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Article Highlights

Thanks to the works of distinguished philosophers and thinkers, there is no doubt that since ancient times, humanity has begun to focus on important questions and elaborate complex hypotheses regarding the concepts of free will and freedom of choice. Apparently, the questions seem to change over time, as they are expressed in different forms both in the ancient epics (such as the "Epic of Gilgamesh") and in modern and recent academic studies of quantum physics or neuroscience. However, the question if "mankind is truly free and able to choose freely?" remains constant throughout millennia and, in all probability, seems to be destined to remain unanswered and generate further speculation in the future. In a certain sense, the answers that were provided over the centuries also seem to provide a portrait of the many societies (and their relative vices as well as virtues) that have followed one to another. Starting from the results obtained after at least a decade intensively devoted to the study of the effects of the Internet, social networks and new technologies on psychopathology, Donatella Marazziti (2022) (pp. 277-279) attempts to provide answers to the aforementioned questions in the brilliant editorial that opens this autumn issue of Clinical Neuropsychiatry. However, if it is true that it is not the truth that sets us free but the doubt, Professor Marazziti is able to boldly hit this goal by inviting readers and colleagues to answer further questions that, sharply, reflect the current society in which we are living (or surviving). After all – according to a very personal opinion of mine that is dictated by the current historical moment – I fear that we cannot feel completely sure that we are able to distinguish whether we are actually living or surviving. Unfortunately, we are facing both with a conflict that, needless to deny, concerns us, a strictly related economic recession, and with the COVID-19 pandemic that (despite superhuman efforts) only seems to be slowly diminishing. On the other hand, if the intensive care units are now no longer overcrowded with pneumonia cases, a new epidemic has already presented itself to forcefully knock on the doors of family doctors and specialists, namely the cognitive deficits related to COVID-19. Sachdev and Shabbir (2022) (pp. 328-334), recognizing the importance of this new clinical burden, present a careful review of the literature aimed at shedding more light on the association between COVID-19 infection and the development of cognitive deficits, as well as at providing further points of speculation to better understand the underlying etiology and pathogenesis of this clinical consequence. Researching the etiological cause and describing the development of pathology is difficult, however it is no less simple to identify a treatment and understand the response mechanisms. For biological processes that still partly continue to be elusive, even the placebo and nocebo effects are able to elicit concrete and easily identifiable responses in humans. Fabrizio Benedetti, the undisputed leader in the field of research on the placebo effect, and his coworkers (2022) (pp. 298-306) present a study conducted on 378 healthy adults (whose prenatal maternal plasma cortisol level was measured during the three trimesters of pregnancy) aimed determining whether prenatal hyperactivity of hypothalamus-pitui tary-adrenal system (HPA) might influence nocebo effect in adults while, at the same time, at underlying the importance of clinicians-patients communication in perceiving symptoms such as pain. Abnormal and prolonged responses of the hypothalamus-pituitary-adrenal axis appear to be closely linked also with another symptomatic dimension that is transversal to numerous psychic disorders, that is rumination. Rumination may be defined as repetitive and unwanted past-centered negative thinking and described as a dynamic process that fluctuates over time (within hours and/or days). Although rumination is an extremely widespread and represented symptom, its investigation is usually conducted by the means of experiencing sampling methodology (ESM), a technique with measurements in everyday life.

Thanks to the works of distinguished philosophers and thinkers, there is no doubt that since ancient times, humanity has begun to focus on important questions and elaborate complex hypotheses regarding the concepts of free will and freedom of choice. Apparently, the questions seem to change over time, as they are expressed in different forms both in the ancient epics (such as the "Epic of Gilgamesh") and in modern and recent academic studies of quantum physics or neuroscience. However, the question if "mankind is truly free and able to choose freely?" remains constant throughout millennia and, in all probability, seems to be destined to remain unanswered and generate further speculation in the future. In a certain sense, the answers that were provided over the centuries also seem to provide a portrait of the many societies (and their relative vices as well as virtues) that have followed one to another. Starting from the results obtained after at least a decade intensively devoted to the study of the effects of the Internet, social networks and new technologies on psychopathology, Donatella Marazziti (2022) (pp. 277-279) attempts to provide answers to the aforementioned questions in the brilliant editorial that opens this autumn issue of Clinical Neuropsychiatry. However, if it is true that it is not the truth that sets us free but the doubt, Professor Marazziti is able to boldly hit this goal by inviting readers and colleagues to answer further questions that, sharply, reflect the current society in which we are living (or surviving).
