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Martinez M, Fusar-Poli L, Meo V, Patania F, Surace T, Avanzato C, Aguglia E, Signorelli M. The psychological well-being of family caregivers of autistic people during the COVID-19 lockdown in Italy. Eur Psychiatry 2022. [PMCID: PMC9564014 DOI: 10.1192/j.eurpsy.2022.526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction People with autism spectrum disorder (ASD) frequently need support due to the elevated prevalence of psychiatric and medical comorbidities. The Covid-19 outbreak has severely affected the routinary functioning of healthcare services, thus causing severe consequences for autistic people and their caregivers, an already fragile population prone to mental health diseases. Objectives 1. To compare the levels of psychological well-being, insomnia, and family distress perceived by caregivers of autistic people to those perceived by caregivers of people with other types of disability. 2. To evaluate predictors of individual and family distress reported by caregivers of autistic individuals. Methods We collected data through a cross-sectional web-based observational study from April 19 to May 3, 2020. Socio-demographic information were collected, and psychopathological variables were assessed using the General Health Questionnaire-12, the Insomnia Severity Index, the Brief Resilient Coping Scale, and the Family Distress Index. Results No significant differences emerged between the two groups of caregivers in terms of well-being, sleep quality, family distress, and level of resilience. The risk of individual distress during the pandemic was higher in people caring for younger autistic people. Lower levels of resilience predicted higher levels of individual distress among caregivers of autistic people. Conclusions Our study confirmed that caregivers’ mental health is worthy of attention and that people with disabilities may benefit for well-organized healthcare support networks (e.g. in-home services). The non-significant differences found between caregivers of ASD and non-ASD individuals may be related to the severe distress that Covid pandemic caused on the entire population. Disclosure No significant relationships.
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Natale A, Fusar-Poli L, Sturiale S, Concerto C, Aguglia A, Amerio A, Serafini G, Amore M, Aguglia E. Oxytocin as a peripheral biomarker for Autism Spectrum Disorder: a systematic review and meta-analysis. Eur Psychiatry 2022. [PMCID: PMC9566531 DOI: 10.1192/j.eurpsy.2022.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Autism spectrum disorder (ASD) is a group of life-long neurodevelopmental conditions characterized by impairments in social communication and by the presence of restricted interests or repetitive behaviors. Several genetic, biological, and psychosocial mechanisms seem to play a role in the etiopathogenesis of this complex condition. Preclinical models have shown a potential role of oxytocin (OT), a peptide involved in a complex range of behaviors, including those related to social interaction. Therefore, it has been hypothesized that OT levels may be decreased in autistic people.
Objectives
To compare the levels of peripheral OT in autistic people vs neurotypical controls.
Methods
We performed a systematic literature search up to December 2020 according to PRISMA guidelines. Final inclusion was based on the following criteria: (1) Participants: individuals of any age diagnosed with ASD; (2) Controls: neurotypical subjects; (3) Outcome: OT levels, either in saliva, serum, or plasma; (4) Study design: case-control. Meta-analyses are ongoing.
Results
We finally included 21 papers published between 1998 and 2020, of which one recruited adult participants. Fifteen studies measured OT levels in plasma, 4 in saliva, and 2 in serum. Preliminary meta-analyses on 10 studies showed that peripheral OT levels in autistic individuals are reduced compared to neurotypical controls, with sex differences.
Conclusions
Our preliminary findings show that peripheral OT might represent a potential biomarker for ASD. Future well-conducted case-control studies with a detailed phenotypical characterization of samples are needed to understand the role of OT deficits in specific subgroups.
Disclosure
No significant relationships.
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Martinez M, Fichera C, Fusar-Poli L, Rodolico A, Guloksuz S, Aguglia E, Signorelli M. Association between polygenic risk scores for psychiatric disorders and social cognition: a systematic review. Eur Psychiatry 2022. [PMCID: PMC9567603 DOI: 10.1192/j.eurpsy.2022.2262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Social cognition refers to a complex set of mental abilities that support the construction of adequate social competence and adaptation. Impairments in social cognition can be found in several psychiatric disorders, particularly in psychoses. Polygenic Risk Scores (PRSs) represent single metrics of molecular genetic risk and are a predictor of the genetic susceptibility to diseases, although they explain only a small part of the risk. Objectives To explore the association between PRS for psychiatric disorders and social cognition. Methods We conducted a systematic search in PubMed and Scopus according to the PRISMA guidelines up to August 2021. We included papers evaluating PRS and social cognition with psychometric scales. Articles concerning single-nucleotide polymorphisms and biological measures of social cognition (e.g., neuroimaging, peripheral biomarkers) were excluded. Results We initially retrieved 150 articles. After removing duplicates, we screened 133 titles and abstracts and preliminary selected 19 papers. Participants recruited in the papers of interest were either people with schizophrenia, ASD or ADHD, their family members or healthy subjects. Articles evaluated the association between different psychometrical measures of social cognition and PRS for schizophrenia, Autism Spectrum Disorder and ADHD. Conclusions Literature regarding the association between PRS for psychiatric disorders and social cognition is heterogeneous in terms of populations, genetic risk evaluation, and outcome tools. Given the critical role played by social cognition in the onset and progression of mental disorders and its association with real-world functioning, future research should try to disentangle the complex genetic basis of this domain. Disclosure No significant relationships.
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Ciancio A, Fusar-Poli L, Gabbiadini A, Saitta G, Signorelli M, Aguglia E. Examining the association between personality traits and university faculty: a web-survey among Italian students. Eur Psychiatry 2022. [PMCID: PMC9565116 DOI: 10.1192/j.eurpsy.2022.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
The influence of personality on field of study choice is comparable to that of cognitive skills. Additionally, personality traits seem linked with academic motivation, and engagement. Choosing the most suitable career is also related to students’ personal well-being and work success.
Objectives
To explore how personality traits are associated with the choice of university courses among Italian students.
Methods
A web-survey was spread on social networks between March and June 2020 through Google Forms. Eligibility criteria for inclusion were: 1) Being a university student between 18 and 35 years of age; 2) Attending a course in an Italian university; 3) Good comprehension of Italian language. On-line informed consent, socio-demographic, and career data were collected during the survey. Personality traits were assessed using the Big Five Inventory
(BFI). We computed multinomial linear regressions to calculate potential associations between personality traits and university courses.
Results
Lower Conscientiousness, higher Neuroticism, and higher Openness to experience are associated with the attendance of Humanities compared with students of Health faculties. Higher Neuroticism traits are associated with the attendance of a scientific course compared with Health faculties. High Conscientiousness is significantly associated with the attendance of Law-related courses compared with Health courses. Non significant differences were detected in the other domains according to the big five personality model.
Conclusions
Our results suggest interesting associations between personality traits and educational choices. Future research may investigate this relationship in high-school students to implement appropriate strategies for better addressing students’ educational needs and career outcomes.
Disclosure
No significant relationships.
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Fusar-Poli L, Saitta G, Mormino M, Avanzato C, Signorelli M, Aguglia E. Do personality traits influence the stigmatizing attitudes toward people with mental illness? A web-survey among university students. Eur Psychiatry 2021. [PMCID: PMC9471720 DOI: 10.1192/j.eurpsy.2021.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionPeople from the general population often tend to believe that psychiatric patients may be incurable, dangerous, and unpredictable. Stigma represents a critical issue which should be defeated. In spite of the interest of research, little is known about the relationship between personality traits and level of stigma toward people with mental illness.ObjectivesTo evaluate whether certain personality traits can influence the level of stigma towards mental illness in a population of university students.MethodsA web-survey was spread on social networks between March and June 2020 through Google Forms. Eligibility criteria for inclusion were:1) Being 18 years of age or older; 2) Attending a degree course in an Italian University; 3) Provide informed consent. Socio-demographic characteristics of the participants were collected. Stigma was measured using the Attribution Questionnaire (AQ-27), personality traits were evaluated through the Big Five Inventory (BFI) and the Mental Health Knowledge Schedule (MAKS-i) investigated the knowledge about mental illness. Statistical analyses were performed using SPSS 24.0.ResultsWe computed a multiple linear regression to calculate potential predictors of stigma, adjusted on the basis of the knowledge of mental illness. Results showed that age and faculty class were not related to stigma. Agreeableness (A) and Openness to experience (O) were associated with less stigmatizing attitudes. Conversely, Neuroticism (N) and Conscientiousness (C) seemed to predict higher levels of stigma.ConclusionsOur results suggest an interesting relationship between personality traits and stigmatizing attitudes, which deserves to be further studied. They also confirm the importance of implementing appropriate strategies against the stigma of mental illness.DisclosureNo significant relationships.
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Fusar-Poli L, Surace T, Aguglia A, Aguglia E. The relationship between sleep disorders and psychotic-like symptoms in the general population. Eur Psychiatry 2021. [PMCID: PMC9471228 DOI: 10.1192/j.eurpsy.2021.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionAbnormalities of sleep patterns are common in people with psychiatric disorders and often represent a source of distress, worsening the outcome. However, little is knwon about the relationship between psychotic-like symptoms and sleep disorders in the general population.Objectives1. Whether there is a relationship between sleep disorders and psychotic-like experiences in a sample of individuals belonging to the general population. 2. Which sleep disorders are more commonly associated with psychotic-like experiences.MethodsA web survey was spread thorugh social networks. We administered the SLEEP-50 to investigate the presence of sleep disorders and the Community Assessment of Psychic Experience (CAPE) for psychotic-like symptoms. Moreover, socio-demographic characteristics of participants were collected.ResultsThe web-survey was completed by 824 participants. Six people refused to give consent and 95 were excluded because they declared to suffer from psychiatric disorder sor other medical conditions potentially infleuncing on sleep. Therefore, 729 subjects were included in the analysis. Pearson correlation coefficients showed strong correlations between the scale regarding SLEEP-50 “All sleep disorders” scale and CAPE Total and Depressive scales (r = 0.52, p < 0.001). A moderate correlation was found between “All sleep disorders” and CAPE Negative (r = 0.49) and Positive (r = 0.32) scales. Correlations with specific SLEEP-50 subscales were also found.ConclusionsThere seems to be a strong relationship between psychotic-like symptoms and sleep problems in the general population. Our findings might indicate that some sleep abnormalities may represent earlier symptoms of a psychiatric condition and need to be always monitored even in the non-psychiatric population.DisclosureNo significant relationships.
