and Loss Spectrum (SCI-TALS). Clin Pract Epidemiol Ment Health. 2008;4:2.CrossRefPubMedPubMedCentral Dell’Osso L, Shear MK, Carmassi C, Rucci P, Maser JD, Frank E, Endicott J, Lorettu L, Altamura CA, Carpiniello B, et al. Validity and reliability of the Structured Clinical Interview for the Trauma and Loss Spectrum (SCI-TALS). Clin Pract Epidemiol Ment Health. 2008;4:2.CrossRefPubMedPubMedCentral
20.
go back to reference Mundt JC, Marks IM, Shear MK, Greist JH. The Work and Social Adjustment Scale: a simple measure of impairment in functioning. Br J Psychiatry 2002;180:461–64.CrossRefPubMed Mundt JC, Marks IM, Shear MK, Greist JH. The Work and Social Adjustment Scale: a simple measure of impairment in functioning. Br J Psychiatry 2002;180:461–64.CrossRefPubMed
21.
go back to reference Carmassi C, Stratta P, Massimetti G, Bertelloni CA, Conversano C, Cremone IM, Miccoli M, Baggiani A, Rossi A, Dell’Osso L. New DSM-5 maladaptive symptoms in PTSD: gender differences and correlations with mood spectrum symptoms in a sample of high school students following survival of an earthquake. Ann Gen Psychiatry. 2014;13:28.CrossRefPubMedPubMedCentral Carmassi C, Stratta P, Massimetti G, Bertelloni CA, Conversano C, Cremone IM, Miccoli M, Baggiani A, Rossi A, Dell’Osso L. New DSM-5 maladaptive symptoms in PTSD: gender differences and correlations with mood spectrum symptoms in a sample of high school students following survival of an earthquake. Ann Gen Psychiatry. 2014;13:28.CrossRefPubMedPubMedCentral
22.
go back to reference Carmassi C, Antonio Bertelloni C, Massimetti G, Miniati M, Stratta P, Rossi A, Dell’Osso L. Impact of DSM-5 PTSD and gender on impaired eating behaviors in 512 Italian earthquake survivors. Psychiatry Res. 2015;225(1–2):64–9.CrossRefPubMed Carmassi C, Antonio Bertelloni C, Massimetti G, Miniati M, Stratta P, Rossi A, Dell’Osso L. Impact of DSM-5 PTSD and gender on impaired eating behaviors in 512 Italian earthquake survivors. Psychiatry Res. 2015;225(1–2):64–9.CrossRefPubMed
23.
go back to reference Carmassi C, Akiskal HS, Bessonov D, Massimetti G, Calderani E, Stratta P, Rossi A, Dell’Osso L. Gender differences in DSM-5 versus DSM-IV-TR PTSD prevalence and criteria comparison among 512 survivors to the L’Aquila earthquake. J Affect Disord. 2014;160:55–61.CrossRefPubMed Carmassi C, Akiskal HS, Bessonov D, Massimetti G, Calderani E, Stratta P, Rossi A, Dell’Osso L. Gender differences in DSM-5 versus DSM-IV-TR PTSD prevalence and criteria comparison among 512 survivors to the L’Aquila earthquake. J Affect Disord. 2014;160:55–61.CrossRefPubMed
24.
go back to reference Dell’Osso L, Stratta P, Conversano C, Massimetti E, Akiskal KK, Akiskal HS, Rossi A, Carmassi C. Lifetime mania is related to post-traumatic stress symptoms in high school students exposed to the 2009 L’Aquila earthquake. Compr Psychiatry. 2014;55(2):357–62.CrossRefPubMed Dell’Osso L, Stratta P, Conversano C, Massimetti E, Akiskal KK, Akiskal HS, Rossi A, Carmassi C. Lifetime mania is related to post-traumatic stress symptoms in high school students exposed to the 2009 L’Aquila earthquake. Compr Psychiatry. 2014;55(2):357–62.CrossRefPubMed
25.
go back to reference Carmassi C, Akiskal HS, Yong SS, Stratta P, Calderani E, Massimetti E, Akiskal KK, Rossi A, Dell’Osso L. Post-traumatic stress disorder in DSM-5: estimates of prevalence and criteria comparison versus DSM-IV-TR in a non-clinical sample of earthquake survivors. J Affect Disord. 2013;151(3):843–8.CrossRefPubMed Carmassi C, Akiskal HS, Yong SS, Stratta P, Calderani E, Massimetti E, Akiskal KK, Rossi A, Dell’Osso L. Post-traumatic stress disorder in DSM-5: estimates of prevalence and criteria comparison versus DSM-IV-TR in a non-clinical sample of earthquake survivors. J Affect Disord. 2013;151(3):843–8.CrossRefPubMed
26.
