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Brunetti V, Marotta J, Simoncini Malucelli G, Marano G, Mazza M, Della Marca G. Dissociative episode and panic attacks triggered by pitolisant in a narcoleptic patient. Int Clin Psychopharmacol 2023; 38:114-116. [PMID: 36165509 DOI: 10.1097/yic.0000000000000430] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Pitolisant is a histamine 3-receptor antagonist/inverse agonist effective and safe for the treatment of excessive daytime sleepiness and cataplexy in narcolepsy. We report a 19-year-old woman affected by narcolepsy type 1 who presented panic attacks and dissociative symptoms induced by pitolisant. The patient medical history was unremarkable except that for familiarity for anxiety disorder and chronic insomnia. Moreover, a detailed psychometric evaluation revealed a profile of low resilience, a severe grade of depression, an anxiety trait and a propension to dissociative symptoms. Our report suggests that caution should be used in patients with predisposing factors to psychiatric disorders, especially during the first period of treatment with pitolisant. In consideration of the high prevalence of psychiatric comorbidities in narcolepsy, it seems worth to carefully investigate psychiatric background of narcoleptic patients.
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Affiliation(s)
- Valerio Brunetti
- UOC Neurologia, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS
- Università Cattolica del Sacro Cuore
| | | | | | - Giuseppe Marano
- Università Cattolica del Sacro Cuore
- UOC Psichiatria Clinica e d'Urgenza, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Marianna Mazza
- Università Cattolica del Sacro Cuore
- UOC Psichiatria Clinica e d'Urgenza, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giacomo Della Marca
- UOC Neurologia, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS
- Università Cattolica del Sacro Cuore
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2
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Huang H, Wan X, Lu G, Ding Y, Chen C. The Relationship Between Alexithymia and Mobile Phone Addiction Among Mainland Chinese Students: A Meta-Analysis. Front Psychiatry 2022; 13:754542. [PMID: 35222110 PMCID: PMC8866180 DOI: 10.3389/fpsyt.2022.754542] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 01/17/2022] [Indexed: 01/01/2023] Open
Abstract
Alexithymia and mobile phone addiction are common phenomena in daily life. Many studies have explored the internal relationship between them based on different theoretical perspectives, but the extent of the exact correlation is still controversial. To address this controversy and clarify the reasons for the divergence, a meta-analysis of 26 articles comprising 23,387 Chinese students was conducted. The results show that alexithymia was highly positively correlated with mobile phone addiction (r = 0.41, 95% CI = [0.37, 0.45]). Furthermore, the relationship was moderated by mobile phone addiction measurement tool and year of publication, with studies using the Mobile Phone Addiction Tendency Scale (MPATS) having higher correlation coefficients than those using the Mobile Phone Addiction Index (MPAI) or other measurement tools. Studies published in 2020-2021 yielded higher correlations than those published in 2014-2016 and 2017-2019. However, the relationship was not moderated by gender, region, or measures of alexithymia. Therefore, our meta-analysis of available published data indicated that alexithymia and mobile phone addiction in Chinese students are not only highly positively correlated but also affected by mobile phone addiction measurement tools and publication year. Longitudinal studies or experimental studies should be strengthened in the future to further establish the direction(s) of causality for the relation between alexithymia and mobile phone addiction.
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Affiliation(s)
- Haitao Huang
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Xiao Wan
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Guangli Lu
- School of Business, Henan University, Kaifeng, China
| | - Yueming Ding
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Chaoran Chen
- Institute of Nursing and Health, Henan University, Kaifeng, China
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3
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Warchoł-Biedermann K, Bugajski P, Budzicz Ł, Ziarko M, Jasielska A, Samborski W, Daroszewski P, Greberski K, Bączyk G, Karoń J, Mojs E. Relationship between stress and alexithymia, emotional processing and negative/positive affect in medical staff working amid the COVID-19 pandemic. J Investig Med 2022; 70:428-435. [PMID: 34815298 PMCID: PMC8616640 DOI: 10.1136/jim-2021-001942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 11/04/2022]
Abstract
The psychological burden of the COVID-19 pandemic may have a lasting effect on emotional well-being of healthcare workers. Medical personnel working at the time of the pandemic may experience elevated occupational stress due to the uncontrollability of the virus, high perceived risk of infection, poor understanding of the novel virus transmission routes and unavailability of effective antiviral agents. This study used path analysis to analyze the relationship between stress and alexithymia, emotional processing and negative/positive affect in healthcare workers. The sample included 167 nurses, 65 physicians and 53 paramedics. Sixty-two (21.75 %) respondents worked in COVID-19-designated hospitals. Respondents were administered the Toronto Alexithymia Scale-20, Cohen's Perceived Stress Scale, Emotional Processing Scale, and the Positive and Negative Affect Schedule. The model showed excellent fit indices (χ2 (2)=2.642, p=0.267; CFI=0.999, RMSEA=0.034, SRMR=0.015). Multiple group path analysis demonstrated physicians differed from nurses and paramedics at the model level (X2diff (7)=14.155, p<0.05 and X2diff (7)=18.642, p<0.01, respectively). The relationship between alexithymia and emotional processing was stronger in nurses than in physicians (difference in beta=0.27; p<0.05). Individual path χ2 tests also revealed significantly different paths across these groups. The results of the study may be used to develop evidence-based intervention programs promoting healthcare workers' mental health and well-being.
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Affiliation(s)
| | - Paweł Bugajski
- Department of Cardiovascular Disease Prevention, Poznan University of Medical Sciences, Poznan, Poland
- Department of General and Colorectal Surgery, Józef Strus Hospital, Poznan, Poland
| | - Łukasz Budzicz
- Department of Psychology, University of Zielona Gora, Zielona Gora, Poland
| | - Michał Ziarko
- Institute of Psychology, Uniwersytet im Adama Mickiewicza w Poznaniu, Poznan, Poland
| | - Aleksandra Jasielska
- Faculty of Psychology and Cognitive Sciences (FPCS AMU), Adam Mickiewicz University, Poznan, Poland
| | - Włodzimierz Samborski
- Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland
| | - Przemysław Daroszewski
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Poznan, Poland
| | - Krzysztof Greberski
- Department of Cardiovascular Disease Prevention, Poznan University of Medical Sciences, Poznan, Poland
- Department of Cardiac Surgery, Józef Strus Hospital, Poznan, Poland
| | - Grażyna Bączyk
- Department of Practice Nursing, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Karoń
- Department of General and Colorectal Surgery, Józef Strus Hospital, Poznan, Poland
| | - Ewa Mojs
- Department of Clinical Psychology, Poznan University of Medical Sciences, Poznan, Poland
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4
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Wang W, Guo X, Kang L, Zhang N, Ma S, Cheng J, Fang L, Liu Z. The Influence of Family-Related Factors on Suicide in Major Depression Patients. Front Psychiatry 2022; 13:919610. [PMID: 35845470 PMCID: PMC9283679 DOI: 10.3389/fpsyt.2022.919610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To explore the influence of family-related factors on suicide-related behaviors of patients with major depression disorder, and to provide scientific evidence for effective preventive measures. METHODS A total of 852 outpatients at Renmin Hospital of Wuhan University were enrolled in this cross-sectional study from April 2019 to January 2021. The general demographic information and family-related information of the patients were collected via a general information questionnaire, the Family Assessment Device, the Egna Minnen av Barndoms Uppfostran, and the Childhood Trauma Questionnaire. RESULTS Participants without suicide-related behaviors accounted for 10.45% of the total sample, those with suicidal ideation accounted for 47.54%, those with suicidal plans accounted for 24.77% and with suicidal attempts for 17.25%. Patients with major depression disorder who have lower education level, who were separated from their parents, who have severely impaired family function, who experienced childhood abuse, and whose parents adopted apathetic and severe child-rearing styles had a higher risk of suicide-related behaviors. In the multivariate regression model, degree of major depression disorder, education and child-rearing style were independent risk factors for suicide-related behaviors. CONCLUSION Patients with major depression disorder who have been separated from their parents, have severely impaired family function, were abused in childhood or have been exposed to improper childrearing styles have a greater risk of suicide. Family-related factors play a predictive role in suicide in patients with major depression disorder. More attention should be paid to family-related factors to reduce the occurrence of suicidal ideation and attempt.
