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Monti L, Marconi E, Bocci MG, Kotzalidis GD, Mazza M, Galliani C, Tranquilli S, Vento G, Conti G, Sani G, Antonelli M, Chieffo DPR. COVID-19 pandemic in the intensive care unit: Psychological implications and interventions, a systematic review. World J Psychiatry 2023; 13:191-217. [PMID: 37123099 PMCID: PMC10130962 DOI: 10.5498/wjp.v13.i4.191] [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: 12/10/2022] [Revised: 02/06/2023] [Accepted: 03/27/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic produced changes in intensive care units (ICUs) in patient care and health organizations. The pandemic event increased patients’ risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff; this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties.
AIM To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff.
METHODS We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles, upon which we commented.
RESULTS Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories.
CONCLUSION As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.
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Affiliation(s)
- Laura Monti
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Elisa Marconi
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Maria Grazia Bocci
- UOC Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Georgios Demetrios Kotzalidis
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- NESMOS Department, Facoltà di Medicina e Psicologia, Sant’Andrea University Hospital, Rome 00189, Italy
| | - Marianna Mazza
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Carolina Galliani
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Sara Tranquilli
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giovanni Vento
- UOC Neonatologia, Dipartimento di Scienze Della Salute Della Donna, Del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- UOC Neonatologia, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giorgio Conti
- UOC Terapia Intensiva Pediatrica e Trauma Center Pediatrico, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- UOC Terapia Intensiva Pediatrica e Trauma Center Pediatrico, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Gabriele Sani
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Massimo Antonelli
- UOC Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Anesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Daniela Pia Rosaria Chieffo
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
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Marano G, Mazza M, Lisci FM, Ciliberto M, Traversi G, Kotzalidis GD, De Berardis D, Laterza L, Sani G, Gasbarrini A, Gaetani E. The Microbiota-Gut-Brain Axis: Psychoneuroimmunological Insights. Nutrients 2023; 15:nu15061496. [PMID: 36986226 PMCID: PMC10059722 DOI: 10.3390/nu15061496] [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: 01/30/2023] [Revised: 03/18/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023] Open
Abstract
There is growing interest in the role that the intestinal microbiota and the related autoimmune processes may have in the genesis and presentation of some psychiatric diseases. An alteration in the communication of the microbiota-gut-brain axis, which constitutes a communicative model between the central nervous system (CNS) and the gastro-enteric tract, has been identified as one of the possible causes of some psychiatric diseases. The purpose of this narrative review is to describe evidence supporting a role of the gut microbiota in psychiatric diseases and the impact of diet on microbiota and mental health. Change in the composition of the gut microbiota could determine an increase in the permeability of the intestinal barrier, leading to a cytokine storm. This could trigger a systemic inflammatory activation and immune response: this series of events could have repercussions on the release of some neurotransmitters, altering the activity of the hypothalamic-pituitary-adrenal axis, and reducing the presence of trophic brain factors. Although gut microbiota and psychiatric disorders seem to be connected, more effort is needed to understand the potential causative mechanisms underlying the interactions between these systems.
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Affiliation(s)
- Giuseppe Marano
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Marianna Mazza
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesco Maria Lisci
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Michele Ciliberto
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gianandrea Traversi
- Unit of Medical Genetics, Department of Laboratory Medicine, Fatebenefratelli Isola Tiberina-Gemelli Isola, 00168 Rome, Italy
| | - Georgios Demetrios Kotzalidis
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sant'Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
| | | | - Lucrezia Laterza
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gabriele Sani
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonio Gasbarrini
- Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, 00168 Rome, Italy
| | - Eleonora Gaetani
- Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Mazza M, Avallone C, Kotzalidis GD, Marano G, Moccia L, Serio AM, Balocchi M, Sessa I, Janiri D, De Luca I, Brisi C, Spera MC, Monti L, Gonsalez del Castillo A, Angeletti G, Chieffo D, Rinaldi L, Janiri L, Lanzone A, Scambia G, Mercuri EM, Sani G. Depressive Symptoms during Pregnancy: Prevalence and Correlates with Affective Temperaments and Psychosocial Factors. J Pers Med 2023; 13:jpm13020211. [PMID: 36836445 PMCID: PMC9967878 DOI: 10.3390/jpm13020211] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/12/2023] [Accepted: 01/24/2023] [Indexed: 01/27/2023] Open
Abstract
Pregnancy is a unique experience in women's life, requiring a great ability of adaptation and self-reorganization; vulnerable women may be at increased risk of developing depressive symptoms. This study aimed to examine the incidence of depressive symptomatology during pregnancy and to evaluate the role of affective temperament traits and psychosocial risk factors in predicting them. We recruited 193 pregnant women, collected data regarding sociodemographic, family and personal clinical variables, social support and stressful life events and administered the Mood Disorder Questionnaire (MDQ), the Patient Health Questionnaire-9 (PHQ-9), and the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire (TEMPS-A). In our sample, prevalence of depressive symptomatology was 41.45% and prevalence of depression was 9.85% (6.75% mild and 3.10% moderate depression). We have chosen a cutoff >4 on PHQ-9 to identify mild depressive symptoms which may predict subsequent depression. Statistically significant differences between the two groups were found in the following factors: gestational age, occupation, partner, medical conditions, psychiatric disorders, family psychiatric history, stressful life events, and TEMPS-A mean scores. In our sample mean scores on all affective temperaments but the hyperthymic, were significantly lower in the control group. Only depressive and hyperthymic temperaments were found to be, respectively, risk and protective factors for depressive symptomatology. The current study confirms the high prevalence and complex aetiology of depressive symptomatology during pregnancy and suggests that affective temperament assessment seems to be a useful adjunctive instrument to predict depressive symptomatology during pregnancy and postpartum.