go back to reference Dell'Osso L, Carmassi C, Stratta P, Massimetti G, Akiskal KK, Akiskal HS, Maremmani I, Rossi A. Gender differences in the relationship between maladaptive behaviors and post-traumatic stress disorder. A study on 900 L’ Aquila 2009 earthquake survivors. Front Psychiatry. 2009;2012(3):111. Dell'Osso L, Carmassi C, Stratta P, Massimetti G, Akiskal KK, Akiskal HS, Maremmani I, Rossi A. Gender differences in the relationship between maladaptive behaviors and post-traumatic stress disorder. A study on 900 L’ Aquila 2009 earthquake survivors. Front Psychiatry. 2009;2012(3):111.
27.
go back to reference Dell’Osso L, Carmassi C, Massimetti G, Stratta P, Riccardi I, Capanna C, Akiskal KK, Akiskal HS, Rossi A. Age, gender and epicenter proximity effects on post-traumatic stress symptoms in L’Aquila 2009 earthquake survivors. J Affect Disord. 2013;146(2):174–80.CrossRefPubMed Dell’Osso L, Carmassi C, Massimetti G, Stratta P, Riccardi I, Capanna C, Akiskal KK, Akiskal HS, Rossi A. Age, gender and epicenter proximity effects on post-traumatic stress symptoms in L’Aquila 2009 earthquake survivors. J Affect Disord. 2013;146(2):174–80.CrossRefPubMed
28.
go back to reference Dell’Osso L, Carmassi C, Massimetti G, Conversano C, Daneluzzo E, Riccardi I, Stratta P, Rossi A. Impact of traumatic loss on post-traumatic spectrum symptoms in high school students after the L’Aquila 2009 earthquake in Italy. J Affect Disord. 2011;134(1–3):59–64.CrossRefPubMed Dell’Osso L, Carmassi C, Massimetti G, Conversano C, Daneluzzo E, Riccardi I, Stratta P, Rossi A. Impact of traumatic loss on post-traumatic spectrum symptoms in high school students after the L’Aquila 2009 earthquake in Italy. J Affect Disord. 2011;134(1–3):59–64.CrossRefPubMed
29.
go back to reference Dell’Osso L, Carmassi C, Massimetti G, Daneluzzo E, Di Tommaso S, Rossi A. Full and partial PTSD among young adult survivors 10 months after the L’Aquila 2009 earthquake: gender differences. J Affect Disord. 2011;131(1–3):79–83.CrossRefPubMed Dell’Osso L, Carmassi C, Massimetti G, Daneluzzo E, Di Tommaso S, Rossi A. Full and partial PTSD among young adult survivors 10 months after the L’Aquila 2009 earthquake: gender differences. J Affect Disord. 2011;131(1–3):79–83.CrossRefPubMed
30.
go back to reference Beaton R, Murphy S, Johnson C, Pike K, Corneil W. Coping responses and posttraumatic stress symptomatology in urban fire service personnel. J Trauma Stress. 1999;12(2):293–308.CrossRefPubMed Beaton R, Murphy S, Johnson C, Pike K, Corneil W. Coping responses and posttraumatic stress symptomatology in urban fire service personnel. J Trauma Stress. 1999;12(2):293–308.CrossRefPubMed
31.
go back to reference Berger W, Figueira I, Maurat AM, Bucassio EP, Vieira I, Jardim SR, Coutinho ES, Mari JJ, Mendlowicz MV. Partial and full PTSD in Brazilian ambulance workers: prevalence and impact on health and on quality of life. J Trauma Stress. 2007;20(4):637–42.CrossRefPubMed Berger W, Figueira I, Maurat AM, Bucassio EP, Vieira I, Jardim SR, Coutinho ES, Mari JJ, Mendlowicz MV. Partial and full PTSD in Brazilian ambulance workers: prevalence and impact on health and on quality of life. J Trauma Stress. 2007;20(4):637–42.CrossRefPubMed
32.
go back to reference Corneil W, Beaton R, Murphy S, Johnson C, Pike K. Exposure to traumatic incidents and prevalence of posttraumatic stress symptomatology in urban firefighters in two countries. J Occup Health Psychol. 1999;4(2):131–41.CrossRefPubMed Corneil W, Beaton R, Murphy S, Johnson C, Pike K. Exposure to traumatic incidents and prevalence of posttraumatic stress symptomatology in urban firefighters in two countries. J Occup Health Psychol. 1999;4(2):131–41.CrossRefPubMed
33.