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Affiliation(s)
- Wei Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xin Guo
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lijun Kang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Nan Zhang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Simeng Ma
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jing Cheng
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Li Fang
- Department of Psychiatry, Jingmen No. 2 People's Hospital, Jingmen, China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
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Perna G, Cuniberti F, Daccò S, Nobile M, Caldirola D. Impact of respiratory protective devices on respiration: Implications for panic vulnerability during the COVID-19 pandemic. J Affect Disord 2020; 277:772-778. [PMID: 33065816 PMCID: PMC7476564 DOI: 10.1016/j.jad.2020.09.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/25/2020] [Accepted: 09/02/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The wearing of respiratory protective devices (RPDs) correctly and continually in situations where people are at risk of respiratory infections is crucial for infection prevention. Certain people are poorly compliant with RPDs due to RPD-related annoyance, including respiratory discomfort. We hypothesized that individuals vulnerable to panic attacks are included in this group. No published studies on this topic are available. The evidence for our hypothesis was reviewed in this study as a starting point for future research. METHODS We selected a set of experimental studies that measured the respiratory physiological burden in RPD wearers through objective and validated methods. We conducted a bibliographic search of publications in the PubMed database (January 2000-May 2020) to identify representative studies that may be of interest for panic respiratory pathophysiology. RESULTS Five studies were included. Wearing RPDs exerted significant respiratory effects, including increased breathing resistance, CO2 rebreathing due to CO2 accumulation in the RPD cavity, and decreased inhaled O2 concentration. We discussed the implications of these effects on the respiratory pathophysiology of panic. LIMITATIONS Most studies had a small sample size, with a preponderance of young participants. Different methodologies were used across the studies. Furthermore, differences in physical responses between wearing RPDs in experimental settings or daily life cannot be excluded. CONCLUSIONS This research supports the idea that panic-prone individuals may be at higher risk of respiratory discomfort when wearing RPDs, thereby reducing their tolerance for these devices. Strategies to decrease discomfort should be identified to overcome the risk of poor compliance.
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Affiliation(s)
- Giampaolo Perna
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy.
| | - Francesco Cuniberti
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy
| | - Silvia Daccò
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy
| | - Maria Nobile
- Scientific Institute IRCCS Eugenio Medea, Bosisio Parini 23842, Lecco, Italy
| | - Daniela Caldirola
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy
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6
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Renzi A, Di Trani M, Solano L, Minutolo E, Tambelli R. Alexithymia, infertility-related stress and quality of life in women undergoing an assisted reproductive treatment. Stress Health 2020; 36:654-662. [PMID: 32472734 DOI: 10.1002/smi.2967] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/06/2020] [Accepted: 05/08/2020] [Indexed: 01/20/2023]
Abstract
The investigation of the association between alexithymia and quality of life in infertility is a relatively neglected area of research. The aim of this study was to evaluate the association between alexithymia and infertility-related quality of life in women during Assisted Reproductive Treatment. Data were collected in a clinic in Rome, 93 infertile women completed the 20-item Toronto Alexithymia Scale (TAS-20), the Fertility Quality of Life (FertiQoL) questionnaire and a socio-demographic questionnaire. TAS-20 total and two factors-Difficulty in Identifying Feelings (DIF) and Difficulty in Describing Feelings (DDF)-showed significant negative correlations with the overall questionnaire and with both Core and Treatment modules of FertiQoL. The regression model explained the 43% variance in FertiQol overall scores (R2 = 0.43; adjusted R2 = .38); a significant effect was reported for the number of previous attempts (beta = 0.20; p < .04), TAS-20 DIF (beta = -0.47; p < .001) and TAS-20 Externally Orientated Thinking (EOT) (beta = 0.20; p < .04); after applying Benjamini-Hochberg correction procedure only TAS-20 DIF maintained its significance. Alexithymia is associated with a worsened quality of life in infertile women; specifically, low difficulties in identifying feelings were associated to higher quality of life. Further investigations are needed also to develop specific therapeutic interventions aimed to promote emotional abilities in infertile people.
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Affiliation(s)
- Alessia Renzi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Luigi Solano
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Elisa Minutolo
- Department of Reproductive Medicine, Altamedica-Artemisia SpA, Rome, Italy
| | - Renata Tambelli
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
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7
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Scheer V, Blanco C, Olfson M, Lemogne C, Airagnes G, Peyre H, Limosin F, Hoertel N. A comprehensive model of predictors of suicide attempt in individuals with panic disorder: Results from a national 3-year prospective study. Gen Hosp Psychiatry 2020; 67:127-135. [PMID: 33129137 DOI: 10.1016/j.genhosppsych.2020.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/20/2020] [Accepted: 09/28/2020] [Indexed: 02/04/2023]
Abstract
OBJECTIVE People with panic disorder are at increased risk of suicide. Multiple factors influence their risk suggesting a need to combine them into an integrative model to develop more effective suicide prevention strategies for this population. In this report, we sought to build a comprehensive model of the 3-year risk of suicide attempt in individuals with panic disorder using a longitudinal nationally representative study, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; wave 1, 2001-2002; wave 2, 2004-2005). METHOD We used structural equation modeling to simultaneously examine effects of six broad groups of clinical factors previously identified as potential predictors of suicide attempt in adults with panic disorder: 1) severity of panic disorder, 2) severity of comorbidity, 3) prior history of suicide attempt, 4) family history of psychiatric disorders, 5) sociodemographic characteristics and 6) treatment-seeking behavior. RESULTS The 3-year prevalence rate of suicide attempt was 4.6%. A general psychopathology factor, lower physical health-related quality of life, prior suicide attempt and a greater number of stressful life events at baseline significantly and independently predicted suicide attempt between the two waves (p < .05). R-square of the models ranged from 0.47 to 0.50. CONCLUSION This model may help inform future research and identify high-risk individuals among adults with panic disorder.
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Affiliation(s)
- Valentin Scheer
- Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, France.
| | - Carlos Blanco
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA
| | - Mark Olfson
- Department of Psychiatry, New York State Psychiatric Institute / Columbia University, New York, NY 10032, USA
| | - Cédric Lemogne
- Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, France; Faculté de médecine Paris Descartes, Université de Paris, Paris, France; Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Guillaume Airagnes
- Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, France; UMS 011, Population-based Epidemiological Cohorts, Inserm, Villejuif, France
| | - Hugo Peyre
- Robert Debré Hospital, Child and Adolescent Psychiatry Department, Assistance Publique-Hôpitaux de Paris, Paris, France; Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France
| | - Frédéric Limosin
- Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, France; Faculté de médecine Paris Descartes, Université de Paris, Paris, France; Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Nicolas Hoertel
- Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, France; Faculté de médecine Paris Descartes, Université de Paris, Paris, France; Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
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8
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Chen L, Ngoubene-Atioky AJ, Zanardelli G, Yuanping D, Yu L. Childhood Abuse and Suicidal Behaviors Among Chinese Migrant Workers: The Mediating Role of Alexithymia and Social Support. Arch Suicide Res 2020; 24:633-647. [PMID: 31502515 DOI: 10.1080/13811118.2019.1658142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study aims to investigate the lifetime prevalence of suicidal behaviors in a sample of Chinese migrant workers. It also examined the mediating role of alexithymia and social support in the link between childhood abuse and suicidal behaviors. A total of 1,563 migrant workers were surveyed by using cluster sampling. Results showed that the estimated lifetime prevalence of suicide ideation, plan, and attempt among Chinese migrant workers was 12.8%, 8.1%, and 4.6%, respectively. Structural equation modeling analyses revealed a significant positive association between childhood abuse and suicidal behaviors; this association was partially mediated by social support. A significant path from childhood abuse through alexithymia and social support to suicidal behaviors was also established. Findings of this study emphasize the importance of social support and alexithymia in understanding the possible mechanisms underlying the relationship between childhood abuse and suicidal behaviors and suggest possible avenues for suicide interventions.
