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Ferrucci SM, Tavecchio S, Nicolini G, Angileri L, Ceresa A, Del Tordello G, Berti E, Marzano AV, Buoli M. Mental health in patients affected by atopic dermatitis: which effects of treatment with dupilumab? Int Clin Psychopharmacol 2024; 39:201-205. [PMID: 37781860 DOI: 10.1097/yic.0000000000000511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Atopic dermatitis (AD) is an inflammatory skin disease. Patients with AD are prone to develop anxiety and mood disorders. Aim of this study is to investigate if treatment with dupilumab may improve mental health status of patients affected by AD. A total of 66 patients with severe AD were included: 24 subjects were candidate or have just started (one month) treatment with dupilumab, and 42 have been in treatment for one year. 25.8%, 30.3%, and 45.5% of the total sample showed, respectively, clinically significant anxiety, depression, and symptoms of Internet addiction. Patients with anxiety symptoms resulted to have more severe AD, more sleep problems ( P = 0.028), less quality of life ( P = 0.001), more severe depressive symptoms ( P < 0.001), to be more frequently women ( P = 0.016), to be less frequently treated with dupilumab for one year ( P = 0.025). Similarly, patients with clinically significant depressive symptoms resulted to have more severe AD, more sleep problems ( P = 0.003), less quality of life ( P < 0.001), more severe anxiety symptoms ( P < 0.001), to be less frequently treated with dupilumab for one year ( P = 0.008). Patients with AD treated for one year with dupilumab showed a better mental health profile in terms of less severe anxiety and depression with respect to their counterparts.
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Affiliation(s)
| | - Simona Tavecchio
- Dermatology Section, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
- Department of Pathophysiology and Transplantation, University of Milan
| | - Gregorio Nicolini
- Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco Hospital, University of Milan
| | - Luisa Angileri
- Dermatology Section, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
| | - Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia Del Tordello
- Dermatology Section, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
| | - Emilio Berti
- Dermatology Section, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
- Department of Pathophysiology and Transplantation, University of Milan
| | - Angelo Valerio Marzano
- Dermatology Section, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
- Department of Pathophysiology and Transplantation, University of Milan
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Ferrucci SM, Tavecchio S, Ceresa A, Angileri L, Berti E, Marzano AV, Buoli M. Which Factors Are Associated with Persistence of Depressive and Anxiety Symptoms in Patients Affected by Atopic Dermatitis despite 2-Year Treatment with Dupilumab? J Clin Med 2024; 13:1980. [PMID: 38610745 PMCID: PMC11012912 DOI: 10.3390/jcm13071980] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Atopic Dermatitis (AD) is a prevalent inflammatory skin disease whose course is often complicated by the presence of concomitant anxiety and depressive disorders. Dupilumab has been demonstrated to be largely effective in AD. The aims of the present study were to (1) to verify the effectiveness of 2-year dupilumab treatment on the depressive and anxiety symptoms of patients affected by AD and (2) to identify predictors of the persistence of psychiatric symptoms despite maintenance treatment with dupilumab. Methods: A total of 331 patients with severe AD were assessed at baseline and at different times over 2 years by a large set of rating scales, including the Eczema Area and Severity Index (EASI), the Hospital Anxiety and Depression Scale (HADS), and the Dermatology Life Quality Index (DLQI). Paired sample t-tests were performed to verify the effectiveness of dupilumab on the severity of AD and mental health items. Two binary logistic regression models were then used to identify the predictors of the persistence of clinically significant depression and anxiety, defined by a score ≥ 8 on each sub-scale of the HADS. Results: After 2 years of treatment with dupilumab, the patients benefited, showing a significant improvement in both the dermatological disease and comorbid depression/anxiety (p < 0.001 for all scales). Overall, 17.5% and 13% of patients, respectively, reported residual depressive and anxiety symptoms after the 2-year treatment with dupilumab. The baseline predictors of the persistence of clinically significant depressive symptoms after the 2-year treatment with dupilumab were found to be a higher body mass index (BMI) (p = 0.012), a lower impact of dermatological disease on quality of life (p = 0.015), and more severe depressive symptoms (p < 0.01), while for anxiety, the only predictor was found to be female gender (p = 0.03). Conclusions: Using a multidisciplinary approach, at baseline, dermatologists should more closely monitor patients who are at a greater risk of maintaining residual psychiatric symptoms despite therapy, such as those with more severe depressive symptoms and those who are overweight.
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Affiliation(s)
- Silvia Mariel Ferrucci
- Dermatology Section, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (S.M.F.)
| | - Simona Tavecchio
- Dermatology Section, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (S.M.F.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| | - Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Luisa Angileri
- Dermatology Section, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (S.M.F.)
| | - Emilio Berti
- Dermatology Section, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (S.M.F.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| | - Angelo Valerio Marzano
- Dermatology Section, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (S.M.F.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
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Esposito CM, Barkin JL, Ceresa A, Buoli M. Does the comorbidity of borderline personality disorder affect the response to treatment in bipolar patients? Int Clin Psychopharmacol 2024; 39:51-58. [PMID: 37551606 DOI: 10.1097/yic.0000000000000489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Bipolar disorder (BD) is a highly prevalent condition whose response to pharmacological treatment is associated with a number of factors including psychiatric comorbidity. Borderline personality disorder (BPD) shares clinical symptoms and biological vulnerability with BD and the two conditions are frequently comorbid, thus representing a clinical challenge. The purpose of the present review is to summarize the data related to treatment response in bipolar patients with comorbid BPD. According to systematic review process, a literature search was performed on the PubMed, Embase, PsycInfo, Isi Web of Knowledge, Medscape, and Cochrane Library databases. Peer-reviewed articles until December 2022 were eligible for inclusion. Comorbidity with BPD seems to be associated with a more difficult clinical stabilization in bipolar patients, often requiring poly-therapy or a longer duration of hospitalization. However, three studies, assessing the effectiveness of mood stabilizers in bipolar patients, did not demonstrate a prominent influence of BPD comorbidity in achieving clinical response. The most frequently administered pharmacological treatments in the selected studies include mood stabilizers and atypical antipsychotics. The presence of comorbid BPD in bipolar patients may hamper treatment effectiveness. Future studies, comparing different treatments and with larger samples, are needed to confirm the results critically summarized in the present review.
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Affiliation(s)
- Cecilia Maria Esposito
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Jennifer L Barkin
- Department of Community Medicine, Mercer University School of Medicine, Macon, Georgia, USA
| | - Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico
- 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
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Legnani F, Tassi L, Surace T, Capuzzi E, Caldiroli A, Clerici M, Buoli M. Is Pilates effective in improving depressive disorders? A comprehensive overview. Int Clin Psychopharmacol 2024:00004850-990000000-00122. [PMID: 38277272 DOI: 10.1097/yic.0000000000000541] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 01/28/2024]
Abstract
Depressive disorders are disabling conditions that account for high social costs. Pilates demonstrated to have several beneficial effects on health. Objective of this manuscript was to systematically review the literature about the effects of Pilates on depressive disorders. A bibliographic search was conducted in the main database sources (Pubmed, Medline, and Scopus). The inclusion criteria consisted of articles written in English language about the effectiveness of Pilates on depressive symptoms. Most of included studies are randomized controlled trials (10 out of 12). The available literature agrees in indicating that Pilates is effective in improving depressive symptoms especially when compared to inactivity and when this practice is administered for a medium-long period (8-16 weeks). In addition, Pilates seems to have at least comparable effectiveness than aerobic exercise. Pilates can be considered a reliable complementary treatment for people with depressive disorders. These findings should be interpreted considering the different types of practice administered as well as the different duration of the programs or rating scales used to assess mood symptoms. Studies with a more homogenous design are needed to confirm and make generalizable the results presented in this review.
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Affiliation(s)
- Francesca Legnani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan
| | - Lorenzo Tassi
- School of Medicine and Surgery, University of Milano Bicocca
| | - Teresa Surace
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, Monza (MB)
| | - Enrico Capuzzi
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, Monza (MB)
| | - Alice Caldiroli
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, Monza (MB)
| | - Massimo Clerici
- School of Medicine and Surgery, University of Milano Bicocca
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, Monza (MB)
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Capuzzi E, Quitadamo C, Caldiroli A, Clerici M, Buoli M. The impact of efficacy of long-acting injectable antipsychotics on caregivers' burden of patients with schizophrenia. Int Clin Psychopharmacol 2024:00004850-990000000-00129. [PMID: 38381900 DOI: 10.1097/yic.0000000000000539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/23/2024]
Affiliation(s)
- Enrico Capuzzi
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori
| | - Cecilia Quitadamo
- Department of Medicine and Surgery, University of Milan Bicocca, Monza (MB)
| | - Alice Caldiroli
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori
| | - Massimo Clerici
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori
- Department of Medicine and Surgery, University of Milan Bicocca, Monza (MB)
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Surace T, Buoli M, Affaticati LM, Esposito G, Capuzzi E, Colzani L, La Tegola D, Biagi E, Colmegna F, Caldiroli A, Clerici M. Which clinical factors delay proper treatment in panic disorder? A cross-sectional multicentric study. Early Interv Psychiatry 2024. [PMID: 38357849 DOI: 10.1111/eip.13506] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/30/2023] [Accepted: 01/24/2024] [Indexed: 02/16/2024]
Abstract
AIM The aim of the present study was to identify clinical and socio-demographic factors associated with duration of untreated illness (DUI) in patients affected by panic disorder (PD). METHODS Data were collected from patients' medical records (N = 157) of two mental health services respectively located in Milan and in Monza (Italy). Correlation analyses and analysis of variance (ANOVAs) were run to analyse the relation between DUI and quantitative/qualitative variables respectively. Statistically significant variables in uni- variate analyses were then inserted in a linear multivariable regression model (backward procedure). RESULTS Mean DUI was 27.33 (±50.56) months. Patients with an earlier age at onset (r = -0.270; p < .01), a longer duration of illness (r = 0.483; p < .01) and who received a lifetime psychotherapy (F = 6.86; p = .01) had a longer DUI. The final global model showed that a longer DUI was associated with pre-onset poly-substance misuse (p = .05) and a longer duration of illness (p < .01). CONCLUSION The results of our study showed that a longer DUI was predicted by clinical factors such as the presence of a pre-onset poly-substance use disorder and that delayed proper treatment can lead to a chronicization of PD, as indicated by a longer duration of illness. Further studies are needed to in-depth investigate the role of DUI in influencing the course and outcome of anxiety disorders, including PD.
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Affiliation(s)
- T Surace
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - M 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
| | - L M Affaticati
- Department of Medicine and Surgery, University of Milan Bicocca, Monza, Italy
| | - G Esposito
- Department of Medicine and Surgery, University of Milan Bicocca, Monza, Italy
| | - E Capuzzi
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - L Colzani
- Department of Medicine and Surgery, University of Milan Bicocca, Monza, Italy
| | - D La Tegola
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - E Biagi
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - F Colmegna
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - A Caldiroli
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - M Clerici
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- Department of Medicine and Surgery, University of Milan Bicocca, Monza, Italy
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Chiesa M, Nicolini G, Buoli M. The Approach of Physiotherapists in the Management of Patients with Persistent Pain and Comorbid Anxiety/Depression: Are There Any Differences between Male and Female Professionals? Medicina (Kaunas) 2024; 60:292. [PMID: 38399579 PMCID: PMC10890251 DOI: 10.3390/medicina60020292] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/29/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Chronic pain is a prevalent condition that is frequently complicated by mood and anxiety disorders. The purpose of the present article is to identify differences in the management of patients with chronic pain and anxiety/mood disorders depending on the physiotherapists' gender. Materials and Methods: An ad hoc questionnaire was developed and sent to 327 physiotherapists by e-mail. The two groups identified by gender were compared by unpaired-sample t tests for continuous variables and χ2 tests for qualitative ones. A binary logistic regression was then performed with factors resulting as statistically significant in univariate analyses as independent variables and gender as a dependent one. Results: Female physiotherapists exhibited a higher level of confidence than male physiotherapists in administering continued physiotherapy for patients affected by Generalized Anxiety Disorder (GAD) (p = 0.01), as well as for individuals who had previously engaged with a mental health professional (p = 0.01). Furthermore, female physiotherapists believed that pharmacotherapy was less associated with motor side effects (p < 0.01) and more frequently recognized the importance of training to identify affective disorders (p = 0.01) and the need for more education in mental health (p = 0.01). The binary logistic regression model confirmed that female professionals were less likely to work = freelance (p = 0.015) and were more confident in the receival of physiotherapy by patients with GAD (p = 0.05). Conclusions: Female physiotherapists compared to male ones seem to be more comfortable with patients affected by mental conditions and to be more aware of the need for training on mental health. Further studies are needed to confirm the results of the present study.
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Affiliation(s)
- Michele Chiesa
- Faculty of Medicine, University of Milan, 20122 Milan, Italy;
| | - Gregorio Nicolini
- Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco Hospital, University of Milan, Via G.B. Grassi, 74, 20157 Milan, Italy;
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
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Pardon MK, Dimmock J, Chande R, Kondracki A, Reddick B, Davis A, Athan A, Buoli M, Barkin JL. Mental health impacts of climate change and extreme weather events on mothers. Eur J Psychotraumatol 2024; 15:2296818. [PMID: 38224060 PMCID: PMC10791077 DOI: 10.1080/20008066.2023.2296818] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/06/2023] [Indexed: 01/16/2024] Open
Abstract
Background: The perinatal period is a time of increased vulnerability for perinatal mood and anxiety disorders (PMADs). Emotional trauma is a risk factor for PMAD development and is common among survivors of extreme weather events (EWEs), which are becoming more frequent and intense as the climate crisis progresses. EWE-related stress and anxiety have not been extensively studied in the perinatal population. However, the limited available data suggest a negative impact of EWE exposure on perinatal mental health, warranting further investigation and investment.Objective: To address this knowledge gap, we interviewed new Australian mothers to understand how EWEs affect the mental health of the perinatal population.Method: Australian mothers (18 years of age or older) with a baby under 12 months of age were recruited to participate in a single virtual focus group session (seven group sessions were run in total) and complete an anonymous survey. Participants were asked questions regarding their concerns about extreme weather and its impact, as well as their general maternal functioning. Maternal functioning, depression, and climate distress were measured via the survey.Results: The study sample comprised 31 Australian mothers (Mage = 31.74, SD = 4.86), predominantly located in Queensland. Findings from the focus groups suggested six key themes; however, of focus to this study are three themes related to maternal mental health: health and well-being, helplessness and avoidant coping, and resilience and adaptation. Predominant subthemes focused on trauma resulting from EWE exposure, economic and heat concerns, social isolation, hopelessness about the future, and feelings of resilience.Conclusions: The evidence linking adverse perinatal mental health outcomes with climate change and EWEs highlights the urgent need for interventions in this context to protect perinatal mental health and well-being. By acknowledging the traumatic impact of these experiences on mothers, this study supports advocacy for policies that specifically address this issue.
