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Volume 155, No. 11

Published November 1, 2025

Original article

  1. Noemi Raio, Sofia Amylidi-Mohr, Daniel Surbek, Maria Luisa Gasparri, Luigi Raio (Author)

    Adherence to postpartum screening in women diagnosed with gestational diabetes: a retrospective single-centre experience in Switzerland

    STUDY AIMS: A history of gestational diabetes mellitus is a known risk factor for developing type 2 diabetes in the future. Therefore, screening for persistent dysglycaemia in the postpartum period is of utmost importance. However, follow-up rates tend to be low. The aim of this study was to investigate postpartum screening adherence at a tertiary care centre and to identify factors contributing to persistent dysglycaemia.

    METHODS: A cohort of women with gestational diabetes mellitus diagnosed between 2015 and 2018 at the department of Obstetrics and Gynaecology, University Hospital Bern, Switzerland, was retrospectively studied. Ethnicity, parity, pre-pregnancy BMI, family history of diabetes mellitus, first trimester glycosylated haemoglobin (HbA1c), 75 g oral glucose tolerance test during pregnancy and in the postpartum period were analysed. Postpartum dysglycaemia was defined as overt diabetes (fasting plasma glucose ≥7.0 mmol/l and/or 2 hours plasma glucose ≥11.1 mmol/l for the 75 g oral glucose tolerance test), impaired glucose tolerance (2 hours plasma glucose 7.8–11.0 mmol/l) or impaired fasting glucose (plasma glucose 5.6–6.9 mmol/l). Parametric and non-parametric tests as well as multivariate regression were used. ROC analyses were performed to assess the prognostic accuracy of HbA1c and oral glucose tolerance test results at predicting postpartum dysglycaemia.

    RESULTS: We included 489 women with gestational diabetes mellitus in our study. Of these, 217 (44.4%) returned for postpartum testing and 59/217 (27.2%) had an abnormal oral glucose tolerance test. Ethnicity was found to be a factor in adherence to follow-up. Specifically, women of African origin showed a significantly higher compliance than Asian or Caucasian women (61.8% vs 47.8% vs 34.5%, respectively; p = 0.04). The multivariate analysis revealed that obesity (OR: 3.64, 95% CI: 1.41–9.37) and first trimester HbA1c >5.7% (OR: 3.67, 95% CI: 1.28–10.52) are significantly associated with an increased risk of postpartum dysglycaemia.

    CONCLUSION: Our study indicates that adherence to postpartum screening after gestational diabetes mellitus is low but in line with the existing experience. This is of particular concern as 1 of 4 women undergoing postpartum screening show some sort of disturbed glucose metabolism. In particular, women with higher first trimester HbA1c and/or obesity may warrant closer observation and motivation for testing as the risk for persistent metabolic disorders is increased.

  2. Sarah E. Lehmann, Marc Dupuis, Stephen P. Jenkinson, Estelle Kaiser, Carla Meyer-Massetti, Anna Schoeni, Julian Jakob, Isabelle Jacot-Sadowski, Sophie Du Pasquier, Eva-Maria Franz, Reto Auer, Karen A. Maes (Author)

    Attitudes towards smoking cessation interventions and alternative nicotine delivery systems among community pharmacists in Switzerland – a national cross-sectional study

    STUDY AIMS:Community pharmacies serve as important partners in reducing the tobacco burden in the population by delivering effective smoking cessation interventions. This study depicts the current clinical practice of smoking cessation interventions in Swiss community pharmacies and assesses pharmacists’ attitudes towards integrating alternative nicotine delivery systems in smoking cessation interventions.

    METHODS: An interprofessional group developed and distributed an online survey to all community pharmacies affiliated with the Swiss Pharmacists’ Association. One pharmacist per pharmacy was invited to complete the survey. Surveys completed between 1 April and 9 May 2022 were used in the data analysis. Using R, the frequencies and proportions of the answers to the categorical questions were reported. To evaluate responses to questions rated on a 6-point Likert-type scale, the mean, standard deviation, and 95% confidence interval were calculated.