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9
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Hjell G, Mørch-Johnsen L, Holst R, Tesli N, Bell C, Lunding SH, Rødevand L, Werner MCF, Melle I, Andreassen OA, Lagerberg TV, Steen NE, Haukvik UK. Disentangling the relationship between cholesterol, aggression, and impulsivity in severe mental disorders. Brain Behav 2020; 10:e01751. [PMID: 32681586 PMCID: PMC7507477 DOI: 10.1002/brb3.1751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE Low total cholesterol has been linked with adverse mental symptoms such as aggression and impulsivity in severe mental disorders (SMDs). This putative association may affect the clinician's decision making about cholesterol lowering in this patient group. Here, we investigated the associations between cholesterol levels, aggression, and impulsivity in a large representative sample of in- and outpatients with SMD. METHODS Patients with schizophrenia- or bipolar spectrum disorders (N = 1 001) underwent thorough clinical characterization and blood sampling (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol). Aggression was characterized by the Positive and Negative Syndrome Scale Excited Component. Impulsivity was measured with the Barratt Impulsiveness Scale in a subsample of patients (N = 288). We used a multinomial logistic regression model to analyze the association between cholesterol and aggression and a multiple linear regression model to analyze the association between cholesterol and impulsivity, while controlling for confounders. RESULTS We found no significant associations between cholesterol levels and aggression or impulsivity. There were no significant interactions between cholesterol and diagnostic group or inpatient versus outpatient status. Controlling for medication use, body mass index, alcohol or illicit substance use did not affect the results. CONCLUSION In this large sample of patients with schizophrenia- and bipolar spectrum disorders, we found no associations between cholesterol levels and aggression or impulsivity. This has clinical implications as patients with SMD are at increased CVD risk and currently undertreated with statins.
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Affiliation(s)
- Gabriela Hjell
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Departments of Psychiatry and Clinical Research, Ostfold Hospital, Gralum, Norway
| | - Lynn Mørch-Johnsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Departments of Psychiatry and Clinical Research, Ostfold Hospital, Gralum, Norway
| | - René Holst
- Departments of Psychiatry and Clinical Research, Ostfold Hospital, Gralum, Norway.,Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Natalia Tesli
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Christina Bell
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Synve Hoffart Lunding
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Linn Rødevand
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Maren Caroline Frogner Werner
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole Andreas Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trine Vik Lagerberg
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nils Eiel Steen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Unn Kristin Haukvik
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Adult Psychiatry, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Centre of Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway
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10
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Alexithymia and self-harm: A review of nonsuicidal self-injury, suicidal ideation, and suicide attempts. Psychiatry Res 2020; 288:112920. [PMID: 32279008 DOI: 10.1016/j.psychres.2020.112920] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 03/12/2020] [Accepted: 03/13/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Suicide attempts are a significant global public health concern. Research into non-traditional factors, such as the presence of alexithymia, may shed light on the prediction of suicidal behaviours, which can aid intervention and prevention strategies. To ascertain whether alexithymia is a unique risk factor for suicide attempts, this article reviews the evidence on alexithymia related to suicidal ideation, attempts, and non-suicidal self-injury (NSSI). METHODS A literature search was conducted for original articles examining the general and psychiatric populations. RESULTS There is consistent evidence linking alexithymia with suicidal ideation and NSSI, but inconsistent evidence linking it to suicide attempts. CONCLUSION The relationship between alexithymia and suicidality seems to differ based on whether the research focuses on suicidal ideation, suicide attempts, or NSSI. The relationship between alexithymia and suicidality can be understood within the context of multiple code theory and childhood trauma. Future research should explore the whether alexithymia can reliably distinguish between those with a single attempt and those with multiple suicide attempts as well as alexithymia levels pre- and post-intervention with suicide-related behavior as outcomes in treatment studies.
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11
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Cosci F, Bertoli G, Mansueto G, Asiaghi M, Schruers K, Nardi AE. The Role of Anxiety Sensitivity and Expectancy Manipulation on Panic-Like Response to the 35% CO2 Challenge in Healthy Subjects. Neuropsychobiology 2020; 78:209-217. [PMID: 31437853 DOI: 10.1159/000502150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/16/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND The 35% CO2 challenge is a well-established method triggering panic attacks under laboratory-controlled conditions. There is an ongoing debate whether single or the joined effects of the instructional set and anxiety sensitivity (AS) can alter the outcome of the challenge. OBJECTIVES The present study investigated the effects of instruction manipulation and AS on panic-like response to the 35% CO2 challenge. METHODS Eighty healthy subjects, with high or low levels of AS, were randomized into 4 groups based on standard/manipulated instructional sets as well as 35% CO2 mixture/room air inhalation. Subjects filled in the Visual Analogue Scale of Anxiety (VAAS), the Visual Analogue Scale of Fear (VAS-F), the VAS of Discomfort (VAS-D), and the Panic Symptom List (PSL). Blood pressure and heart rate were measured at pre- and posttest. RESULTS Hierarchical multiple regression analyses showed greater psychological responses at VAAS, VAS-F, VAS-D, and PSL and higher systolic blood pressure under 35% CO2 challenge if compared to room air inhalation while instructional set and AS did not influence the response. CONCLUSIONS The present study confirms that neither instructional test nor AS alter the outcome of the 35% CO2 challenge.
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Affiliation(s)
- Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy, .,Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands,
| | - Giuly Bertoli
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Giovanni Mansueto
- Department of Health Sciences, University of Florence, Florence, Italy.,Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Martina Asiaghi
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Koen Schruers
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Antonio E Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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12
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De Berardis D, Vellante F, Fornaro M, Anastasia A, Olivieri L, Rapini G, Serroni N, Orsolini L, Valchera A, Carano A, Tomasetti C, Varasano PA, Pressanti GL, Bustini M, Pompili M, Serafini G, Perna G, Martinotti G, Di Giannantonio M. Alexithymia, suicide ideation, affective temperaments and homocysteine levels in drug naïve patients with post-traumatic stress disorder: an exploratory study in the everyday 'real world' clinical practice. Int J Psychiatry Clin Pract 2020; 24:83-87. [PMID: 31829763 DOI: 10.1080/13651501.2019.1699575] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective: The present exploratory study aimed to investigate relationships between alexithymia, suicide ideation, affective temperaments and homocysteine levels among drug-naïve adult outpatients with Post-Traumatic Stress Disorder (PTSD) in an everyday 'real world' clinical setting.Method: Sixty-four adult outpatients with PTSD were evaluated using the Davidson Trauma Scale (DTS), the Toronto Alexithymia Scale (TAS-20), the Scale of Suicide Ideation (SSI), the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego-Autoquestionnaire. As well, homocysteine levels were measured.Results: Alexithymic subjects showed higher values on all scales but not homocysteine levels. Partial correlations showed that almost all studied variables were correlated with each other, except homocysteine levels. Regression analysis showed that higher disorder severity as measured by DTS and TAS-20 'Difficulty in Identifying Feelings' dimension was associated with higher SSI scores.Conclusions: In conclusion, alexithymic PTSD outpatients may be characterised by higher disorder severity and difficulty in identifying feelings that may be linked to increased suicide ideation, regardless of affective temperaments or homocysteine levels. Homocysteine levels were not related to any studied variable. However, study limitations are discussed and must be considered. KeypointsPatients with alexithymia showed increased PTSD severity, a higher score on TEMPS-A subscales, and more severe suicide ideation.The Difficulty in Identifying Feelings (DIF) dimension of TAS-20 was associated with suicide ideation in patients with PTSD.Homocysteine did not correlate with any studied variables.This study was exploratory and cross-sectional: further larger and prospective studies are needed.