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Affiliation(s)
- M. K. Pardon
- Department of Psychology, James Cook University, Townsville, Australia
| | - J. Dimmock
- Department of Psychology, James Cook University, Townsville, Australia
| | - R. Chande
- Department of Psychology, Mercer University, Macon, GA, USA
| | - A. Kondracki
- Department of Community Medicine, Mercer University School of Medicine, Savannah, GA, USA
| | - B. Reddick
- Department of Community Medicine, Mercer University School of Medicine, Savannah, GA, USA
| | - A. Davis
- Clinical Mental Health Counseling Program, Southwestern College , Santa Fe, NM, USA
| | - A. Athan
- Teachers College, Columbia University, New York, NY, USA
| | - M. Buoli
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - J. L. Barkin
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA, USA
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Esposito CM, Ceresa A, Auxilia AM, Zanelli Quarantini F, Caldiroli A, Capuzzi E, Clerici M, Buoli M. Which Clinical and Demographic Factors are Related to Incarceration in Male Patients With Antisocial Personality Disorder? Int J Offender Ther Comp Criminol 2023; 67:1630-1641. [PMID: 36495101 DOI: 10.1177/0306624x221139073] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Antisocial Personality Disorder (APD) is a condition largely represented in detention centers where can reach a prevalence of 60% in male prisoners. The objective of this study is to identify the clinical and demographic factors that differentiate subjects with APD and hosted in penitentiary with respect to those are treated in outpatient psychiatric clinics. We recruited 65 male patients affected by APD, whose 26 were followed up in community mental health services and 39 were serving their sentence in a detention center located in Monza. Socio-demographic and clinical data were obtained through a review of the clinical charts, and interviews with patients or their relatives (if available). We performed descriptive analyses on the total sample, then we compared the two groups identified by the type of setting (outpatient clinic vs. penitentiary) by independent sample t tests (quantitative variables) or χ2 tests (qualitative ones). For qualitative variables odds ratios (ORs) were also calculated. Outpatients with APD (with respect to those hosted in the detention center) resulted: to be older (p = .02), to be less likely married (p = .01), to have more pre-onset psychiatric comorbidity (p = .05), to have more pre-onset substance poly-misuse (p = .01), to have more previous psychiatric hospitalizations (p < .01), and to be less likely to have received lifetime psychotherapy (p < .01). Globally, the results of this study show how the presence of psychiatric comorbidity or substance abuse (with the probable access to psychiatric services) before the onset of APD prevents imprisonment. This aspect is even more surprising when we consider that the two groups of patients show no differences in the frequency of crimes. Future research will have to confirm if early mental health care can really limit the access to penitentiary of subjects affected by APD.
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Affiliation(s)
| | - Alessandro Ceresa
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | | | | | - Massimo Clerici
- University of Milano Bicocca, Monza, Italy
- Azienda Socio Sanitaria Territoriale Monza, Italy
| | - Massimiliano Buoli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- University of Milan, Italy
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Esposito CM, Auxilia AM, Ceresa A, Zanvit FG, Zanelli Quarantini F, Capuzzi E, Caldiroli A, Clerici M, Buoli M. Which factors are associated with duration of untreated illness in borderline personality disorder? Early Interv Psychiatry 2023; 17:1216-1221. [PMID: 37046384 DOI: 10.1111/eip.13429] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/02/2023] [Accepted: 03/28/2023] [Indexed: 04/14/2023]
Abstract
AIM Borderline personality disorder (BPD) is a prevalent condition associated with high rates of hospitalizations. The purpose of this manuscript was to detect the factors associated with duration of untreated illness (DUI) in BPD. METHODS Through chart review, we identified 152 patients followed up by community psychiatry services in Milan and Monza, Italy. The association between DUI and socioeconomic and clinical variables was examined using Pearson correlation and analyses of variances. The statistically significant variables from univariate analyses were then inserted in regression models. RESULTS A longer DUI was associated with several variables (substance misuse after the onset of BPD, older age, earlier age at onset, longer duration of illness), but these results were not maintained in the regression analyses. CONCLUSIONS In conclusion, DUI does not seem to be significantly associated with specific clinical aspects of BPD, or significantly modify the course and outcome of the disorder. Studies with larger samples have to confirm these preliminary findings.
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Affiliation(s)
- Cecilia Maria Esposito
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Maria Auxilia
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Francesco Zanelli Quarantini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, 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
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Affaticati LM, Buoli M, Vaccaro N, Manzo F, Scalia A, Coloccini S, Zuliani T, La Tegola D, Capuzzi E, Nicastro M, Colmegna F, Clerici M, Dakanalis A, Caldiroli A. The Impact of Clinical Factors, Vitamin B12 and Total Cholesterol on Severity of Anorexia Nervosa: A Multicentric Cross-Sectional Study. Nutrients 2023; 15:4954. [PMID: 38068810 PMCID: PMC10707803 DOI: 10.3390/nu15234954] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/13/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
Severe forms of Anorexia Nervosa (AN) are characterized by medical complications, psychiatric comorbidity, and high mortality. This study investigated potential associations between clinical/biological factors and the severity of AN, measured by the Body Mass Index (BMI). Red and white blood cells, hemoglobin, platelets, iron, vitamins D and B12, folate, and total cholesterol were measured in a mixed sample of 78 inpatients and outpatients. Linear regressions and one-way analyses of variance (ANOVAs) were carried out to evaluate the relationship between BMI and clinical/biochemical variables. BMI was significantly lower in hospitalized patients (F = 4.662; p = 0.034) and in those under pharmacological treatment (F = 5.733; p = 0.019) or poly-therapy (F = 5.635; p = 0.021). Higher vitamin B12 (β = -0.556, p < 0.001), total cholesterol (β = -0.320, p = 0.027), and later age at onset (with a trend towards significance) (β = -0.376, p = 0.058) were associated with a lower BMI. Increased total cholesterol and vitamin B12, later age at onset, current pharmacological treatment, and poly-therapy might be distinctive in patients with a lower BMI. In clinical practice, these findings may contribute to the early identification of AN patients at higher risk of developing complicated or chronic forms of the disorder. Further studies on larger samples are needed to identify potential predictive factors of AN severity in the framework of precision medicine.
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Affiliation(s)
- Letizia Maria Affaticati
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, MB, Italy; (L.M.A.); (N.V.); (F.M.); (A.S.); (M.C.)
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, 20122 Milan, MI, Italy;
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, MI, Italy
| | - Nadia Vaccaro
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, MB, Italy; (L.M.A.); (N.V.); (F.M.); (A.S.); (M.C.)
| | - Francesca Manzo
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, MB, Italy; (L.M.A.); (N.V.); (F.M.); (A.S.); (M.C.)
| | - Alberto Scalia
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, MB, Italy; (L.M.A.); (N.V.); (F.M.); (A.S.); (M.C.)
| | - Sara Coloccini
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, 95124 Catania, CT, Italy;
| | - Tommaso Zuliani
- Department of Medicine and Surgery, University of Milan, 20122 Milan, MI, Italy;
| | - Davide La Tegola
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, MB, Italy; (D.L.T.); (E.C.); (M.N.); (F.C.); (A.C.)
| | - Enrico Capuzzi
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, MB, Italy; (D.L.T.); (E.C.); (M.N.); (F.C.); (A.C.)
| | - Monica Nicastro
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, MB, Italy; (D.L.T.); (E.C.); (M.N.); (F.C.); (A.C.)
| | - Fabrizia Colmegna
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, MB, Italy; (D.L.T.); (E.C.); (M.N.); (F.C.); (A.C.)
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, MB, Italy; (L.M.A.); (N.V.); (F.M.); (A.S.); (M.C.)
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, MB, Italy; (D.L.T.); (E.C.); (M.N.); (F.C.); (A.C.)
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, MB, Italy; (L.M.A.); (N.V.); (F.M.); (A.S.); (M.C.)
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, MB, Italy; (D.L.T.); (E.C.); (M.N.); (F.C.); (A.C.)
| | - Alice Caldiroli
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, MB, Italy; (D.L.T.); (E.C.); (M.N.); (F.C.); (A.C.)
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Buoli M, Legnani F, Nosari G, Pan A, Ciappolino V, Esposito CM, Ceresa A, Di Paolo M, Surace T, Auxilia AM, Capellazzi M, Tagliabue I, Cirella L, Zanelli Quarantini F, Dakanalis A, Clerici M, Capuzzi E, Caldiroli A. Which clinical factors and biochemical parameters are associated with late-life major depression? Int J Psychiatry Clin Pract 2023; 27:359-366. [PMID: 37755139 DOI: 10.1080/13651501.2023.2260426] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023]
Abstract
INTRODUCTION Late-life major depression (MD) is a frequent and high-cost psychiatric disorder. Our purpose was to detect clinical and biological factors possibly associated with this condition to better prevent and treat it. METHODS We recruited 343 patients, consecutively admitted for a Major Depressive Episode to the inpatient clinic of Policlinico of Milan and ASST Monza, Italy. A large set of clinical and biochemical variables was collected from clinical charts. Univariate analyses were performed both dividing the sample into two groups (age < or ≥65) and considering age as a continuous quantitative variable. Regression analyses were then performed considering as independent variables only those statistically significant at univariate analyses. RESULTS Patients aged ≥ 65 resulted in having longer duration of illness, shorter duration of last antidepressant therapy, higher number of antidepressants assumed in the past, higher frequency of treatment-resistant depression, higher frequency of overweight/obesity and diabetes. As for biochemical parameters, patients ≥ 65 showed lower total plasmatic proteins and albumin, higher uric acid and creatinine. CONCLUSIONS These preliminary results suggest less effectiveness of antidepressants, more susceptibility to metabolic disorders and poor nutritional status in patients with late-life depression; such aspects may consequently be taken into consideration for a proper therapeutic approach. KEY POINTSDepression in late life seems to be associated with poorer response to antidepressants;Clinicians should prefer compounds with minimal pharmacokinetic interactions and less risk of side effects including metabolic ones;The poor nutritional status and the higher risk of metabolic disorders in older patients points out the importance of proper diet and healthy lifestyle in this group of subjects;Further studies are needed to confirm the results of this research.
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Affiliation(s)
- 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
| | - Francesca Legnani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Pan
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Cecilia Maria Esposito
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Martina Di Paolo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Teresa Surace
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Anna Maria Auxilia
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Martina Capellazzi
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Luisa Cirella
- Healthcare Professionals Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Zanelli Quarantini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
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13
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Capuzzi E, Di Forti CL, Caldiroli A, Cova F, Surace T, Buoli M, Clerici M. Sociodemographic and clinical factors associated with prescription of first- versus second-generation long-acting antipsychotics in incarcerated adult males. Int Clin Psychopharmacol 2023:00004850-990000000-00098. [PMID: 37781763 DOI: 10.1097/yic.0000000000000516] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 10/03/2023]
Abstract
Information on patterns of prescription of long-acting injection (LAI) antipsychotics among people who are incarcerated is lacking. Therefore, we aimed to evaluate prescribing rates for first-generation antipsychotic (FGA)-LAI versus second-generation antipsychotic (SGA)-LAI and to identify the factors associated with the prescription of one of the two classes of LAI. A cross-sectional study was conducted among incarcerated adult males hosted in Monza detention center between January 2013 and April 2023. Socio-demographic and clinical data were retrospectively collected. Descriptive and univariate statistics as well as logistic regression analyses were performed. Data were available for 135 consecutive incarcerated adult males with different mental disorders who received a LAI as part of their treatment. 75.6% of our sample was treated with FGA-LAIs, with haloperidol as the most commonly prescribed drug, followed by zuclopentixol and aripiprazole. Diagnosis of bipolar disorder and concomitant administration of antidepressants were statistically significant predictors of SGA-LAI prescription. Some patients' characteristics may influence prescription patterns in prison. Further longitudinal studies with larger samples should confirm these findings.
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Affiliation(s)
- Enrico Capuzzi
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori
| | | | - Alice Caldiroli
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori
| | - Francesca Cova
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori
| | - Teresa Surace
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Massimo Clerici
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori
- School of Medicine and Surgery, University of Milano Bicocca, Monza (MB)
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14
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Esposito CM, Barkin JL, Ceresa A, Nosari G, Di Paolo M, Legnani F, Cirella L, Surace T, Tagliabue I, Capuzzi E, Caldiroli A, Dakanalis A, Politi P, Clerici M, Buoli M. Are There Any Differences in Clinical and Biochemical Variables between Bipolar Patients with or without Lifetime Psychotic Symptoms? J Clin Med 2023; 12:5902. [PMID: 37762843 PMCID: PMC10531939 DOI: 10.3390/jcm12185902] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION Psychotic symptoms occur in more than half of patients affected by Bipolar Disorder (BD) and are associated with an unfavorable course of the disorder. The objective of this study is to identify the differences in the clinical and biochemical parameters between bipolar patients with or without psychotic symptoms. METHODS A total of 665 inpatients were recruited. Demographic, clinical, and biochemical data related to the first day of hospitalization were obtained via a screening of the clinical charts and intranet hospital applications. The two groups identified via the lifetime presence of psychotic symptoms were compared using t tests for quantitative variables and χ2 tests for qualitative ones; binary logistic regression models were subsequently performed. RESULTS Patients with psychotic BD (compared to non-psychotic ones) showed a longer duration of hospitalization (p < 0.001), higher Young Mania Rating Scale scores (p < 0.001), lower Global Assessment of Functioning scores (p = 0.002), a less frequent history of lifetime suicide attempts (p = 0.019), less achievement of remission during the current hospitalization (p = 0.028), and a higher Neutrophile to Lymphocyte Ratio (NLR) (p = 0.006), but lower total cholesterol (p = 0.018) and triglycerides (p = 0.013). CONCLUSIONS Patients with psychotic BD have a different clinical and biochemical profile compared to their counterparts, characterized by more clinical severity, fewer metabolic alterations, and a higher grade of inflammation. Further multi-center studies have to confirm the results of this present study.
