Ramona Di Stefano

Dr. Ramona Di Stefano

orcid

Research Focus & Metrics

Academic Career Length

6Years (2021-Present)

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

Representative Publications

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15 October 2021 in European Neuropsychopharmacology
Verified
Journal Article
Closed access
Konstantinos N FountoulakisKonstantinos N Fountoulakis
Konstantinos N Fountoulakis
GKGrigorios Karakatsoulis
Grigorios Karakatsoulis
SASeri Abraham
Seri Abraham
KAKristina Adorjan
Kristina Adorjan
HAHelal Uddin Ahmed
Helal Uddin Ahmed
DSDaria Smirnova
Daria Smirnova

19 September 2023 in Psychiatry Research
Verified
Journal Article
Open access
Valentina BaldiniValentina Baldini
Valentina Baldini
RSRamona Di Stefano
Ramona Di Stefano
LRLorenzo Vittorio Rindi
Lorenzo Vittorio Rindi
AAAnthony O Ahmed
Anthony O Ahmed
MKMaju Mathew Koola
Maju Mathew Koola
GOGiovanni Ostuzzi
Giovanni Ostuzzi
Assessing and managing suicide behaviors is highly relevant to individuals with schizophrenia spectrum disorders. Our study aims to assess the association between adverse childhood experiences and suicidal behaviors in individuals with schizophrenia spectrum disorders. We included observational studies comparing the probability of suicide behaviors in adults with schizophrenia spectrum disorders exposed and unexposed to adverse childhood experiences. Odds ratio estimates were obtained by pooling data using a random-effects pairwise meta-analysis. Standardized criteria were used to assess the strength of the association of the pooled estimate. We found 21 eligible studies reporting outcomes for 6257 individuals from 11 countries. The primary outcome revealed an association between any suicidal behavior and adverse childhood experiences, which resulted "highly suggestive" according to validated Umbrella Criteria. Similarly, a positive association was confirmed for suicidal ideation and suicide attempt and for any subtype of adverse childhood experience. This meta-analysis showed that exposure to adverse childhood experiences strongly increases the probability of suicide behaviors in people with schizophrenia spectrum disorders.

14 March 2023 in Annals of General Psychiatry
Verified
Journal Article
Open access
PDF file
GDGiulia D’aUrizio
Giulia D’aUrizio
RSRamona Di Stefano
Ramona Di Stefano
VSValentina Socci
Valentina Socci
ARAlessandro Rossi
Alessandro Rossi
TBTommaso Barlattani
Tommaso Barlattani
RRRodolfo Rossi
Rodolfo Rossi
Background: The emotional regulation process plays a pivotal role in daily-life functioning, modulating goal-directed and adaptive behavior. Conversely, altering this cognitive function can disrupt self-regulation and bring emotional dysregulation. Emotional instability could represent a core characteristic of BPD, also modulating the BPD symptom's onset. This systematic review aims to summarize the existing literature reporting the role of emotional instability in BPD to better define the role of the impairment of the emotional processes in the onset of the cognitive and behavioral symptoms of this complex mental disorder. Methods: MEDLINE, Scopus and Web of Science were independently searched for relevant studies. Eligible studies had to be identifiable through database searching, published and accessible. This systematic review was conducted according to PRISMA guidelines. The search period was from 2012 to 14 September 2022. Results: A pool of 120 studies was identified, out of which 11 met the selection criteria and were included. Overall, the studies confirm a relationship between emotional instability and borderline personality disorder. Conclusions: The evidences retrieved seem to point out the role of the emotional impairment not only in worsening of the disorder, but could also be one of the risk factors for its onset.

