1
|
Salvatore S, Ruffolo AF, Phillips C, Athanasiou S, Cardozo L, Serati M. Vaginal laser therapy for GSM/VVA: where we stand now - a review by the EUGA Working Group on Laser. Climacteric 2023; 26:336-352. [PMID: 37395104 DOI: 10.1080/13697137.2023.2225766] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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] [Received: 02/28/2023] [Revised: 06/09/2023] [Accepted: 07/12/2023] [Indexed: 07/04/2023]
Abstract
Vulvovaginal atrophy (VVA) is a chronic progressive condition that involves the genital and lower urinary tracts, related to the decrease of serum estrogenic levels when menopause occurs. The definition of genitourinary syndrome of menopause (GSM) is a medically more accurate, all-encompassing and publicly acceptable term than VVA. Due to the chronic progressive trend of GSM, symptoms tend to reappear after the cessation of therapy, and frequently long-term treatment is required. First-line therapies include vulvar and vaginal lubricant or moisturizers, and, in the case of failure, low-dose vaginal estrogens are the preferred pharmacological therapy. Populations of patients, such as breast cancer (BC) survivors, are affected by iatrogenic GSM symptoms with concerns about the use of hormonal therapies. The non-ablative erbium:YAG laser and the fractional microablative CO2 vaginal laser are the two main lasers evaluated for GSM treatment. The aim of this comprehensive review is to report the efficacy and safety of Er:YAG and CO2 vaginal lasers for GSM treatment. Vaginal laser therapy has been demonstrated to be effective in restoring vaginal health, improving VVA symptoms and sexual function. The data suggest that both Er:YAG and CO2 vaginal lasers are safe energy-based therapeutic options for management of VVA and/or GSM symptoms in postmenopausal women and BC survivors.
Collapse
Affiliation(s)
- S Salvatore
- Obstetrics and Gynaecology Department, IRRCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - A F Ruffolo
- Obstetrics and Gynaecology Department, IRRCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - C Phillips
- Department of Obstetrics and Gynecology, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK
| | - S Athanasiou
- First Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens, 'Alexandra' General Hospital, Athens, Greece
| | - L Cardozo
- Department of Urogynaecology, King's College Hospital, London, UK
| | - M Serati
- Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, Varese, Italy
| |
Collapse
|
2
|
Barrow K, McGreal A, LiVecche D, Van Cleve S, Sikes C, Buoli M, Serati M, Bridges CC, Ezeamama A, Barkin JL. Are Pediatric Providers On-Board With Current Recommendations Related to Maternal Mental Health Screening at Well-Child Visits in the State of Georgia? J Am Psychiatr Nurses Assoc 2022; 28:444-454. [PMID: 33174469 DOI: 10.1177/1078390320971358] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND The American Academy of Pediatrics (AAP) recommends that pediatric providers screen mothers for postpartum depression at the 1-, 2-, 4-, and 6-month well-child visits. However, compliance with this recommendation varies greatly and is far from 100%. This is significant, as perinatal mood and anxiety disorders (PMADs) represent the most common complication of childbearing. AIMS This investigation was conducted to explore barriers to screening in the pediatric setting, reported advantages of screening, providers' knowledge of mental health supports in the community, and commonly observed (and explicitly stated) mental health issues in new mothers. All data collection took place in the state of Georgia, which has the worst rates of maternal mortality and morbidity in the United States. METHODS A convenience sample of five pediatric practices was selected through the Mercer University School of Medicine's community preceptor network. All clinical staff at each site participated in one of five focus groups for a total of 31 participants. The conversations were audio-taped, transcribed, and thematically analyzed. RESULTS Providers from two practices were formally screening for Postpartum Depression; they indicated that it added value to their practice. Those not screening cited several barriers including lack of time, training, and access to the mother's medical records. Several clinicians asserted that they were not trained to address mental health issues in their pediatric patients' mothers and that it was out of their realm of expertise. CONCLUSIONS Provider compliance with the current AAP recommendations may increase with mandatory, specialized training in recognizing and treating PMADs.
Collapse
Affiliation(s)
- Kaitlyn Barrow
- Kaitlyn Barrow, BS, Mercer University School of Medicine, Macon, GA, USA
| | - Analise McGreal
- Analise McGreal, BS, Mercer University School of Medicine, Macon, GA, USA
| | - Dillon LiVecche
- Dillon LiVecche, BS, Mercer University School of Medicine, Macon, GA, USA
| | - Susan Van Cleve
- Susan Van Cleve, DNP, RN, University of Iowa, Iowa City, IA, USA
| | - Chris Sikes
- Chris Sikes, RN, BSN, Georgia Department of Public Health, North Central Health District, Macon, GA, USA
| | - Massimiliano Buoli
- Massimiliano Buoli, MD, Department of Psychiatry, University of Milan, Milan, Italy
| | - Marta Serati
- Marta Serati, MD, Department of Mental Health, ASST Rhodense, Rho, Milan, Italy
| | - Christy C Bridges
- Christy C. Bridges, PhD, Mercer University School of Medicine, Macon, GA, USA
| | - Amara Ezeamama
- Amara Ezeamama, PhD, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Jennifer L Barkin
- Jennifer L. Barkin, PhD, Mercer University School of Medicine, Macon, GA, USA
| |
Collapse
|
3
|
Mancini V, Martino L, d’Altilia N, Annese P, Illiano E, Costantini E, Serati M, Li Marzi V, Greco P, Gubbiotti M, Giannantoni A, Balzarro M, Rubilotta E, Busetto G, Bettocchi C, Cormio L, Carrieri G. A multicenter italian study: the coexistent overactive-underactive bladder (COUB) syndrome. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01098-9] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
4
|
Ceresa A, Esposito CM, Surace T, Legnani F, Cirella L, Cetti D, Di Paolo M, Nosari G, Zanelli Quarantini F, Serati M, Ciappolino V, Caldiroli A, Capuzzi E, Buoli M. Gender differences in clinical and biochemical parameters of patients consecutively hospitalized for unipolar depression. Psychiatry Res 2022; 310:114476. [PMID: 35240393 DOI: 10.1016/j.psychres.2022.114476] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 10/18/2021] [Revised: 02/14/2022] [Accepted: 02/20/2022] [Indexed: 10/19/2022]
Abstract
Major Depressive Disorder (MDD) is a medical illness twice as common in women than in men lifetime. Purpose of this study is to identify gender differences in clinical and biochemical parameters in subjects affected by MDD to implement individualized treatment strategies. We recruited 234 patients (112 males and 122 females) consecutively hospitalized for MDD in Milan (Italy). Data were obtained through a screening of the clinical charts and blood analyses. Univariate analyses, binary logistic regressions and a final logistic regression model were performed. The final logistic regression model showed that female patients (compared to males) had lower plasmatic levels of hemoglobin (p = 0.020) and uric acid (p = 0.002), higher levels of cholesterol (p < 0.001), had been treated with a lower number of antidepressants (p = 0.011), presented lower red blood cells (p < 0.001) and showed more frequently comorbidity with hypothyroidism (p = 0.036). Univariate analyses identified also that women had an earlier age at onset (p = 0.043), were less likely to have comorbidity with diabetes (p = 0.002) and were less frequently treated with a psychiatric polytherapy (p < 0.001). Finally, female patients had achieved more frequently remission in the last depressive episode (p = 0.001) and were more likely to have family history for psychiatric disorders (p < 0.001) than males. Female patients globally have a better response to treatments, but they seem to be more vulnerable to specific metabolic abnormalities as showed by more frequent hypercholesterolemia and lower plasma levels of uric acid. These results have to be confirmed by further studies.
Collapse
Affiliation(s)
- Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Cecilia Maria Esposito
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Teresa Surace
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Via Santa Sofia 78, Catania 95123, Italy
| | - Francesca Legnani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Luisa Cirella
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy
| | - Denise Cetti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy
| | - Martina Di Paolo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy
| | - Francesco Zanelli Quarantini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy
| | - Marta Serati
- Department of Mental Health, ASST RHODENSE, Rho, Italy
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| |
Collapse
|
5
|
Gubbiotti M, Giannantoni A, Rubilotta E, Balzarro M, Rosadi S, Serati M. Development and validation of the international female coital incontinence questionnaire (IFCI-Q). EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00844-2] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
6
|
Gubbiotti M, Giannantoni A, Rubilotta E, Balzarro M, Rosadi S, Serati M. Development and validation of the international female coital incontinence questionnaire (IFCI-Q). Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00485-1] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
7
|
Serati M, Grassi S, Redaelli M, Pergoli L, Cantone L, La Vecchia A, Barkin JL, Colombo E, Tiso G, Abbiati C, Bollati V, Buoli M. Is There an Association Between Oxytocin Levels in Plasma and Pregnant Women's Mental Health? J Am Psychiatr Nurses Assoc 2021; 27:222-230. [PMID: 31782341 DOI: 10.1177/1078390319890400] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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] [Indexed: 01/02/2023]
Abstract
BACKGROUND: Mood and anxiety disorders are prevalent in women during peripartum. AIMS: Purpose of the present article was to study the relationship between oxytocin (OT) plasma levels and affective symptoms in women during the third trimester of pregnancy. METHODS: Thirty-four pregnant women (13 with an affective disorder, 9 with preeclampsia, and 12 controls) were evaluated through the Edinburgh Postnatal Depression Scale (EPDS), the State/Trait Anxiety Inventory Form Y (STAI-Y), and the Prenatal Attachment Inventory (PAI). A blood sample was collected from all participants, and OT plasma levels have been compared between diagnostic groups. The total sample has been divided into two groups, according to OT median plasma levels, and compared using (a) χ2 tests for qualitative variables and (b) a multivariate analysis of covariance for quantitative ones. RESULTS: No statistically significant difference was found among the diagnostic groups in terms of OT plasma levels (F = 0.49, p = .62). Women with lower OT plasma levels, independent from the presence of preeclampsia or an affective disorder, showed worse EPDS and STAI-S total scores than individuals with higher hormone levels (F = 5.93, p = .02 and F = 7.57, p = .01, respectively). CONCLUSIONS: OT may play a role in the etiology of anxious/depressive symptoms during perinatal period independent from a medical or psychiatric diagnosis. This result has a clear effect on the quality of the relationship of patients with mental health professionals, including nurses, and higher levels of this hormone, in the light of its anxiolytic and antidepressive effect, may make easier medical and nursing procedures.
