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Bernardini F, Attademo L, Trezzi R, Gobbicchi C, Balducci P, Del Bello V, Menculini G, Pauselli L, Piselli M, Sciarma T, Moretti P, Tamantini A, Quartesan R, Compton M, Tortorella A. Air pollutants and daily number of admissions to psychiatric emergency services: evidence for detrimental mental health effects of ozone. Epidemiol Psychiatr Sci 2019; 29:e66. [PMID: 31690359 PMCID: PMC8061137 DOI: 10.1017/s2045796019000623] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 10/07/2019] [Accepted: 10/09/2019] [Indexed: 11/23/2022] Open
Abstract
AIMS Aim of the current study is to investigate the associations between daily levels of air pollutants (particulate matter, ozone, carbon monoxide, nitrogen dioxide) and daily admissions for mental disorders to the emergency department of two general hospitals in Umbria region (Italy). METHODS We collected data about daily admissions to psychiatric emergency services of two general hospitals, air pollutants' levels and meteorological data for the time period 1 January 2015 until 31 December 2016. We assessed the impact of an increase in air pollutants on the number of daily admissions using a time-series econometric framework. RESULTS A total of 1860 emergency department admissions for mental disorders were identified. We observed a statistically significant impact of ozone levels on daily admissions. The estimated coefficient of O3 is statistically significant at the 1% level. All other pollutants were not significantly associated with the number of daily admissions. CONCLUSIONS Short-term exposure to ozone may be associated with increased psychiatric emergency services admissions. Findings add to previous literature on existing evidence for air pollution to have an impact on mental health. Ozone may be considered a potential environmental risk factor for impaired mental health.
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Affiliation(s)
- F. Bernardini
- Department of Mental Health, AAS5 ‘Friuli Occidentale’, Pordenone, Italy
| | - L. Attademo
- Department of Mental Health, ASP Basilicata, Potenza, Italy
| | - R. Trezzi
- Research and Statistics Division, Board of Governors of the Federal Reserve System, Washington, DC, USA
| | - C. Gobbicchi
- Department of Mental Health, AUSL Umbria 2, Terni, Italy
| | - P.M. Balducci
- Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
| | - V. Del Bello
- Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
| | - G. Menculini
- Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
| | - L. Pauselli
- Columbia University, College of Physicians & Surgeons, New York, USA
| | - M. Piselli
- Department of Mental Health, AUSL Umbria 2, Terni, Italy
- Functional Area of Psychiatry, University of Perugia, Perugia, Italy
| | - T. Sciarma
- Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
| | - P. Moretti
- Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
| | - A. Tamantini
- Department of Mental Health, AUSL Umbria 2, Terni, Italy
- Functional Area of Psychiatry, University of Perugia, Perugia, Italy
| | - R. Quartesan
- Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
| | - M.T. Compton
- Columbia University, College of Physicians & Surgeons, New York, USA
| | - A. Tortorella
- Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
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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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Verdolini N, Murru A, Attademo L, Garinella R, Pacchiarotti I, Bonnin CDM, Samalin L, Pauselli L, Piselli M, Tamantini A, Quartesan R, Carvalho AF, Vieta E, Tortorella A. The aggressor at the mirror: Psychiatric correlates of deliberate self-harm in male prison inmates. Eur Psychiatry 2017. [PMID: 28641217 DOI: 10.1016/j.eurpsy.2017.04.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Deliberate self-harm (DSH) causes important concern in prison inmates as it worsens morbidity and increases the risk for suicide. The aim of the present study is to investigate the prevalence and correlates of DSH in a large sample of male prisoners. METHODS A cross-sectional study evaluated male prisoners aged 18+ years. Current and lifetime psychiatric diagnoses were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders - DSM-IV Axis I and Axis II Disorders and with the Addiction Severity Index-Expanded Version. DSH was assessed with The Deliberate Self-Harm Inventory. Multivariable logistic regression models were used to identify independent correlates of lifetime DSH. RESULTS Ninety-three of 526 inmates (17.7%) reported at least 1 lifetime DSH behavior, and 58/93 (62.4%) of those reported a DSH act while in prison. After multivariable adjustment (sensitivity 41.9%, specificity 96.1%, area under the curve=0.854, 95% confidence interval CI=0.811-0.897, P<0.001), DSH was significantly associated with lifetime psychotic disorders (adjusted Odds Ratio aOR=6.227, 95% CI=2.183-17.762, P=0.001), borderline personality disorder (aOR=6.004, 95% CI=3.305-10.907, P<0.001), affective disorders (aOR=2.856, 95% CI=1.350-6.039, P=0.006) and misuse of multiple substances (aOR=2.024, 95% CI=1.111-3.687, P=0.021). CONCLUSIONS Borderline personality disorder and misuse of multiple substances are established risk factors of DSH, but psychotic and affective disorders were also associated with DSH in male prison inmates. This points to possible DSH-related clinical sub-groups, that bear specific treatment needs.
