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1.
Psychiatry Res ; 340: 116115, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39128168

RESUMEN

Eating disorders (EDs) are severe mental illnesses with a multifactorial etiology and a chronic course. Among the biological factors related to pathogenesis and maintenance of EDs, inflammation acquired growing scientific interest. This study aimed to assess the inflammatory profile of EDs, focusing on anorexia nervosa, bulimia nervosa, and including for the first time binge eating disorder. A comprehensive research of existing literature identified 51 eligible studies for meta-analysis, comparing levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), osteoprotegerin (OPG), soluble receptor activator of nuclear factor kappa-B ligand (sRANKL), interleukin-1ß (IL-1ß), and interleukin-10 (IL-10) between patients with EDs and healthy controls (HCs). The systematic review explored other inflammatory biomarkers of interest, which did not meet the meta-analysis criteria. Results revealed significantly elevated levels of TNF-α, OPG, sRANKL, and IL-1ß in patients with EDs compared to HCs. Additionally, the results highlighted the heterogeneity of inflammatory state among patients with EDs, emphasizing the need for further research into the association between inflammatory biomarkers and psychopathological correlates. This approach should transcend categorical diagnoses, enabling more precise subcategorizations of patients. Overall, this study contributed to the understanding of the inflammatory pathways involved in EDs, emphasizing potential implications for diagnosis, staging, and targeted interventions.


Asunto(s)
Biomarcadores , Inflamación , Humanos , Biomarcadores/sangre , Inflamación/sangre , Inflamación/diagnóstico , Trastornos de Alimentación y de la Ingestión de Alimentos/sangre , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Factor de Necrosis Tumoral alfa/sangre , Osteoprotegerina/sangre , Proteína C-Reactiva/metabolismo , Interleucina-1beta/sangre , Interleucina-6/sangre , Anorexia Nerviosa/sangre , Anorexia Nerviosa/diagnóstico
2.
Eur J Investig Health Psychol Educ ; 14(7): 1953-1968, 2024 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-39056645

RESUMEN

The Visceral Sensitivity Index (VSI) represents a significant advancement in the assessment of gastrointestinal-specific anxiety among patients with irritable bowel syndrome (IBS) and chronic inflammatory bowel diseases (IBD)-such as ulcerative colitis and Crohn's disease. However, an Italian version of the instrument is not yet available for the Italian-speaking population. This study utilized a national sample of 500 individuals divided into four groups: (a) patients with Crohn's disease, (b) patients with ulcerative colitis, (c) patients with IBS, and (d) healthy controls (individuals without any diagnoses) to test the validity and reliability of the Italian VSI. Using back-translation methodology to ensure translation fidelity, this research applied a questionnaire and the VSI through an online format to 500 participants. Confirmatory Factor Analysis (CFA) revealed that the Italian VSI had excellent psychometric properties, demonstrating high internal consistency (Cronbach's α = 0.949) and construct validity. The scale proved sensitive in detecting significant differences in visceral sensitivity among groups, highlighting its utility as a clinical and research assessment tool. Specifically, the Italian VSI exhibited a unidimensional factorial structure and maintained a strong correlation with interoceptive awareness, type of disease, and gastrointestinal symptom severity, confirming its role in enhancing the understanding and management of IBD and IBS in Italy.

3.
J Commun Healthc ; : 1-10, 2024 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-39041376

RESUMEN

BACKGROUND: Online content can inform the personal risk of developing an eating disorder, and it can influence the time and motivation to seek treatment. Patients routinely seek information online, and access to information is crucial for both prevention and treatment. The primary aim of the current study was to quantify the readability scores of online content on eating disorders using natural language processing algorithms, across two languages: English and Italian. METHODS: Unique terms related to single diagnoses were searched using Google®. The content available on Wikipedia was also assessed. Readability was defined according to the Flesch Readability Ease (FRE) and the Rate Readability Index (RIX). The scientific support of retrieved content and the authoritativeness of sources were measured through standardized variables. RESULTS: In Italian, online content was more likely published by private psychotherapy institutes or by websites that promote diet-advice or weight-loss. In both languages, the most readable content was on Anorexia Nervosa (RIX 4.18, FRE-en 59.6, FRE-it 41.69), Bulimia Nervosa (RIX 3.99, FRE-en 66.27, FRE-it 39.66) or Binge Eating (RIX 4.01, FRE-en 68.10, FRE-it 38.62). English sources consistently had more references than Italian pages (range 35-182, vs 1-163, respectively). and had a higher percentage of citations available in the target language. The content of these references was mainly reflective of peer-reviewed or clinical manuals. CONCLUSION: Attention should be given to developing online content for Muscle Dysmorphia and Orthorexia Nervosa, as well as improving the overall readability of online content on eating disorders, especially for languages other than English.