Collapse
Affiliation(s)
- Marta Serati
- Marta Serati, MD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Grassi
- Silvia Grassi, MD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Redaelli
- Marta Redaelli, PsyD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Pergoli
- Laura Pergoli, ScD, University of Milan, Milan, Italy
| | - Laura Cantone
- Laura Cantone, ScD, University of Milan, Milan, Italy
| | - Adriano La Vecchia
- Adriano La Vecchia, MD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Jennifer L Barkin
- Jennifer L. Barkin, PhD, Mercer University School of Medicine, Macon, GA, USA
| | - Elisa Colombo
- Elisa Maria Colombo, MD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia Tiso
- Giulia Tiso, MD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cristina Abbiati
- Cristina Abbiati, PMHCNS, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Massimiliano Buoli
- Massimiliano Buoli, MD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
8
|
Iodice S, Ceresa A, Esposito CM, Mucci F, Conti DM, Pergoli L, Tarantini L, Vigna L, Bollati V, Buoli M, Serati M. The Independent Role of Body Mass Index (BMI) and Severity of Depressive Symptoms on Biological Changes of Women Affected by Overweight/Obesity. Int J Environ Res Public Health 2021; 18:ijerph18062923. [PMID: 33809270 PMCID: PMC8001334 DOI: 10.3390/ijerph18062923] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 02/07/2023]
Abstract
Background: Both obesity and depression are medical conditions associated with severe disability and biological abnormalities. Our aim was to study associations between Body Mass Index (BMI), depression and biological changes in women affected by overweight or obesity. Methods: Depressive symptoms were evaluated by the Beck Depression Inventory II (BDI-II) questionnaire in 200 women affected by overweight/obesity (mean age of the sample 52.7 ± 12.9 years, BMI 33.8 ± 5.5 kg/m2). A blood sample was obtained for evaluation of biochemical (oxytocin and vitamin D), inflammatory and epigenetic (methylation of clock genes) parameters. Multivariable linear regression models were used to study the association between BMI or severity of depressive symptoms (BDI-II scores) with different biomarkers. Results: BMI was found to be associated with severity of depressive symptoms (p = 0.050). Severity of obesity resulted to be associated with lower plasma levels of oxytocin (p = 0.053), vitamin D deficiency (p = 0.006) and higher plasma levels of IFN-γ (p = 0.004), IL-6 (p = 0.013), IL-7 (p = 0.013), TNF-alpha (p = 0.036) and chemokine ligand 3 (CCL3) (p = 0.013, R2 = 0.03). Severity of depression was significantly associated with more methylation of clock genes CRY1 (p = 0.034, R2 = 0.16) and CRY2 (p = 0.019, R2 = 0.47). More severe depression together with higher levels of IL-8 strongly predicted lower methylation of CLOCK gene (p = 0.009); Conclusions: Different biological abnormalities have been found to be independently associated with BMI and severity of depressive symptoms in women affected by overweight/obesity. The complex interplay between overweight, depression and biological changes will have to be better clarified by future studies.
Collapse
Affiliation(s)
- Simona Iodice
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy; (S.I.); (L.P.); (L.T.); (V.B.)
| | - Alessandro Ceresa
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (C.M.E.); (F.M.); (M.B.)
- Correspondence: ; Tel.: +39-02-55035983
| | - Cecilia Maria Esposito
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (C.M.E.); (F.M.); (M.B.)
| | - Francesco Mucci
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (C.M.E.); (F.M.); (M.B.)
| | - Diana Misaela Conti
- Occupational Health Unit, Center of Obesity and Work EASO Collaborating Centers for Obesity Management, Fondazione Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.M.C.); (L.V.)
| | - Laura Pergoli
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy; (S.I.); (L.P.); (L.T.); (V.B.)
| | - Letizia Tarantini
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy; (S.I.); (L.P.); (L.T.); (V.B.)
| | - Luisella Vigna
- Occupational Health Unit, Center of Obesity and Work EASO Collaborating Centers for Obesity Management, Fondazione Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.M.C.); (L.V.)
| | - Valentina Bollati
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy; (S.I.); (L.P.); (L.T.); (V.B.)
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (C.M.E.); (F.M.); (M.B.)
- Department of Neurosciences and Mental Health, Fondazione IRCSS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
| | - Marta Serati
- Department of Mental Health, ASST Rhodense, 20024 Rho, Italy;
| | | |
Collapse
|
9
|
Barkin JL, Bloch JR, Smith KER, Telliard SN, McGreal A, Sikes C, Ezeamama A, Buoli M, Serati M, Bridges CC. Knowledge of and Attitudes Toward Perinatal Home Visiting in Women with High-Risk Pregnancies. J Midwifery Womens Health 2021; 66:227-232. [PMID: 33522692 DOI: 10.1111/jmwh.13204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/11/2020] [Revised: 09/22/2020] [Accepted: 09/28/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Published research indicates that some perinatal home visiting programs are highly effective. However, there is a dearth of information regarding how these services apply to women experiencing a high-risk pregnancy. The aim of this study was to determine the potential acceptability of home visiting services within this vulnerable population and identify what services women want. METHODS Four focus groups (N = 32) were conducted with a population of low-income, pregnant individuals in medically underserved central Georgia (United States). Participants were evaluated based on their current exposure to home visiting, receptiveness to home visiting, and reasons for apprehension regarding home visiting. RESULTS The results of this study were mixed, with women expressing both interest in and reluctance about home visiting programs. Themes of distrust and fear of judgment or persecution existed. Women also varied with regard to what home visiting services they would like offered. Those discussed included assistance with maternal or infant medical needs, maternal function tasks, household tasks, and child care. DISCUSSION Home visiting programs can be effective for improving maternal and child health outcomes. However, not all home visiting programs effectively reach their target population. More research is needed to determine what women who have high-risk conditions during pregnancy want help with and how to increase receptiveness. The results of this study could be informative to health care providers who treat persons with high-risk conditions in identifying adjunctive services for those in need of additional support.
Collapse
Affiliation(s)
- Jennifer L Barkin
- Department of Community Medicine and Obstetrics and Gynecology, School of Medicine, Mercer University, Macon, Georgia
| | - Joan Rosen Bloch
- Department of Doctoral Nursing, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania
| | | | - Sarah N Telliard
- Department of Dermatology, Geisinger Health System, Danville, Pennsylvania
| | - Analise McGreal
- Mercer University School of Medicine, Mercer University, Macon, Georgia
| | - Chris Sikes
- Georgia Department of Public Health, Houston County Health Department, Warner Robins, Georgia
| | - Amare Ezeamama
- Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan
| | - Massimiliano Buoli
- Department of Psychiatry, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Marta Serati
- Department of Psychiatry, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Christy C Bridges
- Department of Biomedical Sciences, School of Medicine, Mercer University, Macon, Georgia
| |
Collapse
|
10
|
Iodice S, Di Paolo M, Barkin JL, Tarantini L, Grassi S, Redaelli M, Serati M, Favalli V, Cirella L, Bollati V, Buoli M. The Methylation of Clock Genes in Perinatal Depression: Which Role for Oxytocin? Front Psychiatry 2021; 12:734825. [PMID: 34650456 PMCID: PMC8505798 DOI: 10.3389/fpsyt.2021.734825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/31/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Perinatal Depression (PD) is a widespread disabling condition that is hypothesized to be associated with abnormalities in circadian rhythms and neuropeptide release including oxytocin (OXT). Methods: Fourty-four pregnant women (28 with PD, and 16 controls) were evaluated through the Edinburgh Postnatal Depression Scale (EPDS), the State/Trait Anxiety Inventory Form Y (STAI-Y), and the Prenatal Attachment Inventory (PAI). A blood sample was collected from all participants, and OXT plasma levels, DNA methylation of clock genes, as well as of FOXp3 and HERV-W were measured. Linear regression analyses were performed to assess the effect of oxytocin on the methylation of selected genes. Continuous ordinal regression models was further applied to see if the score of rating scales was associated to gene methylation, adjusting for oxytocin-methylation interaction. Results: OXT plasma levels were positively associated with CRY1 methylation. Women with higher OXT plasma levels showed an association between higher degree of CRY2 methylation (thus, reduced expression) and lower EPDS (OR = 0.21; P = 0.043) and STAI-S scores (OR = 6.96; P = 0.019). Finally, with high OXT levels, hypermethylation of CRY1 was associated to higher scores on the PAI (OR = 2.74; P = 0.029) while higher methylation of HERV-W related to lower PAI scores (OR = 0.273; P = 0.019). Conclusion: Our results suggest a possible protective role played by oxytocin in the development of PD by promoting a favorable methylation profile characterized by reduced expression of CRY1 and CRY2. Moreover, oxytocin strengthens the association between maternal prenatal attachment with a favorable pattern of methylation of clock genes and HERV-W, which is essential for pregnancy outcomes.