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Affiliation(s)
- N Verdolini
- Bipolar Disorders Unit, Institute of Neuroscience, University of Barcelona, IDIBAPS CIBERSAM, Hospital Clínic, c/Villarroel, 170, 12-0, 08036 Barcelona, Spain; Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132 Perugia, Italy
| | - A Murru
- Bipolar Disorders Unit, Institute of Neuroscience, University of Barcelona, IDIBAPS CIBERSAM, Hospital Clínic, c/Villarroel, 170, 12-0, 08036 Barcelona, Spain
| | - L Attademo
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132 Perugia, Italy; Department of Mental Health, Division of Psychiatry 1, "Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII", Piazza OMS 1, 24127 Bergamo, Italy
| | - R Garinella
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132 Perugia, Italy; Centro di Selezione e Reclutamento Nazionale dell'Esercito, Italian Ministry of Defence, Viale Mezzetti, 2, 06034 Foligno, Perugia, Italy
| | - I Pacchiarotti
- Bipolar Disorders Unit, Institute of Neuroscience, University of Barcelona, IDIBAPS CIBERSAM, Hospital Clínic, c/Villarroel, 170, 12-0, 08036 Barcelona, Spain
| | - C Del Mar Bonnin
- Bipolar Disorders Unit, Institute of Neuroscience, University of Barcelona, IDIBAPS CIBERSAM, Hospital Clínic, c/Villarroel, 170, 12-0, 08036 Barcelona, Spain
| | - L Samalin
- Bipolar Disorders Unit, Institute of Neuroscience, University of Barcelona, IDIBAPS CIBERSAM, Hospital Clínic, c/Villarroel, 170, 12-0, 08036 Barcelona, Spain; EA 7280, Department of Psychiatry, CHU Clermont-Ferrand, University of Auvergne, 58, rue Montalembert, 63000 Clermont-Ferrand, France; Pôle de psychiatrie, Fondation FondaMental, hôpital Albert-Chenevier, 40, rue de Mesly, 94000 Créteil, France
| | - L Pauselli
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132 Perugia, Italy; New York Psychiatric Institute Columbia University Medical Center, 1051 Riverside Dr, Unit 100, 10032 New York City, NY, USA
| | - M Piselli
- Functional Area of Psychiatry, University of Perugia, AUSL Umbria 2, Servizio Psichiatrico Diagnosi e Cura Ospedale "S. Giovanni Battista", via Massimo Arcamone, 06034 Foligno, Perugia, Italy
| | - A Tamantini
- Functional Area of Psychiatry, University of Perugia, AUSL Umbria 2, Servizio Psichiatrico Diagnosi e Cura Ospedale "S. Giovanni Battista", via Massimo Arcamone, 06034 Foligno, Perugia, Italy
| | - R Quartesan
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132 Perugia, Italy
| | - A F Carvalho
- Department of Clinical Medicine, Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Av. da Universidade, 2853, 60020-180 Benfica, Fortaleza - CE, Brazil
| | - E Vieta
- Bipolar Disorders Unit, Institute of Neuroscience, University of Barcelona, IDIBAPS CIBERSAM, Hospital Clínic, c/Villarroel, 170, 12-0, 08036 Barcelona, Spain.