4.
Front Psychiatry ; 15: 1378439, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38895037

RESUMEN

Psychotic symptoms are among the most debilitating and challenging presentations of severe psychiatric diseases, such as schizophrenia, schizoaffective, and bipolar disorder. A pathophysiological understanding of intrinsic brain activity underlying psychosis is crucial to improve diagnosis and treatment. While a potential continuum along the psychotic spectrum has been recently described in neuroimaging studies, especially for what concerns absolute and relative amplitude of low-frequency fluctuations (ALFF and fALFF), these efforts have given heterogeneous results. A transdiagnostic meta-analysis of ALFF/fALFF in patients with psychosis compared to healthy controls is currently lacking. Therefore, in this pre-registered systematic review and meta-analysis PubMed, Scopus, and Embase were searched for articles comparing ALFF/fALFF between psychotic patients and healthy controls. A quantitative synthesis of differences in (f)ALFF between patients along the psychotic spectrum and healthy controls was performed with Seed-based d Mapping, adjusting for age, sex, duration of illness, clinical severity. All results were corrected for multiple comparisons by Family-Wise Error rates. While lower ALFF and fALFF were detected in patients with psychosis in comparison to controls, no specific finding survived correction for multiple comparisons. Lack of this correction might explain the discordant findings highlighted in previous literature. Other potential explanations include methodological issues, such as the lack of standardization in pre-processing or analytical procedures among studies. Future research on ALFF/fALFF differences for patients with psychosis should prioritize the replicability of individual studies. Systematic review registration: https://osf.io/, identifier (ycqpz).

5.
J Sex Med ; 21(7): 635-647, 2024 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-38778740

RESUMEN

BACKGROUND: Childhood traumatic experiences have been associated with hypersexuality and sexual dysfunctions. However, the mediators of the interactions between these variables should be clarified in men. AIM: This study aimed to investigate the interaction of early traumatic experiences, psychopathology, and sexuality with respect to erectile dysfunction (ED) and hypersexual behavior. The hypothesized model expected that traumatic experiences would be associated with hypersexual behavior and reduced sexual functioning through the mediation of body uneasiness and psychological distress. METHODS: The study was cross-sectional and observational. A total of 317 men were enrolled. Male patients with a primary complaint of ED and an indication for psychiatry referral represented the clinical sample (n = 116; mean ± SD age, 42.82 ± 16.89 years). Clinical classification was assessed with the Structured Interview on Erectile Dysfunction. The second sample (n = 201, 30.82 ± 11.94 years) was recruited from the general population. All participants were administered the following questionnaires: Brief Symptom Inventory, Childhood Trauma Questionnaire-Short Form, Hypersexual Behavior Inventory, Body Uneasiness Test-A, and 5-item International Index of Erectile Function. OUTCOMES: Psychopathology and sexual functioning were assessed by a dimensional approach, and a multivariate model was computed by structural equation model analysis. RESULTS: When compared with the sample from the general population, the clinical sample exhibited a higher prevalence of early traumatic experiences, as measured by scores on the Childhood Trauma Questionnaire-Short Form (45.08 ± 14.25 vs 39.03 ± 10.22, F = 17.63, P < .001), and a higher tendency to engage in hypersexual behaviors (34.63 ± 13.55 vs 30.79 ± 12.44, F = 6.97, P < .01). Structural equation model analysis showed excellent fit indices indicating that early traumatic experiences predicted hypersexual behaviors and ED through the exacerbating mediating effect of body uneasiness and psychopathology. CLINICAL IMPLICATIONS: Clinicians should not limit their attention to the behavioral level when assessing sexual dysfunction in men; rather, they should also consider the complex psychopathologic consequences of childhood trauma. Integrated treatments that address the potential presence of childhood trauma with its wider psychological correlates (eg, emotion dysregulation, body uneasiness) might improve treatment response. STRENGTHS AND LIMITATIONS: The study reports novel data on the relationship among childhood maltreatment, male sexuality, and psychopathologic mediators with a dimensional assessment. However, the assessment was cross-sectional, and causality was mainly derived from previous studies. CONCLUSION: The present study enriches the current literature, strengthening the hypothesis that childhood traumatic experiences significantly shape development and sexuality. Body uneasiness and psychopathology can both tax sexual functioning, as assessed by erectile functioning or hypersexuality.