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Affiliation(s)
- Marianna Mazza
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Carla Avallone
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Georgios Demetrios Kotzalidis
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
- Correspondence:
| | - Giuseppe Marano
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Lorenzo Moccia
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Anna Maria Serio
- Unit of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Marta Balocchi
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ilenia Sessa
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Delfina Janiri
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ilaria De Luca
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Caterina Brisi
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Maria Chiara Spera
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Laura Monti
- Unit of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Angela Gonsalez del Castillo
- Unit of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gloria Angeletti
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy
| | - Daniela Chieffo
- Unit of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Lucio Rinaldi
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luigi Janiri
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonio Lanzone
- Department of Obstetrics and Gynaecology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giovanni Scambia
- Division of Gynecologic Oncology, Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Eugenio Maria Mercuri
- Paediatric Neurology Unit, Fondazione Policlinico Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gabriele Sani
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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4
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Chieffo D, Avallone C, Serio A, Kotzalidis GD, Balocchi M, De Luca I, Hirsch D, Gonsalez del Castillo A, Lanzotti P, Marano G, Rinaldi L, Lanzone A, Mercuri E, Mazza M, Sani G. Pregnancy-related psychopathology: A comparison between pre-COVID-19 and COVID-19–related social restriction periods. World J Clin Cases 2022; 10:6370-6384. [PMID: 35979303 PMCID: PMC9294903 DOI: 10.12998/wjcc.v10.i19.6370] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/13/2021] [Accepted: 05/08/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic impacted in a still undefined way pregnant women’s mental health. There are reports of mood and affect changes in the general population and the suggestion that similar changes occur also in the pregnant population. The greater vulnerability of women during the COVID-19 restriction period may translate into a greater risk for mental disorders in the gestational period. We hypothesised that pregnant women in the pre-pandemic period would have less psychopathology and more psychological support than pregnant women during the pandemic restriction period.
AIM To compare pregnant women for anxiety, prenatal depression, psychopathology, and social support before and after the awareness of the pandemic.
METHODS We administered to women willing to participate in their 2nd-3rd trimesters of pregnancy the Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory Form Y (STAI-Y), and the Symptom CheckList-90-Revised (SCL-90R); we further collected sociodemographic variables and explored women’s social support. The comparison was cross-sectional. The first sample was termed nonCOVID-19 because data were gathered before the COVID-19 outbreak (January 2020-February 2020) was declared, and the second sample termed COVID-19 because participants were already subjected to the COVID-19–related restrictive measures (January 2021-February 2021). Since normal distribution was not met (Shapiro-Wilk test applied), we applied nonparametric Mann-Whitney’s U-test to compare psychometric tests. Ethical standards were met.
RESULTS The nonCOVID-19 group reported higher support from partners only, while the COVID-19 group reported multiple support (χ2 = 9.7181; P = 0.021); the nonCOVID-19 group scored higher than the COVID-19 group only on state anxiety among psychometric scales [STAI-Y1, nonCOVID-19 median = 39 (95%CI: 39.19-51.10) vs COVID-19 median= 32 (95%CI: 30.83-38.90); Mann-Whitney’s U=117.5, P = 0.00596]. Other measures did not differ meaningfully between the two groups. Scores on the EPDS, the state and trait subscales of the STAI-Y, and most SCL-90R subscales inter-correlated with one another. The anxiety component of the EPDS, EPDS-3A, correlated poorly with other measures, while it was the Global Symptom Index of the SCL-90-R that correlated most strongly with most measures. Our results are at odds with most literature and do not confirm increased depression and anxiety rates in pregnant women during the pandemic.
CONCLUSION The ability of pregnant women to deal with novel generalised threats involves mobilization of inner resources. Increasing sources of social support may have produced anxiolysis in the COVID-19 sample.