| | - A Tortorella
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Santa Maria della Misericordia Hospital, Edificio Ellisse, 8 Piano, Sant'Andrea delle Fratte, 06132 Perugia, Italy
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Russo A, Verdolini N, Menculini G, Moretti P, Quartesan R, Tortorella A. Not the same old madness: Evaluating the clinical profile of the “schizophrenia spectrum” disorders. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
IntroductionThe “schizophrenia spectrum” concept allowed better identifying the psychopathology underpinning disorders including schizophrenia, schizoaffective disorder (SZA) and cluster A personality disorders (PD).AimsTo compare the clinical portrait of the schizophrenia spectrum disorders, focusing on the impact of the affective dimension.MethodsInpatients at the acute psychiatric ward of Perugia (Umbria-Italy) were evaluated with the structured clinical interview for DSM-IV Axis I and Axis II disorders and diagnosed with a “schizophrenia spectrum” disorder according to DSM-IV-TR. The clinical evaluation was conducted using the positive and negative syndrome scale (PANSS). Pearson correlations of the different subscales in the three groups and between the negative scales with the affective symptom “depression” were conducted.ResultsThe sample consisted of 72 inpatients (schizophrenia 55.6%, SZA 20% and cluster A PD 19.4%). The negative and the general psychopathology scales directly correlated at different degrees in the three groups (schizophrenia: r = 0.750; P < 0.001; SZA: r = 0.625, P = 0.006; cluster A PD: r = 0.541, P = 0.046). The symptom “depression” directly correlated with 5 out of 7 negative symptoms: blunted affect (r = 0.616, P < 0.001), emotional withdrawal (r = 0.643, P < 0.001), poor rapport (r = 0.389, P = 0.001), passive/apathetic social withdrawal (r = 0.538, P < 0.001), lack of spontaneity & flow of conversation (r = 0.399, P = 0.001).ConclusionsOur study confirmed the existence of the “schizophrenia spectrum” with combined different disorders lying on a continuum in which negative symptoms mainly correlated with the psychopathological functioning. Noteworthy, the symptoms of the negative scale strongly correlated with the “depression” symptom, underlying the impact of the affective symptoms on the severity of the “schizophrenia spectrum” disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Gambi F, De Berardis D, Sepede G, Campanella D, Galliani N, Carano A, La Rovere L, Salini G, Penna L, Cicconetti A, Spinella S, Quartesan R, Salerno RM, Ferro FM. Effect of Mirtazapine on Thyroid Hormones in Adult Patients with Major Depression. Int J Immunopathol Pharmacol 2016; 18:737-44. [PMID: 16388723 DOI: 10.1177/039463200501800417] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Hypothalamic pituitary thyroid (HPT) axis abnormalities and alterations in major depression are reported in literature. The aim of our study was to evaluate the effect of mirtazapine on thyroid hormones after 6 months of therapy in a sample of adult outpatients with Major Depression (MD). 17 adult outpatients (7 men, 10 women) with MD according to DSM-IV criteria, were included in the study. All participants had to have met criteria for a major depressive episode with a score of at least 15 on the Hamilton Depression Rating Scale (HAM-D). Fasting venous blood samples were obtained for determination of serum Thyroid Stimulating Hrmone (TSH), Free T3 (FT3) and Free T4 (FT4) concentrations both at baseline and after 6 months of therapy. HAM-D scores decreased significantly from the first day of treatment to the end of the treatment period (p<0.001) and twelve patients (70.6%) were classified as responders. A significant increase in FT3 concentrations was found between baseline and the end of treatment period (P=0.015) whereas FT4 concentrations decreased (P=0.046). No significant changes were found in TSH levels. Higher FT4 concentrations at baseline predicted higher HAM-D scorers both at baseline and at the end of the treatment period. Furthermore, higher FT3 concentrations at endpoint were found to be predictors of lower HAM-D scores. Long-term treatment with mirtazapine increases FT3 levels and decreases FT4 maybe involving the deiodination process of T4 into T3.
