Introduction: COVID-19 restrictions introduced several changes in university academic and social experience. Self-isolation and online teaching have amplified students’ mental health vulnerability. Thus, we aimed to explore feelings and perspectives about the impact of the pandemic on mental health, comparing students from Italy and the UK. Methods: Data were collected from the qualitative portion of “the CAMPUS study”, longitudinally assessing mental health of students at the University of Milano-Bicocca (Italy) and the University of Surrey (UK). We conducted in-depth interviews and thematically analysed the transcripts. Results: The explanatory model was developed from four themes identified across 33 interviews: anxiety exacerbated by COVID-19; putative mechanisms leading to poor mental health; the most vulnerable subgroups; and coping strategies. Generalised and social anxiety resulted from COVID-19 restrictions by being associated with loneliness, excessive time online, unhealthy management of time and space and poor communication with the university. Freshers, international students, and people on the extremes of the introversion/extroversion spectrum, were identified as vulnerable, while effective coping strategies included taking advantage of free time, connection with family and mental health support. The impact of COVID-19 was mostly related to academic issues by students from Italy, whereas to the drastic loss of social connectedness by the UK sample. Conclusions: Mental health support for students has an essential role, and measures that encourage communication and social connectedness are likely to be beneficial.

Attention deficit/hyperactivity disorder (ADHD) is associated with poor academic performance also among university students. This relationship may be made more complex by comorbid conditions. The aim of this study was to evaluate the mediating role of anxiety and depressive symptoms in the relationship between ADHD and academic performance. Data were drawn from the CAMPUS study (registration number: 0058642/21), an ongoing survey on university students’ mental health. Using a logit model, mediation analyses were carried out to test whether the relationship between ADHD symptoms (assessed by ASRS-5) and academic performance might be mediated by depressive (assessed by PHQ-9) and anxiety (assessed by GAD-7) symptoms. Our results showed that worse academic performance is associated with ADHD symptoms (p < 0.001). However, about 24% of the overall association between ADHD symptoms and academic performance was mediated by depressive symptoms (indirect effect: 0.065, 95%CI 0.022; 0.100), whereas the contribution of anxiety symptoms to the model was not significant. Along with the association between ADHD symptoms and poor academic performance, our findings highlight the key mediating role of depressive symptoms, which may be targeted with tailored support, ultimately improving both the academic performance and the well-being of university students with ADHD.

Schizophrenia is a severe mental illness causing a high degree of disability. First- and second-generation antipsychotics (FGAs and SGAs) represent key resources for its acute and long-term management. Since a poor adherence to oral treatments may negatively impact the course of the disorder, long-acting injectable antipsychotics (LAIs) are often used to reduce clinical relapses. Notwithstanding their potential beneficial features, LAIs use in clinical practice remains somewhat hampered by the limited amount of relevant systematic information. This review thus aims at providing a clinical, practical guidance for the use of LAIs in the treatment of schizophrenia. We synthetized main information on indications, dosage, and administration of LAIs approved by the US Food and Drug Administration (FDA) and/or in EU countries, as well as evidence from the most recent systematic reviews and meta-analyses. Currently available information, though heterogeneous, shows that LAIs can prevent relapses and rehospitalizations, improving clinical outcomes and favouring sustained remission among people with schizophrenia. The use of SGA LAIs is supported by more robust evidence than FGA LAIs. Along with their positive impact on the prevention of treatment discontinuation, some LAIs might also enhance individual global functioning and quality of life, without additional adverse events or health-care costs, as compared with oral antipsychotics. Although which LAIs can be considered a first-choice option, as well as their superiority over oral antipsychotics, remain unclear issues, this review offers a comprehensive overview of information available on the use of LAIs for people with schizophrenia, providing clinicians with practical guidance in terms of efficacy and acceptability of single agents. Literature gaps and future research needs are also described.

