<p>Correlations between items of certainty subscale (RFQ_C) and uncertainty subscale (RFQ_U... more <p>Correlations between items of certainty subscale (RFQ_C) and uncertainty subscale (RFQ_U); cs stands for certainty scale items, us for uncertainty scale items.</p
<p>Receiver operating characteristic curve using RFQ_U to discriminate between healthy part... more <p>Receiver operating characteristic curve using RFQ_U to discriminate between healthy participants and borderline personality disorder patients.</p
<p>Correlations between uncertainty (RFQ_U) and certainty (RFQ_C) about mental states and m... more <p>Correlations between uncertainty (RFQ_U) and certainty (RFQ_C) about mental states and measures of depression, anxiety, age and severity of borderline personality disorder (BPD) in a sample of 59 BPD patients.</p
<p>Significant correlations between certainty (RFQ_C) and uncertainty (RFQ_U) about mental ... more <p>Significant correlations between certainty (RFQ_C) and uncertainty (RFQ_U) about mental states and measures of mentalizing-related constructs among healthy controls (<i>n</i> = 154).</p
Impulsivity has been proposed as an endophenotype for bipolar disorder (BD); moreover, impulsivit... more Impulsivity has been proposed as an endophenotype for bipolar disorder (BD); moreover, impulsivity levels have been shown to carry prognostic significance and to be quality-of-life predictors. To date, reports about the genetic determinants of impulsivity in mood disorders are limited, with no studies on BD individuals. Individuals with BD and healthy controls (HC) were recruited in the context of an observational, multisite study (GECOBIP). Subjects were genotyped for three candidate single-nucleotide polymorphisms (SNPs) (5-HTTLPR, COMT rs4680, BDNF rs6265); impulsivity was measured through the Italian version of the Barratt Impulsiveness Scale (BIS-11). A mixed-effects regression model was built, with BIS scores as dependent variables, genotypes of the three polymorphisms as fixed effects, and centers of enrollment as random effect. Compared to HC, scores for all BIS factors were higher among subjects with euthymic BD (adjusted β for Total BIS score: 5.35, p < 0.001). No signi...
In this work we try to delineate the knowledge about the Electroconvulsive Therapy, trying to sho... more In this work we try to delineate the knowledge about the Electroconvulsive Therapy, trying to show the use of this therapy in Italy, describing the medical structure in which it's used and the number of treatment did in these hospitals. So, we try to found the clinics in which the ETC is present and we analized the number of patients treat with this therapy: in our country this technique is presents in 14 hospitals, 5 pubblics and 7 linking to SSN. We compare also the Italian situation with the use in the foreign country.
Many studies have revealed the presence of an association between traumatic experiences, exposure... more Many studies have revealed the presence of an association between traumatic experiences, exposure to stress and Borderline Personality Disorder (BPD). In particular, seems to assume greater importance in the etiopathogenesis of BPD abuse during childhood. In 40-70% of cases is, in fact, reported a history of sexual abuse, while physical abuse in 25-73% of the patients. These negative experiences are not neither necessary nor sufficient conditions for the development of BPD, but are undoubtedly important risk factors.
L’infertilita, condizione patologica molto frequente nella popolazione occidentale, e il suo trat... more L’infertilita, condizione patologica molto frequente nella popolazione occidentale, e il suo trattamento rappre-sentano un importante evento stressante e traumatico nell’esistenza di una donna determinando un peggioramento della sua qualita di vita. Il percorso di diagnosi e di cura risulta inoltre particolarmente lungo e faticoso, gli esami a cui le donne vengono sottoposte sono numerosi e le tecniche di PMA usate per il suo tratta-mento spesso risultano invasive e caratterizzate da numerosi fallimenti. Abbiamo analizzato la letteratura rela-tiva agli aspetti psichiatrici dell’infertilita e di uno degli esami eseguiti di routine per un completo inquadramento di tale condizione, l’isterosalpingografia. Da quest’analisi e emerso che l’isterosalpingografia e un esame accompagnato da un’importante componente emotiva e che l’infertilita e una condizione patologica che provoca una vera e propria crisi esistenziale e che risulta spesso associata ad ansia e depressione. Risulta dunque fond...