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Affiliation(s)
- Cecilia Maria Esposito
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.C.); (G.N.); (M.D.P.); (F.L.)
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Jennifer L. Barkin
- Department of Community Medicine, School of Medicine, Mercer University, Macon, GA 31207, USA;
| | - Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.C.); (G.N.); (M.D.P.); (F.L.)
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.C.); (G.N.); (M.D.P.); (F.L.)
| | - Martina Di Paolo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.C.); (G.N.); (M.D.P.); (F.L.)
| | - Francesca Legnani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.C.); (G.N.); (M.D.P.); (F.L.)
| | - Luisa Cirella
- Healthcare Professionals Department, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Teresa Surace
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy; (T.S.); (I.T.); (E.C.); (A.C.); (M.C.)
| | - Ilaria Tagliabue
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy; (T.S.); (I.T.); (E.C.); (A.C.); (M.C.)
| | - Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy; (T.S.); (I.T.); (E.C.); (A.C.); (M.C.)
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy; (T.S.); (I.T.); (E.C.); (A.C.); (M.C.)
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, 20126 Monza, Italy;
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy; (T.S.); (I.T.); (E.C.); (A.C.); (M.C.)
- Department of Medicine and Surgery, University of Milano Bicocca, 20126 Monza, Italy;
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.C.); (G.N.); (M.D.P.); (F.L.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
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Capuzzi E, Caldiroli A, Quitadamo C, Butturini F, Surace T, Clerici M, Buoli M. Novel pharmacotherapy targeting the positive symptoms of schizophrenia. Expert Opin Pharmacother 2023; 24:1623-1648. [PMID: 37401388 DOI: 10.1080/14656566.2023.2231346] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/27/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION The severity of positive symptoms in schizophrenia is associated with poor prognosis. About one-third of schizophrenia patients partially respond to treatment with available antipsychotics. The purpose of the present manuscript is to provide an updated overview of novel pharmacotherapy targeting positive symptoms in schizophrenia. AREAS COVERED A comprehensive research on the main database sources (PubMed, PsychINFO, Isi Web of Knowledge, MEDLINE, and EMBASE) was performed to obtain original articles published till 31st January 2023 about new pharmacological strategies for the treatment of positive symptoms in schizophrenia. EXPERT OPINION The most promising compounds include: lamotrigine, pro-cognitive-compounds (donepezil - in the short term, idazoxan and piracetam) and drugs acting partially or totally outside the Central Nervous System (CNS) (anti-inflammatory drugs: celecoxib, methotrexate; cardiovascular compounds: L-theanine, mononitrate isosorbide, propentofylline, sodium nitroprusside; metabolic regulators: diazoxide, allopurinol; others: bexarotene, raloxifene [in women]). The effectiveness of the latter compounds indicates that other biological systems, such as immunity or metabolism can be object of future research to identify pharmacological targets for positive symptoms of schizophrenia. Mirtazapine could be useful for treating negative symptoms without increasing the risk of a worsening of delusions/hallucinations. Nevertheless, the lack of replication of studies prevents to draw definitive conclusions and future studies are needed to confirm the findings presented in this overview.
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Affiliation(s)
- Enrico Capuzzi
- Fondazione IRCCS, Department of Mental Health and Addiction, San Gerardo Dei Tintori, Monza, Italy
| | - Alice Caldiroli
- Fondazione IRCCS, Department of Mental Health and Addiction, San Gerardo Dei Tintori, Monza, Italy
| | - Cecilia Quitadamo
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy
| | - Francesco Butturini
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy
| | - Teresa Surace
- Fondazione IRCCS, Department of Mental Health and Addiction, San Gerardo Dei Tintori, Monza, Italy
| | - Massimo Clerici
- Fondazione IRCCS, Department of Mental Health and Addiction, San Gerardo Dei Tintori, Monza, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, 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
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16
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Caldiroli A, La Tegola D, Manzo F, Scalia A, Affaticati LM, Capuzzi E, Colmegna F, Argyrides M, Giaginis C, Mendolicchio L, Buoli M, Clerici M, Dakanalis A. The Impact of the COVID-19 Pandemic on Binge Eating Disorder: A Systematic Review. Nutrients 2023; 15:3777. [PMID: 37686811 PMCID: PMC10490470 DOI: 10.3390/nu15173777] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/30/2023] [Revised: 08/18/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
The aim of this systematic review was to synthesise the impact of the COVID-19 pandemic on binge eating disorder (BED) the new onset and course. Inclusion criteria: original articles and BED diagnosis; and the main outcomes: relationships between the COVID-19 pandemic and the new onset/clinical changes in BED, and specific results for BED. Exclusion criteria: mixed/inaccurate diagnoses and articles not written in English. We searched four databases and one registry until 5 May 2023. The quality appraisal was conducted using the Effective Public Health Practice Project (EPHPP) tool. Twelve studies with 4326 participants were included. All studies were observational with nine cross-sectional and three longitudinal. Four of the included studies investigated new-onset BED, while eight examined the BED clinical course of patients with a previous diagnosis. With the exception of one study, the available literature indicates both an increase in BED diagnoses and a clinical worsening during COVID-19. Major limitations include study quality (weak-to-moderate) and high heterogeneity in terms of pandemic phase, population, geographical areas, and psychometric tools. Our findings indicate that BED patients are particularly vulnerable to events characterised by social distancing and over-worry, and should be, therefore, carefully monitored. Further studies are needed to corroborate our findings, implement preventive strategies, and promote personalised treatments. PROSPERO registration number: CRD42023434106.
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Affiliation(s)
- Alice Caldiroli
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
| | - Davide La Tegola
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
| | - Francesca Manzo
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (F.M.); (A.S.); (L.M.A.)
| | - Alberto Scalia
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (F.M.); (A.S.); (L.M.A.)
| | - Letizia Maria Affaticati
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (F.M.); (A.S.); (L.M.A.)
| | - Enrico Capuzzi
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
| | - Fabrizia Colmegna
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
| | - Marios Argyrides
- Department of Psychology, Neapolis University Pafos, Paphos 8042, Cyprus;
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece;
| | - Leonardo Mendolicchio
- Istituto Auxologico Italiano IRCCS, U.O. dei Disturbi del Comportamento Alimentare, Ospedale San Giuseppe, 28824 Piancavallo, Italy;
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy;
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Massimo Clerici
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (F.M.); (A.S.); (L.M.A.)
| | - Antonios Dakanalis
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (F.M.); (A.S.); (L.M.A.)
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17
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Esposito CM, De Cagna F, Caldiroli A, Capuzzi E, Ceresa A, Di Paolo M, Auxilia AM, Capellazzi M, Tagliabue I, Cirella L, Clerici M, Brondino N, Barkin JL, Politi P, Buoli M. Gender differences in clinical and biochemical parameters among patients hospitalized for schizophrenia: towards precision medicine. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01644-4. [PMID: 37436457 DOI: 10.1007/s00406-023-01644-4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/25/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND The scientific literature shows some gender differences in the clinical course of schizophrenia. The aim of this study is to identify gender differences in clinical and biochemical parameters in subjects affected by schizophrenia. This would allow for the implementation of individualized treatment strategies. METHODS We examined a large set of clinical and biochemical parameters. Data were obtained from clinical charts and blood analyses from a sample of 555 schizophrenia patients consecutively admitted for exacerbation of symptoms to the inpatient clinic of Fondazione IRCCS Policlinico (Milan) or ASST Monza in Italy from 2008 to 2021. Univariate analyses, binary logistic regression, and a final logistic regression model were performed with gender as dependent variable. RESULTS The final logistic regression models showed that male patients (compared to females) were more prone to lifetime substance use disorders (p = 0.010). However, they also had higher GAF (global functioning) mean scores (p < 0.001) at the time of hospitalization. Univariate analyses showed that male patients (with respect to females) had an earlier age at onset (p < 0.001), a more frequent family history of multiple psychiatric disorders (p = 0.045), were more often smokers (p < 0.001), had a more frequent comorbidity with at least one psychiatric disorder (p = 0.001), and less often suffered from hypothyroidism (p = 0.011). In addition, men had higher levels of albumin (p < 0.001) and bilirubin (t = 2.139, p = 0.033), but lower levels of total cholesterol (t = 3.755, p < 0.001). CONCLUSIONS Our analyses indicate a less severe clinical profile in female patients. This is evident especially in the early years of the disorder, as suggested by less comorbidity with psychiatric disorders or later age at onset; this is consistent with the related literature. In contrast, female patients seem to be more vulnerable to metabolic alterations as demonstrated by more frequent hypercholesterolemia and thyroid dysfunction. Further studies are needed to confirm these results in the framework of precision medicine.
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Affiliation(s)
- Cecilia Maria Esposito
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.
| | | | - Alice Caldiroli
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, Monza, Italy
| | - Enrico Capuzzi
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, Monza, Italy
| | - Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy
| | - Martina Di Paolo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy
| | - Anna Maria Auxilia
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Martina Capellazzi
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Luisa Cirella
- Healthcare Professionals Department, Foundation IRCCS Ca Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, Monza, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Natascia Brondino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- ASST Pavia, Pavia, Italy
| | | | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- ASST Pavia, Pavia, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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18
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Fracas E, Costantino A, Vecchi M, Buoli M. Depressive and Anxiety Disorders in Patients with Inflammatory Bowel Diseases: Are There Any Gender Differences? Int J Environ Res Public Health 2023; 20:6255. [PMID: 37444101 PMCID: PMC10340762 DOI: 10.3390/ijerph20136255] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/11/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023]
Abstract
Gender differences were identified in the frequency and clinical presentations of inflammatory bowel disease (IBD) and depressive and anxiety disorders, which are more common in IBD patients than in the general population. The present manuscript provides a critical overview of gender differences in the frequency and clinical course of mood and anxiety disorders in IBD patients, with the aim of helping clinicians provide individualized management for patients. All of the included studies found that IBD patients reported a higher frequency of depressive and anxiety disorders than the general population. These findings should encourage healthcare providers to employ validated tools to monitor the mental health of their IBD patients, such as the Patient Health Questionnaire (PHQ-9). In addition, most studies confirm that women with IBD are more likely than men to develop affective disorders and show that up to 65% of women with IBD have depressive and anxiety disorders. Women with IBD require close mental health monitoring and ultimately a multidisciplinary approach involving mental health professionals. Drug treatment in women should be individualized and medications that may affect mental health (e.g., corticosteroids) should be thoroughly reconsidered. Further data are needed to ensure individualized treatment for IBD patients in a framework of precision medicine.
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Affiliation(s)
- Elia Fracas
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (E.F.); (A.C.); (M.V.)
| | - Andrea Costantino
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (E.F.); (A.C.); (M.V.)
- Division of Gastroenterology and Endoscopy, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Maurizio Vecchi
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (E.F.); (A.C.); (M.V.)
- Division of Gastroenterology and Endoscopy, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; (E.F.); (A.C.); (M.V.)
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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19
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Buoli M. [New research horizons of epidemiology applied to mental health.]. Recenti Prog Med 2023; 114:380-381. [PMID: 37229689 DOI: 10.1701/4042.40235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Epidemiological research in psychiatry has always played an important role, having allowed a precise classification of psychiatric disorders and a quantification of their spread in the general population. In the current context of precision psychiatry, the fields of development of epidemiological research include: 1) the relationship between mental health and physical well-being, overcoming the stigma associated with psychiatric disorders; 2) gender differences; 3) the impact of the physical environment on mental health beyond the socio-cultural context. These issues can be explored through a close collaboration between various health professionals, and also by spreading the culture of mental health monitoring in contexts outside psychiatry.
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Affiliation(s)
- Massimiliano Buoli
- Dipartimento di Neuroscienze e salute mentale, Fondazione Irccs Ca' Granda Ospedale Maggiore Policlinico, Milano - Dipartimento di Fisiopatologia medico-chirurgica e dei trapianti, Università di Milano
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20
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Surace T, Quitadamo C, Caldiroli A, Capuzzi E, Colmegna F, Nosari G, Borroni E, Fedrizzi L, Bollati V, Pesatori AC, Carugno M, Clerici M, Buoli M. Air Pollution and Perinatal Mental Health: A Comprehensive Overview. J Clin Med 2023; 12:jcm12093146. [PMID: 37176587 PMCID: PMC10179699 DOI: 10.3390/jcm12093146] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/21/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The aim of the present study was to summarise the available data about the link between air pollution exposure and the new-onset and severity of psychiatric disorders in pregnant women during the perinatal period. MATERIALS AND METHODS We selected articles published until June 2022 on PubMed and the Web of Science. Pollutants included were PM2.5 (particulate matter 2.5 micrometres and smaller), PM10 (particulate matter 10 micrometres and smaller), NO2 (nitrogen dioxide), O3 (ozone), SO2 (sulphur dioxide), CO (carbon monoxide), PBDEs (polybrominated diphenyl ethers), PFAS (per- and polyfluoroalkyl substances), lead, and cadmium. The perinatal period was considered as the time of pregnancy until one year after childbirth. RESULTS Nine studies were included; most of them evaluated the association between exposure to air pollutants and the onset of Postpartum Depression (PPD). Two studies showed an association between, respectively, only PM2.5 and both PM2.5 and NO2 exposure and PPD onset 12 months after childbirth, while another study found a significant association between NO2 exposure and PPD occurrence 6 months after childbirth. PBDE blood levels were associated with more severe depressive symptoms. Lastly, one study observed a link between stressful symptoms and exposure to PM2.5, PM10 during pregnancy. CONCLUSION More comprehensive and uniform studies are required to make a roadmap for future interventions, given the growing relevance of issues such pollution and mental health, particularly during the perinatal period.
