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Guidetti C, Serra G, Apicella M, Andracchio E, Iannoni ME, Trasolini M, Della Santa G, Maglio G, Vicari S. Childhood Clinical Features Preceding the Onset of Bipolar Versus Major Depressive Disorders During Adolescence. J Atten Disord 2024; 28:648-663. [PMID: 38327097 DOI: 10.1177/10870547231225819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To identify childhood psychopathological features that predict the onset of adolescent Bipolar (BD) versus Unipolar Major Depressive Disorder (UD) during adolescence. METHOD We analyzed clinical data from 495 juveniles diagnosed with DSM-5 UD (n = 359), and BD (n = 136), using bivariate analysis and multivariate logistic regression model. RESULTS BD subjects exhibited earlier onset of any psychiatric feature compared to UD. Antecedents associated with later BD were: oppositional defiant > specific phobias > ADHD > obsessive compulsive (OCD). Antecedents selectively associated with later UD were: social anxiety and separation anxiety. Factors significantly and independently associated with later BD diagnosis were: [a] emotional dysregulation at onset of the mood disorder; [b] first depressive episode with mixed features; [c] antecedent ADHD; [d] antecedent OCD, and [e] antecedent oppositional-defiance. CONCLUSION Identifying developmental differences in BD and UD symptoms can aid clinicians in early identification and treatment planning for bipolar disorder in youth.
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Affiliation(s)
- Clotilde Guidetti
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Life Sciences and Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Giulia Serra
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Massimo Apicella
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Elisa Andracchio
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria Elena Iannoni
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Monia Trasolini
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Giorgia Della Santa
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Gino Maglio
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Life Sciences and Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
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Fanni D, Gerosa C, Serra G, Miglianti M, Coghe F, Van Eyken P, Faa G, La Nasa G, Guido M. Autoimmune liver disease triggered by SARS-CoV-2: a case report and review of the literature. Eur Rev Med Pharmacol Sci 2024; 28:1632-1638. [PMID: 38436196 DOI: 10.26355/eurrev_202402_35493] [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: 03/05/2024]
Abstract
BACKGROUND An increasing number of coronavirus disease 2019 (COVID-19) related autoimmune hepatitis (AIH) and autoimmune liver disease (AILD) has been already described so far in the last three years. This rise has set up some diagnostic and therapeutic concerns, although steroid therapy has mostly been efficient, avoiding main significant side effects. CASE REPORT We report the case of a 52-year-old subject displaying liver function impairment at the laboratory tests while positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) swab. Needle liver biopsy showed severe portal inflammation, interface hepatitis, lobular inflammation, abundant plasma cells, bridging necrosis, endothelialitis, bile duct vanishing disease, and ductular reaction. The diagnosis of autoimmune liver disease (AILD) was performed. After a month of steroid and ursodeoxycholic acid medications, liver function fully recovered. Azathioprine was introduced, and steroids were gradually reduced. CONCLUSIONS Probably triggered by the SARS-CoV-2-induced cytokine storm, the association between COVID-19 and autoimmune-related inflammatory injury may display a particular paradigm of AILD pathogenesis.
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Affiliation(s)
- D Fanni
- Unit of Pathology, Department of Medical Sciences and Public Health, AOU of Cagliari, University of Cagliari, Cagliari, Italy.
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Serra G, Apicella M, Iannoni ME, Trasolini M, Andracchio E, Chieppa F, Averna R, Guidetti C, Maglio G, Reale A, Vicari S. Urgent Psychiatric Consultations for Suicidal Ideation and Behaviors in Italian Adolescents during Different COVID-19 Pandemic Phases. J Pers Med 2023; 13:1112. [PMID: 37511725 PMCID: PMC10381114 DOI: 10.3390/jpm13071112] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/27/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Access to the emergency department (ED) for acute psychiatric problems, especially for suicide attempts (SA), has increased in the last decade. This increase has exceptionally accelerated after the COVID-19 pandemic. The aim of this project was to study the increase in acute psychiatric care demand of children and adolescents in the short and medium term after the pandemic, in relation to public health measures and in comparison with a pre pandemic reference period. We retrospectively studied 5445 child psychiatric (CP) consultations requested for any reason and for suicide attempt (SA), suicidal ideation (SI) and non-suicidal self-injury (NSSI) in a pediatric ED during three different pandemic periods in Italy (from March 2020 to May 2022) and compared them to a pre-pandemic reference period (from January 2018 to February 2020). Monthly CP consultations for any reason increased significantly by 2.2 times from 70.9 in 2018 to 157 in 2022 (p < 0.001). During the pandemic, monthly CP consultations for any reason increased significantly from 75/month in the first lockdown to 153/month in the second lockdown, remaining stable in the following year. CP consultations for SA increased significantly from 5/month in the first lockdown to 16/month in the second. Consultations for SI increased gradually but significantly from the pre-pandemic period to the end of the pandemic. Juveniles evaluated for SA during the pandemic vs. pre-pandemic more frequently attempted suicide by self-poisoning and less frequently by precipitation, and they were more likely to be diagnosed with a major depressive disorder. CP consultations for any reason and for suicide attempts significantly increased in the decade before the pandemic and peaked in the second lockdown period in Italy.
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Affiliation(s)
- Giulia Serra
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Massimo Apicella
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Maria Elena Iannoni
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Monia Trasolini
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Elisa Andracchio
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Fabrizia Chieppa
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Roberto Averna
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Clotilde Guidetti
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Gino Maglio
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Antonino Reale
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Stefano Vicari
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
- Department of Life Sciences and Public Health, Catholic University, 00168 Rome, Italy
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Apicella M, Serra G, Trasolini M, Andracchio E, Chieppa F, Averna R, Iannoni ME, Infranzi A, Moro M, Guidetti C, Maglio G, Raucci U, Reale A, Vicari S. Urgent psychiatric consultations for suicide attempt and suicidal ideation before and after the COVID-19 pandemic in an Italian pediatric emergency setting. Front Psychiatry 2023; 14:1135218. [PMID: 37457771 PMCID: PMC10348632 DOI: 10.3389/fpsyt.2023.1135218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/29/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Suicidal attempts (SAs) in youth have been increasing during the last decades. Methods We studied consultations, SA, and suicidal ideation (SI) in a pediatric emergency department (ED). Results From 1 January 2011 to 31 May 2022, 606,159 patients accessed the ED, 8,397 of who had a child psychiatry consultation (CPC). CPCs increased significantly by 11 times in the last decade (155 in 2011 vs. 1,824 in 2021, p < 0.001); CPCs for SA increased significantly by 33 times, from 6 in 2011 to 200 in 2021 (3.9% of total CPC vs. 11%, p < 0.001). While total CPCs increased constantly during the entire period (annual percent change (APC) of 21.7 from 2011 to 2021 in a 0 joinpoint model), CPCs for SA increased significantly from 2011 to 2016, were approximately stable from 2016 to 2020, and then had a peak in 2021 after the COVID-19 pandemic (APC from 2011 to 2016 of 64.1, APC of 1.2 from 2016 to 2020, and APC of 230 after 2020 in a 2-joinpoint model). Discussion Total CPCs in ED as well as evaluation for SA and SI increased significantly during the last decade. CPCs for SA had an additional increase after the COVID-19 pandemic. This picture warrants timely and efficient improvements in emergency settings and mental health resources.
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Affiliation(s)
- Massimo Apicella
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Giulia Serra
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Monia Trasolini
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Elisa Andracchio
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Fabrizia Chieppa
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Roberto Averna
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Maria Elena Iannoni
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Antonio Infranzi
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Marianna Moro
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Clotilde Guidetti
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Gino Maglio
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Umberto Raucci
- Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Antonino Reale
- Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Stefano Vicari
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- Department of Life Sciences and Public Health, Catholic University, Rome, Italy
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Vascellari S, Orrù CD, Groveman BR, Parveen S, Fenu G, Pisano G, Piga G, Serra G, Oppo V, Murgia D, Perra A, Angius F, Hughson AG, Haigh CL, Manzin A, Cossu G, Caughey B. α-Synuclein seeding activity in duodenum biopsies from Parkinson's disease patients. PLoS Pathog 2023; 19:e1011456. [PMID: 37390080 DOI: 10.1371/journal.ppat.1011456] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/02/2023] [Indexed: 07/02/2023] Open
Abstract
Abnormal deposition of α-synuclein is a key feature and biomarker of Parkinson's disease. α-Synuclein aggregates can propagate themselves by a prion-like seeding-based mechanism within and between tissues and are hypothesized to move between the intestine and brain. α-Synuclein RT-QuIC seed amplification assays have detected Parkinson's-associated α-synuclein in multiple biospecimens including post-mortem colon samples. Here we show intra vitam detection of seeds in duodenum biopsies from 22/23 Parkinson's patients, but not in 6 healthy controls by RT-QuICR. In contrast, no tau seeding activity was detected in any of the biopsies. Our seed amplifications provide evidence that the upper intestine contains a form(s) of α-synuclein with self-propagating activity. The diagnostic sensitivity and specificity for PD in this biopsy panel were 95.7% and 100% respectively. End-point dilution analysis indicated up to 106 SD50 seeding units per mg of tissue with positivity in two contemporaneous biopsies from individual patients suggesting widespread distribution within the superior and descending parts of duodenum. Our detection of α-synuclein seeding activity in duodenum biopsies of Parkinson's disease patients suggests not only that such analyses may be useful in ante-mortem diagnosis, but also that the duodenum may be a source or a destination for pathological, self-propagating α-synuclein assemblies.
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Affiliation(s)
- Sarah Vascellari
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Christina D Orrù
- Laboratory of Neurological Infections and Immunity (LNII), Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Health (NIH), Hamilton, Montana, United States
| | - Bradley R Groveman
- Laboratory of Neurological Infections and Immunity (LNII), Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Health (NIH), Hamilton, Montana, United States
| | - Sabiha Parveen
- Laboratory of Neurological Infections and Immunity (LNII), Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Health (NIH), Hamilton, Montana, United States
| | - Giuseppe Fenu
- S. C. Neurology and Stroke Unit, AOBrotzu, Cagliari, Italy
| | - Giada Pisano
- S. C. Neurology and Stroke Unit, AOBrotzu, Cagliari, Italy
| | - Giuseppe Piga
- S. C. Neurology and Stroke Unit, AOBrotzu, Cagliari, Italy
| | - Giulia Serra
- S. C. Neurology and Stroke Unit, AOBrotzu, Cagliari, Italy
| | - Valentina Oppo
- S. C. Neurology and Stroke Unit, AOBrotzu, Cagliari, Italy
| | - Daniela Murgia
- S. C. Neurology and Stroke Unit, AOBrotzu, Cagliari, Italy
| | - Andrea Perra
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Fabrizio Angius
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Andrew G Hughson
- Laboratory of Neurological Infections and Immunity (LNII), Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Health (NIH), Hamilton, Montana, United States
| | - Cathryn L Haigh
- Laboratory of Neurological Infections and Immunity (LNII), Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Health (NIH), Hamilton, Montana, United States
| | - Aldo Manzin
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Giovanni Cossu
- S. C. Neurology and Stroke Unit, AOBrotzu, Cagliari, Italy
| | - Byron Caughey
- Laboratory of Neurological Infections and Immunity (LNII), Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Health (NIH), Hamilton, Montana, United States
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Serra G, Ruotolo I, Berardi A, Carlizza A, Galeoto G. The Effect of Hydrokinetic Therapy on Patients with Low Back Pain: A Systematic Review and Meta-Analysis. Muscles Ligaments Tendons J 2023. [DOI: 10.32098/mltj.01.2023.10] [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] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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Guidetti C, Serra G, Pani L, Pappagallo M, Maglio G, Martin SD, Mattarei A, Folli F, Manfredi PL, Fava M. Subanalysis of Subjective Cognitive Measures From a Phase 2, Double-Blind, Randomized Trial of REL-1017 in Patients With Major Depressive Disorder. Prim Care Companion CNS Disord 2023; 25. [PMID: 36821775 DOI: 10.4088/pcc.22m03267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
Objective: Improvement of cognitive function in patients with major depressive disorder (MDD) is an important treatment outcome. REL-1017 (esmethadone HCl) is a novel N-methyl-d-aspartate receptor (NMDAR) channel blocker and a potentially rapidly acting antidepressant. The objective of this study was to define the effects of REL-1017 on subjective cognitive measures in patients with MDD. Methods: Post hoc analysis was conducted of subjective cognitive measures from the Montgomery-Asberg Depression Rating Scale (MADRS) and the Symptoms of Depression Questionnaire (SDQ) from a randomized, double-blind, placebo-controlled, Phase 2a study. The study, designed to assess the safety, tolerability, and efficacy of 2 dosages (25 mg and 50 mg) of REL-1017 as an adjunctive treatment in patients with MDD unresponsive to standard antidepressants, included 62 patients. We analyzed subjective cognitive measures derived from the MADRS and SDQ scales at baseline and up to day 14, 7 days after the last dose of study drug. We developed 2 composite indexes that included subjective cognitive measures selected from the MADRS and SDQ. Results: The subanalysis of single measures and the 2 composite indexes derived from the MADRS and SDQ measures showed clinically meaningful and statistically significant improvements in cognitive function (P < .05). Conclusions: In a Phase 2a clinical trial, REL-1017 improved subjective measures of cognitive impairment, in addition to improving total MADRS and SDQ scores. These results need to be confirmed in larger and longer studies in MDD that include objective measures of cognitive function. Phase 3 studies of REL-1017 for MDD are currently underway. Clinical Trials Registration: ClinicalTrials.gov identifier: NCT03051256.
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Affiliation(s)
- Clotilde Guidetti
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Pediatric Hospital, IRCCS, Rome, Italy
| | - Giulia Serra
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Pediatric Hospital, IRCCS, Rome, Italy
| | - Luca Pani
- Department of Psychiatry and Behavioral Sciences, University of Miami, School of Medicine, Miami, Florida.,Relmada Therapeutics, Coral Gables, Florida
| | - Marco Pappagallo
- Relmada Therapeutics, Coral Gables, Florida.,Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, New York
| | - Gino Maglio
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Pediatric Hospital, IRCCS, Rome, Italy
| | - Sara De Martin
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Andrea Mattarei
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Franco Folli
- Department of Health Science, University of Milan, Milan, Italy
| | - Paolo L Manfredi
- Relmada Therapeutics, Coral Gables, Florida.,Corresponding author: Paolo L. Manfredi, MD, Relmada Therapeutics, 2222 Ponce de Leon Blvd Floor 3, Coral Gables, FL 33134
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
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Rodia R, Meloni PE, Mascia C, Balestrieri C, Ruggiero V, Serra G, Conti M, Loi M, Pes F, Onali S, Perra A, Littera R, Velluzzi F, Mariotti S, Chessa L, Boi F. Direct-acting antivirals used in HCV-related liver disease do not affect thyroid function and autoimmunity. J Endocrinol Invest 2023; 46:359-366. [PMID: 36048357 PMCID: PMC9859881 DOI: 10.1007/s40618-022-01909-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/19/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE It is well known that interferon-α (IFN-α), used for long time as the main therapy for HCV-related disease, induces thyroid alterations, but the impact of the new direct-acting antivirals (DAAs) on thyroid is not established. Aim of this prospective study was to evaluate if DAAs therapy may induce thyroid alterations. METHODS A total of 113 HCV patients, subdivided at the time of the enrollment in naïve group (n = 64) and in IFN-α group (n = 49) previously treated with pegylated interferon-α and ribavirin, were evaluated for thyroid function and autoimmunity before and after 20-32 weeks of DAAs. RESULTS Before starting DAAs, a total of 8/113 (7.1%) patients showed Hashimoto's thyroiditis (HT) all belonging to IFN-α group (8/49, 16.3%), while no HT cases were found in the naïve group. Overall, 7/113 (6.2%) patients were hypothyroid: 3/64 (4.7%) belonging to naïve group and 4/49 (8.2%) to IFN-α group. Furthermore, a total of 8/113 patients (7.1%) showed subclinical hyperthyroidism: 2/64 (3.1%) were from naïve group and 6/49 (12.2%) from IFN-α group. Interestingly, after DAAs therapy, no new cases of HT, hypothyroidism and hyperthyroidism was found in all series, while 6/11 (54.5%) patients with non-autoimmune subclinical thyroid dysfunction became euthyroid. Finally, the only association between viral genotypes and thyroid alterations was genotype 1 and hypothyroidism. CONCLUSIONS This study supports evidence that DAAs have a limited or missing influence on thyroid in patients with HCV-related diseases. Moreover, it provides preliminary evidence that subclinical non-autoimmune thyroid dysfunction may improve after HCV infection resolution obtained by DAAs.