Collapse
Affiliation(s)
- Simona Iodice
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Martina Di Paolo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Jennifer Lynn Barkin
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA, United States
| | - Letizia Tarantini
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Silvia Grassi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Redaelli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Serati
- Department of Mental Health, ASST Rhodense, Rho, Italy
| | - Virginia Favalli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luisa Cirella
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Valentina Bollati
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| |
Collapse
|
11
|
Barkin JL, Beals L, Bridges CC, Ezeamama A, Serati M, Buoli M, Erickson A, Chapman M, Bloch JR. Maternal Functioning and Depression Scores Improve Significantly With Participation in Visiting Moms® Program. J Am Psychiatr Nurses Assoc 2021; 27:54-63. [PMID: 31561726 DOI: 10.1177/1078390319877444] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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] [Indexed: 01/25/2023]
Abstract
BACKGROUND: Postpartum depression is the most common complication of childbearing can affect the entire family unit. Health professionals must strive to identify and develop effective, feasible solutions for women during this critical period. AIMS: To determine whether postpartum maternal functioning (as measured by the Barkin Index of Maternal Functioning) and depression symptoms (as measured by the Patient Health Questionnaire-9) were improved after participation in the Visiting Moms program. METHOD: Paired data were collected from women at program intake and after completion of the Visiting Moms program. Visiting Moms provides services through eastern and central Massachusetts and was designed to support new mothers throughout the infant's first year of life. The study population was composed of adult women living in the Jewish Family and Children's Services geographic catchment area, who enrolled in Visiting Moms between January 1, 2013, and December 31, 2015. Descriptive statistics were calculated for all 402 women enrolled in this timeframe. Utilizing a pretest/posttest design, paired t tests were performed for the Barkin Index of Maternal Functioning (n = 149) and for the Patient Health Questionnaire-9 (n = 156), where women had complete scores at both intake and completion, to determine the program's potential impact on depressive symptoms and functional status. RESULTS: Functioning and depression scores were significantly improved after participation in the program. CONCLUSIONS: Visiting moms, and similar programs, aimed at delivery of enhanced social support, may be effective in promoting mental and emotional wellness among new mothers who are require additional support in the postpartum period.
Collapse
Affiliation(s)
| | - Laura Beals
- Laura Beals, PhD, Jewish Family & Children's Service, Waltham, MA, USA
| | | | - Amara Ezeamama
- Amara Ezeamama, PhD, Michigan State University, East Lansing, MI, USA
| | - Marta Serati
- Marta Serati, MD, ASST Rhodense, Rho, Milan, Italy
| | | | - Amber Erickson
- Amber Erickson, MPH, Georgia Department of Public Health, North Central Health District, Macon, GA, USA
| | - Megan Chapman
- Megan Chapman, BSN, RN, Georgia Department of Public Health, North Central Health District, Macon, GA, USA
| | | |
Collapse
|
12
|
Serati M, Esposito CM, Grassi S, Bollati V, Barkin JL, Buoli M. The Association between Plasma ERVWE1 Concentrations and Affective Symptoms during Pregnancy: Is This a Friendly Alien? Int J Environ Res Public Health 2020; 17:ijerph17249217. [PMID: 33317172 PMCID: PMC7763945 DOI: 10.3390/ijerph17249217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/02/2020] [Accepted: 12/08/2020] [Indexed: 12/24/2022]
Abstract
Human endogenous retroviruses (HERVs) comprise 8% of the human genome, and HERV DNA was reported to be essential in human embryonic development. Specifically, HERV-W encodes a protein, syncytin-1, alternatively known as ERVWE1 (Human Endogenous Retrovirus W EnvC7-1 Envelope Protein), participating in human placental morphogenesis and having a role in immune system regulation. Syncytin-1 activity is increased in neuropsychiatric disorders, autoimmune diseases, and cancer. In our study, forty-four women in the third trimester of pregnancy were tested for ERVWE1 plasma levels. In concomitance with blood samples the following rating scales were administered to women: the Edinburgh Postnatal Depression Scale (EPDS), State Anxiety Inventory (STAI-S), Trait Anxiety Inventory (STAI-T), and Prenatal Attachment Inventory (PAI). We found that higher ERVWE1 protein plasma levels were significantly associated with higher PAI scores (p = 0.02), an earlier gestational age at the time of blood collection (p = 0.01), a longer duration of symptoms (p = 0.03), and fewer lifetime attempted suicides (p = 0.02). Our results seem to support the role of ERVWE1 in maintaining clinical psychiatric symptoms as a result of potential prolonged inflammation. At the same time, this protein may have a protective role in pregnant women by a reduction of suicidal behavior and a better mother-fetus relationship.
Collapse
Affiliation(s)
- Marta Serati
- Department of Mental Health, ASST RHODENSE, 20024 Rho, Italy;
| | - Cecilia Maria Esposito
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (C.M.E.); (S.G.)
| | - Silvia Grassi
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (C.M.E.); (S.G.)
| | - Valentina Bollati
- EPIGET-Epidemiology, Epigenetics and Toxicology Lab-Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy;
| | - Jennifer Lynn Barkin
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA 31207, USA;
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (C.M.E.); (S.G.)
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-02-55035983; Fax: +39-02-55033140
| |
Collapse
|
13
|
Tabano S, Caldiroli A, Terrasi A, Colapietro P, Grassi S, Carnevali GS, Fontana L, Serati M, Vaira V, Altamura AC, Miozzo M, Buoli M. A miRNome analysis of drug-free manic psychotic bipolar patients versus healthy controls. Eur Arch Psychiatry Clin Neurosci 2020; 270:893-900. [PMID: 31422452 DOI: 10.1007/s00406-019-01057-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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] [Received: 02/11/2019] [Accepted: 08/07/2019] [Indexed: 12/11/2022]
Abstract
The lifetime presence of psychotic symptoms is associated with more clinical severity, poorer outcome and biological changes in patients affected by bipolar disorder (BD). Epigenetic mechanisms have been evoked to explain the onset of psychotic symptoms in BD as well as the associated biological changes. The main objective of the present study was to evaluate the expression profiles of circulating microRNAs (miRNAs) in drug-free manic psychotic bipolar patients versus healthy controls (HC), to identify possible non-invasive molecular markers of the disorder. 15 drug-free manic psychotic bipolar patients and 9 HC were enrolled and 800 miRNAs expression profile was measured by Nanostring nCounter technology on plasma samples and validated through qPCR. Overall, twelve miRNAs showed a significantly altered expression between the two groups (p < 0.05). Functional annotation of predicted miRNAs targets by MultiMIR R tool showed repression in bipolar patients of genes with a role in neurodevelopment and neurogenesis, and upregulation of genes involved in metabolism regulation. We identified a signature of circulating miRNA characteristic of manic psychotic bipolar patients, suggesting a possible role in neurodevelopment and metabolic processes regulation.
Collapse
Affiliation(s)
- Silvia Tabano
- Department of Pathophysiology and Transplantation, Medical Genetics, Università degli Studi di Milano, Milan, Italy
| | - Alice Caldiroli
- Department of Psychiatry, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Via F. Sforza 35, 20122, Milan, Italy.
| | - Andrea Terrasi
- Department of Pathophysiology and Transplantation, Medical Genetics, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Università degli Studi di Milano, Milan, Italy
| | - Patrizia Colapietro
- Department of Pathophysiology and Transplantation, Medical Genetics, Università degli Studi di Milano, Milan, Italy
| | - Silvia Grassi
- Department of Psychiatry, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Via F. Sforza 35, 20122, Milan, Italy
| | - Greta Silvia Carnevali
- Department of Psychiatry, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Via F. Sforza 35, 20122, Milan, Italy
| | - Laura Fontana
- Department of Pathophysiology and Transplantation, Medical Genetics, Università degli Studi di Milano, Milan, Italy
| | - Marta Serati
- Department of Psychiatry, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Via F. Sforza 35, 20122, Milan, Italy
| | - Valentina Vaira
- Department of Pathophysiology and Transplantation, Medical Genetics, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Università degli Studi di Milano, Milan, Italy
| | - A Carlo Altamura
- Department of Psychiatry, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Via F. Sforza 35, 20122, Milan, Italy
| | - Monica Miozzo
- Department of Pathophysiology and Transplantation, Medical Genetics, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Università degli Studi di Milano, Milan, Italy
| | - Massimiliano Buoli
- Department of Psychiatry, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Via F. Sforza 35, 20122, Milan, Italy
| |
Collapse
|
14
|
Serati M, Bertino V, Malerba MR, Mucci F, Barkin JL, Grassi S, Altamura AC, Buoli M. Obstetric complications and subsequent risk of mood disorders for offspring in adulthood: a comprehensive overview. Nord J Psychiatry 2020; 74:470-478. [PMID: 32297541 DOI: 10.1080/08039488.2020.1751878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/11/2018] [Revised: 02/25/2020] [Accepted: 04/01/2020] [Indexed: 01/21/2023]
Abstract
Background: A number of studies reported obstetric complications (OCs) to be a risk factor for the development of psychiatric conditions in the adulthood, including mood disorders.Aim: The aim of this study was to review the literature about the link between OCs during the perinatal period (items of Lewis-Murray scale) and the future risk of developing a mood disorder in adulthood, such as the major depressive disorder (MDD) or the bipolar disorder (BD).Methods: A research in the main database sources has been conducted to obtain an overview of the association mentioned above.Results: Few studies have investigated the role of OCs in the development of mood disorders in adulthood. The most robust evidence is that low birth weight (LBW) and preterm birth may be risk factors for the development of MDD in the future, even if some of the available data come from studies with small sample sizes or a retrospective design.Conclusion: OCs may confer a risk of developing mood disorders in adulthood. Future research should confirm these preliminary findings and clarify if other obstetric or neonatal complications (e.g. cyanosis or newborn epileptic seizures) may have a role in the future onset of mood disorders.