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Affiliation(s)
- Teresa Surace
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Cecilia Quitadamo
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Alice Caldiroli
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Enrico Capuzzi
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Fabrizia Colmegna
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Elisa Borroni
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Luca Fedrizzi
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via San Barnaba 8, 20122 Milan, Italy
| | - Valentina Bollati
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Angela Cecilia Pesatori
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via San Barnaba 8, 20122 Milan, Italy
| | - Michele Carugno
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via San Barnaba 8, 20122 Milan, Italy
| | - Massimo Clerici
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
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21
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Borroni E, Pesatori AC, Nosari G, Monti P, Ceresa A, Fedrizzi L, Bollati V, Buoli M, Carugno M. Understanding the Interplay between Air Pollution, Biological Variables, and Major Depressive Disorder: Rationale and Study Protocol of the DeprAir Study. Int J Environ Res Public Health 2023; 20:ijerph20065196. [PMID: 36982103 PMCID: PMC10049152 DOI: 10.3390/ijerph20065196] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 05/27/2023]
Abstract
Major depressive disorder (MDD) is a serious and disabling condition, whose etiological mechanisms are not fully understood. The aim of the DeprAir study is to verify the hypothesis that air pollution exposure may exacerbate neuroinflammation with consequent alterations in DNA methylation of genes involved in circadian rhythms and hormonal dysregulation, resulting in the worsening of depressive symptoms. The study population consists of 420 depressed patients accessing the psychiatry unit of the Policlinico Hospital (Milan, Italy), from September 2020 to December 2022. Data collection is still ongoing for about 100 subjects. For each participant demographic and lifestyle information, depression history and characteristics, as well as blood samples, were collected. MDD severity was assessed through five rating scales commonly used in clinical practice to assess the severity of affective symptoms. Exposure to particulate and gaseous air pollutants is assigned to each subject using both air pollution monitoring station measurements and estimates derived from a chemical transport model. DeprAir is the first study investigating in a comprehensive picture whether air pollution exposure could be an important modifiable environmental factor associated with MDD severity and which biological mechanisms mediate the negative effect of air pollution on mental health. Its results will represent an opportunity for preventive strategies, thus entailing a tremendous impact on public health.
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Affiliation(s)
- Elisa Borroni
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy; (E.B.); (A.C.P.); (P.M.); (V.B.)
| | - Angela Cecilia Pesatori
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy; (E.B.); (A.C.P.); (P.M.); (V.B.)
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via san Barnaba 8, 20122 Milan, Italy;
| | - Guido Nosari
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, 20122 Milan, Italy; (G.N.); (A.C.); (M.B.)
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
| | - Paola Monti
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy; (E.B.); (A.C.P.); (P.M.); (V.B.)
| | - Alessandro Ceresa
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, 20122 Milan, Italy; (G.N.); (A.C.); (M.B.)
| | - Luca Fedrizzi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via san Barnaba 8, 20122 Milan, Italy;
| | - Valentina Bollati
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy; (E.B.); (A.C.P.); (P.M.); (V.B.)
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via san Barnaba 8, 20122 Milan, Italy;
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, 20122 Milan, Italy; (G.N.); (A.C.); (M.B.)
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
| | - Michele Carugno
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy; (E.B.); (A.C.P.); (P.M.); (V.B.)
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via san Barnaba 8, 20122 Milan, Italy;
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Caldiroli A, Colzani L, Capuzzi E, Quitadamo C, La Tegola D, Surace T, Russo S, Capetti M, Leo S, Tringali A, Marcatili M, Zanelli Quarantini F, Colmegna F, Dakanalis A, Buoli M, Clerici M. Clinical Markers of Panic and Generalized Anxiety Disorder: Overlapping Symptoms, Different Course and Outcome. J Pers Med 2023; 13:jpm13030491. [PMID: 36983673 PMCID: PMC10052351 DOI: 10.3390/jpm13030491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/11/2023] Open
Abstract
Generalized Anxiety Disorder (GAD) and Panic Disorder (PD) share underlying neurobiological mechanisms and several clinical features which, with medical comorbidities, may increase misdiagnosis and delay proper treatment. The aim of the study was to evaluate the association between clinical/socio-demographic markers and GAD/PD diagnosis. Outpatients (N = 290) with PD or GAD were identified in mental health services in Monza and Milan (Italy). Descriptive analyses and a binary logistic regression model were performed. Post-onset psychiatric (p = 0.05) and medical (p = 0.02) multiple co-morbidities were associated with GAD; treatment with selective serotonin reuptake inhibitors (SSRIs) was associated with PD, while GAD diagnosis was associated with treatment with atypical antipsychotics or GABAergic drugs (p = 0.03), as well as psychodynamic psychotherapy (p < 0.01). Discontinuation of the last pharmacological treatment was associated with GAD diagnosis rather than the PD one (p = 0.02). GAD patients may have a worse prognosis than PD patients because of more frequent multiple co-morbidities, relapses and poorer treatment compliance. The different treatment approaches were consistent with the available literature, while the association between GAD and psychodynamic psychotherapy is an original finding of our study. Further studies on larger samples are necessary to better characterize clinical factors associated with GAD or PD.
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Affiliation(s)
- Alice Caldiroli
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
- Correspondence: ; Tel.: +39-0392336046
| | - Lia Colzani
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Enrico Capuzzi
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Cecilia Quitadamo
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Davide La Tegola
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Teresa Surace
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Stefania Russo
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Mauro Capetti
- Department of Medicine and Surgery, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Silvia Leo
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Agnese Tringali
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Matteo Marcatili
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Francesco Zanelli Quarantini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Fabrizia Colmegna
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Antonios Dakanalis
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Massimo Clerici
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
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23
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Capuzzi E, Caldiroli A, Cella F, Turco M, Buoli M, Clerici M. Sociodemographic and clinical characteristics associated with delirium in hospitalized patients with COVID-19: are immigrants a vulnerable group? Intern Emerg Med 2023; 18:937-941. [PMID: 36877433 PMCID: PMC9987365 DOI: 10.1007/s11739-023-03232-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/10/2023] [Accepted: 02/14/2023] [Indexed: 03/07/2023]
Affiliation(s)
- Enrico Capuzzi
- Psychiatric Department, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Via Pergolesi 33, 20900, Monza, Italy.
| | - Alice Caldiroli
- Psychiatric Department, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Via Pergolesi 33, 20900, Monza, Italy
| | - Francesca Cella
- School of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900, Monza, MB, Italy
| | - Marco Turco
- School of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900, Monza, MB, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Massimo Clerici
- Psychiatric Department, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Via Pergolesi 33, 20900, Monza, Italy
- School of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900, Monza, MB, Italy
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24
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Caldiroli A, La Tegola D, Affaticati LM, Manzo F, Cella F, Scalia A, Capuzzi E, Nicastro M, Colmegna F, Buoli M, Clerici M, Dakanalis A. Clinical and Peripheral Biomarkers in Female Patients Affected by Anorexia: Does the Neutrophil/Lymphocyte Ratio (NLR) Affect Severity? Nutrients 2023; 15:nu15051133. [PMID: 36904132 PMCID: PMC10005379 DOI: 10.3390/nu15051133] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
Anorexia Nervosa (AN) is a disabling disorder characterized by extreme weight loss and frequent chronicization, especially in its most severe forms. This condition is associated with a pro-inflammatory state; however, the role of immunity in symptom severity remains unclear. Total cholesterol, white blood cells, neutrophils, lymphocytes, platelets, iron, folate, vitamin D and B12 were dosed in 84 female AN outpatients. Mildly severe (Body Mass Index-BMI ≥ 17) versus severe (BMI < 17) patients were compared using one-way ANOVAs or χ2 tests. A binary logistic regression model was run to investigate the potential association between demographic/clinical variables or biochemical markers and the severity of AN. Patients with severe anorexia (compared to mild forms) were older (F = 5.33; p = 0.02), engaged in more frequent substance misuse (χ2 = 3.75; OR = 3.86; p = 0.05) and had a lower NLR (F = 4.12; p = 0.05). Only a lower NLR was predictive of severe manifestations of AN (OR = 0.007; p = 0.031). Overall, our study suggests that immune alterations may be predictive of AN severity. In more severe forms of AN, the response of the adaptive immunity is preserved, while the activation of the innate immunity may be reduced. Further studies with larger samples and a wider panel of biochemical markers are needed to confirm the present results.
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Affiliation(s)
- Alice Caldiroli
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Davide La Tegola
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Letizia Maria Affaticati
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Francesca Manzo
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Francesca Cella
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Alberto Scalia
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Enrico Capuzzi
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Monica Nicastro
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Fabrizia Colmegna
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Massimo Clerici
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy
- Correspondence: ; Tel.: +39-3755-651904
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Caldiroli A, Capuzzi E, Tagliabue I, Ledda L, Clerici M, Buoli M. New frontiers in the pharmacological treatment of social anxiety disorder in adults: an up-to-date comprehensive overview. Expert Opin Pharmacother 2023; 24:207-219. [PMID: 36519357 DOI: 10.1080/14656566.2022.2159373] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Social anxiety disorder (SAD) is associated with scarce functioning and poor quality of life. Although selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are currently first-line treatments, side effects are common and affect treatment compliance in approximately 50% of patients. This review aimed to summarize data on the efficacy of unlabeled molecules for SAD treatment. AREAS COVERED Research in the main psychiatric databases was conducted (PubMed, PsychINFO, and EMBASE-Ovid) to select studies investigating the efficacy of marketed molecules not labeled for SAD treatment. EXPERT OPINION Pregabalin at high doses (450-600 mg/day) appears to be a reliable alternative strategy for SAD treatment. Among the SSRIs not labeled for SAD, citalopram showed the most promising results. Quetiapine, levetiracetam, and other antidepressants/serotonergic agents, such as fluoxetine, duloxetine, monoamine oxidase inhibitors, tricyclics, mirtazapine, atomoxetine, nefazodone, vilazodone, and buspirone, presented negative, limited, or contrasting results. Data on anticonvulsants, olanzapine, tiagabine, and ketamine were positive, but preliminary. The risk/benefit ratio must be considered in the prescription of unlabeled compounds; treatment with pregabalin may be associated with somnolence and dizziness. Future research may contribute to the identification of targeted molecules for the treatment of this disorder.
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Affiliation(s)
- Alice Caldiroli
- Department of Mental Health and Addiction, ASST Monza, Monza, Italy
| | - Enrico Capuzzi
- Department of Mental Health and Addiction, ASST Monza, Monza, Italy
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Luisa Ledda
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Massimo Clerici
- Department of Mental Health and Addiction, ASST Monza, Monza, Italy.,Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Caldiroli A, Capuzzi E, Affaticati LM, Surace T, Di Forti CL, Dakanalis A, Clerici M, Buoli M. Candidate Biological Markers for Social Anxiety Disorder: A Systematic Review. Int J Mol Sci 2023; 24:835. [PMID: 36614278 PMCID: PMC9821596 DOI: 10.3390/ijms24010835] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/24/2022] [Accepted: 12/29/2022] [Indexed: 01/05/2023] Open
Abstract
Social anxiety disorder (SAD) is a common psychiatric condition associated with a high risk of psychiatric comorbidity and impaired social/occupational functioning when not promptly treated. The identification of biological markers may facilitate the diagnostic process, leading to an early and proper treatment. Our aim was to systematically review the available literature about potential biomarkers for SAD. A search in the main online repositories (PubMed, ISI Web of Knowledge, PsychInfo, etc.) was performed. Of the 662 records screened, 61 were included. Results concerning cortisol, neuropeptides and inflammatory/immunological/neurotrophic markers remain inconsistent. Preliminary evidence emerged about the role of chromosome 16 and the endomannosidase gene, as well as of epigenetic factors, in increasing vulnerability to SAD. Neuroimaging findings revealed an altered connectivity of different cerebral areas in SAD patients and amygdala activation under social threat. Some parameters such as salivary alpha amylase levels, changes in antioxidant defenses, increased gaze avoidance and QT dispersion seem to be associated with SAD and may represent promising biomarkers of this condition. However, the preliminary positive correlations have been poorly replicated. Further studies on larger samples and investigating the same biomarkers are needed to identify more specific biological markers for SAD.
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Affiliation(s)
- Alice Caldiroli
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (E.C.); (T.S.); (M.C.)
| | - Enrico Capuzzi
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (E.C.); (T.S.); (M.C.)
| | - Letizia M. Affaticati
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (L.M.A.); (C.L.D.F.); (A.D.)
| | - Teresa Surace
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (E.C.); (T.S.); (M.C.)
| | - Carla L. Di Forti
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (L.M.A.); (C.L.D.F.); (A.D.)
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (L.M.A.); (C.L.D.F.); (A.D.)
| | - Massimo Clerici
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (E.C.); (T.S.); (M.C.)
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (L.M.A.); (C.L.D.F.); (A.D.)
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy;
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
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Barkin JL, Philipsborn RP, Curry CL, Upadhyay S, Geller PA, Pardon M, Dimmock J, Bridges CC, Sikes CA, Kondracki AJ, Buoli M. Climate Change is an Emerging Threat to Perinatal Mental Health. J Am Psychiatr Nurses Assoc 2022:10783903221139831. [PMID: 36482670 DOI: 10.1177/10783903221139831] [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: 12/13/2022]
Abstract
OBJECTIVE In this discussion, we build the case for why climate change is an emerging threat to perinatal mental health. METHOD A search of current literature on perinatal and maternal mental health and extreme weather events was conducted in PubMed/MEDLINE and Web of Science databases. Only articles focusing on maternal mental health were included in this narrative review. RESULTS The perinatal period represents a potentially challenging timeframe for women for several reasons. Necessary role adjustments (reprioritization), changes in one's ability to access pre-birth levels (and types) of social support, fluctuating hormones, changes in body shape, and possible complications during pregnancy, childbirth, or postpartum are just a few of the factors that can impact perinatal mental health. Trauma is also a risk factor for negative mood symptoms and can be experienced as the result of many different types of events, including exposure to extreme weather/natural disasters. CONCLUSION While the concepts of "eco-anxiety," "climate despair," and "climate anxiety" have garnered attention in the mainstream media, there is little to no discussion of how the climate crisis impacts maternal mental health. This is an important omission as the mother's mental health impacts the family unit as a whole.
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Affiliation(s)
- Jennifer L Barkin
- Jennifer L. Barkin, PhD, Mercer University School of Medicine, Macon, GA, USA
| | | | - Carolann L Curry
- Carolann L. Curry, MLIS, Mercer University School of Medicine, Macon, GA, USA
| | - Saswati Upadhyay
- Saswati Upadhyay, MBBS, MPH, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Pamela A Geller
- Pamela A. Geller, PhD, Drexel University, Philadelphia, PA, USA
- Pamela A. Geller, PhD, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Madelyn Pardon
- Madelyn Pardon, PhD, James Cook University, Townsville, Queensland, Australia
| | - James Dimmock
- James Dimmock, Telethon Kids Institute, Western Australia, Australia
- James Dimmock, James Cook University, Townsville, Queensland, Australia
| | - Christy C Bridges
- Christy C. Bridges, PhD, Mercer University School of Medicine, Macon, GA, USA
| | - Christina A Sikes
- Christina A. Sikes, RN, BSN, North Central Health District, Macon, GA, USA
| | - Anthony J Kondracki
- Anthony J. Kondracki, MD, PhD, Mercer University School of Medicine Savannah, Savannah, GA, USA
| | - Massimiliano Buoli
- Massimiliano Buoli, MD, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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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.