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Affiliation(s)
- F Gambi
- Department of Oncology and Neurosciences, Institute of Psychiatry, University G. d' Annunzio, Chieti, Italy.
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Gambi F, De Berardis D, Sepede G, Quartesan R, Calcagni E, Salerno RM, Conti CM, Ferro FM. Cannabinoid Receptors and Their Relationships with Neuropsychiatric Disorders. Int J Immunopathol Pharmacol 2016; 18:15-9. [PMID: 15698507 DOI: 10.1177/039463200501800103] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cannabinoids are the costituents of the marijuana plants. The central effects of exogenous cannabinoids are implicated in enhancing mood, altering emotional states, and interfering in the formation of short-term memory. Cannabinoid receptors are G protein-coupled receptors with seven transmembrane domains that are expressed on the cell surface with their binding domain exposed to the extracellular space. To date, two cannabinoid receptors have been cloned, CB1 and CB2. Recent evidence suggests that a third ‘CB3’ receptor may be cloned in the near future. The endocannabinoids may represent the first members of a new classes of neuromodulators, that are not stored in cell vesicles, but rather synthesised by the cell on demand. The endogenous cannabinoid system could play a central role in several neuropsychiatric disorders and is also involved in other conditions such as pain, spasticity and neuroprotection. Implication of cannabinoid system in the pathogenesis and development of schizophrenia is also discussed.
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Affiliation(s)
- F Gambi
- Psychiatry Division, University of Chieti, Italy.
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Verdolini N, Dean J, Elisei S, Quartesan R, Zaman R, Agius M. The Clinical Assessment of Prognostic Factors in Bipolar Disorder- an Audit. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30885-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Sirri L, Fava GA, Guidi J, Porcelli P, Rafanelli C, Bellomo A, Grandi S, Grassi L, Pasquini P, Picardi A, Quartesan R, Rigatelli M, Sonino N. Type A behaviour: a reappraisal of its characteristics in cardiovascular disease. Int J Clin Pract 2012; 66:854-61. [PMID: 22897462 DOI: 10.1111/j.1742-1241.2012.02993.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AIMS The role of type A behaviour in cardiovascular disease is controversial and most of the research is based on self-rating scales. The aim of this study was to assess the prevalence of type A behaviour in cardiology and in other medical settings using reliable interview methods that reflect its original description. METHODS A sample of 1398 consecutive medical patients (198 with heart transplantation, 153 with a myocardial infarction, 190 with functional gastrointestinal disorders, 104 with cancer, 545 with skin disorders and 208 referred for psychiatric consultation) was administered the Structured Clinical Interview for the DSM-IV and the Structured Interview for the Diagnostic Criteria for Psychosomatic Research (DCPR) which identifies 12 clusters, including type A behaviour. RESULTS A cardiac condition was present in 366 patients. There was a significant difference in the prevalence of type A behaviour in cardiovascular disease (36.1%) compared with other medical disorders (10.8%). Type A behaviour frequently occurred together with psychiatric and psychosomatic disturbances, particularly irritable mood, even though in the majority of cases it was not associated with DSM-IV diagnoses. Among cardiac patients, those with type A behaviour were less depressed, demoralised and worried about their illness. CONCLUSIONS Type A behaviour was found to occur in about a third of cases of patients with cardiovascular disease. Only in a limited number of cases was it associated with depression. It has a lifestyle connotation that may have important clinical consequences as to stress vulnerability and illness behaviour.
