The interplay between childhood trauma, hopelessness, depressive symptoms, and mental pain in a large sample of patients with severe mental disorders: A network analysis

Stefano Barlati¹, Marco Innamorati², Antonio Vita¹, Gabriele Nibbio³, Denise Erbuto⁴, Salvatore Sarubbi⁵, Valeria Del Vecchio⁶, Mario Luciano⁶, Gaia Sampogna⁶, Giovanni Abbate-Daga⁷, Claudia Carmassi⁸, Giovanni Castellini⁹, Pasquale De Fazio¹⁰, Giorgio Di Lorenzo¹¹, Marco Di Nicola¹², Silvia Ferrari¹³, Arianna Goracci¹⁴, Carla Gramaglia¹⁵, Giovanni Martinotti¹⁶, Maria Giulia Nanni¹⁷, Massimo Pasquini¹⁸, Federica Pinna¹⁹, Nicola Poloni²⁰, Gianluca Serafini²¹, Maria Signorelli²², Alfonso Tortorella²³, Antonio Ventriglio²⁴, Umberto Volpe²⁵, Andrea Fiorillo⁶, Maurizio Pompili⁴

Affiliations

¹ Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy.
² Department of Human Sciences, European University of Rome, Rome, Italy.
³ Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. Electronic address: gabriele.nibbio@gmail.com.
⁴ Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
⁵ Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, Rome, Italy.
⁶ Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy.
⁷ Eating Disorders Center, Department of Neuroscience, University of Turin, Turin, Italy.
⁸ Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
⁹ Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy.
¹⁰ Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy.
¹¹ Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
¹² Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
¹³ Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Dipartimento ad Attività Integrata di Salute Mentale e Dipendenze Patologiche, AUSL- IRCCS Reggio Emilia, Reggio Emilia, Italy.
¹⁴ Department of Molecular Medicine, University of Siena, Siena, Italy.
¹⁵ Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Psychiatry Division, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy.
¹⁶ Department of Neuroscience, Imaging and Clinical Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy.
¹⁷ Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.
¹⁸ Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
¹⁹ Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
²⁰ Division of Psychiatry, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
²¹ Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS San Martino, Genoa, Italy.
²² Department of Clinical and Experimental Medicine, AOU Policlinico Hospital, University of Catania, Catania, Italy.
²³ Department of Psychiatry, University of Perugia, Perugia, Italy.
²⁴ Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
²⁵ Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine and Surgery, Polytechnic University of Marche, Ancona, Italy.

PMID: 40180038
DOI: 10.1016/j.jad.2025.03.185

Free article

Observational Study

The interplay between childhood trauma, hopelessness, depressive symptoms, and mental pain in a large sample of patients with severe mental disorders: A network analysis

Stefano Barlati et al. J Affect Disord. 2025.

Free article

. 2025 Jul 1:380:545-551.

doi: 10.1016/j.jad.2025.03.185. Epub 2025 Apr 1.

Authors

Affiliations

¹ Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy.
² Department of Human Sciences, European University of Rome, Rome, Italy.
³ Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. Electronic address: gabriele.nibbio@gmail.com.
⁴ Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
⁵ Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, Rome, Italy.
⁶ Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy.
⁷ Eating Disorders Center, Department of Neuroscience, University of Turin, Turin, Italy.
⁸ Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
⁹ Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy.
¹⁰ Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy.
¹¹ Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
¹² Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
¹³ Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Dipartimento ad Attività Integrata di Salute Mentale e Dipendenze Patologiche, AUSL- IRCCS Reggio Emilia, Reggio Emilia, Italy.
¹⁴ Department of Molecular Medicine, University of Siena, Siena, Italy.
¹⁵ Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Psychiatry Division, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy.
¹⁶ Department of Neuroscience, Imaging and Clinical Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy.
¹⁷ Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.
¹⁸ Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
¹⁹ Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
²⁰ Division of Psychiatry, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
²¹ Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS San Martino, Genoa, Italy.
²² Department of Clinical and Experimental Medicine, AOU Policlinico Hospital, University of Catania, Catania, Italy.
²³ Department of Psychiatry, University of Perugia, Perugia, Italy.
²⁴ Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
²⁵ Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine and Surgery, Polytechnic University of Marche, Ancona, Italy.

PMID: 40180038
DOI: 10.1016/j.jad.2025.03.185

Abstract

Background: Mental pain represents a significant risk factor for suicidal behavior in severe mental disorders. The present study aims to investigate the interplay between childhood traumatic experiences, hopelessness, depressive symptoms and mental pain, using a network analysis approach in a large transdiagnostic sample of participants living in the community.

Methods: The present investigation was conducted using data gathered in a multicentric observational cross-section study organized as a joint project, including different Italian research and clinical settings. Considering the assessment tools adopted in the study, 12 different variables were included as nodes in the EBICglasso network analysis. Stability of the edges and of centrality indices were assessed using bootstrap procedures, considering case-dropping and node-dropping procedures.

Results: A total of 2147 participants were included in the analysis. Mental pain represents a central feature in a complex network of relationships, including traumatic experiences, hopelessness, and depressive symptoms. More in deatail, mental pain and, to a lesser extent, affective and cognitive depressive symptoms emerged as the most central and influential nodes of the network, highlighting the strong link existing between these aspects and their importance in the lives of people with mental disorders.

Conclusions: Results confirm the importance of mental pain as a transdiagnostic feature, requiring careful assessment and consideration in all patients, beyond the diagnostic categories and regardless of suicide risk. Assessing and managing the presence and severity of mental pain should be taken into account in clinical practice, in the perspective of providing significant clinical benefits, as well as relevant research insight.

Keywords: Childhood trauma; Depression; Hopelessness; Mental pain; Psychache; Severe mental illness.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare no conflict of interest.

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- ClinicalKey
- Elsevier Science
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

The interplay between childhood trauma, hopelessness, depressive symptoms, and mental pain in a large sample of patients with severe mental disorders: A network analysis

Affiliations

The interplay between childhood trauma, hopelessness, depressive symptoms, and mental pain in a large sample of patients with severe mental disorders: A network analysis

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical