Cinzia Correale
@iss.it
Center for Behavioral Science and Mental Health
National Health Institute
RESEARCH, TEACHING, or OTHER INTERESTS
Psychology, Clinical Psychology, Neuropsychology and Physiological Psychology
Scopus Publications
Scopus Publications
Nicola Pietrafusa, Marina Trivisano, Susanna Casellato, Cinzia Correale, Simona Cappelletti, Paola De Liso, Ilaria Onida, Stefano Sotgiu, Ambra Butera, Nicola Specchio,et al.
Wiley
AbstractDravet syndrome (DS) is a rare developmental and epileptic encephalopathy. Infants with DS are especially vulnerable to the detrimental effects of prolonged and frequent seizures on development. Fenfluramine (FFA) is approved for the treatment of DS in patients aged 2 years and older. This study aims to evaluate the safety and efficacy of FFA in patients with DS younger than 2 years. We analyzed safety, tolerability, seizure, and neuropsychological outcome in a real‐world setting. Developmental profile was investigated using Griffiths Mental Development Scales (GMDS). Five patients received FFA at a mean age of 14.9 months (9.6–18.6). Median follow‐up was 13 months (interquartile range [IQR] = 12.9–24.4). All patients showed good tolerance to FFA. No significant variation of body mass index or echocardiographic issue was observed. Monthly median convulsive seizure frequency (MCSF) was 1.71 (IQR = 1.56–3.27) at the 6‐month baseline period and .92 (IQR = .43–1.28) at last follow‐up, with a median 54.43 (IQR = 40.91–60.83) percentage reduction in MCSF. Two of five patients had a performance improvement on GMDS subscales. Overall, the use of FFA below the age of 2 years in our small sample of patients was safe and represents a promising opportunity for seizure control and for protection of the neurodevelopmental outcome.
Paolo Surdi, Marina Trivisano, Angela De Dominicis, Mattia Mercier, Ludovica Maria Piscitello, Giusy Carfì Pavia, Costanza Calabrese, Simona Cappelletti, Cinzia Correale, Luigi Mazzone,et al.
Wiley
AbstractObjectiveDevelopmental and epileptic encephalopathies (DEEs) are neurological disorders characterized by developmental impairment and epilepsy. Our study aims to assess disease progression by comparing clinical findings, electroencephalography (EEG), and neuropsychological data from seizure onset to the last follow‐up evaluation.MethodsWe retrospectively reviewed patients with genetic DEEs who were followed‐up at the epilepsy unit of Bambino Gesù Children's Hospital, Rome. We collected information regarding gender, family history, genetic variant, age at onset and at last follow‐up, neurological examination, type of seizure, drug resistance, occurrence of status epilepticus, and movement and cognitive and behavioral disorders. We compared EEG background activity, epileptiform abnormalities, and cognitive functions between seizure onset and the last follow‐up evaluation using the McNemar‐Bowker test (α = 5%).ResultsA total of 160 patients (94 female) were included. Genetic analysis revealed a spectrum of pathogenic variants, with SCN1A being the most prevalent (25%). The median age at seizure onset and at the last follow‐up was 0.37 (interquartile range [IQR]: 0.09–0.75) and 8.54 years (IQR: 4.32–14.55), respectively. We documented a statistically significant difference in EEG background activity (p = .017) and cognitive impairment (p = .01) from seizure onset to the last follow‐up evaluation. No significant differences were detected for epileptiform abnormalities (p = .2). In addition, high prevalence rates were observed for drug resistance (81.9%), movement disorders (60.6%), behavioral and autism spectrum disorders (45%), neurological deficits (31.3%), and occurrence of status epilepticus (23.1%).SignificanceOur study provides evidence that a clinical progression may appear in genetic DEEs, manifesting as development or worsening of cognitive impairment and disruption of EEG background activity. These results highlight the challenging clinical course and the importance of early intervention and personalized care in the management of patients with DEEs.