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Affiliation(s)
- L Sirri
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
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Fava GA, Guidi J, Porcelli P, Rafanelli C, Bellomo A, Grandi S, Grassi L, Mangelli L, Pasquini P, Picardi A, Quartesan R, Rigatelli M, Sonino N. A cluster analysis-derived classification of psychological distress and illness behavior in the medically ill. Psychol Med 2012; 42:401-407. [PMID: 24438853 DOI: 10.1017/s0033291711001231] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The classification of psychological distress and illness behavior in the setting of medical disease is still controversial. Current psychiatric nosology does not seem to cover the spectrum of disturbances. The aim of this investigation was to assess whether the joint use of DSM-IV categories and the Diagnostic Criteria for Psychosomatic Research (DCPR), that provide identification of syndromes related to somatization, abnormal illness behavior, irritable mood, type A behavior, demoralization and alexithymia, could yield subtyping of psychosocial variables in the medically ill. METHOD A cross-sectional assessment using both DSM-IV and the DCPR was conducted in eight medical centers in the Italian Health System. Data were submitted to cluster analysis. Participants were consecutive medical out-patients and in-patients for whom a psychiatric consultation was requested. A total of 1700 subjects met eligibility criteria and 1560 agreed to participate. RESULTS Three clusters were identified: non-specific psychological distress, irritability and affective disturbances with somatization. CONCLUSIONS Two-step cluster analysis revealed clusters that were found to occur across clinical settings. The findings indicate the need of expanding clinical assessment in the medically ill to include the various manifestations of somatization, illness behavior and subclinical distress encompassed by the DCPR.
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Affiliation(s)
- G A Fava
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
| | - J Guidi
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
| | - P Porcelli
- Psychosomatic Unit, IRCCS De Bellis Hospital, Castellana Grotte, Bari, Italy
| | - C Rafanelli
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
| | - A Bellomo
- Section of Psychiatry and Clinical Psychology, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - S Grandi
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
| | - L Grassi
- Section of Psychiatry, Department of Medical Sciences of Communication and Behavior, University of Ferrara, Ferrara, Italy
| | - L Mangelli
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
| | - P Pasquini
- Clinical Epidemiology Unit, Istituto Dermapatico dell'Immacolata (IDI-IRCCS), Roma, Italy
| | - A Picardi
- Mental Health Unit, Italian National Institute of Health Center of Epidemiology, Surveillance and Health Promotion, Roma, Italy
| | - R Quartesan
- Section of Psychiatry, Clinical Psychology and Psychiatric Rehabilitation, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy
| | - M Rigatelli
- Department of Neuroscience, University of Modena and Reggio Emilia, Modena, Italy
| | - N Sonino
- Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA
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Attademo L, Quartesan R, Moretti P. [Efficacy of aripiprazole on cognitive and behavioral changes in a young woman with systemic lupus erythematosus]. Clin Ter 2012; 163:e319-e323. [PMID: 23099980] [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: 06/01/2023]
Abstract
This paper describes the use of aripiprazole for the management of cognitive deficits and behavioral disorders in a young female patient suffering from systemic lupus erythematosus (SLE). Cognitive impairment, although often transient, is reported up to 75% of patients with SLE. The behavioral changes and, more generally, clear psychotic episodes have an incidence of 5% but they lead to considerable difficulties in clinical and therapeutic management. In cases with psychiatric manifestations of SLE, it is often necessary to introduce psychopharmacological therapy. The choice of aripiprazole has been made especially in light of low liability to cause weight gain and metabolic side effects. In fact aripiprazole is characterized by an original mechanism of action: it combines partial agonist activity on D(2), D(3) and 5-HT(1A) receptor with antagonistic activity on 5-HT(2A) and D(2). Aripiprazole has demonstrated efficacy in the management of behavioral disturbances and has improved some of impaired cognitive functions. Aripiprazole, therefore, could be a great tool in young patients with SLE.
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Affiliation(s)
- L Attademo
- Dipartimento di Medicina Clinica e Sperimentale, Sezione di Psichiatria, Psicologia Clinica e Riabilitazione Psichiatrica, Università egli Studi di Perugia, Azienda Ospedaliera di Perugia, Ospedale Santa Maria della Misericordia, Perugia, Italia.