Background: The transition to university often leads to increased demands and changes in lifestyle habits, which may affect mental health. In particular, loneliness could play a key role in the onset of psychological distress. Although many patterns are consistent across countries, cultural differences may influence students’ mental health and feelings of loneliness. Aims: The aim of this study was thus to examine mental health domains and their relationship with loneliness among students from the University of Milano-Bicocca (Italy) and the University of Surrey (United Kingdom). Method: Data were from the CAMPUS study, a cross-national survey on students’ mental health. A structural equation modelling (SEM) approach was carried out to simultaneously test the pathways between loneliness and clinical domains in the two populations. Results: Anxiety and depressive symptoms were identified as the most common conditions in both the samples. However, Italian students were likely to show a higher degree of anxiety ( t = 7.01, p < .001), while UK undergraduates greater depressive symptoms ( t = −2.50, p = .013) and a higher prevalence of insomnia ( t = −9.55, p < .001). Poor academic performance, along with limited social interactions were associated with worse psychological well-being, despite the likely influence of lifestyle differences among countries. Finally, a significant correlation between loneliness, anxiety and depressive symptoms, as well as insomnia was found both in Italian and UK samples, as confirmed by multivariate analyses. Conclusions: Our findings highlight the existence of a cross-nationally, clinically meaningful psychological burden among university students, with a major role played by loneliness. Extensive promotion of healthy social networks, as well as interventions to support academic performance are needed.

Risperidone was the first second-generation antipsychotic to be developed as a long-acting injectable (LAI). In the early 2000s, a risperidone microsphere formulation, intramuscularly administered every 2 weeks (BW-RLAI), was introduced. To date, five different risperidone LAI formulations have been marketed – including a second biweekly microsphere injection (LY03004), a newer monthly intramuscular formulation using in situ microparticles (ISM) technology that does not require an oral risperidone run-in, and two subcutaneous formulations (RBP-7000 and TV-46000). Understanding the advantages and limitations of each option is essential for tailoring treatment regimens based on clinical needs and patient preferences. In this review, with the aim of offering insights for clinical practice and future research, we provide a comprehensive synthesis of the currently available risperidone LAI formulations, examining their efficacy and safety for the treatment of schizophrenia and bipolar I disorder. While evidence supporting the efficacy, tolerability, and safety of risperidone LAI for schizophrenia is available for all marketed formulations to date, advantages for newer formulations, such as longer dosing intervals without oral supplementation, are also reviewed. In addition, although the Food and Drug Administration approved the biweekly LAIs for bipolar I disorder, there is no data on effectiveness of the other risperidone LAI formulations for this indication so far. The variety of the available risperidone LAI options is likely to enable a more personalized treatment approach. To facilitate this, healthcare providers should develop a comprehensive understanding of these formulations to select the most suitable option. While risperidone ISM, RBP-7000, and TV-46000 may enhance treatment feasibility and adherence, further research is needed to build an evidence base comparable to that available for BW-RLAI, particularly in the treatment of BD. Plain Language Summary: Risperidone is a second-generation antipsychotic used to treat schizophrenia and bipolar I disorder. It was the first drug of its class to be made available as a long-acting injectable (LAI), offering continuous treatment without the need for daily pills. Over time, several risperidone LAI formulations have been developed, including biweekly and monthly intramuscular injections – such as risperidone microspheres and risperidone in situ microparticles (ISM) – as well as subcutaneous options available exclusively in the United States. This review provides an updated overview of the efficacy and safety of all currently available risperidone LAI formulations for the treatment of schizophrenia and bipolar I disorder. Each formulation has distinct advantages and limitations: for instance, some require an initial period of oral risperidone supplementation, while others do not; some allow for longer dosing intervals, reducing the frequency of injections. Selecting the most appropriate option depends on both clinical needs and patient preferences. While all approved risperidone LAI formulations have demonstrated their role in treating schizophrenia, only the biweekly risperidone microsphere formulation has been officially approved for bipolar I disorder. Further research is needed to assess the effectiveness of other formulations for this condition. A thorough understanding of these options can help clinicians provide more personalized and effective treatment for individuals with schizophrenia and bipolar I disorder.