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Affiliation(s)
- Daniela Chieffo
- Service of Clinical Psychology, Catholic University of Sacred Heart, Rome 00168, Italy
| | - Carla Avallone
- Department of Neurosciences, Catholic University of Sacred Heart , Rome 00168, Italy
| | - Annamaria Serio
- Service of Clinical Psychology, Catholic University of Sacred Heart, Rome 00168, Italy
| | | | - Marta Balocchi
- Service of Clinical Psychology, Catholic University of Sacred Heart, Rome 00168, Italy
| | - Ilaria De Luca
- Department of Neurosciences, Catholic University of Sacred Heart , Rome 00168, Italy
| | - Daniele Hirsch
- Department of Neurosciences, Catholic University of Sacred Heart , Rome 00168, Italy
| | | | - Pierluigi Lanzotti
- Department of Neurosciences, Catholic University of Sacred Heart , Rome 00168, Italy
| | - Giuseppe Marano
- Department of Neurosciences, Catholic University of Sacred Heart , Rome 00168, Italy
| | - Lucio Rinaldi
- Department of Neurosciences, Catholic University of Sacred Heart , Rome 00168, Italy
| | - Antonio Lanzone
- Department of Obstetrics and Gynaecology, Catholic University of Sacred Heart, Rome 00168, Italy
| | - Eugenio Mercuri
- Paediatric Neurology Unit, Catholic University of Sacred Heart, Rome 00168, Italy
| | - Marianna Mazza
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Gabriele Sani
- Department of Neurosciences, Catholic University of Sacred Heart , Rome 00168, Italy
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5
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Del Casale A, Rossi-Espagnet MC, Napolitano A, Lucignani M, Bonanni L, Kotzalidis GD, Buscajoni A, Manelfi L, Perrone V, Gualtieri I, Brugnoli R, De Pisa E, Girardi P, Romano A, Ferracuti S, Bozzao A, Pompili M. Cerebral cortical thickness and gyrification changes in first-episode psychoses and multi-episode schizophrenia. Arch Ital Biol 2021; 159:3-20. [PMID: 34159573 DOI: 10.12871/00039829202111] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Cortical thickness (CT) and local gyrification index (LGI) in psychotic disorders may show modifications that relate to clinical course. This observational study aimed to analyse such variables in patients with schizophrenia, compared to healthy controls (HCs). We compared CT and LGI of 18 patients with first-episode psychosis with that of 21 with multi-episode schizophrenia and 16 HCs. CT corrected for false-positive cases (Family-Wise Error Rate) showed a reduction in the multi-episode group compared to HCs in left temporal and parietal, and right temporal, parietal, occipital, and hippocampal cortices. Family-wise corrected LGI was increased in the left inferior and middle frontal cortices, and in the right fusiform gyrus, cingulate, lingual, and parahippocampal gyri in first onset patients compared to HCs. Increased LGI was absent from later stages of psychosis, suggesting that specific CT and LGI alterations may underlie different stages of illness.
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Affiliation(s)
- A Del Casale
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University, Rome; Unit of Psychiatry, 'Sant'Andrea' University Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy -
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6
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Mosca A, Del Casale A, Borro M, Gentile G, Pomes LM, Padovano A, Fiaschè F, Pinzone V, Rapinesi C, Zoppi T, Brugnoli R, Sani G, Kotzalidis GD, Girardi P, Ferracuti S, Simmaco M, Pompili M. PON1 polymorphisms can predict generalized anxiety and depressed mood in patients with multiple chemical sensitivity. Per Med 2021; 18:255-267. [PMID: 33728967 DOI: 10.2217/pme-2019-0141] [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] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background: Multiple chemical sensitivity (MCS) is a chronic condition with somatic, cognitive and affective symptoms that follow contact with chemical agents at usually non toxic concentrations. We aimed to assess the role of genetic polymorphisms involved in oxidative stress on anxiety and depression in MCS. Materials & methods: Our study investigated the CAT rs1001179, MPO rs2333227, PON1 rs662 and PON1 rs705379 polymorphisms in MCS. Results: The AG genotype of the PON1 rs662 and the TT and CT genotypes of the PON1 rs705379 were involved in anxiety and depression. Discussion: These results are in line with existing evidence of PON1 involvement in MCS and suggest a further role of this gene in the exhibition of anxiety and depression in this disease.
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Affiliation(s)
- Alessio Mosca
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy
| | - Antonio Del Casale
- Department of Dynamic & Clinical Psychology, & Health Studies, Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Marina Borro
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Laboratory & Advanced Molecular Diagnostics, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Giovanna Gentile
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Laboratory & Advanced Molecular Diagnostics, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Leda Marina Pomes
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Laboratory & Advanced Molecular Diagnostics, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Alessio Padovano
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Federica Fiaschè
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Vito Pinzone
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Chiara Rapinesi
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy
| | - Teodolinda Zoppi
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Roberto Brugnoli
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Gabriele Sani
- Institute of Psychiatry & Psychology, Department of Geriatrics, Neuroscience & Orthopedics, Fondazione Policlinico Universitario IRCCS "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Georgios Demetrios Kotzalidis
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy
| | - Paolo Girardi
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Stefano Ferracuti
- Department of Human Neuroscience, Sapienza University; Unit of Risk Management, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Maurizio Simmaco
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Laboratory & Advanced Molecular Diagnostics, 'Sant'Andrea' University Hospital, Rome, Italy
| | - Maurizio Pompili
- Department of Neuroscience, Mental Health, & Sensory Organs (NESMOS), Faculty of Medicine & Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
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Del Casale A, Rapinesi C, Kotzalidis GD, Ferracuti S, Padovano A, Grassi C, Sani G, Girardi P, Pompili M. Neural functional correlates of emotional processing in patients with first-episode psychoses: an activation likelihood estimation (ALE) meta-analysis. Arch Ital Biol 2018; 156:1-11. [PMID: 30039831 DOI: 10.12871/00039829201811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Early emotional recognition impairment characterises rst-episode psychoses (FEP) and remains stable thereafter. Patients with FEP consistently show brain activation changes during emotional processing in functional neuroimaging studies. AIM AND METHODS To identify and compare cerebral activation correlates of FEP patients and healthy controls (HCs) during emotional task performances, we performed an Activation Likelihood Estimation (ALE) meta-analysis of peer-reviewed functional magnetic resonance imaging (fMRI) studies. RESULTS Five studies included 71 patients with FEP and 75 HCs. Within-group analyses showed that HCs activated during emotional task performance the bilateral inferior parietal lobule (BAs 39 and 40), left inferior frontal gyrus (BAs 9 and 47), right amygdala, left middle frontal gyrus (BA 9), right cingulate gyrus (BA 32), and right middle temporal gyrus (BA 21). FEP activations correlating with emotional tasks included the right cuneus (BA 17) and right angular gyrus (BA 39). CONCLUSIONS During emotional task performance, FEP patients fail to activate an extensive brain network comprising emotional processing-related areas, including both cortical and subcortical areas.
