1
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Vita A, Barlati S, Deste G, Rossi A, Rocca P, Bertolino A, Aguglia E, Altamura CA, Amore M, Bellomo A, Bucci P, Carpiniello B, Cuomo A, Dell’Osso L, Giuliani L, Marchesi C, Martinotti G, Monteleone P, Montemagni C, Nibbio G, Pasquini M, Pompili M, Rampino A, Roncone R, Rossi R, Siracusano A, Tenconi E, Zeppegno P, Galderisi S, Maj M. Autistic symptoms in unaffected first-degree relatives of people with schizophrenia: results from the Italian Network for Research on Psychoses multicenter study. Eur Psychiatry 2023; 66:e85. [PMID: 37869966 PMCID: PMC10755574 DOI: 10.1192/j.eurpsy.2023.2455] [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: 06/11/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Autistic symptoms represent a frequent feature in schizophrenia spectrum disorders (SSD). However, the prevalence and the cognitive and functional correlates of autistic symptoms in unaffected first-degree relatives of people with SSD remain to be assessed. METHODS A total of 342 unaffected first-degree relatives related to 247 outpatients with schizophrenia were recruited as part of the multicenter study of the Italian Network for Research on Psychoses (NIRP). Autistic features were measured with the PANSS Autism Severity Scale. Three groups of participants, defined on the presence and severity of autistic symptoms, were compared on a wide array of cognitive and functional measures. RESULTS Of the total sample, 44.9% presented autistic symptoms; 22.8% showed moderate levels of autistic symptoms, which can be observed in the majority of people with SSD. Participants with higher levels of autistic symptoms showed worse performance on Working Memory (p = 0.014) and Social Cognition (p = 0.025) domains and in the Global Cognition composite score (p = 0.008), as well as worse on functional capacity (p = 0.001), global psychosocial functioning (p < 0.001), real-world interpersonal relationships (p < 0.001), participation in community activities (p = 0.017), and work skills (p = 0.006). CONCLUSIONS A high prevalence of autistic symptoms was observed in first-degree relatives of people with SSD. Autistic symptoms severity showed a negative correlation with cognitive performance and functional outcomes also in this population and may represent a diagnostic and treatment target of considerable scientific and clinical interest in both patients and their first-degree relatives.
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Affiliation(s)
- Antonio Vita
- Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy
- Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
| | - Stefano Barlati
- Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy
- Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
| | - Giacomo Deste
- Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy
- Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
| | - Alessandro Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Paola Rocca
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Alessandro Bertolino
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - Eugenio Aguglia
- Department of Clinical and Molecular Biomedicine, Psychiatry Unit, University of Catania, Catania, Italy
| | | | - Mario Amore
- Section of Psychiatry, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Antonello Bellomo
- Psychiatry Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - Paola Bucci
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Alessandro Cuomo
- Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, Siena, Italy
| | - Liliana Dell’Osso
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Luigi Giuliani
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Carlo Marchesi
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy
| | - Giovanni Martinotti
- Department of Neuroscience and Imaging, G. d’Annunzio University, Chieti, Italy
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy
| | - Cristiana Montemagni
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Gabriele Nibbio
- Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy
| | - Massimo Pasquini
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Antonio Rampino
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - Rita Roncone
- Unit of Psychiatry, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Rodolfo Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Alberto Siracusano
- Department of Systems Medicine, Psychiatry and Clinical Psychology Unit, Tor Vergata University of Rome, Rome, Italy
| | - Elena Tenconi
- Psychiatric Clinic, Department of Neurosciences, University of Padua, Padua, Italy
| | - Patrizia Zeppegno
- Department of Translational Medicine, Psychiatric Unit, University of Eastern Piedmont, Novara, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
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Prevete E, Catalani V, Singh D, Kuypers KPC, Theunissen EL, Townshend HD, Banayoti H, Ramaekers JG, Pasquini M, Corazza O. A Preliminary Inventory of Kratom (Mitragyna Speciosa) Products and Vendors on the Darknet and Cryptomarkets. J Psychoactive Drugs 2023:1-11. [PMID: 37702482 DOI: 10.1080/02791072.2023.2242361] [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] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
In recent years, the online sale of kratom (Mitragyna speciosa), a Southeast Asian plant with both medicinal and psychoactive properties, has raised health concerns mainly due to the uncontrolled diffusion of adulterated kratom-related products. This exploratory study provides, for the first time, a snapshot of the availability of kratom products on the darknet which has been further validated by data searches on the surface web. A total of 231 listings of kratom across 23 darknet marketplaces were identified between March 2020 and October 2021. Among these, 40 were found actively sold across five markets by thirteen vendors. Listed items were mainly advertised as "safe" substitutes for medicinal products for the self-management of pain and other health conditions and offered in various forms (e.g., dry leaf powder, pills, capsules). Purchases were made using cryptocurrencies, with some vendors offering Pretty Good Privacy, and were shipped from Europe, Australia, the United States, and the United Kingdom. Goods sold by the same sellers also included illicit drugs and fraud-related products. Our study discovered a previously unknown diffusion of kratom products on the darknet mainly for self-treating a variety of medical conditions, suggesting the need for further research and immediate interventions to safeguard the well-being and health of kratom consumers.
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Affiliation(s)
- Elisabeth Prevete
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Valeria Catalani
- Department of Clinical, Pharmacological and Biological Sciences, College Lane, University of Hertfordshire, Hatfield, UK
| | - Darshan Singh
- Centre for Drug Research, Universiti Sains Malaysia, Minden, Penang, Malaysia
| | - Kim P C Kuypers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Eef L Theunissen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | | | | | - Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Ornella Corazza
- Department of Clinical, Pharmacological and Biological Sciences, College Lane, University of Hertfordshire, Hatfield, UK
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
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3
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Frascarelli M, Accinni T, Buzzanca A, Carlone L, Ghezzi F, Moschillo A, Kotzalidis GD, Bucci P, Giordano GM, Fanella M, Di Bonaventura C, Putotto C, Marino B, Pasquini M, Biondi M, Di Fabio F. Social cognition and real-life functioning in patient samples with 22q11.2 deletion syndrome with or without psychosis, compared to a large sample of patients with schizophrenia only and healthy controls. J Neuropsychol 2023; 17:564-583. [PMID: 37159847 DOI: 10.1111/jnp.12322] [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: 03/14/2022] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 05/11/2023]
Abstract
Patients with the 22q11.2 deletion syndrome (DS) show an increased risk of developing a psychotic illness lifetime. 22q11.2DS may represent a reliable model for studying the neurobiological underpinnings of schizophrenia. The study of social inference abilities in a genetic condition at high risk for psychosis, like 22q11.2DS, may shed light on the relationships between neurocognitive processes and patients' daily general functioning. The study sample consisted of 1736 participants, divided into four groups: 22q11.2DS patients with diagnosis of psychotic disorder (DEL SCZ, N = 20); 22q11.2DS subjects with no diagnosis of psychosis (DEL, N = 43); patients diagnosed with schizophrenia without 22q11.2DS (SCZ, N = 893); and healthy controls (HC, N = 780). Social cognition was assessed through The Awareness of Social Inference Test (TASIT) and general functioning through the Specific Levels of Functioning (SLoF) scale. We analysed data through regression analysis. The SCZ and DEL groups had similar levels of global functioning; they both had significantly lower SLoF Total scores than HC (p < .001); the DEL SCZ group showed significantly lower scores compared to the other groups (SCZ, p = .004; DEL, p = .003; HC, p < .001). A significant deficit in social cognition was observed in the three clinical groups. In the DEL SCZ and SCZ groups, TASIT scores significantly predicted global functioning (p < .05). Our findings of social cognition deficit in psychosis-prone patients point to the possible future adoption of rehabilitation programmes, like Social Skills Training and Cognitive Remediation, during premorbid stages of psychosis.
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Affiliation(s)
| | - Tommaso Accinni
- Department of Neurosciences, Sapienza University, Rome, Italy
| | | | - Luca Carlone
- Department of Neurosciences, Sapienza University, Rome, Italy
| | | | | | - Georgios D Kotzalidis
- Department of Human Neurosciences, Mental Health and Sensory Organs, Sapienza University, Rome, Italy
| | - Paola Bucci
- Department of Psychiatry, Campania University "Luigi Vanvitelli", Naples, Italy
| | | | - Martina Fanella
- Department of Neurosciences, Sapienza University, Rome, Italy
| | | | | | - Bruno Marino
- Department of Paediatrics, Sapienza University, Rome, Italy
| | | | - Massimo Biondi
- Department of Neurosciences, Sapienza University, Rome, Italy
| | - Fabio Di Fabio
- Department of Neurosciences, Sapienza University, Rome, Italy
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4
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Camerota F, Mariani R, Cordiano G, Di Trani M, Lodato V, Ferraris A, Pasquini M, Celletti C. The Language of Pain in the Hypermobile Ehlers-Danlos Syndrome: Metaphors as a Key to Understanding the Experience of Pain and as a Rehabilitation Tool. Brain Sci 2023; 13:1042. [PMID: 37508973 PMCID: PMC10377642 DOI: 10.3390/brainsci13071042] [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: 05/30/2023] [Revised: 06/30/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Ehlers-Danlos syndromes are a heterogeneous group of Heritable Connective Tissue Disorders characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. Among the different types, the hypermobile Ehlers-Danlos syndrome is the most frequent and includes generalized joint hypermobility as the major diagnostic criterion. Joint hypermobility in hypermobile Ehlers-Danlos syndrome is often associated with pain that does not always allow the use of effective pain-reducing treatments. Patients with hEDS constantly describe their pain in detail. Eighty-nine patients with hEDS diagnoses were recruited and evaluated. They were asked to describe their pain in writing. The texts were examined through Linguistic Inquiry and Word Count. Correlational analyses were conducted between pain perception and language. A comparison of high/low pain perception and the quality of metaphors was carried out. The results showed that language quality varies depending on how much pain is perceived. The greater the pain is perceived, the lesser the positive effects and the greater the negative effects and dehumanizing metaphors are being used. Moreover, a greater pain seems to be related to a verbal experience of greater isolation and less self-care. In conclusion, the use of metaphors is a useful tool for examining illness experience and may help clinicians in the rehabilitation program.
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Affiliation(s)
- Filippo Camerota
- Physical Medicine and Rehabilitation, Umberto I University Hospital, 00161 Rome, Italy
| | - Rachele Mariani
- Department of Dynamic and Clinical Psychology, and Health Studies Sapienza, University of Rome, 00133 Rome, Italy
| | | | - Michela Di Trani
- Department of Dynamic and Clinical Psychology, and Health Studies Sapienza, University of Rome, 00133 Rome, Italy
| | - Valentina Lodato
- Laboratory of Medical Genetics, Department of Experimental Medicine, San Camillo Forlanini Hospital, Sapienza University of Rome, 00185 Rome, Italy
| | - Alessandro Ferraris
- Laboratory of Medical Genetics, Department of Experimental Medicine, San Camillo Forlanini Hospital, Sapienza University of Rome, 00185 Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Claudia Celletti
- Physical Medicine and Rehabilitation, Umberto I University Hospital, 00161 Rome, Italy
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5
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Prevete E, Kuypers KPC, Theunissen EL, Esposito G, Ramaekers JG, Pasquini M, Corazza O. Clinical Implications of Kratom ( Mitragyna speciosa) Use: a Literature Review. Curr Addict Rep 2023; 10:317-334. [PMID: 37266188 PMCID: PMC10177737 DOI: 10.1007/s40429-023-00478-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 06/03/2023]
Abstract
Purpose of Review This work aims to provide an up-to-date review of the preclinical and clinical scientific literature on the therapeutic value of kratom to better understand the underlying mechanisms related to its use and inform future therapeutic applications. Recent Findings A growing number of studies, mainly of cross-sectional nature, describe the widespread use of kratom by individuals to self-treat pain, psychiatric symptoms, and substance use disorders (SUD) outside a controlled clinical setting. Preclinical evidence suggests kratom is effective as an analgesic agent and might decrease the self-administration of other drugs. A randomized controlled trial has further supported kratom's therapeutic value as an analgesic. Investigations in nonclinical samples of long-term kratom users also indicate its therapeutic benefit in managing SUD symptoms (e.g., craving) and long-term or acute symptoms (e.g., withdrawal) for alcohol, opioids, and other illicit drugs. However, episodes of kratom-related intoxications have also been reported, often due to the adulteration and the contamination of kratom products mainly sold online or mixed toxicities when consumed outside clinical and traditional settings. Summary Evidence on the clinical implications of kratom use is still limited and uncertain, with kratom research constantly evolving. Therefore, further randomized trials are needed.
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Affiliation(s)
- Elisabeth Prevete
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell’Università 30, 00185 Rome, Italy
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
| | - Kim Paula Colette Kuypers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
| | - Eef Lien Theunissen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Corso Bettini, 84, 38068 Rovereto, Italy
| | - Johannes Gerardus Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell’Università 30, 00185 Rome, Italy
| | - Ornella Corazza
- Department of Psychology and Cognitive Science, University of Trento, Corso Bettini, 84, 38068 Rovereto, Italy
- Department of Clinical, Pharmacological and Biological Sciences, University of Hertfordshire, College Lane, Hatfield, AL10 9AB UK
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6
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Maraone A, Trebbastoni A, Di Vita A, D'Antonio F, De Lena C, Pasquini M. Memantine for Refractory Obsessive-Compulsive Disorder: Protocol for a Pragmatic, Double-blind, Randomized, Parallel-Group, Placebo-Controlled, Monocenter Trial. JMIR Res Protoc 2023; 12:e39223. [PMID: 37166948 DOI: 10.2196/39223] [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: 05/03/2022] [Revised: 03/15/2023] [Accepted: 03/21/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a psychiatric syndrome characterized by unwanted and repetitive thoughts and repeated ritualistic compulsions for decreasing distress. Symptoms can cause severe distress and functional impairment. OCD affects 2% to 3% of the population and is ranked within the 10 leading neuropsychiatric causes of disability. Cortico-striatal-thalamo-cortical circuitry dysfunction has been implicated in OCD, including altered brain activation and connectivity. Complex glutamatergic signaling dysregulation within cortico-striatal circuitry has been proposed in OCD. Data obtained by several studies indicate reduced glutamatergic concentrations in the anterior cingulate cortex, combined with overactive glutamatergic signaling in the striatum and orbitofrontal cortex. A growing number of randomized controlled trials have assessed the utility of different glutamate-modulating drugs as augmentation medications or monotherapies for OCD, including refractory OCD. However, there are relevant variations among studies in terms of patients' treatment resistance, comorbidity, age, and gender. At present, 4 randomized controlled trials are available on the efficacy of memantine as an augmentation medication for refractory OCD. OBJECTIVE Our study's main purpose is to conduct a double-blind, randomized, parallel-group, placebo-controlled, monocenter trial to assess the efficacy and safety of memantine as an augmentative agent to a selective serotonin reuptake inhibitor in the treatment of moderate to severe OCD. The study's second aim is to evaluate the effect of memantine on cognitive functions in patients with OCD. The third aim is to investigate if responses to memantine are modulated by variables such as gender, symptom subtypes, and the duration of untreated illness. METHODS Investigators intend to conduct a double-blind, randomized, parallel-group, placebo-controlled, monocenter trial to assess the efficacy and safety of memantine as an augmentative agent to a selective serotonin reuptake inhibitor in the treatment of patients affected by severe refractory OCD. Participants will be rated via the Yale-Brown Obsessive Compulsive Scale at baseline and at 2, 4, 6, 8, 10, and 12 months. During the screening period and T4 and T6 follow-up visits, all participants will undergo an extensive neuropsychological evaluation. The 52-week study duration will consist of 4 distinct periods, including memantine titration and follow-up periods. RESULTS Recruitment has not yet started. The study will be conducted from June 2023 to December 2024. Results are expected to be available in January 2025. Throughout the slow-titration period, we will observe the minimum effective dose of memantine, and the follow-up procedure will detail its residual efficacy after drug withdrawal. CONCLUSIONS The innovation of this research proposal is not limited to the evaluation of the efficacy and safety of memantine as an augmentation medication for OCD. We will also test if memantine acts as a pure antiobsessive medication or if memantine's ability to improve concentration and attention mimics an antiobsessive effect. TRIAL REGISTRATION ClinicalTrials.gov NCT05015595; https://clinicaltrials.gov/ct2/show/NCT05015595. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/39223.
