Papers by Pierluigi Politi
Current Drug Discovery Technologies, 2013
A growing body of evidence suggests that omega (ω)-3 polyunsaturated fatty acids (PUFAs) are clin... more A growing body of evidence suggests that omega (ω)-3 polyunsaturated fatty acids (PUFAs) are clinically useful in patients with psychiatric disorders. In the present review, we summarize the findings of randomized, placebo-controlled clinical trials that have focused on the potential therapeutic utility of ω-3 PUFAs in patients with mental illnesses. We searched the PubMed database for placebo-controlled clinical trials using the keywords "PUFAs", "omega-3", "eicosapentaenoic acid", and "docosahexaenoic acid" in combination with the following terms: "anxiety disorders", "mood disorders", "autism", "attention-deficit hyperactivity disorder" (ADHD), "personality disorders", and "schizophrenia". The literature review indicated that personality disorders, autism, and anxiety disorders have been investigated less frequently than mood disorders, schizophrenia, and ADHD. Although no definite conclusions can be drawn on the therapeutic efficacy of ω-3 PUFAs in the majority of the psychiatric illnesses examined here, the evidence suggests that these molecules have a potential preventive role in people at extremely high risk for developing psychosis. Future studies in the field should examine ω-PUFAs turnover in neural membranes. Moreover, special attention should be paid to potential confounds, such as smoking and dietary habits.
European Neuropsychopharmacology
Current Psychology
During the CoViD-19 pandemic, University students may have suffered from increased anxiety due to... more During the CoViD-19 pandemic, University students may have suffered from increased anxiety due to interferences in their relationships and in academic requirements, as didactic activities have moved to distance learning systems. However, being surrounded by supportive relationships and being motivated to cultivate personal interests might have decreased anxiety. In this pilot study, we collected the responses of 174 students from Italian University merit colleges to an online questionnaire, investigating their perceived anxiety, the quality of surrounding relationships, whether they were cultivating any personal interests and whether they had spent the period of lockdown in college or at home. Regression analyses indicated that both quality of relationships and personal interests predicted low levels of anxiety (p
Brain Sciences
The COVID-19 pandemic has posed a serious challenge for the life and mental health of people with... more The COVID-19 pandemic has posed a serious challenge for the life and mental health of people with autism spectrum disorder (ASD). COVID-19 sanitary restrictions led to significant changes in the lives of people with ASD, including their routines; similarly, these modifications affected the daily activities of the daycare centers which they attended. The present retrospective study evaluated the impact of COVID-19 restrictions on challenging behaviors in a cohort of people with severe ASD attending a daycare center in Italy at the beginning of the pandemic. During the first two weeks of the pandemic, we did not observe variations in challenging behaviors. This suggests that adaptations used to support these individuals with ASD in adapting to the COVID-19 emergency restrictions were effective for managing their behavior.
Brain Sciences
Autism spectrum disorders (ASDs) are hard to characterize due to their clinical heterogeneity. Wh... more Autism spectrum disorders (ASDs) are hard to characterize due to their clinical heterogeneity. Whether epilepsy and other highly prevalent comorbidities may be related to specific subphenotypes such as regressive ASD (i.e., the onset of symptoms after a period of apparently typical development) is controversial and yet to be determined. Such discrepancies may be related to the fact that age, level of cognitive functioning, and environmental variables are often not taken into account. We considered a sample of 20 subjects (i) between 20 and 55 years of age, (ii) with severe/profound intellectual disability, (iii) living in the same rural context of a farm community. As a primary aim, we tested for the association between epilepsy and regressive ASD. Secondly, we explored differences in behavioral and pharmacological profiles related to the presence of each of these conditions, as worse behavioral profiles have been separately associated with both epilepsy and regressive ASD in previo...
European Archives of Psychiatry and Clinical Neuroscience
Autism spectrum disorder (ASD) is a group of life-long neurodevelopmental disorders affecting 1.5... more Autism spectrum disorder (ASD) is a group of life-long neurodevelopmental disorders affecting 1.5% of the general population. The present study aimed to evaluate the psychiatric history of a group of adults who received the first diagnosis of ASD in two Italian university centers. Diagnoses of ASD were confirmed by a team of psychiatrists with wide expertise in the field, after the administration of standardized tools (i.e., ADOS-2, ADI-R). The sample comprised 161 participants, of which 114 (79.5%) were males. The median age of diagnosis was 23 years (range 18–55), with a median IQ of 100 (range 30–145). The first evaluation by a mental health professional was performed at a median age of 13 years, with a gap of 11 years between the first evaluation and the diagnosis of ASD. 33.5% of participants had never received a psychiatric diagnosis, while the rest of the sample had received one or more diagnoses different from ASD. The most common past diagnoses were intellectual disability,...