Collapse
Affiliation(s)
- Marta Serati
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Vincenzo Bertino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Rosaria Malerba
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Mucci
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Jennifer L Barkin
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA, USA
| | - Silvia Grassi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A Carlo Altamura
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| |
Collapse
|
15
|
Regusci L, Fasolini F, Meinero P, Caccia G, Ruggeri G, Serati M, Braga A. Video-Assisted Anal Fistula Treatment (VAAFT) for complex anorectal fistula: efficacy and risk factors for failure at 3-year follow-up. Tech Coloproctol 2020; 24:741-746. [PMID: 32318991 DOI: 10.1007/s10151-020-02213-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 01/21/2020] [Accepted: 04/07/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The aim of this study was to assess the 3-year objective and subjective outcomes of patients with complex anorectal fistula treated with Video-Assisted Anal Fistula Treatment (VAAFT). Furthermore, we evaluated the risk factors associated with recurrence. METHODS All consecutive patients with complex anorectal fistula who underwent VAAFT in Beata Vergine Hospital of Mendrisio, Switzerland, from January 2013 to January 2016, were enrolled. Patients with suspicion or diagnosis of Crohn's disease, malignancy, previous history of radiotherapy or radical pelvic surgery were excluded. Preoperative clinical assessment based upon medical history, physical examination and endosonography, was performed in all patients. Data regarding subjective outcomes (the Patient Global Impression of Improvement, patient satisfaction scores and Wexner score), objective cure rate (absence of fistula at clinical examination), and adverse events were collected during follow-up. Uni and multivariate analysis were performed to investigate outcomes. RESULTS One hundred and four patients had VAAFT. At 3-year follow-up, 96 patients (92.3%) were available for the evaluation. At 3 years after surgery, 81 of 96 patients (84.4%) declared themselves cured (p = 0.60). Similarly, at 3-year evaluation, 80 of 96 patients (83.3%) were objectively cured (p = 0.52). No serious intraoperative or postoperative complications were reported. All recurrences were treated with a repeat VAAFT procedure resulting in a complete healing. Uni and multivariate analysis of variables potentially involved in the failure of VAAFT showed that age ≥ 50 years was the only factor associated at risk of recurrence. CONCLUSIONS VAAFT is a highly effective safe procedure for the treatment of anorectal fistula, with a low recurrence rate at 3-year follow-up. However, our study demonstrated that age ≥ 50 years is a risk factor for failure of VAAFT.
Collapse
Affiliation(s)
- L Regusci
- Department of General Surgery, EOC-Beata Vergine Hospital, Mendrisio, Switzerland
| | - F Fasolini
- Department of General Surgery, EOC-Beata Vergine Hospital, Mendrisio, Switzerland
| | - P Meinero
- Department of General Surgery, EOC-Beata Vergine Hospital, Mendrisio, Switzerland
| | - G Caccia
- Department of Obstetrics and Gynecology, EOC-Beata Vergine Hospital, Via Turconi 23 CP 1652, 6850, Mendrisio, Switzerland
| | - G Ruggeri
- Department of Obstetrics and Gynecology, EOC-Beata Vergine Hospital, Via Turconi 23 CP 1652, 6850, Mendrisio, Switzerland
| | - M Serati
- Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, Varese, Italy
| | - A Braga
- Department of Obstetrics and Gynecology, EOC-Beata Vergine Hospital, Via Turconi 23 CP 1652, 6850, Mendrisio, Switzerland.
| |
Collapse
|
16
|
Serati M, Delvecchio G, Orsenigo G, Mandolini GM, Lazzaretti M, Scola E, Triulzi F, Brambilla P. Corrigendum to “The Role of the Subplate in Schizophrenia and Autism: A Systematic Review” [Neuroscience 408C (2019) 58–67]. Neuroscience 2020; 426:87. [DOI: 10.1016/j.neuroscience.2019.11.040] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
17
|
Guenzani D, Buoli M, Caldiroli L, Carnevali GS, Serati M, Vezza C, Armelloni S, Messa P, Vettoretti S. Malnutrition and inflammation are associated with severity of depressive and cognitive symptoms of old patients affected by chronic kidney disease. J Psychosom Res 2019; 124:109783. [PMID: 31443824 DOI: 10.1016/j.jpsychores.2019.109783] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 01/09/2019] [Revised: 07/12/2019] [Accepted: 07/20/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Chronic kidney disease (CKD) is a disabling condition associated with different medical comorbidities including depression and cognitive impairment. We investigated the association between malnutrition, inflammation and depressive/cognitive symptoms in elderly subjects with advanced CKD. METHODS We evaluated cross-sectionally 132 elderly subjects (age ≥65 years) with advanced CKD (stage 4-5, non-dialytic-ND) in regular follow up at the outpatient clinic of nephrology. Blood and urinary samples were collected after an overnight fast. All patients were evaluated by Geriatric Depression Scale (GDS)-30 items for severity of depressive symptoms, Mini Mental State Examination (MMSE) and the Clock Drawing Test (CDT) for cognition. Nutritional status was assessed by Malnutrition Inflammation Score (MIS). Different linear regression models were performed to study the association between clinical variables, diet and inflammatory parameters with the above mentioned rating scale scores. A final linear regression model with only previous statistically significant variables was performed for GDS scores. RESULTS Our cohort consisted of 95 males and 37 females with a mean age of 78 ± 7. Female gender (B = 3.20, p < .01), higher MIS (B = 0.29, p = .02) and higher IL-12p70 serum levels (pg/mL) (B = 0.37, p = .03) were associated with severity of depressive symptoms. MIS was associated with the severity of cognitive impairment as assessed by MMSE (B = -0.19, p < .01) and CDT (B = 0.10, p = .03). CONCLUSION In elderly subjects affected by CKD the severity of depressive symptoms and cognitive impairment is associated with specific inflammatory and nutritional parameters. These results have to be considered as preliminary and need replication by further studies.
Collapse
Affiliation(s)
- Dalila Guenzani
- Department of Psychiatry, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Massimiliano Buoli
- Department of Psychiatry, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy; University of Milan, Milan, Italy.
| | - Lara Caldiroli
- Unit of Nephrology Dialysis and Renal Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Greta Silvia Carnevali
- Department of Psychiatry, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Marta Serati
- Department of Psychiatry, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Carlotta Vezza
- University of Milan, Milan, Italy; Unit of Gerontology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Armelloni
- Unit of Nephrology Dialysis and Renal Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Piergiorgio Messa
- Unit of Nephrology Dialysis and Renal Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; University of Milan, Milan, Italy
| | - Simone Vettoretti
- Unit of Nephrology Dialysis and Renal Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | |
Collapse
|
18
|
Serati M, Delvecchio G, Orsenigo G, Mandolini GM, Lazzaretti M, Scola E, Triulzi F, Brambilla P. The Role of the Subplate in Schizophrenia and Autism: A Systematic Review. Neuroscience 2019; 408:58-67. [PMID: 30930130 DOI: 10.1016/j.neuroscience.2019.03.049] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 08/21/2018] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 02/07/2023]
Abstract
The subplate (SP) represents a transitory cytoarchitectural fetal compartment containing most subcortical and cortico-cortical afferents, and has a fundamental role in the structural development of the healthy adult brain. There is evidence that schizophrenia and autism may be determined by developmental defects in the cortex or cortical circuitry during the earliest stages of pregnancy. This article provides an overview on fetal SP development, considering its role in schizophrenia and autism, as supported by a systematic review of the main databases. The SP has been described as a cortical amplifier with a role in the coordination of cortical activity, and sensitive growth and migration windows have crucial consequences with respect to cognitive functioning. Although there are not enough studies to draw final conclusions, improved knowledge of the SP's role in schizophrenia and autism spectrum disorders may help to elucidate and possibly prevent the onset of these two severe disorders.
Collapse
Affiliation(s)
- Marta Serati
- Department of Mental Health, ASST Rhodense, Rho, Milan, Italy.