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Affiliation(s)
| | | | | | | | - Carlo De Lena
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale San Raffaele, Rome, Italy
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7
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Accinni T, Fanella M, Frascarelli M, Buzzanca A, Kotzalidis GD, Putotto C, Marino B, Panzera A, Moschillo A, Pasquini M, Biondi M, Di Bonaventura C, Di Fabio F. The Relationship between Motor Symptoms, Signs, and Parkinsonism with Facial Emotion Recognition Deficits in Individuals with 22q11.2 Deletion Syndrome at High Genetic Risk for Psychosis. Acta Neurol Scand 2023. [DOI: 10.1155/2023/8546610] [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: 03/30/2023]
Abstract
Background. The 22q11.2 Deletion Syndrome (22q11.2DS) is a genetic condition at high risk of developing both psychosis and motor disorders. Social Cognition (SC) deficits have been associated not only with schizophrenia but also with Parkinson’s disease (PD). The present study assessed SC deficits in 22q11.2DS and investigated the interaction between motor symptoms and deficits in Facial Emotion Expressions (FEE) recognition and in Theory of Mind (ToM) tasks in people with 22q11.2DS. Methods. We recruited 38 individuals with 22q11.2DS without psychosis (
, DEL) and 18 with 22q11.2DS and psychosis (
, DEL_SCZ). The Positive And Negative Syndrome Scale (PANSS), Ekman’s 60 Faces Test (EK-60F), the Awareness of Social Inference Test (TASIT EmRec), and the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale part III (UPDRS III) were administered. Correlations were sought between UPDRS III and both TASIT EmRec and EK-60F scores. Analyses were conducted separately for each psychopathological subgroup. Results. Higher UPDRS III (
) and lower EK-60F (
) scores were observed in the DEL_SCZ group. We found inverse correlations between UPDRS III and both TASIT EmRec (
,
) and EK-60F (
,
) scores in the whole sample. Correlations were no longer significant in the DEL_SCZ group (UPDRS III-TASIT EmRec
; UPDRS III-EK60F
) whilst being stronger in the DEL group (TASIT EmRec,
,
; EK60F,
,
). Analyses were adjusted for CPZ Eq and IQ. Conclusions. A modulation between FEE recognition deficits and motor symptoms and signs was observed in the 22q11.2DS group, likely affecting patients’ quality of life.
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8
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Imperatori C, Barchielli B, Corazza O, Carbone GA, Prevete E, Montaldo S, De Rossi E, Massullo C, Tarsitani L, Ferracuti S, Pasquini M, Biondi M, Farina B, Bersani FS. The Relationship Between Childhood Trauma, Pathological Dissociation, and Behavioral Addictions in Young Adults: Findings from a Cross-Sectional Study. J Trauma Dissociation 2023; 24:348-361. [PMID: 36814178 DOI: 10.1080/15299732.2023.2181479] [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] [Indexed: 02/24/2023]
Abstract
Interactions between childhood trauma (CT) and dissociation can contribute to psychiatric disturbances. We explored this phenomenon in relation to behavioral addictions (BAs) in a sample (n = 633) of young adults (age: 18-34 years). Self-report measures investigating CT, dissociation, and symptoms related to gambling disorder, internet gaming disorder, problematic social media use, exercise dependence and compulsive buying were used. Scales related to BAs were summarized into a single measure ("Total Behavioral Addiction Index" - TBAI) for inferential analyses. A model analyzing the direct and indirect effects of CT on TBAI through the mediation of pathological dissociation was performed, controlling for confounding factors. Measures on CT, dissociation, and TBAI were significantly associated with each other (all p < .001). The total effect of CT on TBAI was significant (B = 0.063; CI: 0.045; 0.081); pathological dissociation significantly mediated such association (B = 0.023; CI: 0.013; 0.036). Our findings support the possibility that the interaction between CT and dissociation contributes to increase disturbances related to BAs.
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Affiliation(s)
- Claudio Imperatori
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Benedetta Barchielli
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Ornella Corazza
- Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, Hatfield, UK
| | - Giuseppe Alessio Carbone
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Elisabeth Prevete
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Simone Montaldo
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Elena De Rossi
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Chiara Massullo
- Experimental Psychology Laboratory, Department of Education, Roma Tre University, Rome, Italy
| | - Lorenzo Tarsitani
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Stefano Ferracuti
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Benedetto Farina
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
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Pinucci I, Maraone A, Tarsitani L, Pasquini M. Insomnia among Cancer Patients in the Real World: Optimising Treatments and Tailored Therapies. Int J Environ Res Public Health 2023; 20:3785. [PMID: 36900794 PMCID: PMC10001409 DOI: 10.3390/ijerph20053785] [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: 12/28/2022] [Revised: 02/11/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Insomnia is commonly reported by cancer patients. Its multifaceted pathophysiology makes this symptom a complex challenge for the clinician, who should bear in mind the manifold world of causes and consequences of sleep disturbances in these patients and the importance of accurate treatment that should consider the frequent co-prescription of multiple medications. With our work, we aim to provide a tool to better master the treatment of this symptom in cancer patients, considering the gap between clinical and pharmacodynamic knowledge about the efficacy of different molecules and evidence-based prescribing. METHODS A narrative review of the studies investigating the pharmacological treatment of insomnia in cancer patients was conducted. Three hundred and seventy-six randomised controlled trials (RCTs), systematic reviews and meta-analyses were identified through PubMed. Only publications that investigated the efficacy of the pharmacological treatment of insomnia symptoms in cancer patient were considered. RESULTS Among the 376 publications that were individuated, fifteen studies were eligible for inclusion in the review and were described. Pharmacological treatments were outlined, with a broad look at specific clinical situations. CONCLUSIONS The management of insomnia in cancer patients should be personalised, as is already the case for the treatment of pain, taking into account both the pathophysiology and the other medical treatments prescribed to these patients.
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Frascarelli M, Accinni T, Buzzanca A, Di Bonaventura C, Fanella M, Putotto C, Marino B, Pasquini M, Biondi M, Colonnese C, Di Fabio F. Similar grey matter abnormalities in 22q11.2DS and chronic schizophrenia: a voxel-based morphometry study. Riv Psichiatr 2023; 58:10-20. [PMID: 36715578 DOI: 10.1708/3964.39426] [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: 01/31/2023]
Abstract
BACKGROUND The 22q11.2 Deletion Syndrome (22q11.2DS) is considered the most reliable biological model to study genetic vulnerability to schizophrenia. It appears useful to investigate neuroanatomical characteristics of people with 22q11.2DS compared to chronic schizophrenia and healthy controls. METHODS The sample consisted of 16 individuals with a diagnosis of schizophrenia for over 10 years (SCZ>10), 14 with a diagnosis for less than 10 years (SCZ≤10), 11 patients with 22q11.2DS with no diagnosis of psychotic disorder (DEL, n=11) and 19 healthy controls (HCs, n=19). Global intelligence (IQ) was evaluated for all subjects. Voxel-Based Morphometry (VBM) was employed to investigate potential differences between groups in grey matter volumes. RESULTS VBM located the most significant difference between SCZ and HCs in the left medial frontal gyrus, where SCZ>10 group showed a significant reduction of grey matter volume; the same cluster resulted significantly decreased in DEL group compared to HCs as well. Despite the extensive grey matter abnormalities observed in 22q11.2DS, the DEL group showed the only significant differences compared to the SCZ>10 group in the right lingual gyrus volumes. CONCLUSIONS Despite the small sample, our study identified a common area of grey matter loss both in idiopathic schizophrenia and 22q11.2DS.
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Affiliation(s)
| | - Tommaso Accinni
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Antonino Buzzanca
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | | | - Martina Fanella
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Carolina Putotto
- Department of Pediatrics, Obstetrics and Gynecology, Sapienza University of Rome, Italy
| | - Bruno Marino
- Department of Pediatrics, Obstetrics and Gynecology, Sapienza University of Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Claudio Colonnese
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Fabio Di Fabio
- Department of Human Neurosciences, Sapienza University of Rome, Italy
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11
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Buzzanca A, Accinni T, Frascarelli M, Troisi E, Kotzalidis GD, Di Bonaventura C, Fanella M, Putotto C, Marino B, Pasquini M, Biondi M, Di Fabio F. Recognition of facial emotion expressions and perceptual processes in 22q11.2 deletion syndrome. Early Interv Psychiatry 2023; 17:76-84. [PMID: 35347860 PMCID: PMC10078714 DOI: 10.1111/eip.13295] [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: 10/29/2021] [Revised: 01/25/2022] [Accepted: 03/13/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Social cognition (SC) deficits and of its facial emotion expression (FEE) component have been described in 22q11.2 Deletion Syndrome (22q11.2DS), a high-risk for schizophrenia (SCZ) systemic genetic syndrome. Correlations between deficits in FEE skills and visual-spatial abilities in people with 22q11.2DS warrant investigation. METHODS The sample consisted of 37 patients with 22q11.2DS (DEL), 19 with 22q11.2DS and psychosis (DEL-SCZ), 23 with idiopathic SCZ, and 48 healthy controls. We assessed FEE through The Ekman 60 Faces test (EK-F60), visual-spatial skills with Raven's Standard Progressive Matrices, and symptom severity with the positive And negative syndrome scale. Statistics were conducted through multivariate analysis of variance and correlation analysis. RESULTS Patients with 22q11.2DS performed worse that the other groups in recognizing Surprise, Disgust, Rage, Fear, and Neutral expressions on the EK-F60. Recognition of Surprise and Disgust correlated positively with visual-spatial abilities in patients with 22q11.2DS; negative and cognitive symptoms correlated negatively with recognition of Sadness, Surprise, and Disgust. CONCLUSIONS Patients with 22q11.2DS show impairments of both peripheral and central steps of the emotional recognition process, leading to SC deficits. The latter are present regardless of the presence of a full-blown psychosis.
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Affiliation(s)
- Antonino Buzzanca
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Tommaso Accinni
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Marianna Frascarelli
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Eloisa Troisi
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Georgios D Kotzalidis
- Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Carlo Di Bonaventura
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Martina Fanella
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Carolina Putotto
- Department of Paediatrics, Obstetrics and Gynaecology, Sapienza University of Rome, Rome, Italy
| | - Bruno Marino
- Department of Paediatrics, Obstetrics and Gynaecology, Sapienza University of Rome, Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Fabio Di Fabio
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
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12
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Mariani R, Marini I, Di Trani M, Catena C, Patino F, Riccioni R, Pasquini M. Emotional dysregulation and linguistic patterns as a defining feature of patients in the acute phase of anorexia nervosa. Eat Weight Disord 2022; 27:3267-3277. [PMID: 35939211 PMCID: PMC9358383 DOI: 10.1007/s40519-022-01456-w] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/20/2022] [Indexed: 01/06/2023] Open
Abstract
PURPOSE This research aims to analyze the relationship between emotional regulation and the symbolic process in autobiographical narratives of a group of individuals diagnosed with restrictive anorexia nervosa (AN), compared to a non-clinical group. The study is framed within multiple code theory (MCT) (Bucci, 1997; 2021), which considers mind-body integration. The purposes of this study are to investigate whether participants of the AN group will show greater alexithymia and emotional dysregulation than the non-clinical group; and whether the specific linguistic and symbolic features, such as somato-sensory words, affect words, and difficulty in the symbolizing process will predict the AN group. METHODS Twenty-nine female participants hospitalized with AN during an acute phase (mean age 19.8 ± 4.1) and 36 non-clinical female participants (mean age 21 ± 2.4) were selected through snow-ball sampling. The participants completed the Toronto Alexithymia Scale (TAS-20), the Profile of Mood of State (POMS), the Emotion Regulation Questionnaire (ERQ), and the Relationship Anecdotes Paradigm Interview (RAP). The RAP interview was audio-recorded and transcribed to apply the Referential Process (RP) Linguistic Measures. A T test for paired samples and a logistic binary regression was performed. RESULTS AN presented a significantly higher emotional dysregulation through the ERQ, TAS20 and POMS measures. Specifically, AN showed higher ER expression/suppression strategies, fewer functional cognitive strategies, higher alexithymia, and higher mood dysregulation. Specific linguistic features such as sensory-somatic, word affect, and difficulty in RP symbolizing predict the AN group (R2 = 0.349; χ2 = 27,929; df = 3; p = .001). CONCLUSIONS Emotional dysregulation is connected to AN symptoms and autobiographical narratives. The results can help a clinical assessment phase showing specific linguistic features in AN patients. LEVEL OF EVIDENCE Level II, controlled trial without randomization.