28 May 2025 in European Psychiatry
Verified
Journal Article
Open access
PDF file
Valentina BaldiniValentina Baldini
Valentina Baldini
CGCarolina Gottardi
Carolina Gottardi
RSRamona Di Stefano
Ramona Di Stefano
LRLorenzo Vittorio Rindi
Lorenzo Vittorio Rindi
GPGabriele Pazzocco
Gabriele Pazzocco
GOGiovanni Ostuzzi
Giovanni Ostuzzi
Background: Exposure to Adverse Childhood Experiences (ACEs) might increase the risk of suicide behaviors in the general adult population, while this association in individuals with affective disorders remains less characterized. Methods: A comprehensive search was conducted in MEDLINE, PsycINFO, CINAHL, Web of Science, Scopus, and PubMed up to July 10th, 2024. Observational studies that compared the risk of suicide behaviors in individuals exposed and unexposed to ACEs were included. Pairwise random-effects meta-analyses were conducted, and the certainty of evidence was assessed with validated criteria. Results: A total of 41 studies from 17 countries, comprising 19,588 participants, were analyzed. The main findings indicated a significant association between ACEs and suicidal behaviors, with an odds ratio (OR) of 1.98 (95% confidence interval [CI] 1.74–2.26), and a “highly suggestive” strength of association. This was consistent across diagnostic subgroups (i.e., Major Depressive Disorders, Bipolar Disorders, and mixed diagnoses). The association was confirmed for any ACE, with sexual abuse being the most frequently reported and showing the highest risk (OR 2.24; 95% CI 1.90–2.64), for suicidal ideation (OR 2.16; 95% CI 1.42–3.29), and for suicide attempts (OR 1.95; 95% CI 1.70–2.25), while death by suicide and non-suicidal self-injury were underreported. Meta-regression analyses did not suggest potential moderators, though underreporting was noted. Conclusions: This meta-analysis shows that exposure to ACEs nearly doubles the risk of suicide behaviors in individuals with affective disorders, warranting the targeted clinical, research, and policy measures to timely address this global mental health issue.

1 July 2022 in Psychiatry Research
Verified
Journal Article
Closed access
Konstantinos N FountoulakisKonstantinos N Fountoulakis
Konstantinos N Fountoulakis
GKGrigorios N. Karakatsoulis
Grigorios N. Karakatsoulis
SASeri Abraham
Seri Abraham
KAKristina Adorjan
Kristina Adorjan
HAHelal Uddin Ahmed
Helal Uddin Ahmed
DSDaria Smirnova
Daria Smirnova

3 March 2023 in Social Psychiatry and Psychiatric Epidemiology
Verified
Journal Article
Open access
PDF file
Konstantinos N FountoulakisKonstantinos N Fountoulakis
Konstantinos N Fountoulakis
GKGrigorios N. Karakatsoulis
Grigorios N. Karakatsoulis
SASeri Abraham
Seri Abraham
KAKristina Adorjan
Kristina Adorjan
HAHelal Uddin Ahmed
Helal Uddin Ahmed
DSDaria Smirnova
Daria Smirnova
Introduction The current study aimed to investigate the rates of anxiety, clinical depression, and suicidality and their changes in health professionals during the COVID-19 outbreak. Materials and methods The data came from the larger COMET-G study. The study sample includes 12,792 health professionals from 40 countries (62.40% women aged 39.76 ± 11.70; 36.81% men aged 35.91 ± 11.00 and 0.78% non-binary gender aged 35.15 ± 13.03). Distress and clinical depression were identified with the use of a previously developed cut-off and algorithm, respectively. Statistical analysis Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses, and Factorial Analysis of Variance (ANOVA) tested relations among variables. Results Clinical depression was detected in 13.16% with male doctors and ‘non-binary genders’ having the lowest rates (7.89 and 5.88% respectively) and ‘non-binary gender’ nurses and administrative staff had the highest (37.50%); distress was present in 15.19%. A significant percentage reported a deterioration in mental state, family dynamics, and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (24.64% vs. 9.62%; p < 0.0001). Suicidal tendencies were at least doubled in terms of RASS scores. Approximately one-third of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop clinical depression was associated with a history of Bipolar disorder (RR = 4.23). Conclusions The current study reported findings in health care professionals similar in magnitude and quality to those reported earlier in the general population although rates of clinical depression, suicidal tendencies, and adherence to conspiracy theories were much lower. However, the general model of factors interplay seems to be the same and this could be of practical utility since many of these factors are modifiable.