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De Ronchi D, Bellini F, Cremante G, Ujkaj M, Tarricone I, Selleri R, Quartesan R, Piselli M, Scudellari P. Psychopathology of first-episode psychosis in HIV-positive persons in comparison to first-episode schizophrenia: a neglected issue. AIDS Care 2007; 18:872-8. [PMID: 17012075 DOI: 10.1080/09540120500307842] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study aims to detect different psychopathological dimensions in first-episode psychoses with different underlying causes. We evaluated 22 subjects with first-episode psychosis, who differed in biological variables (HIV-positive versus HIV-negative) and who were compared by using the Structured Clinical Interview for DSM-III-Reviewer, the 18-item Brief Psychiatric Rating Scale (BPRS), the 17-item Hamilton Depression Rating Scale, the 14-item Hamilton Anxiety Rating Scale and the Mini-Mental State Examination. HIV-positive subjects had higher mean scores on the global BPRS and on the paranoid Positive and Negative Syndrome Scale subscale compared with HIV-negative subjects. Conversely, higher prevalence of affective and anxious symptoms was found in the HIV-negative patients in comparison to HIV-positives. HIV-positives had significantly greater attention/concentration impairment than HIV-negative persons. In conclusion, taking into account psychopathological dimensions may help psychiatrists in clinical decision-making regarding the differential diagnosis of psychotic symptoms. The psychopathological pattern of first-episode psychosis in HIV-positive patients may represent an 'elementary model' of acute psychosis characterized by paranoid delusions in the absence of the usual affective symptoms.
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Affiliation(s)
- D De Ronchi
- Institute of Psychiatry, University of Bologna, Bologna, Italy.
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Abstract
OBJECTIVE To evaluate the incidence and effects of factors potentially influencing eating disordered patients' dropping out of outpatient cognitive-behavioural therapy (CBT). METHOD Sixty-seven (64 female, 3 male) patients with eating disorders participated in the study. All patients followed a multidisciplinary team approach for a median period of 9 months. Several factors potentially affecting dropout were retrospectively assessed prior to treatment. RESULTS The dropout rate was significantly higher in patients with purging anorexia nervosa (AN) compared to those with restrictive AN, bulimia nervosa and eating disorder not otherwise specified (33% vs. 27%, 25% or 21%, respectively, p<0.05). Among several factors influencing dropout, there was a significant association of patient low cooperativeness, purging episodes, restrictive eating, use of several weight control practices and psychiatric co-morbidity in patients who dropped out compared to completers (all p<0.05). CONCLUSIONS In outpatient eating disorder treatment, non-compliance and premature interruption of therapy are affected primarily by factors which are related to patients' attitude and behaviour. These factors should be carefully addressed in patients with eating disorders to improve outcome.
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Affiliation(s)
- S Bandini
- Eating Disorder Centre, Section of Clinical Nutrition, Department of Internal Medicine, University of Perugia, Perugia, Italy
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Abbate Daga G, Gianotti L, Mondelli V, Quartesan R, Fassino S. The psychopharmacotherapy of anorexia nervosa: clinical, neuroendocrine and metabolic aspects. J Endocrinol Invest 2004; 27:975-81. [PMID: 15762050 DOI: 10.1007/bf03347545] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Anorexia nervosa (AN) is a complex mental disorder presenting psychiatric and physical symptoms. Literature recognizes the role of several factors in the pathogenesis of this disorder, according to the biopsychosocial model. Many mechanisms are still partly unclear. Endocrine and metabolic alterations usually occur in AN, probably having a role in its pathogenesis and in the disorder perseverance. In consideration of the multifactorial pathogenesis, a multidisciplinary approach is needed in the treatment of anorexic patients. Up-to-date psychotherapy, psychopharmacological, endocrine and nutritional treatments are considered effective in improving AN. Literature does not however provide evidence of a single validated psychopharmacotherapy for anorexic patients. It is known that psychopharmacotherapy can influence hormonal and metabolic states in some conditions, but for the moment few data are present about these effects in AN. This article aims to review the data about the psychopharmacotherapy role in AN, focusing on the endocrine and metabolic effects of anti-depressants (AD) and novel antipsychotic drugs which seem to be the most effective in AN. Scant data are however available and further research should provide more evidence about these effects and also assess whether the severity of the neuroendocrine, hormonal and metabolic impairments can predict the lack of response to the psychopharmacological treatment with AD and neuroleptics.