Simona Cappelletti, Cinzia Correale, Mattia Mercier, Giusy Carfi Pavia, Chiara Falamesca, Alessandro De Benedictis, Carlo Efisio Marras, Chiara Quintavalle, Concetta Luisi, Chiara Pepi,et al.
Wiley
AbstractObjectiveThe aim of this study is to describe the pre‐ and post‐operative developmental and intellectual functions in a cohort of patients who underwent surgery for drug‐resistant epilepsy (DRE) before the age of 5 years.MethodWe retrospectively reviewed the medical records and neurodevelopmental assessments of a cohort of 80 surgically treated pediatric patients with DRE. We included patients if they had at least one pre‐ and one post‐surgical neuropsychological assessments; 27 met the inclusion criteria. We evaluated Developmental Quotient (DQ) and Intelligence Quotient (IQ) before and after surgery. We identified two groups based on psychological evaluation outcome: Group 1, with stable or improved developmental and intellectual functions, and Group 2, experiencing developmental and intellectual loss.ResultsThe mean age at seizure onset was 1.2 ± 1.0 years, and the mean age at surgery was 2.9 ± 1.2 years. At the last follow‐up (mean 4 years, SD ± 2), 19/27 (70%) patients were seizure‐ and drug‐free; 18/27 patients (67%) fit in Group 1, and 9/27 (33%) fit in Group 2. The mean age at surgery was 2.6 years (SD ± 1.1; range 1.2–5.1) in Group 1 and 3.4 years in Group 2 (SD ± 1.1; range 1.6–5.0). Group 1 had a lower pre‐operative DQ/IQ total score than Group 2 (median DQ/IQ respectively 82 vs 108, p = 0.05). Between pre‐ and post‐assessments, we found that in Group 1, Performance scores improved (82.7 vs 102, p = 0.001), while in Group 2, the Total and Verbal scores worsened (respectively 108 vs 75, p = 0.008, and 100 vs 76, p = 0.021).SignificanceOur study's results emphasize the positive impact of surgery before the age of 5 years on developmental and intellectual outcomes. Despite limitations such as a small sample size, lack of a control group, and diverse etiologies, our findings support the crucial role of early intervention in preserving or enhancing developmental and intellectual functions in young patients with DRE.Plain Language SummaryThis retrospective study, conducted at the Bambino Gesù Children Hospital in Italy, reports neuropsychological and developmental and/or cognitive data for children undergoing early epilepsy surgery (before the age of 5). It found that children with lower developmental or cognitive profiles gained the highest scores on post‐operative neuropsychological evaluations. This study provides information on the potential benefits of early surgery in shortening the duration of epilepsy, preventing or arresting deterioration, and enhancing plasticity and recovery.
Cinzia Correale, Chiara Falamesca, Ilaria Tondo, Marta Borgi, Francesca Cirulli, Mauro Truglio, Oriana Papa, Laura Vagnoli, Cinzia Arzilli, Cristina Venturino,et al.
MDPI AG
COVID-19 is continuing to spread around the world, having a direct impact on people’s daily lives and health. Although the knowledge of the impact of the COVID-19 pandemic on mental health in the general population is now well established, there is less information on its effect on specific and vulnerable populations, such as children with chronic illness (CI). We conducted a multi-centered cross-sectional study among pediatric patients in six public children’s hospitals in Italy during the first lockdown, with the aim of assessing the proportion of children with CI presenting anxiety and depressive symptoms, and the clinical and demographic characteristics affecting such symptomatology. We included children with at least one chronic condition, with no cognitive delay, aged between 11 and 18 years. Brief standardized questionnaires were administered during medical scheduled visits to screen anxiety and depressive symptoms. We found a very high proportion of children showing mild to severe depressive and anxiety symptomatology (approximately 68% and 63%, respectively). Our results highlight the need of ensuring tailored psychological interventions to protect children with CI from the effect of the pandemic (and related restrictive measures such as quarantine and social distancing), with the final aim of promoting mental health and psychological well-being in this vulnerable population.