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Affiliation(s)
- Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'G. Mazzini', Teramo, Italy.,Department of Neurosciences and Imaging, University 'G. D'Annunzio, Chieti, Italy
| | - Federica Vellante
- Department of Neurosciences and Imaging, University 'G. D'Annunzio, Chieti, Italy
| | - Michele Fornaro
- Department of Psychiatry, Federico II University, Naples, Italy.,Polyedra, Teramo, Italy
| | | | - Luigi Olivieri
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'G. Mazzini', Teramo, Italy
| | - Gabriella Rapini
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'G. Mazzini', Teramo, Italy
| | - Nicola Serroni
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'G. Mazzini', Teramo, Italy
| | - Laura Orsolini
- Polyedra, Teramo, Italy.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Alessandro Valchera
- Polyedra, Teramo, Italy.,Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy
| | - Alessandro Carano
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'Madonna Del Soccorso', NHS, Ascoli Piceno, Italy
| | - Carmine Tomasetti
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'SS. Annunziata' ASL, Giulianova, Italy
| | | | | | - Massimiliano Bustini
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'San Camillo de Lellis' ASL, Rieti, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, S. Andrea Hospital, Sapienza University, Rome, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giampaolo Perna
- Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, FoRiPsi, Albese con Cassano, Italy.,Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, Miami University, Miami, FL, USA
| | - Giovanni Martinotti
- Department of Neurosciences and Imaging, University 'G. D'Annunzio, Chieti, Italy
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13
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López-Muñoz F, Pérez-Fernández F. A History of the Alexithymia Concept and Its Explanatory Models: An Epistemological Perspective. Front Psychiatry 2020; 10:1026. [PMID: 32082200 PMCID: PMC7005782 DOI: 10.3389/fpsyt.2019.01026] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 12/27/2019] [Indexed: 12/30/2022] Open
Abstract
Alexithymia, as a theoretical psychotherapeutic construct, finds its origins in psychosomatic medicine, actually being quite old. However, beyond the specific observations and case studies, their characterization and systematization is relatively recent. However, from an epistemological point of view, it remains the subject of debate and therefore remains outside the conventional diagnostic guidelines. Possibly, its history, closely linked to psychoanalysis, as well as the lack of clear empirical references, has turned the alexithymia construct before into a good descriptive and comprehensive framework than in a precise diagnostic model. In this article it is, following the thread conduits of the historical perspective, to deepen these epistemological aspects.
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Affiliation(s)
- Francisco López-Muñoz
- Department of Psychology, Faculty of Education and Health, University Camilo José Cela, Madrid, Spain
- Neuropsychopharmacology Unit, Hospital Doce de Octubre Research Institute (i+12), Madrid, Spain
- Portucalense Institute of Neuropsychology and Cognitive and Behavioural Neurosciences (INPP), Portucalense University, Porto, Portugal
- Thematic Network for Cooperative Health Research (RETICS), Addictive Disorders Network, Health Institute Carlos III, MICINN and FEDER, Madrid, Spain
| | - Francisco Pérez-Fernández
- Department of Psychology, Faculty of Education and Health, University Camilo José Cela, Madrid, Spain
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14
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De Berardis D, Fornaro M, Orsolini L. Editorial: "No Words for Feelings, Yet!" Exploring Alexithymia, Disorder of Affect Regulation, and the "Mind-Body" Connection. Front Psychiatry 2020; 11:593462. [PMID: 33061929 PMCID: PMC7530238 DOI: 10.3389/fpsyt.2020.593462] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 08/31/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital "G. Mazzini", Teramo, Italy
| | - Michele Fornaro
- Section of Psychiatry, Department of Neuroscience, Reproductive Sciences, and Dentistry, Federico II University, Naples, Italy
| | - Laura Orsolini
- Section of Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Ancona, Ancona, Italy.,Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
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15
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Lee SW, Won S, Jeong B. Moderating effect of emotional awareness on the association between maltreatment experiences and resilience. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2019.05.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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16
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Fang Y, Zeng B, Chen P, Mai Y, Teng S, Zhang M, Zhao J, Yang X, Zhao J. Mindfulness and Suicide Risk in Undergraduates: Exploring the Mediating Effect of Alexithymia. Front Psychol 2019; 10:2106. [PMID: 31572279 PMCID: PMC6753216 DOI: 10.3389/fpsyg.2019.02106] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/30/2019] [Indexed: 11/13/2022] Open
Abstract
The present study was designed to examine the relationship between dispositional mindfulness and suicide risk in undergraduates, and it further explored the potential mediating role of alexithymia in this relationship. A total of 2,633 undergraduates completed the Mindful Attention Awareness Scale (MAAS), the Suicidal Behaviors Questionnaire – Revised (SBQ-R), and the 20-item Toronto Alexithymia Scale (TAS-20). The results indicate that mindfulness and suicide risk were negatively correlated, and alexithymia partially mediated the relationship between mindfulness and suicide risk only in the female undergraduates. Moreover, only the difficulty in identifying feelings (DIF) factor of alexithymia mediated the relationship between mindfulness and suicide risk in the female undergraduates. These findings contribute to the potential mechanism that explains the relationship between mindfulness and suicide risk. Furthermore, it is possible to implement mindfulness in the suicide intervention of alexithymic individuals.
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Affiliation(s)
- Yuan Fang
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Baoer Zeng
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Peiyi Chen
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yiling Mai
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Shan Teng
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Minting Zhang
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jingbo Zhao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xueling Yang
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jiubo Zhao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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17
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Hemming L, Taylor P, Haddock G, Shaw J, Pratt D. A systematic review and meta-analysis of the association between alexithymia and suicide ideation and behaviour. J Affect Disord 2019; 254:34-48. [PMID: 31103905 PMCID: PMC6599888 DOI: 10.1016/j.jad.2019.05.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/03/2019] [Accepted: 05/07/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Alexithymia reflects a difficulty with identifying and expressing emotions. This experience has been proposed as having an association with suicide ideation and behaviour. This review aimed to synthesise the evidence to establish the bivariate and multivariate relationships between alexithymia, and its subcomponents, with suicide ideation and behaviour. METHODS Search terms related to alexithymia and suicide ideation and behaviour were searched across nine prominent databases in May 2018. Studies were eligible for inclusion if they reported original empirical quantitative findings from adult samples, used a validated measure of alexithymia, and any measure of suicide ideation or behaviour. RESULTS Thirty-four studies were eligible for inclusion in this review. The review found a large effect size for the relationship between alexithymia and suicide ideation (r = 0.54, 95% CI= 0.40-0.65) and a small effect size for the relationship between alexithymia and suicide behaviour (r = 0.25, 95% CI = 0.16-0.34). LIMITATIONS A high level of heterogeneity was found in the meta-analysis meaning that results should be interpreted with caution. CONCLUSION A positive association was found between alexithymia and suicide ideation and, to a lesser extent, behaviour across a range of clinical and general population samples. This review has potentially important clinical implications, and promotes the need for suicide prevention to focus on emotion regulation skills.
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Affiliation(s)
- Laura Hemming
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK; Manchester Academic Health Sciences Centre, Manchester, UK.
| | - Peter Taylor
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK; Manchester Academic Health Sciences Centre, Manchester, UK
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK; Manchester Academic Health Sciences Centre, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Jennifer Shaw
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK; Manchester Academic Health Sciences Centre, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK; Manchester Academic Health Sciences Centre, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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18
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Davey S, Halberstadt J, Bell E, Collings S. A scoping review of suicidality and alexithymia: The need to consider interoception. J Affect Disord 2018; 238:424-441. [PMID: 29913380 DOI: 10.1016/j.jad.2018.06.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 05/07/2018] [Accepted: 06/05/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Alexithymia is a problem of emotion regulation and for this reason alone may relate to suicidality. This article investigates the evidence for a direct relationship. It explores the possibility of an additional role for interoception in future research. METHODS A scoping review of peer-reviewed journal articles examining alexithymia and suicidality was undertaken, followed by a critical assessment of the overall state of the evidence base in relation to interoception. RESULTS The review identified 27 journal articles. The evidence base was heterogeneous, involving a variety of clinical and non-clinical samples, and displays mixed findings. The measurement of alexithymia (using the Toronto Alexithymia Scale) and management of confounding variables were identified as problematic in determining its relationship with suicidality. LIMITATIONS The review was limited to published research in the English language. The review findings were not tested and refined by stakeholders. Some of the research studies cited in the critical assessment of interoception were themselves subject to the limitations of the Toronto Alexithymia Scale. CONCLUSION The scoping review identified a collection of articles that were too diverse to permit a definitive answer to the research question. Interoception may provide a fruitful new avenue in understanding the relationship between emotion regulation and suicide.
