Non-suicidal self-injury (NSSI) is defined as any deliberate destruction of one’s body tissue, engaged in for reasons that are non-suicidal. Online platforms, notably social media, witness a surge in NSSI-related content, amplified by the COVID-19 pandemic. Young individuals increase video and post uploads, prompting scholarly inquiry into the impact on vulnerable demographics in the online environment. Despite potential benefits, concerns surface regarding content reinforcing self-injurious behavior. The Blue Whale phenomenon exemplifies serious consequences in this digital landscape.

The present study aims at screening the prevalence of NSSIs on SNS among Italian young people.

An observational cross-sectional study was conducted by recruiting 373 Italian young people (aged 18-25). Bergen Social Media Addiction Scale (BSMAS), Fear Of Missing Out Scale (FOMO), Inventory of Statements About Self-Injury (ISAS) were administered to investigate the relationship between NSSIs, social media use and frequency and underpinned motivations.

Overall, 99.7 % (n=372) of participants declared to have used at least one social network. Around 92.5 % (n=345) declared to know Blue Whale Challenge and more than half of the sample (51.5%) referred to have looked for NSSI contents on SNS, mostly (28.7 % (n=107)) have sought for curiosity, 17.7 % (n=66) have sought for help/support. 53.4 % (n=199) of the sample was found to have problematic social media use (PSMU) according to BSMAS. 85 % (n=317) have committed self-injurious gestures in the past, 66.2 % (n=247) practice NSSI currently, most subjects practice them to vent 51.7% (n=193), calm themselves 41.6% (n=155), and punish themselves 30% (n=112). The mean age of transgender and nonbinary subjects (30 % n=112)) who sought/saw content pertaining to NSSIs appears to be lower (p=0.033) than cisgender subjects. Those who searched for content inherent to NSSIs scored higher mean scores on the FOMO (p=0.022) and BSMAS (p=0.013) scales. Those who follow social pages inherent to NSSIs scored higher on the FOMO scale (p=0.035). Subjects who practice NSSIs at their present state, on average, have higher scores on the FOMO and BSMAS scales (p=<.001). Linear regression analysis was conducted showing an association between BSMAS and FOMO (R²=0.199, B=0.260; F(1.371)=92.334; p=<.001). Logistic regression analyses were conducted to define the effects of FOMO, PMSU, sex, and NSSI search on the development of self-injurious conduct. The logistic regression model was statistically significant, χ2 (1)=3.909; p=0.048.

The study examines NSSI behaviors among young Italian college students on digital platforms, particularly social networks. It stresses the critical need for targeted interventions, addressing concerns like social media addiction, to provide essential mental health support and foster a safer online environment for this population.

None Declared

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition marked by difficulties in attention, hyperactivity, and impulsivity. Its subtypes—predominantly inattentive, predominantly hyperactive-impulsive, and combined—vary in symptom presentation and impact on daily functioning. Understanding these subtypes is crucial for tailored interventions and support.

Our aim is to clinically characterize the psychopathological aspects of the subtypes of ADHD.

Our study is conducted on patients (>18 years) referred to the adult ADHD outpatient service of the Psychiatric Clinic of Ancona (Università Politecnica delle Marche, Italy). The Diagnostic Interview for ADHD in adults (DIVA 5.0) was used for diagnosing ADHD. The following rating scale were administered: Temperament Evaluation in Memphis, Pisa and San Diego (TEMPS-M), and Temperament and Character Inventory-Revised (TCI-R).

