A growing body of scientific literature suggests that HIV seroprevalence among people with serious mental illness has increased substantially in recent years. In the Italian context, specialized services (mental health or infectious disease) more and more are requested for combined management of dual diagnosis. Consequently health care workers (HCW) have to face difficulties due to new situations of care. To fill these gaps, the core purpose of this study is to analyze HCW experiences from their own perspectives in order to understand their difficulties and create good practices in health care.

A qualitative study was conducted in public services Mental Health and HIV/AIDS workers, in Lazio region, Italy.

HCW were asked in anonymous way about their experiences. The interviews, consisting of one open_question, were audio taped and integrally transcribed and the texts were analysed through software T-Lab (cluster and correspondence analysis).

91 HCW were interviewed. We identified, trough cluster analysis, six cultural models about dual diagnosis: Disease as personal experience, Fear of contagion, Training as support to work, Service as integration function, Families as object of the intervention, Disease as scientific knowledge

In conclusion, this study examines for the first time the constructions of dual diagnosis in the Italian context through text and language of HCW. It reveal that we need further elaboration because of sociocultural meanings of dual diagnosis are not fixed but are ongoingly co-constructed by the various participants of health context.

A growing body of scientific literature emphasizes a strong linkage between HIV/Aids and serious mental illness. In the Italian context, specialized services for combined management of dual diagnosis are increasingly requested, and healthcare professionals (HPWs) have to face up the difficulty emerging by this new situation. To bridge these gaps, the present study aimed at studying the representations of dual diagnosis, analyzing HPWs’ experiences from their own perspectives, in order to understand their difficulty and create future good practices in healthcare services.

A quali-quantitative study was conducted with a multidisciplinary sample of professionals (N=91), drawn by HIV/Aids and Mental Health sites. Due to the exploratory nature of the research, data were collected from semi-structured interviews: HPWs were asked about their work experiences with HIV/Aids and Mental Illness. The interviews were fully audio-taped and verbatim transcribed. A computer-aided lexical correspondence analysis was conducted by a dedicated text-analysis software.

Data analysis showed out two main factorial dimensions: the first regarding the representation of the “Management of dual diagnosis within Health Services”, and the second one referring to the “categorization of HIV/Aids-Mental Illness co-morbidity”. Furthermore, four different Representational Conceptions were highlighted, corresponding to as many different ways HPWs use to represent/depict the aims of Health Service in relation to HIV/Aids-Mental Illness co-morbidity.

This study reveals that socio-cultural meanings of dual diagnosis are not fixed; rather, they are ongoing co-constructed within the activities carried out by the HPWs involved in their specific health contexts in the exercise of their profession.

A link between anxiety and disfunctions of the Hypotalamic-pituitary-adrenal (HPA) axis has been widely reported in both normal and pathological anxiety, but research findings are controversial.

To explore gender differences in the relationships between cortisol and neurosteroids and subthreshold anxiety dimensions.

To investigate the possible correlations between serum cortisol and dehydroepiandrosterone sulphate (DHEA-S) levels, or DHEA-S/cortisol ratio, and the subthreshold panic dimensions in a sample of healthy subjects.

Forty-two Italian civilians, without current or lifetime psychiatry disorders, were recruited and assessed by means of the Structured Clinical Interview for DSM-IV (SCID-I/P) and a specific questionnaire, the so-called Panic Agoraphobic Spectrum-Self Report lifetime version (PAS-SR), for assessing subthreshold panic-agoraphobic dimensions.

The results showed the presence of significant negative correlations between the cortisol levels and the total scores of the PAS-SR and of the following domains: separation sensitivity, panic like symptoms and medication/substance sensitivity. The PAS-SR total and the panic-like symptoms domain scores were related positively to the DHEAS/cortisol ratio. When the sample was distinguished in women and men, it turned out that this correlations were present only in women.

This findings would indicate that cortisol levels are related to subthreshold panic-agoraphobic symptoms, with a gender specificity. Therefore, further studies are needed to investigate those subthreshold conditions in order to indentify possible gender differences that may account for phenotypes at higher risk for psychiatric disorders.

Recent studies indicate that Adult Separation Anxiety Disorder (ASAD) may represent a discrete diagnostic entity worthy of attention. Adults with ASAD report estreme anxiety and fear about separations from major attachment figures. These symptoms lead to severe impairment in social relationships and are not better accounted for by the presence of agoraphobia. In a previous study, we found platelet expression reduction of the 18 kDa Translocator Protein (TSPO) in patients with panic disorder with associated ASAD.

To explore whether separation anxiety might be a factor differentiating TSPO expression in a sample of patients with major depression.

The equilibrium binding parameters of the specific TSPO ligand [3H]PK 11195 were estimated on platelet membranes from 40 adult outpatients with MDD, with or without separation anxiety symptoms, and 20 healthy controls. Patients were assessed by SCID-I, HAM-D, the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS) and the Adult Separation Anxiety Self-report Checklist (ASA-27).

A significant reduction of platelet TSPO density mean value was found in depressed patients with associated ASAD, while no significant differences were found between depressed patients without ASAD and the control group. Individual TSPO density values were significantly and negatively correlated with both SCI-SAS-A and ASA-27 total scores, but not with HAM-D total score or HAM-D anxiety/somatization factor score.

Reduction of platelet TSPO density in our sample of patients with depression was specifically related to the presence of ASAD. These data suggest that TSPO expression evaluation is a useful biological marker of ASAD.