title: Perceived insecurity, mental health and urbanization: Results from a multicentric study.
abstract: OBJECTIVE
  This article aims to (1) explore the levels of perceived insecurity in a sample of patients with mood or anxiety disorders and (2) assess whether living in 'big cities' can influence the levels of patients' perceived insecurity and social contacts compared to living in a non-urbanized context.
  
  
  METHODS
  A total of 24 Italian mental health centers (MHCs) have been invited to participate. Twenty patients consecutively accessing the MHC have been recruited. All patients have been assessed using validated assessment tools.
  
  
  RESULTS
  The sample consisted of 426 patients, mostly female, with a mean age of 45 years. Globally, 52.2% of patients had a diagnosis of mood disorders, and 37.8% had anxiety disorders. Half of the sample declared that the main feeling toward life is uncertainty; higher levels of pessimistic views toward life have been detected in patients living in urban areas. A positive association between negative attitudes toward life and higher levels of depressive and anxiety symptoms, poor social functioning and higher levels of perceived psychological distress has been found.
  
  
  CONCLUSIONS
  Our findings confirm the presence of a common sense of perceived uncertainty among our sample. Such attitude toward life can have a detrimental impact on patients' psychological and physical well-being, contributing to high levels of distress.
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy mario-luciano@hotmail.it.
authors.forename: M
authors.initials: M
authors.lastname: Luciano
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: C
authors.initials: C
authors.lastname: De Rosa
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Del Vecchio
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Sampogna
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Sbordone
authors.affiliation: Department of Biomedical and Neuromotor Sciences, Institute of Psychiatry, University of Bologna, Bologna, Italy.
authors.forename: A R
authors.initials: AR
authors.lastname: Atti
authors.affiliation: Department of Mental Health, Grosseto, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bardicchia
authors.affiliation: Mental Health Centre of Maddalena, ASS1 'Triestina', Trieste, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bertossi
authors.affiliation: 'Vito Fazzi' Hospital, Lecce, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Calò
authors.affiliation: Mental Health Centre of Rende, Rende, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Cava
authors.affiliation: Mental Health Centre of Reggio Calabria, Reggio Calabria, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Ciafone
authors.affiliation: Psychiatric Unit, Department of Health Sciences, University of Magna Graecia of Catanzaro, Catanzaro, Italy.
authors.forename: P
authors.initials: P
authors.lastname: De Fazio
authors.affiliation: Department of Mental Health, 'G. Mazzini' Hospital, Teramo, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Di Iorio
authors.affiliation: Mental Health Centre of Camerino, Camerino, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Fantini
authors.affiliation: Department of Diagnostic-Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Ferrari
authors.affiliation: Department of Psychiatry, University of Sassari, Sassari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ginanneschi
authors.affiliation: DSMeD, ASL3 Genovese, IDEA Onlus, Genova, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Gotelli
authors.affiliation: Department of Mental Health, Mons. Dimiccoli Hospital, Barletta, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Macina
authors.affiliation: Psychiatric Unit, University Hospital 'P. Giaccone', Palermo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mulè
authors.affiliation: Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Papanti
authors.affiliation: Human Resource Department, Local Health Agency of Reggio Emilia, Reggio Emilia, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Pingani
authors.affiliation: Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Pinna
authors.affiliation: Perugia University and SPDC 'S. Giovanni Battista', Foligno, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Piselli
authors.affiliation: Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy.
authors.forename: M S
authors.initials: MS
authors.lastname: Signorelli
authors.affiliation: Bologna Transcultural Psychosomatic Team (BoTPT), Department of Medical and Surgical Sciences, Bologna University Hospital Authority St. Orsola-Malpighi Polyclinic, Bologna, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Tarricone
authors.affiliation: Department of Neurology and Psychiatry, Policlinico Umberto I, Sapienza - University of Rome, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Tarsitani
authors.affiliation: Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ventriglio
authors.affiliation: University College London, London, UK.
authors.forename: G
authors.initials: G
authors.lastname: Carrà
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Catapano
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Fiorillo
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology*; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology*; D010465:Perception; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires; D035501:Uncertainty; D014504:Urban Health; D014507:Urbanization / Q000639:trends*
keywords: Perceived insecurity; social cohesion; uncertainty; urban mental health; urbanization