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Fagiolini A, Aguglia E, Ballerini A, Callista G, Carpiniello B, Clerici M, Corrivetti G, De Fazio P, De Filippis S, De Giorgi S, Favaretto G, Ferri E, Gargiulo G, Giustra MG, La Barbera D, Maina G, Mencacci C, Montagnani G, Panariello A, Pigato G, Tortorella A, Vernacotola L, Vita A. Real-world effectiveness of long acting aripiprazole: Treatment persistence and its correlates in the Italian clinical practice. Psychiatry Res 2019; 272:698-706. [PMID: 30832189 DOI: 10.1016/j.psychres.2019.01.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/18/2018] [Accepted: 01/03/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To identify the variables that are associated with persistence to Aripiprazole-Long Acting (A-LAI), in adult patients with schizophrenia. METHODS Observational, retrospective, non-interventional study involving 261 patients with schizophrenia. RESULTS Eighty-six percent of study subjects were persistent for at least 6 months. All subjects with baseline CGI-S of 1 or 2, 95% of subjects with CGI-S of 3, 86% with CGI-S of 4, 82% of subjects with CGI-S of 5, 73% of subjects with CGI of 6 and 90% of subjects with CGI of 7 were persistent. A-LAI treatment continuation rate was higher in patients with: 1) baseline CGI score ≤ 4; 2) schizophrenia dimension (LDPS) mania score ≤ 5; 3) psychotic spectrum schizoid score ≤ 11. CONCLUSIONS A relatively high number of patients (n = 225, 86%) were persistent to A-LAI for at least 6 months. Not surprisingly, very severe patients were more unlikely to be persistent. However, it is noteworthy that a large number of subjects with high CGI score at the time when A-LAI was started (82% of subjects with CGI-S of 5, 73% of subjects with CGI of 6 and 90% of subjects with CGI of 7) were persistent. Larger, controlled, prospective and longer studies are warranted.
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Affiliation(s)
| | | | - A Ballerini
- U Sod di Psichiatria, AOU Careggi Firenze, Italy
| | - G Callista
- UOSD S.P.D.C. P.O. Giulianova Asl Teramo, Italy
| | | | | | | | - P De Fazio
- University Magna Graecia, Catanzaro, Italy
| | - S De Filippis
- Neuropsychiatric clinic villa von Siebenthal-Rome, Italy
| | - S De Giorgi
- Department of Mental Health, ASL Lecce, Italy
| | - G Favaretto
- Department of Mental Health, Ulss2 Marca Trevigiana, Italy
| | | | - G Gargiulo
- Area Vasta2, Ancona-A.S.U.R.Marche, Italy
| | | | | | | | - C Mencacci
- DSMD - Neuroscienze Asst Fatebenefratelli- Sacco, Milano, Italy
| | | | | | - G Pigato
- University of Padova Medical Center, Italy
| | | | | | - A Vita
- University of Brescia, Italy
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8
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Carpita B, Muti D, Muscarella A, Dell’Oste V, Diadema E, Massimetti G, Signorelli M, Fusar Poli L, Gesi C, Aguglia E, Politi P, Carmassi C, Dell’Osso L. Sex Differences in the Relationship between PTSD Spectrum Symptoms and Autistic Traits in a Sample of University Students. Clin Pract Epidemiol Ment Health 2019; 15:110-119. [PMID: 31819759 PMCID: PMC6882188 DOI: 10.2174/1745017901915010110] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 07/27/2019] [Accepted: 07/27/2019] [Indexed: 04/16/2023]
Abstract
BACKGROUND While growing literature is stressing the link between Autistic Traits (AT) and trauma-/stress-related disorders, in both conditions significant differences have been separately reported. OBJECTIVE This study aims to evaluate the relationship between AT and trauma-/stress-related symptoms with respect to sex. METHODS 178 university students were assessed with the Structured Clinical Interview for DSM-5, the Trauma and Loss Spectrum (TALS) and the Adult Autism Subthreshold Spectrum (AdAS). In order to evaluate sex differences in trauma-/stress-related symptoms among subjects with higher or lower AT, the sample was split in two groups with an equal number of subjects on the basis of the median score reported on AdAS Spectrum ("AdAS high scorers" and "AdAS low scorers"). RESULTS Females reported significantly higher TALS total score, Loss events and Grief reaction domain scores than males in the whole sample, while AdAS high scorers reported significantly higher TALS total and domain scores than AdAS low scorers. A significant interaction between high/low AdAS score and sex emerged for TALS domains, with females scoring significantly higher than males only among AdAS low scorers, specifically on Loss events, Grief reaction, Re-experiencing and Personal characteristics/Risk factors domains. Finally, among AdAS high scorers a significantly higher rate of subjects fulfilled symptomatological criteria for PTSD than among AdAS low scorers, without sex differences. CONCLUSION Our results confirm a significant relationship between AT and trauma-/stress-related symptoms, which seems to prevail on sex differences among high-risk subjects.
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Affiliation(s)
- B. Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Address correspondence to this author at Department of Clinical and Experimental Medicine, Section of Psichiatry, University of Pisa, Via Roma, 67, 56100 Pisa, Italy; Tel: +39 3911105675; E-mail: barbara.carpita
| | - D. Muti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - A. Muscarella
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - V. Dell’Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - E. Diadema
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - G. Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M.S. Signorelli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - L. Fusar Poli
- Department of Brain and Behavioral Sciences, University of Pavia, via Bassi 21, Pavia 27100, Italy
| | - C. Gesi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - E. Aguglia
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - P. Politi
- Department of Brain and Behavioral Sciences, University of Pavia, via Bassi 21, Pavia 27100, Italy
| | - C Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - L. Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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9
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Bucci P, Galderisi S, Mucci A, Rossi A, Rocca P, Bertolino A, Aguglia E, Amore M, Andriola I, Bellomo A, Biondi M, Cuomo A, dell'Osso L, Favaro A, Gambi F, Giordano GM, Girardi P, Marchesi C, Monteleone P, Montemagni C, Niolu C, Oldani L, Pacitti F, Pinna F, Roncone R, Vita A, Zeppegno P, Maj M. Premorbid academic and social functioning in patients with schizophrenia and its associations with negative symptoms and cognition. Acta Psychiatr Scand 2018; 138:253-266. [PMID: 29984409 DOI: 10.1111/acps.12938] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The study aimed to explore premorbid academic and social functioning in patients with schizophrenia, and its associations with the severity of negative symptoms and neurocognitive impairment. METHOD Premorbid adjustment (PA) in patients with schizophrenia was compared to early adjustment in unaffected first-degree relatives and healthy controls. Its associations with psychopathology, cognition, and real-life functioning were investigated. The associations of PA with primary negative symptoms and their two factors were explored. RESULTS We found an impairment of academic and social PA in patients (P ≤ 0.000001) and an impairment of academic aspects of early adjustment in relatives (P ≤ 0.01). Patients with poor PA showed greater severity of negative symptoms (limited to avolition after excluding the effect of depression/parkinsonism), working memory, social cognition, and real-life functioning (P ≤ 0.01 to ≤0.000001). Worse academic and social PA were associated with greater severity of psychopathology, cognitive impairment, and real-life functioning impairment (P ≤ 0.000001). Regression analyses showed that worse PA in the academic domain was mainly associated to the impairment of working memory, whereas worse PA in the social domain to avolition (P ≤ 0.000001). CONCLUSION Our findings suggest that poor early adjustment may represent a marker of vulnerability to schizophrenia and highlight the need for preventive/early interventions based on psychosocial and/or cognitive programs.
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Affiliation(s)
- P Bucci
- Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy
| | - S Galderisi
- Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy
| | - A Mucci
- Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy
| | - A Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - P Rocca
- Section of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy
| | - A Bertolino
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - E Aguglia
- Department of Clinical and Molecular Biomedicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - M Amore
- Section of Psychiatry, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy
| | - I Andriola
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - A Bellomo
- Psychiatry Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - M Biondi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - A Cuomo
- Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, Siena, Italy
| | - L dell'Osso
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - A Favaro
- Department of Neurosciences, Psychiatric Clinic, University of Padua, Padua, Italy
| | - F Gambi
- Chair of Psychiatry, Department of Neuroscience and Imaging, G. d'Annunzio University, Chieti, Italy
| | - G M Giordano
- Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy
| | - P Girardi
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - C Marchesi
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy
| | - P Monteleone
- Chair of Psychiatry, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - C Montemagni
- Section of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy
| | - C Niolu
- Chair of Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - L Oldani
- Department of Psychiatry, University of Milan, Milan, Italy
| | - F Pacitti
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - F Pinna
- Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - R Roncone
- Unit of Psychiatry, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - A Vita
- Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy.,Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
| | - P Zeppegno
- Psychiatric Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - M Maj
- Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy
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10
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Mucci A, Galderisi S, Green MF, Nuechterlein K, Rucci P, Gibertoni D, Rossi A, Rocca P, Bertolino A, Bucci P, Hellemann G, Spisto M, Palumbo D, Aguglia E, Amodeo G, Amore M, Bellomo A, Brugnoli R, Carpiniello B, Dell'Osso L, Di Fabio F, di Giannantonio M, Di Lorenzo G, Marchesi C, Monteleone P, Montemagni C, Oldani L, Romano R, Roncone R, Stratta P, Tenconi E, Vita A, Zeppegno P, Maj M. Familial aggregation of MATRICS Consensus Cognitive Battery scores in a large sample of outpatients with schizophrenia and their unaffected relatives. Psychol Med 2018; 48:1359-1366. [PMID: 29017620 DOI: 10.1017/s0033291717002902] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The increased use of the MATRICS Consensus Cognitive Battery (MCCB) to investigate cognitive dysfunctions in schizophrenia fostered interest in its sensitivity in the context of family studies. As various measures of the same cognitive domains may have different power to distinguish between unaffected relatives of patients and controls, the relative sensitivity of MCCB tests for relative-control differences has to be established. We compared MCCB scores of 852 outpatients with schizophrenia (SCZ) with those of 342 unaffected relatives (REL) and a normative Italian sample of 774 healthy subjects (HCS). We examined familial aggregation of cognitive impairment by investigating within-family prediction of MCCB scores based on probands' scores. METHODS Multivariate analysis of variance was used to analyze group differences in adjusted MCCB scores. Weighted least-squares analysis was used to investigate whether probands' MCCB scores predicted REL neurocognitive performance. RESULTS SCZ were significantly impaired on all MCCB domains. REL had intermediate scores between SCZ and HCS, showing a similar pattern of impairment, except for social cognition. Proband's scores significantly predicted REL MCCB scores on all domains except for visual learning. CONCLUSIONS In a large sample of stable patients with schizophrenia, living in the community, and in their unaffected relatives, MCCB demonstrated sensitivity to cognitive deficits in both groups. Our findings of significant within-family prediction of MCCB scores might reflect disease-related genetic or environmental factors.
