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Furneri G, Varrasi S, Guerrera CS, Platania GA, Torre V, Boccaccio FM, Testa MF, Martelli F, Privitera A, Razza G, Santagati M, Di Nuovo S, Pirrone C, Castellano S, Caraci F, Monastero R. Combining Mini-Mental State Examination and Montreal Cognitive Assessment for assessing the clinical efficacy of cholinesterase inhibitors in mild Alzheimer's disease: a pilot study. Aging Clin Exp Res 2024; 36:95. [PMID: 38630416 PMCID: PMC11023996 DOI: 10.1007/s40520-024-02744-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/20/2024] [Indexed: 04/19/2024]
Abstract
Current drugs for Alzheimer's Disease (AD), such as cholinesterase inhibitors (ChEIs), exert only symptomatic activity. Different psychometric tools are needed to assess cognitive and non-cognitive dimensions during pharmacological treatment. In this pilot study, we monitored 33 mild-AD patients treated with ChEIs. Specifically, we evaluated the effects of 6 months (Group 1 = 17 patients) and 9 months (Group 2 = 16 patients) of ChEIs administration on cognition with the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Frontal Assessment Battery (FAB), while depressive symptoms were measured with the Hamilton Depression Rating Scale (HDRS). After 6 months (Group 1), a significant decrease in MoCA performance was detected. After 9 months (Group 2), a significant decrease in MMSE, MoCA, and FAB performance was observed. ChEIs did not modify depressive symptoms. Overall, our data suggest MoCA is a potentially useful tool for evaluating the effectiveness of ChEIs.
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Affiliation(s)
- Giovanna Furneri
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Simone Varrasi
- Department of Educational Sciences, University of Catania, Catania, Italy
| | | | | | - Vittoria Torre
- Department of Educational Sciences, University of Catania, Catania, Italy
| | | | | | - Federica Martelli
- Department of Educational Sciences, University of Catania, Catania, Italy
| | | | - Grazia Razza
- Department of Mental Health, ASP3 Catania, Alzheimer Psychogeriatric Center, Catania, Italy
| | - Mario Santagati
- Department of Mental Health, ASP3 Catania, Alzheimer Psychogeriatric Center, Catania, Italy
| | - Santo Di Nuovo
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Concetta Pirrone
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Sabrina Castellano
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Filippo Caraci
- Department of Drug and Health Sciences, University of Catania, Catania, Italy.
- Oasi Research Institute - IRCCS, Troina, Italy.
| | - Roberto Monastero
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy.
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2
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Guerrera CS, Boccaccio FM, Varrasi S, Platania GA, Coco M, Pirrone C, Castellano S, Caraci F, Ferri R, Lanza G. A narrative review on insomnia and hypersomnolence within Major Depressive Disorder and bipolar disorder: A proposal for a novel psychometric protocol. Neurosci Biobehav Rev 2024; 158:105575. [PMID: 38331126 DOI: 10.1016/j.neubiorev.2024.105575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/27/2024] [Accepted: 02/03/2024] [Indexed: 02/10/2024]
Abstract
Sleep disorders have become increasingly prevalent, with many adults worldwide reporting sleep dissatisfaction. Major Depressive Disorder (MDD) and Bipolar Disorder (BD) are common conditions associated with disrupted sleep patterns such as insomnia and hypersomnolence. These sleep disorders significantly affect the progression, severity, treatment, and outcome of unipolar and bipolar depression. While there is evidence of a connection between sleep disorders and depression, it remains unclear if sleep features differ between MDD and BD. In light of this, this narrative review aims to: (1) summarize findings on common sleep disorders like insomnia and hypersomnolence, strongly linked to MDD and BD; (2) propose a novel psychometric approach to assess sleep in individuals with depressive disorders. Despite insomnia seems to be more influent in unipolar depression, while hypersomnolence in bipolar one, there is no common agreement. So, it is essential adopting a comprehensive psychometric protocol for try to fill this gap. Understanding the relationship between sleep and MDD and BD disorders are crucial for effective management and better quality of life for those affected.
