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Giannunzio V, Degortes D, Tenconi E, Collantoni E, Solmi M, Santonastaso P, Favaro A. Decision-making impairment in anorexia nervosa: New insights into the role of age and decision-making style. Eur Eat Disord Rev 2018; 26:302-314. [PMID: 29665149 DOI: 10.1002/erv.2595] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 02/04/2018] [Accepted: 03/08/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Patients with anorexia nervosa (AN) often report difficulties in decision making, which may interfere with treatment. The aim of this study was to investigate decision making in a large sample of adolescent and adult patients with AN, by using the Iowa gambling task. METHOD Participants were 611 female individuals (310 patients and 301 controls) who underwent neuropsychological and clinical assessment. RESULTS Significantly poorer decision-making performance was observed in adult patients, whereas no difference emerged between affected and nonaffected adolescents. Both adolescent and adult patients were characterized by trends for higher levels of attention to losses in comparison with healthy controls. Although healthy adult women exhibited better decision-making performance than healthy adolescents, in AN, there was no improvement of decision making with age. A cluster analysis identified 2 different styles of decision making in both patients and controls: a conservative style and an impulsive style. DISCUSSION Our study provides evidence of dysfunctional decision making in adult patients with AN and reveals an association between poor decision making and excessive punishment sensitivity in AN. The clinical and scientific implications of these findings merit further exploration.
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Affiliation(s)
- Valeria Giannunzio
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Italy
| | - Daniela Degortes
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Italy
| | - Elena Tenconi
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Italy
| | - Enrico Collantoni
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Italy
| | - Marco Solmi
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Italy
| | - Paolo Santonastaso
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Italy
| | - Angela Favaro
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Italy
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Solmi M, Gallicchio D, Collantoni E, Correll CU, Clementi M, Pinato C, Forzan M, Cassina M, Fontana F, Giannunzio V, Piva I, Siani R, Salvo P, Santonastaso P, Tenconi E, Veronese N, Favaro A. Serotonin transporter gene polymorphism in eating disorders: Data from a new biobank and META-analysis of previous studies. World J Biol Psychiatry 2016; 17:244-57. [PMID: 26895183 DOI: 10.3109/15622975.2015.1126675] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
UNLABELLED Objectives Growing interest focuses on the association between 5-HTTLPR polymorphism and eating disorders (ED), but published findings have been conflicting. Methods The Italian BIO.VE.D.A. biobank provided 976 samples (735 ED patients and 241 controls) for genotyping. We conducted a literature search of studies published up to 1 April 2015, including studies reporting on 5HTTLPR genotype and allele frequencies in obesity and/or ED. We ran a meta-analysis, including data from BIO.VE.D.A. - comparing low and high-functioning genotype and allele frequencies in ED vs. CONTROLS Results Data from 21 studies, plus BIO.VE.D.A., were extracted providing information from 3,736 patients and 2,707 controls. Neither low- nor high-functioning genotype frequencies in ED patients, with both bi- and tri-allelic models, differed from controls. Furthermore, neither low- nor high-functioning allele frequencies in ED or in BN, in both bi- and triallelic models, differed from control groups. After sensitivity analysis, results were the same in AN vs. CONTROLS Results remained unaltered when investigating recessive and dominant models. Conclusions 5HTTLPR does not seem to be associated with ED in general, or with AN or BN in particular. Future studies in ED should explore the role of ethnicity and psychiatric comorbidity as a possible source of bias.