Asunto(s)
Disfunción Eréctil , Conducta Sexual , Humanos , Masculino , Estudios Transversales , Adulto , Disfunción Eréctil/psicología , Disfunción Eréctil/etiología , Conducta Sexual/psicología , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
6.
Artículo en Inglés | MEDLINE | ID: mdl-38613397

RESUMEN

BACKGROUND: Psychotic-like anomalous self-experiences (ASEs) are core and early features of schizophrenia spectrum disorders, which have been recently also postulated to underlie embodiment disturbance in feeding and eating disorders (FEDs). The present study was aimed at investigating the interplay between ASEs and specific psychopathology in FED. METHODS: Ninety persons with Anorexia Nervosa and 41 with Bulimia Nervosa were evaluated with the inventory of psychotic-like anomalous self-experiences (IPASE), identity and eating disorders (IDEA), body uneasiness test (BUT), and eating disorder examination questionnaire (EDE-Q). The same assessment was performed for 92 subjects recruited from the general population. Structural equation modelling was employed to test the role of embodiment/identity disorders in mediating the relationship between ASEs and ED psychopathology. RESULTS: Patients with FED displayed high scores on IPASE, comparable with people with schizophrenia spectrum disorders. A significant correlation was also demonstrated between IPASE, BUT and EDE-Q. All IPASE domains were strongly related to feeling extraneous from one's own body by IDEA. All IPASE domains demonstrated a high relationship with BUT Depersonalization scale. A strong correlation was also reported between total scores of IPASE and IDEA. The mediation model confirmed that ASEs impact on FED symptomatology through the mediation of both embodiment/identity disorders and body image. DISCUSSION: Anomalous interoceptive processes may represent the first step of a maladaptive process-impairing embodiment, selfhood, and identity in FED. Assessment of ASEs might be a valid tool to identify an early-shared vulnerability of severe disorders characterized by embodiment alterations.

7.
Neuroimage ; 291: 120585, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38527658

RESUMEN

BACKGROUND: The dynamics of global, state-dependent reconfigurations in brain connectivity are yet unclear. We aimed at assessing reconfigurations of the global signal correlation coefficient (GSCORR), a measure of the connectivity between each voxel timeseries and the global signal, from resting-state to a stop-signal task. The secondary aim was to assess the relationship between GSCORR and blood-oxygen-level-dependent (BOLD) activations or deactivation across three different trial-conditions (GO, STOP-correct, and STOP-incorrect). METHODS: As primary analysis we computed whole-brain, voxel-wise GSCORR during resting-state (GSCORR-rest) and stop-signal task (GSCORR-task) in 107 healthy subjects aged 21-50, deriving GSCORR-shift as GSCORR-task minus GSCORR-rest. GSCORR-tr and trGSCORR-shift were also computed on the task residual time series to quantify the impact of the task-related activity during the trials. To test the secondary aim, brain regions were firstly divided in one cluster showing significant task-related activation and one showing significant deactivation across the three trial conditions. Then, correlations between GSCORR-rest/task/shift and activation/deactivation in the two clusters were computed. As sensitivity analysis, GSCORR-shift was computed on the same sample after performing a global signal regression and GSCORR-rest/task/shift were correlated with the task performance. RESULTS: Sensory and temporo-parietal regions exhibited a negative GSCORR-shift. Conversely, associative regions (ie. left lingual gyrus, bilateral dorsal posterior cingulate gyrus, cerebellum areas, thalamus, posterolateral parietal cortex) displayed a positive GSCORR-shift (FDR-corrected p < 0.05). GSCORR-shift showed similar patterns to trGSCORR-shift (magnitude increased) and after global signal regression (magnitude decreased). Concerning BOLD changes, Brodmann area 6 and inferior parietal lobule showed activation, while posterior parietal lobule, cuneus, precuneus, middle frontal gyrus showed deactivation (FDR-corrected p < 0.05). No correlations were found between GSCORR-rest/task/shift and beta-coefficients in the activation cluster, although negative correlations were observed between GSCORR-task and GO/STOP-correct deactivation (Pearson rho=-0.299/-0.273; Bonferroni-p < 0.05). Weak associations between GSCORR and task performance were observed (uncorrected p < 0.05). CONCLUSION: GSCORR state-dependent reconfiguration indicates a reallocation of functional resources to associative areas during stop-signal task. GSCORR, activation and deactivation may represent distinct proxies of brain states with specific neurofunctional relevance.