Case report di un paziente affetto da Sclerosi Tuberosa, Sindrome di Klippel-Trenaunay ed Autismo... more Case report di un paziente affetto da Sclerosi Tuberosa, Sindrome di Klippel-Trenaunay ed Autismo Atipico che ha sviluppato un episodio di depressione all’eta di 18 anni. Viene fornito un inquadramento della multidimensionalita delle alterazioni del neurosviluppo. Specifica attenzione verra data alla “vulnerabilita intrinseca” per patologie psichiatriche propria di questa condizione.
E stato condotto uno studio osservazionale trasversale su 43 pazienti che alla valutazione del Ce... more E stato condotto uno studio osservazionale trasversale su 43 pazienti che alla valutazione del Centro Interdipar-timentale di Ricerca sui disturbi di Personalita (CIRDiP) soddisfavano i criteri per il Disturbo Bordeline della Personalita (BPD) del DSM-IV per esaminarne le caratteristiche in base alla presenza di Attacchi di Panico (PA) al baseline, allo scopo di delineare due gruppi di pazienti psicopatologicamente omogenei per cui si potessero ipotizzare specifiche modalita evolutive. Sebbene al baseline non sia stata riscontrata alcuna differenza statisti-camente significativa delle scale psicometriche tra i due gruppi, il maggiore punteggio medio alla Zanarini Rating Scale (ZAN-BPD) e il minore alla revised-Relationship Anecdotes Paradigm (r-RAP) del gruppo senza PA indicano scompensi rappresentati principalmente dai sintomi tipici della fase acuta del BPD, alquanto mute-voli e quindi passibili di miglioramento. D’altro canto, nei soggetti con PA il disturbo appare meno grave, po...
In this work we try to delineate the knowledge about the Electroconvulsive Therapy, trying to sho... more In this work we try to delineate the knowledge about the Electroconvulsive Therapy, trying to show the use of this therapy in Italy, describing the medical structure in which it’s used and the number of treatment did in these hospitals. So, we try to found the clinics in which the ETC is present and we analized the number of patients treat with this therapy: in our country this technique is presents in 14 hospitals, 5 pubblics and 7 linking to SSN. We compare also the Italian situation with the use in the foreign country.
Background: personality features have been repeatedly associated with depression treatment outcom... more Background: personality features have been repeatedly associated with depression treatment outcome in Major Depressive Disorder (MDD), however conclusive results are still lacking. Moreover, as for Bipolar Disorder (BD), results are only few and preliminary. Aim: the aim of the present study was to perform an exploratory investigation of the influence of personality traits as assessed by the Temperament and Character Inventory (TCI), on principal depression treatment outcomes (non remission, non response and resistance). Methods: 743 mood disorders patients (455 MDD (61.24%) and 288 BD (38.76%)) were recruited in the context of 6 European studies. Generalized logit models were performed to test the effects of TCI dimensions on treatment outcomes, considering possible confounders such as age, gender and education. Positive results were controlled for comorbidities (anxiety and substance use disorders) as well. Results: MDD Non-Remitters showed high Harm Avoidance (HA) and Self Transcendence (ST) (p=0.0004, d=0.40; p=0.007, d=0.36 respectively) and low Persistence (P) and Self Directedness (SD) (p=0.05; d=0.18; p=0.002, d=0.40, respectively); MDD Non-Responders showed a slightly different profile with high HA and low Reward Dependence (RD) and SD; finally, MDD Resistants showed low RD, P and Cooperativeness (C). In BD patients, only higher HA in non response was observed. Limitations: the retrospective cross-sectional design, the TCI assessment regardless of the mood state and the small number of bipolar patients represent the main limitations. Conclusion: specific TCI personality traits are associated with depression treatment outcome in MDD patients. The inclusion of such personality traits, together with other socio-demographic and clinical predictors, could ameliorate the accuracy of the prediction models available to date.