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Affiliation(s)
- Claudia Savia Guerrera
- Department of Educational Sciences, University of Catania, Via Biblioteca, 4, 95124 Catania, Italy; Department of Biomedical and Biotechnological Sciences, University of Catania, Torre Biologica, Via Santa Sofia, 97, 95123 Catania, Italy.
| | | | - Simone Varrasi
- Department of Educational Sciences, University of Catania, Via Biblioteca, 4, 95124 Catania, Italy
| | | | - Marinella Coco
- Department of Educational Sciences, University of Catania, Via Biblioteca, 4, 95124 Catania, Italy
| | - Concetta Pirrone
- Department of Educational Sciences, University of Catania, Via Biblioteca, 4, 95124 Catania, Italy
| | - Sabrina Castellano
- Department of Educational Sciences, University of Catania, Via Biblioteca, 4, 95124 Catania, Italy
| | - Filippo Caraci
- Department of Drug and Health Sciences, University of Catania, Cittadella Universitaria, Via Santa Sofia, 95123 Catania, Italy; Unit of Neuropharmacology and Translation Neurosciences, Oasi Research Institute - IRCCS, Via Conte Ruggero 73, 94018 Troina, En, Italy
| | - Raffaele Ferri
- Sleep Research Centre, Department of Neurology IC, Oasi Research Institute - IRCCS, Via Conte Ruggero 73, 94018 Troina, En, Italy
| | - Giuseppe Lanza
- Unit of Neuropharmacology and Translation Neurosciences, Oasi Research Institute - IRCCS, Via Conte Ruggero 73, 94018 Troina, En, Italy; Department of Surgery and Medical-Surgical Specialties, University of Catania, A.O.U. "Policlinico - San Marco", Via Santa Sofia, 78, 95123 Catania, Italy
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3
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Guerrera CS, Platania GA, Boccaccio FM, Sarti P, Varrasi S, Colliva C, Grasso M, De Vivo S, Cavallaro D, Tascedda F, Pirrone C, Drago F, Di Nuovo S, Blom JMC, Caraci F, Castellano S. The dynamic interaction between symptoms and pharmacological treatment in patients with major depressive disorder: the role of network intervention analysis. BMC Psychiatry 2023; 23:885. [PMID: 38017462 PMCID: PMC10683186 DOI: 10.1186/s12888-023-05300-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/23/2023] [Indexed: 11/30/2023] Open
Abstract
INTRODUCTION The Major Depressive Disorder (MDD) is a mental health disorder that affects millions of people worldwide. It is characterized by persistent feelings of sadness, hopelessness, and a loss of interest in activities that were once enjoyable. MDD is a major public health concern and is the leading cause of disability, morbidity, institutionalization, and excess mortality, conferring high suicide risk. Pharmacological treatment with Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin Noradrenaline Reuptake Inhibitors (SNRIs) is often the first choice for their efficacy and tolerability profile. However, a significant percentage of depressive individuals do not achieve remission even after an adequate trial of pharmacotherapy, a condition known as treatment-resistant depression (TRD). METHODS To better understand the complexity of clinical phenotypes in MDD we propose Network Intervention Analysis (NIA) that can help health psychology in the detection of risky behaviors, in the primary and/or secondary prevention, as well as to monitor the treatment and verify its effectiveness. The paper aims to identify the interaction and changes in network nodes and connections of 14 continuous variables with nodes identified as "Treatment" in a cohort of MDD patients recruited for their recent history of partial response to antidepressant drugs. The study analyzed the network of MDD patients at baseline and after 12 weeks of drug treatment. RESULTS At baseline, the network showed separate dimensions for cognitive and psychosocial-affective symptoms, with cognitive symptoms strongly affecting psychosocial functioning. The MoCA tool was identified as a potential psychometric tool for evaluating cognitive deficits and monitoring treatment response. After drug treatment, the network showed less interconnection between nodes, indicating greater stability, with antidepressants taking a central role in driving the network. Affective symptoms improved at follow-up, with the highest predictability for HDRS and BDI-II nodes being connected to the Antidepressants node. CONCLUSION NIA allows us to understand not only what symptoms enhance after pharmacological treatment, but especially the role it plays within the network and with which nodes it has stronger connections.