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giulia Orsenigo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Gian Mario Mandolini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Matteo Lazzaretti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Elisa Scola
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Triulzi
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, TX, USA
| |
Collapse
|
19
|
Barkin JL, Stausmire JM, Te MN, Pazik-Huckaby A, Serati M, Buoli M, Harding RS, Bruss CA, Stausmire KL. Evaluation of Maternal Functioning in Mothers of Infants Admitted to the Neonatal Intensive Care Unit. J Womens Health (Larchmt) 2019; 28:941-950. [PMID: 30681387 DOI: 10.1089/jwh.2018.7168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: Factors associated with maternal functioning in biological mothers whose infants were admitted to a Neonatal Intensive Care Unit (NICU) were identified as measured by a modified version of the Barkin Index of Maternal Functioning. Materials and Methods: This multivariable regression analysis explored sociodemographic and clinical data from 146 mother-infant dyads admitted to a Level III NICU between February 2015 and May 2016. Eligible dyads included: (1) adult biological mothers with singleton infants discharged home alive after NICU admission meeting criteria and (2) infants discharged home alive from the NICU with adult, biological mothers after a minimum 6-day admission. Results: Lower scores on the Edinburgh Postnatal Depression Scale (p < 0.0001), and an infant admission diagnosis of hypoglycemia (p = 0.0295) were significantly associated with higher levels of maternal functioning. Conclusions: The significant association between maternal functioning and depressive symptom score is corroborated by the literature. Results relative to a diagnosis of infant hypoglycemia and higher levels of maternal functioning are intriguing, considering current literature linking increased postpartum depression to gestational diabetes. The severity of other possible admission diagnoses may provide a partial explanation. We believe this is the first study suggesting a potential role between infant admission diagnosis and the level of maternal functioning.
Collapse
Affiliation(s)
- Jennifer L Barkin
- 1Department of Community Medicine, Mercer University School of Medicine, Macon, Georgia
| | - Julie M Stausmire
- 2Regional Academic Affairs, Mercy Health St. Vincent Medical Center, Toledo, Ohio
| | - Minda N Te
- 3Pediatrics/Neonatal Intensive Care Unit, Mercy Children's Hospital, Toledo, Ohio
| | - Alicia Pazik-Huckaby
- 4Obstetrics & Gynecology Residency Program, Mercy Health St. Vincent Medical Center, Toledo, Ohio
| | - Marta Serati
- 5Fondazione IRCCS Ca'Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Roberta S Harding
- 7Neonatal Intensive Care Unit, Mercy Children's Hospital, Toledo, Ohio
| | - Cynthia A Bruss
- 7Neonatal Intensive Care Unit, Mercy Children's Hospital, Toledo, Ohio
| | | |
Collapse
|
20
|
Serati M, Delvecchio G, Orsenigo G, Perlini C, Barillari M, Ruggeri M, Altamura AC, Bellani M, Brambilla P. Potential Gender-Related Aging Processes Occur Earlier and Faster in the Vermis of Patients with Bipolar Disorder: An MRI Study. Neuropsychobiology 2018; 75:32-38. [PMID: 28803247 DOI: 10.1159/000477967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 02/07/2017] [Accepted: 05/29/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND In the last decades, there has been increasing interest in investigating the role of the vermis in bipolar disorder (BD), especially because of its involvement in cognitive processes. The main aims of this study were to explore the integrity of the vermis and elucidate the role of demographic and clinical variables on vermis volumes in BD patients, stratified according to gender. METHODS T1-weighted images were obtained for 38 BD patients and 38 healthy controls using a 1.5-T MRI scanner. Images were analyzed with a PC workstation with BRAINS2 software on a Linux system. Anatomical regions were traced manually from a blinded operator, with respect to subject identity and other clinical variables. RESULTS The direct comparison between the 2 groups showed no significant gray matter differences in vermis volumes. Interestingly, vermis volumes were significantly inversely associated with chronological age and age of BD onset, particularly in male subjects. CONCLUSIONS Our study provides evidence of the impact of aging on the vermis in BD, potentially related to earlier and faster gender-related neurodegenerative phenomena occurring during the progression of the disease.
Collapse
Affiliation(s)
- Marta Serati
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Caldiroli A, Serati M, Orsenigo G, Caletti E, Buoli M. Age at Onset and Social Cognitive Impairment in Clinically Stabilized Patients with Schizophrenia: An Ecological Cross-Sectional Study. Iran J Psychiatry 2018; 13:84-93. [PMID: 29997653 PMCID: PMC6037576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Purposes of the present study were to assess the social cognitive impairment in schizophrenia and to detect if some clinical variables (particularly age at onset) are predictive of general/social cognitive deficit in schizophrenia patients. Method: Thirty-five clinically stabilized schizophrenia outpatients were assessed by the Brief Assessment of Cognition in Schizophrenia (BACS) and by Torralva's social cognition battery. Binary logistic models were performed to find an eventual association between continuous clinical variables and cognitive test failures. The total sample was divided in groups according to dichotomous variables (gender, diagnostic subtypes and type of abuse) and the presence of cognitive deficits was compared between groups by χ2 tests. Results: An earlier age at onset was found to be predictive of frontal cognitive impairment (Tower of London p=0.038, OR=0.702). Female gender was more probably associated with mistakes at MET-HV (χ2= 4.80, p=0.05, phi=0.40) and HOTEL tests (χ2= 5.25, p=0.04, phi=0.4) than male one. Cannabis abusers showed more frequently deficits on verbal fluency (χ2= 9.35, p=0.04, phi=0.52) and executive functioning (Tower of London) (χ2= 11.67, p=0.02, phi=0.58) than alcohol/cocaine ones. Conclusion: Female patients with an early age at onset and cannabis abuse seem to have the worst general and social cognitive profile among patients suffering from schizophrenia.
Collapse
Affiliation(s)
| | | | | | | | - Massimiliano Buoli
- Corresponding Author: Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via F, Sforza 35, 20122, Milan, Italy. Tel.: +39-02-55035983, Fax: +39-02-55033190, E-mail:
| |
Collapse
|
22
|
Guenzani D, Buoli M, Carnevali GS, Serati M, Messa P, Vettoretti S. Is there an association between severity of illness and psychiatric symptoms in patients with chronic renal failure? PSYCHOL HEALTH MED 2018; 23:970-979. [DOI: 10.1080/13548506.2018.1426868] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- D. Guenzani
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M. Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G. S. Carnevali
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M. Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P. Messa
- Unit of Nephrology Dialysis and Renal Transplantation, Fondazione Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milano, Italy
| | - S. Vettoretti
- Unit of Nephrology Dialysis and Renal Transplantation, Fondazione Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milano, Italy
| |
Collapse
|
23
|
Buoli M, Serati M, Altamura AC. Biological aspects and candidate biomarkers for rapid-cycling in bipolar disorder: A systematic review. Psychiatry Res 2017; 258:565-575. [PMID: 28864122 DOI: 10.1016/j.psychres.2017.08.059] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 03/03/2017] [Revised: 07/24/2017] [Accepted: 08/23/2017] [Indexed: 01/23/2023]
Abstract
Rapid-cycling bipolar disorder represents a frequent severe subtype of illness which has been associated with poor response to pharmacological treatment. Aim of the present article is to provide an updated review of biological markers associated with rapid-cycling bipolar disorder. A research in the main database sources has been conducted to identify relevant papers about the topic. Rapid-cycling bipolar disorder patients seem to have a more frequent family history for bipolar spectrum disorders (d range: 0.44-0.74) as well as an increased susceptibility to DNA damage or mRNA hypo-transcription (d range: 0.78-1.67) than non rapid-cycling ones. A susceptibility to hypothyroidism, which is exacerbated by treatment with lithium, is possible in rapid-cycling bipolar disorder, but further studies are needed to draw definitive conclusions. Rapid-cycling bipolar patients might have more insuline resistance as well as more severe brain changes in frontal areas (d range: 0.82-0.94) than non rapid-cycling ones. Many questions are still open about this topic. The first is whether the rapid-cycling is inheritable or is more generally the manifestation of a severe form of bipolar disorder. The second is whether some endocrine dysfunctions (diabetes and hypothyroidism) predispose to rapid-cycling or rapid-cycling is the consequence of drug treatment or medical comorbidities (e.g. obesity).
Collapse
Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy.
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| |
Collapse
|
24
|
Serati M, Barkin JL, Orsenigo G, Altamura AC, Buoli M. Research Review: The role of obstetric and neonatal complications in childhood attention deficit and hyperactivity disorder - a systematic review. J Child Psychol Psychiatry 2017; 58:1290-1300. [PMID: 28714195 DOI: 10.1111/jcpp.12779] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [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: 05/22/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Attention deficit and hyperactivity disorder (ADHD) is a developmental disorder characterized by an inability to sustain attention, activity levels and impulse control, and, according to the latest studies, the prevalence is about 8% and in some countries less than 1%. Currently, it is well-known that complications during the perinatal period have significant implications on child's physical and mental health. Purpose of the present paper is to review the literature about the association between perinatal complications and future risk of an ADHD diagnosis. METHODS A research in the main database sources has been conducted to obtain a systematic review on the perinatal risk factors of ADHD. RESULTS Among perinatal complications, available data indicate low birth weight (LBW) (Cohen's d effect size range: 0.31-1.64-small effect size) and preterm birth (PB) (range d: 0.41-0.68) as the most important factors associated with a future diagnosis of ADHD. CONCLUSIONS PB and LBW children should be carefully monitored for an early diagnosis of ADHD limiting the impact of the disease in life span. A systematic review focusing on these risk factors have not been published until now, in the next future preventive strategies should be developed in order to minimize ADHD onset.