discriminated BPD patients from healthy individuals (area under the curve = 78%, cut of 4.5 point... more discriminated BPD patients from healthy individuals (area under the curve = 78%, cut of 4.5 points, sensitivity = 73%, specificity = 68%). Within the patient group, regression analyses showed uncertainty about mental states to have a significant unique contribution in predicting BPD severity (p < 0.05), explaining 12% of the variance. Conclusions Results largely supported the reliability and validity of the Italian version of the RFQ. These findings also provide further evidence for the role of impairments in mentalizing and reinforce the rationale for offering mentalization-based interventions to individuals with this disorder.
differentiate Bipolar Disorder from Schizophrenia during decision-making. Psychological Medicine ... more differentiate Bipolar Disorder from Schizophrenia during decision-making. Psychological Medicine 12, 1-10. [2] Brambilla, P., Cerruti, S., Bellani, M., Perlini, C., Ferro, A., Marinelli, Giusto, D., Tomelleri, L., Rambaldelli, G., Tansella, M., Vaibhav A. D., 2011. Shared impairment in associative learning in schizophrenia and bipolar disorder. Progress in Neuro-Psychopharmacology & Biological Psychiatry 35, 1093–1099. [3] Soeiro-de-Souza, M.G., Machado-Vieirab, R., Soares Bioa, D., Martins Do Pradob, C., Alberto Moreno R., 2012 COMT polymorphisms as predictors of cognitive dysfunction during manic and mixed episodes in bipolar I disorder. Bipolar Disorders 14, 554–564. [4] Wirgenes, K.V., Djurovic, S., Sundet, K., Agartz, I., Mattingsdal, M., Athanasiu, L., Melle, I., Andreassen, O.A., 2010 Catechol O-methyltransferase variants and cognitive performance in schizophrenia and bipolar disorder versus controls. Schizophrenia Research 122, 31–37. !
Introduction 3. C-reactive protein 4. Homocysteine 5. Cystatin C 6. Lipoprotein(a) and apolipopro... more Introduction 3. C-reactive protein 4. Homocysteine 5. Cystatin C 6. Lipoprotein(a) and apolipoprotein(a) 7. Soluble receptor for advanced glycation endproducts (sRAGE) 8. Osteoprotegerin 9. Miscellaneous markers 10. Imaging biomarkers of atherosclerosis in Alzheimer's disease 11. Open issues 12. Perspectives 13. References
Background: Cognitive deficits in bipolar disorder are significant enough to impact everyday func... more Background: Cognitive deficits in bipolar disorder are significant enough to impact everyday functioning. A key question for treatments aimed at cognition is which cognitive domains are most affected by bipolar disorder and which cognitive tests have the best psychometric characteristics for this population. Method: 432 patients assessed at study entry in a treatment study of bipolar depression were assessed with a version of a new cognitive measure-the Brief Assessment of Cognition in Affective Disorder (BAC-A), which assesses traditional cognitive constructs with six subtests measuring memory, processing speed, working memory, and reasoning and problem solving, and a new measure of affective processing. From the cohort of 432 patients, 309 were selected based upon their demographic similarities to a previously collected healthy control sample of 309 subjects. Patients and controls completed the traditional cognitive tests and the Affective Processing Test. Results. Patients with bipolar depression and healthy controls differed significantly on all cognitive measures (P<.001). The two alternate forms of the Affective Processing Test were very similar in both groups. The most robust discriminator of the groups was a composite score that combined the six core cognitive subtests of the Brief Assessment of Cognition (BAC) with two of the measures from the Affective Processing Test. Limitations: Test-retest reliabilities of the individual Affective Processing Test measures were low. Conclusion: The BAC-A is sensitive to the cognitive impairments in bipolar disorder patients in traditional neuropsychological domains and in cognitive processes believed to be specifically impaired in affective disorders.