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Affiliation(s)
- Claudia Savia Guerrera
- Department of Educational Sciences, University of Catania, Catania, Italy
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | | | | | - Pierfrancesco Sarti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Simone Varrasi
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Chiara Colliva
- Azienda Unità Sanitaria Locale Di Modena, Distretto Di Carpi, Carpi, Italy
| | - Margherita Grasso
- Unit of Neuropharmacology and Translation Neurosciences, Oasi Research Institute - IRCCS, Troina, Italy
| | | | | | - Fabio Tascedda
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Concetta Pirrone
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Santo Di Nuovo
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Johanna M C Blom
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
- Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy.
| | - Filippo Caraci
- Unit of Neuropharmacology and Translation Neurosciences, Oasi Research Institute - IRCCS, Troina, Italy
- Department of Drug and Health Sciences, University of Catania, Catania, Italy
| | - Sabrina Castellano
- Department of Educational Sciences, University of Catania, Catania, Italy
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4
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Sarti P, Colliva C, Varrasi S, Guerrera CS, Platania GA, Boccaccio FM, Castellano S, Pirrone C, Pani L, Tascedda F, di Nuovo S, Caraci F, Blom JMC. A network study to differentiate suicide attempt risk profiles in male and female patients with major depressive disorder. Clin Psychol Psychother 2023. [PMID: 37922512 DOI: 10.1002/cpp.2924] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 11/05/2023]
Abstract
Suicide attempts are a possible consequence of Major Depressive Disorder (MDD), although their prevalence varies across different epidemiological studies. Suicide attempt is a significant predictor of death by suicide, highlighting its importance in understanding and preventing tragic outcomes. Researchers are increasingly recognizing the need to study the differences between males and females, as several distinctions emerge in terms of the characteristics, types and motivations of suicide attempts. These differences emphasize the importance of considering gender-specific factors in the study of suicide attempts and developing tailored prevention strategies. We conducted a network analysis to represent and investigate which among multiple neurocognitive, psychosocial, demographic and affective variables may prove to be a reliable predictor for identifying the 'suicide attempt risk' (SAR) in a sample of 81 adults who met DSM-5 criteria for MDD. Network analysis resulted in differences between males and females regarding the variables that were going to interact and predict the SAR; in particular, for males, there is a stronger link toward psychosocial aspects, while for females, the neurocognitive domain is more relevant in its mnestic subcomponents. Network analysis allowed us to describe otherwise less obvious differences in the risk profiles of males and females that attempted to take their own lives. Different neurocognitive and psychosocial variables and different interactions between them predict the probability of suicide attempt unique to male and female patients.
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Affiliation(s)
- Pierfrancesco Sarti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Chiara Colliva
- Azienda Unità Sanitaria Locale di Modena, Distretto di Carpi, Modena, Italy
| | - Simone Varrasi
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Claudia Savia Guerrera
- Department of Educational Sciences, University of Catania, Catania, Italy
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | | | | | - Sabrina Castellano
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Concetta Pirrone
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Luca Pani
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Department of Biomedical, Metabolic and Neural Sciences, Pharmacology Unit, University of Modena and Reggio Emilia, Modena, Italy
- Department of Psychiatry and Behavioural Sciences, University of Miami, Miami, Florida, USA
- Department of Specialist Medicines, Digital and Predictive Medicine, Pharmacology and Clinical Metabolic Toxicology-Headache Centre and Drug Abuse, Laboratory of Clinical Pharmacology and Pharmacogenomics, AOU Policlinico Di Modena, Modena, Italy
| | - Fabio Tascedda
- Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Santo di Nuovo
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Filippo Caraci
- Department of Drug and Health Sciences, University of Catania, Catania, Italy
