The effects of sustained COVID-19 emergency and restrictions on the mental health of subjects with serious mental illness: A prospective study

Few longitudinal studies have so far investigated the impact of sustained COVID-19 among people with pre-existing psychiatric disorders. We conducted a prospective study involving people with serious mental illness (n = 114) and healthy controls (n = 41) to assess changes in the Perceived Stress Scale, Generalized Anxiety Disorder Scale, Patient Health Questionnaire, and Specific Psychotic Experiences Questionnaire scores 18 months after the COVID-19 pandemic outset. Subjects underwent interviews with a mental health professional in April 2020 and at the end of the local third wave (October 2021). A significant increase in perceived stress was found in healthy controls, especially females. Psychiatric patients showed a significant worsening of anxiety symptoms compared to baseline records (t = -2.3, p = 0.036). Patients who rejected vaccination had significantly higher paranoia scores compared to those willing to get vaccinated (U = 649.5, z = -2.02, p = 0.04). These findings indicate that COVID-19's sustained emergency may cause enduring consequences on mental health, soliciting further investigations.

The Cerebellar Dopaminergic System

In the central nervous system (CNS), dopamine (DA) is involved in motor and cognitive functions. Although the cerebellum is not been considered an elective dopaminergic region, studies attributed to it a critical role in dopamine deficit-related neurological and psychiatric disorders [e.g., Parkinson's disease (PD) and schizophrenia (SCZ)]. Data on the cerebellar dopaminergic neuronal system are still lacking. Nevertheless, biochemical studies detected in the mammalians cerebellum high dopamine levels, while chemical neuroanatomy studies revealed the presence of midbrain dopaminergic afferents to the cerebellum as well as wide distribution of the dopaminergic receptor subtypes (DRD1-DRD5). The present review summarizes the data on the cerebellar dopaminergic system including its involvement in associative and projective circuits. Furthermore, this study also briefly discusses the role of the cerebellar dopaminergic system in some neurologic and psychiatric disorders and suggests its potential involvement as a target in pharmacologic and non-pharmacologic treatments.

Cognitive styles and specific learning disorders in children and adolescents

Introduction

Learning Difficulties relates to significant and unusual difficulties in the acquisition and use of one or more of the following areas: listening, speaking, reading, writing and mathematical skills. In the last twenty years, following the research conducted by cognitive psychology, from neuropsychology, from pedagogy and from the confrontation between educators and psychologists, the attention was focused on the cognitive modalities of the subjects engaged in learning tasks.

Objectives

Thanks to the study of cognitive styles and Learning Styles thelearning subject was placed at the center of the educational project, stimulating from on the one hand there is also reflection on teaching styles and the most appropriate ones methodologies, teaching methods and methods of approaching the individual disciplines and, on the other hand, prompting clinicians to research around the intellectual peculiarities of each subject and a outline a descriptive criterion of his / her cognitive functioning profile.

Methods

The intellectual scale (WISC IV) of 32 children (aged between 7 and 15 years) with specific learning disabilities was analyzed, in order to highlight the underlying intellectual functioning and any cognitive styles.

Results

According to the international scientific literature, the results show a greater fall in the area of working memory, followed by the cognitive domain concerning processing speed.

Conclusions

In detail, by analyzing the individual subtests, greater difficulties are noted, at all ages, in the processes of abstraction and conceptualization, in short-term auditory memory, in the speed of processing and visual-praxic motor coordination.

Evaluation of plasma levels of BDNF in patients with disorder depressive

Introduction

According to the World Health Organization (WHO, 2017) depressive disorder continues to be the most widespread and growing mental illness in the world, also assumes that in 2020 depression will have a prevalence equal to one in six individuals. Studies of neuroanatomy have highlighted structural alterations in the hippocampus, striatal nuclei and prefrontal cortex in patients with mood disorders. This alteration in depressed patients is closely related to the secretion of neurotrophic factors, in particular there is a reduction in BDNF (Brain Derived Neurotrophic Factor).

Objectives

The objective of this study is to demonstrate which treatments are effective in reducing depressive symptoms that allow the increase of BDNF and consequently the structural homostaticity of the brain.

Methods

We have selected data from the literature of the last decade, collected on major search engines such as: Google Scholar, Research Gate, PubMed, Ebsco. Articles collected by selecting the following Keyword: depression, BDNF (Brain Derived Neurotrophic Factor), neuroimaging cognitive behavior therapy.

Results

The results show that in patients treated with a single drug treatment or vagus nerve stimulation, repetitive transcranial magnetic stimulation (Lang et al., 2008) or electroconvulsive therapy had improvements in BDNF levels, although compared to drug treatment there are problems of no responders, no compliance and lack of effectiveness in reducing vulnerability to relapse. In addition, the study has shown that patients treated with cognitive behavioral therapy have reported greater changes in the frontal and temporal cortex reducing both depressive symptoms and the risk of relapse.