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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
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Capuzzi E, Caldiroli A, Auxilia AM, Borgonovo R, Capellazzi M, Clerici M, Buoli M. Biological Predictors of Treatment Response in Adult Attention Deficit Hyperactivity Disorder (ADHD): A Systematic Review. J Pers Med 2022; 12:jpm12101742. [PMID: 36294881 PMCID: PMC9605680 DOI: 10.3390/jpm12101742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent condition with onset in childhood and in many cases persisting into adulthood. Even though an increasing number of studies have investigated the efficacy of pharmacotherapy in the management of adult ADHD, few authors have tried to identify the biological predictors of treatment response. Objectives: To summarize the available data about the biological markers of treatment response in adults affected by ADHD. Methods: A search on the main biomedical and psychological archives (PubMed, Embase, Scopus, and PsycINFO) was performed. Manuscripts in English, published up to May 2022 and having the biological predictors of treatment response in adults with ADHD as their main topic, were included. Results: A total of 3855 articles was screened. Twenty-two articles were finally included. Most of the manuscripts studied neuroimaging and electrophysiological factors as potential predictors of treatment response in adult ADHD patients. No reliable markers were identified until now. Promising findings on this topic regard genetic polymorphisms in snap receptor (SNARE) proteins and default mode network-striatum connectivity. Conclusions: Even though some biological markers seem promising for the prediction of treatment response in adults affected by ADHD, further studies are needed to confirm the available data in the context of precision medicine.
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Affiliation(s)
- Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy
- Correspondence: ; Tel.: +39-0392339670
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy
| | - Anna Maria Auxilia
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Riccardo Borgonovo
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Martina Capellazzi
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Reschini M, Buoli M, Facchin F, Limena A, Dallagiovanna C, Bollati V, Somigliana E. Women's quality of sleep and in vitro fertilization success. Sci Rep 2022; 12:17477. [PMID: 36261696 PMCID: PMC9581906 DOI: 10.1038/s41598-022-22534-0] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 10/17/2022] [Indexed: 01/12/2023] Open
Abstract
Women undergoing in vitro fertilization (IVF) are emotionally challenged. Anxiety, depression, and sleep disturbances are common complaints. The impact of these symptoms on IVF outcome is however debated. In this study, we aimed at investigating whether sleep quality and psychological health can affect the chances of success of the procedure. Women undergoing IVF were recruited at the time of oocytes retrieval. Women's sleep quality and psychological health was assessed using the Pittsburgh Sleep Quality Index (PSQI), the Fertility Problem Inventory (FPI), and the Hospital Anxiety and Depression Scale (HADS). Baseline characteristics and results of the three scales were compared between women who did and did not succeed. Overall, 263 women were included, of whom 81 had a clinical pregnancy (31%). As expected, successful women were younger, and their ovarian reserve was more preserved. FPI and HADS scores did not differ. Conversely, a statistically significant difference emerged for the PSQI score, the median [interquartile range] in pregnant and non-pregnant women being 4 [3-5] and 5 [3-7], respectively (p = 0.004). The crude and adjusted OR of pregnancy in women with a PSQI > 5 (indicating impaired sleep quality) was 0.46 (95% CI 0.25-0.86, p = 0.02) and 0.50 (95% CI: 0.26-0.94, p = 0.03), respectively. In conclusion, low sleep quality is common in women scheduled for IVF and could influence the success of the procedure.
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Affiliation(s)
- Marco Reschini
- grid.414818.00000 0004 1757 8749Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via M. Fanti, 6, 20122 Milan, Italy
| | - Massimiliano Buoli
- grid.414818.00000 0004 1757 8749Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Federica Facchin
- grid.8142.f0000 0001 0941 3192Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Alessia Limena
- grid.414818.00000 0004 1757 8749Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via M. Fanti, 6, 20122 Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Chiara Dallagiovanna
- grid.414818.00000 0004 1757 8749Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via M. Fanti, 6, 20122 Milan, Italy
| | - Valentina Bollati
- grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Edgardo Somigliana
- grid.414818.00000 0004 1757 8749Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via M. Fanti, 6, 20122 Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
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Caldiroli A, Tagliabue I, Turco M, Capuzzi E, Fortunato A, Tringali A, Montana C, Maggioni L, Pellicioli C, Sibilla M, Marcatili M, Crespi G, Colmegna F, Buoli M, Clerici M. Comparing the COVID-19-related PTSD symptoms between psychiatric patients and healthy subjects: an observational retrospective study from Northern Italy. PSYCHOL HEALTH MED 2022; 28:1298-1308. [PMID: 36093977 DOI: 10.1080/13548506.2022.2121971] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 10/14/2022]
Abstract
COVID-19 pandemic had a great impact on mental health, both in the general population and psychiatric patients. Little is known about the difference between these two populations in perceiving the pandemic as a traumatic event. The aim of the study was to compare psychiatric patients and healthy controls (HC) in terms of change over time of post-traumatic (PTSD) symptoms. Demographic and clinical variables were collected. Impact of Event Scale Revised (IES-R) scores were registered at T1 as lockdown period (March-April 2020) and T2 as restarting (May-June 2020). Descriptive analyses and linear regression models were performed. A total of 166 outpatients and 57 HC were recruited. Time (F = 15.76; p < 0.001) and diagnosis (F = 4.94; p < 0.001) had a significant effect on the change of IES-R scores, which resulted T1 > T2 (p < 0.001), except for subjects affected by Obsessive-Compulsive Disorder (OCD). Overall, IES-R scores were < in patients than in HC (p = 0.02), particularly in the schizophrenia (SKZ) subgroup (p < 0.001). IES-R scores of subjects with personality disorders (PDs) resulted to be > HC, although not statistically significant. The lockdown period was perceived as more traumatic than the reopening phase by both groups, with the exception of OCD patients, probably because of the clinical worsening associated with the urge of control against risks of contamination. Overall, HC reported more PTSD symptoms than psychiatric patients did, particularly SKZ ones. PD patients, in contrast, may be more vulnerable to PTSD symptoms probably as a result of poor coping skills. Together with OCD patients, subjects with PDs may need closer monitoring during the different phases of the pandemic. Trial Registration: ClinicalTrials.gov Identifier: NCT04694482.
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Affiliation(s)
- A Caldiroli
- Department of Mental Health and Addiction, ASST Monza, Monza (MB), Italy
| | - I Tagliabue
- Department of Medicine and Surgery, University of Milan Bicocca, Monza (MB), Italy
| | - M Turco
- Department of Medicine and Surgery, University of Milan Bicocca, Monza (MB), Italy
| | - E Capuzzi
- Department of Mental Health and Addiction, ASST Monza, Monza (MB), Italy
| | - A Fortunato
- Department of Medicine and Surgery, University of Milan Bicocca, Monza (MB), Italy
| | - A Tringali
- Department of Medicine and Surgery, University of Milan Bicocca, Monza (MB), Italy
| | - C Montana
- Department of Medicine and Surgery, University of Milan Bicocca, Monza (MB), Italy
| | - L Maggioni
- Department of Medicine and Surgery, University of Milan Bicocca, Monza (MB), Italy
| | - C Pellicioli
- Department of Medicine and Surgery, University of Milan Bicocca, Monza (MB), Italy
| | - M Sibilla
- Department of Medicine and Surgery, University of Milan Bicocca, Monza (MB), Italy
| | - M Marcatili
- Department of Mental Health and Addiction, ASST Monza, Monza (MB), Italy
| | - G Crespi
- Department of Mental Health and Addiction, ASST Monza, Monza (MB), Italy
| | - F Colmegna
- Department of Mental Health and Addiction, ASST Monza, Monza (MB), Italy
| | - M 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
| | - M Clerici
- Department of Mental Health and Addiction, ASST Monza, Monza (MB), Italy
- Department of Medicine and Surgery, University of Milan Bicocca, Monza (MB), Italy
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Barbieri S, Amadio P, Macchi C, Zarà M, Favero C, Solazzo G, Vigna L, Greco M, Buoli M, Sirtori C, Ieraci A, Ruscica M, Bollati V. Relation among brain-derived neurotrophic factor, depression, and extracellular vesicles-derived miRNA: Results from an Italian cohort. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Amadio P, Macchi C, Favero C, Zarà M, Solazzo G, Dioni L, Sandrini L, Vigna L, Greco MF, Buoli M, Sirtori CR, Pesatori AC, Ieraci A, Ruscica M, Barbieri SS, Bollati V. Brain-Derived Neurotrophic Factor and Extracellular Vesicle-Derived miRNAs in an Italian Cohort of Individuals With Obesity: A Key to Explain the Link Between Depression and Atherothrombosis. Front Cardiovasc Med 2022; 9:906483. [PMID: 35911513 PMCID: PMC9326054 DOI: 10.3389/fcvm.2022.906483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/16/2022] [Indexed: 12/28/2022] Open
Abstract
BackgroundObesity and depression are intertwined diseases often associated with an increased risk of cardiovascular (CV) complications. Brain-Derived Neurotrophic Factor (BDNF), altered in the brain both of subjects with depression and obesity, provides a potential link between depression and thrombosis. Since the relationship among peripheral BDNF, depression and obesity is not well-defined, the aim of the present report has been to address this issue taking advantage of the contribution played by extracellular vesicle (EV)-derived miRNAs.Research ProcessAssociations among circulating BDNF, depression and EV-derived miRNAs related to atherothrombosis have been evaluated in a large Italian cohort of obese individuals (n = 743), characterized by the Beck Depression Inventory (BDI-II) score.ResultsBDI-II was negatively associated with BDNF levels without a significant impact of the rs6265 BDNF polymorphism; this association was modified by raised levels of IFN-γ. BDNF levels were linked to an increase of 80 EV-derived miRNAs and a decrease of 59 miRNAs related to atherosclerosis and thrombosis. Network analysis identified at least 18 genes targeted by these miRNAs, 7 of which involved in depression and CV risk. The observation of a possible link among BDNF, depression, and miRNAs related to atherothrombosis and depression in obesity is novel and may lead to a wider use of BDNF as a CV risk biomarker in this specific subject group.
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Affiliation(s)
- Patrizia Amadio
- Brain-Heart Axis: Cellular and Molecular Mechanisms Unit, Centro Cardiologico Monzino Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Chiara Macchi
- Department of Biomolecular and Pharmacological Sciences, University of Milan, Milan, Italy
| | - Chiara Favero
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Marta Zarà
- Brain-Heart Axis: Cellular and Molecular Mechanisms Unit, Centro Cardiologico Monzino Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Giulia Solazzo
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Laura Dioni
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Leonardo Sandrini
- Brain-Heart Axis: Cellular and Molecular Mechanisms Unit, Centro Cardiologico Monzino Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Luisella Vigna
- Occupational Health Unit, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Francesca Greco
- Department of Biomolecular and Pharmacological Sciences, University of Milan, Milan, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca'Granda Ospedale, Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Cesare R. Sirtori
- Department of Biomolecular and Pharmacological Sciences, University of Milan, Milan, Italy
| | - Angela Cecilia Pesatori
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Occupational Health Unit, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandro Ieraci
- Department of Pharmaceutical Sciences, University of Milan, Milan, Italy
| | - Massimiliano Ruscica
- Department of Biomolecular and Pharmacological Sciences, University of Milan, Milan, Italy
- *Correspondence: Massimiliano Ruscica
| | - Silvia Stella Barbieri
- Brain-Heart Axis: Cellular and Molecular Mechanisms Unit, Centro Cardiologico Monzino Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
- Silvia Stella Barbieri
| | - Valentina Bollati
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Limena A, Reschini M, Buoli M, Facchin F, Dallagiovanna C, Bollati V, Somigliana E. P-726 Women’s quality of sleep and in vitro fertilization success. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Can sleep quality and psychological health of women undergoing In Vitro Fertilization (IVF) affect the chances of success of the procedure?
Summary answer
Psychological health doesn’t seem to affect IVF outcomes while sleep disturbances are common in women undergoing IVF and could influence the success of the procedure.
What is known already
IVF is saddled with a significant emotional burden causing anxiety, depression, and sleep disturbances. Baseline high levels of stress seem to be negatively associated with IVF success whereas studies evaluating the effect of anxiety and depression are discordant. Investigating sleep disorders in this setting is particularly attracting because of the significant association with anxiety and stress and because it is a simple information to collect. In addition, sleep disorders could negatively affect IVF success, as it does for natural conceptions, due to the well-established association between sleep and the hormonal system. Evidence on this issue is however scant and inconclusive.
Study design, size, duration
This is a single-center prospective cohort study designed to examine whether the sleep quality and psychological health of women undergoing IVF affect the chances of success of the procedure. Two hundred sixty-three women undergoing IVF between September to December 2019 were enrolled. Baseline characteristics and women’s sleep quality and psychological health were compared between women who did and did not have a live birth.
Participants/materials, setting, methods
Inclusion criteria were admission for oocyte pick-up. Women with neurologic or psychiatric disorders, obstructive sleep apnea syndrome, anatomical factors that can reduce embryo implantation and limited understanding of the Italian language were excluded. Women’s sleep quality and psychological health were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Fertility Problem Inventory (FPI), and the Hospital Anxiety and Depression Scale (HADS).
Main results and the role of chance
Overall, 81 women had a live birth (31%). As expected, successful women were younger, and their ovarian reserve was more preserved. No significant group differences were detected for education, employment, parity, smoking status, body mass index and indication to IVF. FPI and HADS scores did not differ. Conversely, our findings revealed that sleep disturbances were associated with lower chances of live birth in IVF: a statistically significant difference emerged for the PSQI score, the median [interquartile range] in pregnant and non-pregnant women being 4 [3-5] and 5 [3-7], respectively (p = 0.004). The crude and adjusted OR of pregnancy in women with a PSQI >5 (indicating impaired sleep quality) was 0.46 (95%CI: 0.25-0.86, p = 0.02) and 0.50 (95%CI: 0.26-0.94, p = 0.03), respectively.