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Affiliation(s)
- R Rodia
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - P E Meloni
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - C Mascia
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - C Balestrieri
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - V Ruggiero
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - G Serra
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - M Conti
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - M Loi
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - F Pes
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - S Onali
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - A Perra
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - R Littera
- Complex Structure of Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - F Velluzzi
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - S Mariotti
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - L Chessa
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - F Boi
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy.
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Apicella M, Serra G, Iannoni ME, Trasolini M, Maglio G, Andracchio E, Vicari S. Gender Differences in the Psychopathology of Mixed Depression in Adolescents with a Major Depressive Episode. Curr Neuropharmacol 2023; 21:1343-1354. [PMID: 36237159 PMCID: PMC10324339 DOI: 10.2174/1570159x20666221012113458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Gender differences have been reported in the severity and psychopathological features of major depressive disorders among adults but are poorly reported in adolescent samples. OBJECTIVE This study aimed to examine gender differences in the psychopathology of mixed depression among adolescents. METHODS We analyzed 341 outpatients with the current major depressive episode (MDE) retrospectively to identify patients with DSM-5 MDE with mixed features. We compared examiner-rated depressive and (hypo)manic symptoms and self- and parent-reported symptoms between sexes. RESULTS We identified 76 patients with an MDE with mixed features (67.1% females, 32.9% with bipolar disorder). Depression severity was significantly greater in females versus males (CDRS-R total score 56.2 vs. 48.2, p = 0.014). Depressive symptoms were significantly and independently found to be more severe among females in a logistic regression model, including excessive fatigue (OR 1.68; p = 0.025), low self-esteem (OR 1.67; p = 0.04), excessive weeping (OR 1.62; p = 0.021), and CBCL AAA index (OR 1.04; p = 0.015). None of the depressive symptoms scored greater in males. Males had higher levels of motor activity (2.12 vs. 1.69; p = 0.048) and pressured speech (1.80 vs. 1.24; p = 0.004). Self-rated anxiety (69.3 vs. 56.8, p = 0.047) and CBCL AAA index (207 vs. 189; p = 0.007) were higher in females. CONCLUSION Adolescent depression with mixed features is more severe in women, with a higher expression of core affective symptoms and excessive fatigue. While in males, slightly higher levels of psychomotor activation are reported, in females, emotional dysregulation and excessive weeping may subtend a difference in a broader spectrum of mixed features.
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Affiliation(s)
- Massimo Apicella
- Department of Neuroscience, Child Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Giulia Serra
- Department of Neuroscience, Child Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Maria Elena Iannoni
- Department of Neuroscience, Child Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Monia Trasolini
- Department of Neuroscience, Child Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Gino Maglio
- Department of Neuroscience, Child Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Elisa Andracchio
- Department of Neuroscience, Child Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Department of Neuroscience, Child Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Life Sciences and Public Health, Catholic University, Rome, Italy
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Uchida M, Bukhari Q, DiSalvo M, Green A, Serra G, Hutt Vater C, Ghosh SS, Faraone SV, Gabrieli JDE, Biederman J. Can machine learning identify childhood characteristics that predict future development of bipolar disorder a decade later? J Psychiatr Res 2022; 156:261-267. [PMID: 36274531 PMCID: PMC9999264 DOI: 10.1016/j.jpsychires.2022.09.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/26/2022] [Accepted: 09/24/2022] [Indexed: 11/05/2022]
Abstract
Early identification of bipolar disorder may provide appropriate support and treatment, however there is no current evidence for statistically predicting whether a child will develop bipolar disorder. Machine learning methods offer an opportunity for developing empirically-based predictors of bipolar disorder. This study examined whether bipolar disorder can be predicted using clinical data and machine learning algorithms. 492 children, ages 6-18 at baseline, were recruited from longitudinal case-control family studies. Participants were assessed at baseline, then followed-up after 10 years. In addition to sociodemographic data, children were assessed with psychometric scales, structured diagnostic interviews, and cognitive and social functioning assessments. Using the Balanced Random Forest algorithm, we examined whether the diagnostic outcome of full or subsyndromal bipolar disorder could be predicted from baseline data. 45 children (10%) developed bipolar disorder at follow-up. The model predicted subsequent bipolar disorder with 75% sensitivity, 76% specificity, and an Area Under the Receiver Operating Characteristics of 75%. Predictors best differentiating between children who did or did not develop bipolar disorder were the Child Behavioral Checklist Externalizing and Internalizing behaviors, the Child Behavioral Checklist Total t-score, problematic school functions indexed through the Child Behavioral Checklist School Competence scale, and the Child Behavioral Checklist Anxiety/Depression and Aggression scales. Our study provides the first quantitative model to predict bipolar disorder. Longitudinal prediction may help clinicians assess children with emergent psychopathology for future risk of bipolar disorder, an area of clinical and scientific importance. Machine learning algorithms could be implemented to alert clinicians to risk for bipolar disorder.
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Affiliation(s)
- Mai Uchida
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Qasim Bukhari
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Maura DiSalvo
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Allison Green
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Giulia Serra
- Department of Neuroscience, Child Neuropsychiatry Unit, I.R.C.C.S. Children Hospital Bambino Gesù, Rome, Italy
| | - Chloe Hutt Vater
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Satrajit S Ghosh
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Otolaryngology Head and Neck Surgery, Harvard Medical School, USA
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - John D E Gabrieli
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Joseph Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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11
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Fenu G, Oppo V, Serra G, Lorefice L, Di Sfefano F, Deagostini D, Mancosu C, Fadda E, Melis C, Siotto P, Cocco E, Melis M, Cossu G. Relationship between CSF tau biomarkers and structural brain MRI measures in frontotemporal lobar degeneration. J Neurol Sci 2022; 442:120415. [PMID: 36115219 DOI: 10.1016/j.jns.2022.120415] [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: 03/03/2022] [Revised: 08/08/2022] [Accepted: 09/05/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Recently in the field neurodegenerative diseases increasing attention has been pointed to CSF biomarkers and their integration with neuroimaging (1). Frontotemporal lobar degeneration (FTLD) refers to a heterogeneous group of clinical syndromes with different underlying proteinopathies including tau pathology. CSF biomarkers have been proposed as diagnostic and prognostic factors. Aim of our study was to evaluate the relationship between CSF tau biomarkers and structural MRI brain measures in FTLD. METHODS We included early FTLD patient. All included patients underwent lumbar puncture to evaluate amyloid, total-tau (t-tau), phospho-tau 181 (p-tau); p-tau/t-tau ratio was also calculated; brain MRI was performed to estimate whole brain volume, volume of principal deep grey matter structures and regional cortical thickness. RESULTS Demographic characteristics of the 28 included patients were as follows: female/male: 9/19; mean ± SD age: 68.1 ± 7.8 years. The p-tau/t-tau ratio was significantly correlated with whole brain volume (r = 0.69; p: 0.001), left putamen volume (r = 0.55 p: 0.009), left pallidum volume (r = 0.41; p: 0.01), right accumbens area (r = 0.47; p: 0.02). P-tau/t tau ratio showed also a significant correlation with cortical thickness of left temporal lobe (r = 0.74; p: 0.001) and right lateral orbital frontal cortex (r = 0.45; p: 0.03). Linear regression showed a significant relationship between p-tau/t-tau ratio and left temporal pole (p = 0.01; r2: 0.60) and brain volume (p:0.002; r2: 0.56) after controlling for age and gender. CONCLUSIONS Our data suggest that CSF biomarkers, especially p-tau/t-tau ratio, could play a role as prognostic factor in FTLD. Further longitudinal investigations are needed to confirm these findings.
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Affiliation(s)
- Giuseppe Fenu
- Department of Neuroscience, ARNAS Brotzu, Cagliari, Italy.
| | - Valentina Oppo
- Department of Neuroscience, ARNAS Brotzu, Cagliari, Italy
| | - Giulia Serra
- Department of Neuroscience, ARNAS Brotzu, Cagliari, Italy
| | - Lorena Lorefice
- Multiple Sclerosis Centre, University of Cagliari, Cagliari, Italy
| | | | | | - Cristina Mancosu
- Multiple Sclerosis Centre, University of Cagliari, Cagliari, Italy
| | - Elisabetta Fadda
- Multiple Sclerosis Centre, University of Cagliari, Cagliari, Italy
| | - Cristina Melis
- Multiple Sclerosis Centre, University of Cagliari, Cagliari, Italy
| | | | - Eleonora Cocco
- Multiple Sclerosis Centre, University of Cagliari, Cagliari, Italy
| | - Maurizio Melis
- Department of Neuroscience, ARNAS Brotzu, Cagliari, Italy
| | - Giovanni Cossu
- Department of Neuroscience, ARNAS Brotzu, Cagliari, Italy
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12
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Serra G, De Crescenzo F, Maisto F, Galante JR, Iannoni ME, Trasolini M, Maglio G, Tondo L, Baldessarini RJ, Vicari S. Suicidal behavior in juvenile bipolar disorder and major depressive disorder patients: Systematic review and meta-analysis. J Affect Disord 2022; 311:572-581. [PMID: 35588913 DOI: 10.1016/j.jad.2022.05.063] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/02/2022] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To assess rates and lethality of suicidal behavior in studies of children and adolescents diagnosed with major depressive disorder (MDD) or bipolar disorder (BD). METHODS This PROSPERO-registered protocol (CRD-42019159676) systematically reviewed reports on suicidal behavior among juveniles (age ≤ 18 years), and pooled data on risk (% of subjects) and rates (%/year), followed by random-effects meta-analysis and multivariable linear regression modeling. RESULTS Included were 41 reports (1995-2020) from 15 countries involving 104,801 juveniles (102,519 diagnosed with MDD, 2282 with BD), at risk for 0.80-12.5 years. Meta-analytically pooled suicide attempter-rates averaged 7.44%/year [95%CI: 5.63-9.25] with BD and 6.27%/year [5.13-7.41] with MDD. Meta-analysis of 5 studies with both diagnostic groups found significantly greater attempt risk with BD vs. MDD (OR = 1.59 [1.24-2.05], p < 0.0001). In 6 studies, suicide rate with juvenile mood disorders averaged 125 [56.9-236]/100,000/year, similar to adult rates, >30-times greater than in the general juvenile population, and higher among older adolescents. The ratio of attempts/suicides (A/S) was 52.6 among mood-disordered juveniles, indicating greater lethality than among juveniles in the general population (A/S ≥ 250), but somewhat less than in the estimated adult general population (A/S ca. 30). CONCLUSIONS Rates of suicide attempts in juveniles with a major mood disorder averaged 6580/100,000/year, were greater in BD versus MDD observed under the same conditions, and greater with shorter periods of observation. Lethality (fatalities per suicide attempt) was greater in juveniles diagnosed with major affective disorders than in the juvenile general population, but less than in adults.
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Affiliation(s)
- Giulia Serra
- Child Neuropsychiatry Unit, Department of Neuroscience, IRCCS Bambino Gesù Pediatric Hospital, Rome, Italy; International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA.
| | | | - Francesco Maisto
- Dipartimento di Salute Mentale e delle Patologie da Dipendenza, ASL-FR, Frosinone, Italy
| | - João R Galante
- Oxford University Hospitals NHS Foundation Trust, Oxford, England, UK
| | - Maria Elena Iannoni
- Child Neuropsychiatry Unit, Department of Neuroscience, IRCCS Bambino Gesù Pediatric Hospital, Rome, Italy
| | - Monia Trasolini
- Child Neuropsychiatry Unit, Department of Neuroscience, IRCCS Bambino Gesù Pediatric Hospital, Rome, Italy
| | - Gino Maglio
- Child Neuropsychiatry Unit, Department of Neuroscience, IRCCS Bambino Gesù Pediatric Hospital, Rome, Italy
| | - Leonardo Tondo
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Centro Lucio Bini, Rome, Italy; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Ross J Baldessarini
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Stefano Vicari
- Child Neuropsychiatry Unit, Department of Neuroscience, IRCCS Bambino Gesù Pediatric Hospital, Rome, Italy; Child Neuropsychiatry, Catholic University of the Sacred Heart, Rome, Italy
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13
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Castaldo L, Serra G, Piga S, Reale A, Vicari S. Suicidal behaviour and non-suicidal self-injury in children and adolescents seen at an Italian paediatric emergency department. Ann Ist Super Sanita 2021; 56:303-314. [PMID: 32959796 DOI: 10.4415/ann_20_03_08] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Increasing rates of non-fatal self-harm amongst adolescents represent growing concern. The objective of the study is to describe non-fatal self-harm - including suicidal behaviour (SB), suicidal ideation (SI) and non-suicidal self-injury (NSSI) - observed at an Italian paediatric emergency department (ED). METHODS Retrospective analysis of the clinical records of patients admitted to ED from 2011 to 2016, who underwent child psychiatry consultation (CPc). We analyzed: rates of CPc for SB, SI and NSSI; risk factors for SB and SI in patients admitted to the hospital's Child Psychiatry Unit after a CPc; and, correlations between NSSI and SB/SI. RESULTS The rate of CPc for SB, SI and NSSI switched from 7.7% in 2011 to 19% in 2016, with a statistically significant increase over the years (p < 0.001), a 2.2:1 female/male ratio, and an average age of 15.5 ± 1.8 years. SB consisted mainly in drug poisoning (53%), with a significant prevalence in female. Mood disorder was identified in 82.5% of patients hospitalized for SB or SI. Substance abuse was more frequently found in patients admitted for SB when compared to the SI group. Almost half (48%) of the patients admitted for SB or SI reported a current or lifelong history of NSSI. In patients admitted for SB or SI, 3 factors were significantly and independently associated with NSSI: being female, substance abuse, and more severe depressive symptoms. CONCLUSIONS Between 2011 and 2016, there was a significant growing need for CP consultations for suicidal behaviours, mainly in female adolescents. The subjects admitted for SI or SB, who also presented NSSI, were mainly substance abusers, and presented with more severe depressive symptoms.