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Affiliation(s)
- Steven Davey
- Suicide and Mental Health Research Group, University of Otago, PO Box 7343, Newtown, Wellington 6242, New Zealand.
| | | | - Elliot Bell
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Sunny Collings
- Suicide and Mental Health Research Group, University of Otago, Wellington, New Zealand
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19
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De La Vega D, Giner L, Courtet P. Suicidality in Subjects With Anxiety or Obsessive-Compulsive and Related Disorders: Recent Advances. Curr Psychiatry Rep 2018; 20:26. [PMID: 29594718 DOI: 10.1007/s11920-018-0885-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW Historically, anxiety disorders have not been considered as important determinants of suicide, but in the last years, many works have challenged this assumption. Here, we will review the available evidence on the relationship between suicide and anxiety disorders (e.g., obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, panic disorder, and body dysmorphic disorder), with special emphasis on findings published in the last years. RECENT FINDINGS Overall, anxiety disorders increase the risk of suicide. Specifically, 16% of patients with social anxiety disorder reported suicidal ideation in the previous month, and 18% of them had a history of suicide attempts. Similarly, in patients with panic disorder, suicidal ideation prevalence ranged between 17 and 32%, and 33% of them had a history of suicide attempts. Generalized anxiety disorder (GAD) was the most frequent anxiety disorder in completed suicides (present in 3% of people who committed suicide) and also subthreshold GAD was clearly linked to suicide ideation. Post-traumatic stress disorder was positively associated with suicidal ideation, and in patients with obsessive-compulsive disorder, suicide ideation rates ranged from 10 to 53% and suicide attempts from 1 to 46%. Body dysmorphic disorders presented a suicide ideation prevalence of about 80%. Suicide risk is increased in subjects with anxiety disorder. This risk is higher in the presence of comorbidities, but it is not clear whether it is independent from such comorbidities in some disorders.
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Affiliation(s)
- Diego De La Vega
- Unidad de Hospitalización de Salud Mental, Unidad de Gestión Clínica de Salud Mental del Hospital Virgen Macarena, Servicio Andaluz de Salud, Sevilla, Spain
| | - Lucas Giner
- Department of Psychiatry, School of Medicine, Universidad de Sevilla, Av. Sánchez-Pizjuán s/n, 41009, Seville, Spain.
| | - Philippe Courtet
- CHRU Montpellier, University of Montpellier, INSERM unit 1061, Montpellier, France.,Fondamental Foundation, Créteil, France
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20
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Ghorbani F, Khosravani V, Sharifi Bastan F, Jamaati Ardakani R. The alexithymia, emotion regulation, emotion regulation difficulties, positive and negative affects, and suicidal risk in alcohol-dependent outpatients. Psychiatry Res 2017; 252:223-230. [PMID: 28285249 DOI: 10.1016/j.psychres.2017.03.005] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 01/22/2017] [Accepted: 03/03/2017] [Indexed: 01/21/2023]
Abstract
The aim of this study was to evaluate the potential contributing factors such as alexithymia, emotion regulation and difficulties in emotion regulation, positive/negative affects and clinical factors including severity of alcohol dependence and depression connected to high suicidality in alcohol-dependent outpatients. 205 alcohol-dependent outpatients and 100 normal controls completed the demographic questionnaire, the Persian version of the Toronto Alexithymia Scale (FTAS-20), the Difficulties in Emotion Regulation Scale (DERS), the Emotion Regulation Questionnaire (ERQ), the Positive/Negative Affect Scales, the Alcohol Use Disorders Identification Test (AUDIT), and the Beck Depression Inventory-II (BDI-II). The suicidal risk was assessed using the Scale for Suicide Ideation (SSI) and history taking. Alcohol-dependent outpatients showed higher means in alexithymia, difficulties in emotion regulation, suppression subscale, negative affect, and suicide ideation than normal controls. Logistic regression analysis revealed that negative affect, duration of alcohol use, externally-oriented thinking, and severity of alcohol dependence explained lifetime suicide attempts. Depression, impulsivity, severity of alcohol dependence, reappraisal (reversely), externally-oriented thinking, difficulties engaging in goal-directed behaviors, and negative affect significantly predicted the suicidal risk. The findings may constitute useful evidence of the relevancies of alexithymia, emotion regulation, emotion regulation difficulties, and affects to suicidality in alcoholic patients.
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Affiliation(s)
- Fatemeh Ghorbani
- Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Vahid Khosravani
- Psychosocial Injuries Research Centre, Ilam University of Medical Sciences, Ilam, Iran.
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21
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Oh J, Kim TS. Serum lipid levels in depression and suicidality: The Korea National Health and Nutrition Examination Survey (KNHANES) 2014. J Affect Disord 2017; 213:51-58. [PMID: 28189965 DOI: 10.1016/j.jad.2017.02.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/31/2017] [Accepted: 02/04/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND The level of serum lipids has been reported to be associated with depression and suicidality, but the exact relationship between these factors remains controversial. The aim of this study was to investigate the association between lipid levels and depression with suicidality in large sample. METHODS We examined the association between serum lipid levels and the existence of mild depression measured using Patient Health Questionnaire 9 (PHQ-9) in a national sample of Korean. The data of 2055 men and 2894 women who participated in the 6th Korea National Health and Nutrition Examination Survey (KNHNES VI) were used. The serum concentration of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride, and total cholesterol were dichotomized and complex samples logistic regression was employed in the analysis. RESULTS There was a significant association between high level of HDL-C (≥40mg/dl) and depression in adult men, and between high level of triglyceride (≥150mg/dl) and depression in adult women. In middle-aged adults 45-64 year), increased level of depression and suicidality was related to high level of triglyceride, respectively. (depression, OR=2.20 (95% CI 1.26-3.85); suicidality, OR=3.66 (95% CI 1.41-9.51). Furthermore, we found that the increased number of abnormal lipids level was significantly associated with the increased prevalence of depression in women (OR =1.34, 95% CI =1.12-1.60) and in middle-aged adults (OR=1.43, 95% CI =1.12-1.82). LIMITATIONS As this study had a cross-sectional design, it was hard to investigate causation between lipid levels and depression, and the assessment of suicidality needs more validation. CONCLUSION Our findings support a significant association between the high level of HDL-C, triglyceride and depression in large sample data. Triglyceride was highly associated with suicidality in younger and middle-aged adults, but not in elderly adults. Further assessment could delineate relationship between serum lipid levels and depression with suicidality in other ethnic groups.
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Affiliation(s)
- Jihoon Oh
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Tae-Suk Kim
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea.
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22
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Kreuze E, Lamis DA. A Review of Psychometrically Tested Instruments Assessing Suicide Risk in Adults. OMEGA-JOURNAL OF DEATH AND DYING 2017; 77:36-90. [PMID: 28056621 DOI: 10.1177/0030222816688151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Identify suicidal ideation and behavior screening instruments with the strongest psychometric properties, using the Interpersonal-Psychological Theory of Suicidal Behavior. METHODS Information databases PsycINFO and PubMed were systematically searched, and articles evaluating the psychometric properties of instruments assessing suicidal ideation and behavior ( n = 2,238) were reviewed. International populations and articles with diverse methodologies were integrated. RESULTS Review of records resulted in the inclusion of 51 articles that assessed 16 instruments. The majority of studies used the English language version (68.6%) and included U.S. populations (65.7%). However, global populations and non-English language versions were also represented. CONCLUSION More diverse population representation, and non-English versions of instruments, is required to improve generalizability of assessment measures. Including underrepresented groups and non-English instruments will promote culturally and linguistically sensitive instruments that may better assess suicide risk in diverse populations.