go back to reference de Girolamo G, Polidori G, Morosini P, Scarpino V, Reda V, Serra G, Mazzi F, Alonso J, Vilagut G, Visona G, et al. Prevalence of common mental disorders in Italy: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD). Soc Psychiatry Psychiatr Epidemiol. 2006;41(11):853–61.CrossRefPubMed de Girolamo G, Polidori G, Morosini P, Scarpino V, Reda V, Serra G, Mazzi F, Alonso J, Vilagut G, Visona G, et al. Prevalence of common mental disorders in Italy: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD). Soc Psychiatry Psychiatr Epidemiol. 2006;41(11):853–61.CrossRefPubMed
35.
go back to reference Perrin MA, DiGrande L, Wheeler K, Thorpe L, Farfel M, Brackbill R. Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers. Am J Psychiatry. 2007;164(9):1385–94.CrossRefPubMed Perrin MA, DiGrande L, Wheeler K, Thorpe L, Farfel M, Brackbill R. Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers. Am J Psychiatry. 2007;164(9):1385–94.CrossRefPubMed
36.
go back to reference Bennett P, Williams Y, Page N, Hood K, Woollard M. Levels of mental health problems among UK emergency ambulance workers. Emerg Med J. 2004;21(2):235–6.CrossRefPubMedPubMedCentral Bennett P, Williams Y, Page N, Hood K, Woollard M. Levels of mental health problems among UK emergency ambulance workers. Emerg Med J. 2004;21(2):235–6.CrossRefPubMedPubMedCentral
37.
38.
39.
go back to reference Pole N, Best SR, Weiss DS, Metzler T, Liberman AM, Fagan J, Marmar CR. Effects of gender and ethnicity on duty-related posttraumatic stress symptoms among urban police officers. J Nerv Ment Dis. 2001;189(7):442–8.CrossRefPubMed Pole N, Best SR, Weiss DS, Metzler T, Liberman AM, Fagan J, Marmar CR. Effects of gender and ethnicity on duty-related posttraumatic stress symptoms among urban police officers. J Nerv Ment Dis. 2001;189(7):442–8.CrossRefPubMed
40.
go back to reference Engel CC, Litz B, Magruder KM, Harper E, Gore K, Stein N, Yeager D, Liu X, Coe TR. Delivery of self training and education for stressful situations (DESTRESS-PC): a randomized trial of nurse assisted online self-management for PTSD in primary care. Gen Hosp Psychiatry. 2015;37(4):323–8.CrossRefPubMedPubMedCentral Engel CC, Litz B, Magruder KM, Harper E, Gore K, Stein N, Yeager D, Liu X, Coe TR. Delivery of self training and education for stressful situations (DESTRESS-PC): a randomized trial of nurse assisted online self-management for PTSD in primary care. Gen Hosp Psychiatry. 2015;37(4):323–8.CrossRefPubMedPubMedCentral
41.
go back to reference Wagner D, Heinrichs M, Ehlert U. Prevalence of symptoms of posttraumatic stress disorder in German professional firefighters. Am J Psychiatry. 1998;155(12):1727–32.CrossRefPubMed Wagner D, Heinrichs M, Ehlert U. Prevalence of symptoms of posttraumatic stress disorder in German professional firefighters. Am J Psychiatry. 1998;155(12):1727–32.CrossRefPubMed
42.
go back to reference Zohar J, Juven-Wetzler A, Sonnino R, Cwikel-Hamzany S, Balaban E, Cohen H. New insights into secondary prevention in post-traumatic stress disorder. Dialogues Clin Neurosci. 2011;13(3):301–9.PubMedPubMedCentral Zohar J, Juven-Wetzler A, Sonnino R, Cwikel-Hamzany S, Balaban E, Cohen H. New insights into secondary prevention in post-traumatic stress disorder. Dialogues Clin Neurosci. 2011;13(3):301–9.PubMedPubMedCentral
43.
go back to reference Zohar J, Sonnino R, Juven-Wetzler A, Cohen H. Can posttraumatic stress disorder be prevented? CNS Spectr. 2009;14(1 Suppl 1):44–51.PubMed Zohar J, Sonnino R, Juven-Wetzler A, Cohen H. Can posttraumatic stress disorder be prevented? CNS Spectr. 2009;14(1 Suppl 1):44–51.PubMed
Metadata
Title
Exploring PTSD in emergency operators of a major University Hospital in Italy: a preliminary report on the role of gender, age, and education
Authors
Claudia Carmassi
Camilla Gesi
Martina Corsi
Ivan M. Cremone
Carlo A. Bertelloni
Enrico Massimetti
Maria Cristina Olivieri
Ciro Conversano
Massimo Santini
Liliana Dell’Osso
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Annals of General Psychiatry / Issue 1/2018
Electronic ISSN: 1744-859X
DOI
https://doi.org/10.1186/s12991-018-0184-4

Other articles of this Issue 1/2018

Annals of General Psychiatry 1/2018 Go to the issue