<p>Correlations between items of certainty subscale (RFQ_C) and uncertainty subscale (RFQ_U... more <p>Correlations between items of certainty subscale (RFQ_C) and uncertainty subscale (RFQ_U); cs stands for certainty scale items, us for uncertainty scale items.</p
<p>Receiver operating characteristic curve using RFQ_U to discriminate between healthy part... more <p>Receiver operating characteristic curve using RFQ_U to discriminate between healthy participants and borderline personality disorder patients.</p
<p>Correlations between uncertainty (RFQ_U) and certainty (RFQ_C) about mental states and m... more <p>Correlations between uncertainty (RFQ_U) and certainty (RFQ_C) about mental states and measures of depression, anxiety, age and severity of borderline personality disorder (BPD) in a sample of 59 BPD patients.</p
<p>Significant correlations between certainty (RFQ_C) and uncertainty (RFQ_U) about mental ... more <p>Significant correlations between certainty (RFQ_C) and uncertainty (RFQ_U) about mental states and measures of mentalizing-related constructs among healthy controls (<i>n</i> = 154).</p
Impulsivity has been proposed as an endophenotype for bipolar disorder (BD); moreover, impulsivit... more Impulsivity has been proposed as an endophenotype for bipolar disorder (BD); moreover, impulsivity levels have been shown to carry prognostic significance and to be quality-of-life predictors. To date, reports about the genetic determinants of impulsivity in mood disorders are limited, with no studies on BD individuals. Individuals with BD and healthy controls (HC) were recruited in the context of an observational, multisite study (GECOBIP). Subjects were genotyped for three candidate single-nucleotide polymorphisms (SNPs) (5-HTTLPR, COMT rs4680, BDNF rs6265); impulsivity was measured through the Italian version of the Barratt Impulsiveness Scale (BIS-11). A mixed-effects regression model was built, with BIS scores as dependent variables, genotypes of the three polymorphisms as fixed effects, and centers of enrollment as random effect. Compared to HC, scores for all BIS factors were higher among subjects with euthymic BD (adjusted β for Total BIS score: 5.35, p < 0.001). No signi...
In this work we try to delineate the knowledge about the Electroconvulsive Therapy, trying to sho... more In this work we try to delineate the knowledge about the Electroconvulsive Therapy, trying to show the use of this therapy in Italy, describing the medical structure in which it's used and the number of treatment did in these hospitals. So, we try to found the clinics in which the ETC is present and we analized the number of patients treat with this therapy: in our country this technique is presents in 14 hospitals, 5 pubblics and 7 linking to SSN. We compare also the Italian situation with the use in the foreign country.
Many studies have revealed the presence of an association between traumatic experiences, exposure... more Many studies have revealed the presence of an association between traumatic experiences, exposure to stress and Borderline Personality Disorder (BPD). In particular, seems to assume greater importance in the etiopathogenesis of BPD abuse during childhood. In 40-70% of cases is, in fact, reported a history of sexual abuse, while physical abuse in 25-73% of the patients. These negative experiences are not neither necessary nor sufficient conditions for the development of BPD, but are undoubtedly important risk factors.
L’infertilita, condizione patologica molto frequente nella popolazione occidentale, e il suo trat... more L’infertilita, condizione patologica molto frequente nella popolazione occidentale, e il suo trattamento rappre-sentano un importante evento stressante e traumatico nell’esistenza di una donna determinando un peggioramento della sua qualita di vita. Il percorso di diagnosi e di cura risulta inoltre particolarmente lungo e faticoso, gli esami a cui le donne vengono sottoposte sono numerosi e le tecniche di PMA usate per il suo tratta-mento spesso risultano invasive e caratterizzate da numerosi fallimenti. Abbiamo analizzato la letteratura rela-tiva agli aspetti psichiatrici dell’infertilita e di uno degli esami eseguiti di routine per un completo inquadramento di tale condizione, l’isterosalpingografia. Da quest’analisi e emerso che l’isterosalpingografia e un esame accompagnato da un’importante componente emotiva e che l’infertilita e una condizione patologica che provoca una vera e propria crisi esistenziale e che risulta spesso associata ad ansia e depressione. Risulta dunque fond...
