Objective: Environmental conditions during early life may affect individual vulnerability to both physiological changes as well as psychiatric conditions, especially in those with a genetic susceptibility. Among all factors, sunlight exposure intensity has a crucial effect on affecting circadian functions high-risk individuals. A potential explanation of this relation is that excessive sunlight exposure is able to impair biological mechanisms, possibly through the dysregulation of serotonin and/or melatonin production/metabolism. The aim of this study was to evaluate the influence of excessive sunlight exposure in a sample of emergency psychiatry inpatients. Methods: All subjects were consecutively recruited from the Psychiatric Inpatient Unit of San Luigi Gonzaga Hospital, Orbassano (University of Turin, Italy) from September 2013 to August 2015. Socio-demographic and clinical characteristics were carefully collected. Results: We initially screened a sample of 900 patients; however, only 730 subjects voluntary accepted to participate in the study. Patients with admissions in spring/summer (a period in which daylight/darkness ratio is longer) showed a higher prevalence of involuntary admission, an earlier age at illness onset, a longer duration of hospitalization and admission for (hypo)manic episode. Conclusions: Excessive sunlight exposure may exert a fundamental role on psychopathological conditions presumably affecting biological vulnerability. A better understanding of its effect on the course of bipolar and other psychiatric disorders may assist in tailoring the adequate treatment for patients resulting in a shorter stay within hospitalized settings and a better treatment response.

Background: Adding short-term psychodynamic psychotherapy (STPP) to antidepressants increases treatment efficacy, but it is unclear which patients benefit specifically. This study examined efficacy moderators of combined treatment (STPP + antidepressants) v. antidepressants for adults with depression.Methods: For this systematic review and meta-analysis (PROSPERO registration number: CRD42017056029), we searched PubMed, PsycINFO, Embase.com, and the Cochrane Library from inception to 1 January 2022. We included randomized clinical trials comparing combined treatment (antidepressants + individual outpatient STPP) v. antidepressants in the acute-phase treatment of depression in adults. Individual participant data were requested and analyzed combinedly using mixed-effects models (adding Cochrane risk of bias items as covariates) and an exploratory machine learning technique. The primary outcome was post-treatment depression symptom level.Results: Data were obtained for all seven trials identified (100%, n = 482, combined: n = 238, antidepressants: n = 244). Adding STPP to antidepressants was more efficacious for patients with high rather than low baseline depression levels [B = −0.49, 95% confidence interval (CI) −0.61 to −0.37, p < 0.0001] and for patients with a depressive episode duration of >2 years rather than <1 year (B = −0.68, 95% CI −1.31 to −0.05, p = 0.03) and than 1–2 years (B = −0.86, 95% CI −1.66 to −0.06, p = 0.04). Heterogeneity was low. Effects were replicated in analyses controlling for risk of bias.Conclusions: To our knowledge, this is the first study that examines moderators across trials assessing the addition of STPP to antidepressants. These findings need validation but suggest that depression severity and episode duration are factors to consider when adding STPP to antidepressants and might contribute to personalizing treatment selection for depression.

Due to the increased lifetime prevalence and personal, social, and economic burden of mental disorders, psychiatry is in need of a significant change in several aspects of its clinical and research approaches. Over the last few decades, the development of personalized / precision medicine in psychiatry focusing on tailored therapies that fit each patient’s unique individual, physiological, and genetic profile has not achieved the same results as those obtained in other branches, such as oncology. The long-awaited revolution has not yet surfaced. There are various explanations for this including imprecise diagnostic criteria, incomplete understanding of the molecular pathology involved, absence of available clinical tools and, finally, the characteristics of the patient. Since then, the co-existence of the two terms has sparked a great deal of discussion around the definition and differentiation between the two types of psychiatry, as they often seem similar or even superimposable. Generally, the two terminologies are used indiscriminately, alternatively, and / or separately, within the same scientific works. In this paper, an overview is provided on the overlap between the application and meaning of the terms ‘precision psychiatry’ and ‘personalized psychiatry’.