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Affiliation(s)
- Laura Castaldo
- Unità di Neuropsichiatria Infantile, Dipartimento di Neuroscience, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Giulia Serra
- Unità di Neuropsichiatria Infantile, Dipartimento di Neuroscience, Ospedale Pediatrico Bambino Gesù, Rome, Italy - Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, Italy
| | - Simone Piga
- Unità di Epidemiologia Clinica, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Antonino Reale
- Dipartimento di Pediatria dell'Emergenza, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Stefano Vicari
- Unità di Neuropsichiatria Infantile, Dipartimento di Neuroscience, Ospedale Pediatrico Bambino Gesù, Rome, Italy - Dipartimento di Psichiatria, Università Cattolica del Sacro Cuore, Rome, Italy
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14
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Serra G, Iannoni ME, Trasolini M, Maglio G, Frattini C, Casini MP, Baldessarini RJ, Vicari S. Characteristics Associated with Depression Severity in 270 Juveniles in a Major Depressive Episode. Brain Sci 2021; 11:440. [PMID: 33805486 PMCID: PMC8066522 DOI: 10.3390/brainsci11040440] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/13/2021] [Accepted: 03/16/2021] [Indexed: 12/18/2022] Open
Abstract
Introduction: Severe depression is prevalent in young persons and can lead to disability and elevated suicidal risk. Objectives: To identify clinical and demographic factors associated with the severity of depression in juveniles diagnosed with a major mood disorder, as a contribution to improving clinical treatment and reducing risk of suicide. Methods: We analyzed factors associated with depression severity in 270 juveniles (aged 6-18 years) in a major depressive episode, evaluated and treated at the Bambino Gesù Children's Hospital of Rome. Depressive symptoms were rated with the revised Children's Depression Rating Scale (CDRS-R) and manic symptoms with the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) Mania Rating Scale (K-SADS-MRS). Bivariate comparisons were followed by multivariable linear regression modeling. Results: Depression severity was greater among females than males (55.0 vs. 47.2), with the diagnosis of a major depressive disorder (MDD) vs. bipolar disorder (BD; 53.8 vs. 49.3), and tended to increase with age (slope = 1.14). Some symptoms typical of mania were associated with greater depression severity, including mood lability, hallucinations, delusions, and irritability, whereas less likely symptoms were hyperactivity, pressured speech, grandiosity, high energy, and distractibility. Factors independently and significantly associated with greater depression severity in multivariable linear regression modeling were: MDD vs. BD diagnosis, female sex, higher anxiety ratings, mood lability, and irritability. Conclusions: Severe depression was significantly associated with female sex, the presence of some manic or psychotic symptoms, and with apparent unipolar MDD. Manic/psychotic symptoms should be assessed carefully when evaluating a juvenile depressive episode and considered in treatment planning in an effort to balance risks of antidepressants and the potential value of mood-stabilizing and antimanic agents to decrease the severity of acute episodes and reduce suicidal risk.
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Affiliation(s)
- Giulia Serra
- Child Neuropsychiatry Unit, Department of Neuroscience, I.R.C.C.S. Children Hospital Bambino Gesù, 00165 Rome, Italy; (M.E.I.); (M.T.); (G.M.); (C.F.); (M.P.C.); (S.V.)
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA 02478, USA;
| | - Maria Elena Iannoni
- Child Neuropsychiatry Unit, Department of Neuroscience, I.R.C.C.S. Children Hospital Bambino Gesù, 00165 Rome, Italy; (M.E.I.); (M.T.); (G.M.); (C.F.); (M.P.C.); (S.V.)
| | - Monia Trasolini
- Child Neuropsychiatry Unit, Department of Neuroscience, I.R.C.C.S. Children Hospital Bambino Gesù, 00165 Rome, Italy; (M.E.I.); (M.T.); (G.M.); (C.F.); (M.P.C.); (S.V.)
| | - Gino Maglio
- Child Neuropsychiatry Unit, Department of Neuroscience, I.R.C.C.S. Children Hospital Bambino Gesù, 00165 Rome, Italy; (M.E.I.); (M.T.); (G.M.); (C.F.); (M.P.C.); (S.V.)
| | - Camilla Frattini
- Child Neuropsychiatry Unit, Department of Neuroscience, I.R.C.C.S. Children Hospital Bambino Gesù, 00165 Rome, Italy; (M.E.I.); (M.T.); (G.M.); (C.F.); (M.P.C.); (S.V.)
- Department of Clinical and Dynamic Psychology, Medicine and Psychology Faculty, Sapienza University of Rome, 00185 Rome, Italy
| | - Maria Pia Casini
- Child Neuropsychiatry Unit, Department of Neuroscience, I.R.C.C.S. Children Hospital Bambino Gesù, 00165 Rome, Italy; (M.E.I.); (M.T.); (G.M.); (C.F.); (M.P.C.); (S.V.)
- Psychiatric Emergency in adolescence Departmental Unit Umberto I General Hospital, 00161 Rome, Italy
| | - Ross J. Baldessarini
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA 02478, USA;
- Department of Psychiatry, Harvard Medical School, Boston, MA 02478, USA
| | - Stefano Vicari
- Child Neuropsychiatry Unit, Department of Neuroscience, I.R.C.C.S. Children Hospital Bambino Gesù, 00165 Rome, Italy; (M.E.I.); (M.T.); (G.M.); (C.F.); (M.P.C.); (S.V.)
- Child Neuropsychiatry, Catholic University, 00168 Rome, Italy
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15
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Alfieri P, Cumbo F, Serra G, Trasolini M, Frattini C, Scibelli F, Licchelli S, Cirillo F, Caciolo C, Casini MP, D’Amico A, Tartaglia M, Digilio MC, Capolino R, Vicari S. Manic and Depressive Symptoms in Children Diagnosed with Noonan Syndrome. Brain Sci 2021; 11:brainsci11020233. [PMID: 33668418 PMCID: PMC7918671 DOI: 10.3390/brainsci11020233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/01/2021] [Accepted: 02/08/2021] [Indexed: 12/12/2022] Open
Abstract
Noonan syndrome (NS) is a dominant clinically variable and genetically heterogeneous developmental disorder caused by germ-line mutations encoding components of the Ras–MAPK signaling pathway. A few studies have investigated psychopathological features occurring in individuals with NS, although they were poorly analyzed. The aim of the present work is to investigate the psychopathological features in children and adolescents with NS focusing on depressive and hypo-manic symptoms. Thirty-seven subjects with molecularly confirmed diagnosis were systematically evaluated through a psychopathological assessment. In addition, an evaluation of the cognitive level was performed. Our analyses showed a high recurrence of attention deficit and hyperactivity disorder symptoms, emotional dysregulation, irritability, and anxiety symptomatology. The mean cognitive level was on the average. The present study provides new relevant information on psychopathological features in individuals with NS. The implications for clinicians are discussed including the monitoring of mood disorders in a clinical evolution.
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Affiliation(s)
- Paolo Alfieri
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.C.); (G.S.); (M.T.); (C.F.); (F.S.); (S.L.); (F.C.); (C.C.); (M.P.C.); (S.V.)
- Correspondence: ; Tel.: +39-0668594721
| | - Francesca Cumbo
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.C.); (G.S.); (M.T.); (C.F.); (F.S.); (S.L.); (F.C.); (C.C.); (M.P.C.); (S.V.)
| | - Giulia Serra
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.C.); (G.S.); (M.T.); (C.F.); (F.S.); (S.L.); (F.C.); (C.C.); (M.P.C.); (S.V.)
| | - Monia Trasolini
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.C.); (G.S.); (M.T.); (C.F.); (F.S.); (S.L.); (F.C.); (C.C.); (M.P.C.); (S.V.)
| | - Camilla Frattini
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.C.); (G.S.); (M.T.); (C.F.); (F.S.); (S.L.); (F.C.); (C.C.); (M.P.C.); (S.V.)
| | - Francesco Scibelli
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.C.); (G.S.); (M.T.); (C.F.); (F.S.); (S.L.); (F.C.); (C.C.); (M.P.C.); (S.V.)
| | - Serena Licchelli
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.C.); (G.S.); (M.T.); (C.F.); (F.S.); (S.L.); (F.C.); (C.C.); (M.P.C.); (S.V.)
- Fondazione UILDM Lazio Onlus, 00167, Rome, Italy
| | - Flavia Cirillo
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.C.); (G.S.); (M.T.); (C.F.); (F.S.); (S.L.); (F.C.); (C.C.); (M.P.C.); (S.V.)
| | - Cristina Caciolo
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.C.); (G.S.); (M.T.); (C.F.); (F.S.); (S.L.); (F.C.); (C.C.); (M.P.C.); (S.V.)
| | - Maria Pia Casini
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.C.); (G.S.); (M.T.); (C.F.); (F.S.); (S.L.); (F.C.); (C.C.); (M.P.C.); (S.V.)
- Section of Child and Adolescent Neurology and Psychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00161 Rome, Italy
| | - Adele D’Amico
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (M.T.); (M.C.D.); (R.C.)
| | - Maria Cristina Digilio
- Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (M.T.); (M.C.D.); (R.C.)
| | - Rossella Capolino
- Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (M.T.); (M.C.D.); (R.C.)
| | - Stefano Vicari
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.C.); (G.S.); (M.T.); (C.F.); (F.S.); (S.L.); (F.C.); (C.C.); (M.P.C.); (S.V.)
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Oppo V, Serra G, Fenu G, Murgia D, Ricciardi L, Melis M, Morgante F, Cossu G. Parkinson's Disease Symptoms Have a Distinct Impact on Caregivers' and Patients' Stress: A Study Assessing the Consequences of the COVID-19 Lockdown. Mov Disord Clin Pract 2020; 7:865-867. [PMID: 33043088 DOI: 10.1002/mdc3.13030] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/06/2020] [Accepted: 07/19/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- Valentina Oppo
- Department of Neuroscience Movement Disorders and Neurophysiology Unit Cagliari Italy
| | - Giulia Serra
- Department of Neuroscience Movement Disorders and Neurophysiology Unit Cagliari Italy
| | - Giuseppe Fenu
- Department of Neuroscience Movement Disorders and Neurophysiology Unit Cagliari Italy
| | - Daniela Murgia
- Department of Neuroscience Movement Disorders and Neurophysiology Unit Cagliari Italy
| | - Lucia Ricciardi
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London London UK.,MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences Oxford UK
| | - Maurizio Melis
- Department of Neuroscience Movement Disorders and Neurophysiology Unit Cagliari Italy
| | - Francesca Morgante
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London London UK.,Department of Experimental and Clinical Medicine University of Messina Messina Italy
| | - Giovanni Cossu
- Department of Neuroscience Movement Disorders and Neurophysiology Unit Cagliari Italy
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17
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Serra G, Koukopoulos A, De Chiara L, Koukopoulos A, Sani G, Tondo L, Girardi P, Reginaldi D, Baldessarini R. Early clinical predictors and correlates of long-term morbidity in bipolar disorder. Eur Psychiatry 2020; 43:35-43. [DOI: 10.1016/j.eurpsy.2017.02.480] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/31/2017] [Accepted: 02/06/2017] [Indexed: 10/20/2022] Open
Abstract
AbstractObjectives:Identifying factors predictive of long-term morbidity should improve clinical planning limiting disability and mortality associated with bipolar disorder (BD).Methods:We analyzed factors associated with total, depressive and mania-related long-term morbidity and their ratio D/M, as %-time ill between a first-lifetime major affective episode and last follow-up of 207 BD subjects. Bivariate comparisons were followed by multivariable linear regression modeling.Results:Total % of months ill during follow-up was greater in 96 BD-II (40.2%) than 111 BD-I subjects (28.4%; P = 0.001). Time in depression averaged 26.1% in BD-II and 14.3% in BD-I, whereas mania-related morbidity was similar in both, averaging 13.9%. Their ratio D/M was 3.7-fold greater in BD-II than BD-I (5.74 vs. 1.96; P < 0.0001). Predictive factors independently associated with total %-time ill were: [a] BD-II diagnosis, [b] longer prodrome from antecedents to first affective episode, and [c] any psychiatric comorbidity. Associated with %-time depressed were: [a] BD-II diagnosis, [b] any antecedent psychiatric syndrome, [c] psychiatric comorbidity, and [d] agitated/psychotic depressive first affective episode. Associated with %-time in mania-like illness were: [a] fewer years ill and [b] (hypo)manic first affective episode. The long-term D/M morbidity ratio was associated with: [a] anxious temperament, [b] depressive first episode, and [c] BD-II diagnosis.Conclusions:Long-term depressive greatly exceeded mania-like morbidity in BD patients. BD-II subjects spent 42% more time ill overall, with a 3.7-times greater D/M morbidity ratio, than BD-I. More time depressed was predicted by agitated/psychotic initial depressive episodes, psychiatric comorbidity, and BD-II diagnosis. Longer prodrome and any antecedent psychiatric syndrome were respectively associated with total and depressive morbidity.
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Serra G, Koukopoulos A, De Chiara L, Koukopoulos AE, Sani G, Tondo L, Girardi P, Reginaldi D, Baldessarini RJ. Early clinical predictors of long-term morbidity in major depressive disorder. Early Interv Psychiatry 2019; 13:999-1002. [PMID: 30511367 DOI: 10.1111/eip.12768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 06/04/2018] [Accepted: 11/04/2018] [Indexed: 11/29/2022]
Abstract
AIMS To identify early clinical factors predictive of later morbidity in major depressive disorder (MDD). METHODS We analysed factors associated with long-term depressive morbidity (%-time ill) between a first-lifetime major depressive episode and last follow-up of 116 adults diagnosed with DSM-IV major depressive disorder. Bivariate comparisons were followed by multivariable linear regression modelling. RESULTS Three factors were independently associated with an average of 25%-time-depressed over 17 years at risk: (a) agitated-mixed, or psychotic features in initial major depressive episodes, (b) anxiety syndromes prior to a first-lifetime major depressive episode, and (c) anxiety symptoms in childhood. CONCLUSION Early anxiety symptoms and syndromes and agitated-mixed or psychotic initial depressive episodes predicted more long-term depressive morbidity in MDD.