Conclusions

Underlines the importance of an integrated approach

Relationship between cognitive functions and empathy in patients with neurocognitive deficit

Introduction

Empathy is a social emotive skill that let to experience the same feelings of another person without being in the same situation. It changes during the growth becoming more over sophisticated with the involving of cognitive functions such as perspective taking (Hoffmann, 2000). Several researches observed a correlation between empathy and psychopathologies that involve cognitive functions such as attention and executive functions (Abdel-Hamid et al., 2019; Blair, 2018; Pijper et al., 2018) or decision-making (Francis et al., 2019).

Objectives

To investigate the impact of cognitive impairment on different empathy dimensions.

Methods

80 subjects with severe neurocognitive deficit were examined. WAIS-R, neuropsychological battery and IRI test were performed.

Results

The impairment of perspective-taking dimension was significantly noticeable (=or<17/30). In addition, impairments of self-regulation process and inner-state monitoring mechanisms were also observed (=or<18/40).

Conclusions

According to previous researches, this study confirms that empathy can be reduced when cognitive functions are compromised by psychopathologies or other medical conditions. Personal distress and perspective taking are empathy dimensions more affected in these cases.

Rorschach test with exner cs in assessing damage and trauma in suspected cases of abuse. Traumatic intrusions in thinking: Ptsd and adaptation disorder

Introduction

This study wants to identify elements that could be informative in diagnosis and prognosis process of all those subjects who, following traumatic experiences, may develop PTSD, or even show signs of a more general and pervasive adaptation disorder, allowing a more precise damage assessment.

Objectives

In this perspective, the analysis of the Rorschach test according to the comprehensive system of Exner, reading Structural Summary and the analysis of the constellations, allows to make interesting inferences, in all the descriptive areas associated with the key variables as regards not only the cognitive area (Processing >> Mediation >> Ideation) but also the affective and relational area (Interpersonal Perception >> Self-Perception >> Controll >> Affect), so as to have a picture of the functioning of these subjects and, to be able to plan a more functional therapeutic plan.

Methods

It is based on a sample of 29 subjects, 20 women and 9 men with an average age of about 35 years (54-14 years), who came to the attention of the clinic, at the request of the reference psychiatrist for diagnostic personality assessment. All subjects complained of various kinds of discomfort, affective-relational difficulties and anxious-depressive symptoms.

Results

The results that emerged, in line with the initial hypotheses, converge in describing a personality style, not very resilient that could suffer in overcoming difficulties and in the search for new equilibrium.

Conclusions

It’s emphasized how the weight of a traumatic event like abuse can evolve into an adaptation disorder,strongly affecting the functionality of the subjects and their social integration.

Executive functions and theory of mind across age: The role of cognitive flexibility in perspective-taking skill

Introduction

Research has demonstrated that greater cognitive flexibility and perspective taking skills are associated with positive outcomes throughout the lifespan. Cognitive flexibility is a core component of executive function allowing us to control goal-directed behaviour and to face new and unexpected conditions in the environment. Perspective-taking or Theory of Mind (ToM) refers to the capacity to make inferences about and represent others’ point of view, mental states and intentions.

Objectives

The aim of this study was to assess age-related effects on executive functions and the role of cognitive flexibility in perspective-taking skills.

Methods

Two age groups (34-44 years and 45-55 years) were compared on a task-switching paradigm the MATeM neuropsychological software (Maria Grazia Inzaghi, 2019) and all participants completed the Edinburgh Handedness Inventory (Oldfield, 1971), the IRI Interpersonal Reactivity Index (Davis, 1980), the RMET Reading the Mind in the Eyes (Baron-Cohen, 2001) and the BIDR-6 Balanced Inventory of Desirable Responding (Paulhus, 1991).

Results

suggested that increased age was associated with decreased set-shifting, perspective-taking, mindreading abilities and increased tendency to give overly positive answers (socially desirable responding). Furthermore, participants with reduced cognitive flexibility (higher switch cost) were less able to attribute mental states to others and to appreciate another person’s point of view.

Conclusions

It can be argued that readiness to appropriately adjust one’s behaviour according to a changing environment is related to flexibly shift between conflicting psychological perspectives. Future research include training studies which would further our understanding of these relationships and allow more effective cognitive and social interventions.

Cognitive correlates of borderline intellectual functioning in borderline personality disorder

Borderline intellectual functioning (BIF) is highly prevalent in patients with borderline personality disorder (BPD), but their relationship remains poorly understood. This retrospective study aimed to investigate the cognitive profile of BIF among people diagnosed with BPD. Clinical, demographic, and neuropsychological data of fifty-five outpatients with BPD were analyzed. The sample split into two groups: BPD with BIF (BIF+: n = 25; intelligence quotient - IQ - range: 71-84) and BPD without BIF (BIF-: n = 30; IQ range: 86-124). Between-group comparisons employed either parametric and non-parametric descriptive statistics, as necessary. Neuropsychological measures (Wechsler Adult Intelligence Scale-Revised - WAIS-R IQ, factor index, subtest scores) and cognitive performance deficits in the two groups were likewise compared aside, followed by Spearman's correlation test conducted on relevant metrics. The cognitive, but not the clinical and demographic profiles differed significantly between the two groups. BIF+ was associated with a specific pattern of verbal, attentive, and planning dysfunctions. The verbal comprehension index had the highest discriminative value for the presence of BIF in patients with BPD, and it was tightly associated with adaptive and social functioning. The neuropsychological assessment of BPD may be relevant to plan targeted interventions based on measures of cognitive functioning which could also serve to evaluate treatment efficacy and outcomes. Clinical implications and future directions are discussed.