- Oasi Research Institute-IRCCS, Troina, Italy
| | - Johanna M C Blom
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
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5
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Boccaccio FM, Platania GA, Guerrera CS, Varrasi S, Privitera CR, Caponnetto P, Pirrone C, Castellano S. Autism Spectrum Disorder: recommended psychodiagnostic tools for early diagnosis. Health Psychol Res 2023; 11:77357. [PMID: 37670796 PMCID: PMC10477006 DOI: 10.52965/001c.77357] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Affiliation(s)
| | | | - Claudia Savia Guerrera
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, CT, Italy
| | - Simone Varrasi
- Department of Educational Sciences, University of Catania, 95124 Catania, CT, Italy
| | | | - Pasquale Caponnetto
- Department of Educational Sciences, University of Catania, 95124 Catania, CT, Italy
| | - Concetta Pirrone
- Department of Educational Sciences, University of Catania, 95124 Catania, CT, Italy
| | - Sabrina Castellano
- Department of Educational Sciences, University of Catania, 95124 Catania, CT, Italy
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6
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Varrasi S, Guerrera CS, Platania GA, Castellano S, Pirrone C, Caponnetto P, Nicolosi C, Insanguine F, Greco E, Perrone M, Pulvirenti C, Randazzo D, Ferro G, Consoli M, Di Nuovo S. Professional quality of life and psychopathological symptoms among first-line healthcare workers facing COVID-19 pandemic: an exploratory study in an Italian southern hospital. Health Psychol Res 2023; 11:67961. [PMID: 36777810 PMCID: PMC9907327 DOI: 10.52965/001c.67961] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background The COVID-19 pandemic has significantly affected the mental health of healthcare workers, who have taken on the major problems triggered by the emergency. The mental consequences concern high levels of insomnia, anxiety, depression and burnout, which inevitably affect their professional quality of life too. Objective The aim of this study was to analyze the relationship between psychopathological symptoms (tested with the Depression Anxiety Stress Scale, DASS-21) and professional quality of life (measured with the Professional Quality of Life Scale, ProQol) in a hospital of southern Italy. Methods 204 healthcare workers were recruited by non-probabilistic sampling and divided by age, gender, work roles (physicians, nurses and intermediate care technicians) and clinical departments (Cardio-medicine, Infectious Diseases, Emergency Medicine, First Aid, Obstetrics and Pneumology). Results The results showed higher levels of Secondary Traumatic Stress, Depression, Anxiety and Stress in women than in men. Physicians and nurses experienced lower levels of Compassion Satisfaction but higher Burnout than intermediate care technicians; likewise, nurses were more anxious than physicians. The Emergency Medicine had higher scores in Compassion Satisfaction than Infectious Disease, Pneumology, Obstetrics and Cardio-Medicine. Conclusion In light of what has been said so far, it appears essential to intervene on the first mild signs of Burnout and Secondary Traumatic Stress, because they precede the onset of Depression, Stress and Anxiety in healthcare workers.
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Affiliation(s)
- Simone Varrasi
- Department of Educational Sciences, University of Catania
| | | | | | | | | | | | - Costanza Nicolosi
- Psychology Service, Azienda Ospedaliero Universitaria Policlinico “G. Rodolico – San Marco” – P.O. “San Marco”
| | - Francesca Insanguine
- Psychology Service, Azienda Ospedaliero Universitaria Policlinico “G. Rodolico – San Marco” – P.O. “San Marco”
| | - Emanuela Greco
- Psychology Service, Azienda Ospedaliero Universitaria Policlinico “G. Rodolico – San Marco” – P.O. “San Marco”
| | - Mariacatena Perrone
- Psychology Service, Azienda Ospedaliero Universitaria Policlinico “G. Rodolico – San Marco” – P.O. “San Marco”
| | - Carmen Pulvirenti
- Psychology Service, Azienda Ospedaliero Universitaria Policlinico “G. Rodolico – San Marco” – P.O. “San Marco”
| | - Diletta Randazzo
- Psychology Service, Azienda Ospedaliero Universitaria Policlinico “G. Rodolico – San Marco” – P.O. “San Marco”
| | - Gabriele Ferro
- Psychology Service, Azienda Ospedaliero Universitaria Policlinico “G. Rodolico – San Marco” – P.O. “San Marco”
| | - Maurizio Consoli
- Psychology Service, Azienda Ospedaliero Universitaria Policlinico “G. Rodolico – San Marco” – P.O. “San Marco”
| | - Santo Di Nuovo
- Department of Educational Sciences, University of Catania
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