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Affiliation(s)
- Giulia Serra
- Child Psychiatry Unit, Dept. of Neuroscience, I.R.C.C.S. Children Hospital Bambino Gesù, Rome, Italy.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, Massachusetts.,Lucio Bini Mood Disorder Center, Rome, Italy
| | - Athanasios Koukopoulos
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, Massachusetts.,Lucio Bini Mood Disorder Center, Rome, Italy
| | - Lavinia De Chiara
- NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Alexia E Koukopoulos
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Lucio Bini Mood Disorder Center, Rome, Italy
| | - Gabriele Sani
- Lucio Bini Mood Disorder Center, Rome, Italy.,NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Leonardo Tondo
- Child Psychiatry Unit, Dept. of Neuroscience, I.R.C.C.S. Children Hospital Bambino Gesù, Rome, Italy.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, Massachusetts.,Lucio Bini Mood Disorder Center, Cagliari, Sardinia, Italy
| | - Paolo Girardi
- Lucio Bini Mood Disorder Center, Rome, Italy.,NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Daniela Reginaldi
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, Massachusetts.,Lucio Bini Mood Disorder Center, Rome, Italy
| | - Ross J Baldessarini
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, Massachusetts
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19
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Lau B, Meier N, Serra G, Czernecki V, Schuepbach M, Navarro S, Cornu P, Grabli D, Agid Y, Vidailhet M, Karachi C, Welter ML. Axial symptoms predict mortality in patients with Parkinson disease and subthalamic stimulation. Neurology 2019; 92:e2559-e2570. [PMID: 31043471 PMCID: PMC6556086 DOI: 10.1212/wnl.0000000000007562] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 01/25/2019] [Indexed: 12/01/2022] Open
Abstract
Objective To characterize how disease progression is associated with mortality in a large cohort of patients with Parkinson disease (PD) with long-term follow-up after subthalamic nucleus deep brain stimulation (STN-DBS). Methods Motor and cognitive disabilities were assessed before and 1, 2, 5, and 10 years after STN-DBS in 143 consecutive patients with PD. We measured motor symptoms “off” and “on” levodopa and STN-DBS and recorded causes of death. We used linear mixed models to characterize symptom progression, including interactions between treatment conditions and time to determine how treatments changed efficacy. We used joint models to link symptom progression to mortality. Results Median observation time was 12 years after surgery, during which akinesia, rigidity, and axial symptoms worsened, with mean increases of 8.8 (SD 6.5), 1.8 (3.1), and 5.4 (4.1) points from year 1–10 after surgery (“on” dopamine/“on” STN-DBS), respectively. Responses to dopaminergic medication and STN-DBS were attenuated with time, but remained effective for all except axial symptoms, for which both treatments and their combination were predicted to be ineffective 20 years after surgery. Cognitive status significantly declined. Forty-one patients died, with a median time to death of 9 years after surgery. The current level of axial disability was the only symptom that significantly predicted death (hazard ratio 4.30 [SE 1.50] per unit of square-root transformed axial score). Conclusions We quantified long-term symptom progression and attenuation of dopaminergic medication and STN-DBS treatment efficacy in patients with PD and linked symptom progression to mortality. Axial disability significantly predicts individual risk of death after surgery, which may be useful for planning therapeutic strategies in PD.
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Affiliation(s)
- Brian Lau
- From INSERM 1127 (B.L., N.M., Y.A., M.V., C.K., M.-L.W.), Sorbonne Universités, Université Pierre et Marie Curie-Paris Université Paris 06 6, Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France; Department of Neurology (N.M., M.S.), Hôpital Universitaire de Bern, Switzerland; Clinical Investigation Centre (N.M., G.S.), Department of Neurology (V.C., D.G., M.V.), and Department of Neurosurgery (S.N., P.C., C.K.), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; and Department of Neurophysiology (M.-L.W.), CHU Charles Nicolle, Rouen University, France.
| | - Niklaus Meier
- From INSERM 1127 (B.L., N.M., Y.A., M.V., C.K., M.-L.W.), Sorbonne Universités, Université Pierre et Marie Curie-Paris Université Paris 06 6, Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France; Department of Neurology (N.M., M.S.), Hôpital Universitaire de Bern, Switzerland; Clinical Investigation Centre (N.M., G.S.), Department of Neurology (V.C., D.G., M.V.), and Department of Neurosurgery (S.N., P.C., C.K.), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; and Department of Neurophysiology (M.-L.W.), CHU Charles Nicolle, Rouen University, France
| | - Giulia Serra
- From INSERM 1127 (B.L., N.M., Y.A., M.V., C.K., M.-L.W.), Sorbonne Universités, Université Pierre et Marie Curie-Paris Université Paris 06 6, Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France; Department of Neurology (N.M., M.S.), Hôpital Universitaire de Bern, Switzerland; Clinical Investigation Centre (N.M., G.S.), Department of Neurology (V.C., D.G., M.V.), and Department of Neurosurgery (S.N., P.C., C.K.), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; and Department of Neurophysiology (M.-L.W.), CHU Charles Nicolle, Rouen University, France
| | - Virginie Czernecki
- From INSERM 1127 (B.L., N.M., Y.A., M.V., C.K., M.-L.W.), Sorbonne Universités, Université Pierre et Marie Curie-Paris Université Paris 06 6, Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France; Department of Neurology (N.M., M.S.), Hôpital Universitaire de Bern, Switzerland; Clinical Investigation Centre (N.M., G.S.), Department of Neurology (V.C., D.G., M.V.), and Department of Neurosurgery (S.N., P.C., C.K.), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; and Department of Neurophysiology (M.-L.W.), CHU Charles Nicolle, Rouen University, France
| | - Michael Schuepbach
- From INSERM 1127 (B.L., N.M., Y.A., M.V., C.K., M.-L.W.), Sorbonne Universités, Université Pierre et Marie Curie-Paris Université Paris 06 6, Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France; Department of Neurology (N.M., M.S.), Hôpital Universitaire de Bern, Switzerland; Clinical Investigation Centre (N.M., G.S.), Department of Neurology (V.C., D.G., M.V.), and Department of Neurosurgery (S.N., P.C., C.K.), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; and Department of Neurophysiology (M.-L.W.), CHU Charles Nicolle, Rouen University, France
| | - Soledad Navarro
- From INSERM 1127 (B.L., N.M., Y.A., M.V., C.K., M.-L.W.), Sorbonne Universités, Université Pierre et Marie Curie-Paris Université Paris 06 6, Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France; Department of Neurology (N.M., M.S.), Hôpital Universitaire de Bern, Switzerland; Clinical Investigation Centre (N.M., G.S.), Department of Neurology (V.C., D.G., M.V.), and Department of Neurosurgery (S.N., P.C., C.K.), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; and Department of Neurophysiology (M.-L.W.), CHU Charles Nicolle, Rouen University, France
| | - Philippe Cornu
- From INSERM 1127 (B.L., N.M., Y.A., M.V., C.K., M.-L.W.), Sorbonne Universités, Université Pierre et Marie Curie-Paris Université Paris 06 6, Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France; Department of Neurology (N.M., M.S.), Hôpital Universitaire de Bern, Switzerland; Clinical Investigation Centre (N.M., G.S.), Department of Neurology (V.C., D.G., M.V.), and Department of Neurosurgery (S.N., P.C., C.K.), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; and Department of Neurophysiology (M.-L.W.), CHU Charles Nicolle, Rouen University, France
| | - David Grabli
- From INSERM 1127 (B.L., N.M., Y.A., M.V., C.K., M.-L.W.), Sorbonne Universités, Université Pierre et Marie Curie-Paris Université Paris 06 6, Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France; Department of Neurology (N.M., M.S.), Hôpital Universitaire de Bern, Switzerland; Clinical Investigation Centre (N.M., G.S.), Department of Neurology (V.C., D.G., M.V.), and Department of Neurosurgery (S.N., P.C., C.K.), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; and Department of Neurophysiology (M.-L.W.), CHU Charles Nicolle, Rouen University, France
| | - Yves Agid
- From INSERM 1127 (B.L., N.M., Y.A., M.V., C.K., M.-L.W.), Sorbonne Universités, Université Pierre et Marie Curie-Paris Université Paris 06 6, Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France; Department of Neurology (N.M., M.S.), Hôpital Universitaire de Bern, Switzerland; Clinical Investigation Centre (N.M., G.S.), Department of Neurology (V.C., D.G., M.V.), and Department of Neurosurgery (S.N., P.C., C.K.), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; and Department of Neurophysiology (M.-L.W.), CHU Charles Nicolle, Rouen University, France
| | - Marie Vidailhet
- From INSERM 1127 (B.L., N.M., Y.A., M.V., C.K., M.-L.W.), Sorbonne Universités, Université Pierre et Marie Curie-Paris Université Paris 06 6, Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France; Department of Neurology (N.M., M.S.), Hôpital Universitaire de Bern, Switzerland; Clinical Investigation Centre (N.M., G.S.), Department of Neurology (V.C., D.G., M.V.), and Department of Neurosurgery (S.N., P.C., C.K.), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; and Department of Neurophysiology (M.-L.W.), CHU Charles Nicolle, Rouen University, France
| | - Carine Karachi
- From INSERM 1127 (B.L., N.M., Y.A., M.V., C.K., M.-L.W.), Sorbonne Universités, Université Pierre et Marie Curie-Paris Université Paris 06 6, Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France; Department of Neurology (N.M., M.S.), Hôpital Universitaire de Bern, Switzerland; Clinical Investigation Centre (N.M., G.S.), Department of Neurology (V.C., D.G., M.V.), and Department of Neurosurgery (S.N., P.C., C.K.), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; and Department of Neurophysiology (M.-L.W.), CHU Charles Nicolle, Rouen University, France
| | - Marie-Laure Welter
- From INSERM 1127 (B.L., N.M., Y.A., M.V., C.K., M.-L.W.), Sorbonne Universités, Université Pierre et Marie Curie-Paris Université Paris 06 6, Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France; Department of Neurology (N.M., M.S.), Hôpital Universitaire de Bern, Switzerland; Clinical Investigation Centre (N.M., G.S.), Department of Neurology (V.C., D.G., M.V.), and Department of Neurosurgery (S.N., P.C., C.K.), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris; and Department of Neurophysiology (M.-L.W.), CHU Charles Nicolle, Rouen University, France.
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Alañón ME, Castle SM, Serra G, Lévèques A, Poquet L, Actis-Goretta L, Spencer JPE. Acute study of dose-dependent effects of (-)-epicatechin on vascular function in healthy male volunteers: A randomized controlled trial. Clin Nutr 2019; 39:746-754. [PMID: 31014775 DOI: 10.1016/j.clnu.2019.03.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 12/19/2018] [Revised: 03/24/2019] [Accepted: 03/28/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND & AIMS There is convincing clinical evidence to suggest that flavanol-containing foods/beverages are capable of inducing improvements in human vascular function. However, whilst (-)-epicatechin has been tested for efficacy, a full dose-dependency has yet to be established, particularly at doses below 1 mg/kg BW. The current study examined the dose-dependent effects of (-)-epicatechin on human vascular function with concurrent measurement of plasma (-)-epicatechin metabolites and levels of circulating nitrite and nitrate species, NOx. METHODS An acute, double-blind, placebo-controlled, crossover intervention trial was conducted in 20 healthy males with 4 treatment arms: water-based (-)-epicatechin (0.1, 0.5 and 1.0 mg/kg BW) and a water only as control. Vascular function was assessed by flow-mediated dilatation (FMD) measured at the brachial artery, laser Doppler imaging with iontophoresis (LDI) at the subcutaneous capillaries of the forearm (response to Ach and SNP) and peripheral blood pressure (BP) at baseline, 1, 2, 4 and 6 h post-intervention. Plasma analysis of epicatechin metabolites was conducted by LC-MS and circulating plasma of nitrite and nitrate species were performed using an HPLC-based system (ENO-30). RESULTS Significant increases in % FMD were found to occur at 1 and 2 h following intake of 1 mg/kg BW, and at 2 h for the 0.5 mg/kg BW intake. There were no significant changes in LDI or BP at any time-points or intake levels. Increases in FMD over the 6 h timeframe were closely paralleled by the appearance of total plasma (-)-epicatechin metabolites. Non-significant changes in circulating NOx was observed. CONCLUSIONS Our data add further evidence that (-)-epicatechin is a causal vasoactive molecule within flavanol-containing foods/beverages. In addition, we show for the first time that intake levels as low as 0.5 mg/kg BW are capable of inducing acute improvements in vascular function (FMD) in healthy volunteers.
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Affiliation(s)
- M E Alañón
- Regional Institute for Applied Scientific Research (IRICA), Area of Food Science and Technology, University of Castilla-La Mancha, Avd. Camilo José Cela 10, 13071, Ciudad Real, Spain; Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, PO Box 226, RG2 6AP, Reading, United Kingdom.
| | - S M Castle
- Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, PO Box 226, RG2 6AP, Reading, United Kingdom
| | - G Serra
- Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, PO Box 226, RG2 6AP, Reading, United Kingdom
| | - A Lévèques
- Nestlé Research, 1026 Lausanne, Switzerland
| | - L Poquet
- Nestlé Research, 1026 Lausanne, Switzerland
| | | | - J P E Spencer
- Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, PO Box 226, RG2 6AP, Reading, United Kingdom
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Serra G, Uchida M, Battaglia C, Casini MP, De Chiara L, Biederman J, Vicari S, Wozniak J. Pediatric Mania: The Controversy between Euphoria and Irritability. Curr Neuropharmacol 2018; 15:386-393. [PMID: 28503110 PMCID: PMC5405608 DOI: 10.2174/1570159x14666160607100403] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 05/10/2016] [Accepted: 05/24/2016] [Indexed: 01/19/2023] Open
Abstract
Abstract: Pediatric Bipolar Disorder (BD) is a highly morbid pediatric psychiatric disease, consistently associated with family psychiatric history of mood disorders and associated with high levels of morbidity and disability and with a great risk of suicide. While there is a general consensus on the symptomatology of depression in childhood, the phenomenology of pediatric mania is still highly debated and the course and long-term outcome of pediatric BD still need to be clarified. We reviewed the available studies on the phenomenology of pediatric mania with the aim of summarizing the prevalence, demographics, clinical correlates and course of these two types of pediatric mania. Eighteen studies reported the number of subjects presenting with either irritable or elated mood during mania. Irritability has been reported to be the most frequent clinical feature of pediatric mania reaching a sensitivity of 95–100% in several samples. Only half the studies reviewed reported on number of episodes or cycling patterns and the described course was mostly chronic and ultra-rapid whereas the classical episodic presentation was less common. Few long-term outcome studies have reported a diagnostic stability of mania from childhood to young adult age. Future research should focus on the heterogeneity of irritability aiming at differentiating distinct subtypes of pediatric psychiatric disorders with distinct phenomenology, course, outcome and biomarkers. Longitudinal studies of samples attending to mood presentation, irritable versus elated, and course, chronic versus episodic, may help clarify whether these are meaningful distinctions in the course, treatment and outcome of pediatric onset bipolar disorder.