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Affiliation(s)
- G Abbate Daga
- Division of Psychiatry, Department of Neurosciences, University of Turin, Turin, Italy
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Domizio S, Sabatino G, Albanese A, Barbante E, Puglielli C, Di Giannantonio M, Quartesan R, Domizio R, Sabatino G. Focal Cerebral Infarction in Newborn: Description of Three Cases. EUR J INFLAMM 2004. [DOI: 10.1177/1721727x0400200308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We observed 3 full-term newborns with focal ischemic injury of the middle cerebral artery (MCA), in which diagnosis of MCA stroke was suspected by US and confirmed by CT scan and MRI. A four-year follow-up was carried out to study the effect of neonatal stroke on neurodevelopmental outcome. All children had a history of pre-perinatal risk factors: neonatal cerebral infarction in term infants, in fact, has many possible causes, including bacterial meningitis, inherited or acquired coagulopathies, trauma and hypoxia-ischemia. The prognosis of neonatal MCA infarction depends on early diagnosis, on the CNS plasticity mechanism and, finally, on medical therapy and neuropsychological rehabilitation.
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Affiliation(s)
| | - G.M.D. Sabatino
- Neurosurgery Unit, University “Cattolica del Sacro Cuore”- Roma
| | - A. Albanese
- Neurosurgery Unit, University “Cattolica del Sacro Cuore”- Roma
| | | | | | | | - R. Quartesan
- Department of Psychiatry, University of Perugia, Italy
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Gerli R, Caponi L, Tincani A, Scorza R, Sabbadini MG, Danieli MG, De Angelis V, Cesarotti M, Piccirilli M, Quartesan R, Moretti P, Cantoni C, Franceschini F, Cavazzana I, Origgi L, Vanoli M, Bozzolo E, Ferrario L, Padovani A, Gambini O, Vanzulli L, Croce D, Bombardieri S. Clinical and serological associations of ribosomal P autoantibodies in systemic lupus erythematosus: prospective evaluation in a large cohort of Italian patients. Rheumatology (Oxford) 2002; 41:1357-66. [PMID: 12468814 DOI: 10.1093/rheumatology/41.12.1357] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To verify the association of ribosomal anti-P antibodies (anti-P), as detected by a sensitive ELISA, with serological findings and clinical manifestations, including neuropsychiatric involvement evaluated according to the American College of Rheumatology (ACR) nomenclature, in a large cohort of patients with systemic lupus erythematosus (SLE). METHODS Anti-P were evaluated in the serum of 149 consecutive Italian SLE patients by an ELISA using a multiple antigen peptide carrying four copies of a common P0, P1 and P2 epitope. A complete laboratory evaluation and clinical examination were performed in each patient. In addition, all patients underwent an accurate neuropsychiatric and neuropsychological assessment performed by trained specialists according to the 1999 ACR suggestions. RESULTS Serum anti-P were detected in 18/149 patients (12.1%). The anti-P prevalence was similar (11.7%) when the analysis was performed in a larger series of sera including 82 additional SLE patients, who were not included in the clinical study. The age of anti-P-positive patients at disease onset was less than 33 yr and, in comparison with the anti-P-negative patients, these patients showed more active disease activity and a higher prevalence of photosensitivity and malar and discoid rash. A strong association between IgG anticardiolipin antibodies and anti-P was also found. However, anti-P were associated with neither neuropsychiatric syndromes nor cognitive impairment. CONCLUSION This study does not seem to confirm the described association of anti-P with SLE neuropsychiatric manifestations. However, it supports the anti-P association with different skin manifestations as well as the presence of anticardiolipin in a subset of patients with SLE characterized by early disease onset.