Cinzia Correale, Marta Borgi, Barbara Collacchi, Chiara Falamesca, Simonetta Gentile, Federico Vigevano, Simona Cappelletti, and Francesca Cirulli
Frontiers Media SA
IntroductionAnimal Assisted Interventions (AAIs) are increasingly common in pediatric care settings as a means to promote the physical, mental, and emotional well-being of hospitalized children and adolescents.ObjectivesThe aim of this work was to review published studies implementing AAIs in hospital settings and to assess the effects of AAIs on the biobehavioral response to stress and pain, social behavior, quality of life and level of satisfaction with hospitalization in children and adolescents. Stress and burden, quality of life, mood and level of satisfaction with hospitalization in parents/caregivers as well as stress and burden, perception of the work environment and job satisfaction in hospital staff were also reviewed.MethodsAll published studies reporting quantitative assessments were systematically searched using PubMed, Scopus, ProQuest and Web of Science databases in accordance with PRISMA guidelines. The aim was to identify studies examining the effects of AAIs on behavioral, psychological and physiological responses to stress in children and adolescents (0–18 years) formally admitted to a hospital for a stay, as well as in those undergoing a visit for treatments or medical examinations.ResultsOf the 350 studies screened, 21 were eligible for inclusion. Most of them focused on stress, pain, and anxiety reduction in pediatric patients, and used both physiological parameters and behavioral and psychological observations/scales. All studies employed dogs. Results show the potential of AAIs to reduce anxiety and behavioral distress in pediatric patients while acting on physiological measures associated with arousal.ConclusionAlthough further, more rigorous studies are still needed, the findings of this review may have implications for clinical practices suggesting appropriate planning of AAIs by pediatric healthcare professionals.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=178993], identifier [CRD42020178993].
Cinzia Correale, Marta Borgi, Francesca Cirulli, Fiorenzo Laghi, Barbara Trimarco, Maurizio Ferraro, and Aldina Venerosi
MDPI AG
Background: Autism spectrum disorder (ASD) is a complex developmental condition that affects the whole family. The gap between childrens’ needs and their satisfaction, especially regarding what concerns the presence of social and healthcare services, is still a source of burden, particularly after the transition to adulthood. Our study aimed to gather a comprehensive view on how parents of adults with ASD perceive (and interact with) health and social services, and how the provision of care impacts family quality of life with the aim to advise ASD intervention programs. The goal is to identify specific areas of change useful to influence autism intervention strategies so that they more effectively meet the needs of young people with autism and their families. Methods: We conducted two focus groups with parents of young adults with ASD. A semi-structured focus group methodology was adopted. The QoL conceptual framework guided data collection and analysis as part of a directed theory-driven content analysis approach. Results: The lack of structured care pathways and the low level of integration of different services were the main limits reported by parents during the focus group, while a shared positive perception of the experience conducted together as caring families emerged. Conclusions: The experience here reported claims for a greater role of the institutions in order to facilitate the building of networks that are really inclusive for persons with autism in society and to support the implementation of innovative solutions for the welfare system. Furthermore, parents stressed the need for the provision of support to the family.
M. Borgi, B. Collacchi, C. Correale, Mario Marcolin, Paolo Tomasin, A. Grizzo, Roberto Orlich and F. Cirulli
Nature-based contextual factors are being recognized as fundamental for mental health prevention and promotion. Rural areas, indeed, are increasingly recognized as an elective place for the promotion of mental health. In recent years there has been a surge of rurally-based hybrid governance models in which public bodies, local communities and economic actors join forces to create innovative welfare solutions to facilitate the financial (and organizational) challenges faced by the National Health Systems. Using agricultural resources, such as animals and plants, social farming is able to address specific social needs, including rehabilitation, sheltered employment, life-long education and other activities that contribute to social inclusion. At the same time social farming is able to strengthen the economic and social viability of rural communities. We have been studying the factors underlying the potentiality of social farms to provide job placement programs and rehabilitation for people with mental disorders. Using novel methodologies and appropriate tools, we have been collecting data indicating the positive effects of farming activities on individual's social functioning, as well as the impact of farms' networking on system's sustainability.