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Affiliation(s)
- Elizabeth Kreuze
- 1 Medical University of South Carolina, College of Nursing, Charleston, SC, USA
| | - Dorian A Lamis
- 2 Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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23
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De Berardis D, Serroni N, Campanella D, Marini S, Rapini G, Valchera A, Iasevoli F, Mazza M, Fornaro M, Perna G, Di Iorio G, Martinotti G, Di Giannantonio M. Alexithymia, Suicide Ideation, C-Reactive Protein, and Serum Lipid Levels Among Outpatients with Generalized Anxiety Disorder. Arch Suicide Res 2017; 21:100-112. [PMID: 25856390 DOI: 10.1080/13811118.2015.1004485] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of the present study was to investigate the relationships between alexithymia, suicide ideation, C-Reactive Protein (CRP), and serum lipid levels in adult outpatients with a DSM-IV diagnosis of Generalized Anxiety Disorder (GAD). Seventy consecutive patients with GAD were recruited and evaluated. Measures were the Hamilton Anxiety Scale, the Toronto Alexithymia Scale (TAS-20), the Scale of Suicide Ideation (SSI), and the Montgomery Åsberg Depression Rating Scale (MADRS). All patients were assessed for: CRP, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceridaemia (TG), and very-low-density lipoprotein cholesterol (VLDL-C). TC/HDL-C and LDL-C/HDL-C ratios were also evaluated. Alexithymic patients showed higher scores on almost all rating scales and altered serum CRP and lipid levels vs. non-alexithymics. In the hierarchical regression model, the presence of higher MADRS scores together with higher scores at the Difficulty in Identifying Feelings dimension of TAS-20 were associated with higher rates of suicide ideation. Although alexithymic subjects with GAD may show a CRP and cholesterol dysregulation, this latter seems independent on increased suicide ideation, rather to Difficulty in Identifying Feelings, and subthreshold depressive symptoms. Study limitations and future research implications are discussed.
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De Berardis D, Fornaro M, Orsolini L, Valchera A, Carano A, Vellante F, Perna G, Serafini G, Gonda X, Pompili M, Martinotti G, Di Giannantonio M. Alexithymia and Suicide Risk in Psychiatric Disorders: A Mini-Review. Front Psychiatry 2017; 8:148. [PMID: 28855878 PMCID: PMC5557776 DOI: 10.3389/fpsyt.2017.00148] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 07/28/2017] [Indexed: 11/18/2022] Open
Abstract
It is well known that alexithymic individuals may show significantly higher levels of anxiety, depression, and psychological suffering than non-alexithymics. There is an increasing evidence that alexithymia may be considered a risk factor for suicide, even simply increasing the risk of development of depressive symptoms or per se. Therefore, the purpose of this narrative mini-review was to elucidate a possible relationship between alexithymia and suicide risk. The majority of reviewed studies pointed out a relationship between alexithymia and an increased suicide risk. In several studies, this relationship was mediated by depressive symptoms. In conclusion, the importance of alexithymia screening in everyday clinical practice and the evaluation of clinical correlates of alexithymic traits should be integral parts of all disease management programs and, especially, of suicide prevention plans and interventions. However, limitations of studies are discussed and must be considered.
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Affiliation(s)
- Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy.,Department of Neurosciences and Imaging, Chair of Psychiatry, Università degli Studi 'G. d'Annunzio' Chieti - Pescara, Chieti, Italy
| | - Michele Fornaro
- New York Psychiatric Institute, Columbia University, New York City, NY, United States.,Polyedra, Teramo, Italy
| | - Laura Orsolini
- Polyedra, Teramo, Italy.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy
| | - Alessandro Valchera
- Polyedra, Teramo, Italy.,Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy
| | - Alessandro Carano
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "Madonna Del Soccorso", NHS, San Benedetto del Tronto, Italy
| | - Federica Vellante
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy.,Department of Neurosciences and Imaging, Chair of Psychiatry, Università degli Studi 'G. d'Annunzio' Chieti - Pescara, Chieti, Italy
| | - Giampaolo Perna
- Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, Italy.,Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, Netherlands.,Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genova, Genova, Italy
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Kutvolgyi Clinical Center, Semmelweis University, Budapest, Hungary.,MTA-SE Neuropsychopharmacology Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary.,Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Giovanni Martinotti
- Department of Neurosciences and Imaging, Chair of Psychiatry, Università degli Studi 'G. d'Annunzio' Chieti - Pescara, Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neurosciences and Imaging, Chair of Psychiatry, Università degli Studi 'G. d'Annunzio' Chieti - Pescara, Chieti, Italy
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Loas G, Dalleau E, Lecointe H, Yon V. Relationships between anhedonia, alexithymia, impulsivity, suicidal ideation, recent suicide attempt, C-reactive protein and serum lipid levels among 122 inpatients with mood or anxious disorders. Psychiatry Res 2016; 246:296-302. [PMID: 27744231 DOI: 10.1016/j.psychres.2016.09.056] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 09/19/2016] [Accepted: 09/19/2016] [Indexed: 10/20/2022]
Abstract
Several studies have explored the relationship between C-reactive protein (CRP), serum lipid levels, risk of suicide and alexithymia or impulsivity in mood or anxiety disorders. However, to date, no study has evaluated the effects of anhedonia on these parameters. The aim of the study was to evaluate the relationship between anhedonia, alexithymia, impulsivity, suicidal ideation, recent suicide attempt, C-reactive protein (CRP) and lipid levels in patients with mood or anxiety disorders. One hundred and twenty-two inpatients with mood or anxiety disorders were recruited. Alexithymia and impulsivity were rated by the 20-item Toronto Alexithymia Scale (TAS-20) and the Barratt impulsivity scale (BIS-10), respectively. Anhedonia and depression were rated by the Temporal Experience Pleasure Scale (TEPS) and the Beck Depression inventory (BDI-II). The TEPS contained two subscales rating anticipatory and consummatory anhedonia. From the BDI-II an anhedonia subscale was extracted rating anhedonia-state. Trait consummatory anhedonia and state anhedonia were associated with low levels of total cholesterol or HDL and low levels of triglycerides respectively. Trait anticipatory anhedonia and state anhedonia were associated with suicidal ideations. The difficulty of identifying feelings component of alexithymia was associated with low levels of total cholesterol and LDL. A high level of suicidal ideation was associated with low levels of HDL. Higher levels of CRP were found in inpatients having recently attempted suicide compared with inpatients who had not attempted suicide. In mood and anxiety disorders, anhedonia and the "difficulty of identifying feelings" component of alexithymia (which has previously been found to be associated with suicide risk) could explain the relationship between serum lipid levels and higher suicide risk.
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Affiliation(s)
- Gwenolé Loas
- University Department of Psychiatry, Hôpital Nord, CHU d'Amiens, France; Department of Psychiatry, Hôpital Erasme, ULB, Bruxelles, Belgium.
| | - Elodie Dalleau
- University Department of Psychiatry, Hôpital Nord, CHU d'Amiens, France
| | - Héloïse Lecointe
- University Department of Psychiatry, Hôpital Nord, CHU d'Amiens, France
| | - Valérie Yon
- University Department of Psychiatry, Hôpital Nord, CHU d'Amiens, France
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Wang J, Jiang C, Chen L, Wu S, Lin J, Gao L, Xie B, Zheng D, Yang R, Li S, Pan X, Liao Y. A cross-sectional study to investigate the correlation between depression comorbid with anxiety and serum lipid levels. Compr Psychiatry 2016; 69:163-8. [PMID: 27423357 DOI: 10.1016/j.comppsych.2016.05.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 01/22/2016] [Accepted: 05/05/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Depression is a common psychological disorder that severely threatens human health. Its pathology remains unclear, but it has been suggested to be associated with abnormal blood lipid metabolism. OBJECTIVES This study aimed to explore the changes in blood lipid levels in patients with depression accompanied or not by anxiety, and assess whether adjusting the clinical therapeutic strategy could be based on blood lipid test results, providing a novel insight into depression treatment. METHODS This was a cross-sectional study. We assessed 60 outpatients and inpatients diagnosed with depression from January 2013 to January 2014 who met the Chinese Classification of Mental Disorders version 3 (CCMD-3) criteria, with Hamilton Rating Scale for Depression (HAMD-24) ≥20. They were grouped into depression with anxiety (n=29) and depression without anxiety (n=31) groups by the Hamilton Anxiety Scale (HAMA). RESULTS TG levels were higher in the depression with anxiety group compared with patients without anxiety (P=0.045), which was confirmed by multifactorial analysis [P=0.017, OR=4.394, 95% CI (1.303-14.824)]. A negative correlation between anxiety score and HDL levels was observed in patients with depression (r=-0.340, P=0.046). Meanwhile, positive associations were obtained between retardation and LDL levels (r=0.307, P=0.017) as well as age at disease onset and total cholesterol levels (r=0.410, P=0.002). CONCLUSION TG levels differ in patients with depression accompanied by anxiety compared with those without anxiety.