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Affiliation(s)
- R Gerli
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Perugia, Italy
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Sabbadini MG, Manfredi AA, Bozzolo E, Ferrario L, Rugarli C, Scorza R, Origgi L, Vanoli M, Gambini O, Vanzulli L, Croce D, Campana A, Messa C, Fazio F, Tincani A, Anzola G, Cattaneo R, Padovani A, Gasparotti R, Gerli R, Quartesan R, Piccirilli M, Farsi A, Emmi E, Passaleva A. Central nervous system involvement in systemic lupus erythematosus patients without overt neuropsychiatric manifestations. Lupus 1999; 8:11-9. [PMID: 10025594 DOI: 10.1191/096120399678847344] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To verify whether features of CNS involvement can be detected in SLE patients without overt neuropsychiatric manifestations. METHODS 114 SLE patients who had never received a diagnosis of neuropsychiatric lupus (never-NPSLE) were studied and compared to 65 SLE patients with known neuropsychiatric involvement (NPSLE). The study relied on evaluation of neurocognitive functions by means of a battery of neuropsychological tests, on psychiatric and neuropsychological assessments and on neuroimaging studies (computed tomography, magnetic resonance, single photon emission computed tomography (SPECT)). RESULTS Clinical features, including disease duration/activity and pharmacological therapy, of never-NPSLE and NPSLE patients were similar. Short-term and long-term memory, visuo-spatial and verbal information processing were similarly compromised in never-NPSLE and in NPSLE patients; only attention was significantly more compromised in NPSLE patients. Psychiatric morbidity was higher than expected in never-NPSLE patients, although less than in the control neuropsychiatric group. Ischemic lesions, multiple small high intensity lesions and cortical atrophy, detected by CT and MR scans, as well as abnormal SPECT were also frequently detected in never-NPSLE patients. Interestingly, left parietal and occipital area hypoperfusion by SPECT was significantly more frequent in the patients with impaired visuo-spatial intelligence and short-term memory. CONCLUSIONS Most abnormalities detected by available diagnostic tools and characteristics of neuropsychiatric SLE are also present in non-symptomatic patients. They may derive from an unexpected widespread involvement of the CNS and are not per se sufficient, in the absence of clinical manifestations, for a diagnosis of neuropsychiatric SLE.
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Ambrosi F, Ricci S, Quartesan R, Moretti P, Pelicci G, Pagliacci C, Nicoletti I. Effects of acute benzodiazepine administration on growth hormone, prolactin and cortisol release after moderate insulin-induced hypoglycemia in normal women. Psychopharmacology (Berl) 1986; 88:187-9. [PMID: 3081931 DOI: 10.1007/bf00652238] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Benzodiazepines are known to affect pituitary hormone release, and it has recently been hypothesized that the adenohypophysial hormone response to stress may be modified by previous benzodiazepine treatment. We investigated, therefore, whether a single dose of triazolam, a short-acting benzodiazepine, and flurazepam, a long-acting one, could influence the response of prolactin (PRL), growth hormone (GH) and cortisol to a mild hypoglycemic stress in young healthy volunteers. Neither triazolam nor flurazepam pretreatment resulted in a significant effect on the pituitary response to hypoglycemic stimulus. The GH, PRL and cortisol peaks after both benzodiazepines were similar to those observed after placebo. Our results seem to exclude, therefore, any relevant effect of acute benzodiazepine administration on the neuroendocrine response to mild stress.
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Piccirilli M, Quartesan R. [Review of problems in the treatment of the parkinsonian syndrome with L-dopa]. Clin Ter 1976; 76:467-77. [PMID: 991553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Agostini L, Biagini S, Quartesan R. [Complications of the treatment with long-acting neuroleptic preparations. Brain disease due to fluphenazine decanoate]. Acta Neurol (Napoli) 1976; 31:74-8. [PMID: 970267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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