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Affiliation(s)
| | - C Rapinesi
- Sapienza University, Rome, Italy, School of Medicine and Psychology, NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sant'Andrea Hospital, 00189 Rome, Italy -
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8
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Serata D, Rapinesi C, Kotzalidis GD, Alessi MC, Janiri D, Massolo AC, Ferri VR, Criscuolo S, Callovini G, Angeletti G, Girardi P, Del Casale A. Effectiveness of long-acting risperidone in a patient with comorbid intellectual disability, catatonic schizophrenia, and oneiroid syndrome. Int J Psychiatry Med 2016; 50:251-6. [PMID: 26443711 DOI: 10.1177/0091217415610512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A patient with comorbid intellectual disability, catatonic schizophrenia, and recurrent oneiroid state of consciousness improved on long-acting risperidone and remains well at the three-year follow-up. We report a case treated with 50 mg long-acting risperidone administered every 14 days, who has been followed-up for three years. We studied his regional cerebral blood flow through technetium-99 m hexamethylpropyleneamine oxime single-photon emission computed tomography after two years of treatment. Symptoms of catatonic schizophrenia improved after two months of treatment, followed suit by oneiroid syndrome remission. Two years later, his brain perfusion was normal. No side effect has occurred since the patient was started on long-acting risperidone. Long-acting risperidone proved to be safe and effective in treating symptoms of catatonia and oneiroid syndrome.
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Affiliation(s)
- Daniele Serata
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University, Rome, Italy School of Medicine and Psychology, Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy Department of Neuropsychiatry, Suore Hospitaliere of the Sacred Heart of Jesus, Viterbo, Italy
| | - Chiara Rapinesi
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University, Rome, Italy School of Medicine and Psychology, Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy Department of Neuropsychiatry, Suore Hospitaliere of the Sacred Heart of Jesus, Viterbo, Italy
| | - Georgios Demetrios Kotzalidis
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University, Rome, Italy School of Medicine and Psychology, Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy
| | - Maria Chiara Alessi
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University, Rome, Italy School of Medicine and Psychology, Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy
| | - Delfina Janiri
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University, Rome, Italy School of Medicine and Psychology, Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy
| | - Anna Claudia Massolo
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University, Rome, Italy School of Medicine and Psychology, Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy
| | - Vittoria Rachele Ferri
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University, Rome, Italy School of Medicine and Psychology, Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy Department of Neuropsychiatry, Suore Hospitaliere of the Sacred Heart of Jesus, Viterbo, Italy
| | - Silvia Criscuolo
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University, Rome, Italy School of Medicine and Psychology, Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy
| | - Gemma Callovini
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University, Rome, Italy School of Medicine and Psychology, Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy
| | - Gloria Angeletti
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University, Rome, Italy School of Medicine and Psychology, Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy
| | - Paolo Girardi
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University, Rome, Italy School of Medicine and Psychology, Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy Department of Neuropsychiatry, Suore Hospitaliere of the Sacred Heart of Jesus, Viterbo, Italy
| | - Antonio Del Casale
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University, Rome, Italy Department of Psychiatric Rehabilitation, P. Alberto Mileno Onlus Foundation, Vasto (CH), Italy
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Scatena P, Sette G, Rapinesi C, Kotzalidis GD, Ferri VR, Di Pietro S, Raccah RN, Ferracuti S, Orzi F, Girardi P. EHMTI-0358. Improved chronic migraine after DTMS. J Headache Pain 2014. [PMCID: PMC4182179 DOI: 10.1186/1129-2377-15-s1-m10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Masillo A, Valmaggia LR, Lanna A, Brandizzi M, Lindau JF, Curto M, Solfanelli A, Kotzalidis GD, Patanè M, Godeas L, Leccisi D, Girardi P, Fiori Nastro P. Validation of the Italian version of interpersonal sensitivity measure (IPSM) in adolescents and young adults. J Affect Disord 2014; 156:164-70. [PMID: 24439250 DOI: 10.1016/j.jad.2013.12.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [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: 07/31/2013] [Revised: 12/05/2013] [Accepted: 12/05/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND Interpersonal sensitivity is a personality trait that describes as excessive awareness of both the behaviour and feelings of others. High interpersonal sensitivity has been associated with the development and maintenance of mental health problems. This study aimed to examine whether the Italian version of the interpersonal sensitivity measure (IPSM) has good internal consistence and convergent validity. METHODS Validity was established on a sample of 153 Italian adolescents and young adult help seekers for several psychological problems. These subjects were divided in two groups - depressive spectrum disorder group (n=42) and other diagnosis group (n=111) - according to Structured Clinical Interview (SCID-I) for DSM-IV and Kiddie-Sads-Present and Lifetime Version (K-SADS-PL). For convergent validity, we studied the correlation between total and each subscale IPSM scores and the General Symptoms (included depressive and dysphoric symptoms) of Prodromal Questionnaire. RESULTS The internal consistency were adequate and comparable to the original Boyce and Parker study. The validity was good, as indicated by both the convergent validity analysis and the depressive spectrum disorder group and other diagnosis group comparison. LIMITATIONS The absence of another scale measuring interpersonal sensitivity to assess the construct validity of IPSM; the clinical heterogeneity of the sample; the absence of test re-test reliability of the instrument. CONCLUSIONS Analysis of the results of internal consistency and convergent validity of the IPSM indicates that this version translated into Italian is valid and reliable.