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Affiliation(s)
- A Mucci
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
| | - S Galderisi
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
| | - M F Green
- Department of Psychiatry and Biobehavioral Sciences,Semel Institute for Neuroscience and Human Behavior,University of California Los Angeles,Los Angeles,CA,USA
| | - K Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences,Semel Institute for Neuroscience and Human Behavior,University of California Los Angeles,Los Angeles,CA,USA
| | - P Rucci
- Department of Biomedical and Neuromotor Sciences,University of Bologna,Bologna,Italy
| | - D Gibertoni
- Department of Biomedical and Neuromotor Sciences,University of Bologna,Bologna,Italy
| | - A Rossi
- Department of Biotechnological and Applied Clinical Sciences,Section of Psychiatry,University of L'Aquila,L'Aquila,Italy
| | - P Rocca
- Department of Neuroscience,Section of Psychiatry,University of Turin,Turin,Italy
| | - A Bertolino
- Department of Neurological and Psychiatric Sciences,University of Bari,Bari,Italy
| | - P Bucci
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
| | - G Hellemann
- Department of Psychiatry and Biobehavioral Sciences,Semel Institute for Neuroscience and Human Behavior,University of California Los Angeles,Los Angeles,CA,USA
| | - M Spisto
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
| | - D Palumbo
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
| | - E Aguglia
- Department of Clinical and Molecular Biomedicine,Psychiatry Unit,University of Catania,Catania,Italy
| | - G Amodeo
- Department of Molecular Medicine and Clinical Department of Mental Health,University of Siena,Siena,Italy
| | - M Amore
- Department of Neurosciences,Rehabilitation,Ophthalmology,Genetics and Maternal and Child Health,Section of Psychiatry,University of Genoa,Genoa,Italy
| | - A Bellomo
- Department of Medical Sciences,Psychiatry Unit,University of Foggia,Foggia,Italy
| | - R Brugnoli
- Department of Neurosciences,Mental Health and Sensory Organs,S. Andrea Hospital,Sapienza University of Rome,Rome,Italy
| | - B Carpiniello
- Department of Public Health,Clinical and Molecular Medicine,Section of Psychiatry,University of Cagliari,Cagliari,Italy
| | - L Dell'Osso
- Department of Clinical and Experimental Medicine,Section of Psychiatry,University of Pisa,Pisa,Italy
| | - F Di Fabio
- Department of Neurology and Psychiatry,Sapienza University of Rome,Rome,Italy
| | - M di Giannantonio
- Department of Neuroscience and Imaging,Chair of Psychiatry,G. d'Annunzio University,Chieti,Italy
| | - G Di Lorenzo
- Department of Systems Medicine,Chair of Psychiatry,Tor Vergata University of Rome,Rome,Italy
| | - C Marchesi
- Department of Neuroscience,Psychiatry Unit,University of Parma,Parma,Italy
| | - P Monteleone
- Department of Medicine and Surgery,Chair of Psychiatry,University of Salerno,Salerno,Italy
| | - C Montemagni
- Department of Neuroscience,Section of Psychiatry,University of Turin,Turin,Italy
| | - L Oldani
- Department of Psychiatry,University of Milan,Milan,Italy
| | - R Romano
- Department of Neurological and Psychiatric Sciences,University of Bari,Bari,Italy
| | - R Roncone
- Department of Life,Health and Environmental Sciences,Unit of Psychiatry,University of L'Aquila,L'Aquila,Italy
| | - P Stratta
- Department of Biotechnological and Applied Clinical Sciences,Section of Psychiatry,University of L'Aquila,L'Aquila,Italy
| | - E Tenconi
- Psychiatric Clinic,Department of Neurosciences,University of Padua,Padua,Italy
| | - A Vita
- Department of Mental Health,Psychiatric Unit,School of Medicine,University of Brescia,Spedali Civili Hospital,Brescia,Italy
| | - P Zeppegno
- Department of Translational Medicine,Psychiatric Unit,University of Eastern Piedmont,Novara,Italy
| | - M Maj
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
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11
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Ferrari S, Signorelli MS, Cerrato F, Pingani L, Massimino M, Valente S, Forlani M, Bonasegla P, Arcidiacono E, De Ronchi D, Rigatelli M, Aguglia E, Atti AR. Never too late to be anxious: validation of the Geriatric Anxiety Inventory, Italian version. Clin Ter 2017; 168:e120-e127. [PMID: 28383623 DOI: 10.7417/ct.2017.1992] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM The aim of this work was to validate the Italian version of GAI (GAI-It) and its short form (GAI-It SF) in an over 65-population. METHODS In 3 recruitment areas across Italy, two raters reciprocally blind to results assessed eligible subjects; a semi-structured diagnostic clinical interview was performed by a psychiatrist. RESULTS Among the 76 enrolled subjects (mean age 72.7±6.8 years), anxiety symptoms were very common: 69.7% (moderate/ severe HADS-Anxiety), 76.3% (moderate/severe STAI-state), 71.0% (moderate/severe STAI-trait), 61.8% (GAI), 55.3% (GAI-SF). Sensitivity, specificity and positive predictive value of GAI confirmed a good reliability of the Italian version, with Cronbach's Alpha equal to 0.93 for GAI-It and to 0.77 for GAI-It SF, indicating a very good and good construct validity, respectively, of the scales. The Pearson correlation index demonstrated a moderately positive correlation among GAI, GAI-SF and STAI. CONCLUSIONS Our data confirm the validity of GAI-It as a valuable instrument to assess anxiety in an elderly population, for clinical and research purposes.
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Affiliation(s)
- S Ferrari
- Department of Diagnostic-Clinical Medicine and Public Health, University of Modena & Reggio Emilia, Modena
| | - M S Signorelli
- Department of Clinical and Experimental Medicine, University of Catania, Catania
| | - F Cerrato
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna
| | - L Pingani
- Human Resources Department, Local Health Agency of Reggio Emilia, Reggio Emilia, Italy
| | - M Massimino
- Department of Clinical and Experimental Medicine, University of Catania, Catania
| | - S Valente
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna
| | - M Forlani
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna
| | - P Bonasegla
- Department of Diagnostic-Clinical Medicine and Public Health, University of Modena & Reggio Emilia, Modena
| | - E Arcidiacono
- Department of Clinical and Experimental Medicine, University of Catania, Catania
| | - D De Ronchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna
| | - M Rigatelli
- Department of Diagnostic-Clinical Medicine and Public Health, University of Modena & Reggio Emilia, Modena
| | - E Aguglia
- Department of Clinical and Experimental Medicine, University of Catania, Catania
| | - A R Atti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna
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12
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Dell'Osso L, Gesi C, Massimetti E, Cremone IM, Barbuti M, Maccariello G, Moroni I, Barlati S, Castellini G, Luciano M, Bossini L, Rocchetti M, Signorelli M, Aguglia E, Fagiolini A, Politi P, Ricca V, Vita A, Carmassi C, Maj M. Adult Autism Subthreshold Spectrum (AdAS Spectrum): Validation of a questionnaire investigating subthreshold autism spectrum. Compr Psychiatry 2017; 73:61-83. [PMID: 27918948 DOI: 10.1016/j.comppsych.2016.11.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 10/25/2016] [Accepted: 11/02/2016] [Indexed: 01/01/2023] Open
Abstract
AIM Increasing literature has shown the usefulness of a dimensional approach to autism. The present study aimed to determine the psychometric properties of the Adult Autism Subthreshold Spectrum (AdAS Spectrum), a new questionnaire specifically tailored to assess subthreshold forms of autism spectrum disorder (ASD) in adulthood. METHODS 102 adults endorsing at least one DSM-5 symptom criterion for ASD (ASDc), 143 adults diagnosed with a feeding and eating disorder (FED), and 160 subjects with no mental disorders (CTL), were recruited from 7 Italian University Departments of Psychiatry and administered the following: SCID-5, Autism-Spectrum Quotient (AQ), Ritvo Autism and Asperger Diagnostic Scale 14-item version (RAADS-14), and AdAS Spectrum. RESULTS The AdAS Spectrum demonstrated excellent internal consistency for the total score (Kuder-Richardson's coefficient=.964) as well as for five out of seven domains (all coefficients>.80) and sound test-retest reliability (ICC=.976). The total and domain AdAS Spectrum scores showed a moderate to strong (>.50) positive correlation with one another and with the AQ and RAADS-14 total scores. ASDc subjects reported significantly higher AdAS Spectrum total scores than both FED (p<.001) and CTL (p<.001), and significantly higher scores on the Childhood/adolescence, Verbal communication, Empathy, Inflexibility and adherence to routine, and Restricted interests and rumination domains (all p<.001) than FED, while on all domains compared to CTL. CTL displayed significantly lower total and domain scores than FED (all p<.001). A significant effect of gender emerged for the Hyper- and hyporeactivity to sensory input domain, with women showing higher scores than men (p=.003). A Diagnosis* Gender interaction was also found for the Verbal communication (p=.019) and Empathy (p=.023) domains. When splitting the ASDc in subjects with one symptom criterion (ASD1) and those with a ASD, and the FED in subjects with no ASD symptom criteria (FED0) and those with one ASD symptom criterion (FED1), a gradient of severity in AdAS Spectrum scores from CTL subjects to ASD patients, across FED0, ASD1, FED1 was shown. CONCLUSIONS The AdAS Spectrum showed excellent internal consistency and test-retest reliability and strong convergent validity with alternative dimensional measures of ASD. The questionnaire performed differently among the three diagnostic groups and enlightened some significant effects of gender in the expression of autistic traits.