76% (n=170) of all screened patients were diagnosed with ADHD in adulthood. 57.6% (n=98) were diagnosed with ADHD combined subtype, 35.3% (n=60) with ADHD inattentive subtype, and 7.1% (n=12) with ADHD hyperactive subtype. Only 12.9% (n=22) were diagnosed with ADHD in childhood. Based on the results obtained at TEMPS-M, 43.8% (n=32) of patients were found to have cyclothymic temperament. Subjects with ADHD combined subtype scored significantly higher mean on the irritable temperament subscale of the TEMPS-M than those with ADHD inattentive subtype (p=0.016), while patients with ADHD inattentive subtype had a significantly higher mean score on the disorderliness subscale of the TCI-R than those with ADHD hyperactive and combined subtype (p=0.010). Given the logistic regression analyses using the TCI-R, developing an inattentive type of ADHD is negatively predicted by the disorderliness subscale of the TCI-R (exp(B)=0.788, IC95%=0.669-0.929, p=0.005) and positively predicted by the extravagance subscale of the TCI-R (exp(B)=1.104, IC95%=1.009-1.208, p=0.031), the hyperactive subtype of ADHD is negatively predicted by the fatigability subscale of the TCI-R (exp(B)=0.775, IC95%=0.597-1.005, p=0.055) and the combined subtype that is positively predicted by the disorderliness subscale of the TCI-R (exp(B)=1.140, IC95%=1.011-1.287, p=0.033). Regarding temperament, through a logistic regression analysis, the inattentive subtype of ADHD is negatively predicted by the irritable temperament subscale of the TEMPS-M (exp(B)=0.904, IC95%=8.39-0.974, p=0.008), while for the combined subtype of ADHD it is positively predicted by the irritable temperament subscale of the TEMPS-M (exp(B)=1.088, IC95%=1.014-1.167, p=0.019).

The results show that irritable temperament is a predictor for the inattentive and combined subtype, but with different polarities. In addition, how different patterns of personality are specific to the various subtypes of ADHD are highlighted.

None Declared

Nomophobia, a neologism derived from the combination of “no mobile,” “phone” and “phobia,” represents one of the syndromes of today’s digital and virtual society. By this term, we refer to the discomfort, anxiety, nervousness, and distress generated by the individual’s loss of connection to his or her cell phone or other technological medium that allows connection to the Internet. No study has attempted to evaluate the impact of disconnection syndrome on a clinical sample of patients with Severe Mental Illness (SMI).

Our study has the objective of characterizing subject affected by SMI with nomophobia.

Our study is conducted on inpatients (>16 years) referred to our Psychiatric ward in Ancona (Università Politecnica delle Marche, Italy). The following rating scales were administered to these subjects: Nomophobia Questionnaire (NMP-Q), Smartphone Addiction Scale - Short Version (SAS-SV), Multidimendional State Boredom Scale (MSBS), Intolerance of Uncertainty Scale (IUS), Temperament Evaluation in Memphis, Pisa and San Diego (TEMPS-M), Coping Orientation to the Problems Experiences-new Italian version (COPE-NVI).

Most of the subjects included in the study tested positive for nomophobia (99%; n=97). The mean score scored on the NMPQ is 69.2±27.9, while the mean score obtained at SAS-SV is 25.1±12.7. Gender has no influence on the scores obtained at the NMPQ (p=0.823), as well as the type of SMI (p=0.376). Those not in a relationship scored a higher mean score than who has a relationship (p=0.02). Patients who suffer from insomnia scored higher mean score on the NMPQ (p=0.21). A linear univariate regression between SAS-SV and NMPQ was observed (R2=0.575, F=129.731, p<0.001). A multivariate linear regression was observed between the NMPQ (R=0.556, R2=0.2830, F=12.057, p<0.001) and the IUS (B=1.343, p<0.001), the irritable temperament subscale of the TEMPS (B=1.293, p=0.003) and the inattention subscale of the MSBS (B=-1.029, p=0.033). In the men-only sample, a multivariate linear regression was observed between the NMPQ (R2=0.437, F=9.847, p<0.001) and the IUS (B=1.361, p<0.001), the anxious temperament subscale of the TEMPS (B=1.687, p=0.005) and the inattention subscale of the MSBS (B=-1.465, p=0.002).

Patients with higher intolerance to uncertainty, irritable temperament and lower inattention have higher risk to develop nomophobia. In men with SMI, nomophobia is associated with higher intolerance to uncertainty, anxious temperament, and lower inattention. Further study have to be conducted to expand data and results.

None Declared

Coping and emotional regulation mechanisms may play a significant role in the neurodevelopment and in the subsequent psychopathological trajectories, especially in youth. The boredom dimension may also have a pathoplastic role.

Considering the poor literature in adolescents and young people (15-24 years-old), our study aims at investigating the relationships between coping patterns and emotional dysregulation as well the mediatory role of boredom, by particularly focussing on a sample at early onset of mood disorders.

Cross-sectional, observational design study. Descriptive analyses were performed considering a set of socio-demographic and clinical variables (DERS, MSBS, COPE-NVI). Kruskal-Wallis, Spearman correlations and linear regression models were performed between DERS (dependent variable) and COPE-NVI (independent variable), together with mediation analyses (MSBS as mediator).