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Affiliation(s)
- A Masillo
- Department of Neurology and Psychiatry, Sapienza University of Rome, Faculty of Medicine and Odontology, Rome 00156, Italy.
| | - L R Valmaggia
- Department of Psychology, King's College London, Institute of Psychiatry, UK; Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, UK
| | - A Lanna
- Department of Computer, Control, and Management Engineering "A. Ruberti", Sapienza University of Rome, Rome, Italy
| | - M Brandizzi
- Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - J F Lindau
- Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - M Curto
- Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - A Solfanelli
- Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - G D Kotzalidis
- Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - M Patanè
- Department of Neurology and Psychiatry, Sapienza University of Rome, Faculty of Medicine and Odontology, Rome 00156, Italy
| | - L Godeas
- Community Mental Health Service, ASL Rome H, Rome, Italy
| | - D Leccisi
- Community Mental Health Service, ASL Rome H, Rome, Italy
| | - P Girardi
- Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - P Fiori Nastro
- Department of Neurology and Psychiatry, Sapienza University of Rome, Faculty of Medicine and Odontology, Rome 00156, Italy
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Del Casale A, Kotzalidis GD, Rapinesi C, Serata D, Ambrosi E, Simonetti A, Pompili M, Ferracuti S, Tatarelli R, Girardi P. Functional neuroimaging in obsessive-compulsive disorder. Neuropsychobiology 2011; 64:61-85. [PMID: 21701225 DOI: 10.1159/000325223] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 01/23/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIM Obsessive-compulsive disorder (OCD) is a severe, highly prevalent and chronically disabling psychiatric disorder that usually emerges during childhood or adolescence. This paper aims to review the literature on functional neuroimaging in OCD, analysing the reported dysfunctional connectivity in the corticostriatothalamocortical circuitry. METHOD This study included papers published in peer-reviewed journals dealing with functional imaging in OCD. RESULTS Striatal dysfunction, mainly of the caudate nucleus, leads to inefficient thalamic gating, resulting in hyperactivity within the orbitofrontal cortex (intrusive thoughts) and the anterior cingulate cortex (non-specific anxiety). Compulsions consist of ritualistic behaviours performed to recruit the inefficient striatum and neutralise unwanted thoughts and anxiety. Functional neuroimaging findings are discussed against the background of specific cognitive impairments, mainly regarding visuospatial processing, executive functioning and motor speed. Cognitive deficits are partial and specific, matching imaging data. CONCLUSIONS Several studies have targeted brain regions hypothesised to be involved in the pathogenesis of OCD, showing the existence of dysfunctional connectivity in the corticostriatothalamocortical circuitry. Improvements in spatial resolution of neuroimaging techniques may contribute to a better understanding of the neurocircuitry of OCD and other anxiety disorders.
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Affiliation(s)
- A Del Casale
- NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University and Sant'Andrea Hospital, Rome, Italy.
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12
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Rizzi M, Barrella M, Kotzalidis GD, Bevilacqua M. Periodic Limbic Movement Disorder during Sleep as Diabetes-Related Syndrome? A Polysomnographic Study. ISRN Endocrinol 2011; 2011:246157. [PMID: 22363869 PMCID: PMC3262626 DOI: 10.5402/2011/246157] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/22/2011] [Accepted: 06/20/2011] [Indexed: 11/23/2022]
Abstract
Introduction. Periodic limb movements during sleep (PLMs) is common in the elderly. When quality-of-life drops due to sleep disturbances, we speak about periodic limb movement disorder during sleep (PLMD). Another similar disorder, restless legs syndrome (RLS), is considered to be related to diabetes; RLS and PLMDs are genetically related. Our aim was to detect PLMDs in a population of diabetic patients and identify them as possible hallmarks of these autonomic disorders. Material and Methods. We selected 41 type-2 diabetics with no sleep comorbidity, and compared them with 38 healthy matched volunteers. All participants underwent the Epworth Sleepiness Scale (ESS) and polysomnography (PSG). A periodic limb movement (PLM) index >5, that is, the higher number of PLMs/sleep hour for the entire night, was considered as abnormal. Results. Diabetics showed lower sleep efficiency than controls on the ESS, lower proportions of REM and non-REM sleep, and higher arousal and PLM indexes, as assessed through PSG. PLMDs were diagnosed in 13 of 41 diabetic patients (31%); the latter showed lower sleep efficiency, lower non-REM slow-wave sleep, and increased arousal and PLM indexes. Conclusion. The relationship between PLMs-related sleep fragmentation and endocrine carbohydrate metabolism regulation might be casual or genetically determined. This deserves further investigations.