Istituto Lombardo - Accademia di Scienze e Lettere - Incontri di Studio
Thanks to a broad historical-anthropological and clinical examination, the authors re-evaluate th... more Thanks to a broad historical-anthropological and clinical examination, the authors re-evaluate the role of hunger in the development of our species, and also in that of the individual. The alternation empty/full, internal/ external, the complex game that is established between need, object and desire, structures the childhood of the human cub. In the same way, the alternation between active and passive gaze inaugurates and accompanies the adolescent turbulence, often dictating the rhythms. The third stage of this speech, relating to the season of maturity, focuses on the (dangerous) intersection between food and air, between when we breathe and when we swallow. The lecture ends with the theme of fasting in old age, which engages the themes of depression, involution and detachment.
Autism
The number of trials aimed at evaluating treatments for autism spectrum disorder has been increas... more The number of trials aimed at evaluating treatments for autism spectrum disorder has been increasing progressively. However, it is not clear which outcome measures should be used to assess their efficacy, especially for treatments which target core symptoms. The present review aimed to provide a comprehensive overview regarding the outcome measures used in clinical trials for people with autism spectrum disorder. We systematically searched the Web of KnowledgeSM database between 1980 and 2016 to identify published controlled trials investigating the efficacy of interventions in autism spectrum disorder. We included 406 trials in the final database, from which a total of 327 outcome measures were identified. Only seven scales were used in more than 5% of the studies, among which only three measured core symptoms (Autism Diagnostic Observation Schedule, Childhood Autism Rating Scale, and Social Responsiveness Scale). Of note, 69% of the tools were used in the literature only once. Our...
Psychiatry research, Jan 16, 2018
An increasing number of studies highlighted significant correlations between autistic traits (AT)... more An increasing number of studies highlighted significant correlations between autistic traits (AT) and mood spectrum symptoms. Moreover, recent data showed that individuals with high AT are likely to develop trauma and stressor-related disorders. This study aims to investigate the relationship between AT and mood symptoms among university students, focusing in particular on how AT interact with ruminations and trauma-related symptomatology in predicting mood symptoms. 178 students from three Italian Universities of excellence were assessed with The Structured Clinical Interview for DSM-5 (SCID-5), the Adult Autism Subthreshold Spectrum (AdAS Spectrum), the Ruminative Response Scale (RRS), the Trauma and Loss Spectrum (TALS) and the Moods Spectrum (MOODS). Considering the AdAS Spectrum total scores, 133 subjects (74.7%) were categorized as "low scorers" and 45 subjects (25.3%) as "high scorers". Students in the high scorer group showed significantly higher scores o...
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2018
In this prospective, single-center, observational study, we investigated the association between ... more In this prospective, single-center, observational study, we investigated the association between repeated short periods of circulatory arrest with moderate hypothermia during pulmonary endarterectomy (PEA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and different neuropsychological dimensions. We examined 70 patients with CTEPH, >18 to 80 years of age, who had been treated with PEA. Neuropsychological testing was performed. Learning ability and delayed memory remained well within the normal range for patients' age. We found a statistically significant post-surgical improvement in motor speed, which was accompanied by a better quality of life and reduced symptoms of depression and anxiety. PEA with repeated short periods of circulatory arrest in CTEPH did not result in any neuropsychological complications and may even lead to post-surgical psychological improvements.
Resuscitation, 2018
Survival with good neurological outcome after an out-of-hospital cardiac arrest (OHCA) has increa... more Survival with good neurological outcome after an out-of-hospital cardiac arrest (OHCA) has increased in the last fifteen years, [1] but, despite the quality of life of cardiac arrest survivors is generally acceptable, the incidence of depression after the event is not negligible, varying from 10% to 50% [2]. This fact is extremely important considering that depression negatively affect the quality of life and the outcomes [3]. However, available data refers mostly to Northern Europe area with a lack of data on Southern Europe people and this is not to be underestimated considering that the incidence of depressive disorders vary across different countries and, moreover, there are only few data about any correlation between OHCA characteristics and the onset of later depression [4]. We wanted to evaluate the incidence of depression in a population of Italian OHCA survivors and we wanted to verify whether some characteristics of the event could be associated to depression or not. We considered, through the Pavia Province Cardiac Arrest Registry (Pavia CARe), all the patients who suffered an OHCA in Pavia Province between October 2014 and September 2016 and who were discharged alive with CPC 1 or 2. A clinical psychologist telephone-administered PHQ-9 questionnaire focused to the first two weeks after the patient was discharged at home. The PHQ-9 questionnaire score ranges from 0 to 27 with cut points of 5, 10, 15, and 20 representing mild, moderate, moderately severe, and severe depression, respectively.
The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry, Jan 5, 2018
Ciliary neurotrophic factor (CNTF) is a neurotrophin which could signal neuronal suffering and at... more Ciliary neurotrophic factor (CNTF) is a neurotrophin which could signal neuronal suffering and at the same time acts as a neuroprotective agent. In the present study we aimed to evaluate CNTF serum levels in Autism Spectrum Disorders (ASD). In fact, considering the role of CNTF as a neuronal damage signal and the role of neuroinflammation, excito-inhibitory imbalance and excitotoxicity in the pathogenesis of ASD, a possible alteration of CNTF in ASD could be hypothesised. We recruited 23 individuals with ASD and intellectual disability (ID), 20 ID subjects and 26 typical adults. A complete medical and psychopathological characterisation of the participants was performed. CNTF serum levels were measured with ELISA. CNTF serum levels were significantly higher in the ASD+ID group compared to ID (p < 0.001) or typically developed subjects (p < 0.001). CNTF may be considered as a potential biomarker candidate for ASD in the context of severe ID. Our results support the hypothesis o...