86 subjects (mean age=18.4±2.8) were enrolled. DERS score was 114.8±33.3, COPE-NVI was 129.1±22.1, MSBS was 136.22±45.8. Positive correlation between DERS total and avoidance strategies (r=+0.6,p<0.001) and negative correlation between DERS total and problem orientation strategies (r=-0.467,p=0.023) were found. Linear regression analyses showed statistically significant differences between DERS and COPE-NVI avoidance strategies (p<0.001) and COPE-NVI problem orientation (p<0.023). Mediation analyses confirmed the mediatory role of boredom dimension in the association between COPE-NVI avoidance subscale and DERS total (B=0.6849, p <0,001), between avoidance subscale and DERS lack of acceptance subscale (B=0.1286, p<0.001). Moreover, a mediatory role of MSBS inattention subscale was found in the association between COPE-NVI avoidance subscale and DERS lack of control subscale (B=0.1027, p<0.001).

Maladaptive coping strategies (particularly avoidance) were associated with increased DERS levels. A predominant use of more adaptive coping strategies (i.e., problem solving, planning) were associated with lower DERS levels. Their relationship appears to be mediated by boredom dimension.

None Declared

In recent years, more evidence is emerging in favor of a new form of depression, aka “Modern-Type Depression” (MTD). It has also been theorized that MTD may have multiple relationships with other psychiatric disorders, including techno-addictions.

Our study aims at clinically characterizing subjects with MTD in a sample of individuals affected with Internet Gaming Disorder (IGD).

1,157 subjects were recruited from a sample of Italian young people (aged 18-35), and selected only if they declared to be video game players (48.6%, n=542). Video game players filled out the 22-item Tarumi’s Modern-Type Depression Trait Scale (TACS-22), Motives for Online Gaming Questionnaire (MOGQ), Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), Problematic Online Gaming Questionnaire (POGQ), Multidimensional State Boredom Scale (MSBS), Symptom Checklist-90 (SCL-90). Subjects were classified as IGD+/IGD- and MTD+/MTD-. Descriptive analysis, Mann-Whitney’s U-test for independent data and Chi-square tests were carried out.

60.5% (n=328) of the sample were male. 21.7% (n=118) were positive to MTD. MTD subjects reported significantly higher scores at IGDS9-SF (p<0.001), POGQ (p<0.001), MOGQ (p=0.003), MSBS (p<0.001). Significant higher scores were found at the MOGQ subscales “reality avoidance” (p<0.001), “coping” (p=0.001), and “fantasy” (p<0.001) and at the SCL-90 subscales “interpersonal sensitivity” (p<0.001), “phobic anxiety” (p<0.001), and “psychoticism” (p<0.001).

MTD displayed a strong association with technopathies, particularly IGD. Therefore, further studies should evaluate whether MTD could represent a predictor to IGD onset and/or maintenance and adequately address this aspect from a preventive and treatment perspective.

None Declared

During the last decade, a growing digitalization allowed to implement technologies in daily life activities. Conversely, the increased use of technologies in general population, particularly in youths, facilitated the emergence of new web-based psychopathologies, including Pathological Internet use (PIU).

Our study aims at investigating the relationship between PIU and boredom as well as loneliness dimensions in youths, by also focusing on the association with the main psychopathological symptomatology (i.e., depression, anxiety and stress).

A nationwide population-based cross-sectional case-control study was conducted by recruiting a sample of Italian young adults (aged 18-24), using a snowball sampling strategy. After data cleaning, only 1,643 participants were selected for analysis based on age and classified according to the presence/absence of PIU/non-PIU. Linear regression analyses as well as Pearson correlation analyses were conducted to check for possible associations and correlations between PIU and stress/anxiety/depression. Subsequently, mediation analyses regarding boredom and loneliness were conducted on these relationships.

Participants were predominantly females (68.7%; n = 1,129). The mean age was 21.8 years (SD = 1.7), particularly ranging 20-24 years-old (88.5%; n = 1454). Around 41.7% (n = 685) of the sample declared previous psychological issues without a history of professional support (psychological and/or psychiatric), while 32.7% (n = 538) stated that they had an overt mental disorder and were currently receiving professional support. Mediation analysis demonstrated that both boredom and loneliness act as mediators in the association between PIU and depression.

Further studies are needed to evaluate how boredom and loneliness dimensions could be managed in order to alleviate the emergence of PIU in youths with clinically relevant depressive symptomatology.