Asunto(s)
Imagen por Resonancia Magnética , Corteza Motora , Humanos , Encéfalo/diagnóstico por imagen , Encéfalo/fisiología , Mapeo Encefálico , Lóbulo Parietal , Descanso/fisiología , Adulto Joven , Adulto , Persona de Mediana Edad
8.
Eat Weight Disord ; 29(1): 22, 2024 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-38528258

RESUMEN

PURPOSE: Individuals with anorexia nervosa (AN) and bulimia nervosa (BN) frequently exhibit Non-Suicidal Self-Injury (NSSI), yet their co-occurrence is still unclear. To address this issue, the aim of this study was to elucidate the role of impairments in interoception in explaining the NSSI phenomenon in AN and BN, providing an explanatory model that considers distal (insecure attachment/IA and traumatic childhood experiences/TCEs) and proximal (dissociation and emotional dysregulation) risk factors for NSSI. METHOD: 130 patients with AN and BN were enrolled and administered self-report questionnaires to assess the intensity of NSSI behaviors, interoceptive deficits, IA, TCEs, emotional dysregulation and dissociative symptoms. RESULTS: Results from structural equation modeling revealed that impairments in interoception acted as crucial mediators between early negative relational experiences and factors that contribute to NSSI in AN and BN, particularly emotional dysregulation and dissociation. Precisely, both aspects of IA (anxiety and avoidance) and various forms of TCEs significantly exacerbated interoceptive deficits, which in turn are associated to the emergence of NSSI behaviors through the increase in levels of dissociation and emotional dysregulation. CONCLUSIONS: The proposed model provided a novel explanation of the occurrence of NSSIs in patients with AN and BN by accounting for the significance of interoception. LEVEL OF EVIDENCE: Level V-Cross-sectional observational study.


Asunto(s)
Anorexia Nerviosa , Bulimia Nerviosa , Interocepción , Conducta Autodestructiva , Humanos , Bulimia Nerviosa/complicaciones , Bulimia Nerviosa/psicología , Anorexia , Estudios Transversales , Conducta Autodestructiva/epidemiología , Conducta Autodestructiva/psicología , Anorexia Nerviosa/complicaciones , Anorexia Nerviosa/psicología
9.
Acta Psychiatr Scand ; 149(3): 177-194, 2024 03.
Artículo en Inglés | MEDLINE | ID: mdl-38167781