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Affiliation(s)
- Giulia Serra
- Child Psychiatry Unit, Department of Neuroscience Bambino Gesù Children's Hospital, IRCCS Rome, Italy.,Lucio Bini Mood Disorder Center, Rome, Italy.,Harvard Medical School, Department of Psychiatry, Boston, MA, United States
| | - Mai Uchida
- Massachusetts General Hospital, Department of Pediatric Psychopharmacology, Boston, MA, United States.,Harvard Medical School, Department of Psychiatry, Boston, MA, United States
| | - Claudia Battaglia
- Child Psychiatry Unit, Department of Neuroscience Bambino Gesù Children's Hospital, IRCCS Rome, Italy
| | - Maria Pia Casini
- Child Psychiatry Unit, Department of Neuroscience Bambino Gesù Children's Hospital, IRCCS Rome, Italy
| | - Lavinia De Chiara
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy.,Lucio Bini Mood Disorder Center, Rome, Italy
| | - Joseph Biederman
- Massachusetts General Hospital, Department of Pediatric Psychopharmacology, Boston, MA, United States.,Harvard Medical School, Department of Psychiatry, Boston, MA, United States
| | - Stefano Vicari
- Child Psychiatry Unit, Department of Neuroscience Bambino Gesù Children's Hospital, IRCCS Rome, Italy
| | - Janet Wozniak
- Massachusetts General Hospital, Department of Pediatric Psychopharmacology, Boston, MA, United States.,Harvard Medical School, Department of Psychiatry, Boston, MA, United States
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22
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Saddi MV, Sarchioto M, Serra G, Murgia D, Ricchi V, Melis M, Arca R, Carreras P, Sitzia L, Zedda S, Dui G, Rossi R, Ticca A, Melis M, Cossu G. Percutaneous Endoscopic Transgastric Jejunostomy (PEG-J) Tube Placement for Levodopa-Carbidopa Intrajejunal Gel Therapy in the Interventional Radiology Suite: A Long-term Follow-up. Mov Disord Clin Pract 2018; 5:191-194. [PMID: 30363413 DOI: 10.1002/mdc3.12569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/23/2017] [Accepted: 11/07/2017] [Indexed: 01/13/2023] Open
Abstract
Background Percutaneous endoscopic gastrojejunostomy (PEG) and radiologically inserted gastrojejunostomy (RIG) are both safe and effective techniques for gastrojejunal tube placement. The authors compared these 2 procedures in patients with advanced Parkinson's disease (PD) who required the continuous intrajejunal delivery of a levodopa/carbidopa gel suspension (LCIG). Methods Outcomes were retrospectively collated from 30 PEG and 12 RIG procedures performed at 2 centers in patients with advanced PD for the delivery of LCIG. Results Baseline clinical characteristics, incidence of early severe adverse events, late major complications, dropout, and the mean time-lapse of tube replacements were comparable in the PEG and RIG groups. Conclusion The current results suggest that, in patients with PD, the RIG technique is as safe and effective as the endoscopic procedure, and it can be considered a valid option for patients who require LCIG when the endoscopic procedure is not available or unfeasible.
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Affiliation(s)
| | - Marianna Sarchioto
- Neurology Department and Stroke Unit Azienda Ospedaliera Brotzu "G. Brotzu" Hospital Cagliari Sardinia Italy.,Department of Medical Sciences University of Cagliari and Public Health Cagliari Cagliari Sardinia Italy
| | - Giulia Serra
- Neurology Department and Stroke Unit S. Francesco Hospital Nuoro Italy
| | - Daniela Murgia
- Neurology Department and Stroke Unit Azienda Ospedaliera Brotzu "G. Brotzu" Hospital Cagliari Sardinia Italy
| | - Valeria Ricchi
- Neurology Department and Stroke Unit Azienda Ospedaliera Brotzu "G. Brotzu" Hospital Cagliari Sardinia Italy
| | - Marta Melis
- Neurology Department and Stroke Unit Azienda Ospedaliera Brotzu "G. Brotzu" Hospital Cagliari Sardinia Italy.,Department of Medical Sciences University of Cagliari and Public Health Cagliari Cagliari Sardinia Italy
| | - Roberta Arca
- Neurology Department and Stroke Unit Azienda Ospedaliera Brotzu "G. Brotzu" Hospital Cagliari Sardinia Italy
| | - Pierpaolo Carreras
- Digestive Endoscopy Service Azienda Ospedaliera Brotzu "G. Brotzu" Hospital Cagliari Sardinia Italy
| | - Loredana Sitzia
- Digestive Endoscopy Service Azienda Ospedaliera Brotzu "G. Brotzu" Hospital Cagliari Sardinia Italy
| | - Sandro Zedda
- Diagnostic Imaging Services Department of Interventional Radiology S. Francesco Hospital Nuoro Italy
| | - Giovanni Dui
- Diagnostic Imaging Services Department of Interventional Radiology S. Francesco Hospital Nuoro Italy
| | - Rosario Rossi
- Neurology Department and Stroke Unit S. Francesco Hospital Nuoro Italy
| | - Anna Ticca
- Neurology Department and Stroke Unit S. Francesco Hospital Nuoro Italy
| | - Maurizio Melis
- Neurology Department and Stroke Unit Azienda Ospedaliera Brotzu "G. Brotzu" Hospital Cagliari Sardinia Italy
| | - Giovanni Cossu
- Neurology Department and Stroke Unit Azienda Ospedaliera Brotzu "G. Brotzu" Hospital Cagliari Sardinia Italy
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Perrino F, Licchelli S, Serra G, Piccini G, Caciolo C, Pasqualetti P, Cirillo F, Leoni C, Digilio MC, Zampino G, Tartaglia M, Alfieri P, Vicari S. Psychopathological features in Noonan syndrome. Eur J Paediatr Neurol 2018; 22:170-177. [PMID: 29037749 DOI: 10.1016/j.ejpn.2017.09.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 07/29/2017] [Accepted: 09/19/2017] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Noonan syndrome (NS) is an autosomal dominant disorder characterized by short stature, skeletal and haematological/lymphatic defects, distinctive facies, cryptorchidism, and a wide spectrum of congenital heart defects. Recurrent features also include variable cognitive deficits and behavioural problems. Recent research has been focused on the assessment of prevalence, age of onset and characterization of psychiatric features in this disorder. Herein, we evaluated the prevalence of attention deficit and hyperactivity disorder (ADHD), anxiety and depressive symptoms and syndromes in a cohort of individuals with clinical and molecular diagnosis of NS. METHODS The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version (K-SADS PL) has been used for the assessment of psychiatric disorders according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Multidimensional Anxiety Scale for Children (MASC) and the Children's Depression Inventory (CDI) have been assessed for the evaluation of anxiety and depressive symptoms and syndromes, whereas Conners Teacher and Parent Rating Scales-long version (CRS-R) have been used to evaluate ADHD. RESULTS The study included 27 individuals (67% males) with an average age of 10.4 years (range 6-18 years) receiving molecular diagnosis of NS or a clinically related condition, evaluated and treated at the Neuropsychiatric Unit of Children's Hospital Bambino Gesù and at the Center for Rare Diseases of Fondazione Policlinico Universitario Agostino Gemelli, in Rome. Twenty individuals showed mutations in PTPN11, five in SOS1 and two in SHOC2. The mean IQ was 94 (Standard Deviation = 17, min = 56, max = 130). Seventy percent of the individuals (n = 19; 95% Confidence Interval = 52-85%) showed ADHD features, with six individuals reaching DSM-IV-TR criteria for ADHD disorder, and thirteen showing subsyndromal traits. Symptoms or syndrome of anxiety were present in 37% of the cohort (n = 10; 95% Confidence Interval = 19-56%), with two individuals showing anxiety disorder and eight cases exhibiting subsyndromal traits. CONCLUSION Our results show individuals with NS do present a very high risk to develop psychiatric disorders or symptoms during paediatric age. Based on these findings, preschool assessment of inattentive, hyperactivity/impulsivity and anxiety/depressive symptoms is recommended in order to plan a personalized treatment for psychological/psychiatric issues in affected individuals. Dedicated prospective studies are required to confirm the present data and better characterize the psychopathological profile in NS.
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Affiliation(s)
- Francesca Perrino
- Center for Rare Diseases, Department of Pediatrics, Polo Salute Donna e Bambino, Fondazione Policlinico Universitario A. Gemelli, Catholic University, Rome, Italy
| | - Serena Licchelli
- Department of Neuroscience, Unit of Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Giulia Serra
- Department of Neuroscience, Unit of Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy; NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, Italy; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Giorgia Piccini
- Department of Neuroscience, Unit of Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Cristina Caciolo
- Department of Neuroscience, Unit of Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Patrizio Pasqualetti
- Service of Medical Statistics and Information Technology, Fatebenefratelli Foundation for Health Research and Education, Rome, Italy; Language and Communication Across Modalities Laboratory (LaCAM), Institute of Cognitive Sciences and Technologies (ISTC-CNR), Italy
| | - Flavia Cirillo
- Department of Neuroscience, Unit of Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Chiara Leoni
- Center for Rare Diseases, Department of Pediatrics, Polo Salute Donna e Bambino, Fondazione Policlinico Universitario A. Gemelli, Catholic University, Rome, Italy
| | - Maria Cristina Digilio
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Giuseppe Zampino
- Center for Rare Diseases, Department of Pediatrics, Polo Salute Donna e Bambino, Fondazione Policlinico Universitario A. Gemelli, Catholic University, Rome, Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Paolo Alfieri
- Department of Neuroscience, Unit of Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Stefano Vicari
- Department of Neuroscience, Unit of Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Serra G, Koukopoulos A, De Chiara L, Napoletano F, Koukopoulos A, Sani G, Faedda GL, Girardi P, Reginaldi D, Baldessarini RJ. Child and Adolescent Clinical Features Preceding Adult Suicide Attempts. Arch Suicide Res 2017; 21:502-518. [PMID: 27673411 DOI: 10.1080/13811118.2016.1227004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The objective of this study was to identify the predictive value of juvenile factors for adult suicidal behavior. We reviewed clinical records to compare factors identified in childhood and adolescence between adult suicidal versus nonsuicidal major affective disorder subjects. Suicide attempts occurred in 23.1% of subjects. Age-at-first-symptom was 14.2 vs. 20.2 years among suicidal versus nonsuicidal subjects (p < 0.0001). More prevalent in suicidal versus non-suicidal subjects by multivariate analysis were: depressive symptoms, hyper-emotionality, younger-at-first-affective-episode, family suicide history, childhood mood-swings, and adolescence low self-esteem. Presence of one factor yielded a Bayesian sensitivity of 64%, specificity of 50%, and negative predictive power of 86%. Several juvenile factors were associated with adult suicidal behavior; their absence was strongly associated with a lack of adult suicidal behavior.
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Welter ML, Houeto JL, Thobois S, Bataille B, Guenot M, Worbe Y, Hartmann A, Czernecki V, Bardinet E, Yelnik J, du Montcel ST, Agid Y, Vidailhet M, Cornu P, Tanguy A, Ansquer S, Jaafari N, Poulet E, Serra G, Burbaud P, Cuny E, Aouizerate B, Pollak P, Chabardes S, Polosan M, Borg M, Fontaine D, Giordana B, Raoul S, Rouaud T, Sauvaget A, Jalenques I, Karachi C, Mallet L. Anterior pallidal deep brain stimulation for Tourette's syndrome: a randomised, double-blind, controlled trial. Lancet Neurol 2017. [PMID: 28645853 DOI: 10.1016/s1474-4422(17)30160-6] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Deep brain stimulation (DBS) has been proposed to treat patients with severe Tourette's syndrome, and open-label trials and two small double-blind trials have tested DBS of the posterior and the anterior internal globus pallidus (aGPi). We aimed to specifically assess the efficacy of aGPi DBS for severe Tourette's syndrome. METHODS In this randomised, double-blind, controlled trial, we recruited patients aged 18-60 years with severe and medically refractory Tourette's syndrome from eight hospitals specialised in movement disorders in France. Enrolled patients received surgery to implant bilateral electrodes for aGPi DBS; 3 months later they were randomly assigned (1:1 ratio with a block size of eight; computer-generated pairwise randomisation according to order of enrolment) to receive either active or sham stimulation for the subsequent 3 months in a double-blind fashion. All patients then received open-label active stimulation for the subsequent 6 months. Patients and clinicians assessing outcomes were masked to treatment allocation; an unmasked clinician was responsible for stimulation parameter programming, with intensity set below the side-effect threshold. The primary endpoint was difference in Yale Global Tic Severity Scale (YGTSS) score between the beginning and end of the 3 month double-blind period, as assessed with a Mann-Whitney-Wilcoxon test in all randomly allocated patients who received active or sham stimulation during the double-blind period. We assessed safety in all patients who were enrolled and received surgery for aGPi DBS. This trial is registered with ClinicalTrials.gov, number NCT00478842. FINDINGS Between Dec 6, 2007, and Dec 13, 2012, we enrolled 19 patients. We randomly assigned 17 (89%) patients, with 16 completing blinded assessments (seven [44%] in the active stimulation group and nine [56%] in the sham stimulation group). We noted no significant difference in YGTSS score change between the beginning and the end of the 3 month double-blind period between groups (active group median YGTSS score 68·5 [IQR 34·0 to 83·5] at the beginning and 62·5 [51·5 to 72·0] at the end, median change 1·1% [IQR -23·9 to 38·1]; sham group 73·0 [69·0 to 79·0] and 79·0 [59·0 to 81·5], median change 0·0% [-10·6 to 4·8]; p=0·39). 15 serious adverse events (three in patients who withdrew before stimulation and six each in the active and sham stimulation groups) occurred in 13 patients (three who withdrew before randomisation, four in the active group, and six in the sham group), with infections in DBS hardware in four patients (two who withdrew before randomisation, one in the sham stimulation group, and one in the active stimulation group). Other serious adverse events included one electrode misplacement (active stimulation group), one episode of depressive signs (active stimulation group), and three episodes of increased tic severity and anxiety (two in the sham stimulation group and one in the active stimulation group). INTERPRETATION 3 months of aGPi DBS is insufficient to decrease tic severity for patients with Tourette's syndrome. Future research is needed to investigate the efficacy of aGPi DBS for patients over longer periods with optimal stimulation parameters and to identify potential predictors of the therapeutic response. FUNDING French Ministry of Health.