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Affiliation(s)
- Rachele Mariani
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy.
| | - Isabella Marini
- Azienda Ospedaliera-Universitaria, Policlinico Umberto I, Rome, Italy
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Carlotta Catena
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Francesca Patino
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | | | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University, Rome, Italy
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13
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Barbui C, Tedeschi F, Acarturk C, Anttila M, Au T, Baumgartner J, Carswell K, Churchill R, Cuijpers P, Karyotaki E, Klein T, Koesters M, Lantta T, Nosè M, Ostuzzi G, Pasquini M, Prina E, Sijbrandij M, Tarsitani L, Turrini G, Uygun E, Välimäki M, Walker L, Wancata J, White RG, Purgato M. Risk factors for mental disorder development in asylum seekers and refugees resettled in Western Europe and Turkey: Participant-level analysis of two large prevention studies. Int J Soc Psychiatry 2022; 69:664-674. [PMID: 36326024 DOI: 10.1177/00207640221132430] [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: 11/06/2022]
Abstract
BACKGROUND In asylum seekers and refugees, the frequency of mental disorders, such as depression, anxiety and post-traumatic stress disorder, is higher than the general population, but there is a lack of data on risk factors for the development of mental disorders in this population. AIM This study investigated the risk factors for mental disorder development in a large group of asylum seekers and refugees resettled in high- and middle-income settings. METHODS Participant-level data from two randomized prevention studies involving asylum seekers and refugees resettled in Western European countries and in Turkey were pooled. The two studies randomized participants with psychological distress, but without a diagnosis of mental disorder, to the Self-Help Plus psychological intervention or enhanced care as usual. At baseline, exposure to potentially traumatic events was measured using the Harvard Trauma Questionnaire-part I, while psychological distress and depressive symptoms were assessed with the General Health Questionnaire and the Patient Health Questionnaire. After 3 and 6 months of follow-up, the proportion of participants who developed a mental disorder was calculated using the Mini International Neuropsychiatric Interview. RESULTS A total of 1,101 participants were included in the analysis. At 3- and 6-month follow-up the observed frequency of mental disorders was 13.51% (115/851) and 24.30% (207/852), respectively, while the frequency estimates after missing data imputation were 13.95% and 23.78%, respectively. After controlling for confounders, logistic regression analysis showed that participants with a lower education level (p = .034), a shorter duration of journey (p = .057) and arriving from countries with war-related contexts (p = .017), were more at risk of developing mental disorders. Psychological distress (p = .004), depression (p = .001) and exposure to potentially traumatic events (p = .020) were predictors of mental disorder development. CONCLUSIONS This study identified several risk factors for the development of mental disorders in asylum seekers and refugees, some of which may be the target of risk reduction policies. The identification of asylum seekers and refugees at increased risk of mental disorders should guide the implementation of focused preventative psychological interventions.
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Affiliation(s)
- Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy
| | - Federico Tedeschi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy
| | - Ceren Acarturk
- Department of Psychology, Koc University, Istanbul, Turkey
| | - Minna Anttila
- University of Turku, Department of Nursing Science, University of Turku, Finland
| | - Teresa Au
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Josef Baumgartner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Ken Carswell
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | | | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, The Netherlands.,WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, The Netherlands.,Babeș-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, The Netherlands.,WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, The Netherlands
| | - Thomas Klein
- Department of Psychiatry II, Ulm University, Germany
| | | | - Tella Lantta
- University of Turku, Department of Nursing Science, University of Turku, Finland
| | - Michela Nosè
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy
| | - Giovanni Ostuzzi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Eleonora Prina
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy
| | - Marit Sijbrandij
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, The Netherlands.,WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, The Netherlands
| | - Lorenzo Tarsitani
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Giulia Turrini
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy
| | - Ersin Uygun
- Trauma and Disaster Mental Health, Istanbul Bilgi University, Turkey
| | - Maritta Välimäki
- University of Turku, Department of Nursing Science, University of Turku, Finland.,Xiangya Nursing School, Central South University, Xiangya Center for Evidence-Based Practice and Healthcare Innovation, Changsha, China
| | - Lauren Walker
- Department of Health Sciences, University of York, UK
| | - Johannes Wancata
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Ross G White
- School of Psychology, Queen's University Belfast, UK
| | - Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy
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14
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Berardelli I, Rogante E, Sarubbi S, Erbuto D, Cifrodelli M, Concolato C, Pasquini M, Lester D, Innamorati M, Pompili M. Is Lethality Different between Males and Females? Clinical and Gender Differences in Inpatient Suicide Attempters. Int J Environ Res Public Health 2022; 19:ijerph192013309. [PMID: 36293891 PMCID: PMC9602518 DOI: 10.3390/ijerph192013309] [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] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 05/09/2023]
Abstract
According to the gender paradox in suicidology, an important sex difference has been reported with a preponderance of females in nonfatal suicidal behavior and a preponderance of males in completed suicide. Furthermore, females and males present different risk factors for suicide. The present study explored possible clinical differences between male and female psychiatric inpatients who had recently attempted suicide. The study included 177 adult inpatients hospitalized following a suicide attempt at the University Psychiatric Clinic, Sant'Andrea Hospital, Sapienza University of Rome. Clinical features assessed included psychiatric diagnosis, method and lethality of suicide attempts using the Risk/Rescue Rating Scale, the history of suicide attempts, age at onset of psychiatric illness, the presence of substance or alcohol use, and the length of stay. The results found that males and females differed in the method used for the suicide attempt, the scores for risk and rescue, and the length of hospitalization post-suicide attempt. In conclusion, identifying gender characteristics of patients at higher risk of suicide is important for implementing specific suicide prevention strategies and reducing the risk of future suicidal behavior in psychiatric inpatients.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
- Correspondence: ; Tel.: +06-33-775-675
| | - Elena Rogante
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy
| | - Salvatore Sarubbi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy
| | - Denise Erbuto
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Mariarosaria Cifrodelli
- Psychiatry Residency Training Program, Psychiatry Unit, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Cristina Concolato
- Psychiatry Residency Training Program, Psychiatry Unit, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy
| | - David Lester
- Psychology Program, Stockton University, Galloway, NJ 08205, USA
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
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15
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Tarsitani L, Pinucci I, Tedeschi F, Patanè M, Papola D, Palantza C, Acarturk C, Björkenstam E, Bryant R, Burchert S, Davisse-Paturet C, Díaz-García A, Farrel R, Fuhr DC, Hall BJ, Huizink AC, Lam AIF, Kurt G, Leijen I, Mittendorfer-Rutz E, Morina N, Panter-Brick C, Purba FD, Quero S, Seedat S, Setyowibowo H, van der Waerden J, Pasquini M, Sijbrandij M, Barbui C. Resilience of people with chronic medical conditions during the COVID-19 pandemic: a 1-year longitudinal prospective survey. BMC Psychiatry 2022; 22:633. [PMID: 36183067 PMCID: PMC9525930 DOI: 10.1186/s12888-022-04265-8] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/12/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUNDS Individuals with chronic medical conditions are considered highly exposed to COVID-19 pandemic stress, but emerging evidence is demonstrating that resilience is common even among them. We aimed at identifying sustained resilient outcomes and their predictors in chronically ill people during the first year of the pandemic. METHODS This international 4-wave 1-year longitudinal online survey included items on socio-demographic characteristics, economic and living situation, lifestyle and habits, pandemic-related issues, and history of mental disorders. Adherence to and approval of imposed restrictions, trust in governments and in scientific community during the pandemic were also investigated. The following tools were administered: the Patient Health Questionnaire, the Generalized Anxiety Disorder scale, the PTSD Checklist DSM-5, the Oslo Social Support Scale, the Padua Inventory, and the Portrait Values Questionnaire. RESULTS One thousand fifty-two individuals reporting a chronic condition out of 8011 total participants from 13 countries were included in the study, and 965 had data available for the final model. The estimated probability of being "sustained-resilient" was 34%. Older male individuals, participants employed before and during the pandemic or with perceived social support were more likely to belong to the sustained-resilience group. Loneliness, a previous mental disorder, high hedonism, fear of COVID-19 contamination, concern for the health of loved ones, and non-approving pandemic restrictions were predictors of not-resilient outcomes in our sample. CONCLUSIONS We found similarities and differences from established predictors of resilience and identified some new ones specific to pandemics. Further investigation is warranted and could inform the design of resilience-building interventions in people with chronic diseases.
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Affiliation(s)
- Lorenzo Tarsitani
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
| | - Irene Pinucci
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- Department of Clinical, Neuro-, and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, the Netherlands
| | - Federico Tedeschi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Martina Patanè
- Department of Clinical, Neuro-, and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, the Netherlands
| | - Davide Papola
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Christina Palantza
- Department of Clinical, Neuro-, and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, the Netherlands
| | - Ceren Acarturk
- Department of Psychology, Koc University, Istanbul, Turkey
| | - Emma Björkenstam
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Berzelius väg 3, 17177, Stockholm, Sweden
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Sebastian Burchert
- Department of Education and Psychology, Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | | | - Amanda Díaz-García
- Department of Psychology and Sociology, Universidad de Zaragoza (Teruel), Teruel, Spain
| | - Rachel Farrel
- Department of Anthropology, Yale University, New Haven, USA
| | - Daniela C Fuhr
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, Tavistock Place, London, UK
| | - Brian J Hall
- Center for Global Health Equity, NYU Shanghai, Shanghai, People's Republic of China
- New York University School of Global Public Health, New York, NY, USA
| | - Anja C Huizink
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Agnes Iok Fong Lam
- Centre for Macau Studies, University of Macau, Macau, SAR, People's Republic of China
- Department of Communications, University of Macau, Macau, SAR, People's Republic of China
| | - Gülşah Kurt
- Department of Psychology, Koc University, Istanbul, Turkey
| | - Ingmar Leijen
- Department of Marketing, School of Business and Economics, Vrije Universiteit, Amsterdam, The Netherlands
| | - Ellenor Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Berzelius väg 3, 17177, Stockholm, Sweden
| | - Naser Morina
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Catherine Panter-Brick
- Department of Anthropology, Yale University, New Haven, USA
- Jackson School for Global Affairs, Yale University, New Haven, USA
| | | | - Soledad Quero
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Hari Setyowibowo
- Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Judith van der Waerden
- INSERM U1136, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Social Epidemiology Research Team, Paris, France
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Marit Sijbrandij
- Department of Clinical, Neuro-, and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, the Netherlands
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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16
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Pompili M, Innamorati M, Erbuto D, Luciano M, Sampogna G, Abbate-Daga G, Barlati S, Carmassi C, Castellini G, De Fazio P, Di Lorenzo G, Di Nicola M, Ferrari S, Goracci A, Gramaglia C, Martinotti G, Nanni MG, Pasquini M, Pinna F, Poloni N, Serafini G, Signorelli M, Tortorella A, Ventriglio A, Volpe U, Fiorillo A. High depression symptomatology and mental pain characterize suicidal psychiatric patients. Eur Psychiatry 2022; 65:e54. [PMID: 36041998 PMCID: PMC9491079 DOI: 10.1192/j.eurpsy.2022.2312] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [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] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Symptoms of depression are transdiagnostic heterogenous features frequently assessed in psychiatric disorders, that impact the response to first-line treatment and are associated with higher suicide risk. This study assessed whether severe mental pain could characterize a specific phenotype of severely depressed high-risk psychiatric patients. We also aimed to analyze differences in treatments administered. METHODS 2,297 adult patients (1,404 females and 893 males; mean age = 43.25 years, SD = 15.15) treated in several Italian psychiatric departments. Patients were assessed for psychiatric diagnoses, mental pain, symptoms of depression, hopelessness, and suicide risk. RESULTS More than 23% of the patients reported high depression symptomatology and high mental pain (HI DEP/HI PAIN). Compared to patients with lower symptoms of depression, HI DEP/HI PAIN is more frequent among females admitted to an inpatient department and is associated with higher hopelessness and suicide risk. In addition, HI DEP/HI PAIN (compared to both patients with lower symptoms of depression and patients with higher symptoms of depression but lower mental pain) were more frequently diagnosed in patients with personality disorders and had different treatments. CONCLUSIONS Patients reporting severe symptoms of depression and high mental pain presented a mixture of particular dangerousness (high trait hopelessness and the presence of suicide ideation with more frequency and less controllability and previous suicide behaviors). The presence of severe mental pain may act synergically in expressing a clinical phenotype that is likewise treated with a more complex therapeutic regime than that administered to those experiencing symptoms of depression without mental pain.
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Affiliation(s)
- Maurizio Pompili
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Denise Erbuto
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Giovanni Abbate-Daga
- Eating Disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Claudia Carmassi
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Pasquale De Fazio
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marco Di Nicola
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Dipartimento ad Attività Integrata di Salute Mentale e Dipendenze Patologiche, AUSL - IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Arianna Goracci
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Carla Gramaglia
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.,Psychiatry Division, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Maria Giulia Nanni
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Nicola Poloni
- Division of Psychiatry, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS San Martino, Genoa, Italy
| | - Maria Signorelli
- Department of Clinical and Experimental Medicine, AOU Policlinico Hospital, University of Catania, Catania, Italy
| | | | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine and Surgery, Polytechnic University of Marche, Ancona, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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17
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Pasquini M, Maraone A. Schema Therapy and Obsessive-Compulsive Disorder. ALPHA PSYCHIATRY 2022; 23:164-165. [DOI: 10.5152/alphapsychiatry.2022.22080622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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18
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Pompili M, Erbuto D, Innamorati M, Luciano M, Sampogna G, Abbate-Daga G, Barlati S, Carmassi C, Castellini G, De Fazio P, Di Lorenzo G, Di Nicola M, Ferrari S, Gramaglia C, Nanni MG, Pasquini M, Pinna F, Poloni N, Serafini G, Signorelli M, Ventriglio A, Volpe U, Fiorillo A. The Relationship Between Mental Pain, Suicide Risk, and Childhood Traumatic Experiences: Results From a Multicenter Study. J Clin Psychiatry 2022; 83. [PMID: 35704708 DOI: 10.4088/jcp.21m14176] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 10/18/2022]
Abstract
Objective: Mental pain and exposure to maltreatment are significant risk factors for suicidal behavior. This study aimed to investigate whether mental pain could be associated with a recent suicide attempt and whether it could mediate the relationship between childhood traumatic experiences and suicide risk in psychiatric patients. Methods: A multicenter observational study was organized as a joint project with representatives of numerous mixed Italian academic and clinical settings. Between December 2017 and March 2020, batteries of tests were administered to patients, assessing suicidal ideation and behavior, mental pain (usual and worst mental pain in the past 15 days), depression, and childhood maltreatment. Results: A total of 2,137 psychiatric patients (1,313 women and 824 men) were included in the final sample, and 315 reported having attempted suicide in the last 3 months. Suicide attempters (compared to nonattempters) had higher odds of reporting worse mental pain (odds ratios [ORs] between 1.02 and 1.17; P < .001) and suicidal intent with/without a specific plan (ORs between 11.57 and 11.77; P < .001). They also had higher odds of having a personality disorder (borderline personality disorder: ORs between 2.65 and 3.01; P < .001; other personality disorders: ORs between 1.96 and 2.28; P < .01) and major depression (ORs between 1.62 and 1.70; P < .05). Childhood trauma was associated with suicide risk directly (standardized effects between 0.06 and 0.07; P < .01) and indirectly through mental pain (usual mental pain: standardized indirect effect = 0.11, P < .001; worst mental pain in the past 15 days: standardized indirect effect = 0.12, P < .001). Conclusions: Mental pain constitutes a crucial framework for assessing the individual need for psychiatric help. Assessing mental pain allows identification of the main ingredient of suicide risk and puts the clinician in a strategic position to unlock some motives behind the wish to die. Further research is needed to learn if childhood adversities may interact with adult mental pain and thus foster suicide risk.