RESUMEN

BACKGROUND: A better characterization of educational processes during psychiatry training is needed, both to foster personal resilience and occupational proficiency. METHODS: An adequate coverage of medical residents at the national level was reached (41.86% of the total reference population, 29 out of 36 training centers-80.55%). Controls were recruited among residents in other medical specialties. All participants were assessed by questionnaires to evaluate early life experiences, attachment style, personality traits, coping strategies, emotional competencies. A Structural Equation Model (SEM) framework was employed to investigate the interplay between individual factors. RESULTS: A total sample of 936 people was recruited (87.9% response-rate; 645 residents in psychiatry, 291 other medical residents). Psychiatry trainees reported a higher prevalence of adverse childhood experiences (emotional abuse, emotional neglect, physical neglect), greater attachment insecurity (anxious or avoidant) in comparison to other medical trainees. Psychiatry residents also reported higher social support-seeking as a coping strategy, lower problem-orientation, and lower transcendence. Lower neuroticism, higher openness to experience, and higher emotional awareness were also observed in psychiatry trainees. Psychiatry training was associated with a redefinition of conflict management skills as a function of seniority. The SEM model provided support for an interplay between early traumatic experiences, mentalization skills (coping strategies, emotion regulation), interpersonal competencies and occupational distress. CONCLUSIONS: The findings of the present study supported a theoretical model based on mentalization theory for the interactions between personal and relational competencies in psychiatry training, thus providing potential target of remodulation and redefinition of this specific process of education.


Asunto(s)
Agotamiento Profesional , Internado y Residencia , Mentalización , Psiquiatría , Humanos , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicología , Encuestas y Cuestionarios , Neuroticismo
10.
Eat Weight Disord ; 29(1): 8, 2024 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-38217553

RESUMEN

BACKGROUND: Phenomenological research has enriched the scientific and clinical understanding of Eating Disorders (ED), describing the significant role played by disorders of embodiment in shaping the lived experience of patients with ED. According to the phenomenological perspective, disorders of embodiment in ED are associated with feelings of alienation from one's own body, determining an excessive concern for external appearance as a form of dysfunctional coping. The purpose of the present narrative review is to address the role of gender identity as a risk factor for EDs in the light of phenomenological approaches. METHODS: Narrative review. RESULTS: The current study discusses the interplay between perception, gender identity, and embodiment, all posited to influence eating psychopathology. Internalized concerns for body appearance are described as potentially associated with self-objectification. Furthermore, concerns on body appearance are discussed in relation to gendered social expectations. The current review also explores how societal norms and gender stereotypes can contribute to dysfunctional self-identification with external appearances, particularly through an excessive focus on the optical dimension. The socio-cultural perspective on gender identity was considered as a further explanation of the lived experience of individuals with ED. CONCLUSIONS: By acknowledging the interplay between these factors, clinicians and researchers can gain a deeper understanding of these disorders and develop more effective interventions for affected individuals. LEVEL OF EVIDENCE: Level V narrative review.


Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos , Identidad de Género , Humanos , Femenino , Masculino , Factores de Riesgo , Percepción
11.
Behav Brain Sci ; 46: e203, 2023 09 11.
Artículo en Inglés | MEDLINE | ID: mdl-37694939

RESUMEN

The overarching theme of causality in behavioral genetics is discussed on epistemological grounds. Evidence is offered in favor of a continuum spectrum in causality, in contrast to discrimination between causal factors and associations. The risk of invalidating exploratory studies in behavior genetics is discussed, especially for the potential impact on those fields of medicine interested in complex behaviors.


Asunto(s)
Conocimiento , Lenguaje , Humanos
12.
Mil Psychol ; 35(5): 394-407, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37615558

RESUMEN

The aim of the present study is to describe the prevalence and individual predictors of mental distress (anxiety, depression, and burnout) in a sample of volunteers engaged in emergency services. A total of 823 volunteers enrolled in the Red Cross auxiliary corps were surveyed between 28 June 2021 and 28 August 2021 (299 men and 524 women). After deployment in anti-COVID-19 operations, participants completed the Patient Health Questionnaire, Generalized Anxiety Disorder Questionnaire, Maslach Burnout Inventory, and Big Five Inventory through an online platform. A moderately severe risk of depression was found in 1.70% of the sample. A severe risk for anxiety disorders was found in 1.82%. A high risk for emotional exhaustion was found in 3.40%, depersonalization in 12.88%, and low personal accomplishment in 7.53%. Women showed a higher risk of both depression and anxiety in comparison to males. Personality factors were significant predictors for all dimensions. In contrast to the current literature, openness was found to be a predisposing personality factor in developing burnout dimensions. The relevance of the current findings for the development of effective screening tools before the deployment of reserve forces during medical crises is discussed.