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Affiliation(s)
- Jinmin Wang
- Department of Neurology, The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou,Fujian, China.
| | - Changying Jiang
- Department of Neurology, Chinese Medicine Hospital of Fuzhou Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou,Fujian, China
| | - Liling Chen
- Fuzhou Neuro-psychiatric Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou,Fujian, China
| | - Songying Wu
- Department of Neurology, The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou,Fujian, China
| | - Jushan Lin
- Department of Neurology, The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou,Fujian, China
| | - Lili Gao
- Department of Neurology, The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou,Fujian, China
| | - Buni Xie
- Department of Neurology, The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou,Fujian, China
| | - Dengzi Zheng
- Clinical Laboratory, The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian, China
| | - Ruiling Yang
- Department of Neurology, The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou,Fujian, China
| | - Shiju Li
- Department of Neurology, The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou,Fujian, China
| | - Xiaoming Pan
- Department of Neurology, The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou,Fujian, China
| | - Yuansheng Liao
- Department of Neurology, The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou,Fujian, China
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Iorfino F, Hickie IB, Lee RSC, Lagopoulos J, Hermens DF. The underlying neurobiology of key functional domains in young people with mood and anxiety disorders: a systematic review. BMC Psychiatry 2016; 16:156. [PMID: 27215830 PMCID: PMC4878058 DOI: 10.1186/s12888-016-0852-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 05/08/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Mood and anxiety disorders are leading causes of disability and mortality, due largely to their onset during adolescence and young adulthood and broader impact on functioning. Key factors that are associated with disability and these disorders in young people are social and economic participation (e.g. education, employment), physical health, suicide and self-harm behaviours, and alcohol and substance use. A better understanding of the objective markers (i.e. neurobiological parameters) associated with these factors is important for the development of effective early interventions that reduce the impact of disability and illness persistence. METHODS We systematically reviewed the literature for neurobiological parameters (i.e. neuropsychology, neuroimaging, sleep-wake and circadian biology, neurophysiology and metabolic measures) associated with functional domains in young people (12 to 30 years) with mood and/or anxiety disorders. RESULTS Of the one hundred and thirty-four studies selected, 7.6 % investigated social and economic participation, 2.1 % physical health, 15.3 % suicide and self-harm behaviours, 6.9 % alcohol and substance use, whereas the majority (68.1 %) focussed on clinical syndrome. CONCLUSIONS Despite the predominance of studies that solely examine the clinical syndrome of young people the literature also provides evidence of distinct associations among objective measures (indexing various aspects of brain circuitry) and other functional domains. We suggest that a shift in focus towards characterising the mechanisms that underlie and/or mediate multiple functional domains will optimise personalised interventions and improve illness trajectories.
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Affiliation(s)
- Frank Iorfino
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 94 Mallet Street, Camperdown, NSW, 2050, Australia
| | - Ian B Hickie
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 94 Mallet Street, Camperdown, NSW, 2050, Australia
| | - Rico S C Lee
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 94 Mallet Street, Camperdown, NSW, 2050, Australia
| | - Jim Lagopoulos
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 94 Mallet Street, Camperdown, NSW, 2050, Australia
| | - Daniel F Hermens
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 94 Mallet Street, Camperdown, NSW, 2050, Australia.
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Shin HY, Kang G, Kang HJ, Kim SW, Shin IS, Yoon JS, Kim JM. Associations between serum lipid levels and suicidal ideation among Korean older people. J Affect Disord 2016; 189:192-8. [PMID: 26451502 DOI: 10.1016/j.jad.2015.09.047] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 08/24/2015] [Accepted: 09/25/2015] [Indexed: 01/08/2023]
Abstract
INTRODUCTION There have been inconsistent reports on the relationships between lipids and suicidality, and studies conducted in older adults are rare. This study examined associations between serum lipid levels and suicidal ideation in an older population. METHODS This study used data obtained from a representative Korean sample of 4265 people age 65 years or older who completed a self-administered questionnaire about suicidal ideation over the last year. The fasting serum concentrations of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were measured and categorized into lower, intermediate (reference), and upper quartiles. A complex sample logistic regression stratified by gender was performed to determine the associations between serum lipid levels and suicidal ideation after controlling for covariates including age, education, marital status, current smoking, alcohol drinking, body mass index, hypertension, diabetes, diagnosed depression, antidepressant use, and lipid-lowering therapies. RESULTS In this study, the prevalence of suicidal ideation in an older Korean population was 22.9% (SE=0.9%). The prevalence was significantly higher in women than in men, 27.7% (1.2%) vs. 15.9% (1.1%) respectively. After adjusting for covariates, lower triglyceride levels were significantly associated with a decreased risk of suicidal ideation (OR=0.65; 95% CI=0.43-0.99) among men but no significant associations were observed among women. Additionally, there were no significant associations between any other measure of cholesterol levels and suicidal ideation in either men or women. LIMITATIONS Cross-sectional design cannot infer temporality or the effects of changes in variables. CONCLUSIONS These results support the association between lower triglyceride levels and a reduced risk of suicidal ideation among Korean men over 65. Further studies are necessary to investigate gender difference and the biological mechanism.
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Affiliation(s)
- Hee-Young Shin
- Department of Biomedical Science, Chonnam National University Medical School, 42 Jebongro, Dong-gu, Gwangju 501-746, Republic of Korea
| | - Gaeun Kang
- Division of Clinical Pharmacology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jin-Sang Yoon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
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De Berardis D, Serroni N, Campanella D, Rapini G, Olivieri L, Feliziani B, Carano A, Valchera A, Iasevoli F, Tomasetti C, Mazza M, Fornaro M, Perna G, Di Nicola M, Martinotti G, Di Giannantonio M. Alexithymia, responsibility attitudes and suicide ideation among outpatients with obsessive-compulsive disorder: an exploratory study. Compr Psychiatry 2015; 58:82-7. [PMID: 25591904 DOI: 10.1016/j.comppsych.2014.12.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 11/27/2014] [Accepted: 12/23/2014] [Indexed: 11/28/2022] Open
Abstract
AIMS Obsessive-compulsive disorder (OCD) is psychiatric disorder with a significant suicide risk, and the presence of alexithymia may increase this risk. As several studies attribute an important role, in OCD, to responsibility, the aims of this study were to evaluate possible clinical differences between patients positive or not for alexithymia concerning disorder severity, responsibility attitudes and suicide ideation and investigate which variables were associated with increased suicide ideation. METHODS 104 adult outpatients with OCD were recruited. Alexithymia was measured with Toronto Alexithymia Scale (TAS-20), attitude about responsibility was tested with Responsibility Attitude Scale (RAS), suicide ideation was assessed with Scale of Suicide Ideation (SSI) and depressive symptoms were evaluated with Montgomery Åsberg Depression Rating Scale (MADRS). Score of item #11 on the Y-BOCS was considered as a measure of insight. RESULTS Patients positive for alexithymia showed higher responsibility attitudes and more severe suicide ideation. In a blockwise regression model, the presence of lower insight, higher RAS scores and difficulty in identifying feelings dimension of TAS-20 were associated with higher SSI scores. CONCLUSIONS OCD patients with alexithymia may show higher disorder severity, lower insight and inflated responsibility, all related to suicide ideation, independently from depressive symptoms. Implications were discussed and study limitations considered and reported.