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Affiliation(s)
- Maurizio Pompili
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.,Corresponding author: Maurizio Pompili, MD, PhD, Department of Psychiatry Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035 00189, Rome, Italy
| | - Denise Erbuto
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli," Naples, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli," Naples, Italy
| | - Giovanni Abbate-Daga
- Eating Disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia and Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Pasquale De Fazio
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marco Di Nicola
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Carla Gramaglia
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Psychiatry Division, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Maria Giulia Nanni
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Nicola Poloni
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Varese, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS San Martino, Genoa, Italy
| | - Maria Signorelli
- Department of Clinical and Experimental Medicine, AOU Policlinico Hospital, University of Catania, Catania, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine and Surgery, Polytechnic University of Marche, Ancona, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli," Naples, Italy
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19
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Bersani FS, Accinni T, Carbone GA, Corazza O, Panno A, Prevete E, Bernabei L, Massullo C, Burkauskas J, Tarsitani L, Pasquini M, Biondi M, Farina B, Imperatori C. Problematic Use of the Internet Mediates the Association between Reduced Mentalization and Suicidal Ideation: A Cross-Sectional Study in Young Adults. Healthcare (Basel) 2022; 10:healthcare10050948. [PMID: 35628085 PMCID: PMC9140488 DOI: 10.3390/healthcare10050948] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/03/2022] [Accepted: 05/09/2022] [Indexed: 12/24/2022] Open
Abstract
Suicide is a major public health problem, and it is urgent to investigate its underlying clinical and psychological concomitants. It has been suggested that low mentalization skills and problematic use of the internet (PUI) are factors that can play a role in suicidal behaviors. It is possible that poor mentalization skills contribute to leading to forms of PUI, which, in turn, can represent triggers for suicidal ideation (SI). We tested this hypothesis through a quantitative and cross-sectional study on a sample (n = 623) of young adults (age range: 18−34). Self-report measures investigating symptoms related to Social Media Addiction (SMA), Internet Gaming Disorder (IGD), mentalization capacity, and SI were used. A single mediation analysis with two mediators was carried out to evaluate the direct and indirect effects of mentalization on SI through the mediating role of SMA- and IGD-related symptoms, controlling for potential confounding factors (e.g., socio-demographic and addiction-related variables). The four explored variables were significantly associated with each other (all p < 0.001) across all subjects; the mediational model showed that the total effect of mentalization on SI was significant (B = −0.821, SE = 0.092 (95% CI: −1.001; −0.641)) and that both SMA- (B = −0.073, SE = 0.034 (95% CI: −0.145; −0.008)) and IGD-related symptoms (B = 0.046, SE = 0.027 (95% CI: −0.107; −0.001)) were significant mediators of such association. Our findings support the possibility that PUI severity plays a relevant role in mediating the association between low mentalization skills and levels of SI.
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Affiliation(s)
- Francesco Saverio Bersani
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (T.A.); (E.P.); (L.B.); (L.T.); (M.P.); (M.B.)
- Correspondence:
| | - Tommaso Accinni
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (T.A.); (E.P.); (L.B.); (L.T.); (M.P.); (M.B.)
| | - Giuseppe Alessio Carbone
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, 00163 Rome, Italy; (G.A.C.); (A.P.); (B.F.); (C.I.)
| | - Ornella Corazza
- Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, Hatfield AL10 9EU, UK;
| | - Angelo Panno
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, 00163 Rome, Italy; (G.A.C.); (A.P.); (B.F.); (C.I.)
| | - Elisabeth Prevete
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (T.A.); (E.P.); (L.B.); (L.T.); (M.P.); (M.B.)
| | - Laura Bernabei
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (T.A.); (E.P.); (L.B.); (L.T.); (M.P.); (M.B.)
- Mental Health Department, ASL Roma 5 Hospital, 00184 Rome, Italy
| | - Chiara Massullo
- Experimental Psychology Laboratory, Department of Education, Roma Tre University, 00185 Rome, Italy;
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, 00135 Palanga, Lithuania;
| | - Lorenzo Tarsitani
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (T.A.); (E.P.); (L.B.); (L.T.); (M.P.); (M.B.)
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (T.A.); (E.P.); (L.B.); (L.T.); (M.P.); (M.B.)
| | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (T.A.); (E.P.); (L.B.); (L.T.); (M.P.); (M.B.)
| | - Benedetto Farina
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, 00163 Rome, Italy; (G.A.C.); (A.P.); (B.F.); (C.I.)
| | - Claudio Imperatori
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, 00163 Rome, Italy; (G.A.C.); (A.P.); (B.F.); (C.I.)
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20
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Bersani FS, Barchielli B, Ferracuti S, Panno A, Carbone GA, Massullo C, Farina B, Corazza O, Prevete E, Tarsitani L, Pasquini M, Biondi M, Imperatori C. The association of problematic use of social media and online videogames with aggression is mediated by insomnia severity: A cross-sectional study in a sample of 18- to 24-year-old individuals. Aggress Behav 2022; 48:348-355. [PMID: 34870339 DOI: 10.1002/ab.22008] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 12/24/2022]
Abstract
One of the worrying concomitants of problematic use of Internet (PUI) is aggression. Although the mechanisms underlying such link have not been completely clarified, it has been suggested that problematic use of social media and online videogames (i.e., two common forms of PUI among young adults) lead to increased sleep disturbances which, in turn, represent a relevant trigger for aggression. We have tested this hypothesis in a sample (N = 480) of young individuals (351 females and 129 males; mean age: 21.76 ± 1.92 years; range: 18-24). Self-report measures investigating symptoms related to social media addiction (SMA), Internet gaming disorder (IGD), insomnia severity, and aggression were used. Mediational models analyzing the direct and indirect associations of SMA- and IGD-related symptoms on aggression severity through insomnia-related symptoms were performed controlling for confounding factors. The models showed that the total effects of SMA-related symptoms (B = 0.018; p = .010) and of IGD-related symptoms (B = 0.018; p = .041) on aggression severity were significant and that these associations were mediated by insomnia-related symptoms (respectively, p < .001 and p = .003). Our findings support the potential mediating role of insomnia severity in the association of SMA- and IGD-related disturbances with levels of aggression.
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Affiliation(s)
| | | | - Stefano Ferracuti
- Department of Human Neurosciences Sapienza University of Rome Rome Italy
| | - Angelo Panno
- Department of Human Sciences, Cognitive and Clinical Psychology Laboratory European University of Rome Rome Italy
| | - Giuseppe A. Carbone
- Department of Human Sciences, Cognitive and Clinical Psychology Laboratory European University of Rome Rome Italy
| | - Chiara Massullo
- Department of Human Sciences, Cognitive and Clinical Psychology Laboratory European University of Rome Rome Italy
| | - Benedetto Farina
- Department of Human Sciences, Cognitive and Clinical Psychology Laboratory European University of Rome Rome Italy
| | - Ornella Corazza
- Department of Clinical, Pharmaceutical and Biological Sciences University of Hertfordshire Hatfield UK
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome Latina Italy
| | - Elisabeth Prevete
- Department of Human Neurosciences Sapienza University of Rome Rome Italy
| | - Lorenzo Tarsitani
- Department of Human Neurosciences Sapienza University of Rome Rome Italy
| | - Massimo Pasquini
- Department of Human Neurosciences Sapienza University of Rome Rome Italy
| | - Massimo Biondi
- Department of Human Neurosciences Sapienza University of Rome Rome Italy
| | - Claudio Imperatori
- Department of Human Sciences, Cognitive and Clinical Psychology Laboratory European University of Rome Rome Italy
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21
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Serra R, Di Nicolantonio C, Di Febo R, De Crescenzo F, Vanderlinden J, Vrieze E, Bruffaerts R, Loriedo C, Pasquini M, Tarsitani L. The transition from restrictive anorexia nervosa to binging and purging: a systematic review and meta-analysis. Eat Weight Disord 2022; 27:857-865. [PMID: 34091875 PMCID: PMC8964622 DOI: 10.1007/s40519-021-01226-0] [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: 02/12/2021] [Accepted: 05/24/2021] [Indexed: 11/29/2022] Open
Abstract
Numerous studies addressed the topic of behavioral and symptomatic changes in eating disorders. Rates of transition vary widely across studies, ranging from 0 to 70.8%, depending on the diagnoses taken into account and the study design. Evidence shows that the specific transition from restrictive-type anorexia nervosa (AN-R) to disorders involving binging and purging behaviors (BPB) is related to a worsening of the clinical picture and worse long-term outcomes. The aim of this systematic review and meta-analysis is to focus on this specific transition, review existing literature, and summarize related risk factors. Medline and PsycINFO databases were searched, including prospective and retrospective studies on individuals with AN-R. The primary outcome considered was the rate of onset of BPB. Twelve studies (N = 725 patients) were included in the qualitative and quantitative analysis. A total of 41.84% (95% CI 33.58-50.11) of patients with AN-R manifested BPB at some point during follow-up. Risk factors for the onset of BPB included potentially treatable and untreatable factors such as the family environment, unipolar depression and higher premorbid BMI. These findings highlight that patients with AN-R frequently transition to BPB over time, with a worsening of the clinical picture. Existing studies in this field are still insufficient and heterogeneous, and further research is needed. Mental health professionals should be aware of the frequent onset of BPB in AN-R and its risk factors and take this information into account in the treatment of AN-R. LEVEL OF EVIDENCE: Evidence obtained from a systematic review and meta-analysis, Level I.
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Affiliation(s)
- Riccardo Serra
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, RM, Italy.,Research Group Psychiatry, Department of Neurosciences, KU Leuven University, UZ Gasthuisberg Campus, Herestraat 49, 3000, Leuven, Belgium.,Department of Neurosciences, Public Health Psychiatry, KULeuven, Leuven RM, Belgium
| | - Chiara Di Nicolantonio
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, RM, Italy
| | - Riccardo Di Febo
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, RM, Italy
| | - Franco De Crescenzo
- Pediatric University Hospital-Department (DPUO), Ospedale Pediatrico Bambino Gesù, Piazza di Sant'Onofrio, 4, 00165, Rome, Italy.,Department of Psychiatry, University of Oxford, Warneford Lane, Headington, Oxford, OX3 7JX, UK
| | - Johan Vanderlinden
- Research Group Psychiatry, Department of Neurosciences, KU Leuven University, UZ Gasthuisberg Campus, Herestraat 49, 3000, Leuven, Belgium
| | - Elske Vrieze
- Research Group Psychiatry, Department of Neurosciences, KU Leuven University, UZ Gasthuisberg Campus, Herestraat 49, 3000, Leuven, Belgium
| | - Ronny Bruffaerts
- Research Group Psychiatry, Department of Neurosciences, KU Leuven University, UZ Gasthuisberg Campus, Herestraat 49, 3000, Leuven, Belgium.,Department of Neurosciences, Public Health Psychiatry, KULeuven, Leuven RM, Belgium
| | - Camillo Loriedo
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, RM, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, RM, Italy.
| | - Lorenzo Tarsitani
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, RM, Italy
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22
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Imperatori C, Panno A, Carbone GA, Corazza O, Taddei I, Bernabei L, Massullo C, Prevete E, Tarsitani L, Pasquini M, Farina B, Biondi M, Bersani FS. The association between social media addiction and eating disturbances is mediated by muscle dysmorphia-related symptoms: a cross-sectional study in a sample of young adults. Eat Weight Disord 2022; 27:1131-1140. [PMID: 34176075 PMCID: PMC8235906 DOI: 10.1007/s40519-021-01232-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 05/28/2021] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Although the association between problematic use of the internet and eating disorders (EDs) in young adults has been previously established, its underlying mechanisms have not been completely clarified. It has been suggested that exposure to idealized very thin and toned body images (e.g., "thinspiration" and "fitspiration" trends) on social media might lead to increased feelings of body dissatisfaction which, in turn, can represent a trigger for EDs. We have tested this hypothesis in a sample (N = 721) of young adults (504 females, mean age: 24.13 ± 3.70 years; range 18-34). METHODS Self-report measures investigating symptoms related to social media addiction (SMA), muscle dysmorphia (MD), and EDs were used. A mediational model analyzing the direct and indirect effects of SMA-related symptoms on ED-related symptoms through the mediating role of MD-related symptoms was performed controlling for confounding factors (e.g., socio-demographic variables, substances use, body mass index, psychopathological distress). RESULTS The model showed that the total effect of SMA-related symptoms on ED-related symptoms was significant (B = 0.213; p = 0.022) and that this association was mediated by MD-related symptoms (B = 0.083; p = 0.021). DISCUSSION Our findings support the possibility that MD-related symptoms play a relevant role in mediating the association between SMA severity and ED pathology. LEVEL OF EVIDENCE Level III, evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Claudio Imperatori
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Rome, Italy
| | - Angelo Panno
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Rome, Italy
| | - Giuseppe Alessio Carbone
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Rome, Italy
| | - Ornella Corazza
- Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, Hatfield, UK.,Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Ines Taddei
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Laura Bernabei
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.,Mental Health Department, ASL Roma 5 Hospital, Rome, Italy
| | - Chiara Massullo
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Rome, Italy
| | - Elisabeth Prevete
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Lorenzo Tarsitani
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Benedetto Farina
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Francesco Saverio Bersani
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
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Pasquini M, Berardelli I, Biondi M, Fabbrini G. [Neuropsychiatry as the interface of behavioral manifestations driven by brain dysfunction.]. Riv Psichiatr 2022; 57:106-114. [PMID: 35426430 DOI: 10.1708/3790.37743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Neuropsychiatry mainly deals with processes of the mind related to neurological diseases. Only secondarily, it deal with depressive and anxiety syndromes, as reactions to the presence of an acute, chronic, or degenerative neurological disease. This review illustrate the most frequent neuropsychiatric disorders in the context of the main neurological diseases, focusing on secondary psychic reactions to the development of neurological diseases. The main purpose of this paper is therefore to amplify the sensitivity of psychiatric colleagues towards these clinical conditions in order to create a communication channel with fellow neurologists and neuroradiologists that is not limited to simple counseling.