Preliminary study on the analysis of cognitive profile in subjects with ASD: WISC-IV

Autism spectrum disorder (ASD) is a neurodevelopmental disorder, observed in several contexts and characterized by persistent deficits in the communication, social interaction and behavioral areas (DSM V, 2013). ASD includes a wide range, “a spectrum,” of symptoms, skills, and levels of disability. In the last years, we have noticed a substantial change in the diagnostic criteria due to the fact that, although the huge heterogeneity shown by the disorder, in the majority of autistic subjects, both those with high and low IQ, we can identify a common profile of functioning, as regards communicative, social, motor and behavioral skills (Sharma et al., 2012). As reported by Frith (1989; 2003), this kind of functioning is based on a different cognitive style, characterized by a strong prevalence of “bottom-up” elaboration processes, coexistent with the inability of the subject to integrate perceptual data into a global and coherent representation (weak central coherence theory). In this study, we have administered WISC IV to two adolescents (16 years old), already diagnosed for ASD with a low functioning. As expected, results have evidenced the presence of a rigid cognitive style with impaired conceptualization abilities and high attention to details. Specifically main falls have occurred in the area of visual-perceptual reasoning, underlining a lack of visual-spatial processing skills, as well as a lack of fluid reasoning skills. Particularly deficit resulted in the categorization capabilities and abstraction.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Rank Determination of Mental Functions by 1D Wavelets and Partial Correlation

The main aim of this paper is to classify mental functions by the Wechsler Adult Intelligence Scale-Revised tests with a mixed method based on wavelets and partial correlation. The Wechsler Adult Intelligence Scale-Revised is a widely used test designed and applied for the classification of the adults cognitive skills in a comprehensive manner. In this paper, many different intellectual profiles have been taken into consideration to measure the relationship between the mental functioning and psychological disorder. We propose a method based on wavelets and correlation analysis for classifying mental functioning, by the analysis of some selected parameters measured by the Wechsler Adult Intelligence Scale-Revised tests. In particular, 1-D Continuous Wavelet Analysis, 1-D Wavelet Coefficient Method and Partial Correlation Method have been analyzed on some Wechsler Adult Intelligence Scale-Revised parameters such as School Education, Gender, Age, Performance Information Verbal and Full Scale Intelligence Quotient. In particular, we will show that gender variable has a negative but a significant role on age and Performance Information Verbal factors. The age parameters also has a significant relation in its role on Performance Information Verbal and Full Scale Intelligence Quotient change.

The weight of borderline intellectual functioning on the capacity of integration and social adaptation of patients with borderline personality disorder

From the analysis of current scientific literature are still few studies on the relationship between personality disorders and borderline intellectual functioning, since the latter, without its own specificity, has always been considered as a kind of undefined zone between intellectual functioning medium and intellectual disabilities. Several studies have shown the presence of comorbidity of the personality disorders with BIF, emphasizing a higher frequency of Borderline Personality Disorder. BIF is considered a significant risk factor for the development of a broad spectrum of neuropsychiatric disorders, in particular in our observations ongoing since 2003, it assumes an important weight on the global functioning of patients with personality disorder as we have stated in the intervention SOPSI 2012. In detail, this study focuses on the relationship between BPD and BIF, noting the weight the latter on the social adaptability, job placement and creation of bonds of individuals with Borderline Personality Disorder. Patients included in this study were 52 (40 F and 12 M), of which 27 belonging to the first group had a borderline intellectual functioning in comorbidity with BPD and 25 individuals belonging to the second group with BPD without BIF. The results show that 33% of individuals included in the first group did not find a job working compared to 16% of the second group, showing further falls in attention and concentration, therefore, in the ability to anticipate and generalization, impacting strongly on the degree of adaptation to social life, while there are not significant differences in the ability to create emotional ties between the two groups.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

[Personality disorder and penal imputability: a case of uxoricide in a expert's report]

The personality disorders are generally described as a persistent pattern of inner experience that deviates strongly from the expectations of the culture of an individual in terms of cognition, affectivity, interpersonal functioning and impulse control. They are a complex area of defining and understanding for the clinical and forensic psychiatrist. A recent ruling by the Court of Cassation stated that personality disorder may be a result of reduction or cancellation of the ability to understand and will, if so serious as to affect the same. In the present work is explored, using a psycho-diagnostic protocol, the psychological profile of a person with a narcissistic personality disorder, charged for uxoricidio.