    RESULTS: Of the 1612 surveys distributed, 259 (16%) were completed. Most participants counselled their clients during nicotine replacement therapy sales (71%) or conducted brief opportunistic smoking cessation counselling (51%) at least once a month. Fewer than 21% of pharmacists offered dedicated smoking cessation counselling. Of the participating pharmacists, 69% recommended nicotine replacement therapies, and approximately 21% reported recommending e-cigarettes in some situations. By contrast, 90% reported never recommending tobacco heating systems, snus, or nicotine pouches. Pharmacists stated that a higher demand (mean = 4.78, standard deviation [SD] = 1.42 on a 6-point Likert scale), a decision aid (mean = 4.58, SD = 1.51), more training (mean = 4.39, SD = 1.43), financial compensation (mean = 4.35, SD = 1.63), and better collaboration with other healthcare professionals (mean = 4.25, SD = 2.13) would enhance the frequency of smoking cessation interventions.

    CONCLUSIONS: According to this online survey distributed to pharmacists in Switzerland, basic smoking cessation interventions are common, but counselling on smoking cessation could be intensified. Although Swiss pharmacists are currently reluctant to offer alternative nicotine delivery systems as smoking cessation aids, they show interest in receiving training on such products. Greater financial incentives, targeted campaigns, clear decision aids, and improved interprofessional collaboration could help strengthen future smoking cessation interventions in Swiss community pharmacies.

  3. Marcel Aebi, Jana Dreyer, Christoph Siedler, Karoline Niedenzu, Évi Forgó Baer, Carmelo Campanello, Andreas Wepfer, Francesco Castelli, Thierry Urwyler (Author)

    Assessing psychosocial maturity to diagnose severe personality development disorders in young adult males adjudicated of serious criminal offences: a psychometric validation study of a new instrument

    BACKGROUND: Psychosocial maturity is one of the key factors for understanding the course of criminal offences in juveniles and young adults. Until recently, forensic-psychiatric assessments to diagnose a severe disorder of personality development remained mostly unguided because validated instruments were not available. A new tool, the Young Adult Personality Development (YAPD) instrument, was introduced in 2021 and consists of three dimensions related to psychosocial maturity: YAPD environmental, YAPD pathology and YAPD developmental tasks failure. The current study tested the reliability (internal consistency, interrater reliability) and concurrent validity of these dimensions.

    METHODS: We analysed files of a consecutive sample of young adults in the Canton of Zurich (2007 to 2020, n = 234, mean age: 21.33 years, SD: 1.74 years), who were either assigned to specialised institutional treatment for young adults (Swiss Penal Code [SPC] Article 61) or outpatient treatment (SPC Article 63). Intraclass correlation coefficient (ICC) agreements were used to analyse interrater reliability of YAPD dimensions across three independent raters. In the absence of a gold standard, we analysed concurrent validity by measuring the associations of the YAPD dimensions with expert opinion and sample status (judicial decisions on measures) using multiple logistic regressions.

    RESULTS: Expert-rated personality development disorder was found to be highly prevalent in both samples. The YAPD dimensions showed adequate-to-good interrater reliability (ICC: 0.74–0.92). In logistic regression models, YAPD developmental tasks failure was related to diagnoses of severe development disorder and juridical decision on a measure for young adults according to SPC Art. 61. YAPD environmental was related to the diagnosis of a severe development disorder. YAPD pathology was found to be unrelated to the diagnosis of severe personality development disorder.

    CONCLUSIONS: Our findings support the YAPD developmental tasks failure dimension and to a lesser degree the YAPD environmental dimension as valid dimensions to diagnose severe personality development disorder. Structured assessment instruments such as the YAPD may further improve diagnostic decision-making in forensic psychiatry and psychology.

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