Antonio Maria D'Onofrio

Dr. Antonio Maria D'Onofrio

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Research Focus & Metrics

Academic Career Length

3Years (2024-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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Journal Article
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DNDaniele Napolitano
Daniele Napolitano
Mattia BozzettiMattia Bozzetti
Mattia Bozzetti
Alessio Lo CascioAlessio Lo Cascio
Alessio Lo Cascio
GSGiuseppe De Stefano
Giuseppe De Stefano
NONicoletta Orgiana
Nicoletta Orgiana
DBDavide Bartoli
Davide Bartoli
Background/Objectives: Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), significantly affects patients’ quality of life. Resilience and self-care are vital for disease management, yet their relationship with IBD remains underexplored. This study investigates how self-care behaviours influence resilience in patients with IBD, taking into account sociodemographic and clinical factors. Methods: This was a multicentre observational study. Data were collected during routine outpatient visits between April and June 2024. Participants (≥18 years) with an IBD diagnosis for at least 12 months were recruited. Data were collected using validated instruments, including the Connor-Davidson Resilience Scale (CD-RISC-25), the Self-Care of Chronic Illness Inventory (SC-CII), and sociodemographic and clinical questionnaires. Disease activity was assessed using the Mayo Score (UC) and the Harvey–Bradshaw Index (CD). Descriptive, correlational, and regression analyses explored variable relationships. This study was conducted as part of the N-ECCO Research Grant initiative. Results: A total of 401 participants (CD: 196, UC: 205) were enrolled, with equal gender distribution (50.1% male). The descriptive analysis of self-care levels showed a mean score of 72.6 (SD = 12.5) for self-care maintenance, 81.0 (SD = 18.2) for self-care monitoring, and 70.5 (SD = 18.4) for self-care management. The UC patients had higher self-care management scores than the CD patients (p = 0.002). The median resilience score was 45, and self-care management positively predicted resilience (β = 0.041, p < 0.001). Disease severity negatively affected resilience and self-care, particularly in severe cases (β = −8.334, p < 0.001). The females reported higher resilience and self-care monitoring scores than the men. Conclusions: Resilience and self-care are interrelated and crucial in IBD management. Enhancing resilience through personalised nursing interventions and integrating psychological and educational support may improve self-care and clinical outcomes.

18 August 2024 in Journal of Clinical Medicine
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TCTommaso Callovini
Tommaso Callovini
SMSilvia Montanari
Silvia Montanari
FBFrancesca Bardi
Francesca Bardi
SBSara Barbonetti
Sara Barbonetti
SRSara Rossi
Sara Rossi
Marianna MazzaMarianna Mazza
Marianna Mazza
Background/Objectives: Lithium taken during pregnancy was linked in the past with increased risk for foetal/newborn malformations, but clinicians believe that it is worse for newborn children not to treat the mothers’ underlying psychiatric illness. We set to review the available evidence of adverse foetal outcomes in women who received lithium treatment for some time during their pregnancy. Methods: We searched four databases and a register to seek papers reporting neonatal outcomes of women who took lithium during their pregnancy by using the appropriate terms. We adopted the PRISMA statement and used Delphi rounds among all the authors to assess eligibility and the Cochrane Risk-of-Bias tool to evaluate the RoB of the included studies. Results: We found 28 eligible studies, 10 of which met the criteria for inclusion in the meta-analysis. The studies regarded 1402 newborn babies and 2595 women exposed to lithium. Overall, the systematic review found slightly increased adverse pregnancy outcomes for women taking lithium for both the first trimester only and any time during pregnancy, while the meta-analysis found increased odds for cardiac or other malformations, preterm birth, and a large size for gestational age with lithium at any time during pregnancy. Conclusions: Women with BD planning a pregnancy should consider discontinuing lithium when euthymic; lithium use during the first trimester and at any time during pregnancy increases the odds for some adverse pregnancy outcomes. Once the pregnancy has started, there is no reason for discontinuing lithium; close foetal monitoring and regular blood lithium levels may obviate some disadvantages of lithium administration during pregnancy.