Case report di un paziente affetto da Sclerosi Tuberosa, Sindrome di Klippel-Trenaunay ed Autismo... more Case report di un paziente affetto da Sclerosi Tuberosa, Sindrome di Klippel-Trenaunay ed Autismo Atipico che ha sviluppato un episodio di depressione all’eta di 18 anni. Viene fornito un inquadramento della multidimensionalita delle alterazioni del neurosviluppo. Specifica attenzione verra data alla “vulnerabilita intrinseca” per patologie psichiatriche propria di questa condizione.
E stato condotto uno studio osservazionale trasversale su 43 pazienti che alla valutazione del Ce... more E stato condotto uno studio osservazionale trasversale su 43 pazienti che alla valutazione del Centro Interdipar-timentale di Ricerca sui disturbi di Personalita (CIRDiP) soddisfavano i criteri per il Disturbo Bordeline della Personalita (BPD) del DSM-IV per esaminarne le caratteristiche in base alla presenza di Attacchi di Panico (PA) al baseline, allo scopo di delineare due gruppi di pazienti psicopatologicamente omogenei per cui si potessero ipotizzare specifiche modalita evolutive. Sebbene al baseline non sia stata riscontrata alcuna differenza statisti-camente significativa delle scale psicometriche tra i due gruppi, il maggiore punteggio medio alla Zanarini Rating Scale (ZAN-BPD) e il minore alla revised-Relationship Anecdotes Paradigm (r-RAP) del gruppo senza PA indicano scompensi rappresentati principalmente dai sintomi tipici della fase acuta del BPD, alquanto mute-voli e quindi passibili di miglioramento. D’altro canto, nei soggetti con PA il disturbo appare meno grave, po...
In this work we try to delineate the knowledge about the Electroconvulsive Therapy, trying to sho... more In this work we try to delineate the knowledge about the Electroconvulsive Therapy, trying to show the use of this therapy in Italy, describing the medical structure in which it’s used and the number of treatment did in these hospitals. So, we try to found the clinics in which the ETC is present and we analized the number of patients treat with this therapy: in our country this technique is presents in 14 hospitals, 5 pubblics and 7 linking to SSN. We compare also the Italian situation with the use in the foreign country.
Background: personality features have been repeatedly associated with depression treatment outcom... more Background: personality features have been repeatedly associated with depression treatment outcome in Major Depressive Disorder (MDD), however conclusive results are still lacking. Moreover, as for Bipolar Disorder (BD), results are only few and preliminary. Aim: the aim of the present study was to perform an exploratory investigation of the influence of personality traits as assessed by the Temperament and Character Inventory (TCI), on principal depression treatment outcomes (non remission, non response and resistance). Methods: 743 mood disorders patients (455 MDD (61.24%) and 288 BD (38.76%)) were recruited in the context of 6 European studies. Generalized logit models were performed to test the effects of TCI dimensions on treatment outcomes, considering possible confounders such as age, gender and education. Positive results were controlled for comorbidities (anxiety and substance use disorders) as well. Results: MDD Non-Remitters showed high Harm Avoidance (HA) and Self Transcendence (ST) (p=0.0004, d=0.40; p=0.007, d=0.36 respectively) and low Persistence (P) and Self Directedness (SD) (p=0.05; d=0.18; p=0.002, d=0.40, respectively); MDD Non-Responders showed a slightly different profile with high HA and low Reward Dependence (RD) and SD; finally, MDD Resistants showed low RD, P and Cooperativeness (C). In BD patients, only higher HA in non response was observed. Limitations: the retrospective cross-sectional design, the TCI assessment regardless of the mood state and the small number of bipolar patients represent the main limitations. Conclusion: specific TCI personality traits are associated with depression treatment outcome in MDD patients. The inclusion of such personality traits, together with other socio-demographic and clinical predictors, could ameliorate the accuracy of the prediction models available to date.