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Affiliation(s)
| | - Isabella Berardelli
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso, Ospedale Sant'Andrea, Sapienza Università di Roma
| | - Massimo Biondi
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma
| | - Giovanni Fabbrini
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma - IRCCS Neuromed - Istituto Neurologico Mediterraneo, Pozzilli (Isernia)
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24
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Tarsitani L, Della Rocca B, Pancheri C, Biondi M, Pasquini M, Ferracuti S, Ventriglio A, Mandarelli G. Involuntary psychiatric hospitalization among migrants in Italy: A matched sample study. Int J Soc Psychiatry 2022; 68:429-434. [PMID: 33719677 DOI: 10.1177/00207640211001903] [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: 11/15/2022]
Abstract
BACKGROUND Immigrants in Europe appear to be at higher risk of psychiatric coercive interventions. Involuntary psychiatric hospitalization poses significant ethical and clinical challenges. Nonetheless, reasons for migration and other risk factors for involuntary treatment were rarely addressed in previous studies. The aims of this study are to clarify whether immigrant patients with acute mental disorders are at higher risk to be involuntarily admitted to hospital and to explore clinical and migratory factors associated with involuntary treatment. METHODS In this cross-sectional matched sample study, we compared the rates of involuntary treatment in a sample of first-generation immigrants admitted in a Psychiatric Intensive Care Unit of a large metropolitan academic hospital to their age-, gender-, and psychiatric diagnosis-matched native counterparts. Clinical, sociodemographic, and migratory variables were collected. The Brief Psychiatric Rating Scale-expanded (BPRS-E) and the Clinical Global Impression-Severity (CGI-S) scale were administered. McNemar test was used for paired categorical variables and a binary logistic regression analysis was performed. RESULTS A total of 234 patients were included in the analysis. Involuntary treatment rates were significantly higher in immigrants as compared to their matched natives (32% vs. 24% respectively; p < .001). Among immigrants, involuntary hospitalization was found to be more frequent in those patients whose length of stay in Italy was less than 2 years (OR = 4.2, 95% CI [1.4-12.7]). CONCLUSION Recently arrived immigrants appear to be at higher risk of involuntary admission. Since coercive interventions can be traumatic and negatively affect outcomes, strategies to prevent this phenomenon are needed.
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Affiliation(s)
- Lorenzo Tarsitani
- Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - Bianca Della Rocca
- Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - Corinna Pancheri
- Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - Stefano Ferracuti
- Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Italy
| | - Gabriele Mandarelli
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Italy
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25
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Canevelli M, Bersani FS, Sciancalepore F, Salzillo M, Cesari M, Tarsitani L, Pasquini M, Ferracuti S, Biondi M, Bruno G. Frailty in Caregivers and Its Relationship with Psychological Stress and Resilience: A Cross-SectionalStudy Based on the Deficit Accumulation Model. J Frailty Aging 2022; 11:59-66. [PMID: 35122092 DOI: 10.14283/jfa.2021.29] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Studies increasingly suggest that chronic exposure to psychological stress can lead to health deterioration and accelerated ageing, thus possibly contributing to the development of frailty. Recent approaches based on the deficit accumulation model measure frailty on a continuous grading through the "Frailty Index" (FI), i.e. a macroscopic indicator of biological senescence and functional status. OBJECTIVES The study aimed at testing the relationship of FI with caregiving, psychological stress, and psychological resilience. DESIGN Cross-sectional study, with case-control and correlational analyses. PARTICIPANTS Caregivers of patients with dementia (n=64), i.e. individuals a priori considered to be exposed to prolonged psychosocial stressors, and matched controls (n=64) were enrolled. MEASUREMENTS The two groups were compared using a 38-item FI condensing biological, clinical, and functional assessments. Within caregivers, the association of FI with Perceived Stress Scale (PSS) and Brief Resilience Scale (BRS) was tested. RESULTS Caregivers had higher FI than controls (F=8.308, p=0.005). FI was associated directly with PSS (r=0.660, p<0.001) and inversely with BRS (r=-0.637, p<0.001). Findings remained significant after adjusting for certain confounding variables, after excluding from the FI the conditions directly related to psychological stress, and when the analyses were performed separately among participants older and younger than 65 years. CONCLUSIONS The results provide insight on the relationship of frailty with caregiving, psychological stress, and resilience, with potential implications for the clinical management of individuals exposed to chronic emotional strain.
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Affiliation(s)
- M Canevelli
- Marco Canevelli, Francesco Saverio Bersani, Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy, ,
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Accinni T, Panfili M, Tarsitani L, Biondi M, Pasquini M, Maraone A. A Revision on the Effectiveness of Omega-3 Polyunsaturated Fatty Acids as Monotherapy in the Treatment of Major Depressive Disorder. Int J Clin Pract 2022; 2022:3801235. [PMID: 36474548 PMCID: PMC9683950 DOI: 10.1155/2022/3801235] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Insufficient effectiveness and a difficult tolerability profile of antidepressant drugs for the treatment of major depressive disorder (MDD) have been reported, and polyunsaturated fatty acids (PUFAs) have been posited as reliable therapeutic alternatives. The present study investigated the efficacy of omega-3 PUFAs as monotherapy for MDD. METHODS Two well-trained reviewers independently looked at the most significant randomized clinical trials (RCTs) from the PubMed database regarding PUFAs' employment in MDD compared to placebo; "major depressive disorder" and "omega-3 fatty acids," or "omega-6 fatty acids," or "polyunsaturated fatty acids (PUFA)," or "n - 3 polyunsaturated fatty acids," or "eicosapentaenoic acid (EPA)," or "docosahexaenoic acid (DHA)" were used as the medical subject keywords. RESULTS Of the initial 96 potential RCTs based on titles and abstracts, 82 studies did not meet the inclusion criteria and were excluded. Six studies were excluded from the remaining 14 after full text revision. Eight RCTs met all the inclusion/exclusion criteria without reporting clear evidence of PUFAs' effectiveness in the treatment of MDD. CONCLUSION At present, there is no opportunity to recommend the use of omega-3 PUFAs monotherapy for the treatment of MDD, although their supplementation may be useful in some specific populations.
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Affiliation(s)
- Tommaso Accinni
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell'Universitá 30, 00185 Rome, Italy
| | - Matteo Panfili
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell'Universitá 30, 00185 Rome, Italy
| | - Lorenzo Tarsitani
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell'Universitá 30, 00185 Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell'Universitá 30, 00185 Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell'Universitá 30, 00185 Rome, Italy
| | - Annalisa Maraone
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell'Universitá 30, 00185 Rome, Italy
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Accinni T, Frascarelli M, Vecchioni S, Tarsitani L, Biondi M, Pasquini M. Gender modulation of psychopathological dimensions associated to suicidality. Riv Psichiatr 2022; 57:23-32. [PMID: 35166727 DOI: 10.1708/3749.37324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The dimensional approach to psychopathology has been proposed to reliably evaluate suicidality. Potential gender modulation of psychopathological dimensions associated to suicide attempts was investigated. METHODS 91 subjects who committed a near-lethal suicide (SA group) and 374 who did not (nSA group) were recruited in a Psychiatric Intensive Care Unit regardless of their categorical diagnosis. The Hamilton Depression Rating Scale (HAM-D), the Brief Psychiatric Rating Scale - Expanded version (BPRS-E) and the Scale for Rapid Dimensional Evaluation (SVARAD) were administered at the admission. A Factorial Multivariate ANOVA was conducted according to General Linear Model: Sex and Suicidality were input as fixed factors, HAM-D, BPRS-E and SVARAD scores as dependent variables. RESULTS Men with SA (MSA) displayed significant lower scores in SVARAD Activation dimension compared to women with SA (FSA) (p=0.049), men without SA (MnSA) (p<0.001) and women without SA (FnSA) (p<0.001). Both SA groups displayed significant higher scores compared to nSA groups in regard of Depression item (BPRS-E) (p<0,001). The MSA group displayed significant lower scores in Psychomotor agitation (HAM-D) compared to FSA (p=0,044), MnSA (p<0,001) and FnSA (p<0,001). CONCLUSIONS By means of multifactorial statistics sex resulted a moderator of the relation between activation/agitation and suicidality, despite categorical diagnosis.
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Affiliation(s)
- Tommaso Accinni
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | | | - Sofia Vecchioni
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Lorenzo Tarsitani
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Italy
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Berardelli I, Maraone A, Belvisi D, Pasquini M, Giustini S, Miraglia E, Iacovino C, Pompili M, Frascarelli M, Fabbrini G. The importance of suicide risk assessment in patients affected by neurofibromatosis. Int J Psychiatry Clin Pract 2021; 25:350-355. [PMID: 34270353 DOI: 10.1080/13651501.2021.1921217] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Neurofibromatosis 1 (NF1) is a chronic medical disease that often presents with psychiatric disorders. We investigated suicidal ideation in NF1 patients compared to healthy controls. We also evaluated whether hopelessness, depressive symptoms and perceived disability may mediate suicidal ideation in patients with NF1. METHODS We enrolled 60 patients with NF1 and 50 healthy controls with no history of NF1. Patients underwent a full psychiatric evaluation. Psychiatric diagnosis was made according to Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria. Patients and controls underwent a series of psychometric measures, namely the Columbia Suicide Severity Rating Scale, the Beck Hopelessness Scale, the Italian Perceived Disability Scale and the Beck Depression Inventory. RESULTS Suicidal ideation was significantly higher in patients with NF1 (45%) than in controls (10%). Patients also presented more severe perceived disability and hopelessness and more frequent psychiatric disorders than controls. Multivariable logistic regression analysis showed that perceived disability was independently associated with the presence of suicidal ideation in patients with NF1. CONCLUSIONS In conclusion, our results showed that suicidal ideation was present in almost half of patients with NF1, suggesting the importance of suicide assessment in these patients.Key pointsPatients with NF1 have an increased suicide ideation when compared to healthy controlsIncreased suicidal ideation correlates with perceived disability, but not with the presence of psychiatric disordersAssessment of suicidal ideation should be performed in patients with NF1.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Annalisa Maraone
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Daniele Belvisi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,IRCCS NEUROMED, Pozzilli (IS), Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Sandra Giustini
- Department of Dermatology, Sapienza University of Rome, Rome, Italy
| | | | - Chiara Iacovino
- Department of Dermatology, Sapienza University of Rome, Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,IRCCS NEUROMED, Pozzilli (IS), Italy
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Maraone A, Tarsitani L, Pinucci I, Pasquini M. Antiglutamatergic agents for obsessive-compulsive disorder: Where are we now and what are possible future prospects? World J Psychiatry 2021; 11:568-580. [PMID: 34631461 PMCID: PMC8474998 DOI: 10.5498/wjp.v11.i9.568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/25/2021] [Accepted: 08/06/2021] [Indexed: 02/06/2023] Open
Abstract
Recent data suggest that obsessive-compulsive disorder (OCD) is driven by an imbalance among the habit learning system and the goal-directed system. The frontostriatal loop termed cortico-striatal-thalamo-cortical (CSTC) circuitry loop is involved in habits and their dysfunction plays an important role in OCD. Glutamatergic neurotransmission is the principal neurotransmitter implicated in the CSTC model of OCD. Hyperactivity in the CSTC loop implies a high level of glutamate in the cortical-striatal pathways as well as a dysregulation of GABAergic transmission, and could represent the pathophysiology of OCD. Moreover, the dysregulation of glutamate levels can lead to neurotoxicity, acting as a neuronal excitotoxin. The hypothesis of a role of neurotoxicity in the pathophysiology of OCD clinically correlates to the importance of an early intervention for patients. Indeed, some studies have shown that a reduction of duration of untreated illness is related to an earlier onset of remission. Although robust data supporting a progression of such brain changes are not available so far, an early intervention could help interrupt damage from neurotoxicity. Moreover, agents targeting glutamate neurotransmission may represent promising therapeutical option in OCD patients.
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Affiliation(s)
- Annalisa Maraone
- Department of Human Neurosciences, Sapienza University of Rome, Rome 00185, Lazio, Italy
| | - Lorenzo Tarsitani
- Department of Human Neurosciences, Sapienza University of Rome, Rome 00185, Lazio, Italy
| | - Irene Pinucci
- Department of Human Neurosciences, Sapienza University of Rome, Rome 00185, Lazio, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome 00185, Lazio, Italy
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Costanzo M, Belvisi D, Berardelli I, Maraone A, Baione V, Ferrazzano G, Cutrona C, Leodori G, Pasquini M, Conte A, Fabbrini G, Defazio G, Berardelli A. Effect of Botulinum Toxin on Non-Motor Symptoms in Cervical Dystonia. Toxins (Basel) 2021; 13:toxins13090647. [PMID: 34564651 PMCID: PMC8472845 DOI: 10.3390/toxins13090647] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 11/16/2022] Open
Abstract
Patients with cervical dystonia (CD) may display non-motor symptoms, including psychiatric disturbances, pain, and sleep disorders. Intramuscular injection of botulinum toxin type A (BoNT-A) is the most efficacious treatment for motor symptoms in CD, but little is known about its effects on non-motor manifestations. The aim of the present study was to longitudinally assess BoNT-A’s effects on CD non-motor symptoms and to investigate the relationship between BoNT-A-induced motor and non-motor changes. Forty-five patients with CD participated in the study. Patients underwent a clinical assessment that included the administration of standardized clinical scales assessing dystonic symptoms, psychiatric disturbances, pain, sleep disturbances, and disability. Clinical assessment was performed before and one and three months after BoNT-A injection. BoNT-A induced a significant improvement in dystonic symptoms, as well as in psychiatric disturbances, pain, and disability. Conversely, sleep disorders were unaffected by BoNT-A treatment. Motor and non-motor BoNT-A-induced changes showed a similar time course, but motor improvement did not correlate with non-motor changes after BoNT-A. Non-motor symptom changes after BoNT-A treatment are a complex phenomenon and are at least partially independent from motor symptom improvement.
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Affiliation(s)
- Matteo Costanzo
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy; (M.C.); (D.B.); (A.M.); (V.B.); (G.F.); (C.C.); (G.L.); (M.P.); (A.C.); (G.F.)
| | - Daniele Belvisi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy; (M.C.); (D.B.); (A.M.); (V.B.); (G.F.); (C.C.); (G.L.); (M.P.); (A.C.); (G.F.)
- IRCSS Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
| | - Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035-1039, 00185 Rome, Italy;
| | - Annalisa Maraone
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy; (M.C.); (D.B.); (A.M.); (V.B.); (G.F.); (C.C.); (G.L.); (M.P.); (A.C.); (G.F.)
| | - Viola Baione
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy; (M.C.); (D.B.); (A.M.); (V.B.); (G.F.); (C.C.); (G.L.); (M.P.); (A.C.); (G.F.)
| | - Gina Ferrazzano
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy; (M.C.); (D.B.); (A.M.); (V.B.); (G.F.); (C.C.); (G.L.); (M.P.); (A.C.); (G.F.)
| | - Carolina Cutrona
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy; (M.C.); (D.B.); (A.M.); (V.B.); (G.F.); (C.C.); (G.L.); (M.P.); (A.C.); (G.F.)
| | - Giorgio Leodori
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy; (M.C.); (D.B.); (A.M.); (V.B.); (G.F.); (C.C.); (G.L.); (M.P.); (A.C.); (G.F.)
- IRCSS Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy; (M.C.); (D.B.); (A.M.); (V.B.); (G.F.); (C.C.); (G.L.); (M.P.); (A.C.); (G.F.)
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy; (M.C.); (D.B.); (A.M.); (V.B.); (G.F.); (C.C.); (G.L.); (M.P.); (A.C.); (G.F.)
- IRCSS Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy; (M.C.); (D.B.); (A.M.); (V.B.); (G.F.); (C.C.); (G.L.); (M.P.); (A.C.); (G.F.)