None Declared

COVID-19-related physical isolation, fear and anxiety determined de novo mental illnesses, by potentially facilitating the emergence of Hikikomori traits (i.e., a severe social withdrawal condition).

The present study aims at screening a cohort of university students for the Hikikomori traits and assessing a set of psychopathological determinants associated with Hikikomori, particularly boredom and loneliness dimensions.

A cross-sectional web-based survey was carried out by administering Hikikomori Questionnaire (HQ-11), Italian Loneliness Scale (ILS), Multidimensional State Boredom Scale (MSBS), Depression Anxiety Stress Scale (DASS-21) and Toronto Alexithymia Scale (TAS-20).

1,148 respondents (767 women and 374 men, mean age: 23.2±SD=2.8 years old) were recruited. 70.7% declared to have experienced psychological distress. HQ-11 average total score was 18.4±SD=7.5 with statistically significant higher values in the males (p=0.017) and amongst students studying Informatics, Mathematics/Physics/Chemistry, Science of Communication and Engineering. The HQ-11 positively correlated with ILS (r=0.609), MSBS (r=0.415), TAS-20 (r=0.482) and DASS-21 (r=0.434).

This study represents the first screening of the Hikikomori phenomenon in Italian university students. Hikikomori traits appear to be particularly represented in the Italian youth population and should be carefully investigated in future studies.

No significant relationships.

Hikikomori represents the severe social withdrawal condition of the so-called ‘modern type-depression” (MTD). Digital addictions, including Internet addiction (IA), Internet gaming disorder (IGD) and smartphone addiction, have been associated with MTD and Hikikomori.

This is a post-hoc study aimed at assessing digital addictions in a cohort of university students with a positive screening for MTD and Hikikomori.

A cross-sectional web-based survey was conducted by administering the Hikikomori Questionnaire (HQ-11), Internet Addiction Test (IAT), Internet Gaming Disorder Scale-Short-Form (IGDS9-SF) and the Smartphone addiction scale-Short Version (SAS-SV).

Among 1,148 respondents, a significant association was found between the HQ-11 scale and the DASS-21 total score (r=0.434). The HQ-11 positively correlated with IAT, IGDS9-SF and SAS-SV (r=0.329; r=0.292 and r=0.205 respectively).

Digital addictions appear to be widely diffuse among university students positive to the Hikikomori and MTD screening. Further longitudinal studies are needed to weight and balance the potential consequences of digital tools in Hikikomori subjects.

No significant relationships.

International Classification of Diseases 11th Revision (ICD-11) has inserted complex post-traumatic stress disorder (cPTSD) as a clinically distinct disorder, different from PTSD. The diagnosis of cPTSD has the same requirements for the one of PTSD, in addition to disturbances of self-organization (DSO – e.g., disturbances in relationships, affect dysregulation, and negative self-concept).

This study aimed to explore suicidality in PTSD and cPTSD. We examined also the association between clinical dimensions of hopelessness (feelings, loss of motivation, future expectations) and other symptomatologic variables.

The sample, recruited at the Fondazione Policlinico Tor Vergata, Rome, Italy, consisted of 189 subjects, 132 diagnosed with PTSD, and 57 with cPTSD, according to the ICD-11 criteria. Participants underwent the following clinical assessments: Clinician-Administered PTSD Scale (CAPS), Impact of Event Scale-Revised (IES), Beck Depression Inventory (BDI), Symptom Checklist-90-Revised (SCL-90), Dissociative Experience Scale (DES), Beck Hopelessness Scale (BHS).

cPTSD showed significantly higher BHS-total (p = 0.01) and BHS-loss of motivation subscale (p <0.001) scores than PTSD. Besides, cPTSD showed significantly higher scores in all clinical variables except for the IES-intrusive subscale. By controlling for the confounding factor “depression”, suicidality in cPTSD (and in particular the BHS-total) appears to be correlated with IES-total score (p = 0.042) and with DES-Absorption (p = 0.02). Differently, no such correlations are found in PTSD.

Our study shows significant symptomatologic differences between PTSD and cPTSD, including suicidality. Indeed, suicidality in cPTSD appears to be correlated with the “loss of motivation” dimension, which fits well within the ICD-11 criteria of DSO.

No significant relationships.