Collapse
Affiliation(s)
- Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Jennifer L Barkin
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA, USA
| | - Giulia Orsenigo
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alfredo Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
25
|
Buoli M, Esposito CM, Godio M, Caldiroli A, Serati M, Altamura AC. Have antipsychotics a different speed of action in the acute treatment of mania? A single-blind comparative study. J Psychopharmacol 2017; 31:1537-1543. [PMID: 28462607 DOI: 10.1177/0269881117705098] [Citation(s) in RCA: 10] [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] [Indexed: 12/30/2022]
Abstract
Available antipsychotics show different efficacy on manic symptoms of bipolar patients, but few studies have investigated the speed of action of the various compounds. For this reason, purpose of the present paper was to compare antipsychotic mono-therapies in terms of speed of action in a sample of manic bipolar patients. In total, 155 bipolar patients, treated with antipsychotic mono-therapy and followed-up in Inpatient Psychiatry Clinic of University of Milan, were included in this single-blind comparative study. Clinical response was defined as a reduction of Young Mania Rating Scale (YMRS) scores ⩾50%, while remission as a YMRS score <10. After 4 days patients who had been treated with asenapine, were more likely to have achieved a clinical response than those in treatment with haloperidol ( p = 0.001). After 7 days, a more frequent clinical response was achieved by patients treated with asenapine than those who had been treated with haloperidol ( p < 0.001) or olanzapine ( p = 0.047). Asenapine appears to be faster in determining treatment response in manic patients compared with haloperidol and less markedly with olanzapine.
Collapse
Affiliation(s)
- Massimiliano Buoli
- 1 Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cecilia Maria Esposito
- 1 Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Godio
- 2 Cantonal Psychiatric Clinic, Mendrisio, Switzerland
| | - Alice Caldiroli
- 1 Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Serati
- 1 Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A Carlo Altamura
- 1 Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
26
|
Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico , Milan, Italy
| | - Silvia Grassi
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico , Milan, Italy
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico , Milan, Italy
| | - A. Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico , Milan, Italy
| |
Collapse
|
27
|
Grassi S, Orsenigo G, Serati M, Caletti E, Altamura AC, Buoli M. Cognitive correlates of neuroimaging abnormalities in the onset of schizophrenia: A case report. World J Psychiatry 2017; 7:128-132. [PMID: 28713691 PMCID: PMC5491478 DOI: 10.5498/wjp.v7.i2.128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 04/23/2017] [Accepted: 05/15/2017] [Indexed: 02/05/2023] Open
Abstract
Increasing evidence shows that cognitive impairment and brain abnormalities can appear early in the first episodes of schizophrenia, but it is currently debated how brain changes can correlate with clinical presentation of schizophrenic patients. Of note, this report describes the case of a young schizophrenic male presenting parietal magnetic resonance/positron emission tomography abnormalities and cognitive impairment, documented by specific neuropsychological tests. In our knowledge only few studies have investigated if neuropsychological abnormalities could be concomitant with both structural and functional neuroimaging. This case shows that impairment in specific cognitive domains is associated with structural/functional brain abnormalities in the corresponding brain areas (frontal and parietal lobes), supporting the hypothesis of disconnectivity, involving a failure to integrate anatomical and functional pathways. Future research would define the role of cognitive impairment and neurodegeneration in psychiatric nosography and, in particular, their role in the early phases of illness and long-term outcome of schizophrenic patients.
Collapse
|
28
|
Ghezzi F, Casarin J, De Francesco G, Puggina P, Uccella S, Serati M, Cromi A. Transvaginal contained tissue extraction after laparoscopic myomectomy: a cohort study. BJOG 2017; 125:367-373. [PMID: 28467660 DOI: 10.1111/1471-0528.14720] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To describe the technique and report perioperative outcomes of transvaginal contained extraction of surgical specimens at laparoscopic myomectomy. DESIGN Retrospective analysis of prospectively collected data. SETTING Two Italian referral centres for gynaecological minimally invasive surgery. POPULATION Consecutive patients who underwent laparoscopic myomectomy. METHODS Tissue extraction was accomplished following laparoscopic myomectomy in a specimen retrieval bag via a posterior colpotomy incision. If morcellation was necessary, this was performed extracorporeally, using a scalpel within the specimen retrieval pouch, whose edges were exteriorised through the vaginal introitus. MAIN OUTCOME MEASURES Intra- and postoperative complications. RESULTS A total of 316 women underwent transvaginal specimen retrieval with enclosed manual morcellation. The mean myomectomy specimen weight was 154 ± 128 g, and the mean operative time was 79 ± 26 minutes. No intraoperative complications occurred related to the specimen extraction or morcellation technique, or from rupture of the retrieval bag. Two (0.6%) women had a haemoperitoneum that spontaneously resolved and 16 (5.1%) had fever postoperatively. The final pathological diagnosis was benign in all cases. At the 30-day follow-up, no pelvic infection, vaginal dehiscence, or complaints of dyspareunia were recorded. CONCLUSIONS Contained transvaginal extraction of fibroid specimens can be performed safely and efficiently in most women undergoing laparoscopic myomectomy. This technique represents a valuable minimally invasive alternative to intracorporeal morcellation. TWEETABLE ABSTRACT Transvaginal contained morcellation at laparoscopic myomectomy is a valuable alternative to intracorporeal morcellation.
Collapse
Affiliation(s)
- F Ghezzi
- Department of Obstetrics and Gynaecology, Del Ponte Hospital, University of Insubria, Varese, Italy
| | - J Casarin
- Department of Obstetrics and Gynaecology, Del Ponte Hospital, University of Insubria, Varese, Italy
| | - G De Francesco
- Department of Obstetrics and Gynaecology, Evangelical Hospital, 'Villa Betania', Naples, Italy
| | - P Puggina
- Department of Obstetrics and Gynaecology, Evangelical Hospital, 'Villa Betania', Naples, Italy
| | - S Uccella
- Department of Obstetrics and Gynaecology, Del Ponte Hospital, University of Insubria, Varese, Italy
| | - M Serati
- Department of Obstetrics and Gynaecology, Del Ponte Hospital, University of Insubria, Varese, Italy
| | - A Cromi
- Department of Obstetrics and Gynaecology, Del Ponte Hospital, University of Insubria, Varese, Italy
| |
Collapse
|
29
|
Buoli M, Serati M, Caldiroli A, Galimberti D, Scarpini E, Altamura AC. Pharmacological Management of Psychiatric Symptoms in Frontotemporal Dementia: A Systematic Review. J Geriatr Psychiatry Neurol 2017; 30:162-169. [PMID: 28351199 DOI: 10.1177/0891988717700506] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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] [Indexed: 12/14/2022]
Abstract
Psychiatric symptoms in patients with frontotemporal dementia (FTD) are highly prevalent and may complicate clinical management of these patients. Purpose of the present article is to present and discuss available data about the pharmacological treatment of psychiatric symptoms in patients with FTD. A research in the main database sources has been conducted to obtain an overview of the pharmacological management of psychiatric symptoms in patients with FTD. The search strategy included the following terms-"FTD and psychiatry," "FTD and behavioural disturbances," and "FTD and treatment". Pathophysiology of psychiatric symptoms in FTD is different from other types of dementia. Although drugs for Alzheimer disease appear to be ineffective for the treatment of psychiatric symptoms of FTD, preliminary evidence supports a possible usefulness of serotonergic antidepressants for these patients. Data are too scanty to draw definitive conclusions, but antidepressant treatment, particularly with serotonergic compounds, may improve psychiatric symptoms in patients with FTD. Large observational studies are needed to confirm this preliminary evidence, and a lot of effort and collaboration between neurologists and psychiatrists will be definitely crucial for future research of effective treatments for FTD.