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Affiliation(s)
- L Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - C Gesi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - E Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - I M Cremone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Barbuti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - G Maccariello
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - I Moroni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - S Barlati
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - G Castellini
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - M Luciano
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - L Bossini
- Department of Mental Health and Department of Molecular Medicine, University of Siena, Siena, Italy
| | - M Rocchetti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - M Signorelli
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | - E Aguglia
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | - A Fagiolini
- Department of Mental Health and Department of Molecular Medicine, University of Siena, Siena, Italy
| | - P Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - V Ricca
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - A Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - C Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - M Maj
- Department of Psychiatry, University of Naples SUN, Naples, Italy
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13
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Rocca P, Galderisi S, Rossi A, Bertolino A, Rucci P, Gibertoni D, Montemagni C, Sigaudo M, Mucci A, Bucci P, Acciavatti T, Aguglia E, Amore M, Bellomo A, De Ronchi D, Dell'Osso L, Di Fabio F, Girardi P, Goracci A, Marchesi C, Monteleone P, Niolu C, Pinna F, Roncone R, Sacchetti E, Santonastaso P, Zeppegno P, Maj M. Social cognition in people with schizophrenia: a cluster-analytic approach. Psychol Med 2016; 46:2717-2729. [PMID: 27649341 DOI: 10.1017/s0033291716001100] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND The study aimed to subtype patients with schizophrenia on the basis of social cognition (SC), and to identify cut-offs that best discriminate among subtypes in 809 out-patients recruited in the context of the Italian Network for Research on Psychoses. METHOD A two-step cluster analysis of The Awareness of Social Inference Test (TASIT), the Facial Emotion Identification Test and Mayer-Salovey-Caruso Emotional Intelligence Test scores was performed. Classification and regression tree analysis was used to identify the cut-offs of variables that best discriminated among clusters. RESULTS We identified three clusters, characterized by unimpaired (42%), impaired (50.4%) and very impaired (7.5%) SC. Three theory-of-mind domains were more important for the cluster definition as compared with emotion perception and emotional intelligence. Patients more able to understand simple sarcasm (⩾14 for TASIT-SS) were very likely to belong to the unimpaired SC cluster. Compared with patients in the impaired SC cluster, those in the very impaired SC cluster performed significantly worse in lie scenes (TASIT-LI <10), but not in simple sarcasm. Moreover, functioning, neurocognition, disorganization and SC had a linear relationship across the three clusters, while positive symptoms were significantly lower in patients with unimpaired SC as compared with patients with impaired and very impaired SC. On the other hand, negative symptoms were highest in patients with impaired levels of SC. CONCLUSIONS If replicated, the identification of such subtypes in clinical practice may help in tailoring rehabilitation efforts to the person's strengths to gain more benefit to the person.
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Affiliation(s)
- P Rocca
- Department of Neuroscience, Section of Psychiatry,University of Turin,Turin,Italy
| | - S Galderisi
- Department of Psychiatry,University of Naples SUN,Naples,Italy
| | - A Rossi
- Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry,University of L'Aquila,L'Aquila,Italy
| | - A Bertolino
- Department of Neurological and Psychiatric Sciences,University of Bari,Bari,Italy
| | - P Rucci
- Department of Biomedical and Neuromotor Sciences,University of Bologna,Bologna,Italy
| | - D Gibertoni
- Department of Biomedical and Neuromotor Sciences,University of Bologna,Bologna,Italy
| | - C Montemagni
- Department of Neuroscience, Section of Psychiatry,University of Turin,Turin,Italy
| | - M Sigaudo
- Department of Neuroscience, Section of Psychiatry,University of Turin,Turin,Italy
| | - A Mucci
- Department of Psychiatry,University of Naples SUN,Naples,Italy
| | - P Bucci
- Department of Psychiatry,University of Naples SUN,Naples,Italy
| | - T Acciavatti
- Department of Neuroscience and Imaging, Chair of Psychiatry,G. d'Annunzio University,Chieti,Italy
| | - E Aguglia
- Department of Clinical and Molecular Biomedicine, Psychiatry Unit,University of Catania,Catania,Italy
| | - M Amore
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Psychiatry,University of Genoa,Genoa,Italy
| | - A Bellomo
- Department of Medical Sciences, Psychiatry Unit,University of Foggia,Foggia,Italy
| | - D De Ronchi
- Department of Biomedical and Neuromotor Sciences, Section of Psychiatry,University of Bologna,Bologna,Italy
| | - L Dell'Osso
- Department of Clinical and Experimental Medicine, Section of Psychiatry,University of Pisa,Pisa,Italy
| | - F Di Fabio
- Department of Neurology and Psychiatry,Sapienza University of Rome,Rome,Italy
| | - P Girardi
- Department of Neurosciences, Mental Health and Sensory Organs,S. Andrea Hospital, Sapienza University of Rome,Rome,Italy
| | - A Goracci
- Department of Molecular Medicine and Clinical Department of Mental Health,University of Siena,Siena,Italy
| | - C Marchesi
- Department of Neuroscience, Psychiatry Unit,University of Parma,Parma,Italy
| | - P Monteleone
- Department of Medicine and Surgery, Chair of Psychiatry,University of Salerno,Salerno,Italy
| | - C Niolu
- Department of Systems Medicine, Chair of Psychiatry,Tor Vergata University of Rome,Rome,Italy
| | - F Pinna
- Department of Public Health, Clinical and Molecular Medicine, Section of Psychiatry,University of Cagliari,Cagliari,Italy
| | - R Roncone
- Department of Life, Health and Environmental Sciences, Unit of Psychiatry,University of L'Aquila,L'Aquila,Italy
| | - E Sacchetti
- Psychiatric Unit,School of Medicine, University of Brescia,Brescia,Italy
| | - P Santonastaso
- Psychiatric Clinic, Department of Neurosciences,University of Padua,Padua,Italy
| | - P Zeppegno
- Department of Translational Medicine, Psychiatric Unit,University of Eastern Piedmont,Novara,Italy
| | - M Maj
- Department of Psychiatry,University of Naples SUN,Naples,Italy
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Mineo L, Concerto C, Sarraf Y, Giokas E, Paula M, Coira D, Ellen C, Aguglia E, Battaglia F. Modulation of corticospinal excitability by valerian officinalis root extract: A neuropharmacological Transcranial Magnetic Stimulation (TMS) study. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionValerian officinalis roots extract is a popular medication for insomnia and anxiety treatment. Sedative effect of Valerian is mainly attributed to the modulation of gabaergic transmission, but its pharmacodynamics has not been fully elucidated.ObjectsTo investigate the acute effects of Valerian Officinalis extracts intake on corticoexcitability as measured by TMS.AimsTo obtain further data on Valerian pharmacodynamics.MethodsTwelve healthy volunteers participated in a double-blind randomized crossover placebo-controlled study. They were required to take either 900 mg of Valerian officinalis extract (valerenic acid 0.8%) or placebo. Focal TMS of the hand area of left motor cortex was used to test Resting motor threshold (RMT), Motor evoked potentials (MEPs) amplitude and silent period duration (SP). We also tested Short-interval Intracortical Inhibition (SICI), Intracortical facilitation (ICF), Short and Long afferent Inhibition (SAI and LAI). All parameters were investigated at baseline, 1 hour and 6 hours after drug intake. After a 3-week washout period the subjects switched to the alternate arm of the study.ResultsA mixed RMANOVA revealed a significant main effect of “time” [F(1,22) = 4.03, P = 0.02] and a significant “treatment × time” interaction [F(1,22) = 6.3, P = 0.003]. Post-hoc analysis indicated that the amount of ICF was significantly reduced 1 hour after Valerian intake (P = 0.01) returning to baseline values after 6 hours. No significant changes between the Valerian and placebo groups were observed for the other parameters investigated.ConclusionsThe modulation of ICF induced by Valerian officinalis is likely due to glutamatergic antagonism and might underlie the anti-anxiety therapeutic effects.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Mineo L, Concerto C, Patel D, Myorga T, Coira D, Chusid E, Aguglia E, Battaglia F. Effects of negative autobiographical memories retrieval on corticospinal excitability and sensorimotor integration. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionPrevious transcranial magnetic stimulation (TMS) studies indicate that exposing the subjects to an emotionally valent stimulus results in larger motor evoked potentials (MEP). Up to date, no TMS studies have been conducted in order to investigate the effect of personal memories with emotional value on corticospinal excitability.ObjectsTo investigate changes in corticospinal excitability and sensorimotor integration induced by retrieval of negative or neutral autobiographical memories (AM).AimsTo contribute to a further characterization of neural circuits involved during the evocation of negative AM.MethodsIn 12 healthy volunteers, we recorded motor evoked potentials (MEPs) elicited by TMS pulses during the retrieval of negative AM or neutral AM. Furthermore, we also tested Short-interval Intracortical Inhibition (SICI), Intracortical facilitation (ICF), Short and Long afferent Inhibition (SAI and LAI) in the two different experimental conditions.ResultsRetrieval of negative AM induced a larger increase in MEP amplitude (35.01%) compared to neutral AM (F(1,22) = 7.04, P = 0.013). Furthermore we showed that retrieval of Negative AM increasedn ICF (F(1,22) = 5, P = 0.03) and decrease SAI (F(1,22) = 7.04, P = 0.039). The other TMS parameters were different between conditions.ConclusionsOur results indicate that evocation of negative AM induce a complex modulation of excitatory and inhibitory sensorimotor networks. Further studies are needed to explore the link of these electrophysiological biomarkers with the strength, valence and specificity of negative AM.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Battaglia F, Cannavo' D, Battaglia E, Fazio E, Minutolo G, Aguglia E. The Comorbidity of Depression and Diabetes Mellitus Type 2: an Observational Study. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)31029-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Aguglia E, Biggio G, Signorelli MS, Mencacci C. Italian Study on Depressive Disorders (STudio Italiano MAlattia Depressiva, or STIMA-D): a nationwide snapshot of the status of treatment for major depression. Pharmacopsychiatry 2014; 47:105-10. [PMID: 24846085 DOI: 10.1055/s-0034-1375628] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Major depression is a worldwide problem and often remains undetected and untreated. Given the low rates of detection plus the need to intervene in a short time, it is important to identify factors which are likely to improve treatment outcomes. METHODS STIMA-D was designed to provide the profile of patients with major depression in Italy (focusing on pathway to care, patient characteristics, drug therapy and treatment outcomes). The patients enrolled (M/F, aged between 18 and 65) experienced single/multiple episodes of major depression (DSM-IV-TR). Patients with lifetime or current bipolar syndrome or other mental disorders were excluded. RESULTS 44 of the 50 invited centers sent data concerning 1 140 patients. The majority of patients were women. Among working individuals, 52.5% of them were absent from work due to depression in the previous 6 months. Recurrent episodes of major depression were very common and were associated with persistence of residual post-episodic symptoms, a family history of mood disorders and presence of anxiety. 59.6% of the patients were treated with monotherapy (SSRI or SNRI), while 19.2% of them were treated with SSRI plus SNRI. Only the 25.5% on monotherapy had a complete response compared to 12.4% of patients on dual therapy. DISCUSSION Poor outcomes in major depression have profound implications on patients' quality of life and cost burden. New pharmacological approaches with novel modes of action are therefore urgently needed.