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Affiliation(s)
- Marie-Laure Welter
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Neurology Department, Paris, France; Clinical Investigation Centre, INSERM 1127, Sorbonne Universités, Université Pierre et Marie Curie Université Paris 06, Paris, France; Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France.
| | - Jean-Luc Houeto
- Department of Neurology, INSERM-Centre d'Investigation Clinique 1402, University of Poitiers, Centre Hospitalier Universitaire (CHU) de Poitiers, Poitiers, France
| | - Stéphane Thobois
- Department of Neurology C, Hôpital Neurologique, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France; CNRS, Lyon Centre for Neuroscience Research, University Lyon 1, Bron, France
| | - Benoit Bataille
- Department of Neurosurgery, INSERM-Centre d'Investigation Clinique 1402, University of Poitiers, Centre Hospitalier Universitaire (CHU) de Poitiers, Poitiers, France
| | - Marc Guenot
- Department of Neurosurgery A, Hôpital Neurologique, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Yulia Worbe
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Neurology Department, Paris, France
| | - Andreas Hartmann
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Neurology Department, Paris, France
| | - Virginie Czernecki
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Neurology Department, Paris, France
| | - Eric Bardinet
- Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France
| | - Jerome Yelnik
- Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France
| | - Sophie Tezenas du Montcel
- AP-HP, Pitié-Salpêtrière Hospital, Biostatistics and Medical Informatics Unit and Clinical Research Unit, Paris, France; Sorbonne Universités, Université Pierre et Marie Curie Université Paris 06, UMR S1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Yves Agid
- Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France
| | - Marie Vidailhet
- Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France
| | - Philippe Cornu
- Neurosurgery, INSERM 1127, Sorbonne Universités, Université Pierre et Marie Curie Université Paris 06, Paris, France
| | - Audrey Tanguy
- AP-HP, Pitié-Salpêtrière Hospital, Biostatistics and Medical Informatics Unit and Clinical Research Unit, Paris, France
| | - Solène Ansquer
- Department of Neurology, INSERM-Centre d'Investigation Clinique 1402, University of Poitiers, Centre Hospitalier Universitaire (CHU) de Poitiers, Poitiers, France
| | - Nematollah Jaafari
- Department of Psychiatry, INSERM-Centre d'Investigation Clinique 1402, University of Poitiers, Centre Hospitalier Universitaire (CHU) de Poitiers, Poitiers, France
| | - Emmanuel Poulet
- PsyR2 Team, U 1028, INSERM and UMR 5292, Centre Hospitalier Le Vinatier, Bron, France
| | - Giulia Serra
- Department of Neurology C, Hôpital Neurologique, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Pierre Burbaud
- Department of Neurophysiology, Charles Perrens Hospital, University Bordeaux 2, CNRS UMR 5543, Bordeaux, France
| | - Emmanuel Cuny
- Department of Neurosurgery, Charles Perrens Hospital, University Bordeaux 2, CNRS UMR 5543, Bordeaux, France
| | - Bruno Aouizerate
- Department of Psychiatry, Charles Perrens Hospital, University Bordeaux 2, CNRS UMR 5543, Bordeaux, France
| | - Pierre Pollak
- Department of Neurology, Grenoble Alpes University, CHU Grenoble, Grenoble, France
| | - Stephan Chabardes
- Department of Neurosurgery, Grenoble Alpes University, CHU Grenoble, Grenoble, France
| | - Mircea Polosan
- Department of Psychiatry, Grenoble Alpes University, CHU Grenoble, Grenoble, France
| | - Michel Borg
- Department of Neurology, University Hospital, Nice, France
| | - Denys Fontaine
- Department of Neurosurgery, University Hospital, Nice, France
| | - Bruno Giordana
- Department of Psychiatry, University Hospital, Nice, France
| | - Sylvie Raoul
- Department of Neurosurgery, Nantes University Hospital, Nantes, France
| | - Tiphaine Rouaud
- Department of Neurology, Nantes University Hospital, Nantes, France
| | - Anne Sauvaget
- Department of Psychiatry, Nantes University Hospital, Nantes, France
| | - Isabelle Jalenques
- Department of Psychiatry, CHU Clermont-Ferrand and Clermont Auvergne University, Equipe d'Accueil 7280, Clermont-Ferrand, France
| | - Carine Karachi
- Neurosurgery, INSERM 1127, Sorbonne Universités, Université Pierre et Marie Curie Université Paris 06, Paris, France; Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France
| | - Luc Mallet
- Unité Mixte de Recherche (UMR) S1127, Centre National de la Recherche Scientifique (CNRS), UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France; AP-HP, Personalised Neurology and Psychiatry University Department, Hôpitaux Universitaires Henri Mondor - Albert Chenevier, Université Paris Est Créteil, Créteil, France; Department of Mental Health and Psychiatry, Geneva University Hospital, University of Geneva, Geneva, Switzerland
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Serra G, Casini M, Maggiore V, Baldessarini R, Vicari S. Factors Associated with Depression Severity in Adolescence. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.2219] [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: 11/28/2022] Open
Abstract
IntroductionSevere depression is greatly impairing during adolescence and involves a high risk for suicidal behaviors.Objectives and aimsIdentify clinical and demographic factors associated with severity of depression in adolescents diagnosed with a major mood disorder so as to improve clinical treatment and prevent suicidal behaviors.MethodsWe analyzed factors associated with depression severity in 145 severely ill adolescents diagnosed with a major affective disorder using the K-SADS (Kiddie-Schedule for Affective Disorders and Schizophrenia) at the Mood Disorder Outpatient Program of Bambino Gesù Children's Hospital (Rome). Depressive and manic symptoms were rated with the CDRS-R (Children's Depression Rating Scale-Revised) and K-SADS-MRS (Mania Rating Scale), respectively. Bivariate comparisons were followed by multivariable linear regression modeling.ResultsDepression severity was greater among females than males (mean CDRS scores: 53.0 vs. 42.8; P < 0.0001) and with major depressive versus bipolar disorder diagnosis (50.4 vs. 45.4; P = 0.001). Manic symptoms, including irritability, mood lability, crowded thoughts, delusions, and insomnia, were more likely with more severe depression; their number and severity correlated with CDRS-R total score (respectively, β = 1.53 and 5.44;both P < 0.0001). Factors independently and significantly associated with CDRS-R depression score in multivariate modeling were:– presence of suicidal ideation;– absence of ADHD;– female sex;– greater number of manic symptoms.ConclusionsSevere depression was associated with manic symptoms and with suicidal ideation among adolescents diagnosed with either bipolar or major depressive disorders. This relationship should be considered in treatment planning and suicide prevention, including consideration of mood-stabilizing and antimanic agents in the treatment of severe adolescent depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Castaldo L, Mazzone L, Serra G, Vicari S. Risk Factors for Suicide Attempt: A Retrospective Study. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.268] [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: 11/28/2022] Open
Abstract
IntroductionSuicide is a leading cause of death among adolescents.ObjectivesTo investigate suicidal behaviors among Italian adolescents.AimsTo assess the rates of suicidal ideation (SI) and suicide attempts (SA) and the associated risk factors in patients admitted to emergency department (ED) of the Bambino Gesù Children's Hospital.MethodsRetrospective study based on data of patients admitted to the ED from 1 January 2011 to 30 May 2016 who required a neuropsychiatric (NPI) consultation. We analyzed:– outcome of the NPI consultation (hospitalization or discharge);– risk factors for SA and SI;– methods employed for SA.ResultsThe number of NPI consultations for SI and SA increased from 6.45% in 2011 to 13.3% in 2015. More than 90% of consultations recommended hospitalization in the psychiatric unit (137 patient [66% female]; mean age of 15.5 ± 1.6 years) with average length of stay of 13.64 ± 10.63 days. Risk factors for SI and SA were non-suicidal self-injury, family conflicts and previous suicide attempts. Subjects evaluated for a SA reported a significantly higher frequency of family history of mood disorder (χ2 = 5.94; P = 0.02) and a comorbid substance abuse (χ2 = 4.49; P = 0.03) when compared with SI group. The method most frequently used to attempt suicide was ingestion of medications (52.83%).ConclusionsThere was an increasing demand of NPI consultation of SA and SI in the last years. A family history of mood disorder and a history of substance abuse are risk factors able to differentiate between SI and SA.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Tondo L, Pinna M, Serra G, De Chiara L, Baldessarini RJ. Age at menarche predicts age at onset of major affective and anxiety disorders. Eur Psychiatry 2016; 39:80-85. [PMID: 27992810 DOI: 10.1016/j.eurpsy.2016.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 07/31/2016] [Accepted: 08/01/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Menarche age has been associated inconsistently with the occurrence, timing or severity of major depressive disorder (MDD), but rarely studied in women with bipolar (BDs) or anxiety disorders. METHODS We investigated women patients at a Sardinian mood disorder center for associations of age at menarche with age at illness onset for major affective or anxiety disorders, year of birth, and other selected factors, using bivariate comparisons and multivariate regression modeling. RESULTS Among women (n=1139) with DSM-IV MDD (n=557), BD-I (n=223), BD-II (n=178), or anxiety disorders (n=181), born in 1904-1998, of mean age 42.9 years, menarche age averaged 12.8 [CI: 12.7-12.9] years. Illness onset age averaged 30.9 [30.1-31.8] years, ranking: BD-I, 25.8; anxiety disorders, 28.0; BD-II, 30.3; MDD, 34.1 years. Menarche age declined secularly over birth years, and was associated with younger illness-onset, having no or fewer siblings, more psychiatrically ill first-degree relatives, living in rural environments, being suicidal, substance abuse, and being unemployed. Earlier menarche and earlier illness-onset were significantly associated for onset age groups of ≤ 20, 20-39, and > 40 years. Menarche age versus diagnosis ranked: BD-II<BD-I<anxiety disorders<MDD. CONCLUSIONS Age at menarche in Sardinia, as elsewhere, has declined over the past decades. It was strongly associated with age at onset of bipolar and anxiety, as well as major depressive disorders across the age range, suggesting sustained effects of biological maturational factors.
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Affiliation(s)
- L Tondo
- International Consortium for Psychotic & Mood Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Lucio Bini Mood Disorder Centers, Cagliari and Rome, Italy.
| | - M Pinna
- Lucio Bini Mood Disorder Centers, Cagliari and Rome, Italy
| | - G Serra
- International Consortium for Psychotic & Mood Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; NESMOS Department of Psychiatry, Faculty of Medicine, University (Sapienza) of Rome, Rome, Italy; Child Neuropsychiatry Unit, Department of Neuroscience, IRCCS Children Hospital Bambino Gesù, Rome, Italy
| | - L De Chiara
- NESMOS Department of Psychiatry, Faculty of Medicine, University (Sapienza) of Rome, Rome, Italy
| | - R J Baldessarini
- International Consortium for Psychotic & Mood Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Grego E, Robino P, Tramuta C, Giusto G, Boi M, Colombo R, Serra G, Chiadò-Cutin S, Gandini M, Nebbia P. Evaluation of antimicrobial activity of Italian honey for wound healing application in veterinary medicine. SCHWEIZ ARCH TIERH 2016; 158:521-7. [PMID: 27504886 DOI: 10.17236/sat00075] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Honey as a topical treatment for infected wounds dates back to ancient times. However, few studies have been reported concerning the medical properties of Italian honey. In this study, the microbial contamination, the antimicrobial activity and the antibiotic residues of 6 different varieties of Piedmont honeys were evaluated. The antimicrobial activity of honeys was tested by agar well diffusion method and 1 honey for each variety has been selected and tested by broth micro-dilution test to determine Minimum Inhibitory Concentrations (MICs) and evaluated by Minimum Bactericidal Concentrations (MBCs). The honeys with a high level of antibacterial activity were analyzed for the presence of tetracyclines, sulfonamides and macrolide residues. The agar well diffusion method showed the greatest antimicrobial activity for honeydew, chestnut and lime tree honeys. The MICs and MBCs identified the close similarity to the medical manuka honey of honeydew, polyfloral and chestnut honey. The levels of antibiotic residues on these honeys were below the limit of quantification. Based on our results the Italian variety of honeydew showed the best antimicrobial activity and can be considered for the treatment of infected wounds in animals.
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Affiliation(s)
- E Grego
- Department of Veterinary Sciences, University of Turin, Italy
| | - P Robino
- Department of Veterinary Sciences, University of Turin, Italy
| | - C Tramuta
- Department of Veterinary Sciences, University of Turin, Italy
| | - G Giusto
- Department of Veterinary Sciences, University of Turin, Italy
| | - M Boi
- Council for agricultural research and the analysis of Agrarian Economy, Beekeeping and Silkworm Research Unit (CRA-API), Bologna, Italy
| | - R Colombo
- Council for agricultural research and the analysis of Agrarian Economy, Beekeeping and Silkworm Research Unit (CRA-API), Bologna, Italy
| | - G Serra
- Council for agricultural research and the analysis of Agrarian Economy, Beekeeping and Silkworm Research Unit (CRA-API), Bologna, Italy
| | | | - M Gandini
- Department of Veterinary Sciences, University of Turin, Italy
| | - P Nebbia
- Department of Veterinary Sciences, University of Turin, Italy
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De Chiara L, Serra G, Koukopoulos AE, Koukopoulos A, Serra G. Memantine in the treatment and prophylaxis of bipolar type II mood disorder and co-morbid eating disorder: a case report. Riv Psichiatr 2016; 49:192-4. [PMID: 25174697 DOI: 10.1708/1600.17462] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We have recently reported that memantine has a clinically relevant antimanic and long-lasting mood-stabilizing effect in treatment- resistant bipolar disorders, both as augmenting agent and as a monotherapy. Moreover, we observed an acute antimanic and sustained mood-stabilizing effect also in "naïve" bipolar type I disorder. Here we report a case history of a young woman suffering from bipolar type II mood disorder, associated with a very severe eating disorder, showing an acute antimanic and a long-term prophylactic effect of memantine on bipolar disorder and comorbid eating disorder.
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Serra G. Juvenile clinical predictors of clinical course and outcome in adult bipolar disorder. Lancet Psychiatry 2016; 3:307-9. [PMID: 26873182 DOI: 10.1016/s2215-0366(16)00024-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 01/19/2016] [Accepted: 01/20/2016] [Indexed: 11/20/2022]
Affiliation(s)
- Giulia Serra
- Child Neuropsychiatry Unit, Deptartment of Neuroscience, IRCCS Children Hospital Bambino Gesù, Rome 00165, Italy; NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; International Consortium for Bipolar and Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA.
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Cubeddu A, Astara G, Madeddu C, Ruggiero V, Cabula C, Serra G, Ganga R, Faloppi L, Cascinu S, Scartozzi M. Osteopontin (OPN) and interleukin-6 (IL-6) as predictive biomarkers in HCC receiving loco-regional treatment: preliminary results. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv344.47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Faedda GL, Marangoni C, Serra G, Salvatore P, Sani G, Vázquez GH, Tondo L, Girardi P, Baldessarini RJ, Koukopoulos A. Precursors of bipolar disorders: a systematic literature review of prospective studies. J Clin Psychiatry 2015; 76:614-24. [PMID: 26035191 DOI: 10.4088/jcp.13r08900] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [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: 11/22/2013] [Accepted: 07/14/2014] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the presence of affective signs and symptoms as precursors of bipolar disorder in prospective studies, including assessment of their prevalence, duration, and predictive value. DATA SOURCES We followed PRISMA guidelines to search PubMed, CINAHL, PsycINFO, EMBASE, SCOPUS, and ISI Web of Science databases to May 31, 2013, using the terms bipolar disorder AND (antecedent* OR predict* OR prodrom* OR prospect*) AND (diagnosis OR development). Hand searching of identified reports led to additional relevant references. STUDY SELECTION We included only English-language articles containing (1) prospective, longitudinal studies with at least 2 structured clinical assessments (intake and follow-up); (2) no previous DSM-III or DSM-IV diagnoses of bipolar I or bipolar II; and (3) diagnostic outcome of bipolar I or bipolar II. Studies of subjects at familial risk of bipolar disorder were excluded, as these have been reviewed elsewhere. DATA EXTRACTION We tabulated details of study design, outcomes, precursors, and predictive value. Only studies reporting a positive predictive association were included. RESULTS In 26 published reports meeting selection criteria, methods varied widely in terms of design, duration of follow-up, ages, and populations investigated. Despite such heterogeneity in methods, findings were notably consistent. Precursors of bipolar disorder include mood lability, subsyndromal and major depression, subsyndromal hypomanic symptoms with or without major depression, cyclothymia and bipolar not otherwise specified, major depression with psychotic features, and other psychotic disorders. Bipolar disorder was also predicted by juvenile onset of major depression as well as frequency and loading of hypomanic or depressive symptoms. CONCLUSIONS Despite the limitations of published reports, prospectively identified precursors of bipolar disorder typically arose years prior to syndromal onset, often with significant early morbidity and disability. Prospectively identified precursors of bipolar disorder are generally consistent with findings in retrospective and family-risk studies. Combining precursors and other risk factors may increase predictive value, support earlier diagnosis, improve treatment, and limit disability in bipolar disorder.