Limitations, reasons for caution
Data were collected during treatment, which did not allow to properly investigate the association between sleep quality, infertility, and IVF itself. Sleep quality was assessed using a self-reported sleep measure (although validated and extensively used by clinicians and researchers), which does not ensure the objectivity of observations.
Wider implications of the findings
The assessment of sleep quality throughout the treatment period should be included as an important part of multidisciplinary clinical management of women undergoing IVF. Sleep quality of candidate mothers should be promoted by the implementation of prevention programmes and targeted interventions.
Trial registration number
not applicable
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Affiliation(s)
- A Limena
- IRCCS Ca’ Granda- Ospedale Maggiore Policlinico, Infertility Unit , Milan, Italy
| | - M Reschini
- IRCCS Ca’ Granda- Ospedale Maggiore Policlinico, Infertility Unit , Milan, Italy
| | - M Buoli
- IRCCS Ca’ Granda- Ospedale Maggiore Policlinico, Dept of Neurosciences and Mental Health , Milan, Italy
| | | | - C Dallagiovanna
- IRCCS Ca’ Granda- Ospedale Maggiore Policlinico, Infertility Unit , Milan, Italy
| | - V Bollati
- Università degli Studi di Milano, Dept of Clinical Sciences and Community Health , Milan, Italy
| | - E Somigliana
- IRCCS Ca’ Granda- Ospedale Maggiore Policlinico, Infertility Unit , Milan, Italy
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Coletto LA, Ingegnoli F, Cambria C, Cantone L, De Lucia O, Caporali R, Bollati V, Buoli M, Antonucci F. POS0430 SYNOVIAL FLUID-DERIVED EXTRACELLULAR VESICLES FROM RHEUMATOID ARTHRITIS AND OSTEOARTHRITIS MODULATE DIFFERENT HIPPOCAMPAL SYNAPTIC ACTIVITIES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3188] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundAccumulating evidence suggests that poor mental health is one of the most common comorbidities of both rheumatoid arthritis (RA) and osteoarthritis (OA) [1]. Even if underpinning RA and OA are different genetic, structural, mechanical, and immunologic pathways involved in their pathogenesis, poor mental health, and joint involvement are intertwined and negatively affect their mutual course by contributing to global disability. Thus, new insights into mechanisms that link these disorders are needed to identify new actionable biomarkers to drive more personalized therapeutic strategies. Amidst potential mediators, extracellular vesicles (EVs) play a central role in terms of communication between cells, they cross the blood-brain barrier and based on their cargos can affect the recipient cell function [2].ObjectivesTo isolate EVs from synovial fluid (SF) in RA and OA patients and to evaluate if and how these EVs can alter in vitro synaptic transmission of murine hippocampal neurons.MethodsIn this cross-sectional pilot study, consecutive adult RA and primary OA who were referred to the Rheumatology Unit for aspiration of joint effusion were enrolled. Demographic and clinical variables and mental health rating scales were collected. Discarded SF were collected and EVs were isolated and analyzed by Malvern NanoSight NS300 system to obtain information on their number and size. Afterwards, DIV14 cultured wild-type hippocampal neurons were exposed for two hours to OA- and RA-EVs at low and high concentration EVs. Thus, miniature excitatory and inhibitory postsynaptic currents (mEPSCs and mIPSCs), which reflects glutamatergic and GABA-ergic activity respectively, were examined by exploiting patch-clamp recordings in the whole-cell configuration. Frequency and amplitude were analyzed to evaluate potential changes at the presynaptic or postsynaptic compartment. Mann Whitney test was used to compare two different samples.ResultsEight RA patients (7 female, mean age 57 yrs), and 5 primary OA (4 female, mean age 60 yrs) were recruited for SF aspiration. The mean VAS pain was 7.25 in RA and 6.5 in OA. No statistically significant differences were found between the two groups in mean rating scale scores although patients affected by RA had more severe depressive symptoms (Montgomery Asberg Depression Rating Scale -MADRS- means scores: 16.57) with respect OA group (MADRS mean scores: 10). The Nanoparticle tracking analysis showed that RA-EVs were significantly more in number compared to OA-EVs (Figure 1 A), mimicking more inflammation, while no significant difference in size was observed. Analysis of miniature events revealed the occurrence of two different changes. High concentration of OA-EVs has led to an increased amplitude of excitatory events, meaning an increased susceptibility of neurons to glutamate in the post-synaptic compartment (Figure 1 B). Whereas low concentration of RA-EVs has led to a decreased frequency of inhibitory events, which reflects a reduced function of GABA-ergic synapse in the pre-synaptic compartment (Figure 1 C).Figure 1.ConclusionOur results suggest that SF-derived EVs from OA and RA patients lead to different specific changes of neurotransmission, with different concentration needed to alter neuronal spontaneous activity in post-synaptic and pre-synaptic compartment, respectively. EVs may provide insight into the pathogenesis of joint-brain communication in RA and OA, unraveling specific pathways thus allowing targeted therapies for neuropsychiatric involvement.References[1]Lancet 2017;390(10100): 1211–1259[2]FASEB Bioadv 2021;3(9):665-675Disclosure of InterestsLavinia A. Coletto: None declared, Francesca Ingegnoli: None declared, Clara Cambria: None declared, Laura Cantone: None declared, Orazio De Lucia: None declared, Roberto Caporali Speakers bureau: Abbvie, Amgen, BMS, Celltrion, Galapagos, Lilly, Pfizer, Fresenius-Kabi, MSD, UCB, Roche,Janssen, Novartis, Sandoz, Consultant of: Abbvie, Amgen, BMS, Celltrion, Galapagos, Lilly, Pfizer, MSD, UCB, Janssen, Novartis, Sandoz, Valentina Bollati: None declared, Massimiliano Buoli: None declared, Flavia Antonucci: None declared.
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Enrico C, Caldiroli A, Di Brita C, Colmegna F, Nava R, Colzani LC, Sibilla M, Prodi T, Buoli M, Clerici M. Profile of patients attending psychiatric emergency care during the coronavirus 2019 (COVID 19) pandemic: a comparative cross-sectional study between lockdown and post-lockdown periods in Lombardy, Italy. Int J Psychiatry Clin Pract 2022; 26:132-138. [PMID: 34151680 DOI: 10.1080/13651501.2021.1939385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess the long-term impact of early COVID-19 lockdown phase on emergency psychiatric consultations in two psychiatric emergency departments located in Italy. METHODS We conducted a cross-sectional study comparing the number and characteristics of emergency psychiatric consultations during post-lockdown with respect to the lockdown period. Sociodemographic data, clinical characteristics, referred symptoms, diagnosis, information on multiple psychiatric consultations and hospitalisation were collected. RESULTS A rise of almost 60% in emergency psychiatric consultations during the post-lockdown compared to the lockdown period was observed. Emergency psychiatric consultations in the post-lockdown period were associated with lower rates of cannabis (aOR = 0.42, p = 0.011) and cocaine use (aOR = 0.39, p = 0.011). Despite a lower occurrence of two or more psychiatric consultations was observed during post-lockdown phase (aOR = 0.44, p = 0.008), subjects who had anxiety disorders (aOR = 3.91, p = 0.000) and substance intoxication or withdrawal (aOR = 6.89, p = 0.000) were more likely to present to emergency psychiatric consultations during post-lockdown period compared to the lockdown one. CONCLUSIONS Substance intoxication or withdrawal and anxiety disorders increased after the COVID-19 lockdown. The findings of this study suggest to address more economic and professional sources to the mental health areas potentially more affected by the different phases of a pandemic.KEYPOINTSCOVID-19 pandemic and lockdown measures increased mental health unmet needs.According to our findings, a rise in emergency psychiatric consultations during the post-lockdown compared to the lockdown period was observed.Patients with substance intoxication or withdrawal syndrome and anxiety disorders were significantly more likely to present to emergency psychiatric consultations during post-lockdown.Lockdown was associated with higher rates of both cannabis and cocaine use disorders as well as of multiple psychiatric consultations.Alternative strategies to improve mental health such as e-health technologies should be promoted.
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Affiliation(s)
- Capuzzi Enrico
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Carmen Di Brita
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Fabrizia Colmegna
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Roberto Nava
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Lia Chiara Colzani
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Matteo Sibilla
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Tiziano Prodi
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, 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
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy.,Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
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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.
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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
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Capuzzi E, Ossola P, Caldiroli A, Auxilia AM, Buoli M. Malondialdehyde as a candidate biomarker for bipolar disorder: A meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2022; 113:110469. [PMID: 34740710 DOI: 10.1016/j.pnpbp.2021.110469] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Received: 07/17/2021] [Revised: 09/30/2021] [Accepted: 10/29/2021] [Indexed: 01/10/2023]
Abstract
Malondialdehyde (MDA) represents one of the final products of lipid peroxidation that is thought to be enhanced and accelerated in patients affected by bipolar disorder (BD). Purpose of the present article is to critically summarize the available data about MDA as a candidate biomarker for BD. First, we carried out a systematic review of the literature selecting those papers that evaluated MDA levels in BD. Then, we performed two separate meta-analyses: one of the studies that compared healthy controls (HC) with unmedicated BD and one with the studies that assessed MDA levels before and after treatment in BD, showing that bipolar patients experience more oxidative stress than healthy subjects and that treatment is effective in reducing MDA levels. In the first set of studies, we also explored through a meta-regression whether age, gender and experiencing an episode specifically influenced the difference between BD and HC in MDA levels. Bipolar patients compared to healthy subjects had higher MDA levels (SMD: 0.94, 95% CI: 0.23-1.64). Age (p < 0.01), gender (p < 0.01) and the presence of a current mood episode (p < 0.01) significantly influenced MDA plasma/serum levels. Specifically, studies that included more female, older subjects and more BD in euthymia were more likely to have higher MDA levels. Finally, patients after treatment had lower levels of MDA compared to baseline (SMD: -0.52, 95% CI: -0.85 -0.19). More studies are needed to draw definitive conclusions.
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Affiliation(s)
- Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy.
| | - Paolo Ossola
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Anna Maria Auxilia
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza, MB, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale, Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Buoli M, Capuzzi E, Caldiroli A, Ceresa A, Esposito CM, Posio C, Auxilia AM, Capellazzi M, Tagliabue I, Surace T, Legnani F, Cirella L, Di Paolo M, Nosari G, Zanelli Quarantini F, Clerici M, Colmegna F, Dakanalis A. Clinical and Biological Factors Are Associated with Treatment-Resistant Depression. Behav Sci (Basel) 2022; 12:bs12020034. [PMID: 35200285 PMCID: PMC8869369 DOI: 10.3390/bs12020034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/19/2022] [Accepted: 01/29/2022] [Indexed: 12/13/2022] Open
Abstract
Background: Treatment-resistant depression (TRD) is a debilitating condition associated with unmet clinical needs. Few studies have explored clinical characteristics and serum biomarkers associated with TRD. Aims: We investigated whether there were differences in clinical and biochemical variables between patients affected by TRD than those without. Methods: We recruited 343 patients (165 males and 178 females) consecutively hospitalized for MDD to the inpatient clinics affiliated to the Fondazione IRCCS Policlinico, Milan, Italy (n = 234), and ASST Monza, Italy (n = 109). Data were obtained through a screening of the clinical charts and blood analyses conducted during the hospitalization. Results: TRD versus non-TRD patients resulted to be older (p = 0.001), to have a longer duration of illness (p < 0.001), to be more currently treated with a psychiatric poly-therapy (p < 0.001), to have currently more severe depressive symptoms as showed by the Hamilton Depression Rating Scale (HAM-D) scores (p = 0.016), to have lower bilirubin plasma levels (p < 0.001). In addition, more lifetime suicide attempts (p = 0.035), more antidepressant treatments before the current episode (p < 0.001), and a lower neutrophil to lymphocyte ratio at borderline statistically significant level (p = 0.060) were all associated with the TRD group. Conclusion: We identified candidate biomarkers associated with TRD such as bilirubin plasma levels and NLR, to be confirmed by further studies. Moreover, TRD seems to be associated with unfavorable clinical factors such as a predisposition to suicidal behaviors. Future research should replicate these results to provide robust data in support of the identification of new targets of treatment and implementation of prevention strategies for TRD.
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Affiliation(s)
- Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Enrico Capuzzi
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, 20900 Monza, Italy; (E.C.); (A.C.); (M.C.); (F.C.)
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, 20900 Monza, Italy; (E.C.); (A.C.); (M.C.); (F.C.)
| | - Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-02-55035983
| | - Cecilia Maria Esposito
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Cristina Posio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
| | - Anna Maria Auxilia
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy; (A.M.A.); (M.C.); (I.T.); (A.D.)
| | - Martina Capellazzi
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy; (A.M.A.); (M.C.); (I.T.); (A.D.)
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy; (A.M.A.); (M.C.); (I.T.); (A.D.)
| | - Teresa Surace
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, 20900 Monza, Italy; (E.C.); (A.C.); (M.C.); (F.C.)
| | - Francesca Legnani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Luisa Cirella
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
| | - Martina Di Paolo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
| | - Francesco Zanelli Quarantini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, 20900 Monza, Italy; (E.C.); (A.C.); (M.C.); (F.C.)
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy; (A.M.A.); (M.C.); (I.T.); (A.D.)
| | - Fabrizia Colmegna
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, 20900 Monza, Italy; (E.C.); (A.C.); (M.C.); (F.C.)
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy; (A.M.A.); (M.C.); (I.T.); (A.D.)
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Caldiroli A, Capuzzi E, Tringali A, Tagliabue I, Turco M, Fortunato A, Sibilla M, Montana C, Maggioni L, Pellicioli C, Marcatili M, Nava R, Crespi G, Colmegna F, Buoli M, Clerici M. The psychopathological impact of the SARS-CoV-2 epidemic on subjects suffering from different mental disorders: An observational retrospective study. Psychiatry Res 2022; 307:114334. [PMID: 34902818 PMCID: PMC8664498 DOI: 10.1016/j.psychres.2021.114334] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 11/22/2021] [Accepted: 12/05/2021] [Indexed: 12/16/2022]
Abstract
SARS-CoV-2 infection causes a pulmonary disease (COVID-19) which spread worldwide generating fear, anxiety, depression in the general population as well as among subjects affected by mental disorders. Little is known about which different psychopathological changes the pandemic caused among individuals affected by different psychiatric disorders, which represents the aim of the present study. Specific psychometric scales were administered at three time points: T0 as outbreak of pandemic, T1 as lockdown period, T2 as reopening. Descriptive analyses and linear regression models were performed. A total of 166 outpatients were included. Overall, psychometric scores showed a significant worsening at T1 with a mild improvement at T2. Only psychopathology in schizophrenia (SKZ) patients and obsessive-compulsive (OC) symptoms did not significantly improve at T2. Subjects affected by personality disorders (PDs) resulted to be more compromised in terms of general psychopathology than depressed and anxiety/OC ones, and showed more severe anxiety symptoms than SKZ patients. In conclusion, subjects affected by PDs require specific clinical attention during COVID-19 pandemic. Moreover, the worsening of SKZ and OC symptoms should be strictly monitored by clinicians, as these aspects did not improve with the end of lockdown measures. Further studies on larger samples are needed to confirm our results. ClinicalTrials.gov Identifier: NCT04694482.