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Affiliation(s)
- M Rizzi
- Institute of Pneumology, Luigi Sacco Hospital, Giovanni Battista Grassi Street 74, 20157 Milan, Italy
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13
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Pacchiarotti I, Valentí M, Bonnin CM, Rosa AR, Murru A, Kotzalidis GD, Nivoli AMA, Sánchez-Moreno J, Vieta E, Colom F. Factors associated with initial treatment response with antidepressants in bipolar disorder. Eur Neuropsychopharmacol 2011; 21:362-9. [PMID: 21056928 DOI: 10.1016/j.euroneuro.2010.10.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [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] [Received: 07/20/2010] [Accepted: 10/15/2010] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Controversy in antidepressant (AD) use in bipolar depression relies in its potential induction of mood switches and ineffectiveness. Responders to acute AD add-on treatment maintain response with continued treatment, whilst partial/non-responders fail to reach remission despite continuation treatment. We aimed to identify response predictors to acute AD addition in bipolar depression in order to optimize treatment choice in bipolar depression and avoid unnecessary AD exposure of people unlikely to respond. METHODS Two hundred and twenty-one DSM-IV-TR depressed bipolar - type I and II - patients were treated with AD on an observational study. AD response was defined as an at least 50% drop from baseline of their HDRS17 score after 8weeks of treatment. One hundred and thirty-eight patients (138, 62.4%) fulfilled response criteria (RI) whilst 83 patients (37.6%) did not (NRI). In all cases AD therapy was on top of previously prescribed stabilizers and/or atypical antipsychotics. RESULTS RI patients were more likely to have had previous response to ADs, whereas NRI had a higher number of previous mood switches with ADs during past depressive episodes. Psychotic symptoms were more frequent amongst RI, whilst lifetime history of atypical depression was more frequent amongst NRI. NRI had more total, depressive, and hypomanic, but not manic or mixed, episodes in the past than RI. Analyzed through a logistic regression, higher previous response to ADs and lower rate of past hypomanic episodes in RI were the variables explaining intergroups (RI vs. NRI) differences. DISCUSSION Taking into account the proper caution in the use of Ads in bipolar disorder, there is a subgroup of bipolar patients who might benefit from adjunctive Ads. Looking at specific clinical factors during the course of the illness could help physicians in deciding whether to use an antidepressant in a bipolar depressed patient already treated with mood stabilizers.
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Casale AD, Ferracuti S, Kotzalidis GD, Rapinesi C, Serata D, Ambrosi E, Simonetti A, Savoja V, Pompili M, Angeletti G, Tatarelli R, Girardi P. The functional neuro-anatomy of the human response to fear: A brief review. S Afr J Psychiatr 2011. [DOI: 10.4102/sajpsychiatry.v17i1.270] [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: 11/01/2022] Open
Abstract
The perception of fear and subsequent appropriate behavioral responding are crucial for the adaptation of species to their living environment. Functional neuroimaging studies of the neural basis of fear during the last few decades in humans contributed to significant advancement in the understanding of its mechanisms. Imaging studies help us delineating the role of amygdala-based neurocircuitry in fear activation and attention capture. The aim of this paper was to briefly review the most recent functional neuroimaging studies of fear perception, modulation and learning. Important knowledge was acquired about the factors that set fear in motion, including the role of nonconscious processes and the character of fear in guiding attention. A subcortical network interacts with the prefrontal cortex to modulate emotional response that allows better coping with environmental and social circumstances. Fear learning reduces the need to relearn about danger, and flexibility processes readjust fear behavior when external circumstances change. Future improvement of functional and other neuroimaging techniques may promote better clarification of the neurocircuitry involved in fear perception, learning and modulation.
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Talamo A, Vento A, Savoja V, Di Cosimo D, Lazanio S, Kotzalidis GD, Manfredi G, Girardi N, Tatarelli R. Folie à deux: double case-report of shared delusions with a fatal outcome. Clin Ter 2011; 162:45-49. [PMID: 21448546] [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: 05/30/2023]
Abstract
BACKGROUND Treatment of shared delusional disorder (folie à deux) often involves separation and use of antipsychotic medication, with uncertain outcomes and potential risks. METHODS We report on two highly interdependent and chronically psychotic sisters with shared systematic delusion, followed by psychiatrists over several years. RESULTS The dominant patient was diagnosed with schizoaffective disorder and her non-dominant sister with paranoid schizophrenia. Both received antipsychotics and supportive therapy as outpatients and allowed to continue conjoint therapy with individual psychiatrists-therapists. They returned for follow-up visits for 20 months, when the dominant decided to continue treatment alone, as her sister gradually improved symptomatically and functionally. After separation, the dominant became increasingly anxious. She impulsively ingested an overdose of the non-dominant sister's medicines and died of cardiac arrest, despite her sister's efforts to seek medical assistance. The surviving non-dominant sister developed anxiety and increasing agitation requiring psychiatric hospitalization and increased pharmacotherapy. She improved gradually, but continued to be dysfunctional and required placement in a psychiatric inpatient unit for several months, eventually doing better in a community-based rehabilitative program with regular psychiatric follow-up. CONCLUSIONS Combined treatment of patients with folie à deux may encourage continuous pathological interactions, but separation may increase risk of adverse outcomes.
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Affiliation(s)
- A Talamo
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso "NESMOS", Ospedale Sant'Andrea, Sapienza, Università di Roma, Italia.