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Affiliation(s)
- E Aguglia
- University of Catania, Department of Clinical and Molecular Biomedicine, Psychiatry Unit, Catania, Italy
| | - G Biggio
- University of Cagliari, Department of Sciences of Life and Enviroment, Monserrato (CA), Italy
| | - M S Signorelli
- University of Catania, Department of Clinical and Molecular Biomedicine, Psychiatry Unit, Catania, Italy
| | - C Mencacci
- Fatebenefratelli and Oftalmico General Hospital, Department of Neuroscience, Milano, Italy
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Signorelli M, Calati R, McMurray J, Comings D, Aguglia E, Serretti A. EPA-1307 - Associations between genetic polymorphisms and personality traits in healthy subjects. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78529-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Magnano San Lio F, Petrosino B, Aguglia E. EPA-1755 – High-functioning autism and asperger's syndrome in adults: still an open question in DSM-5. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78885-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Signorelli M, Battaglia F, Aguglia E. EPA-0741 – Comorbid depression and diabetes: an observational study. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78091-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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23
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Spampinato C, Aguglia E, Concerto C, Pennisi M, Lanza G, Bella R, Cantone M, Pennisi G, Kavasidis I, Giordano D. Transcranial magnetic stimulation in the assessment of motor cortex excitability and treatment of drug-resistant major depression. IEEE Trans Neural Syst Rehabil Eng 2013; 21:391-403. [PMID: 23559064 DOI: 10.1109/tnsre.2013.2256432] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Major depression is one of the leading causes of disabling condition worldwide and its treatment is often challenging and unsatisfactory, since many patients become refractory to pharmacological therapies. Transcranial magnetic stimulation (TMS) is a noninvasive neurophysiological investigation mainly used to study the integrity of the primary motor cortex excitability and of the cortico-spinal tract. The development of paired-pulse and repetitive TMS (rTMS) paradigms has allowed investigators to explore the pathophysiology of depressive disorders and other neuropsychiatric diseases linked to brain excitability dysfunctions. Repetitive transcranial magnetic stimulation has also therapeutic and rehabilitative capabilities since it is able to induce changes in the excitability of inhibitory and excitatory neuronal networks that may persist in time. However, the therapeutic effects of rTMS on major depression have been demonstrated by analyzing only the improvement of neuropsychological performance. The aim of this study was to investigate cortical excitability changes on 12 chronically-medicated depressed patients (test group) after rTMS treatment and to correlate neurophysiological findings to neuropsychological outcomes. In detail, we assessed different parameters of cortical excitability before and after active rTMS in the test group, then compared to those of 10 age-matched depressed patients (control group) who underwent sham rTMS. In line with previous studies, at baseline both groups exhibited a significant interhemispheric difference of motor cortex excitability. This neurophysiological imbalance was then reduced in the patients treated with active rTMS, resulting also in a clinical benefit as demonstrated by the improvement in neuropsychological test scores. On the contrary, after sham rTMS, the interhemispheric difference was still evident in the control group. The reported clinical benefits in the test group might be related to the plastic remodeling of synaptic connection induced by rTMS treatment.
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Affiliation(s)
- C Spampinato
- Department of Electrical, Electronic and Computer Engineering, University of Catania, 95125 Catania, Italy.
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Spampinato C, Aguglia E, Concerto C, Pennisi M, Lanza G, Bella R, Cantone M, Pennisi G, Kavasidis I, Giordano D. Transcranial magnetic stimulation in the assessment of motor cortex excitability and treatment of drug-resistant major depression. IEEE Trans Neural Syst Rehabil Eng 2013. [PMID: 23559064 DOI: 10.1109/tnsre.2013.2256432.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Major depression is one of the leading causes of disabling condition worldwide and its treatment is often challenging and unsatisfactory, since many patients become refractory to pharmacological therapies. Transcranial magnetic stimulation (TMS) is a noninvasive neurophysiological investigation mainly used to study the integrity of the primary motor cortex excitability and of the cortico-spinal tract. The development of paired-pulse and repetitive TMS (rTMS) paradigms has allowed investigators to explore the pathophysiology of depressive disorders and other neuropsychiatric diseases linked to brain excitability dysfunctions. Repetitive transcranial magnetic stimulation has also therapeutic and rehabilitative capabilities since it is able to induce changes in the excitability of inhibitory and excitatory neuronal networks that may persist in time. However, the therapeutic effects of rTMS on major depression have been demonstrated by analyzing only the improvement of neuropsychological performance. The aim of this study was to investigate cortical excitability changes on 12 chronically-medicated depressed patients (test group) after rTMS treatment and to correlate neurophysiological findings to neuropsychological outcomes. In detail, we assessed different parameters of cortical excitability before and after active rTMS in the test group, then compared to those of 10 age-matched depressed patients (control group) who underwent sham rTMS. In line with previous studies, at baseline both groups exhibited a significant interhemispheric difference of motor cortex excitability. This neurophysiological imbalance was then reduced in the patients treated with active rTMS, resulting also in a clinical benefit as demonstrated by the improvement in neuropsychological test scores. On the contrary, after sham rTMS, the interhemispheric difference was still evident in the control group. The reported clinical benefits in the test group might be related to the plastic remodeling of synaptic connection induced by rTMS treatment.
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Affiliation(s)
- C Spampinato
- Department of Electrical, Electronic and Computer Engineering, University of Catania, 95125 Catania, Italy.
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Cherubini A, Nisticò G, Rozzini R, Liperoti R, Di Bari M, Zampi E, Ferrannini L, Aguglia E, Pani L, Bernabei R, Marchionni N, Trabucchi M. Subthreshold depression in older subjects: an unmet therapeutic need. J Nutr Health Aging 2012; 16:909-13. [PMID: 23208031 DOI: 10.1007/s12603-012-0373-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Major depression, defined according to DSM IV TR criteria, is less common in older subjects, while other types of depression are two to three times more prevalent. This heterogeneous group of disturbances has received different names: depression not otherwise specified, minor depression, subthreshold or subsyndromal depression. Moreover, each condition has been defined using heterogeneous criteria by different authors. The term of subthreshold depression will be adopted in this position statement. Subthreshold depression has been associated with the same negative consequences of major depression, including reduced well being and quality of life, worsening health status, greater disability, increased morbidity and mortality. Nevertheless, there is a dearth of clinical trials in this area, and therefore older patients with subthreshold depression are either not treated or they are treated with the same non pharmacological and pharmacological therapies used for major depression, despite the lack of supporting scientific evidence. There is an urgent need to reach a consensus concerning the diagnostic criteria for subthreshold depression as well as to perform clinical trials to identify effective and safe therapies in this too long neglected patient group.
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Affiliation(s)
- A Cherubini
- Department of Geriatrics, Research Hospital of Ancona, Italian National Research Center on Aging (INRCA), Ancona, Italy.