Asunto(s)
Agotamiento Profesional , Cruz Roja , Masculino , Humanos , Femenino , Prevalencia , Estudios Transversales , Agotamiento Psicológico , Agotamiento Profesional/epidemiología , Italia/epidemiología
13.
Eat Weight Disord ; 28(1): 64, 2023 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-37526698

RESUMEN

PURPOSE: Pregorexia is a phenomenon posited to occur in the peripartum, characterized by an attempt to counter pregnancy's physiological changes in body shape through reduced calorie intake or increased physical activity. METHODS: In this pre-registered systematic review and meta-analysis, body image dissatisfaction and eating psychopathology in the peripartum according to gestational age were formally assessed. PubMed was searched up to May 2023. Selection criteria were represented by studies on body image concerns or eating psychopathology in the peripartum (up to 1 year after delivery). The population needed to include women from the general population or among patients with a history of (or current) eating disorder. For the meta-analysis, 17 studies were included: 10 for body image dissatisfaction (2625 individuals overall), 7 for eating behaviors (2551 individuals overall). The interplay between body image and the following themes was examined in depth: the adoption of breastfeeding, peripartum depression, sociocultural influences on body image, sexual disturbances, experiencing or reporting an altered food intake. RESULTS: Progressive dissatisfaction with body image during pregnancy by gestational age was observed, stably elevated for at least 12 months postpartum. Eating psychopathology was observed as elevated only at 12 months in the postpartum, but not during pregnancy. DISCUSSION: The current work offers normative values of body image satisfaction and eating psychopathology in the peripartum by gestational age. The relevance of current results was discussed, in order to inform both current clinical practice and future public policies. LEVEL OF EVIDENCE: Level I-Evidence obtained from: systematic reviews and meta-analyses.


Asunto(s)
Insatisfacción Corporal , Trastornos de Alimentación y de la Ingestión de Alimentos , Femenino , Humanos , Embarazo , Imagen Corporal , Edad Gestacional , Periodo Periparto
14.
Pharmacoepidemiol Drug Saf ; 32(10): 1053-1067, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37294623

RESUMEN

PURPOSE: Adverse effects of selective serotonin reuptake inhibitors (SSRIs) on sexual function have been an important area of research for many years. However, the duration of SSRI-associated sexual adverse effects, and their possible persistence after treatment discontinuation, is still uncertain. The aims of the current systematic review were first to identify existing evidence of sexual dysfunction following SSRI discontinuation, and to provide an account of reported symptoms and proposed treatment options; and second, to establish whether current literature allows accurate estimates of the prevalence of such sexual dysfunction. METHODS: A systematic review was conducted on PubMed, Embase, and Google Scholar; papers with clinical data regarding patients with persistent sexual dysfunction after SSRI treatment suspension were included. RESULTS: Overall, two retrospective interventional studies, six observational studies and 11 case reports were judged eligible for inclusion. It was not possible to determine reliable estimates of prevalence. Similarly, a cause-effect relationship between SSRI exposure and persistent sexual impairment could not be ascertained. Nonetheless, the potential for continued sexual disturbances despite discontinuation could not be entirely ruled out. CONCLUSIONS: There is a need to investigate a possible dose-response relationship between SSRI exposure and persistent sexual adverse effects. Treatment options for persistent dysfunctions remain limited, but novel therapeutic approaches may be required in order to address an otherwise neglected need for sexual well-being.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Disfunciones Sexuales Fisiológicas , Humanos , Inhibidores Selectivos de la Recaptación de Serotonina/efectos adversos , Estudios Retrospectivos , Disfunciones Sexuales Fisiológicas/inducido químicamente , Disfunciones Sexuales Fisiológicas/epidemiología , Nivel de Alerta , Genitales
15.
Brain Sci ; 13(4)2023 Mar 24.
Artículo en Inglés | MEDLINE | ID: mdl-37190499