Verified
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FVFederica Di Vincenzo
Federica Di Vincenzo
ADAntonio Maria D'Onofrio
Antonio Maria D'Onofrio
AGAngelo Del Gaudio
Angelo Del Gaudio
ECElena Chiera
Elena Chiera
GFGaspare Filippo Ferrajoli
Gaspare Filippo Ferrajoli
GCGiovanni Camardese
Giovanni Camardese
Depression, anxiety, and perceived stress are common comorbidities in patients with inflammatory bowel disease (IBD) and may negatively influence the disease course. Likewise, severe IBD may contribute to the development or worsening of psychiatric symptoms. Despite the established relevance of the gut–brain axis and frequent use of psychotropic medications in IBD patients, limited evidence exists regarding the effects of psychiatric treatments on gastrointestinal disease activity. Therefore, the aim of this systematic review is to evaluate the effectiveness of psychiatric therapies on gastrointestinal symptoms and disease activity in patients with IBD. The work was conducted in accordance with PRISMA guidelines. Searches were performed across PubMed, Web of Science, and Scopus up to July 2024. Eligible studies evaluated the effectiveness of psychiatric medications—including antidepressants, antipsychotics, anxiolytics, sedative-hypnotics, mood stabilizers, anticonvulsants, and others—on at least one gastrointestinal outcome in patients with IBD. Outcomes included changes in commonly used clinical and endoscopic scores for Crohn’s disease (CD) and ulcerative colitis (UC), number of bowel movements, stool consistency, presence of blood in stool, severity of abdominal pain, as well as in surrogate markers of disease activity following treatment. Out of 8513 initially identified articles, 22 studies involving 45,572 IBD patients met the inclusion criteria. Antidepressants, particularly bupropion, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), venlafaxine, and duloxetine, were associated with improvements in IBD activity scores, including Crohn’s Disease Activity Index (CDAI) and Simple Endoscopic Score for Crohn’s Disease (SES-CD) for CD, Mayo score and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) for UC. Case reports highlighted potential benefits of pregabalin and lithium carbonate, respectively, showed by the reduction in clinical and endoscopic score of disease activity for pregabalin and improvement of UC symptoms for lithium carbonate, while topiramate showed limited efficacy. Clonidine and naltrexone determined the reductions in clinical and endoscopic score of disease activity, including CDAI and Crohn’s disease endoscopy index severity score (CDEIS) for CD and Disease Activity Index (DAI) for UC. Despite the limited data and study heterogeneity, antidepressants, naltrexone, and clonidine were associated with improvements in IBD activity. Larger, prospective studies are needed to confirm the therapeutic potential of psychiatric medications in modulating IBD activity and to guide integrated clinical management.

15 July 2025 in Journal of Affective Disorders
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Journal Article
Open access
GCGiovanni Camardese
Giovanni Camardese
ADAntonio Maria D'Onofrio
Antonio Maria D'Onofrio
FBFrancesca Bardi
Francesca Bardi
ASAlessio Simonetti
Alessio Simonetti
AKAlexia Koukopoulos
Alexia Koukopoulos
GSGabriele Sani
Gabriele Sani
Childhood trauma is a key risk factor for mood disorders and is associated with greater clinical severity, while resilience may act as a protective factor. This study investigates how childhood trauma and resilience interact to shape psychopathology and treatment response in patients with major depressive disorder (MDD) and bipolar disorder (BD). The study included 669 participants: 569 patients (380 MDD, 189 BD) and 100 healthy controls (HC). Symptom severity was assessed using standardized scales, with follow-up evaluations of depressive symptoms at six months. All participants completed the Childhood Trauma Questionnaire (CTQ) and Connor-Davidson Resilience Scale (CD-RISC). Patients showed lower resilience and higher childhood trauma scores than HC (both p < 0.001), with more marked differences in those with depressive or anxiety symptoms (p < 0.05). In MDD, low resilience was linked to anhedonia, psychomotor retardation, general psychopathology, suicidality, and non-remission (all p ≤ 0.001), while in BD, it was associated with depressive and anxiety severity and anhedonia (all p ≤ 0.01). Childhood trauma was unrelated to most outcomes, except for higher scores in suicidal MDD patients (p = 0.010), and showed an inverse correlation with resilience in MDD and HC. Linear regression showed that gender (p = 0.013) and anhedonia (p = 0.005) significantly predicted resilience. Logistic regression revealed that higher resilience predicted remission (p = 0.012). Resilience and childhood trauma influence clinical severity in mood disorders. Resilience emerged as a protective factor and predictor of remission, supporting its role as a therapeutic target.