- IRCSS Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
| | - Giovanni Defazio
- Department of Medical Sciences and Public Health, University of Cagliari, SS 554 Bivio Sestu, 09042 Monserrato, Italy;
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy; (M.C.); (D.B.); (A.M.); (V.B.); (G.F.); (C.C.); (G.L.); (M.P.); (A.C.); (G.F.)
- IRCSS Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
- Correspondence:
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Roselli V, Tarsitani L, Mandarelli G, Maraone A, Magliocchetti V, Bersani FS, Biondi M, Pasquini M. Relationship between the core features of Tellenbach's Typus Melancholicus and unipolar depressive disorders: a cross-sectional study. Riv Psichiatr 2021; 55:191-194. [PMID: 32489197 DOI: 10.1708/3382.33576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE One of the most consistent models investigating the relationship between premorbid personality and depression was described by Tellenbach. According to this model, concern with orderliness, conscientiousness, hyper/hetereonomia and intolerance of ambiguity are the core features of Typus Melancholicus (TM). Previous studies showed a relationship between unipolar depression and TM. The primary hypothesis of this study was that patients affected by unipolar depressive disorders bare more of TM-related features of concern with orderliness and conscientiousness than healthy subjects. METHODS In this single center cross-sectional study we recruited 74 patients affected by unipolar depressive disorders according to DSM-5 criteria and 60 healthy controls. In order to assess the presence of TM's orderliness and conscientiousness we adopted the factors of Kasahara's Inventory for the Melancholic Type Personality (KIMTP) named "harmony in personal relationships" and "social norms". Stress-Related Vulnerability Scale (SVS) was administered to explore the relationship between measures of TM and perceived stress. RESULTS Independent sample t test disclosed significantly higher scores on KIMTP "harmony in personal relationships" (orderliness) but not on "social norms" (conscientiousness) in the clinical sample (p<0.001) compared to the non-clinical sample. Pearson's correlation disclosed a significant positive correlation between stress scores and KIMTP'S "harmony in personal relationships" subscale. DISCUSSION AND CONCLUSIONS KIMTP's "harmony in personal relationships" (orderliness) was higher in patients with unipolar depression than in non-clinical subjects, and positively associated with perceived stress, while KIMTP's "social norms" (conscientiousness) was (i) similarly represented across the two groups, and (ii) not correlated with perceived stress. This raises the possibility that, among the core features of TM, concern with orderliness can be considered as a relevant and potentially premorbid personality factor in relation to unipolar depressive disorders.
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Affiliation(s)
- Valentina Roselli
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
| | - Lorenzo Tarsitani
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
| | - Gabriele Mandarelli
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
| | - Annalisa Maraone
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
| | - Valentina Magliocchetti
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
| | - Francesco Saverio Bersani
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
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Conti S, Spalletti C, Pasquini M, Giordano N, Barsotti N, Mainardi M, Lai S, Giorgi A, Pasqualetti M, Micera S, Caleo M. Combining robotics with enhanced serotonin-driven cortical plasticity improves post-stroke motor recovery. Prog Neurobiol 2021; 203:102073. [PMID: 33984455 DOI: 10.1016/j.pneurobio.2021.102073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/22/2021] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
Despite recent progresses in robotic rehabilitation technologies, their efficacy for post-stroke motor recovery is still limited. Such limitations might stem from the insufficient enhancement of plasticity mechanisms, crucial for functional recovery. Here, we designed a clinically relevant strategy that combines robotic rehabilitation with chemogenetic stimulation of serotonin release to boost plasticity. These two approaches acted synergistically to enhance post-stroke motor performance. Indeed, mice treated with our combined therapy showed substantial functional gains that persisted beyond the treatment period and generalized to non-trained tasks. Motor recovery was associated with a reduction in electrophysiological and neuroanatomical markers of GABAergic neurotransmission, suggesting disinhibition in perilesional areas. To unveil the translational potentialities of our approach, we specifically targeted the serotonin 1A receptor by delivering Buspirone, a clinically approved drug, in stroke mice undergoing robotic rehabilitation. Administration of Buspirone restored motor impairments similarly to what observed with chemogenetic stimulation, showing the immediate translational potential of this combined approach to significantly improve motor recovery after stroke.
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Affiliation(s)
- S Conti
- Translational Neural Engineering Area, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - C Spalletti
- Institute of Neuroscience, National Research Council (CNR), Pisa, Italy
| | - M Pasquini
- Translational Neural Engineering Area, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - N Giordano
- Institute of Neuroscience, National Research Council (CNR), Pisa, Italy
| | - N Barsotti
- Unit of Cell and Developmental Biology, Department of Biology, University of Pisa, Italy
| | - M Mainardi
- Institute of Neuroscience, National Research Council (CNR), Pisa, Italy
| | - S Lai
- Translational Neural Engineering Area, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - A Giorgi
- Unit of Cell and Developmental Biology, Department of Biology, University of Pisa, Italy
| | - M Pasqualetti
- Unit of Cell and Developmental Biology, Department of Biology, University of Pisa, Italy; Center for Neuroscience and Cognitive Systems, Istituto Italiano di Tecnologia, Rovereto, Italy
| | - S Micera
- Translational Neural Engineering Area, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy; Bertarelli Foundation Chair in Translational NeuroEngineering Laboratory, École Polytechnique Fédérale de Lausanne (EPFL), Centre for Neuroprosthetics and Institute of Bioengineering, Lausanne, Switzerland.
| | - M Caleo
- Institute of Neuroscience, National Research Council (CNR), Pisa, Italy; Department of Biomedical Sciences, University of Padova, Italy.
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Accinni T, Frascarelli M, Ghezzi F, Panzera A, Buzzanca A, Fanella M, Di Bonaventura C, Carlone L, Girardi N, Pasquini M, Di Fabio F. Clozapine-induced gastroesophageal rumination in 22q11.2 Deletion Syndrome. A case report on gastroesophageal side effects management without renouncing clozapine's effectiveness. Clin Case Rep 2021; 9:e04134. [PMID: 34084508 PMCID: PMC8142464 DOI: 10.1002/ccr3.4134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 11/16/2022] Open
Abstract
Despite entailing more severe and uncommon side effects in 22q11.2DS compared to idiopathic schizophrenia, we strongly believe that clozapine should continue to be considered the gold standard for all treatment-resistant schizophrenia, even in 22qDS.
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Affiliation(s)
- Tommaso Accinni
- Department of Human NeurosciencesSapienza UniversityRomeItaly
| | | | | | - Alessia Panzera
- Department of Human NeurosciencesSapienza UniversityRomeItaly
| | | | - Martina Fanella
- Department of Human NeurosciencesSapienza UniversityRomeItaly
| | | | - Luca Carlone
- Department of Human NeurosciencesSapienza UniversityRomeItaly
| | | | | | - Fabio Di Fabio
- Department of Human NeurosciencesSapienza UniversityRomeItaly
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Berardelli I, Innamorati M, Sarubbi S, Rogante E, Erbuto D, Costanza A, Casale AD, Pasquini M, Lester D, Pompili M. Are demoralization and insight involved in suicide risk? An observational study on psychiatric inpatients. Eur Psychiatry 2021. [PMCID: PMC9471484 DOI: 10.1192/j.eurpsy.2021.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Introduction Although several authors have investigated the relationship between demoralization, insight, and suicide risk, the role of these factors in determining suicide risk in patients with psychiatric disorders is still unclear [Berardelli et al., 2019; Costanza et al., 2020]. Objectives The main aim of this study was therefore to determine whether suicide risk was associated with better insight and worse demoralization in a sample of 100 adult psychiatric inpatients. Methods The study was performed on 100 psychiatric hospitalized adult patients consecutively enrolled between January 2019 and April 2020 at psychiatric units of Sant’Andrea Medical Center, Sapienza University of Rome. The Columbia Suicide Severity Rating Scale (C-SSRS) was used to assess suicide risk, Demoralization was assessed using the Demoralization Scale (DS) [Kissane et al., 2004] and for the assessment of insight we used the The Insight Scale (IS). Results Only age was significantly associated with higher suicide risk (χ2=9.07, p<0.01). The variable mood disorder was significantly associated with higher suicide risk (χ22=7.50, p<0.05). Non-suicidal self-harm behaviors in the last 3 months (χ2=5.89, p<0.05) and lifetime suicide attempts (χ2=21.80, p<0.001) were significantly associated with higher suicide risk. Only the insight-high dimension (χ2=8.01, p<0.01) and lifetime suicide attempts (χ2=12.33, p<0.001) were significantly associated with higher suicide risk. Conclusions Our results don’t confirm the role of demoralization in suicide risk. In our sample of patients, only high insigth of illness and other psychological variables are involved in suicide risk. Disclosure No significant relationships.
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Maraone A, Tarsitani L, Frascarelli M, Petrini F, Roselli V, Tinè M, Cavaggioni G, Brakoulias V, Biondi M, Pasquini M. Psychic euosmia among obsessive-compulsive personality disorder patients: A case control study. World J Psychiatry 2021; 11:50-57. [PMID: 33643861 PMCID: PMC7896246 DOI: 10.5498/wjp.v11.i2.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/13/2020] [Accepted: 12/28/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Psychic euosmia (PE) has been described as a supposed psychological predisposition for which pleasant smells elicit an immediate sense of pleasure, order and calmness in obsessive-compulsive personality disorder (OCPD). In this study we tried to verify the interpretation that PE is the counterpart of disgust that has been associated to contamination and moral purity. Disgust and morality are significantly associated in people with obsessive-compulsive personality traits. We expected that OCPD patients would experience higher levels of PE.
AIM To investigate the PE frequency in OCPD patients and healthy controls (HC) and to evaluate the relationship between PE and disgust.
METHODS A single-center, case-control study was conducted in an outpatient service for obsessive-compulsive and related disorders. The sample consisted of 129 subjects: 45 OCPD patients and 84 HC. In both groups we submitted the Disgust Scale Revised (DS-R) and the self-report Structured Clinical Interview for DSM-5 Screening Personality Questionnaire to which we added an additional yes or no question to investigate the presence of PE. In order to verify differences between groups, t-test was employed for continuous variables and 2 test for categorical variable; odds ratio was employed to analyze group differences in the PE survey. Correlation was explored with Pearson r correlations.
RESULTS No differences were observed between groups in gender composition or education. A slight significant difference was found in mean age (t = 1.988; P = 0.049). The present study revealed significantly higher proportions of PE among OCPD patients when compared to HC (OR: 5.3, 2.28-12.46). Patients with OCPD were more likely to report PE (n = 36; 80%) whereas a much lower proportion endorsed PE in the HC group (n = 36; 42.9%). Interestingly, no differences were observed between groups in mean score for the Disgust Scale. There was also no difference between the two groups in any of the Disgust Scale Revised subscales. Moreover, no significant correlations were observed in the OCPD group between PE and Disgust Scale Revised subscales.
CONCLUSION Results suggested that PE might be part of the clinical spectrum of OCPD, and it does not reflect the counterpart of disgust. This could also indicate that this phenomenon is a manifestation of orderliness or incompleteness. Further studies will need to be undertaken to better understand PE and its significance in OCPD.
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Affiliation(s)
- Annalisa Maraone
- Department of Human Neurosciences, Sapienza University, Rome 00185, Italy
| | - Lorenzo Tarsitani
- Department of Neurosciences and Mental Health, Umberto I Policlinic, Rome 00185, Italy
| | | | - Federica Petrini
- Department of Human Neurosciences, Sapienza University, Rome 00185, Italy
| | - Valentina Roselli
- Department of Neurosciences and Mental Health, Umberto I Policlinic, Rome 00185, Italy
| | - Massimiliano Tinè
- Department of Human Neurosciences, Sapienza University, Rome 00185, Italy
| | | | - Vlasios Brakoulias
- Department of Psychiatry, School of Medicine, Western Sydney University and Western Sydney Local Health District, Blacktown 2145, SNW, Australia
- Department of Psychiatry, Nepean Hospital, Sydney Medical School, The University of Sydney, Penrith 2751, SNW, Australia
| | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University, Rome 00185, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University, Rome 00185, Italy
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Frascarelli M, Padovani G, Buzzanca A, Accinni T, Carlone L, Ghezzi F, Lattanzi GM, Fanella M, Putotto C, Di Bonaventura C, Girardi N, Pasquini M, Biondi M, Di F. Social cognition deficit and genetic vulnerability to schizophrenia in 22q11 deletion syndrome. Ann Ist Super Sanita 2021; 56:107-113. [PMID: 32242542 DOI: 10.4415/ann_20_01_15] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION 22q11.2 microdeletion syndrome (22q11DS) is associated with a 25% risk of psychotic onset. MATERIALS AND METHODS The sample consist of 120 subjects: 39 schizophrenics (SCZ); 20 siblings of schizophrenic patients (SIB); 34 22q11DS non-psychotic patients (DEL); 17 22q11DS psychotic patients (DEL_scz); 30 control subjects (CS). Social cognition was evaluated with the awareness of social interference test. Intelligence Quotient (IQ) was calculated with Wechsler Adult Intelligence Scale. TASIT (Awareness of Social Inference Test) performance was analyzed via MANOVA, including IQ as covariate. RESULTS Group and IQ showed significant effect (p < 0.001; p = 0.037). The only TASIT variables where IQ showed no effect were paradoxical sarcasm; sincerity; lie. In sincerity, CS group shows a better performance than both 22q11DS groups (p < 0.05). In paradoxical sarcasm and lie, CS group performed better than each clinical group (p < 0.05). Regarding lie, DEL group was worst also respect to SCZ group (p = 0.029). CONCLUSIONS Our results show a specific social cognition deficit in 22q11DS and schizophrenia.