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Comparelli A, De Carolis A, Kotzalidis GD, Masillo A, Ferracuti S, Tatarelli R. A woman lost in the cemetery: A case of time-limited amnesia. Neurocase 2010; 16:23-30. [PMID: 20391183 DOI: 10.1080/13554790903193182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A 43-year-old woman one day experienced a dissociative fugue which she could not recall. She was married, nulliparous, with no history of dissociative disorder or other psychiatric disorders. She had been sexually abused during late childhood-early adolescence. She was examined thoroughly from both psychiatric and medical standpoints to exclude organic causes for her condition. Magnetic Resonance Imaging showed only some non-specific abnormalities. On personality tests, a histrionic structure of personality emerged, with obsessive and narcissistic traits accompanied by rigidity and anxiety, dysphoria and high risk for depression; some impairment was found in executive function tests. Final diagnosis was one of dissociative fugue. In fact, organic traits were not sufficient to establish a diagnosis of Transient Global Amnesia.
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Affiliation(s)
- A Comparelli
- Department of Neurosciences, Sapienza University - Rome, 2nd Medical School, Unit of Psychiatry, Sant'Andrea Hospital, Rome, Italy.
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Pompili M, Innamorati M, Narciso V, Kotzalidis GD, Dominici G, Talamo A, Girardi P, Lester D, Tatarelli R. Burnout, hopelessness and suicide risk in medical doctors. Clin Ter 2010; 161:511-514. [PMID: 21181078] [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: 05/30/2023]
Abstract
OBJECTIVES The aim of the present study was to investigate the association between burnout and hopelessness in medical doctors. MATERIALS AND METHODS We conducted an investigation of 133 medical doctors working either in a hospital setting or in general practice to explore the relationship between the level of burnout and hopelessness, a psychometric marker for suicide risk. The participants were administered the Oldenburg Burnout Inventory (OBI) and Beck's Hopelessness Scale (BHS). RESULTS Burnout is an important issue in mediating the level of hopelessness. Doctors with high hopelessness had higher scores on the disengagement factor (2.61±0.47 vs 2.14±0.41; t131=-4.37; p<0.001; Cohen D=1.07), and on the exhaustion factor (2.68±0.65 vs 2.19±0.54; t131=-3.39; p<0.001; Cohen D=0.82) than doctors with low hopelessness. A multivariate regression analysis confirmed that disengagement and exhaustion are significant predictors of the BHS scores. CONCLUSIONS People in charge of workers' health should pay particular attention to the level of burnout in doctors, intervene with changes in the work environment and evaluate the impact of such procedures.
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Affiliation(s)
- M Pompili
- Department of Neurosciences, Mental Health and Sensory Functions, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome,1035 Via di Grottarossa,Rome, Italy.
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Pacchiarotti I, Mazzarini L, Colom F, Sanchez-Moreno J, Girardi P, Kotzalidis GD, Vieta E. Treatment-resistant bipolar depression: towards a new definition. Acta Psychiatr Scand 2009; 120:429-40. [PMID: 19740127 DOI: 10.1111/j.1600-0447.2009.01471.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To summarize the conceptual and operational definitions of treatment-resistant bipolar depression and to review the evidence-based therapeutic options. METHOD Structured searches of PubMed, Index Medicus, Excerpta Medica and Psyclit conducted in December 2008. RESULTS Criteria for treatment resistance in bipolar depression are commonly based on concepts stemming from treatment resistance as defined for unipolar depression, an approach that proved to be inadequate. In fact, the addition of an ad hoc criterion based on lithium and other mood stabilizer unresponsiveness after reaching adequate plasma levels appears to be a patch that attempts to take into account the uniqueness of bipolar depression but fails to become operational. Recent data from randomized clinical trials of new anticonvulsants and second-generation antipsychotics should lead to the development of a modern definition of treatment-resistant bipolar depression, and specific therapeutic algorithms. CONCLUSION We suggest a redefinition of resistant bipolar I and II depression. We propose different degrees of severity within bipolar depression in a stepwise manner.
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Affiliation(s)
- I Pacchiarotti
- Bipolar Disorders Programme, Institute of Clinical Neuroscience, Hospital Clinic, University of Barcelona, CIBERSAM, 08036-Barcelona, Spain
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Kotzalidis GD, de Pisa E, Patrizi B, Savoja V, Ruberto G, Girardi P. Similar discontinuation symptoms for withdrawal from medium-dose paroxetine and venlafaxine after nine years in the same patient. J Psychopharmacol 2008; 22:581-4. [PMID: 18208915 DOI: 10.1177/0269881107081562] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 11/15/2022]
Abstract
A woman who had developed a discontinuation syndrome nine years ago with paroxetine tapered from 10 to 5 mg/day represented the same syndrome recently when she occasionally missed her 75 mg q 12 h venlafaxine doses. The symptoms, comprising agitation, numbness, pricking sensations, sweating, difficulty concentrating, weakness, derealisation and perceived xerophthalmia, immediately subside upon drug dose reinstitution. The patient had used cannabis irregularly before the onset of pauci-symptomatic panic attacks, but none of her panic symptoms were present in her withdrawal symptomatology. Some symptoms waxed and waned during the withdrawal period. The syndrome is compatible with both hyper- and hypoactivity of the central serotonergic system.
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Affiliation(s)
- G D Kotzalidis
- Department of Neurosciences, Psychiatry Unit, Sapienza University, 2nd Medical School, Sant'Andrea Hospital, Rome, Italy.