Cognitive function is impaired in depressive disorders. Among several factors implicated in regulation of the cognitive function, metabolic syndrome has been showed have a pivotal role cognitive functioning in healthy controls. However, the role of metabolic syndrome in regulating the cognitive functioning of subjects affected by depressive disorders is little studied.

To investigate the effect of metabolic syndrome in regulation of cognition in unipolar and bipolar depression.

One-hundred-sixty-five people affected by a depressive disorder (unipolar depression, UP; bipolar depression, BP) were enrolled at the Psychiatric and Clinic Psychology Unit of the University of Rome Tor Vergata, Rome, Italy. A group of healthy controls (HC) matched for agender and age was enrolled. The cognitive functions were evaluated with a computerized tool, THINC-it.

UP and BP had lower performances in THINC-it cognitive domains than HC. Metabolic syndrome is a negative, independent predictor of low performance in the THINC-it cognitive domains of people with depressive disorders.

Our findings confirm that metabolic syndrome has a prominent role in determining the cognitive efficiency in depressive disorders, independently by the presence of a unipolar or bipolar depressive disorder. Metabolic syndrome has to be considered a major factor that should be considered in the treatment strategies of cognitive functioning improvement of people affected by depressive disorders.

No significant relationships.

Amongst different subtypes of Conversion Disorder (CD), DSM-V lists the Psychogenic Non-epileptic seizures (PNES). PNES are defined as episodes that visually resemble epileptic seizures but, etiologically, they are not due to electrical discharges in the brain.

Our study aims to explore the differences between PNES and other CDs. In particular, we studied the suicidality and its correlations with dissociation and alexithymia.

Patients, recruited from the Psychiatry and Clinical Psychology Unit of the Fondazione Policlinico Tor Vergata, Rome, Italy, were diagnosed with PNES (n=22) and CD (n=16) using the DSM-5 criteria. Patients underwent the following clinical assessments: HAM-D, BDI, DES, BHS, TAS, CTQ.

PNES showed significantly higher scores than CD in all assessments, except for BDI-somatic (p=0.39), BHS-feeling (p=0.86), and the presence of childhood trauma. PNES also showed significantly higher suicidality (p = 0.003). By controlling for the confounding factor “depression”, in PNES suicidality (and in particular the BHS-loss of motivation) appears to be correlated with DES-total score (p = 0.008), DES-amnesia (p = 0.002) and DES -derealization-depersonalization (p = 0.003). On the other hand, in CDs, the BHS-total score shows a correlation with the TAS-total score (p = 0.03) and BHS-Feelings with TAS-Externally-Oriented Thinking (p = 0.035), while only the BHS-Loss of motivation appears correlated with DES-Absorption (p = 0.011).

Our study shows significant differences between PNES and CD, in several symptomatologic dimensions, including suicidality. Indeed, in PNES suicidality appears to be related to dissociation, while in CDs it appears mainly to be correlated with alexithymia.

The deficiency of polyunsaturated fatty acids (PUFAs) and an alteration between the ratio of omega-6 and omega-3 PUFAs may contribute to the pathogenesis of depressive disorders.

To investigate the levels of omega-3 and omega-6 in red cell membranes (mPUFAs) and plasma (pPUFAs) of patients with treatment-resistant (TRD) and non-treatment resistant depression (non-TRD).

TRD and non-TRD consisted of 75 patients enrolled at the Psychiatric and Clinic Psychology Unit of the University of Rome Tor Vergata, Rome, Italy, and met the DSM-IV criteria for major depressive disorder (MDD). A group of healthy controls (HC) matched for agender and age was enrolled. All blood samples were performed in conditions of an empty stomach between 07:00 am and 09:00 am. For each subject were obtained 5 ml of whole blood with the use of tubes for plasma with EDTA as an anticoagulant. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for omega-3 and arachidonic acid (AA) for omega-6 were measured.

Levels of pPUFAs did not differ between the three groups. The mPUFAs were altered in the MDD. TRD and non-TRD had lower EPA and AA values respect to the HC. DHA in red cell membranes was lower in TRD than non-TRD and HC.

Changes in levels of PUFAs in red cell membranes, but not in plasma, may be an important factor to evaluate the resistance to the pharmacological treatment.

Electroconvulsive therapy (ECT) is a medical treatment that is most effective for mood disorders.It has also been shown to be an effective form of treatment for schizophrenia. However, many unanswered questions remain regarding its role in the management of people with schizophrenia.