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Affiliation(s)
- Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy; Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio" of Chieti, Chieti Scalo, Italy.
| | - Nicola Serroni
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy
| | - Daniela Campanella
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy
| | - Gabriella Rapini
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy
| | - Luigi Olivieri
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy
| | - Barbara Feliziani
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy
| | - Alessandro Carano
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio" of Chieti, Chieti Scalo, Italy
| | - Alessandro Valchera
- Hermanas Hospitalarias, FoRiPsi, Villa S. Giuseppe Hospital, Ascoli Piceno, Italy
| | - Felice Iasevoli
- Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy
| | - Carmine Tomasetti
- Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy
| | - Monica Mazza
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - Michele Fornaro
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | - Giampaolo Perna
- Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, The Netherlands; Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, Como, Italy; Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, FL, USA
| | - Marco Di Nicola
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, Rome, Italy
| | - Giovanni Martinotti
- Hermanas Hospitalarias, FoRiPsi, Villa S. Giuseppe Hospital, Ascoli Piceno, Italy
| | - Massimo Di Giannantonio
- Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio" of Chieti, Chieti Scalo, Italy
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Vilibić M, Jukić V, Pandžić-Sakoman M, Bilić P, Milošević M. Association between total serum cholesterol and depression, aggression, and suicidal ideations in war veterans with posttraumatic stress disorder: a cross-sectional study. Croat Med J 2015; 55:520-9. [PMID: 25358885 PMCID: PMC4228297 DOI: 10.3325/cmj.2014.55.520] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Aim To investigate the relationship between total serum cholesterol and levels of depression, aggression, and suicidal ideations in war veterans with posttraumatic stress disorder (PTSD) without psychiatric comorbidity. Methods A total of 203 male PTSD outpatients were assessed for the presence of depression, aggression, and suicidality using the 17-item Hamilton Depression Rating Scale (HAM-D17), Corrigan Agitated Behavior Scale (CABS), and Scale for Suicide Ideation (SSI), respectively, followed by plasma lipid parameters determination (total cholesterol, high density lipoprotein [HDL]-cholesterol, low density lipoprotein [LDL]-cholesterol, and triglycerides). PTSD severity was assessed using the Clinician-Administered PTSD Scale for DSM-IV, Current and Lifetime Diagnostic Version (CAPS-DX) and the Clinical Global Impressions of Severity Scale (CGI-S), before which Mini-International Neuropsychiatric Interview (MINI) was administered to exclude psychiatric comorbidity and premorbidity. Results After adjustments for PTSD severity, age, body mass index, marital status, educational level, employment status, use of particular antidepressants, and other lipid parameters (LDL- and HDL- cholesterol and triglycerides), higher total cholesterol was significantly associated with lower odds for having higher suicidal ideation (SSI≥20) (odds ratio [OR] 0.09; 95% confidence interval [CI] 0.03-0.23], clinically significant aggression (CABS≥22) (OR 0.28; 95% CI 0.14-0.59), and at least moderate depressive symptoms (HAM-D17≥17) (OR 0.20; 95% CI 0.08-0.48). Association of total cholesterol and HAM-D17 scores was significantly moderated by the severity of PTSD symptoms (P < 0.001). Conclusion Our results indicate that higher total serum cholesterol is associated with lower scores on HAM-D17, CABS, and SSI in patients with chronic PTSD.
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Affiliation(s)
- Maja Vilibić
- Maja Vilibic, Vrapce University Psychiatric Hospital, Department of Biological Psychiatry and Psychogeriatrics, Bolnicka 32, 10 090 Zagreb, Croatia,
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Alkan Härtwig E, Crayen C, Heuser I, Eid M. It's in the mix: psychological distress differs between combinations of alexithymic facets. Front Psychol 2014; 5:1259. [PMID: 25429275 PMCID: PMC4228974 DOI: 10.3389/fpsyg.2014.01259] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 10/17/2014] [Indexed: 11/25/2022] Open
Abstract
Alexithymia is a personality trait characterized by difficulties in identifying, describing, and communicating one's emotions. The aim of the present study is to examine the usefulness of a typological approach considering the interaction between distinct alexithymic features within a population of high-alexithymic German adults (N = 217). Latent profile analysis (LPA) was employed to test for possible underlying profiles. A 3-profile solution showed the best fit: The profiles can be described as (1) "low": lower load on all facets of alexithymia, (2) "mixed": specific problems on identifying emotions, and (3) "high": higher load on all facets of alexithymia. Moreover, this study tested how these profiles differed in psychological distress. "Mixed" profile, with specific problems on identifying emotions showed the highest levels of psychological distress. The present study suggests the importance of a specific combination of alexithymic features, rather than total alexithymia scores, as a risk factor for psychological distress.
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Affiliation(s)
- Elif Alkan Härtwig
- Cluster of Excellence “Languages of Emotion,” Freie Universität BerlinBerlin, Germany
- Department of Psychiatry, Charitè University MedicineBerlin, Germany
| | - Claudia Crayen
- Department of Education and Psychology, Freie Universität BerlinBerlin, Germany
| | - Isabella Heuser
- Cluster of Excellence “Languages of Emotion,” Freie Universität BerlinBerlin, Germany
- Department of Psychiatry, Charitè University MedicineBerlin, Germany
| | - Michael Eid
- Cluster of Excellence “Languages of Emotion,” Freie Universität BerlinBerlin, Germany
- Department of Education and Psychology, Freie Universität BerlinBerlin, Germany
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De Berardis D, Serroni N, Marini S, Rapini G, Carano A, Valchera A, Iasevoli F, Mazza M, Signorelli M, Aguglia E, Perna G, Martinotti G, Varasano PA, Pressanti GL, Di Giannantonio M. Alexithymia, suicidal ideation, and serum lipid levels among drug-naïve outpatients with obsessive-compulsive disorder. ACTA ACUST UNITED AC 2014; 36:125-30. [PMID: 24554275 DOI: 10.1590/1516-4446-2013-1189] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 08/17/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE As obsessive-compulsive disorder (OCD) is a relatively common psychiatric disorder with a significant suicide risk, the individuation of potential biomarkers of suicidality, such as cholesterol levels, may enable recognition of at-risk subjects. Therefore, the aims of this study were to: 1) evaluate potential differences in clinical and laboratory parameters between patients with and without alexithymia and compare them with healthy controls; and 2) investigate which clinical and laboratory variables were associated with suicidal ideation. METHODS 79 drug-naïve adult outpatients with a DSM-IV diagnosis of OCD were recruited. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20), suicidal ideation was assessed with the Scale for Suicide Ideation, and depressive symptoms were evaluated with the Montgomery-Åsberg Depression Rating Scale (MADRS). Serum lipid levels of 40 healthy controls were also evaluated. RESULTS Alexithymic patients had altered serum lipid levels in comparison with non-alexithymics and healthy controls. Using a linear regression model, the presence of symmetry/ordering obsessions and compulsions, lower HDL-C levels, and difficulty in identifying feelings dimension of the TAS-20 were associated with higher suicidal ideation. CONCLUSIONS Alexithymic individuals with OCD may exhibit dysregulation of the cholesterol balance, which in turn may be linked to suicidal ideation. Further prospective studies are required to elucidate this potential association.
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Affiliation(s)
- Domenico De Berardis
- Psychiatric Service of Diagnosis and Treatment, Department of Mental Health, G. Mazzini Hospital, Teramo, Italy
| | - Nicola Serroni
- Psychiatric Service of Diagnosis and Treatment, Department of Mental Health, G. Mazzini Hospital, Teramo, Italy
| | - Stefano Marini
- Psychiatric Service of Diagnosis and Treatment, Department of Mental Health, G. Mazzini Hospital, Teramo, Italy
| | - Gabriella Rapini
- Psychiatric Service of Diagnosis and Treatment, Department of Mental Health, G. Mazzini Hospital, Teramo, Italy
| | - Alessandro Carano
- Department of Neurosciences and Imaging, Chair of Psychiatry, Universitè degli Studi G. d'Annunzio Chieti e Pescara, Chieti Scalo, Italy
| | | | - Felice Iasevoli
- Section of Psychiatry, Department of Neuroscience, School of Medicine, Universitè degli Studi di Napoli Federico II, Naples, Italy
| | - Monica Mazza
- Department of Science of Health, Universitè degli Studi dell'Aquila, L'Aquila, Italy
| | - Maria Signorelli
- Department of Clinical and Molecular Biomedicine, Universitè degli Studi di Catania, Catania, Italy
| | - Eugenio Aguglia
- Department of Clinical and Molecular Biomedicine, Universitè degli Studi di Catania, Catania, Italy
| | - Giampaolo Perna
- Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, The Netherlands
| | | | - Paola A Varasano
- Department of Immunohematology and Transfusional Medicine, G. Mazzini Hospital, Teramo, Italy
| | | | - Massimo Di Giannantonio
- Department of Neurosciences and Imaging, Chair of Psychiatry, Universitè degli Studi G. d'Annunzio Chieti e Pescara, Chieti Scalo, Italy
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