discriminated BPD patients from healthy individuals (area under the curve = 78%, cut of 4.5 point... more discriminated BPD patients from healthy individuals (area under the curve = 78%, cut of 4.5 points, sensitivity = 73%, specificity = 68%). Within the patient group, regression analyses showed uncertainty about mental states to have a significant unique contribution in predicting BPD severity (p < 0.05), explaining 12% of the variance. Conclusions Results largely supported the reliability and validity of the Italian version of the RFQ. These findings also provide further evidence for the role of impairments in mentalizing and reinforce the rationale for offering mentalization-based interventions to individuals with this disorder.
differentiate Bipolar Disorder from Schizophrenia during decision-making. Psychological Medicine ... more differentiate Bipolar Disorder from Schizophrenia during decision-making. Psychological Medicine 12, 1-10. [2] Brambilla, P., Cerruti, S., Bellani, M., Perlini, C., Ferro, A., Marinelli, Giusto, D., Tomelleri, L., Rambaldelli, G., Tansella, M., Vaibhav A. D., 2011. Shared impairment in associative learning in schizophrenia and bipolar disorder. Progress in Neuro-Psychopharmacology & Biological Psychiatry 35, 1093–1099. [3] Soeiro-de-Souza, M.G., Machado-Vieirab, R., Soares Bioa, D., Martins Do Pradob, C., Alberto Moreno R., 2012 COMT polymorphisms as predictors of cognitive dysfunction during manic and mixed episodes in bipolar I disorder. Bipolar Disorders 14, 554–564. [4] Wirgenes, K.V., Djurovic, S., Sundet, K., Agartz, I., Mattingsdal, M., Athanasiu, L., Melle, I., Andreassen, O.A., 2010 Catechol O-methyltransferase variants and cognitive performance in schizophrenia and bipolar disorder versus controls. Schizophrenia Research 122, 31–37. !
Introduction 3. C-reactive protein 4. Homocysteine 5. Cystatin C 6. Lipoprotein(a) and apolipopro... more Introduction 3. C-reactive protein 4. Homocysteine 5. Cystatin C 6. Lipoprotein(a) and apolipoprotein(a) 7. Soluble receptor for advanced glycation endproducts (sRAGE) 8. Osteoprotegerin 9. Miscellaneous markers 10. Imaging biomarkers of atherosclerosis in Alzheimer's disease 11. Open issues 12. Perspectives 13. References
Background: Cognitive deficits in bipolar disorder are significant enough to impact everyday func... more Background: Cognitive deficits in bipolar disorder are significant enough to impact everyday functioning. A key question for treatments aimed at cognition is which cognitive domains are most affected by bipolar disorder and which cognitive tests have the best psychometric characteristics for this population. Method: 432 patients assessed at study entry in a treatment study of bipolar depression were assessed with a version of a new cognitive measure-the Brief Assessment of Cognition in Affective Disorder (BAC-A), which assesses traditional cognitive constructs with six subtests measuring memory, processing speed, working memory, and reasoning and problem solving, and a new measure of affective processing. From the cohort of 432 patients, 309 were selected based upon their demographic similarities to a previously collected healthy control sample of 309 subjects. Patients and controls completed the traditional cognitive tests and the Affective Processing Test. Results. Patients with bipolar depression and healthy controls differed significantly on all cognitive measures (P<.001). The two alternate forms of the Affective Processing Test were very similar in both groups. The most robust discriminator of the groups was a composite score that combined the six core cognitive subtests of the Brief Assessment of Cognition (BAC) with two of the measures from the Affective Processing Test. Limitations: Test-retest reliabilities of the individual Affective Processing Test measures were low. Conclusion: The BAC-A is sensitive to the cognitive impairments in bipolar disorder patients in traditional neuropsychological domains and in cognitive processes believed to be specifically impaired in affective disorders.
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