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Abstract
OBJECTIVES This drug utilization study aims to evaluate the incidence and prevalence of prescribed antidepressants (SSRIs or SNRIs) and to describe treatment modalities in Italy during the period 2003-2009. METHODS This retrospective analysis on the prescription and treatment modalities of SSRIs or SNRIs is based on an Italian general practice database, which includes data on about 1,000,000 patients. Eligible patients should have age≥18 years, and ≥1 year of clinical history. Prevalence, incidence of use and adherence were calculated for SSRIs and SNRIs and for the individual agents. RESULTS The prevalence of SSRI use increased from 7.5% (2003) to 13.1% (2009) while the prevalence of SNRI use increased from 0.8% to 2.5%. The most evident increase was reported for escitalopram (+2.78%). The number of new antidepressant users (incidence rate) showed a modest decrease for SSRIs (-0.3%) and a slight increase for SNRIs (+0.9%). A higher percentage of continuers was reported for SSRIs versus SNRIs (15.1% vs 13.0%). Escitalopram was associated with the highest percentage of continuers and with the highest number of days of uninterrupted treatment. Overall, over 10% of antidepressant users switched their first choice during one year of follow-up. Escitalopram was associated with the highest frequency of 'high' adherers (28.5%). CONCLUSIONS SSRIs may be regarded as the elective treatment for depression. Of the SSRIs, escitalopram seems to be associated with the highest number of days of uninterrupted treatment, the lowest proportion of switchers and the highest adherence. This consideration might have practical relevance when comparing escitalopram to other SSRIs and to venlafaxine and duloxetine.
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Affiliation(s)
- E Aguglia
- Università degli Studi di Catania, Catania, Italy
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Signorelli M, Arcidiacono E, Aguglia E. P-1450 - What factors are associated with intimate partner violence? Evaluation of the impact of risk factors and psychopathological consequences. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)75617-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Signorelli M, Geraci A, Aguglia E. P01-248-Theory of mind, moral judgments and neuropsychological functioning in patients with bipolar disorders. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)71959-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
IntroductionSeveral studies revealed that cognitive functioning in BPD are impaired not only in the acute phase but over time (Mur et al., 2008). On Theory of Mind (ToM) recent studies found a impairment of this ability in remitted patients, supporting the theory that ToM deficits are trait-dependent (Bora et al., 2009) in contrast with another study that suggest a partially dependence(Wolf et al. 2010).ObjectivesWe explored: a) ToM in BPD investigating two cognitive processes: emotional recognition, second order beliefs attribution; b) Moral judgments in BPD; c) possible effects of neuropsychological functioning on ToM task and moral dilemmas.AimsThe principal aim is to investigate the domain specificity of ToM and Moral sense, studying selective impairments.MethodA total of 20 patients with bipolar I disorder were tested and 20 healthy controls. We use a complete neuropsychological assessment, two ToM tasks (Eyes test, Sullivan's stories) and we added two moral dilemmas to asses moral judgment Results: We found ToM deficits in BDP, with a multiple correlation between ToM and neuropsychological functioning. Also we found for the first time a impairment on personal moral dilemma, with a correlation between emotional recognition and moral judgments.ConclusionPatients with BPD are impaired in ToM partially independent of other cognitive dysfunctions and in moral reasoning.
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Carta M, Aguglia E, Balestrieri M, Bocchetta A, Drago F, Faravelli C, Morosini P, Nardini M, Hardoy M. The Use of Drugs for Mood Disorders in Italy: Preliminary Results. Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)71018-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background:Some community surveys in Italy have shown that a proportion of subjects without lifetime psychiatric diagnosis (anxiety/depression) used antidepressants. The prescription of AD in bipolar depression appears to be another largely underestimated problem in the clinical practice and is difficult to recognise by means of traditional epidemiological methods (lay interview and structured diagnostic tools).Objectives:The purpose is to use defined and validated international semi-structured interview as diagnostic instrument administered by expert clinicians to evaluate appropriateness and amount of over and under prescription of psychotropic drugs in different Italian community areas. The focus is on general antidepressant use and use in subjects with bipolar disorder and in subsyndromal depression.Methods:Study design: Community survey. Study population: sample randomly drawn, after stratification by sex and age, from the adult population of Municipal records in 6 Italian Regions: about 4000 persons will be interviewed. Tools: Questionnaire on psychotropic drugs consumption, prescription, health services utilisation;diagnostic Structured Clinical Interview np version;Mood Disorders Questionnaire; Short Form Health Survey. Ethical aspects: a signed informed consent for each candidate. The study was approved by the ethical committee of theItalain National Health Institute.Expected results:The study aims to identify the frequency of over and under prescription of psychotropic drugs in different Italian regions and the determinants of prescription related to physicians, patients, comorbidity and symptoms and to establish the basis for a cohort prospective study to assess the future changes.
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Gava I, Barbui C, Aguglia E, Carlino D, Churchill R, De Vanna M, McGuire HF. Psychological treatments versus treatment as usual for obsessive compulsive disorder (OCD). Cochrane Database Syst Rev 2007:CD005333. [PMID: 17443583 DOI: 10.1002/14651858.cd005333.pub2] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Obsessive compulsive disorder (OCD) is a chronic anxiety disorder associated with significant morbidity, social impairment and lower quality of life. Psychological treatments are a frequently used approach for OCD. OBJECTIVES To perform a systematic review of randomised trials of psychological treatments for obsessive compulsive disorder in comparison with treatment as usual. SEARCH STRATEGY We conducted an electronic search of CCDANCTR-Studies (31/10/2006), and other databases. We searched reference lists, and contacted experts in the field. SELECTION CRITERIA Published and unpublished randomised trials of psychological treatments versus treatment as usual for adults with a diagnosis of OCD DATA COLLECTION AND ANALYSIS: Two review authors worked independently throughout the selection of trials and data extraction. Findings were compared and disagreements were discussed with a third review author. Full data extraction, using a standardised data extraction sheet, was performed on all studies included in the review. Results were synthesised using Review Manager software. For dichotomous data, odds ratios were calculated. For continuous data, effect sizes were obtained and the standardised mean difference, with 95% confidence intervals, was calculated. Fixed and random effects models were used to pool the data. Reasons for heterogeneity in studies were explored and sensitivity analyses were performed by excluding trials of lower quality. MAIN RESULTS Eight studies (11 study comparisons) were identified, all of which compared cognitive and/or behavioural treatments versus treatment as usual control groups. Seven studies (ten comparisons) had usable data for meta-analyses. These studies demonstrated that patients receiving any variant of cognitive behavioural treatment exhibited significantly fewer symptoms post-treatment than those receiving treatment as usual (SMD -1.24, 95% CI -1.61 to -0.87, I(2) test for heterogeneity 33.4%). Different types of cognitive and/or behavioural treatments showed similar differences in effect when compared with treatment as usual. The overall treatment effect appeared to be influenced by differences in baseline severity. AUTHORS' CONCLUSIONS The findings of this review suggest that psychological treatments derived from cognitive behavioural models are an effective treatment for adult patients with obsessive compulsive disorder. Larger high quality randomised controlled trials involving longer follow up periods are needed, to further test cognitive behavioural treatments, and other psychological approaches, in comparison to each other and control conditions. Future trials should examine the predictors of response to each treatment, and also conduct cost-effectiveness evaluations.
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Affiliation(s)
- I Gava
- Mandala Clinic, PO Box 361, Gosford, New South Wales, Australia, 2250.
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Onor ML, Trevisiol M, Negro C, Aguglia E. Different perception of cognitive impairment, behavioral disturbances, and functional disabilities between persons with mild cognitive impairment and mild Alzheimer's disease and their caregivers. Am J Alzheimers Dis Other Demen 2006; 21:333-8. [PMID: 17062552 PMCID: PMC10832643 DOI: 10.1177/1533317506292454] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Insight in dementia is a multifaceted concept and ability, which includes the persons' perception of their behavioral and cognitive symptoms and functional disability. This ability seems to deteriorate as dementia progresses. The aim of this study was to evaluate the level of insight in the cognitive, behavioral, and functional disorders in a group of persons with mild cognitive impairment (MCI) or mild AD (Alzheimer's disease) and to compare their perception of their illness with that of their caregivers. The study involved a group of 121 persons with MCI and mild AD and their caregivers. The persons with MCI and mild AD were administered the tests Mini-Mental State Examination, Instrumental Activities of Daily Living, Activities of Daily Living, Neuropsychiatric Inventory, Schedule for the Assessment of Insight, Clinical Insight Rating Scale, and a short interview. Major differences were identified between how the persons with MCI or mild AD and their caregivers perceived the persons' cognitive and behavioral disorders. The group with MCI or mild AD underestimated their deficits, which were considered serious and disabling by their caregivers.
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Affiliation(s)
- M L Onor
- Department of Clinical, Morphological and Technological Sciences, U.C.O. of Clinical Psychiatry, University of Trieste, Italy.
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Abstract
OBJECTIVE We analysed the effects of donepezil, rivastigmine and galantamine, prescribed for the treatment of Alzheimer disease in a real-world setting in Italy. METHODS Outcome measures included the MiniMental State Examination (MMSE), the Alzheimer Disease Assessment Scale cognitive subscale (ADAS-cog), Instrumental Activity of Daily Living (IADL) and ADL scales. RESULTS Seventy patients were treated with donepezil, 121 with rivastigmine and 51 with galantamine. At 6 months, rivastigmine-treated patients improved by 1.29 points from baseline on the ADAS-cog, while donepezil- and galantamine-treated patients showed 'no change' (changes of < 0.2 points). On the IADL, patients treated with rivastigmine, donepezil and galantamine showed decreases of 0.42, 0.58 and 0.75 points, respectively. On the ADL, donepezil- and galantamine-treated patients showed decreases of 0.44 and 0.86 points, respectively, while there was 'no change' with rivastigmine. On the MMSE, donepezil- and rivastigmine-treated patients showed 'no change' and galantamine-treated patients showed a mean decrease of 1.19 points. A subgroup analysis of 'pseudo-randomised' patients (rivastigmine, n = 63; donepezil, n = 55; galantamine, n = 51) supported the main findings. Side effects were similar (in type and frequency) in the three treatment groups. CONCLUSIONS This is the first study to compare the effects of the three most commonly-used cholinesterase inhibitors on the MMSE, ADAS-cog, IADL and ADL. Limitations included its small population size, its open-label design, and the fact that patients were randomised only after the introduction of galantamine. There were no statistically significant differences between the three drugs at 3 months. While numerical trends were observed suggesting the effect of rivastigmine > donepezil > galantamine, larger, longer-term prospective studies are needed to confirm whether there are important differences in the long-term efficacy of the three drugs.