Marta Borgi, Mario Marcolin, Paolo Tomasin, Cinzia Correale, Aldina Venerosi, Alberto Grizzo, Roberto Orlich, and Francesca Cirulli
MDPI AG
Social farming represents a hybrid governance model in which public bodies, local communities, and economic actors act together to promote health and social inclusion in rural areas. Although relational variables are crucial to foster social farm performance, the relational system in which farms are embedded has still not been fully described. Using social network analysis, here we map the nature of the links of a selected sample of social farms operating in Northern Italy. We also explore possible network variations following specific actions taken to potentiate local social farming initiatives. The results show a certain degree of variability in terms of the extension and features of the examined networks. Overall, the actions taken appear to be significant to enlarge and diversify farms’ networks. Social farming has the potential to provide important benefits to society and the environment and to contrast vulnerability in rural areas. Being able to create social and economic networks of local communities, social farming may also represent an innovative way to respond to the cultural shift from institutional psychiatry to community-based mental health care. This study emphasizes the critical role played by network facilitation in diversifying actors, promoting heterogeneous relationships, and, in turn, system complexity.
Marco Cacioppo, Daniela Barni, Cinzia Correale, Sonia Mangialavori, Francesca Danioni, and Alessio Gori
Springer Science and Business Media LLC
Cinzia Correale, Lara Crescimbene, Marta Borgi, and Francesca Cirulli
MDPI AG
Here we describe a pilot Dog-Assisted Activity program that was designed to improve wellbeing and social integration in a multi-cultural elementary classroom in which some episodes of bullying had been reported. We developed a 5-encounters protocol with the aim of introducing pet dogs into the class to stimulate understanding of different types of communication and behavior, ultimately facilitating positive relationships among peers. A preliminary evaluation was carried out in order to assess the effect of the program on teachers’ perception of children’s difficulties (e.g., peer relationship problems) and strengths (prosocial behaviors) by means of a brief behavioral screening tool, the Strengths and Difficulties Questionnaire (SDQ—Teacher version). Overall results indicate that, by means of the recognition of the dogs’ behavior and non-verbal communication, children were able to express their emotions and to show behaviors that had not been recognized by the teachers prior to the intervention. In particular, the SDQ Total Difficulties scores suggest that the teacher had increased awareness of the students’ difficulties as a result of the dog-assisted program. Overall, the presence of animals in the educational environment may provide enjoyment and hands-on educational experiences, enhanced psychological wellbeing, and increased empathy and socio-emotional development.
S. Cerino, M. Borgi, Ilaria Fiorentini, C. Correale, A. Lori and F. Cirulli
An increasing number of studies have shown the beneficial effects of both recreational and therapeutic interventions assisted
by animals for children with Autism Spectrum Disorders (ASD). The observed effects are believed to be mainly due to the ability of some animals to positively engage people, thus potentially counteracting the social withdrawal characterizing these subjects. Here we report the case of a child with high-functioning autism who has been included in an Equine-Assisted Intervention (EAI) program for 2 years. In particular, the relationship with the animal was used to encourage child’s narrative abilities as a primary means of improving cognition and communication. This case represents a first attempt to theorize the role of human-animal interaction as an adjunct to classic therapeutic strategies in ASD. During the intervention, the child appeared to gradually abandon his attitude to avoid the contact with the present and to hide in imaginative past and future. We propose animal-assisted interventions as complementary approaches capable to facilitate the verbalization of the patient’s internal states and to promote psychological well-being through the development of a bond with the animal.