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Uchida M, Serra G, Zayas L, Kenworthy T, Hughes B, Koster A, Faraone SV, Biederman J. Can manic switches be predicted in pediatric major depression? A systematic literature review. J Affect Disord 2015; 172:300-6. [PMID: 25451429 DOI: 10.1016/j.jad.2014.09.046] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 09/30/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The rate of switching from major depression to bipolar disorder is high in children. Predicting who is at risk for switching poses unique challenges and is of high clinical relevance. Our aim was to examine the existing scientific literature elucidating if certain clinical correlates predict ultimate bipolar switches in children initially presenting with a depressive episode. METHODS We conducted a systematic literature search of studies assessing the risk factors for bipolar switching in youth. In all, seven studies fit our a priori criteria and were thus included in our qualitative review. RESULTS Together, these papers found that manic switches in pediatric depression can be predicted by several risk factors, including positive family history of mood disorders, emotional and behavioral dysregulation, subthreshold mania, and psychosis. LIMITATIONS We identified only seven prospective informative studies for our review. The majority of subjects included in these studies were referred and Caucasian. Thus, the results may not generalize to other community samples and other ethnicities. CONCLUSIONS These findings can help alert clinicians of the risk of manic switches.
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Affiliation(s)
- Mai Uchida
- Massachusetts General Hospital, Department of Pediatric Psychopharmacology, Boston, MA, USA; Harvard Medical School, Department of Psychiatry, Boston, MA, USA.
| | - Giulia Serra
- Sant'Andrea Hospital, Sapienza University, NESMOS Department, Rome, Italy; Harvard Medical School, Department of Psychiatry, Boston, MA, USA
| | - Lazaro Zayas
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA; Harvard Medical School, Department of Psychiatry, Boston, MA, USA
| | - Tara Kenworthy
- Massachusetts General Hospital, Department of Pediatric Psychopharmacology, Boston, MA, USA
| | - Brittany Hughes
- Massachusetts General Hospital, Department of Pediatric Psychopharmacology, Boston, MA, USA
| | - Ariana Koster
- Massachusetts General Hospital, Department of Pediatric Psychopharmacology, Boston, MA, USA
| | - Stephen V Faraone
- SUNY Upstate Medical University, Departments of Psychiatry and of Neuroscience and Physiology, Syracuse, NY, USA
| | - Joseph Biederman
- Massachusetts General Hospital, Department of Pediatric Psychopharmacology, Boston, MA, USA; Harvard Medical School, Department of Psychiatry, Boston, MA, USA
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Serra G, Koukopoulos A, De Chiara L, Koukopoulos AE, Tondo L, Girardi P, Baldessarini RJ, Serra G. Three-year, naturalistic, mirror-image assessment of adding memantine to the treatment of 30 treatment-resistant patients with bipolar disorder. J Clin Psychiatry 2015; 76:e91-7. [PMID: 25650685 DOI: 10.4088/jcp.13m08956] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 12/19/2013] [Accepted: 04/23/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND Developing safe and effective long-term treatments for bipolar disorder remains a major challenge. Given available treatments, patients with bipolar disorder remain unwell in half of long-term follow-up, mostly in depression. As memantine, an N-methyl-D-aspartate (NMDA)-glutamate receptor antagonist used to treat dementia, has been proposed for testing in bipolar disorder, we carried out a 3 + 3-year, mirror-image, chart-review study of the effects of adding memantine to stably continued, but insufficiently effective, ongoing mood-stabilizing treatments. METHOD Outpatients diagnosed with DSM-IV-TR bipolar disorder (I or II), followed intensively at the Lucio Bini Mood Disorder Center, Rome, Italy, had responded consistently unsatisfactorily to standard treatments (lithium, anticonvulsants, antipsychotics, antidepressants, and electroconvulsive therapy) for ≥ 3 years (2005-2013). Memantine (20-30 mg/d) was added clinically to otherwise stable regimens for another 3 years. On the basis of chart review, we compared morbidity measures and Clinical Global Impressions scale for Bipolar Disorder (CGI-BP) score before versus during memantine treatment. RESULTS The 30 bipolar I (n = 17) and II (n = 13) subjects showed consistent morbidity for 3 years before memantine, but improved progressively (r = 0.28, P < .01) over 3 years with memantine (23 ± 4.8 mg/d). Markedly decreased (all P values ≤ .01) were (1) percentage of time ill (total, mania, or depression; averaging -75.0%), (2) CGI-BP severity scores (-67.8%), (3) duration of new episodes (-58.6%), and (4) episodes/year (-55.7%). Subjects with previous rapid or continuous cycling were particularly improved (t = 2.61, P = .016). Adverse effects were mild and rare. CONCLUSIONS Memantine added substantial long-term benefits by preventing or ameliorating depressive as well as mania-like morbidity in previously consistently poorly responsive patients with bipolar disorder. Further testing in randomized, controlled trials is required.
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Affiliation(s)
- Giulia Serra
- NESMOS Department, Sant'Andrea Hospital, Sapienza University, Rome, Italy
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Serra G, Demontis F, Serra F, De Chiara L, Spoto A, Girardi P, Vidotto G, Serra G. Memantine: New prospective in bipolar disorder treatment. World J Psychiatry 2014; 4:80-90. [PMID: 25540723 PMCID: PMC4274590 DOI: 10.5498/wjp.v4.i4.80] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 11/23/2014] [Accepted: 12/03/2014] [Indexed: 02/05/2023] Open
Abstract
UNLABELLED We review preclinical and clinical evidences strongly suggesting that memantine, an old drug currently approved for Alzheimer's dementia, is an effective treatment for acute mania and for the prevention of manic/hypomanic and depressive recurrences of manic-depressive illness. Lithium remains the first line for the treatment and prophylaxis of bipolar disorders, but currently available treatment alternatives for lithium resistant patients are of limited and/or questionable efficacy. Thus, research and development of more effective mood stabilizer drugs is a leading challenge for modern psychopharmacology. We have demonstrated that 21 d administration of imipramine causes a behavioural syndrome similar to a cycle of bipolar disorder, i.e., a mania followed by a depression, in rats. Indeed, such treatment causes a behavioural supersensitivity to dopamine D2 receptor agonists associated with an increase sexual activity and aggressivity (mania). The dopamine receptor sensitization is followed, after imipramine discontinuation, by an opposite phenomenon (dopamine receptor desensitization) and an increased immobility time (depression) in the forced swimming test of depression. Memantine blocks the development of the supersensitivity and the ensuing desensitization associated with the depressive like behavior. On the basis of these observations we have suggested the use of memantine in the treatment of mania and in the prophylaxis of bipolar disorders. To test this hypothesis we performed several naturalistic studies that showed an acute antimanic effect and a long-lasting and progressive mood-stabilizing action (at least 3 years), without clinically relevant side effects. To confirm the observations of our naturalistic trials we are now performing a randomized controlled clinical trial. Finally we described the studies reporting the efficacy of memantine in manic-like symptoms occurring in psychiatric disorders other than bipolar. LIMITATIONS A randomized controlled clinical trial is needed to confirm our naturalistic observations. CONCLUSION We believe that this review presents enough pharmacological and clinical information to consider the administration of memantine in the treatment of bipolar disorders that no respond to standard mood stabilizers.
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Faedda GL, Serra G, Marangoni C, Salvatore P, Sani G, Vázquez GH, Tondo L, Girardi P, Baldessarini RJ, Koukopoulos A. Clinical risk factors for bipolar disorders: a systematic review of prospective studies. J Affect Disord 2014; 168:314-21. [PMID: 25086290 DOI: 10.1016/j.jad.2014.07.013] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 07/08/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Early phases and suspected precursor states of bipolar disorder are not well characterized. We evaluate the prevalence, duration, clinical features and predictive value of non-affective psychopathology as clinical risk factors for bipolar disorder in prospective studies. METHODS We screened PubMed, CINAHL, PsycINFO, Embase, SCOPUS, and ISI-Web of Science databases from inception up to January 31, 2014, following PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and searched: bipolar disorder AND [antecedent⁎ OR predict⁎ OR prodrom⁎ OR prospect⁎ OR risk⁎] AND [diagnosis OR development]. We included only English language reports on prospective, longitudinal studies with two structured clinical assessments (intake and follow-up); no DSM intake diagnosis of bipolar-I or -II; diagnostic outcome was bipolar-I or -II. Details of study design, risk factors, and predictive value were tabulated. RESULTS We found 16 published reports meeting selection criteria, with varying study design. Despite heterogeneity in methods, findings across studies were consistent. Clinical risk factors of bipolar disorder were early-onset panic attacks and disorder, separation anxiety and generalized anxiety disorders, conduct symptoms and disorder, ADHD, impulsivity and criminal behavior. LIMITATIONS Since risk factors identified in some prospective studies are predictive of other conditions besides bipolar disorder, these preliminary findings require replication, and their sensitivity, specificity and predictive value need to be assessed. CONCLUSIONS Clinical risk factors for bipolar disorder typically arise years prior to syndromal onset, include anxiety and behavioral disorders with unclear sensitivity and specificity. Prospectively identified clinical risk factors for bipolar disorder are consistent with retrospective and family-risk studies. Combining clinical risk factors with precursors and family-risk may improve early identification and timely and appropriate treatment of bipolar disorder.
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Affiliation(s)
- Gianni L Faedda
- Lucio Bini Mood Disorders Center, New York, NY, United States; New York University Medical Center & Child Study Center, New York, NY, United States; International Consortium for Bipolar Disorder Research, McLean Hospital, Belmont, MA, United States.
| | - Giulia Serra
- Centro Lucio Bini, Rome, Italy; NESMOS Department (Neuroscience, Mental Health and Sensory Organs), "La Sapienza" University School of Medicine and Psychology, and Lithium Clinic, Sant'Andrea Hospital, Rome, Italy; Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Ciro Marangoni
- Section of Neurological, Psychiatric and Psychological Sciences, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Italy
| | - Paola Salvatore
- International Consortium for Bipolar Disorder Research, McLean Hospital, Belmont, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Section of Psychiatry, Department of Neuroscience, University of Parma, Italy
| | - Gabriele Sani
- Centro Lucio Bini, Rome, Italy; NESMOS Department (Neuroscience, Mental Health and Sensory Organs), "La Sapienza" University School of Medicine and Psychology, and Lithium Clinic, Sant'Andrea Hospital, Rome, Italy; IRCCS Santa Lucia Foundation, Department of Clinical and Behavioral Neurology, Neuropsychiatry Laboratory, "La Sapienza" University School of Medicine, Rome, Italy
| | - Gustavo H Vázquez
- International Consortium for Bipolar Disorder Research, McLean Hospital, Belmont, MA, United States; Department of Neuroscience, University of Palermo, Buenos Aires, Argentina
| | - Leonardo Tondo
- International Consortium for Bipolar Disorder Research, McLean Hospital, Belmont, MA, United States; Centro Lucio Bini, Rome, Italy; Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Centro Lucio Bini, Cagliari, Italy
| | - Paolo Girardi
- Centro Lucio Bini, Rome, Italy; NESMOS Department (Neuroscience, Mental Health and Sensory Organs), "La Sapienza" University School of Medicine and Psychology, and Lithium Clinic, Sant'Andrea Hospital, Rome, Italy
| | - Ross J Baldessarini
- International Consortium for Bipolar Disorder Research, McLean Hospital, Belmont, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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Ciliberti M, De Lara F, Serra G, Tafuro F, Iazzetta F, De Martino V, Filosa A, Scognamiglio R, Ciliberti G, Veneri M. Effective management of pressure ulcers using Hydrofibre technology with silver ions. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.wndm.2014.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Vacca A, Loddo S, Melis MT, Funedda A, Puddu R, Verona M, Fanni S, Fantola F, Madrau S, Marrone VA, Serra G, Tore C, Manca D, Pasci S, Puddu MR, Schirru P. A GIS based method for soil mapping in Sardinia, Italy: a geomatic approach. J Environ Manage 2014; 138:87-96. [PMID: 24315681 DOI: 10.1016/j.jenvman.2013.11.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 10/29/2013] [Accepted: 11/14/2013] [Indexed: 06/02/2023]
Abstract
A new project was recently initiated for the realization of the "Land Unit and Soil Capability Map of Sardinia" at a scale of 1:50,000 to support land use planning. In this study, we outline the general structure of the project and the methods used in the activities that have been thus far conducted. A GIS approach was used. We used the soil-landscape paradigm for the prediction of soil classes and their spatial distribution or the prediction of soil properties based on landscape features. The work is divided into two main phases. In the first phase, the available digital data on land cover, geology and topography were processed and classified according to their influence on weathering processes and soil properties. The methods used in the interpretation are based on consolidated and generalized knowledge about the influence of geology, topography and land cover on soil properties. The existing soil data (areal and point data) were collected, reviewed, validated and standardized according to international and national guidelines. Point data considered to be usable were input into a specific database created for the project. Using expert interpretation, all digital data were merged to produce a first draft of the Land Unit Map. During the second phase, this map will be implemented with the existing soil data and verified in the field if also needed with new soil data collection, and the final Land Unit Map will be produced. The Land Unit and Soil Capability Map will be produced by classifying the land units using a reference matching table of land capability classes created for this project.
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Affiliation(s)
- A Vacca
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Cagliari, Via Trentino 51, 09127 Cagliari, Italy.
| | - S Loddo
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - M T Melis
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Cagliari, Via Trentino 51, 09127 Cagliari, Italy
| | - A Funedda
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Cagliari, Via Trentino 51, 09127 Cagliari, Italy
| | - R Puddu
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - M Verona
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - S Fanni
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - F Fantola
- Agenzia LAORE Sardegna, Via Caprera 8, 09123 Cagliari, Italy
| | - S Madrau
- Dipartimento di Ingegneria del Territorio, Università degli Studi di Sassari, Viale Italia 39, 07100 Sassari, Italy
| | - V A Marrone
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Cagliari, Via Trentino 51, 09127 Cagliari, Italy
| | - G Serra
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - C Tore
- Agenzia LAORE Sardegna, Via Caprera 8, 09123 Cagliari, Italy
| | - D Manca
- Agenzia AGRIS Sardegna, Viale Trieste 111, 09123 Cagliari, Italy
| | - S Pasci
- Dipartimento di Scienze Chimiche e Geologiche, Università degli Studi di Cagliari, Via Trentino 51, 09127 Cagliari, Italy
| | - M R Puddu
- Agenzia LAORE Sardegna, Via Caprera 8, 09123 Cagliari, Italy
| | - P Schirru
- Agenzia LAORE Sardegna, Via Caprera 8, 09123 Cagliari, Italy
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Serra G. Neutropenia in newborn: A case report laboratory. Clin Biochem 2014. [DOI: 10.1016/j.clinbiochem.2014.04.070] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Welter ML, Schüpbach M, Czernecki V, Karachi C, Fernandez-Vidal S, Golmard JL, Serra G, Navarro S, Welaratne A, Hartmann A, Mesnage V, Pineau F, Cornu P, Pidoux B, Worbe Y, Zikos P, Grabli D, Galanaud D, Bonnet AM, Belaid H, Dormont D, Vidailhet M, Mallet L, Houeto JL, Bardinet E, Yelnik J, Agid Y. Optimal target localization for subthalamic stimulation in patients with Parkinson disease. Neurology 2014; 82:1352-61. [PMID: 24647024 PMCID: PMC4001189 DOI: 10.1212/wnl.0000000000000315] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective: To further determine the causes of variable outcome from deep brain stimulation of the subthalamic nucleus (DBS-STN) in patients with Parkinson disease (PD). Methods: Data were obtained from our cohort of 309 patients with PD who underwent DBS-STN between 1996 and 2009. We examined the relationship between the 1-year motor, cognitive, and psychiatric outcomes and (1) preoperative PD clinical features, (2) MRI measures, (3) surgical procedure, and (4) locations of therapeutic contacts. Results: Pre- and postoperative results were obtained in 262 patients with PD. The best motor outcome was obtained when stimulating contacts were located within the STN as compared with the zona incerta (64% vs 49% improvement). Eighteen percent of the patients presented a postoperative cognitive decline, which was found to be principally related to the surgical procedure. Other factors predictive of poor cognitive outcome were perioperative confusion and psychosis. Nineteen patients showed a stimulation-induced hypomania, which was related to both the form of the disease (younger age, shorter disease duration, higher levodopa responsiveness) and the ventral contact location. Postoperative depression was more frequent in patients already showing preoperative depressive and/or residual axial motor symptoms. Conclusion: In this homogeneous cohort of patients with PD, we showed that (1) the STN is the best target to improve motor symptoms, (2) postoperative cognitive deficit is mainly related to the surgery itself, and (3) stimulation-induced hypomania is related to a combination of both the disease characteristics and a more ventral STN location.