After allaccording to a very personal opinion of mine that is dictated by the current historical moment -I fear that we cannot feel completely sure that we are able to distinguish whether we are actually living or surviving. Unfortunately, we are facing both with a conflict that, needless to deny, concerns us, a strictly related economic recession, and with the COVID-19 pandemic that (despite superhuman efforts) only seems to be slowly diminishing. On the other hand, if the intensive care units are now no longer overcrowded with pneumonia cases, a new epidemic has already presented itself to forcefully knock on the doors of family doctors and specialists, namely the cognitive deficits related to COVID-19. Sachdev and Shabbir (2022) (pp. 328-334), recognizing the importance of this new clinical burden, present a careful review of the literature aimed at shedding more light on the association between COVID-19 infection and the development of cognitive deficits, as well as at providing further points of speculation to better understand the underlying etiology and pathogenesis of this clinical consequence.
Researching the etiological cause and describing the development of pathology is difficult, however it is no less simple to identify a treatment and understand the response mechanisms. For biological processes that still partly continue to be elusive, even the placebo and nocebo effects are able to elicit concrete and easily identifiable responses in humans. Fabrizio Benedetti, the undisputed leader in the field of research on the placebo effect, and his coworkers (2022) (pp. 298-306) present a study conducted on 378 healthy adults (whose prenatal maternal plasma cortisol level was measured during the three trimesters of pregnancy) aimed determining whether prenatal hyperactivity of hypothalamus-pituitary-adrenal system (HPA) might influence nocebo effect in adults while, at the same time, at underlying the importance of clinicians-patients communication in perceiving symptoms such as pain.
Abnormal and prolonged responses of the hypothalamus-pituitary-adrenal axis appear to be closely linked also with another symptomatic dimension that is transversal to numerous psychic disorders, that is rumination. Rumination may be defined as repetitive and unwanted past-centered negative thinking and described as a dynamic process that fluctuates over time (within hours and/or days). Although rumination is an extremely widespread and represented symptom, its investigation is usually conducted by the means of experiencing sampling methodology (ESM), a technique with measurements in everyday life.
Pisa (Turco and colleaugues, 2022) (pp. 307-313) who, starting from the description of the judicial aspects of five cases of suicide in psychiatric patients, attempt to analyze and discuss whether suicide could be actually preventable and if that could be proven beyond any reasonable doubt (in terms of healthcare responsibility under penal judgment).
In their preliminary study, Hoebeke and colleagues developed an ESM protocol and questionnaire to assess rumination as a multifaced construct in a sample of 40 subjects. Albeit their work remains in need of further validation, this newborn protocol may represent a useful research tool to investigate how rumination's features fluctuate and interact with other constructs over time.
Also, rumination might be one of the several symptoms that occur in overlap in both autism spectrum disorders (ASDs) and cluster C personality disorders (CCPDs), albeit further investigation is still required to disentangle the various phenotypes of the aforementioned psychopathological conditions. Langwerden and his team (2022) (pp. 335-346) present an explorative investigation aimed at finely analyzing and comparing personality and psychopathological dimensions in both samples of adults with ASDs (without intellectual disability), CCPDs and healthy subjects by the means of the Minnesota Multiphasic Personality Inventory 2 Restructured Form (MMPI-2-RF).
The current issue of Clinical Neuropsychiatry presents two systematic reviews of the literature, both conducted by Italian research teams.
In the first review of this issue, Cavicchioli and colleagues (2022) (pp. 314-327) collect and analyze 15 independent studies examining the clinical effects of repetitive transcranial magnetic stimulation (rTMS) in obesity and amongst different eating disorders (EDs), highlighting how rTMS might be useful as augmentation in the treatment of EDs while, at the same time, hinting at an urgent need of further investigations aimed at identifying novel and alternative non-pharmacological interventions in EDs.
In the second review, Bottaro and Faraci (2022) (pp. 280-287) present a fine dissertation on the so-called Upper Disorders (UDs), namely an umbrella term used to describe a wide set of non-specific chronic muscularskeletal disorders in head, neck or lower back and that seem to be very common in high-income countries, with an impact on economics and public health. By analyzing 10 full-text papers, the authors report a significant association between UDs and depression, mood disturbances, anxiety, distress alexithymia, and low social support, while also presenting the possible implications in terms of holistic care.
In closing, this Clinical Neuropsychiatry issue presents a notable contribution resulting from a fruitful collaboration between our colleagues' specialists in forensic medicine and in psychiatry at the University of