RESUMEN

BACKGROUND: The relationship between eating disorder (ED) specific psychopathology and depressive symptomatology in EDs is often debated. The aim of this study was to provide an explicative model regarding the mechanisms by which enhanced cognitive-behavior therapy (CBT-E) might determine an amelioration of depressive symptoms in patients with anorexia nervosa (AN) or bulimia nervosa (BN). METHODS: A total of 157 women with AN or BN and no history of childhood trauma or bipolar disorder were evaluated before treatment and after 12 months of CBT-E. Self-administered questionnaires were used to measure ED psychopathology and depressive symptoms. RESULTS: All psychopathological measures improved after treatment, with no significant additional improvement with the concomitant use of antidepressants. Structural equation modeling using the bivariate latent change score approach showed that higher levels of depressive symptoms at baseline were associated with a worse longitudinal trend of ED psychopathology, and vice versa. Finally, the amelioration of ED psychopathology predicted the improvement in depressive symptoms at follow-up, whereas data did not support the inverse path. CONCLUSION: This study elucidated the complex longitudinal interplay between ED psychopathology and depression during CBT-E, underlining the importance of addressing ED symptoms as a primary target in the case of comorbidity between AN or BN and depressive symptoms.

16.
Dev Psychobiol ; 65(2): e22366, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36811370

RESUMEN

Homotopic connectivity during resting state has been proposed as a risk marker for neurologic and psychiatric conditions, but a precise characterization of its trajectory through development is currently lacking. Voxel-Mirrored Homotopic Connectivity (VMHC) was evaluated in a sample of 85 neurotypical individuals aged 7-18 years. VMHC associations with age, handedness, sex, and motion were explored at the voxel-wise level. VMHC correlates were also explored within 14 functional networks. Primary and secondary outcomes were repeated in a sample of 107 adults aged 21-50 years. In adults, VMHC was negatively correlated with age only in the posterior insula (false discovery rate p < .05, >30-voxel clusters), while a distributed effect among the medial axis was observed in minors. Four out of 14 considered networks showed significant negative correlations between VMHC and age in minors (basal ganglia r = -.280, p = .010; anterior salience r = -.245, p = .024; language r = -.222, p = .041; primary visual r = -.257, p = .017), but not adults. In minors, a positive effect of motion on VMHC was observed only in the putamen. Sex did not significantly influence age effects on VMHC. The current study showed a specific decrease in VMHC for minors as a function of age, but not adults, supporting the notion that interhemispheric interactions can shape late neurodevelopment.


Asunto(s)
Imagen por Resonancia Magnética , Trastornos Mentales , Niño , Humanos , Adolescente , Adulto Joven , Imagen por Resonancia Magnética/métodos , Encéfalo
17.
Psychiatry Res Neuroimaging ; 326: 111541, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36122541

RESUMEN

State-dependent reallocation of cognitive resources is impaired in schizophrenia and may be underlined by alterations in brain local-connectivity. Increasing evidence suggests local connectivity reductions from rest to task in healthy individuals, while insufficient information is available for schizophrenia spectrum. Resting-state and stop-signal task fMRI scans of 107 healthy controls and 32 patients with DSM-IV-TR schizophrenia or schizoaffective disorder were analyzed. As primary aim we measured within-group shifts in local-connectivity from rest to task as voxel-wise Regional Homogeneity (ReHo-shift). Secondary aims were to test: i) Between-groups differences in ReHo-rest, ReHo-task and ReHo-shift; ii) ReHo covariations with task performance (=shorter reaction times) and severity of symptoms (SAPS/SANS scores). Age, sex, and education were accounted for as covariates. Motion, global-signal-regression, antipsychotic dosage and smoothing associations with ReHo were evaluated. Rest-to-task ReHo reductions occurred in both groups on a whole-brain level (False-Discovery-Rate p=0.05). Trends of greater ReHo reductions in patients versus controls were observed. Controls performed better than patients (p<0.001). ReHo negatively correlated with performance in both groups. ReHo-shift predicted worse performance in controls, but better performance in patients (uncorrected p=0.05). ReHo reductions correlated with severity of symptoms. State-dependent reconfigurations in local-connectivity provide new links between neurobiology and behavioral/clinical features of the schizophrenia spectrum.