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Ricciardi A, Ruberto A, García-Hernández MJ, Kotzalidis GD, Trevisi M, Persechino S, Tatarelli R, Ruiz-Doblado S. Alopecia areata with comorbid depression: early resolution with combined paroxetine-triamcinolone treatment. J Eur Acad Dermatol Venereol 2006; 20:1000-1. [PMID: 16922952 DOI: 10.1111/j.1468-3083.2006.01592.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
OBJECTIVE Depression in people related to delivering women is documented in their mates, but only anecdotal in other family members. We describe a case of depression in a woman who had previously experienced postpartum depression after the birth of her nephew. METHOD A clinical description of the case. RESULTS A 53-year-old woman, hysterectomized at age 47 years, was admitted for attempted suicide. She developed major depressive episode 1 month after her daughter had delivered a son. She had a past history of two postpartum depressive episodes clinically identical to the current episode. The episode resolved after 5 weeks. At 1-year follow-up, the patient is still asymptomatic. CONCLUSION Psychological and cultural factors were at play in this case more than hormonal and biopsychosocial ones.
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Affiliation(s)
- G Manfredi
- Department of Psychiatry, La Sapienza University of Rome - Sant'Andrea Hospital, Via di Grottarossa, Rome, Italy.
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22
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Abstract
Cannabis consuming schizophrenic patients are younger at onset, are likely to have started abuse before onset of schizophrenia and show more prominent positive symptoms than nonabusers. It has been suggested that cannabis is a risk-factor for schizophrenia. Our aim was to assess prevalence and pattern of cannabis use in 125 chronic male schizophrenic subjects and its impact on socioepidemiological and clinical variables as well as which disorder precedes the other in onset. Assessment of consumption was made with a semi-structured clinical interview. Clinical status was assessed by means of the SANS, SAPS, PANSS and BPRS scales. Cannabis consumption was found in 54 subjects (43%), 66.7% of whom started it at least three years before onset of schizophrenia. Consumers were younger and with lower negative symptoms, specially abusers and polysubstance abusers. Family history positive for psychosis was more frequent in consumers, especially when consumption started before onset of schizophrenia. Subjects whose onset of schizophrenia preceded the beginning of cannabis abuse had more positive symptoms than those who started abuse before the onset of schizophrenia. On these grounds, our sample could be subdivided into two main groups, one that uses substances to counter distressing symptoms of schizophrenia and another in which cannabis might be one of the factors predisposing to the disease; the former had less negative symptoms than nonabusers. Our data support both heterogeneity of schizophrenia and genetic susceptibility to environmental agents.
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Affiliation(s)
- G Bersani
- III Clinica Psichiatrica, Università di Roma, La Sapienza, Viale dell'Università 30, 00185 Rome, Italy.
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Delle Chiaie R, Pancheri P, Casacchia M, Stratta P, Kotzalidis GD, Zibellini M. Assessment of the efficacy of buspirone in patients affected by generalized anxiety disorder, shifting to buspirone from prior treatment with lorazepam: a placebo-controlled, double-blind study. J Clin Psychopharmacol 1995; 15:12-9. [PMID: 7714222 DOI: 10.1097/00004714-199502000-00003] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.3] [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: 01/26/2023]
Abstract
Forty-four patients with DSM-III-R generalized anxiety disorder participated in this double-blind, randomized study. Patients were on a benzodiazepine before the study and were stabilized on 3 to 5 mg/day lorazepam for 5 weeks (weeks 0 to 5). Thereafter, they were randomized to 15 mg/day buspirone or placebo for the following 6 weeks (weeks 6 to 11). During the first 2 weeks of double-blind, randomized treatment (weeks 6 to 7), lorazepam was tapered off. During weeks 12 to 13, patients received single-blind placebo. Assessment included the Hamilton Rating Scale for Anxiety, the State-Trait Anxiety Inventory, the Zung and Eddy Self-Rating Scale of Anxiety Symptoms, the Hamilton Rating Scale for Depression, and the Rome Depression Inventory, completed at weeks 0, 5, 6, 7, 8, 9, 11, and 13. Side effects were assessed through the Dosage Treatment Emergent Symptoms at the same times. The benzodiazepine-withdrawal syndrome was evaluated through a 27-symptom checklist (Clinical-Rated Benzodiazepine Withdrawal Symptom Schedule) at weeks 0, 5, 6, 7, 11, and 13. The results showed that buspirone was more effective than placebo and comparable to lorazepam. Buspirone-treated patients showed no rebound anxiety or benzodiazepine-withdrawal syndrome compared with placebo. Buspirone caused fewer side effects than lorazepam and was not different from placebo in this respect. Finally, buspirone maintained its anxiolytic effect for at least 2 weeks after the discontinuation of treatment.
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Affiliation(s)
- R Delle Chiaie
- III Cattedra di Clinica Psichiatrica, University La Sapienza Rome, Italy
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24
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Abstract
Studies in human psychoneuroimmunology began around 1919, but a systematic approach wasn't used until the work of Solomon in the 1960s. Recently, the new specialty has achieved relative independence due to considerable data acquisition. Stress research has revealed relationships between neuroendocrine and immune changes. In parallel, increasing evidence of immunological alterations in psychiatric diseases has expanded the field; presently, immunological correlates of psychosomatic diseases and personality are sought. On the other hand, while immunological disease has been psychologically assessed for many years, a clear-cut link between psyche and immunological changes has yet to be shown. This fact, along with the therapeutic implications of advancing knowledge, will influence strongly the future trends of psychoneuroimmunology. Concepts emerging from the study of this field will be of heuristic value to both psychiatry and immunology and will help define new and expanded limits for both disciplines.
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Affiliation(s)
- M Biondi
- Third Psychiatric Clinic, University of Rome, La Sapienza, Italy
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