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Affiliation(s)
- M Solmi
- a BIO.VE.D.A. Group (BIObanca VEneta per I Disturbi Dell'alimentazione: Biobank of the Veneto Region Eating Disorders Units) , Veneto Region , Italy ;,g Department of Neuroscience , University of Padova , Italy
| | - D Gallicchio
- a BIO.VE.D.A. Group (BIObanca VEneta per I Disturbi Dell'alimentazione: Biobank of the Veneto Region Eating Disorders Units) , Veneto Region , Italy ;,g Department of Neuroscience , University of Padova , Italy
| | - E Collantoni
- a BIO.VE.D.A. Group (BIObanca VEneta per I Disturbi Dell'alimentazione: Biobank of the Veneto Region Eating Disorders Units) , Veneto Region , Italy ;,g Department of Neuroscience , University of Padova , Italy
| | - C U Correll
- c The Zucker Hillside Hospital, Psychiatry Research, NorthShore - Long Island Jewish Health System , Glen Oaks , New York , USA ;,d Hofstra North Shore LIJ School of Medicine , Hempstead , New York , USA ;,e The Feinstein Institute for Medical Research , Manhasset , New York , USA ;,f Albert Einstein College of Medicine , Bronx , New York , USA
| | - M Clementi
- h Clinical Genetics Unit, Department of Woman and Child Health , University of Padova
| | - C Pinato
- h Clinical Genetics Unit, Department of Woman and Child Health , University of Padova
| | - M Forzan
- h Clinical Genetics Unit, Department of Woman and Child Health , University of Padova
| | - M Cassina
- h Clinical Genetics Unit, Department of Woman and Child Health , University of Padova
| | - F Fontana
- a BIO.VE.D.A. Group (BIObanca VEneta per I Disturbi Dell'alimentazione: Biobank of the Veneto Region Eating Disorders Units) , Veneto Region , Italy
| | - V Giannunzio
- a BIO.VE.D.A. Group (BIObanca VEneta per I Disturbi Dell'alimentazione: Biobank of the Veneto Region Eating Disorders Units) , Veneto Region , Italy ;,g Department of Neuroscience , University of Padova , Italy
| | - I Piva
- a BIO.VE.D.A. Group (BIObanca VEneta per I Disturbi Dell'alimentazione: Biobank of the Veneto Region Eating Disorders Units) , Veneto Region , Italy
| | - R Siani
- a BIO.VE.D.A. Group (BIObanca VEneta per I Disturbi Dell'alimentazione: Biobank of the Veneto Region Eating Disorders Units) , Veneto Region , Italy
| | - P Salvo
- a BIO.VE.D.A. Group (BIObanca VEneta per I Disturbi Dell'alimentazione: Biobank of the Veneto Region Eating Disorders Units) , Veneto Region , Italy
| | - P Santonastaso
- a BIO.VE.D.A. Group (BIObanca VEneta per I Disturbi Dell'alimentazione: Biobank of the Veneto Region Eating Disorders Units) , Veneto Region , Italy ;,g Department of Neuroscience , University of Padova , Italy ;,i Centro Neuroscience Cognitive (CNC), University of Padova , Italy
| | - E Tenconi
- a BIO.VE.D.A. Group (BIObanca VEneta per I Disturbi Dell'alimentazione: Biobank of the Veneto Region Eating Disorders Units) , Veneto Region , Italy ;,g Department of Neuroscience , University of Padova , Italy ;,i Centro Neuroscience Cognitive (CNC), University of Padova , Italy
| | - N Veronese
- b Department of Medicine- DIMED , Geriatrics Section, University of Padova , Italy
| | - A Favaro
- a BIO.VE.D.A. Group (BIObanca VEneta per I Disturbi Dell'alimentazione: Biobank of the Veneto Region Eating Disorders Units) , Veneto Region , Italy ;,g Department of Neuroscience , University of Padova , Italy ;,i Centro Neuroscience Cognitive (CNC), University of Padova , Italy
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Pigato G, Toffanin T, Ferri G, Di Florio A, Giannunzio V, Perini GI. [A naturalistic study comparing two initial duloxetine dosing strategies in a clinical "real world" setting]. Riv Psichiatr 2009; 44:384-392. [PMID: 20218217] [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: 05/28/2023]
Abstract
UNLABELLED AIMS. To compare, in a "real world" setting, the efficacy and tolerability of two initial duloxetine starting doses: 30 mg once daily (q.d.) for 1 week, followed by escalation to 60 mg q.d. versus 60 mg q.d. without titolation, evaluating expecially the effects on sexual dysfunction. METHODS The sample is constituted by outpatients meeting diagnostic criteria for mild-severe (HAMD17 > or =24 and CGI-S > or =4) Major Depressive Episode as defined by DSM-IV-TR (Diagnostic and Statistic Manual for Mental Disorder, Fourth Edition-Text Revision), based on the Structured Clinical Interview for DSM-IV-TR (Mini International Neuropsychiatric Interview, MINI). The study design planned an initial evaluation and 4 follow-up visits; at each visit the following scales were administered: Hamilton Rating Scale for Depression (HAMD17) and Anxiety (HAMA), Clinical Global Impression Severity Scale (CGI-S) for severity evaluation and Arizona Sexual Experience Scale (ASEX) for sexual disfunction evaluation. RESULTS Both of the groups showed 90% of response (> or = 50% reduction in a patient's HAMD17 total score from baseline) within 2 months of follow-up. 50% of patients receiving a 30 mg q.d. starting dose achieved a HAMD17 total score < or =7 versus 40% of 60 mg q.d. treating group. None showed relapses during the study. After the first treatment month, the 60 mg q.d. receiving group showed a statistical significative amelioration of sexual function (Mann-Whitney test: p=0,02). CONCLUSIONS Our naturalistic "real world" study results confirm previous duloxetine tolerability and efficacy findings suggesting a 60 mg q.d. after meal duloxetine somministration without titolation.
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Affiliation(s)
- Giorgio Pigato
- Dipartimento di Neuroscienze, Sezione Psichiatria, Complesso Azienda Ospedaliero-Universitaria di Padova.
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