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Affiliation(s)
- Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Via G.B. Pergolesi 33 MB, Monza, Italy.
| | - Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Via G.B. Pergolesi 33 MB, Monza, Italy
| | - Agnese Tringali
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Marco Turco
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Andrea Fortunato
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Matteo Sibilla
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Caterina Montana
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Laura Maggioni
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Cristian Pellicioli
- Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
| | - Matteo Marcatili
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Via G.B. Pergolesi 33 MB, Monza, Italy
| | - Roberto Nava
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Via G.B. Pergolesi 33 MB, Monza, Italy
| | - Giovanna Crespi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Via G.B. Pergolesi 33 MB, Monza, Italy
| | - Fabrizia Colmegna
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Via G.B. Pergolesi 33 MB, 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
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Via G.B. Pergolesi 33 MB, Monza, Italy,Department of Medicine and Surgery, University of Milan Bicocca, via Cadore 38 MB, Monza 20900, Italy
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Ingegnoli F, Schioppo T, Ubiali T, Ostuzzi S, Bollati V, Buoli M, Caporali R. Patient Perception of Depressive Symptoms in Rheumatic Diseases: A Cross-sectional Survey. J Clin Rheumatol 2022; 28:e18-e22. [PMID: 32925449 PMCID: PMC10880925 DOI: 10.1097/rhu.0000000000001564] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The presented study aimed to explore the presence and the self-identification of depressive symptoms among patients with rheumatic musculoskeletal diseases (RMDs) through the use of the Patient Health Questionnaire (PHQ-9). METHODS Between June and October 2019, patients from the regional association for people with RMDs in Lombardy, Italy (ALOMAR), were invited to participate in a cross-sectional online survey. Participants completed PHQ-9 along with a survey about their perception of depressive symptoms. Patients were stratified according to PHQ-9 score as follows: not depressed (<4), subclinical or mild depression (5-9), moderate depression (10-14), moderately severe depression (10-14), and severe depression (20-27). Descriptive statistics and analyses of variance were used to explore data. RESULTS Of the 192 RMD patients who completed PHQ-9, 35 (18.2%) were not depressed, 68 (35.4%) had subclinical or mild depression, 42 (21.9%) had moderate depression, 30 (15.6%) had moderately severe depression, and 17 (8.9%) had severe depression. Contrary to the above findings, only 16 respondents (8.3%) reported that they experienced depressive symptoms, and only 7 of the 16 were being followed by a psychiatrist. Respondents with higher PHQ-9 scores tended to have concomitant fibromyalgia, to be younger, and to be overweight. CONCLUSIONS The current results indicate the overall burden of depressive symptoms in RMD patients. While clinical depression (PHQ-9 >10) was detected in 41.2% of respondents, only 8.3% reported that they experience depressive symptoms. Routine screening of RMD patients for depression is therefore critical.
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Affiliation(s)
- Francesca Ingegnoli
- From the Division of Clinical Rheumatology, ASST Pini
- Department of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Research Center for Environmental Health, Università degli Studi di Milano
| | - Tommaso Schioppo
- From the Division of Clinical Rheumatology, ASST Pini
- Department of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Research Center for Environmental Health, Università degli Studi di Milano
| | - Tania Ubiali
- From the Division of Clinical Rheumatology, ASST Pini
| | | | - Valentina Bollati
- Department of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Research Center for Environmental Health, Università degli Studi di Milano
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab, Università degli Studi di Milano
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy
| | - Roberto Caporali
- From the Division of Clinical Rheumatology, ASST Pini
- Department of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Research Center for Environmental Health, Università degli Studi di Milano
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Borroni E, Pesatori AC, Bollati V, Buoli M, Carugno M. Air pollution exposure and depression: A comprehensive updated systematic review and meta-analysis. Environ Pollut 2022; 292:118245. [PMID: 34600062 DOI: 10.1016/j.envpol.2021.118245] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/21/2021] [Accepted: 09/25/2021] [Indexed: 06/13/2023]
Abstract
We provide a comprehensive and updated systematic review and meta-analysis of the association between air pollution exposure and depression, searching PubMed, Embase, and Web of Sciences for relevant articles published up to May 2021, and eventually including 39 studies. Meta-analyses were performed separately according to pollutant type [particulate matter with diameter ≤10 μm (PM10) and ≤2.5 μm (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO)] and exposure duration [short- (<30 days) and long-term (≥30 days)]. Test for homogeneity based on Cochran's Q and I2 statistics were calculated and the restricted maximum likelihood (REML) random effect model was applied. We assessed overall quality of pooled estimates, influence of single studies on the meta-analytic estimates, sources of between-study heterogeneity, and publication bias. We observed an increased risk of depression associated with long-term exposure to PM2.5 (relative risk: 1.074, 95% confidence interval: 1.021-1.129) and NO2 (1.037, 1.011-1.064), and with short-term exposure to PM10 (1.009, 1.006-1.012), PM2.5 (1.009, 1.007-1.011), NO2 (1.022, 1.012-1.033), SO2 (1.024, 1.010-1.037), O3 (1.011, 0.997-1.026), and CO (1.062, 1.020-1.105). The publication bias affecting half of the investigated associations and the high heterogeneity characterizing most of the meta-analytic estimates partly prevent to draw very firm conclusions. On the other hand, the coherence of all the estimates after excluding single studies in the sensitivity analysis supports the soundness of our results. This especially applies to the association between PM2.5 and depression, strengthened by the absence of heterogeneity and of relevant publication bias in both long- and short-term exposure studies. Should further investigations be designed, they should involve large sample sizes, well-defined diagnostic criteria for depression, and thorough control of potential confounding factors. Finally, studies dedicated to the comprehension of the mechanisms underlying the association between air pollution and depression remain necessary.
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Affiliation(s)
- Elisa Borroni
- Department of Clinical Sciences and Community Health, University of Milan, via san Barnaba 8, 20122, Milan, Italy
| | - Angela Cecilia Pesatori
- Department of Clinical Sciences and Community Health, University of Milan, via san Barnaba 8, 20122, Milan, Italy; Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via san Barnaba 8, 20122, Milan, Italy.
| | - Valentina Bollati
- Department of Clinical Sciences and Community Health, University of Milan, via san Barnaba 8, 20122, Milan, Italy
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, 20122, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Michele Carugno
- Department of Clinical Sciences and Community Health, University of Milan, via san Barnaba 8, 20122, Milan, Italy; Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via san Barnaba 8, 20122, Milan, Italy
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Buoli M, Cesana BM, Bolognesi S, Fagiolini A, Albert U, Di Salvo G, Maina G, de Bartolomeis A, Pompili M, Palumbo C, Bondi E, Steardo L, De Fazio P, Amore M, Altamura M, Bellomo A, Bertolino A, Di Nicola M, Di Sciascio G, Fiorillo A, Sacchetti E, Sani G, Siracusano A, Di Lorenzo G, Tortorella A, Altamura AC, Dell'Osso B. Factors associated with lifetime suicide attempts in bipolar disorder: results from an Italian nationwide study. Eur Arch Psychiatry Clin Neurosci 2022; 272:359-370. [PMID: 34652488 PMCID: PMC8938374 DOI: 10.1007/s00406-021-01343-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 10/04/2021] [Indexed: 12/19/2022]
Abstract
The purpose of the present study was to detect demographic and clinical factors associated with lifetime suicide attempts in Bipolar Disorder (BD). A total of 1673 bipolar patients from different psychiatric departments were compared according to the lifetime presence of suicide attempts on demographic/clinical variables. Owing to the large number of variables statistically related to the dependent variable (presence of suicide attempts) at the univariate analyses, preliminary multiple logistic regression analyses were realized. A final multivariable logistic regression was then performed, considering the presence of lifetime suicide attempts as the dependent variable and statistically significant demographic/clinical characteristics as independent variables. The final multivariable logistic regression analysis showed that an earlier age at first contact with psychiatric services (odds ratio [OR] = 0.97, p < 0.01), the presence of psychotic symptoms (OR = 1.56, p < 0.01) or hospitalizations (OR = 1.73, p < 0.01) in the last year, the attribution of symptoms to a psychiatric disorder (no versus yes: OR = 0.71, partly versus yes OR = 0.60, p < 0.01), and the administration of psychoeducation in the last year (OR = 1.49, p < 0.01) were all factors associated with lifetime suicide attempts in patients affected by BD. In addition, female patients resulted to have an increased association with life-long suicidal behavior compared to males (OR: 1.02, p < 0.01). Several clinical factors showed complex associations with lifetime suicide attempts in bipolar patients. These patients, therefore, require strict clinical monitoring for their predisposition to a less symptom stabilization. Future research will have to investigate the best management strategies to improve the prognosis of bipolar subjects presenting suicidal behavior.
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Affiliation(s)
- Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Bruno Mario Cesana
- Department of Clinical Sciences and Community Health, Unit of Medical Statistics, Biometry and Bioinformatics "Giulio A. Maccacaro", Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | | | | | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, Department of Mental Health, UCO Clinica Psichiatrica, ASUGI-Azienda Sanitaria Universitaria Giuliano-Isontina, University of Trieste, Trieste, Italy
| | | | - Giuseppe Maina
- San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Andrea de Bartolomeis
- Laboratory of Molecular Psychiatry and Translational Psychiatry, Unit of Treatment Resistant Psychosis, Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, University School of Medicine of Napoli Federico II, Naples, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sapienza University of Rome, Rome, Italy
| | - Claudia Palumbo
- Department of Psychiatry, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Emi Bondi
- Department of Psychiatry, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Luca Steardo
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Pasquale De Fazio
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Mario Altamura
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Marco Di Nicola
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Emilio Sacchetti
- Department of Mental Health and Addiction Services, ASST Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Gabriele Sani
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alberto Siracusano
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Unit of Psychiatry and Clinical Psychology, Policlinico Tor Vergata Foundation, Rome, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Unit of Psychiatry and Clinical Psychology, Policlinico Tor Vergata Foundation, Rome, Italy
| | | | - A Carlo Altamura
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Psychiatry Unit 2, ASST-Fatebenefratelli-Sacco, via G.B.Grassi 74, 20157, Milan, Italy
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
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Caldiroli A, Capuzzi E, Tagliabue I, Capellazzi M, Marcatili M, Mucci F, Colmegna F, Clerici M, Buoli M, Dakanalis A. Augmentative Pharmacological Strategies in Treatment-Resistant Major Depression: A Comprehensive Review. Int J Mol Sci 2021; 22:ijms222313070. [PMID: 34884874 PMCID: PMC8658307 DOI: 10.3390/ijms222313070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 01/09/2023] Open
Abstract
Treatment resistant depression (TRD) is associated with poor outcomes, but a consensus is lacking in the literature regarding which compound represents the best pharmacological augmentation strategy to antidepressants (AD). In the present review, we identify the available literature regarding the pharmacological augmentation to AD in TRD. Research in the main psychiatric databases was performed (PubMed, ISI Web of Knowledge, PsychInfo). Only original articles in English with the main topic being pharmacological augmentation in TRD and presenting a precise definition of TRD were included. Aripiprazole and lithium were the most investigated molecules, and aripiprazole presented the strongest evidence of efficacy. Moreover, olanzapine, quetiapine, cariprazine, risperidone, and ziprasidone showed positive results but to a lesser extent. Brexpiprazole and intranasal esketamine need further study in real-world practice. Intravenous ketamine presented an evincible AD effect in the short-term. The efficacy of adjunctive ADs, antiepileptic drugs, psychostimulants, pramipexole, ropinirole, acetyl-salicylic acid, metyrapone, reserpine, testosterone, T3/T4, naltrexone, SAMe, and zinc cannot be precisely estimated in light of the limited available data. Studies on lamotrigine and pindolol reported negative results. According to our results, aripiprazole and lithium may be considered by clinicians as potential effective augmentative strategies in TRD, although the data regarding lithium are somewhat controversial. Reliable conclusions about the other molecules cannot be drawn. Further controlled comparative studies, standardized in terms of design, doses, and duration of the augmentative treatments, are needed to formulate definitive conclusions.
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Affiliation(s)
- Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy; (E.C.); (M.M.); (F.C.); (M.C.)
- Correspondence: ; Tel.: +39-3495009941
| | - Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy; (E.C.); (M.M.); (F.C.); (M.C.)
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy; (I.T.); (M.C.); (A.D.)
| | - Martina Capellazzi
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy; (I.T.); (M.C.); (A.D.)
| | - Matteo Marcatili
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy; (E.C.); (M.M.); (F.C.); (M.C.)
| | - Francesco Mucci
- Department of Medicine and Surgery, University of Milan, 20122 Milan, Italy;
| | - Fabrizia Colmegna
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy; (E.C.); (M.M.); (F.C.); (M.C.)
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy; (E.C.); (M.M.); (F.C.); (M.C.)
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy; (I.T.); (M.C.); (A.D.)
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy; (I.T.); (M.C.); (A.D.)
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Ferrucci SM, Tavecchio S, Angileri L, Surace T, Berti E, Buoli M. Factors Associated with Affective Symptoms and Quality of Life in Patients with Atopic Dermatitis. Acta Derm Venereol 2021; 101:adv00590. [PMID: 34518893 PMCID: PMC9455335 DOI: 10.2340/00015555-3922] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to detect demographic and clinical factors associated with affective symptoms and quality of life in patients with severe atopic dermatitis. First, one-way analyses of variance and correlations were performed to compare a large set of qualitative and quantitative clinical variables. Three final multivariable regression models were performed, with depression/anxiety subscales and Dermatology Life Quality Index scores as dependent variables, and the factors that were statistically significant on univariate analyses as independent ones. More severe anxiety symptoms and poorer quality of life (p < 0.01) were significantly associated with more severe depressive symptoms. Female sex and disturbed sleep (p = 0.03) were significantly associated with more severe anxiety. Finally, previous treatment with cyclosporine (p = 0.03) or methotrexate (p = 0.04), more severe depressive symptoms (p < 0.01), itch (p = 0.03), impaired sleep (p < 0.01) and perceived severity of dermatological illness (p < 0.01) were significant predictors of low quality of life. This study shows a complex interplay between the severity of atopic dermatitis, poor quality of life and presence of clinically relevant affective symptoms. These results will help dermatologists to identify patients who need psychiatric consultation within the framework of a multidisciplinary approach.