18.
Brain Imaging Behav ; 16(6): 2526-2542, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35859076

RESUMEN

Eigenvector-Centrality (EC) has shown promising results in the field of Psychiatry, with early results also pertaining to ADHD. Parallel efforts have focused on the description of aberrant interhemispheric coordination in ADHD, as measured by Voxel-Mirrored-Homotopic-Connectivity (VMHC), with early evidence of altered Resting-State fMRI. A sample was collected from the ADHD200-NYU initiative: 86 neurotypicals and 89 participants with ADHD between 7 and 18 years old were included after quality control for motion. After preprocessing, voxel-wise EC and VMHC values between diagnostic groups were compared, and network-level values from 15 functional networks extracted. Age, ADHD severity (Connor's Parent Rating-Scale), IQ (Wechsler-Abbreviated-Scale), and right-hand dominance were correlated with EC/VMHC values in the whole sample and within groups, both at the voxel-wise and network-level. Motion was controlled by censoring time-points with Framewise-Displacement > 0.5 mm, as well as controlling for group differences in mean Framewise-Displacement values. EC was significantly higher in ADHD compared to neurotypicals in the left inferior Frontal lobe, Lingual gyri, Peri-Calcarine cortex, superior and middle Occipital lobes, right inferior Occipital lobe, right middle Temporal gyrus, Fusiform gyri, bilateral Cuneus, right Precuneus, and Cerebellum (FDR-corrected-p = 0.05). No differences were observed between groups in voxel-wise VMHC. EC was positively correlated with ADHD severity scores at the network level (at p-value < 0.01, Inattentive: Cerebellum rho = 0.273; Hyper/Impulsive: High-Visual Network rho = 0.242, Cerebellum rho = 0.273; Global Index Severity: High-Visual Network rho = 0.241, Cerebellum rho = 0.293). No differences were observed between groups for motion (p = 0.443). While EC was more related to ADHD psychopathology, VMHC was consistently and negatively correlated with age across all networks.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Imagen por Resonancia Magnética , Humanos , Niño , Adolescente , Imagen por Resonancia Magnética/métodos , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Lóbulo Occipital , Lóbulo Frontal
19.
Artículo en Inglés | MEDLINE | ID: mdl-35627600

RESUMEN

Body-size perception is an important factor in motivating people to lose weight. Study aim was to explore the perception of body image among first-generation Chinese migrants living in Italy. A sample of 1258 Chinese first-generation immigrants and of 285 native Italians living in Prato, Italy, underwent blood pressure measurements, blood tests (with measurement of glucose, cholesterol, and triglycerides), and anthropometric measurements. Body-size perception was investigated with Pulvers' figure rating scale using logistic or linear multivariable regression adjusted for age, gender, BMI, education and years spent in Italy. Chinese migrants had lower BMI and discrepancy score (preferred minus current body size) than Italians (p < 0.05 for both). After a logistic regression analysis, the discrepancy score remained lower in the Chinese than in the Italian cohort independently from BMI and other confounders (OR 0.68; 95%CI 0.50 to 0.92). In the Chinese cohort, female gender, BMI and years spent in Italy were positive determinants of discrepancy score (desire to be thinner), while age showed negative impact (p < 0.05 for all). Overweight is an important risk factor for diabetes, a very prevalent condition among first-generation Chinese migrants. The present study offers useful information and suggests the need for prevention programs specifically addressed to men.


Asunto(s)
Sobrepeso , Percepción del Tamaño , Pueblo Asiatico , China/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino
20.
Int J Ment Health Addict ; : 1-20, 2022 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-35316933

RESUMEN

The impact of the COVID-19 pandemic on mental health has not been clarified yet, with multiple studies warranting a special focus on women and young adults. A sample of 101 Italian women recruited from the general population was evaluated a few weeks before the onset of the pandemic and during the first and the second wave of the pandemic. Depression values at the Brief Symptom Inventory showed an initial increase followed by a stabilization on higher values in respect to the baseline, whereas Phobic Anxiety was stably worsened. Participants with insecure attachment styles and childhood trauma showed higher levels of distress at all timepoints. In many psychopathological domains, moderation analysis showed an unfavorable trend over time for younger participants. The present study seems to confirm a high burden on mental health for women during the COVID-19 pandemic, highlighting young age, insecure attachment style, and childhood trauma as negative prognostic factors.

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