Collapse
Affiliation(s)
- Massimiliano Buoli
- 1 Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Serati
- 1 Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alice Caldiroli
- 1 Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniela Galimberti
- 2 Department of Neurology, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elio Scarpini
- 2 Department of Neurology, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alfredo Carlo Altamura
- 1 Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
30
|
Vettoretti S, Buoli M, Guenzani D, Caldiroli L, Carnevali GS, Serati M, Altamura AC, Messa P. MP466GERIATRIC PATIENTS WITH ADVANCED CHRONIC KIDENY DISEASE HAVE A HIGH PREVALENCE OF UNDIAGNOSED PSYCHIATRIC SYMPTOMS AND POORER QUALITY OF LIFE. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx173.mp466] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
31
|
Caldiroli A, Buoli M, Dell’Osso B, Carnevali G, Serati M, Suppes T, Ketter T, Altamura A. Obesity and Obstetric Complications are Associated with Rapid-cycling in Italian Patients with Bipolar Disorder. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.238] [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: 10/19/2022] Open
Abstract
IntroductionRapid cycling (RC) worsens the course of bipolar disorder (BD) being associated with poor response to pharmacotherapy. Previous results about clinical variables potentially associated with RCBD were discordant or unreplicated.ObjectivesAn early diagnosis should be the goal to properly treat RCBD patients.AimsTo compare clinical variables between RC and non-RC bipolar patients and to identify related risk factors.MethodsA sample of 238 bipolar patients was enrolled from three different community mental health centers. Descriptive analyses were performed on total sample and patients were compared in terms of sociodemographic and clinical variables according to the presence of RC by multivariate analyses of variance (MANOVAs, continuous variables) or χ2 tests (qualitative variables). Binary logistic regression was performed to calculate odds ratios.ResultsOverall, 28 patients (11.8%) had RC. The two groups were not different in terms of age, age at onset, gender distribution, type of family history, type of substance use disorder, history of antidepressant therapy, main antidepressant, psychotic symptoms, comorbid anxiety disorders, suicide attempts, thyroid diseases, diabetes, type of BD, duration of untreated illness, illness duration, duration of antidepressant treatment and GAF scores. In contrast, RC patients had more often a history of obstetric complications (P < 0.05), obesity (P < 0.05) and a trend to hypercholesterolemia (P = 0.08). In addition, RC bipolar patients presented more frequently lifetime MDMA misuse (P < 0.05) than patients without RC.ConclusionsObesity and obstetric complications are risk factors for the development of RC in BD. Lifetime MDMA misuse may be more frequent in RC bipolar patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Collapse
|
32
|
Affiliation(s)
- Jennifer L. Barkin
- Department of Community Medicine, Mercer University School of Medicine, Macon, Georgia
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anita L. Barkin
- Georgia Department of Public Health, North Central Health District, Macon, Georgia
| |
Collapse
|
33
|
Buoli M, Serati M, Caldiroli A, Cremaschi L, Altamura AC. NEURODEVELOPMENTAL VERSUS NEURODEGENERATIVE MODEL OF SCHIZOPHRENIA AND BIPOLAR DISORDER: COMPARISON WITH PHYSIOLOGICAL BRAIN DEVELOPMENT AND AGING. Psychiat Danub 2017; 29:24-27. [DOI: 10.24869/psyd.2017.24] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
34
|
Buoli M, Caldiroli A, Serati M, Grassi S, Altamura AC. Sex Steroids and Major Psychoses: Which Role for DHEA-S and Progesterone. Neuropsychobiology 2017; 73:178-83. [PMID: 27100685 DOI: 10.1159/000444922] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 10/26/2015] [Accepted: 02/23/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Endocrine pathways seem to play a role in the etiology of major psychoses. The identification of biomarkers associated with psychotic symptoms in schizophrenia (SKZ) and mood disorders would allow the identification of high-risk subjects for delusions and hallucinations. The aim of this study was to evaluate dehydroepiandrosterone sulfate (DHEA-S) and progesterone plasma levels in drug-free patients with major psychoses and their relation with the diagnosis and history of psychotic symptoms. METHODS Eighty-nine consecutive drug-free male inpatients with SKZ or mood disorders were recruited, and DHEA-S and progesterone plasma levels were measured. The groups, divided according to pathological/normal-range hormone levels, were compared in terms of clinical variables using x03C7;2 tests with Bonferroni's corrections or multivariate analyses of variance. The same analyses were performed for groups divided according to the presence/absence of lifetime psychotic symptoms. Binary logistic regression analysis was performed using hormone levels as independent variables and history of lifetime psychotic symptoms as a dependent one. RESULTS A higher number of patients with abnormal DHEA-S levels was found to have a family history of major depressive disorder (p < 0.05). Higher DHEA-S levels (F = 8.31; p = 0.005) were found in patients with a history of psychotic symptoms. In addition, binary logistic regression confirmed that DHEA-S levels were associated with a higher probability of lifetime psychotic symptoms (p = 0.037). CONCLUSIONS Our results confirm previous data about the role of endocrine factors in the etiology of major psychoses. A high DHEA-S level might be a risk factor for psychotic symptoms. Studies with larger samples are needed to confirm these data.
Collapse
Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | | | | |
Collapse
|
35
|
Buoli M, Caldiroli A, Serati M. Pharmacokinetic evaluation of pregabalin for the treatment of generalized anxiety disorder. Expert Opin Drug Metab Toxicol 2017; 13:351-359. [DOI: 10.1080/17425255.2017.1281247] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alice Caldiroli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
36
|
Buoli M, Dell'Osso B, Caldiroli A, Carnevali GS, Serati M, Suppes T, Ketter TA, Altamura AC. Obesity and obstetric complications are associated with rapid-cycling in Italian patients with bipolar disorder. J Affect Disord 2017; 208:278-283. [PMID: 27794251 DOI: 10.1016/j.jad.2016.10.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 05/17/2016] [Revised: 09/28/2016] [Accepted: 10/16/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Rapid cycling (RC) worsens the course of bipolar disorder (BD) being associated with poor response to pharmacotherapy. Previous studies identified clinical variables potentially associated with RCBD: however, in many cases, results were discordant or unreplicated. The present study was aimed to compare clinical variables between RC and non RC bipolar patients and to identify related risk factors. METHODS A sample of 238 bipolar patients was enrolled from 3 different community mental health centers. Descriptive analyses were performed on total sample, and patients were compared in terms of socio-demographic and clinical variables according to the presence of RC by multivariate analyses of variance (MANOVAs, continuous variables) or χ2 tests (qualitative variables). Binary logistic regression was performed to calculate odds ratios. RESULTS Twenty-eight patients (11.8%) had RC. The two groups were not different in terms of age, age at onset, gender distribution, type of family history, type of substance use disorder, history of antidepressant therapy, main antidepressant, psychotic symptoms, comorbid anxiety disorders, suicide attempts, thyroid diseases, diabetes, type of BD, duration of untreated illness, illness duration, duration of antidepressant treatment and GAF scores. In contrast, RC patients had more often a history of obstetric complications (p<0.05), obesity (p<0.05) and a trend to hypercholesterolemia (p=0.08). In addition, RC bipolar patients presented more frequently lifetime MDMA misuse (p<0.05) than patients without RC. DISCUSSION Findings from the present study seem to indicate that obesity and obstetric complications are risk factors for the development of RC in BD. In addition, lifetime MDMA misuse may be more frequent in RC bipolar patients.
Collapse
Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Via F. Sforza 35, 20122 Milan, Italy.
| | - Bernardo Dell'Osso
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Via F. Sforza 35, 20122 Milan, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA
| | - Alice Caldiroli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Via F. Sforza 35, 20122 Milan, Italy
| | - Greta Silvia Carnevali
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Via F. Sforza 35, 20122 Milan, Italy
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Via F. Sforza 35, 20122 Milan, Italy
| | - Trisha Suppes
- Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA
| | - Terence A Ketter
- Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Via F. Sforza 35, 20122 Milan, Italy
| |
Collapse
|
37
|
Caldiroli A, Buoli M, Serati M, Cahn W, Altamura AC. General and social cognition in remitted first-episode schizophrenia patients: a comparative study. Eur Arch Psychiatry Clin Neurosci 2016; 266:639-47. [PMID: 27250978 DOI: 10.1007/s00406-016-0701-x] [Citation(s) in RCA: 11] [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: 02/01/2016] [Accepted: 05/23/2016] [Indexed: 02/03/2023]
Abstract
The aim of this paper was to investigate whether both neurocognitive and social cognitive performances were different between remitted first-episode schizophrenia patients, non-remitters and healthy controls (HC). We assessed social cognition (Degraded Facial Affect Recognition Task-DFAR and Emotional Mentalizing Task-EMT) and neurocognition (Wechsler Adult Intelligence Scale and Word Learning Test-WLT) in 174 remitted first-episode schizophrenia patients, 110 non-remitted first-episode schizophrenia patients and 320 HC. Multivariate analyses of variance with age, gender and IQ as covariates (MANCOVA) were performed to compare mean cognitive test scores between the three groups. Remitted first-episode schizophrenia patients performed significantly worse than HC only in one verbal memory task (WLT immediate recall; p = 0.004); in the same test, they were significantly better than non-remitters (p = 0.027). Non-remitted first-episode schizophrenia patients, differently from remitters, performed significantly worse than HC in terms of social cognition (EMT-p < 0.05 and DFAR-p < 0.05). Remitted first-episode schizophrenia patients presented worse cognitive performance than HC in verbal memory tasks, but not in facial affect recognition and in ToM, while non-remitters did; these results suggest that neurocognitive deficits are the core hallmark of schizophrenia and that social cognition is relatively unaffected in remitted patients after their first episode.
Collapse
Affiliation(s)
- Alice Caldiroli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.
| | - Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.,Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy
| | - Wiepke Cahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy
| |
Collapse
|
38
|
Ferri F, Serati M, Colombo EM, Gallo F, Buoli M. Samaritan donation: A new challenge for the Italian transplant community. Psychiatry Res 2016; 242:26-27. [PMID: 27236590 DOI: 10.1016/j.psychres.2016.03.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 03/22/2016] [Accepted: 03/23/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Francesca Ferri
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy.
| | - Elisa Maria Colombo
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Francesca Gallo
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| |
Collapse
|
39
|
Rovera C, Cremaschi L, Thanju A, Fiorentini A, Mauri MC, Serati M, Lindenmayer JP, Altamura AC. Cabergoline can induce mania with psychotic features in bipolar I disorder: a case report. Asian J Psychiatr 2016; 22:94-5. [PMID: 27520906 DOI: 10.1016/j.ajp.2016.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 05/02/2016] [Accepted: 05/21/2016] [Indexed: 11/16/2022]
Abstract
Up to date, only a small evidence of psychosis induced by cabergoline is available in literature. Herein, the case of a 34-year-old bipolar patient treated with cabergoline has been described. Cabergoline is generally a safe and effective method of reducing prolactin levels and it may be associated with psychiatric side effects, including psychotic features.