Evaluate the main indications of ECT in schizophrenia patients.

To investigate the efficacy of ECT in the treatment of schizophrenic patients, evaluating its effects in the short-term and the long-term, comparing ECT with pharmacotherapy, and assessing the effects of treatment and the main indications for use in patients with schizophrenia.

A systematic review of the literature was conducted for ECT and schizophrenia. Forty-nine articles from peerreviewed journals were identified.

The most common indication for using ECT for schizophrenia patients was to augment pharmacotherapy, while the most common accompanying symptoms were, in order, catatonia, aggression and suicide. Catatonic patients responded significantly better to ECT than patients with any other subtype of schizophrenia. The combination of ECT with pharmacotherapy can be useful for drug-resistant patients. The use of an ECT-risperidone combination or ECT-clozapine combination in patients non-responsive to prior pharmacotherapy was found to be most effective.

ECT, combined with pharmacotherapy, may be a viable option for a selected group of people with schizophrenia. In particular, the use of ECT is recommended for drug-resistant patients, for schizophrenic patients with catatonia, aggression or suicidal behavior, and when rapid global improvement and reduction of acute symptomatology is desired.

Patients with sleep disorders have a significant increase in suicidal ideation and suicide attempts, at the assessment and lifetime (Goodwin et al, 2008; Chellappa et al, 2007; Wojnar et al, 2009; Li et al, 2010).

To evaluate the relationship between sleep disorders and suicidal behavior.

To study factors associated with a diagnosis of insomnia in patients admitted to the Emergency Department.

Participants were 843 patients consecutively admitted to the Emergency Department of the Sant’Andrea University Hospital in Rome, Italy, between January and December 2010. All patients admitted were referred to a psychiatrist. A clinical interview based on the MINI and a semi structured interview were performed. Patients were asked about “ongoing” suicidal ideation or plans for suicide. Clinical diagnoses were assigned according to ICD-10 criteria.

48% received a diagnosis of a mood disorders (BD and MDD) or anxiety disorders, 17.1% Schizophrenia or other non-affective psychosis. Patients with insomnia had more frequently a diagnosis of BD (23.9% vs. 12.4%) or MDD (13.3% vs. 9.5%; P< 0.001). Patients with insomnia less frequently had attempted suicide in the past 24 hours (5.3% vs. 9.5%; P< 0.05) than other patients, but suicide attempters with insomnia more frequently used violent methods (64.3% vs. 23.6%; P< 0.01) than suicide attempters without insomnia.

Our results support a relationship between sleep disorders and suicidal behavior. Clinicians should pay attention to sleep disorders when assessing suicide attempters; in fact, such conditions may have important clinical implications.

The use of Performance and Image-Enhancing Drugs (PIEDs) is on the increase and appears to be associated with several psychopathological disorders, whose prevalence in unclear.

We aimed to evaluate the differences–if any–in the prevalence of body image disorders (BIDs) and eating disorders (EDs) in PIEDs users athletes vs. PIEDs nonusers ones.

We enrolled 84 consecutive professional and amateur athletes (35.8% females; age range = 18–50), training in several sports centers in Italy. They underwent structured interviews (SCID I/SCID II) and completed the Body Image Concern Inventory (BICI) and the Sick, Control, One, Fat, Food Eating Disorder Screening Test (SCOFF). Mann-Whitney U test and Fisher's exact test were used for comparisons.

Of the 84 athletes, 18 (21.4%) used PIEDs. The most common PIEDs were anabolic androgenic steroids, amphetamine-like substances, cathinones, ephedrine, and caffeine derivatives (e.g. guarana). The two groups did not differ in socio-demographic characteristics, but differed in anamnestic and psychopathological ones, with PIEDs users athletes being characterized by significantly (P-values < 0.05) higher physical activity levels, consuming more coffee, cigarettes, and psychotropic medications (e.g. benzodiazepines) per day, presenting more SCID diagnoses of psychiatric disorders, especially Substance Use Disorders, Eating Disorders, Body Dysmorphic Disorder (BDD), and General Anxiety Disorders, showing higher BICI scores, which indicate a higher risk of BDD, and higher SCOFF scores, which suggest a higher risk of BIDs and EDs.

In PIEDs users athletes body image and eating disorders, and more in general psychopathological disorders, are more common than in PIEDs nonusers athletes.

The authors have not supplied their declaration of competing interest.