Article Highlights

Life goes on. Despite a pandemic not yet eradicated, despite the (increasingly global) connotations of one (of the many) ongoing war conflicts, life continues to go on. And so it must be, as in fact it has always been since the beginning of known human history. Not only humanity, finding itself on its knees in front of natural disasters or severe conflicts, has always managed to recover but has even been able to exploit them to overcome its previous limitations or, in certain cases, to make them a source of inspiration both for itself and the studies of nature. If on the one hand the transcending of preexisting limits means identifying answers to questions, on the other it implies raising other doubts. If we consider Medicine as a daily practice of a science, the aforementioned observation becomes tremendously concrete by imagining a common act such as the administration of a drug: how many possible side effects could occur while waiting for the desired therapeutic effects to occur? If this is perhaps the most recurring of the different questions, there exists another one, no less common and still unsolved, subject of debate amongst clinicians: the placebo effect. The importance of placebo is evident in its controversy, being it widely used in the most authoritative research studies to describe “controls” and, contemporary, being formally "discouraged" from its use in daily clinical practice. Undeniably, its relevance acquires an even more significant impact when involved in the field of neuroscience and, in particular, in the practice of psychiatry. The present issue of Clinical Neuropsychiatry proudly begins with an editorial written by Fabrizio Benedetti (pp.69-72), who has dedicated over 30 years of career to an in-depth and unprecedented study of the placebo effect. Starting from the apparently simple question “Drugs and placebos: what’s the difference?”, Benedetti presents an exhaustive albeit concise dissertation aimed at disentangling some of the several questions about the controversy, the clinical importance and the concrete results related to placebo especially regarding neuroscientific field in an extraordinarily clear and linear way. The current issue of Clinical Neuropsychiatry proceeds in presenting a retrospective case-study of Gatta and colleagues (pp-72-84) that aims at providing an epidemiological– clinical analysis of the population of children and adolescents admitted to an Italian Child Neuropsychiatry Unit (CNU) during a five-year period. The need for such an investigation appears immediately evident, in spite of an overall increase in CNU hospitalizations that has almost doubled over the past ten years. Since the most frequent and recurrent reasons for hospitalization in minors appear to be self-injurious and suicidal behaviors, healthcare workers should be adequately trained while, at the same time, diagnostic-therapeutic protocols for psychiatric emergencies should be implemented (or developed) to manage psychiatric acute conditions in the developmental age. Although suicide remains one of the most frequent causes of death in adolescence, it affects all age groups and indeed represents the most dangerous psychiatric emergency, by definition. Therefore, it becomes sadly natural to consider the suicidal risk during the COVID-19 pandemic can be considered as "an emergency within an emergency". After two years, during which hundreds of scientific papers about the impact and the consequences of the COVID-19 on mental health have been published, Barberis et colleagues (pp. 84-97) take together the available literature and provide a systematic review aimed at describe the current state of the art of suicidal behaviours during the ongoing pandemic. There is no doubt that the ongoing pandemic has negatively affected (and worsened) almost all maladaptive behaviors. During these two years, scholars have also been speculating on how and to what extent seclusion, isolation and social distancing mesaures may have influenced behaviors and personality traits across the different pandemic waves. Recently, Joaquim and colleagues (pp.