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Affiliation(s)
| | | | | | | | | | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, IT-20122, Milan, Italy.
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Buoli M, Cesana BM, Fagiolini A, Albert U, Maina G, de Bartolomeis A, Pompili M, Bondi E, Steardo L, Amore M, Bellomo A, Bertolino A, Di Nicola M, Di Sciascio G, Fiorillo A, Rocca P, Sacchetti E, Sani G, Siracusano A, Di Lorenzo G, Tortorella A, Altamura AC, Dell'Osso B. Which factors delay treatment in bipolar disorder? A nationwide study focussed on duration of untreated illness. Early Interv Psychiatry 2021; 15:1136-1145. [PMID: 33058435 DOI: 10.1111/eip.13051] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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] [Received: 07/03/2020] [Revised: 08/28/2020] [Accepted: 09/26/2020] [Indexed: 12/12/2022]
Abstract
AIM The aim of the present study was to detect factors associated with duration of untreated illness (DUI) in bipolar disorder (BD). METHOD A total of 1575 patients were selected for the purposes of the study. Correlation analyses were performed to analyse the relation between DUI and quantitative variables. The length of DUI was compared between groups defined by qualitative variables through one-way analyses of variance or Kruskal-Wallis's tests according to the distribution of the variable. Linear multivariable regressions were used to find the most parsimonious set of variables independently associated with DUI: to this aim, qualitative variables were inserted with the numeric code of their classes by assuming a proportional effect moving from one class to another. RESULTS An inverse significant correlation between length of DUI and time between visits in euthymic patients was observed (r = -.52, P < .001). DUI resulted to be longer in patients with: at least one lifetime marriage/partnership (P = .009), a first psychiatric diagnosis of major depressive disorder or substance abuse (P < .001), a depressive polarity of first episode (P < .001), no lifetime psychotic symptoms (P < .001), BD type 2 (P < .001), more lifetime depressive/hypomanic episodes (P < .001), less lifetime manic episodes (P < .001), presence of suicide attempts (P = .004), depressive episodes (P < .001), hypomanic episodes (P = .004), hospitalizations (P = .011) in the last year. CONCLUSIONS Different factors resulted to increase the length of DUI in a nationwide sample of bipolar patients. In addition, the DUI was found to show a negative long-term effect in terms of more suicidal behaviour, more probability of hospitalization and depressive/hypomanic episodes.
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Affiliation(s)
- 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
| | - Bruno Mario Cesana
- Department of Clinical Sciences and Community Health, Unit of Medical Statistics, Biometry and Bioinformatics "Giulio A. Maccacaro," Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | | | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, Psychiatric Section, University of Trieste, Trieste, Italy
| | - Giuseppe Maina
- San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Andrea de Bartolomeis
- Laboratory of Molecular Psychiatry and Translational Psychiatry, Unit of Treatment Resistant Psychosis, Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, University School of Medicine of Napoli Federico II, Naples, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Roma, Sant'Andrea Hospital, Sapienza University of Rome, Italy
| | - Emi Bondi
- Department of Psychiatry, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Luca Steardo
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Marco Di Nicola
- Department of Psychiatry, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.,Institute of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Paola Rocca
- Department of Neuroscience, School of Medicine, University of Turin, Turin, Italy
| | - Emilio Sacchetti
- Department of Mental Health and Addiction Services, ASST Spedali Civili, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Gabriele Sani
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alberto Siracusano
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Unit of Psychiatry and Clinical Psychology, Policlinico Tor Vergata Foundation, Rome, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Unit of Psychiatry and Clinical Psychology, Policlinico Tor Vergata Foundation, Rome, Italy
| | | | - Alfredo 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
| | - Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Psychiatry Unit 2, ASST-Fatebenefratelli-Sacco, Milan, Italy.,Department of Psychiatry and Behavioral Sciences, Stanford University, California, USA.,CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
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Capuzzi E, Caldiroli A, Leo S, Buoli M, Clerici M. Initiation of psychotropic medication in hospitalized patients with COVID-19: Association with clinical and biological characteristics. Hum Psychopharmacol 2021; 36:e2789. [PMID: 33852168 PMCID: PMC8250257 DOI: 10.1002/hup.2789] [Citation(s) in RCA: 3] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Inpatients with coronavirus disease 2019 (COVID-19) show a high rate of neuropsychiatric manifestations, possibly related to a higher risk of serious illness or death. Use of psychotropic medications (PMs) indicates the presence of neuropsychiatric symptoms in COVID-19 patients. So far, potential clinical predictors of use of PMs have not been much investigated. In order to extend research in this area, we aimed to investigate the prevalence of PM prescription among a sample of inpatients with COVID-19 and to find potential predictors of initiation of PMs in these individuals. METHODS This is a cross-sectional single-center study, conducted during the first outbreak peak in a hospital of northern Italy. Information on socio-demographic characteristics, comorbidities, routine blood test, use of potential COVID-19 treatments, and length of stay were retrieved from medical records. RESULTS Data were available for 151 inpatients. Forty-seven of them (31.1%) started at least one prescription of a PM. PM prescription was significantly inversely associated with lymphocyte and platelet counts. A significant association was also found for lactate dehydrogenase (LDH). CONCLUSION Our findings suggest that the initiation of PMs could be common among COVID-19 inpatients. Lymphocyte and platelet counts as well as LDH levels may reflect neuropsychiatric complications of COVID-19.
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Affiliation(s)
- Enrico Capuzzi
- Psychiatric DepartmentAzienda Socio Sanitaria Territoriale MonzaMonzaItaly
| | - Alice Caldiroli
- Psychiatric DepartmentAzienda Socio Sanitaria Territoriale MonzaMonzaItaly
| | - Silvia Leo
- Department of Medicine and SurgeryUniversity of Milano BicoccaMonzaItaly
| | - Massimiliano Buoli
- Department of Neurosciences and Mental HealthFondazione IRCCS Ca'Granda Ospedale Maggiore PoliclinicoMilanItaly,Department of Pathophysiology and TransplantationUniversity of MilanMilanItaly
| | - Massimo Clerici
- Psychiatric DepartmentAzienda Socio Sanitaria Territoriale MonzaMonzaItaly,Department of Medicine and SurgeryUniversity of Milano BicoccaMonzaItaly
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Capuzzi E, Ceresa A, Caldiroli A, Esposito CM, Ossola P, Buoli M. The Relation between the Plasma Concentrations of Long-Acting Atypical Antipsychotics and Clinical Effectiveness in Patients Affected by Schizophrenia or Schizoaffective Disorder: A Comprehensive Overview. Curr Pharm Des 2021; 27:4070-4077. [PMID: 34459376 DOI: 10.2174/1381612827666210830095349] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 06/24/2021] [Indexed: 11/22/2022]
Abstract
Atypical antipsychotic depot medications are currently recommended for patients with schizophrenia (SCZ) to prevent relapse and ameliorate the long-term prognosis of these patients. This review critically summarizes the available data about the association between the plasma concentrations of long-acting Second- Generation Antipsychotics (SGAs) and the clinical effectiveness of these compounds in patients affected by SCZ or schizoaffective disorder. Our question is if the measurement of these concentrations can be helpful for clinicians in predicting treatment response and clinical stabilization of patients. Bibliographic research on the main databases was performed, and 13 studies were finally included in this review. Contrasting results were found between plasma concentrations of long-acting injectable (LAI) risperidone and clinical amelioration according to rating scale scores. Data are too scanty to draw conclusions for olanzapine and paliperidone. In contrast, despite small sample sizes, data are quite concordant in showing a relation between long-acting SGA plasma concentrations and D2 receptor occupancy. Despite the preliminary encouraging results, particularly for D2 receptor occupancy, future research with larger samples will have to confirm the clinical usefulness of measuring LAI SGA plasma concentrations to predict the clinical response of patients affected by severe mental conditions such as SCZ.
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Affiliation(s)
- Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Cecilia M Esposito
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy
| | - Paolo Ossola
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy
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Capuzzi E, Caldiroli A, Capellazzi M, Tagliabue I, Marcatili M, Colmegna F, Clerici M, Buoli M, Dakanalis A. Long-Term Efficacy of Intranasal Esketamine in Treatment-Resistant Major Depression: A Systematic Review. Int J Mol Sci 2021; 22:9338. [PMID: 34502248 PMCID: PMC8430977 DOI: 10.3390/ijms22179338] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/14/2021] [Accepted: 08/23/2021] [Indexed: 12/02/2022] Open
Abstract
Esketamine (ESK) has been approved as a rapid-acting intranasal treatment for treatment-resistant depression (TRD). Although existing studies have investigated the efficacy of ESK in the 4-week induction phase, our knowledge about long-term ESK efficacy remains poor. The aim of this systematic review was to summarize the available data on long-term ESK efficacy for TRD. A systematic search was performed including articles in English, up to 31 March 2021. The search found 7 relevant studies, involving 1024 adult TRD patients. Continuing treatment with ESK after the 4-week induction phase may be associated with stable efficacy in relapse prevention among TRD patients. Conversely, the long-term antidepressant effectiveness upon discontinuation of ESK might be limited, although data from three studies had a moderate to high risk of bias. Overall, the results on the effectiveness of this compound in the long term are mixed. According to our findings, ESK treatment should be continued following the induction phase to reach a stable efficacy in relapse prevention, while the long-term antidepressant and anti-suicidal effects of ESK after discontinuation are inconsistent. Currently, the level of proof of ESK efficacy in long-term TRD treatment remains low and more RCTs with larger sample sizes and active comparators are needed.
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Affiliation(s)
- Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, via G.B. Pergolesi 33, 20900 Monza, Italy; (E.C.); (M.M.); (F.C.); (M.C.)
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, via G.B. Pergolesi 33, 20900 Monza, Italy; (E.C.); (M.M.); (F.C.); (M.C.)
| | - Martina Capellazzi
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza, Italy; (M.C.); (I.T.); (A.D.)
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza, Italy; (M.C.); (I.T.); (A.D.)
| | - Matteo Marcatili
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, via G.B. Pergolesi 33, 20900 Monza, Italy; (E.C.); (M.M.); (F.C.); (M.C.)
| | - Fabrizia Colmegna
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, via G.B. Pergolesi 33, 20900 Monza, Italy; (E.C.); (M.M.); (F.C.); (M.C.)
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, via G.B. Pergolesi 33, 20900 Monza, Italy; (E.C.); (M.M.); (F.C.); (M.C.)
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza, Italy; (M.C.); (I.T.); (A.D.)
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, via Festa del Perdono 7, 20122 Milan, Italy;
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, via F. Sforza 35, 20122 Milan, Italy
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza, Italy; (M.C.); (I.T.); (A.D.)
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Ingegnoli F, Buoli M, Posio C, Di Taranto R, Lo Muscio A, Cumbo E, Ostuzzi S, Caporali R. COVID-19 related poor mental health and sleep disorders in rheumatic patients: a citizen science project. BMC Psychiatry 2021; 21:385. [PMID: 34344329 PMCID: PMC8330176 DOI: 10.1186/s12888-021-03389-7] [Citation(s) in RCA: 13] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/22/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Patients with chronic rheumatic diseases (RDs) are more vulnerable and the containment measures related to the COVID-19 pandemic might have severe psychological consequences. We investigated the presence of and risk factors associated with poor mental health, sleep disorders among RDs during the pandemic. METHODS This cross-sectional Italian citizen science project evaluated the psychological impact of the COVID-19 pandemic in patients with RDs. Between May and September 2020, eleven RD patients' associations sent the survey by using their mailing list and the related webpage and social network. 507 RD patients completed an ad-hoc anonymous online survey including the Perceived Stress Scale (PSS) and Impact Event Scale-Revised (IES-R). RESULTS The mean scores on the PSS-10 and the IES-R were 18.1 and 29.7, respectively. Higher PSS scores were associated with younger age (p < 0.01), female gender (p < 0.01), overweight/obesity (p = 0.01), psychiatric pharmacotherapy (p < 0.01), and anxiety for loss of income (p < 0.01). Higher IES-R scores were associated with female gender (p < 0.01), intestinal diseases (p = 0.03), anxiety (p < 0.01), and health concern (p < 0.01). Among 375 patients with inflammatory arthritis, 246 (65.6%) had trouble staying asleep, 238 (63.5%) falling asleep, and 112 (29.9%) had dreams about the pandemic. Older age (OR = 1.038, CI 1.002-1.076), psychiatric pharmacotherapy (OR = 25.819, CI 11.465-58.143), and COVID infection (OR = 2.783, CI 1.215-6.372) were predictive of insomnia during the pandemic. CONCLUSIONS A considerable COVID-19 related psychosocial burden has been detected in RDs. Different factors were predictive of poor mental health and sleep disorders in these patients. Focused supportive strategies should be implemented to improve the psychological well-being of fragile patients during pandemics.
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Affiliation(s)
- Francesca Ingegnoli
- Division of Clinical Rheumatology, ASST Pini, Milan, Italy. .,Department of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano, Piazza Cardinal Ferrari 1, 20122, Milan, Italy.
| | - Massimiliano Buoli
- grid.414818.00000 0004 1757 8749Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Cristina Posio
- grid.4708.b0000 0004 1757 2822Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Raffaele Di Taranto
- Division of Clinical Rheumatology, ASST Pini, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano, Piazza Cardinal Ferrari 1, 20122 Milan, Italy
| | - Alessandro Lo Muscio
- grid.4708.b0000 0004 1757 2822Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Enrico Cumbo
- Division of Clinical Rheumatology, ASST Pini, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano, Piazza Cardinal Ferrari 1, 20122 Milan, Italy
| | - Silvia Ostuzzi
- ALOMAR Lombard Association for Rheumatic Diseases, Milan, Italy
| | - Roberto Caporali
- Division of Clinical Rheumatology, ASST Pini, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano, Piazza Cardinal Ferrari 1, 20122 Milan, Italy
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