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Affiliation(s)
- E Aguglia
- Department of Clinical, Morphological and Technological Science, UCO of Clinical Psychiatry, University of Trieste, Trieste, Italy.
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Aguglia E, Onor ML, Trevisiol M, Negro C, Saina M, Maso E. Stress in the caregivers of Alzheimer's patients: an experimental investigation in Italy. Am J Alzheimers Dis Other Demen 2004; 19:248-52. [PMID: 15359564 PMCID: PMC10833810 DOI: 10.1177/153331750401900403] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In Italy, the family constitutes the major caregiving response to the needs of the elderly who are no longer self-sufficient. These caregivers are often wives or daughters who have chosen to keep the patient at home with them. On average, three-quarters of the caregiver's day is devoted to the patient, a proportion that tends to increase linearly as the disease progresses. The primary aim of our study was to describe a group of Italian caregivers of patients with a diagnosis of dementia to assess their levels of stress. We then correlated these caregivers with a number of sociodemographic variables and the patients' degree of cognitive impairment and independence in daily life activities. The study was conducted on a sample group of 236 caregivers of patients with a diagnosis of Alzheimer's disease (AD) according to the DSM-IV criteria. Each caregiver took part in a sociodemographic interview and filled in two questionnaires: the Caregiver Burden Inventory (CBI), to quantify the caregiving workload and the Brief Symptom Inventory (BSI), to assess the level of anxiety and depression. Patients were administered the Mini-Mental State Examination (MMSE) to evaluate their level of cognitive impairment and the Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL) tests to quantify their level of independence. The analysis of the results shows that the average Italian caregiver of an AD patient is a woman, approximately 60 years old. The majority of caregivers are spouses, followed by children. In general, these caregivers work at home, are housewives or retired, and are personally involved in caring for the patients. The greater the level of a patient's cognitive impairment and the less independent they are, the greater amount of care and supervision they require, leaving less free time for the caregiver; this leads to higher levels of anxiety related to caregiving. Toward the final stages of the disease, patient care tasks take up nearly all of the caregiver's free time, leaving them only about two hours per week for themselves or their friends. In conclusion, the management of dementia patients places a particular burden on the caregiver and involves several economic and social costs. The burden becomes heavier as the disease progresses, since the increase of cognitive disorders and the resulting reduction of independence in daily life, together with the onset of behavioral symptoms, heighten the caregiver's distress, anxiety, and depression. Establishing a network of community services able to alleviate the burden on families is therefore a priority. Parallels can be drawn between the stresses documented for American caregivers and their Italian counterparts.
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Affiliation(s)
- E Aguglia
- Department of Clinical, Morphological and Technological Sciences, U.C.O. of Clinical Psychiatry, Alzheimer Evaluation Unit, University of Trieste, Trieste, Italy
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Li Destri G, Sapienza S, Rodolico M, Di Cataldo A, Puleo S, Minutolo V, Aguglia E, Licata A. Stress of routine follow-up in colorectal cancer operated patients. Chir Ital 2000; 52:695-8. [PMID: 11200005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
Postoperative follow-up is the logical consequence of cancer treatment, but colorectal cancer follow-up does not achieve all its goals. These unfavourable findings induced us to assess whether follow-up also causes negative psychological stress in our colorectal cancer patients. In this trial 100 colorectal cancer follow-up patients were asked to compile three questionnaires: 1) the McGil Pain Questionnaires; 2) Profile of Mood Status; and 3) Locus of Control. The questionnaires were handed to the patients at follow-up and were compiled immediately. In addition, the patients were asked to answer the firsts two tests spontaneously 30 days after follow-up and mail the questionnaires. Our results showed that only 41% of the patients complied the tests 30 days after follow-up. The scores for pain and mood disorders were greater in women, especially during the "before follow-up" period. The third test revealed a prevalence of subjects with internal-type reinforcement. Our data revealed that: 1) patients tend to repress the problem; 2) women are affected by greater stress and anxiety; 3) subjects with internal-type reinforcement have a positive attitude during follow-up and this enables the ego to bear the anguish, process it and dilute it to anxiety, thus favouring future life experiences.
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Affiliation(s)
- G Li Destri
- First Surgical Clinic, University of Catania
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Abstract
Depression in the elderly is often not recognised and is frequently under-treated. Reboxetine is a selective noradrenaline reuptake inhibitor (selective NRI) which is effective and well tolerated in the treatment of depressed adult patients. This prospective, uncontrolled, multicentre study was designed to assess the efficacy and tolerability of reboxetine as maintenance therapy for major depressive disorder or dysthymia in 160 elderly patients (aged 65-94 years). One hundred and thirty-nine patients completed the 6-week run-in period and entered the long-term phase; 104 patients completed the 52-week treatment period. The proportion of patients with CGI-global improvement ratings assessed as 'much' and 'very much' improved increased from 15.1% at week 2 to 88.7% at week 6 and to 95.2% at week 52. The mean HAM-D total score showed a reduction from 24.0 at baseline to 10.4 at week 6 and 7.5 at week 52. Twenty-five patients discontinued treatment due to adverse events. The most frequently reported adverse events were nausea (11.9%), insomnia (11.9%), headache (10.0%) and dry mouth (9.1%), and these were of mild or moderate severity. In summary, results from this study show reboxetine to be effective, and well tolerated in both the short- and long-term treatment of elderly depressed or dysthymic patients.
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Affiliation(s)
- E Aguglia
- Universita degli Studi di Trieste, Istituto di Clinica Psichiatrica, Via P. de Ralli 15, Trieste, Italy
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Kane JM, Aguglia E, Altamura AC, Ayuso Gutierrez JL, Brunello N, Fleischhacker WW, Gaebel W, Gerlach J, Guelfi JD, Kissling W, Lapierre YD, Lindström E, Mendlewicz J, Racagni G, Carulla LS, Schooler NR. Guidelines for depot antipsychotic treatment in schizophrenia. European Neuropsychopharmacology Consensus Conference in Siena, Italy. Eur Neuropsychopharmacol 1998; 8:55-66. [PMID: 9452941 DOI: 10.1016/s0924-977x(97)00045-x] [Citation(s) in RCA: 226] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
These guidelines for depot antipsychotic treatment in schizophrenia were developed during a two-day consensus conference held on July 29 and 30, 1995 in Siena, Italy. Depot antipsychotic medications were developed in the 1960s as an attempt to improve the long-term treatment of schizophrenia (and potentially other disorders benefiting from long-term antipsychotic medication). Depot drugs as distinguishable from shorter acting intramuscularly administered agents can provide a therapeutic concentration of at least a seven day duration in one parenteral dose. The prevention of relapse in schizophrenia remains an enormous public health challenge worldwide and improvements in this area can have tremendous impact on morbidity, mortality and quality of life, as well as direct and indirect health care costs. Though there has been debate as to what extent depot (long-acting injectable) antipsychotics are associated with significantly fewer relapses and rehospitalizations, in our view when all of the data from individual trials and metaanalyses are taken together, the findings are extremely compelling in favor of depot drugs. However in many countries throughout the world fewer than 20% of individuals with schizophrenia receive these medications. The major advantage of depot antipsychotics over oral medication is facilitation of compliance in medication taking. Non-compliance is very common among patients with schizophrenia and is a frequent cause of relapse. In terms of adverse effects, there are not convincing data that depot drugs are associated with a significantly higher incidence of adverse effects than oral drugs. Therefore in our opinion any patient for whom long-term antipsychotic treatment is indicated should be considered for depot drugs. In choosing which drug the clinician should consider previous experience, personal patient preference, patients history of response (both therapeutic and adverse effects) and pharmacokinetic properties. In conclusion the use of depot antipsychotics has important advantages in facilitating relapse prevention. Certainly pharmacotherapy must be combined with other treatment modalities as needed, but the consistent administration of the former is often what enables the latter.
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Affiliation(s)
- J M Kane
- Department of Psychiatry, Hillside Hospital, Division of Long Island Jewish Medical Center, Glen Oaks, NY 11004, USA
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Bressi C, Taylor G, Parker J, Bressi S, Brambilla V, Aguglia E, Allegranti I, Bongiorno A, Giberti F, Bucca M, Todarello O, Callegari C, Vender S, Gala C, Invernizzi G. Cross validation of the factor structure of the 20-item Toronto Alexithymia Scale: an Italian multicenter study. J Psychosom Res 1996; 41:551-9. [PMID: 9032718 DOI: 10.1016/s0022-3999(96)00228-0] [Citation(s) in RCA: 427] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The 20-item Toronto Alexithymia Scale (TAS-20) has been shown in previous research to measure a general dimension of alexithymia with three intercorrelated factors. This study evaluated the reliability and factorial validity of an Italian translation of the TAS-20 in a group of normal adults (N = 206) and in a mixed group of medical and psychiatric outpatients (N = 642). Using confirmatory factor analyses, the previously established three-factor model of the TAS-20 was found to be replicable in both groups. In addition, the Italian TAS-20 demonstrated adequate estimates of internal reliability and test-retest reliability. Although evaluation of the convergent, discriminant, and concurrent validity of the TAS-20 is required in Italian populations, the present results support the use of the Italian translation of the scale for clinical and research purposes.
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Affiliation(s)
- C Bressi
- IRCCS, Ospedale Maggiore of Milan, Department of Psychiatry, University of Milan, Italy
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Zorzenon M, Colle R, Vecchio D, Bertoli M, Giavedoni A, Degrassi A, Lavaroni S, Aguglia E, Botta G. Major depression, viral reactivation and immune system. Eur Psychiatry 1996. [DOI: 10.1016/0924-9338(96)89040-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Aguglia E, Ottolenghi F, Riolo A. [Pain in psychopathology. Brief phenomenological analysis]. Minerva Psichiatr 1995; 36:213-6. [PMID: 8721201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The problem of pain is felt more and more by people at various levels of privacy and social life. It is important to examine the possibility of pain as "communicative metalanguage", or language of languages. This language is deeply analogic, metaphoric, symbolic, experienced. The authors, in this paper, try to consider the problem of pain from a psychopathologic point of view and outline some lines of phenomenological analysis, from depression to schizophrenia.