Psychoneuroendocrinology, Jan 9, 2018
Evidence supports the notion that autistic symptoms and behaviors should be regarded as dimension... more Evidence supports the notion that autistic symptoms and behaviors should be regarded as dimensional traits. The present study aimed to investigate the role of vasopressin (AVP), brain-derived neurotrophic factor (BDNF) and oxytocin (OXT) as potential biochemical correlates of subclinical autistic traits in a cohort of healthy young adults. One hundred and fifty-three subjects (80 males, 73 females) were recruited. Participants completed the Autism Spectrum Quotient (AQ), a widely used measure for the identification of autistic traits in the general population. Additionally, blood samples were obtained from all participants at the same time of the day to control for circadian variation. We conducted a multiple regression analysis using the AQ score as the dependent variable and age, sex, AVP, BDNF and OXT levels as the independent variables. The model explained approximately the 22% of the variance of the AQ score. Among the parameters included in the analysis, only BDNF levels were ...
Journal of autism and developmental disorders, Jan 28, 2017
Diagnosing autism spectrum disorder (ASD) in adulthood often represents a challenge in clinical p... more Diagnosing autism spectrum disorder (ASD) in adulthood often represents a challenge in clinical practice. The aim of the present study was to evaluate the sensitivity and specificity of the ADOS and ADI-R in diagnosing ASD in adults. 113 subjects with an IQ of 70 or above were assessed through an extensive clinical evaluation. The ADOS-2 Module 4 and the ADI-R were separately administered by staff members blind to clinical judgment. Our results cautiously confirm the accuracy of ADOS-2 Module 4, while suggest that ADI-R might not be reliable in adults without intellectual disability. Clinicians' training and experience remains of primary importance while assessing adults who could potentially belong to the autism spectrum.
American Journal of Psychiatry, 2017
Research in developmental disabilities, 2017
Autism spectrum disorders (ASD) are a long-life condition frequently associated with intellectual... more Autism spectrum disorders (ASD) are a long-life condition frequently associated with intellectual disability. To date, long-term outcome has been investigated mostly in ASD people with average or above-average intelligence and there is a paucity of data about autistic adults with comorbid intellectual disability. The aim of the present study is to assess long-term variations of adaptive abilities in a sample of autistic adults with intellectual disability and severe language impairment. 22 adults (17 males and 5 females) affected by autism and intellectual disability were recruited and evaluated after their admission in an Italian farm-community. Vineland Adaptive Behavior Scales (VABS) were used as outcome measure for adaptive abilities. After ten years the measurement was repeated in order to study the evolution of patients' skills along time. Additionally, sociodemographic variables, changes in medication and comorbidities were recorded. No statistically significant improveme...
Psychoneuroendocrinology, 2017
Gossip is a pervasive social behavior. Its evolutionary survival seems related to its social func... more Gossip is a pervasive social behavior. Its evolutionary survival seems related to its social functions, such as establishing group rules, punishing trespassers, exercising social influence through reputational systems, and developing and strengthening social bonds. We aimed at evaluating the effect of gossip on hormones (oxytocin and cortisol) and at identifying potential mediators of hormonal response to gossip. Twenty-two female students were randomly assigned to a gossip conversation or to an emotional non-gossip conversation. Additionally, all participants underwent a neutral conversation on the second day of the study. Salivary oxytocin and cortisol levels were measured. Oxytocin increased significantly in the gossip compared to the emotional non-gossip conversation. A decrease in cortisol levels was observed in all three conditions (gossip, emotional non-gossip, neutral). Change in cortisol levels was similar across conditions. Psychological characteristics (e.g. empathy, autistic traits, perceived stress, envy) did not affect oxytocin rise in the gossip condition. Our findings suggest that oxytocin may represent a potential hormonal correlate of gossip behavior.
Schizophrenia bulletin, Mar 17, 2016
Discriminating subjects at clinical high risk (CHR) for psychosis who will develop psychosis from... more Discriminating subjects at clinical high risk (CHR) for psychosis who will develop psychosis from those who will not is a prerequisite for preventive treatments. However, it is not yet possible to make any personalized prediction of psychosis onset relying only on the initial clinical baseline assessment. Here, we first present a systematic review of prognostic accuracy parameters of predictive modeling studies using clinical, biological, neurocognitive, environmental, and combinations of predictors. In a second step, we performed statistical simulations to test different probabilistic sequential 3-stage testing strategies aimed at improving prognostic accuracy on top of the clinical baseline assessment. The systematic review revealed that the best environmental predictive model yielded a modest positive predictive value (PPV) (63%). Conversely, the best predictive models in other domains (clinical, biological, neurocognitive, and combined models) yielded PPVs of above 82%. Using on...
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Papers by Pierluigi Politi