3 January 2024 in Brain Sciences
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ASAlessio Simonetti
Alessio Simonetti
ARAntonio Restaino
Antonio Restaino
EBEvelina Bernardi
Evelina Bernardi
OFOttavia Marianna Ferrara
Ottavia Marianna Ferrara
SMStella Margoni
Stella Margoni
Gabriele SaniGabriele Sani
Gabriele Sani
Interleukin 6 (IL-6) receptor inhibitors tocilizumab and sarilumab have recently been approved for severe coronavirus disease 2019 (COVID-19). They also affect mood, even though their effect on the post-COVID-19 syndrome-related psychopathology still has to be investigated. The aim of this study was to investigate their effect on psychopathology in a sample of patients with post-COVID-19 syndrome. We included 246 patients (34% female, 66% male) aged 18–75 years who had been hospitalized for COVID. Patients were split into those who received anti-IL-6 receptor agents (Anti-IL-6-R, N = 88) and those who did not (Ctrl, N = 158). The former group was further split into those receiving tocilizumab (TOC, N = 67) and those receiving sarilumab (SAR, N = 21). Groups were compared based on clinical characteristics before and during COVID-19 as well as on physical and psychiatric symptoms after COVID-19. Ctrl had less psychiatric and physical symptoms during hospitalization and more post-COVID-19 diarrhea, headache, cough, and dyspnea upon exertion than those receiving IL-6-receptor inhibitors. Ctrl also showed greater difficulties in emotion regulation. These differences were driven by TOC vs. Ctrl, whereas differences between SAR and Ctrl or TOC did not reach significance. IL-6 receptor inhibitors are related to a lower post-COVID-19 illness burden and seem to be effective in emotion regulation. Further research is needed to confirm these findings.

10 July 2025 in Biomedicines
Verified
Journal Article
Open access
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ADAntonio Maria D'Onofrio
Antonio Maria D'Onofrio
EMEleonora Maggio
Eleonora Maggio
VMValentina Milo
Valentina Milo
GFGaspare Filippo Ferrajoli
Gaspare Filippo Ferrajoli
DFDaniele Ferrarese
Daniele Ferrarese
GCGiovanni Camardese
Giovanni Camardese
Background/Objectives: Ulcerative colitis (UC) and Crohn’s disease (CD) are two forms of inflammatory bowel disease (IBD), which, despite their shared inflammatory nature, differ markedly in clinical presentation and disease course. In this study, we aimed to explore whether these clinical differences are also reflected at the psychological level. Specifically, we sought to delineate the personality characteristics of a sample of patients with IBD and to investigate psychological and psychopathological differences between individuals with UC and CD. Methods: We enrolled 29 (44.61%) UC patients and 36 (55.39%) CD patients, all aged 18 years or older. Each participant completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), which was subsequently scored and interpreted by trained psychologists. The MMPI-2 is a 567-item inventory with dichotomous answers (true/false), providing measures of a wide range of symptoms, beliefs, attitudes, and personality traits. Results: The total sample showed clinically significant elevations on hypochondriasis (Hs), health concerns (HEA), general health concerns (HEA3), and physical malfunctioning (D3) scales. UC patients had statistically significant higher scores on hypomania (p = 0.043), lack of ego mastery—defective inhibition (p = 0.006), and fears (p = 0.038) scales than CD patients. On the other hand, CD patients showed statistically significant higher scores on the Overcontrolled Hostility scale (p = 0.043). Conclusions: Both groups of patients experience emotional difficulties related to their clinical conditions, leading to an increased preoccupation with bodily symptoms and illness. These aspects appear to be accompanied by shifts in mood towards a more depressive state. Notably, the UC group demonstrates a greater degree of impairment compared to the CD group, with experiences of anxiety, stress, difficulties in emotional control, and emerging relational challenges.