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Affiliation(s)
| | - Gaia Padovani
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, Italy
| | - Antonino Buzzanca
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, Italy
| | - Tommaso Accinni
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, Italy
| | - Luca Carlone
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, Italy
| | - Francesco Ghezzi
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, Italy
| | | | - Martina Fanella
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, Italy
| | - Carolina Putotto
- Dipartimento Materno Infantile e Scienze Urologiche, Sapienza Università di Roma, Rome, Italy
| | | | - Nicoletta Girardi
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, Italy
| | - Massimo Pasquini
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, Italy
| | - Massimo Biondi
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, Italy
| | - Fabio Di
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, Italy
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Berardelli I, Innamorati M, Sarubbi S, Rogante E, Erbuto D, De Pisa E, Costanza A, Del Casale A, Pasquini M, Lester D, Pompili M. Are Demoralization and Insight Involved in Suicide Risk? An Observational Study on Psychiatric Inpatients. Psychopathology 2021; 54:127-135. [PMID: 33849027 DOI: 10.1159/000515056] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/03/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Several features contribute to determining suicide risk. This study was designed with the aim of evaluating whether insight into illness and demoralization are involved in suicide risk (active suicidal ideation or behavior). METHODS For this purpose, in a sample of 100 adult psychiatric inpatients, we used the Columbia Suicide Severity Rating Scale to assess suicide risk, the Demoralization Scale for demoralization symptoms, and the Insight Scale to assess illness insight. We also investigated several demographic and clinical features, including gender, age, duration of untreated illness, previous suicide attempts, and nonsuicidal self-injurious behavior. RESULTS The results demonstrated that patients with higher scores on the insight-high dimension had 1.35 greater odds of having a higher suicide risk, and those with lifetime suicide attempts had 7.45 greater odds of having a higher suicide risk. Among the various clinical factors, the study indicated that only nonsuicidal self-harm behaviors in the last 3 months was a risk factor for suicide risk. CONCLUSIONS The results indicated that greater illness insight is involved in suicide risk regardless of demoralization.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Rome, Italy
| | | | - Elena Rogante
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Denise Erbuto
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Eleonora De Pisa
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| | - Antonio Del Casale
- Department of Clinical and Dynamic Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences Faculty of Medicine and Dentistry, SAPIENZA University of Rome, Rome, Italy
| | - David Lester
- Psychology Program, Stockton University, Galloway, New Jersey, USA
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Imperatori C, Corazza O, Panno A, Rinaldi R, Pasquini M, Farina B, Biondi M, Bersani FS. Mentalization Impairment Is Associated with Problematic Alcohol Use in a Sample of Young Adults: A Cross-Sectional Study. Int J Environ Res Public Health 2020; 17:ijerph17228664. [PMID: 33266367 PMCID: PMC7700465 DOI: 10.3390/ijerph17228664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 12/13/2022]
Abstract
Background: Alcohol is one of the most widely used drugs among adolescents and young people, and problematic alcohol use (PAU) is related to significant long-term biological, clinical, and psychosocial sequelae. Although preliminary reports have linked deficits in mentalization to increased vulnerability to addiction, no studies have specifically explored this phenomenon in relation to PAU. Methods: The association between mentalization impairment and PAU severity was investigated in a sample of 271 young adults (183 females, 65.9%; mean age: 23.20 ± 3.55 years; range: 18–34). Self-report measures investigating PAU and mentalization were administered to all participants. Results: Individuals with PAU reported a more frequent use of tobacco and illicit drugs in the last 12 months. PAU severity was negatively associated with mentalization capacity (rho = −0.21; p < 0.001), and also, when possible, confounding variables (i.e., gender, age, occupation, education, tobacco and illegal drugs use) were controlled for (rho = −0.17; p = 0.004). Conclusion: The present data showed that mentalization impairment is significantly associated with PAU among young adults, suggesting that it may have a role in the development and/or maintenance of alcohol use.
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Affiliation(s)
- Claudio Imperatori
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, 00163 Rome, Italy; (C.I.); (A.P.); (B.F.)
| | - Ornella Corazza
- Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, Hatfield AL109AB, UK;
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy
| | - Angelo Panno
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, 00163 Rome, Italy; (C.I.); (A.P.); (B.F.)
| | - Raffaella Rinaldi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00185 Rome, Italy;
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (M.P.); (M.B.)
| | - Benedetto Farina
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, 00163 Rome, Italy; (C.I.); (A.P.); (B.F.)
| | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (M.P.); (M.B.)
| | - Francesco Saverio Bersani
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (M.P.); (M.B.)
- Correspondence:
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Piacentino D, Maraone A, Roselli V, Berardelli I, Biondi M, Kotzalidis GD, Pasquini M. Efficacy of nicotine administration on obsessions and compulsions in OCD: a systematic review. Ann Gen Psychiatry 2020; 19:57. [PMID: 33014119 PMCID: PMC7528475 DOI: 10.1186/s12991-020-00309-z] [Citation(s) in RCA: 4] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/21/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Preliminary studies have tested nicotine as a novel treatment for OCD patients who respond partially/incompletely or not at all to first and second-line treatment strategies, with the former represented by SSRIs or clomipramine, and the latter by switching to another SSRI, or augmentation with atypical antipsychotics, and/or combination with/switching to cognitive-behavioural therapy. Some studies found nicotine-induced reduction of obsessive thoughts and/or compulsive behaviour in OCD patients. We aimed to evaluate the efficacy of nicotine administration in OCD patients. METHODS We searched the PubMed, ScienceDirect Scopus, CINHAL, Cochrane, PsycINFO/PsycARTICLES, and EMBASE databases from inception to the present for relevant papers. The 'Preferred Reporting Items for Systematic Review and Meta-Analyses' (PRISMA) standards were used. We included all studies focusing on the effects of nicotine administration on OCD patients' obsessions or compulsions. Studies could be open-label, cross-sectional, randomized controlled trials, case series or case reports. RESULTS A total of five studies could be included. Nicotine administration may ameliorate behavioural features and recurrent thoughts of severe, treatment-resistant OCD patients; however, in one study it was not associated with OC symptom improvement or cognitive enhancement across various executive function subdomains. CONCLUSIONS Although encouraging, the initial positive response from the use of nicotine in OCD needs testing in large controlled studies. This, however, raises ethical issues related to nicotine administration, due to its addiction potential, which were not addressed in the limited literature we examined. As an alternative, novel treatments with drugs able to mimic only the positive effects of nicotine could be implemented.
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Affiliation(s)
- Daria Piacentino
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), School of Medicine and Psychology, Sapienza University, Sant’Andrea Hospital, Rome, Italy
- Department of Human Neurosciences, Sapienza University, Policlinico Umberto I, Rome, Italy
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, National Institute On Drug Abuse Intramural Research Program and National Institute On Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD USA
| | - Annalisa Maraone
- Department of Human Neurosciences, Sapienza University, Policlinico Umberto I, Rome, Italy
| | - Valentina Roselli
- Department of Human Neurosciences, Sapienza University, Policlinico Umberto I, Rome, Italy
| | - Isabella Berardelli
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), School of Medicine and Psychology, Sapienza University, Sant’Andrea Hospital, Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University, Policlinico Umberto I, Rome, Italy
| | - Georgios D. Kotzalidis
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), School of Medicine and Psychology, Sapienza University, Sant’Andrea Hospital, Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University, Policlinico Umberto I, Rome, Italy
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Pancheri C, Maraone A, Roselli V, Altieri M, Di Piero V, Biondi M, Pasquini M, Tarsitani L. The role of stress and psychiatric comorbidities as targets of non-pharmacological therapeutic approaches for migraine. Riv Psichiatr 2020; 55:262-268. [PMID: 33078018 DOI: 10.1708/3457.34458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This narrative review addresses the interconnections among stress, mental disorders and migraine with a specific focus on non-pharmacological interventions that may be effective in improving both migraine and the psychiatric comorbidity. Migraine is often comorbid with depression, anxiety, personality disorders, and sleep disorders. Subjective stress and stressors are common triggers for migraine attacks and are risk factors for chronification, whilst mental disorders and stress responses are closely linked in a bidirectional relation. Recent studies show that psychiatric comorbidity is associated with migraine severity, worse outcomes, increased disability and reduce quality of life. Numerous studies on non-pharmacological interventions for migraine were published and behavioural treatments included biofeedback, cognitive-behavioural therapy, relaxation training, stress management and brief psychodynamic psychotherapy. Taken together, psychological interventions proved to be effective in migraine treatment and a combination of pharmacological and psychological treatment appear to be more effective than either medication or psychotherapy alone. Non-pharmacological interventions effectiveness should be due to the improvement of migraine, stress-related vulnerability and mental disorders together and the combined treatment could prevent the chronification circuit of migraine. Well-designed long-term studies are needed to clarify comparative effectiveness of non-pharmacological techniques in the treatment and the prevention of migraine.
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Affiliation(s)
- Corinna Pancheri
- Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - Annalisa Maraone
- Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - Valentina Roselli
- Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - Marta Altieri
- Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - Vittorio Di Piero
- Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Italy
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Grassi L, Pasquini M, Kissane D, Zerbinati L, Caruso R, Sabato S, Nanni MG, Ounalli H, Maraone A, Roselli V, Murri MB, Biancosino B, Biondi M. Exploring and assessing demoralization in patients with non-psychotic affective disorders. J Affect Disord 2020; 274:568-575. [PMID: 32663989 DOI: 10.1016/j.jad.2020.05.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 04/03/2020] [Accepted: 05/10/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Demoralization, as assessed through the Diagnostic Criteria for Psychosomatic Research-Demoralization (DCPR/D) interview or the Demoralization Scale (DS), has been found to affect about 30% of patients with medical disorders, while few studies have been done in patients with psychiatric disorders. METHODS A convenience sample of 377 patients with ICD-10 diagnoses of mood, anxiety, stress-related disorders or other non-psychotic disorders was recruited from two Italian university psychiatry centers. The DCPR/D interview and the Italian version of the DS (DS-IT) were used to assess demoralization and the Patient Health Questionnaire-9 (PHQ-9) to assess depression. RESULTS Demoralization was diagnosable in more than 50% of the patients. Factor analysis of the DS-IT indicated four main factors, Meaninglessness/Helplessness, Disheartenment, Dysphoria and Sense of Failure, explaining 62% of the variance of the scale. Patients with bipolar or unipolar major depression and personality disorders had the highest prevalence of demoralization (DCPR/D) and the highest scores on all the DS-IT factors in comparison with patients with adjustment or anxiety disorders. About 50% of patients with moderate demoralization (DS-IT) were not clinically depressed (PHQ-9 <10), while almost all with severe demoralization were depressed. LIMITATIONS Prospective studies on larger samples with other psychiatric disorders, also taking into account subjective incompetence, are needed. Since the DCPR/D assesses demoralization as a categorical construct, a dimensional framework should be necessary. CONCLUSIONS The findings enrich the research on demoralization, showing for the first time the importance of this construct, as measured by the DCPR/D and the DS-IT, in patients with psychiatric disorders.
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Affiliation(s)
- Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a, 44100 Ferrara, Italy; University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behaviors, Health Authorities and University S. Anna Hospital, Ferrara, Italy.
| | - Massimo Pasquini
- Department of Human Neurosciences, SAPIENZA University of Rome, Rome Italy.
| | - David Kissane
- Department of Palliative Medicine, University of Notre Dame Australia and Cunningham Centre, St Vincent's Hospital, Sydney, NSW, Australia; Szalmuk Family Research Unit at Cabrini Health, Victoria, Australia.
| | - Luigi Zerbinati
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a, 44100 Ferrara, Italy.
| | - Rosangela Caruso
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a, 44100 Ferrara, Italy; University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behaviors, Health Authorities and University S. Anna Hospital, Ferrara, Italy.
| | - Silvana Sabato
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a, 44100 Ferrara, Italy.
| | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a, 44100 Ferrara, Italy; University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behaviors, Health Authorities and University S. Anna Hospital, Ferrara, Italy.
| | - Heifa Ounalli
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a, 44100 Ferrara, Italy.
| | - Annalisa Maraone
- Department of Human Neurosciences, SAPIENZA University of Rome, Rome Italy.
| | - Valentina Roselli
- Department of Human Neurosciences, SAPIENZA University of Rome, Rome Italy.
| | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a, 44100 Ferrara, Italy; University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behaviors, Health Authorities and University S. Anna Hospital, Ferrara, Italy.
| | - Bruno Biancosino
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behaviors, Health Authorities and University S. Anna Hospital, Ferrara, Italy.
| | - Massimo Biondi
- Department of Human Neurosciences, SAPIENZA University of Rome, Rome Italy.
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Brakoulias V, Starcevic V, Albert U, Arumugham SS, Bailey BE, Belloch A, Borda T, Dell'Osso L, Elias JA, Falkenstein MJ, Ferrao YA, Fontenelle LF, Jelinek L, Kay B, Lochner C, Maina G, Marazziti D, Matsunaga H, Miguel EC, Morgado P, Pasquini M, Perez-Rivera R, Potluri S, Reddy JYC, Riemann BC, do Rosario MC, Shavitt RG, Stein DJ, Viswasam K, Fineberg NA. The rates of co-occurring behavioural addictions in treatment-seeking individuals with obsessive-compulsive disorder: a preliminary report. Int J Psychiatry Clin Pract 2020; 24:173-175. [PMID: 31916881 DOI: 10.1080/13651501.2019.1711424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: To assess the rates of co-occurring putative 'behavioural addictions' in patients with obsessive-compulsive disorder (OCD).Methods: Twenty-three international centres specialising in the treatment of OCD were invited to participate in a survey of the rates of behavioural addictions and other relevant comorbidity within their samples.Results: Sixteen of 23 (69.6%) invited centres from 13 countries had sufficient data to participate in the survey. The use of validated diagnostic tools was discrepant, with most centres relying on a 'clinical diagnosis' to diagnose behavioural addictions. The final sample comprised of 6916 patients with a primary diagnosis of OCD. The reported rates of behavioural addictions were as follows: 8.7% for problematic internet use, 6.8% for compulsive sexual behaviour disorder, 6.4% for compulsive buying, 4.1% for gambling disorder and 3.4% for internet gaming disorder.Conclusions: Behavioural addictions should be better assessed for patients with OCD. The absence of diagnostic scales developed specifically for behavioural addictions and overlapping obsessive-compulsive phenomena such as compulsive checking of information on the internet may explain the relatively high rate of problematic internet use in this sample. The study encourages better efforts to assess and to conceptualise the relatedness of behavioural addictions to obsessive-compulsive 'spectrum' disorders.