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Affiliation(s)
- Marie-Laure Welter
- From the Université Pierre et Marie Curie-Paris 6 (M.-L.W., M.S., V.C., C.K., S.F.-V., J.-L.G., A.H., V.M., F.P., Y.W., D. Grabli, D. Galanaud, D.D., M.V., L.M., E.B., J.Y., Y.A.), Centre de Recherche de l'Institut du Cerveau et de, la Moelle épinière, UMR-S975, Paris; Inserm (M.-L.W., M.S., V.C., C.K., S.F.-V., A.H., V.M., F.P., Y.W., D. Grabli, D. Galanaud, D.D., M.V., L.M., E.B., J.Y., Y.A.), U975, Paris; CNRS (M.-L.W., M.S., C.K., S.F.-V., A.H., V.M., F.P., Y.W., D. Grabli, D. Galanaud, D.D., M.V., L.M., E.B., J.Y., Y.A.), UMR 7225, Paris; Centre d'Investigation Clinique (M.-L.W., M.S., C.K., G.S., A.H., V.M., F.P., Y.W., P.Z., D. Grabli, A.-M.B., M.V., Y.A.), Département de Neurologie (M.-L.W., V.C., A.W., A.H., V.M., D. Grabli, A.-M.B., M.V., Y.A.), IM2A (V.C., F.P.), Service de Neurochirurgie (C.K., S.N., P.C., H.B.), Department of Clinical Neurophysiology (B.P.), and Service de Neuroradiologie Diagnostique et Fonctionnelle (D. Galanaud, D.D.), Hôpitaux Universitaires Pitié-Salpêtrière/Charles Foix, Assistance Publique-Hôpitaux de Paris, France; Department of Neurology (M.S.), University Hospital, Bern, Switzerland; Centre de Neuroimagerie de Recherche (S.F.-V., D. Galanaud, D.D.), Hôpitaux Universitaires Pitié-Salpêtrière/Charles Foix, Paris, France; Département de Biostatistiques et Information Médicale (J.-L.G.), Hôpitaux Universitaires Pitié-Salpêtrière/Charles Foix, Assistance Publique-Hôpitaux de Paris, ER4 (ex EA3974) Modélisation en Recherche Clinique, Paris, France; Department of Neurology (P.Z.), 251 Hellenic Air Force General Hospital, Athens, Greece; and Department of Neurology (J.-L.H.), CHU Poitiers, France
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Serra G, Baranchuk A, Bayes-De-Luna A, Brugada J, Goldwasser D, Capulzini L, Arazo D, Boraita A, Heras ME, Garcia-Niebla J, Elosua R, Brugada R, Brugada P. New electrocardiographic criteria to differentiate the Type-2 Brugada pattern from electrocardiogram of healthy athletes with r'-wave in leads V1/V2. Europace 2014; 16:1639-45. [DOI: 10.1093/europace/euu025] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Serra G, De Chiara L, Manfredi G, Koukopoulos AE, Sani G, Girardi P, Koukopoulos A, Serra G. Memantine in the management of affective recurrences of bipolar disorders after the discontinuation of long-term lithium treatment: three case histories. Ther Adv Psychopharmacol 2014; 4:53-5. [PMID: 24490033 PMCID: PMC3896132 DOI: 10.1177/2045125313507737] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Giulia Serra
- NeSMOS Department (Neurosciences, Mental Health and Sensory Organs), School of Medicine and Psychology, Sapienza University, UOC Psychiatry, Sant'Andrea Hospital, Rome, Italy and Centro Lucio Bini, Rome, Italy
| | - Lavinia De Chiara
- NeSMOS Department (Neurosciences, Mental Health and Sensory Organs), School of Medicine and Psychology, Sapienza University, UOC Psychiatry, Sant'Andrea Hospital, Rome, Italy and Centro Lucio Bini, Rome, Italy
| | - Giovanni Manfredi
- NeSMOS Department (Neurosciences, Mental Health and Sensory Organs), School of Medicine and Psychology, Sapienza University, UOC Psychiatry, Sant'Andrea Hospital, Rome, Italy and Centro Lucio Bini, Rome, Italy
| | - Alexia E Koukopoulos
- NeSMOS Department (Neurosciences, Mental Health and Sensory Organs), School of Medicine and Psychology, Sapienza University, UOC Psychiatry, Sant'Andrea Hospital, Rome, Italy and Centro Lucio Bini, Rome, Italy
| | - Gabriele Sani
- NeSMOS Department (Neurosciences, Mental Health and Sensory Organs), School of Medicine and Psychology, Sapienza University, UOC Psychiatry, Sant'Andrea Hospital, Rome, Italy and Centro Lucio Bini, Rome, Italy and IRCCS Santa Lucia Foundation, Department of Clinical and Behavioural Neurology, Neuropsychiatry Laboratory, Rome, Italy
| | - Paolo Girardi
- NeSMOS Department (Neurosciences, Mental Health and Sensory Organs), School of Medicine and Psychology, Sapienza University, UOC Psychiatry, Sant'Andrea Hospital, Rome, Italy and Centro Lucio Bini, Rome, Italy and IRCCS Santa Lucia Foundation, Department of Clinical and Behavioural Neurology, Neuropsychiatry Laboratory, Rome, Italy
| | | | - Gino Serra
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro, 43/b, 07100 Sassari Italy
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Peña S, Fagundez C, Medeiros A, Comini M, Scarone L, Sellanes D, Manta E, Tulla-Puche J, Albericio F, Stewart L, Yardley V, Serra G. Synthesis of cyclohexapeptides as antimalarial and anti-trypanosomal agents. Med Chem Commun 2014. [DOI: 10.1039/c4md00135d] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Azolic and non-azolic cyclohexapeptides were obtained and/or evaluated as promising antimalarial and/or anti-trypanosomal agents.
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Affiliation(s)
- S. Peña
- Cátedra de Química Farmacéutica
- (DQO)
- Facultad de Química
- Universidad de la República
- Montevideo, Uruguay
| | - C. Fagundez
- Cátedra de Química Farmacéutica
- (DQO)
- Facultad de Química
- Universidad de la República
- Montevideo, Uruguay
| | - A. Medeiros
- Group Redox Biology of Trypanosomes
- Institut Pasteur de Montevideo
- Montevideo, Uruguay
- Departamento de Bioquímica
- Facultad de Medicina
| | - M. Comini
- Group Redox Biology of Trypanosomes
- Institut Pasteur de Montevideo
- Montevideo, Uruguay
| | - L. Scarone
- Cátedra de Química Farmacéutica
- (DQO)
- Facultad de Química
- Universidad de la República
- Montevideo, Uruguay
| | - D. Sellanes
- Cátedra de Química Farmacéutica
- (DQO)
- Facultad de Química
- Universidad de la República
- Montevideo, Uruguay
| | - E. Manta
- Cátedra de Química Farmacéutica
- (DQO)
- Facultad de Química
- Universidad de la República
- Montevideo, Uruguay
| | - J. Tulla-Puche
- Institute for Research in Biomedicine (IRB Barcelona)
- 08028-Barcelona, Spain
- Centre on Bioengineering
- Biomaterials and Nanomedicine
- Barcelona Science Park
| | - F. Albericio
- Institute for Research in Biomedicine (IRB Barcelona)
- 08028-Barcelona, Spain
- Centre on Bioengineering
- Biomaterials and Nanomedicine
- Barcelona Science Park
| | - L. Stewart
- Faculty of Infectious & Tropical Disease
- LSHTM
- London, UK
| | - V. Yardley
- Faculty of Infectious & Tropical Disease
- LSHTM
- London, UK
| | - G. Serra
- Cátedra de Química Farmacéutica
- (DQO)
- Facultad de Química
- Universidad de la República
- Montevideo, Uruguay
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Biederman J, Wozniak J, Tarko L, Serra G, Hernandez M, McDermott K, Woodworth KY, Uchida M, Faraone SV. Re-examining the risk for switch from unipolar to bipolar major depressive disorder in youth with ADHD: a long term prospective longitudinal controlled study. J Affect Disord 2014; 152-154:347-51. [PMID: 24144583 PMCID: PMC3867291 DOI: 10.1016/j.jad.2013.09.036] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 09/04/2013] [Accepted: 09/06/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Recent studies have identified subthreshold forms of bipolar (BP)-I disorder and deficits in emotional regulation as risk factors for bipolar disorder in youth. The primary aim of this study was to investigate whether emotional dysregulation and subthreshold forms of BP-I disorder increase the risk for BP switches in ADHD youth with non-bipolar MDD. METHODS We used data from two large controlled longitudinal family studies of boys and girls with and without ADHD. Subjects (N=522) were followed prospectively and blindly over an average follow up period of 11.4 years. Comparisons were made between ADHD youth with unipolar major depression (MDD) who did (N=24) and did not (N=79) switch to BP-I disorder at follow-up. RESULTS The rate of conversion to BP-I disorder at follow up was higher in MDD subjects with subthreshold BP-I disorder at baseline compared to those without (57% vs. 21%; OR=9.57, 95% CI=1.62-56.56, p=0.013) and in MDD subjects with deficient emotional self-regulation (OR=3.54, 95% CI=1.08-11.60, p=0.037). LIMITATIONS The sample was largely Caucasian, so these results may not generalize to minority groups. The sample of youth with SED was small, which limited the statistical power for some analyses. CONCLUSIONS Switches from unipolar MDD to BP-I disorder in children with ADHD and MDD were predicted by baseline subthreshold BP-I disorder symptoms and baseline deficits in emotional regulation. More work is needed to assess whether these risk factors are operant outside the context of ADHD.
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Affiliation(s)
- Joseph Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Janet Wozniak
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Laura Tarko
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - Giulia Serra
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - Mariely Hernandez
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - Katie McDermott
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - K. Yvonne Woodworth
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - Mai Uchida
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Stephen V. Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY
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Todisco T, Dal Farra F, Ciliberti G, Pirina P, Guelfi R, Serra G, Paris R, Mancuso I, Cepparulo M. An Italian Experience of Sequential Intravenous and Oral Azithromycin Plus Intravenous Ampicillin/Sulbactam in Hospitalized Patients with Community-Acquired Pneumonia. J Chemother 2013. [DOI: 10.1179/joc.2008.20.6.768] [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] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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49
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Zoccarato M, Zuliani L, Saddi M, Serra G, Pelizza M, Rosellini I, Peddone L, Ticca A, Giometto B. AQP4-neuromyelitis optica following NMDAR-encephalitis: A case report. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2296] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Fraioli F, Anzidei M, Serra G, Liberali S, Fiorelli A, Zaccagna F, Longo F, Anile M, Catalano C. Whole-tumour CT-perfusion of unresectable lung cancer for the monitoring of anti-angiogenetic chemotherapy effects. Br J Radiol 2013; 86:20120174. [PMID: 23908346 DOI: 10.1259/bjr.20120174] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To determine whether CT-perfusion (CT-p) can be used to evaluate the effects of chemotherapy and anti-angiogenic treatment in patients with non-small-cell lung carcinoma (NSCLC) and whether CT-p and standard therapeutic response assessment (RECIST) data obtained before and after therapy correlate. METHODS 55 patients with unresectable NSCLC underwent CT-p before the beginning of therapy and 50 of them repeated CT-p 90 days after it. Therapeutic protocol included platinum-based doublets plus bevacizumab for non-squamous carcinoma and platinum-based doublets for squamous carcinoma. RECIST measurements and calculations of blood flow (BF), blood volume (BV), time to peak (TTP) and permeability surface (PS) were performed, and baseline and post-treatment measurements were tested for statistically significant differences. Baseline and follow-up perfusion parameters were also compared based on histopathological subclassification (2004 World Health Organization Classification of Tumours) and therapy response assessed by RECIST. RESULTS Tumour histology was consistent with large cell carcinoma in 14/50 (28%) cases, adenocarcinoma in 22/50 (44%) cases and squamous cell carcinoma in the remaining 14/50 (28%) cases. BF and PS differences for all tumours between baseline and post-therapy measurements were significant (p=0.001); no significant changes were found for BV (p=0.3) and TTP (p=0.1). The highest increase of BV was demonstrated in adenocarcinoma (5.2±34.1%), whereas the highest increase of TTP was shown in large cell carcinoma (6.9±22.4%), and the highest decrease of PS was shown in squamous cell carcinoma (-21.5±18.5%). A significant difference between the three histological subtypes was demonstrated only for BV (p<0.007). On the basis of RECIST criteria, 8 (16%) patients were classified as partial response (PR), 2 (4%) as progressive disease (PD) and the remaining 40 (80%) as stable disease (SD). Among PR, a decrease of both BF (18±9.6%) and BV (12.6±9.2%) were observed; TTP increased in 3 (37.5%) cases, and PS decreased in 6 (75%) cases. SD patients showed an increase of BF, BV, TTP and PS in 6 (15%), 21 (52.5%), 23 (57.5%) and 2 (5%) cases, respectively. PD patients demonstrated an increase of BF (26±0.2%), BV (2.7±0.1%) and TTP (3.1±0.8%) while only PS decreased (23±0.2%). CONCLUSION CT-p can adequately evaluate therapy-induced alterations in NSCLC, and perfusion parameters correlate with therapy response assessment performed with RECIST criteria. ADVANCES IN KNOWLEDGE Evaluating perfusional parameters, CT-p can demonstrate therapy-induced changes in patients with different types of lung cancer and identify response to treatment with excellent agreement to RECIST measurements.
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Affiliation(s)
- F Fraioli
- Department of Nuclear Medicine, University College London Hospitals, NHS Foundation Trust, London, UK.
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