Collapse
Affiliation(s)
- Chiara Rovera
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Laura Cremaschi
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Amod Thanju
- Manhattan Psychiatric Center, New York, NY, United States; Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - Alessio Fiorentini
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimo Carlo Mauri
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Jean Pierre Lindenmayer
- Manhattan Psychiatric Center, New York, NY, United States; Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, United States; New York University Medical Center, New York, NY, United States
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
40
|
Buoli M, Bertino V, Caldiroli A, Dobrea C, Serati M, Ciappolino V, Altamura AC. Are obstetrical complications really involved in the etiology and course of schizophrenia and mood disorders? Psychiatry Res 2016; 241:297-301. [PMID: 27232550 DOI: 10.1016/j.psychres.2016.05.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 09/29/2015] [Revised: 02/19/2016] [Accepted: 05/10/2016] [Indexed: 12/18/2022]
Abstract
The impact of stressful experiences during gestation or early life, leading to increased psychiatric disorders susceptibility, is currently well described in literature, however, few data are available on the association between obstetrical complications and later development of specific diagnoses or clinical features (e.g. psychotic symptoms). Aim of the present paper was to evaluate obstetrical complications frequency in different psychiatric diagnoses and their association with clinical features. Three hundred and eighty-eight patients with a diagnosis of schizophrenia, bipolar disorder or major depressive disorder were compared in terms of clinical presentation according to the presence, type and severity of obstetrical complications. Seventeen percent of the total sample (N=65) had history of at least one obstetrical complication. Patients with a history of at least one obstetrical complication result in an earlier age of onset (F=3.93, p=0.04) and a current higher GAF score (F=6.46, p=0.01). Lewis-Murray scale score was directly correlated with GAF scores (t=2.9, p=0.004) and inversely correlated with age at onset (t=-2.77, p=0.006). Obstetrical complications are frequently registered in patients with schizophrenia or mood disorders. In our sample, they appear to have an anticipatory effect on illness onset, but they seem not to be associated with a specific psychiatric diagnosis.
Collapse
Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy.
| | - Vincenzo Bertino
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Alice Caldiroli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Cristina Dobrea
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Valentina Ciappolino
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| |
Collapse
|
41
|
Buoli M, Kahn RS, Serati M, Altamura AC, Cahn W. Haloperidol versus second-generation antipsychotics in the long-term treatment of schizophrenia. Hum Psychopharmacol 2016; 31:325-31. [PMID: 27297936 DOI: 10.1002/hup.2542] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 10/26/2015] [Revised: 05/04/2016] [Accepted: 05/04/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The purpose of the study was to compare antipsychotic monotherapies in terms of time to discontinuation in a sample of schizophrenia patients followed-up for 36 months. METHODS Two hundred and twenty schizophrenia patients, treated with antipsychotic monotherapy and followed-up in psychiatric outpatient clinics of Universities of Milan and Utrecht were included in the study. A survival analysis (Kaplan-Meier) of the 36-month follow-up period was performed to compare the single treatment groups. End-point was considered as discontinuation of treatment for recurrence, side effects or non-compliance. RESULTS Patients treated with haloperidol discontinued more than the other groups (Breslow: risperidone p < 0.001, olanzapine p < 0.001, quetiapine p = 0.002, clozapine p < 0.001, aripiprazole p = 0.002). Lack of efficacy (recurrence) was a more frequent reason for discontinuation in the haloperidol group than in the olanzapine group (p < 0.05). Extrapyramidal side effects (EPS) were more frequent in the haloperidol group than with olanzapine (p < 0.05). The olanzapine group presented more frequently weight gain than the other groups, without reaching statistical significance. CONCLUSIONS Patients treated with atypical antipsychotics appear to continue pharmacotherapy longer than patients treated with haloperidol. In addition, atypical antipsychotics seem to be more protective against recurrences than haloperidol. However, these results should be cautiously interpreted in the light of potential confounder factors such as duration of illness. Copyright © 2016 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Milan, Italy.,Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - René S Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marta Serati
- Department of Psychiatry, University of Milan, Milan, Italy
| | | | - Wiepke Cahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
42
|
Buoli M, Caldiroli A, Cumerlato Melter C, Serati M, de Nijs J, Altamura AC. Biological aspects and candidate biomarkers for psychotic bipolar disorder: A systematic review. Psychiatry Clin Neurosci 2016; 70:227-44. [PMID: 26969211 DOI: 10.1111/pcn.12386] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [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: 11/02/2015] [Revised: 01/24/2016] [Accepted: 03/06/2016] [Indexed: 12/23/2022]
Abstract
AIM We carried out a systematic review of the available literature about potential biomarkers of psychotic bipolar disorder (BD-P), a specific subset presenting worse outcome and greater risk of relapse than non-psychotic bipolar disorder (BD-NP). METHODS We searched the main psychiatric databases (PubMed, ISI Web of Knowledge, PsychInfo). Only original articles with the main topic of BD-P compared to schizophrenia/BD-NP/healthy controls (HC) written in English from 1994 to 2015 were included. RESULTS BD-P patients presented higher kynurenic acid levels in the cerebrospinal fluid, elevated anti- S accharomyces cerevisiae antibodies levels, and lower serum levels of dehydroepiandrosterone sulfate and progesterone than BD-NP/HC. Event-related potentials abnormalities have been identified in BD-P with respect to BD-NP. BD-P patients also presented bigger ventricles but similar hippocampal volumes compared to BD-NP/HC. Although the results are contrasting, some cognitive deficits seemed to be related to the psychotic dimension of bipolar affective disorder, such as impairment in verbal/logical memory, working memory, verbal and semantic fluency and executive functioning. Finally, polymorphisms of genes, such as NRG1, 5HTTLPR (s), COMT, DAOA and some chromosome regions (16p12 and 13q), were positively associated with BD-P. CONCLUSION Data about the identification of specific biomarkers for BD-P are promising, but most of them have not yet been replicated. They could lead the clinicians to an early diagnosis and proper treatment, thus ameliorating outcome of BD-P and reducing the biological changes associated with a long duration of illness. Further studies with bigger samples are needed to detect more specific biological markers of the psychotic dimension of bipolar affective disorder.
Collapse
Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Psychiatry, University Medical Center Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - Alice Caldiroli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Cumerlato Melter
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Jessica de Nijs
- Department of Psychiatry, University Medical Center Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
43
|
Buoli M, Serati M, Ciappolino V, Altamura AC. May selective serotonin reuptake inhibitors (SSRIs) provide some benefit for the treatment of schizophrenia? Expert Opin Pharmacother 2016; 17:1375-85. [DOI: 10.1080/14656566.2016.1186646] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
44
|
Serati M, Redaelli M, Buoli M, Altamura AC. Perinatal Major Depression Biomarkers: A systematic review. J Affect Disord 2016; 193:391-404. [PMID: 26802316 DOI: 10.1016/j.jad.2016.01.027] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [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: 10/19/2015] [Revised: 12/04/2015] [Accepted: 01/12/2016] [Indexed: 12/20/2022]
Abstract
Postpartum depression, now termed perinatal depression by the DSM-5, is a clinically relevant disorder reaching 15% of incidence. Although it is quite frequent and associated with high social dysfunction, only recently its underpinning biological pathways have been explored, while multiple and concomitant risk factors have been identified (e.g. psychosocial stress). Peripartum depression usually has its onset during the third trimester of pregnancy or in the postpartum, being one of the most common medical complications in new mothers. Purpose of the present review is to summarize the state of art of biological biomarkers involved in the pathogenesis of perinatal depression, in view of the fact that suboptimal prenatal milieu can induce permanent damage in subsequent offspring life and have a negative impact on mother-child relationship. Furthermore, parents' biological changes due to medical/psychiatric disorders or stress exposure could influence offspring life: a concept known as 'intergenerational transmission', acting by variations into gametes and the gestational uterine environment. Given the evidence that perinatal mental disorders involve risks for the mother and offspring, the search for reliable biomarkers in high-risk mothers actually represents a medical priority to prevent perinatal depression.
Collapse
Affiliation(s)
- M Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy.
| | - M Redaelli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - M Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - A C Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| |
Collapse
|
45
|
|
46
|
Leone Roberti Maggiore U, Ottolina J, Parma M, Quaranta L, Serati M, Candiani M, Salvatore S. A patient preference conservative management of recurrent TVT vaginal erosion. J OBSTET GYNAECOL 2016. [PMID: 26207803 DOI: 10.3109/01443615.2015.1030602] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
47
|
Affiliation(s)
- Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Beatrice Benatti
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
48
|
Abstract
BACKGROUND An increasing number of studies identifies the duration of illness (DI) as an important predictor of outcome in patients affected by major psychoses (MP). The aim of the present paper was to revise medical literature about DI and its effects on MP, focusing in particular on the relationship between DI and outcome with particular reference to treatment response, suicidal risk, cognitive impairment and social functioning. METHODS A search in the main database sources has been performed to obtain a comprehensive overview. Studies with different methodologies (open and double-blinded) have been included, while papers considering other variables such as duration of untreated episode/illness were excluded. MP included the diagnoses of schizophrenia, bipolar disorder and major depressive disorder. RESULTS Available data show that DI influences treatment response, suicidal risk and loss of social functioning in schizophrenic patients, while results are more controversial with regard to cognitive impairment. In bipolar disorder, a long DI has been associated with less treatment response, more suicidal risk and cognitive impairment, but more data are needed to draw definitive conclusions. Finally, studies, regarding DI of illness and its predictive value of outcome in major depressive disorder show contradictory results. CONCLUSIONS DI appears a negative outcome factor particularly for schizophrenia, while with regard to mood disorders, more data are needed to draw definitive sound conclusions.
Collapse
Affiliation(s)
- Alfredo Carlo Altamura
- Alfredo C Altamura, Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico , Via F. Sforza 35, 20122, Milan , Italy
| | | | | |
Collapse
|
49
|
Affiliation(s)
- G Bogani
- Department of Obstetrics and Gynaecology, University of Insubria, Del Ponte Hospital , Varese , Italy
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Finazzi AE, Costantini E, Pietropaolo A, Palleschi G, Carbone A, Topazio L, Soligo M, Del Popolo G, Li Marzi V, Salvatore S, Serati M. 386 Urodynamics useless before surgery for female stress urinary incontinence: Are you sure? Results from a multicenter single nation database. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/s1569-9056(14)60381-x] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|