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Affiliation(s)
- E Aguglia
- Istituto di Clinica Psichiatrica, Università degli Studi-Trieste
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Abstract
A mail survey of degree of seasonal suffering was conducted in Italy using the SPAQ (Seasonal Pattern Assessment Questionnaire). Experiencing seasonal changes as a problem was reported by more than half of the 543 responders. Both mean GSS (Global Seasonality Score) and circannual profile of 'feeling worst' yielded results similar to those reported in the USA at comparable latitudes. Global prevalences of SAD, Reverse-SAD and Sub-SAD were 4.4, 2.1 and 4.8%, respectively. Female sex and young age were associated with a higher degree of seasonal sensitivity. No clear evidence was found of higher sensitivity at higher latitudes or of a significant influence of sociocultural factors.
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Affiliation(s)
- G Muscettola
- Dipartimento di Neuroscienze e delle Comunicazioni Interumane, Università Federico II, Napoli, Italy
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Invernizzi G, Aguglia E, Bertolino A, Casacchia M, Ciani N, Marchesi GF, Nardini M, Rapisarda V. The efficacy and safety of tianeptine in the treatment of depressive disorder: results of a controlled double-blind multicentre study vs. amitriptyline. Neuropsychobiology 1994; 30:85-93. [PMID: 7800169 DOI: 10.1159/000119142] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Three hundred in- and outpatients suffering from depressive disorder, as diagnosed using DSM-III criteria were treated for 6 weeks under double-blind conditions in a multicenter controlled study of tianeptine vs. amitriptyline. Both groups presented steady improvement of depressive syndrome from day 7 up to the end of the treatment, as shown by all evaluation scales: HDRS, SAD, CGI. Furthermore, anxiety linked to the depressive syndrome decreased equally in both groups, as shown by the HARS measurements. In addition to the improvement of mood, the tianeptine-treated patients presented less somatic complaints and side effects when compared to the reference antidepressant. These results confirm previous findings that tianeptine is an effective antidepressant with a lower side effect profile than amitriptyline.
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Affiliation(s)
- G Invernizzi
- Clínica Psichiatrica dell'Università di Milano, Policlinico F. Sforza, Italia
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Aguglia E, Casacchia M, Cassano GB, Faravelli C, Ferrari G, Giordano P, Pancheri P, Ravizza L, Trabucchi M, Bolino F. Double-blind study of the efficacy and safety of sertraline versus fluoxetine in major depression. Int Clin Psychopharmacol 1993; 8:197-202. [PMID: 8263318 DOI: 10.1097/00004850-199300830-00010] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
An eight-week double-blind, multicentre study was performed to evaluate the efficacy and safety of sertraline vs. fluoxetine in the treatment of major depression (DSM-III-R). There were 108 out-patients, from nine Italian centres, entered into the study, of whom 88 were evaluable (48 sertraline, 40 fluoxetine). The final mean daily dose of sertraline was 72 mg and for fluoxetine it was 28 mg. Both treatment groups showed a statistically significant improvement from baseline at one week, and this was maintained until the end of treatment for all of the following measures: Hamilton Rating Scales for Depression and Anxiety, the Montgomery Asberg Depression Rating Scale, Clinical Global Impressions Scale, Zung Self-Rating Scale for Anxiety and the Leeds Sleep Evaluation Questionnaire. Although there was a numerical advantage for sertraline on several efficacy measures, there was no statistically significant difference found between the treatment groups. The incidence of adverse events was similar for both treatments; 40.4% for sertraline and 39.3% for fluoxetine. However, adverse events were generally rated by patients as of lower severity in the sertraline group. In addition, for the fluoxetine group, there was a higher incidence of agitation, anxiety and insomnia than for sertraline. Sertraline was considered to be better tolerated than fluoxetine overall, since only 9.6% of sertraline-treated patients discontinued treatment due to therapy failure whereas in the fluoxetine-treated group this figure was 19.6%. By contrast, 13.5% of sertraline-treated patients discontinued prematurely because of clinical improvement, compared with 10.7% of fluoxetine-treated patients.
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Ban TA, Morey LC, Aguglia E, Batista R, Campanella G, Conti L, Dreyfus JF, Fjetland OK, Grossi D, Modaferri A. Glycosaminoglycan polysulfate in the treatment of old age dementias. Prog Neuropsychopharmacol Biol Psychiatry 1991; 15:323-42. [PMID: 1862217 DOI: 10.1016/0278-5846(91)90064-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
1. In a multicenter, placebo-controlled, double-blind clinical trial in 155 elderly patients with cognitive decline, glycosaminoglycan polysulfate was found to be a therapeutically effective agent in the treatment of old age dementias. 2. Treatment with glycosaminoglycan polysulfate in the daily dosage of 600 LRU, administered on the basis of a divided dosage schedule for 12 weeks, was significantly superior to an inactive placebo on several outcome measures including the Wechsler Memory Scale-Russell Revision (Easy Paired Associates Learning and Immediate Visual Reproduction), Mini Mental State Examination, the Sandoz Clinical Assessment Geriatric (Cognitive Dysfunction and Depression), Hachinski Dementia Scale, Brief Psychiatric Rating Scale (Confusion and Depressive Withdrawal) and Global Improvement Scale of the Clinical Global Impression. 3. Adverse effects with glycosaminoglycan polysulfate were few and mild. The drug was equally well tolerated and equally effective in the two major dementias of old age, i.e., primary degenerative and multi-infarct. The number of abnormal laboratory test readings remained essentially unchanged from pre-treatment to post-treatment.
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Affiliation(s)
- T A Ban
- Department of Psychiatry, Vanderbilt University, Nashville, TN
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Ban TA, Morey L, Aguglia E, Azzarelli O, Balsano F, Marigliano V, Caglieris N, Sterlicchio M, Capurso A, Tomasi NA. Nimodipine in the treatment of old age dementias. Prog Neuropsychopharmacol Biol Psychiatry 1990; 14:525-51. [PMID: 2236581 DOI: 10.1016/0278-5846(90)90005-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
1. In a multicenter, placebo-controlled, double-blind clinical study in 178 elderly patients with cognitive decline, nimodipine, a calcium antagonist was found to be a therapeutically effective agent in the treatment of old age dementias. 2. Treatment with 90 mg of nimodipine administered orally in divided doses for 12 weeks was significantly superior to an inactive placebo on all outcome measures including the Wechsler Memory Scale, the Mini Mental State Examination, the Global Deterioration Scale, the Sandoz Clinical Assessment Geriatric Scale, the Plutchik Geriatric Rating Scale, the Severity of Illness and Global Improvement Scales of Clinical Global Impression, and the Hamilton Psychiatric Rating Scale for Depression. 3. Adverse effects with nimodipine were few and mild. The drug was equally well tolerated and equally effective in the two major dementias of old age, i.e., primary degenerative and multi-infarct. The number of abnormal laboratory test readings remained essentially unchanged from pre-treatment to post-treatment.
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Affiliation(s)
- T A Ban
- Department of Psychiatry, Vanderbilt University, Nashville, TN
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Crea L, Aguglia E. [Clinical study of etizolam in patients with anxiety and insomnia]. Riv Eur Sci Med Farmacol 1988; 10:253-7. [PMID: 3274718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Matera M, Virgilio A, Cassarino P, Cassarino S, Aguglia E, Rapisarda E. [Modification of the pain threshold and beta-endorphin level in heroin addicts undergoing withdrawal]. Riv Eur Sci Med Farmacol 1988; 10:73-7. [PMID: 2978935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Aguglia E, Sapienza S. [The polis and metropolis: reflexions on interpersonal dynamics]. Minerva Psichiatr 1987; 28:191-6. [PMID: 3454855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Brambilla F, Aguglia E, Massironi R, Maggioni M, Grillo W, Castiglioni R, Catalano M, Drago F. Neuropeptide therapies in chronic schizophrenia: TRH and vasopressin administration. Neuropsychobiology 1986; 15:114-21. [PMID: 3097570 DOI: 10.1159/000118253] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Twenty-three chronic undifferentiated schizophrenics, 13 women and 10 men, aged 37-64 years with 15-to 40-year histories of the disease were given either thyrotropin-releasing hormone (TRH) (10 subjects) or DDAVP (13 subjects) with the aim to improve the negative symptoms of the disease and memory. TRH (600 micrograms i.v.) and DDAVP (4 micrograms i.m.) were administered every other day for 30 days. Negative symptoms were monitored by the Andreasen rating scale and by the Honingfeld NOSIE rating scale, memory by the Folstein 'Mini mental State' rating scale and by the Luria-Nebraska rating scale before therapy and then at days 15, 16, 30 and 31 of treatment. Both therapies significantly improved negative symptoms. Memory was significantly improved in all the patients treated with TRH and in 9 of the 13 patients treated with DDAVP, who presented less severe cognitive impairments. A peripheral mechanism of action of DDAVP was excluded by the observation that plasma electrolytes and osmolality, blood pressure, ECG patterns, 24-hour urine volume and specific gravity, basal plasma cortisol and growth hormone levels and weight of the patients were unchanged during therapy. TRH treatment induced a transient borderline hyperthyroidism at day 15 and a progressive decrease of the thyrotropin response to TRH stimulation. A common mechanism of action of the two peptides on the central noradrenergic system is suggested.
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Aguglia E, Di Cataldo A, Sapienza S, Urbano D, Latteri F. [Use of hypothalamic phospholipid liposomes in patients with irritable bowel syndrome]. Clin Ter 1985; 113:205-9. [PMID: 4017499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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