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Affiliation(s)
- Vlasios Brakoulias
- Department of Psychiatry, Sydney Medical School - Nepean, The University of Sydney and Nepean Hospital, Sydney/Penrith, Australia.,School of Medicine, Blacktown Hospital, Western Sydney University, Sydney/Blacktown, Australia
| | - Vladan Starcevic
- Department of Psychiatry, Sydney Medical School - Nepean, The University of Sydney and Nepean Hospital, Sydney/Penrith, Australia
| | - Umberto Albert
- Department of Neuroscience, Rita Levi Montalcini, University of Turin, Torino, Italy.,Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Shyam S Arumugham
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | | | - Amparo Belloch
- Department of Personality Psychology, Research Unit for Obsessive-Compulsive and Related Disorders, I'TOC, Universidad de Valencia, Spain
| | - Tania Borda
- Bio-Behavioral Institute, Buenos Aires, Argentina.,Department of Psychology, Argentinian Catholic University (UCA), Buenos Aires, Argentina
| | - Liliana Dell'Osso
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, Univeristy of Pisa, Pisa, Italy.,Dipartmento di Farmacia, Univeristy of Pisa, Pisa, Italy
| | - Jason A Elias
- McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | | | - Ygor A Ferrao
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Leonardo F Fontenelle
- Department of Psychiatry and Legal Medicine, D'Or Institute for Research and Education, Federal University of Rio de Janeiro.,Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia
| | - Lena Jelinek
- Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Brian Kay
- Rogers Memorial Hospital, Oconomowoc, WI, USA
| | - Christine Lochner
- Department of Psychiatry, MRC Unit on Anxiety Disorders, University of Stellenbosch, Cape Town, South Africa
| | - Giuseppe Maina
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Donatella Marazziti
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, Univeristy of Pisa, Pisa, Italy
| | - Hisato Matsunaga
- Department of Neuropsychiatry, Hyogo College of Medicine, Hyogo, Japan
| | - Euripedes C Miguel
- Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,ICVS-3Bs PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Hospital de Braga, Braga, Portugal
| | - Massimo Pasquini
- Department of Human Neurosciences, University of Rome, Sapienza, Italy
| | | | | | - Janardhan Y C Reddy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | | | - Maria C do Rosario
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Roseli G Shavitt
- Department of Neuropsychiatry, Hyogo College of Medicine, Hyogo, Japan
| | - Dan J Stein
- Department of Psychiatry, MRC Unit on Anxiety Disorders, University of Stellenbosch, Cape Town, South Africa
| | - Kirupamani Viswasam
- Department of Psychiatry, Sydney Medical School - Nepean, The University of Sydney and Nepean Hospital, Sydney/Penrith, Australia
| | - Naomi A Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, University of Hertfordshire, Hatfield, UK
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Bersani FS, Canevelli M, Cesari M, Maggioni E, Pasquini M, Wolkowitz OM, Ferracuti S, Biondi M, Bruno G. Frailty Index as a clinical measure of biological age in psychiatry. J Affect Disord 2020; 268:183-187. [PMID: 32174476 DOI: 10.1016/j.jad.2020.03.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/25/2020] [Accepted: 03/04/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Serious mental illnesses may be characterized by accelerated biological aging, and over the last years the research on the topic has been stimulated by studies exploring the molecular underpinnings of senescence. METHODS In the present manuscript we propose that measuring frailty, a general product of organismal ageing, through the "Frailty Index" (FI), a recently-emerged macroscopic indicator of functional status and biological age, adds an important marker to the measurements currently implemented in the study of accelerated biological age in psychiatric illnesses. RESULTS The FI quantifies functional negative health attributes and measures their cumulative effect, thus providing a useful estimate of the individual's biological age and risk profile. Recent studies in older adults have observed significant associations between FI and molecular measures of aging. LIMITATIONS High FI values can be driven by causes different from aging per se, so FI may be a sensitive but not specific measure of biological aging. CONCLUSIONS FI, which is extensively used in geriatrics and gerontology but it has rarely been used in relation to mental health, may be of relevance in the evaluation of age-related phenomena associated with psychiatric diseases.
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Affiliation(s)
| | - Marco Canevelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy; National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Matteo Cesari
- Fondazione IRCCS Ca, Granda Ospedale Maggiore Policlinico, Milan, Italy; Geriatric Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Owen M Wolkowitz
- Department of Psychiatry, University of California San Francisco, San Francisco, USA
| | - Stefano Ferracuti
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Bruno
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
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44
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Pasquini M, Fabbrini G, Moretti G, Berardelli I, Mandarelli G, Chiaie RD, Leone C, Biondi M, Berardelli A. Bradykinesia and Mental Slowness in Patients with Obsessive-compulsive Disorder. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(09)71268-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background:Clinical and experimental findings suggest that Obsessive-Compulsive Disorder (OCD) is due to an abnormality of the cortico-striato-thalamo-cortical circuit. Bradykinesia and mental slowness can be present in patients with basal ganglia disorders affecting the cortico-striato-thalamo-cortical circuit. Aim of this study is to investigate whether bradykinesia and mental slowness are present in patients with OCD.Methods:Participants comprised 19 non-depressed anti-psychotic free patients with OCD.Bradykinesia was assessed with the motor section of the Unified Parkinson's Disease Rating Scale (UPDRS). Mental slowness was investigated with the WAIS-R and the Y-BOCS. Psychiatric evaluation was performed with: SCID-I, Y-BOCS, HAMD, HAM-A, and MMPI. Cognitive functions were assessed with the WAIS-R.Results:Bradykinesia and mental slowness were present respectively in the 39% and 89% of the patients. Bradykinesia was positively correlated to Y-BOCS mental slowness score (rho=0.48, p< 0.05), and inversely related to the WAIS-R Performance IQ score (rho=-0.65, p< 0.01). Patients with bradykinesia scored significantly lower in the Similarities and Digit symbol coding WAIS-R subscales as compared to non-bradykinetic patients. in our sample pathological doubt was not associated with IQ measures nor with bradykinesia. Twelve out of 19 patients (63%) showed impairments in the nonverbal function scores.Conclusions:The novel findings of this study is that bradykinesia can be present in patients with OCD, and it is correlated with mental slowness and nonverbal performance impairment. These preliminary data support the notion that dysfunction of basal ganglia is possibly present in OCD patients.
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Piacentino D, Pasquini M, Cappelletti S, Chetoni C, Sani G, Kotzalidis GD. Pharmacotherapy for Hoarding Disorder: How did the Picture Change since its Excision from OCD? Curr Neuropharmacol 2020; 17:808-815. [PMID: 30678629 PMCID: PMC7059160 DOI: 10.2174/1570159x17666190124153048] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/21/2018] [Accepted: 01/17/2019] [Indexed: 01/10/2023] Open
Abstract
This brief review deals with the various issues that contributed to the creation of the new Diagnostic and Statistical Manual condition of hoarding disorder (HD) and attempts at reviewing its pharmacotherapy. It appears that after the newly founded diagnosis appeared in the literature as an autonomous entity, distinct from obsessive-compulsive disorder, drug trials are not being conducted and the disorder is left in the hands of psychotherapists, who on their part, report fair results in some core dimensions of HD. The few trials on HD specifically regard the serotonin-noradrenaline reuptake inhibitor venlafaxine, and, possibly due to the suggestion of a common biological background of HD with attention-deficit/hyperactivity disorder, the psychostimulant methylphenidate and the noradrenaline reuptake inhibitor atomoxetine. For all these drugs, positive results have been reported, but the evidence level of these studies is low, due to small samples and non-blind designs. Regretfully, there are currently no future studies aiming at seriously testing drugs in HD.
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Affiliation(s)
- Daria Piacentino
- Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, School of Medicine and Psychology, Sapienza University, Rome, Italy.,Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism (NIAAA) Division of Intramural Clinical and Basic Research and National Institute on Drug Abuse (NIDA) Intramural Research Program, National Institutes of Health, Bethesda, MD, United States
| | - Massimo Pasquini
- Department of Neurosciences, School of Medicine and Dentistry, Sapienza University, Rome, Italy
| | - Simone Cappelletti
- Anatomical, Histological, Forensic Medicine, and Orthopedic Sciences (SAIMLAL) Department, Sapienza University, Rome, Italy
| | - Chiara Chetoni
- Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, School of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Gabriele Sani
- Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, School of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Georgios D Kotzalidis
- Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, School of Medicine and Psychology, Sapienza University, Rome, Italy
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46
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Bersani FS, Ghezzi F, Maraone A, Vicinanza R, Cavaggioni G, Biondi M, Pasquini M. The relationship between Vitamin D and depressive disorders. Riv Psichiatr 2020; 54:229-234. [PMID: 31909749 DOI: 10.1708/3281.32541] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Studies have suggested a relationship between low circulating levels of Vitamin D and depression. Vitamin D deficiency may be a consequence of depression-related factors, such as reduced sun exposure, decreased outdoor activity, and dietary changes, but it can also play a role in the pathophysiology of depressive conditions through a range of molecular mechanisms. In the present manuscript, findings related to prospective longitudinal studies on the relationship between Vitamin D levels and depressive symptoms and to randomized controlled trials on Vitamin D supplementation for depressive disorders are reviewed.
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Affiliation(s)
| | - Francesco Ghezzi
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Annalisa Maraone
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Roberto Vicinanza
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | | | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Italy
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47
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Pasquini M, Brakoulias V, Pallanti S. Editorial: Advances in Biological Approaches to Treating Resistant/Refractory Obsessive-Compulsive and Related Disorders. Front Psychiatry 2020; 11:93. [PMID: 32158408 PMCID: PMC7052322 DOI: 10.3389/fpsyt.2020.00093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 02/05/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Massimo Pasquini
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Vlasios Brakoulias
- Department of Psychiatry, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Stefano Pallanti
- Institute of Neuroscience, University of Florence, Florence, Italy.,Department of Psychiatry and Behavioral Science, Stanford University Medical Center, Stanford, CA, United States
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48
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Dell'Osso B, Albert U, Carrà G, Pompili M, Nanni MG, Pasquini M, Poloni N, Raballo A, Sambataro F, Serafini G, Viganò C, Demyttenaere K, McIntyre RS, Fiorillo A. How to improve adherence to antidepressant treatments in patients with major depression: a psychoeducational consensus checklist. Ann Gen Psychiatry 2020; 19:61. [PMID: 33062034 PMCID: PMC7552507 DOI: 10.1186/s12991-020-00306-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 05/01/2020] [Accepted: 09/20/2020] [Indexed: 11/13/2022] Open
Abstract
Studies conducted in primary care as well as in psychiatric settings show that more than half of patients suffering from major depressive disorder (MDD) have poor adherence to antidepressants. Patients prematurely discontinue antidepressant therapy for various reasons, including patient-related (e.g., misperceptions about antidepressants, side-effects, and lack of tolerability), clinician-related (e.g., insufficient instruction received by clinicians about the medication, lack of shared decision-making, and follow-up care), as well as structural factors (e.g., access, cost, and stigma). The high rate of poor adherence to antidepressant treatments provides the impetus for identifying factors that are contributing to noncompliance in an individual patient, to implement a careful education about this phenomenon. As adherence to antidepressants is one of the major unmet needs in MDD treatment, being associated with negative outcomes, we sought to identify a series of priorities to be discussed with persons with MDD with the larger aim to improve treatment adherence. To do so, we analyzed a series of epidemiological findings and clinical reasons for this phenomenon, and then proceeded to define through a multi-step consensus a set of recommendations to be provided by psychiatrists and other practitioners at the time of the first (prescription) visit with patients. Herein, we report the results of this initiative.
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Affiliation(s)
- Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy.,Department of Mental Health, ASST Fatebenefratelli-Sacco, Milan, Italy.,Aldo Ravelli' Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan Medical School, Milan, Italy.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA USA
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.,Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, Clinica Psichiatrica, Trieste, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy
| | - Maurizio Pompili
- Dept. of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences-Faculty of Medicine and Dentistry-SAPIENZA University of Rome, Rome, Italy
| | - Nicola Poloni
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy
| | - Andrea Raballo
- Section of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Perugia, Italy.,Center for Translational, Phenomenological and Developmental Psychopathology, Perugia University Hospital, Perugia, Italy
| | - Fabio Sambataro
- Section of Psychiatry, Department of Neuroscience, University of Padova, Padua, Italy.,Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Gianluca Serafini
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,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
| | - Caterina Viganò
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy.,Department of Mental Health, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Koen Demyttenaere
- Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium.,Campus Gasthuisberg, Universitair Psychiatrisch Centrum KU Leuven (UPC-KUL), Leuven, Belgium
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON Canada.,Institute of Medical Science, University of Toronto, Toronto, ON Canada.,Department of Pharmacology, University of Toronto, Toronto, ON Canada.,Department of Psychiatry, University of Toronto, Toronto, ON Canada.,Brain and Cognition Discovery Foundation, Toronto, ON Canada
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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49
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Tarsitani L, Ferracuti S, Carabellese F, Catanesi R, Biondi M, Quartesan R, Pasquini M, Mandarelli G. Brief Psychiatric Rating Scale-Expanded (BPRS-E) factor analysis in involuntarily hospitalized psychiatric patients. Psychiatry Res 2019; 279:380-381. [PMID: 30857882 DOI: 10.1016/j.psychres.2019.02.055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 02/20/2019] [Accepted: 02/20/2019] [Indexed: 11/26/2022]
Affiliation(s)
- L Tarsitani
- Department of Human Neurosciences, University of Rome "Sapienza", Rome, Italy
| | - S Ferracuti
- Department of Human Neurosciences, University of Rome "Sapienza", Rome, Italy
| | - F Carabellese
- Section of Criminology and Forensic Psychiatry, University of Bari, Department of Interdisciplinary Medicine, Bari, Italy.
| | - R Catanesi
- Section of Criminology and Forensic Psychiatry, University of Bari, Department of Interdisciplinary Medicine, Bari, Italy
| | - M Biondi
- Department of Human Neurosciences, University of Rome "Sapienza", Rome, Italy
| | - R Quartesan
- School of Psychiatry, University of Perugia, Perugia 06156, Italy; Department of Medicine, Division of Psychiatry, Clinical Psychology and Psychiatric Rehabilitation, University of Perugia, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - M Pasquini
- Department of Human Neurosciences, University of Rome "Sapienza", Rome, Italy
| | - G Mandarelli
- Department of Human Neurosciences, University of Rome "Sapienza", Rome, Italy
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50
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Berardelli I, Belvisi D, Pasquini M, Fabbrini A, Petrini F, Fabbrini G. Treatment of psychiatric disturbances in hypokinetic movement disorders. Expert Rev Neurother 2019; 19:965-981. [PMID: 31241368 DOI: 10.1080/14737175.2019.1636648] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 12/26/2022]
Abstract
Introduction: We reviewed studies that assessed the treatment of psychiatric disturbances in Parkinson's disease and atypical parkinsonisms. Neuropsychiatric disturbances in these conditions are frequent and have a profound impact on quality of life of patients and of their caregivers. It is therefore important to be familiar with the appropriate pharmacological and non-pharmacological interventions for treating these disorders. Areas covered: The authors searched for papers in English in Pubmed using the following keywords: Parkinson's disease, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, Lewy body dementia, depression, apathy, anxiety, fatigue, sleep disorders, obsessive compulsive disorders, psychosis, hallucinations, delusions, impulse control disorders. Expert opinion: In Parkinson's disease, depression may benefit from the optimization of dopaminergic therapy, from the use of antidepressants acting on both the serotoninergic and noradrenergic pathways and from cognitive behavioral therapy. Psychosis in Parkinson's disease may improve with the use of clozapine; the serotonin inverse agonist pimavanserin has been shown to be effective. Treatment of impulse control disorders is primarily based on the removal of dopamine agonists. No controlled studies have investigated the treatment of neuropsychiatric disorders in multiple system atrophy, progressive supranuclear palsy or corticobasal degeneration. Acethylcholinesterase inhibitors may be used to treat hallucinations in Lewy body dementia.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy
| | | | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome , Rome , Italy
| | - Andrea Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome , Rome , Italy
| | - Federica Petrini
- Department of Neurosciences and Mental Health, Azienda Universitaria Policlinico Umberto I° , Rome , Italy
| | - Giovanni Fabbrini
- IRCCS Neuromed , Pozzilli , Italy.,Department of Human Neurosciences, Sapienza University of Rome , Rome , Italy
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