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1.
Artigo em Inglês | MEDLINE | ID: mdl-36767724

RESUMO

BACKGROUND: Memory disorders are common among elder people, and nonclinical cognitive decline is commonly experienced with age. Preclinical investigations have explored the possible role of alpha-lipoic acid (ALA), a known antioxidant compound abundant in vegetables and animal tissues, in reducing oxidative stress in the aging brain and preventing cognitive decline. However, clinical evidence is limited, and the few existing results are contrasting. In addition, while most of the existing trials have been focused on the effects of ALA administration in Alzheimer's disease (AD) or other types of dementia, studies evaluating its effects on nonclinical elder population are still missing. METHODS: In the present open-label, pilot study, fifteen elder patients (mean age: 84.5 ± 5.77) received ALA at a daily dose of 600 mg/day for 12 weeks. General cognitive function, executive function, and mood symptom assessment were carried out at baseline and at the endpoint. RESULTS: Overall, ALA administration was generally well-tolerated (only one dropout due to gastrointestinal side effects). However, no statistically significant effects either on cognitive function, executive function, or mood were found. CONCLUSIONS: Despite several limitations, our study found no evidence of positive effects on cognition and mood after ALA administration in elder people without the diagnosis of AD or cognitive impairment. Further clinical trials are needed to better investigate ALA effectiveness on cognition and mood in elder subjects.


Assuntos
Doença de Alzheimer , Transtornos Cognitivos , Ácido Tióctico , Humanos , Ácido Tióctico/uso terapêutico , Ácido Tióctico/farmacologia , Projetos Piloto , Cognição , Suplementos Nutricionais
2.
Artigo em Inglês | MEDLINE | ID: mdl-35992380

RESUMO

Background: Many of the atypical antipsychotics induce metabolic side effects, limiting their use in clinical practice. Alpha-lipoic acid (ALA) was proposed as a new approach in schizophrenia to improve metabolic effects of atypical antipsychotics. The aim of the study is to evaluate the effect of ALA on metabolic and clinical parameters among schizophrenic subjects. Methods: 15 schizophrenic subjects, in stable atypical antipsychotic monotherapy were included in the study. ALA was administrated at the oral daily dose of 600 â€‹mg/d in addition to antipsychotic therapy. Metabolic, clinical, and psychopathological parameters were measured at typical antipsychotics. e initial screening, and after 12 weeks. Results: ALA produced a statistically significant reduction in QTc (p â€‹= â€‹0.012), blood glucose (p â€‹= 0.005), AST (p â€‹= â€‹0.021), γGT (p â€‹= â€‹0.035), CPK (p â€‹= â€‹0.005) and prolactinaemia (p â€‹= â€‹0.026). In contrast, there was a significant increase in HbA1c (p â€‹= â€‹0.026). No effects on body weight and blood lipid levels (triglycerides, total cholesterol, HDL, LDL) emerged. Conclusions: ALA treatment appeared to be effective for reducing diabetes risk, liver functionality parameters, hyperprolactinaemia and QTC interval. ALA appears to be safe as adjunctive components in schizophrenia.

3.
Clin Neuropsychiatry ; 19(2): 97-102, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35601246

RESUMO

Objective: The main purpose of this study was to examine a possible relationship among the three constructs of impulsivity, according to Barratt's theory and metacognition subdimensions, as described in Wells and Cartwright-Hatton's theory, in various psychiatric disorders, in order to explore the potential predictive role of impulsivity on metacognition. Method: The Barratt Impulsiveness Scale-11 (BIS-11) and the Metacognitions Questionnaire (MCQ-30) were administered to a sample of 100 patients affected by psychiatric disorders. Linear regression was used first to study the relationship between impulsivity as an independent variable and metacognition as a dependent variable and then to evaluate the relationship between the three construct of impulsivity and the five subdimensions of metacognition. Results: BIS-11 total score was a valid predictor of Total MCQ-30 (p <.0001), whereas Attentive Impulsiveness was a good predictor of the factors "Negative Beliefs" (p <.0001), "Cognitive Confidence" (p =.004) and "Need to control thoughts" (p =.002). Conclusions: since "Attentive Impulsiveness", "Negative believes", "Cognitive Confidence" and "Need to Control Thought" are psychological constructs, psychotherapy is the more effective tool to intervene on their imbalance. In particular, literature demonstrates the effectiveness of Cognitive-Behavioural Therapy and Mindfulness therapies in rebalancing impulsivity and enhancing metacognitive skills.

4.
Artigo em Inglês | MEDLINE | ID: mdl-35410031

RESUMO

Recent literature has extensively examined sexual behavior during lockdown due to COVID-19. However, there are no recent studies that have considered the relationship between body image quality, sexual arousability, and sexual anxiety. The present study has two main objectives: (1) to examine gender differences in bodily and sexual experience; and (2) the comparison of bodily and sexual experience, before and during the COVID-19 lockdown. A total of 301 adult subjects (161 women and 140 men) aged between 16 and 73 years (Mean = 37.4; S.D. = 10.3) participated in the study. Data on biographical information were collected via an online panel. The Body Uneasiness Test (BUT) and the Sexual Arousability Inventory (SAI) were used for the assessment. Univariate ANOVA showed worse scores for women, compared with men, in terms of body image avoidance, depersonalization, overall severity of body image quality, sexual arousability, and sexual anxiety dimensions. When compared against time, only women showed significant correlations between the function of sexual arousal and all parameters concerning body image alteration. Interestingly, these correlations were weak and sporadic before lockdown, but strong and numerous during lockdown. This finding suggests that the impact of COVID-19 restrictions affected the female population more, with a profound repercussion on self-image and sexual and mental well-being.


Assuntos
Imagem Corporal , COVID-19 , Adolescente , Adulto , Idoso , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Feminino , Humanos , Libido , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Adulto Jovem
5.
Psychiatry Res ; 311: 114527, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35344686

RESUMO

Schizophrenia pathophysiology is still not well understood. Genetic factors involving biochemical systems are key players and oxidative stress takes part to the development and worsening of SZ. Oxidative stress led to the permanent production of oxidation products such as advanced glycation end products (AGEs) and advanced oxidation protein products (AOPPs). These proteins interact with their receptor amplifying ROS production and pro-inflammatory cytokines sustaining a permanent loop. We tested plasma levels of AGEs and AOPPs in 30 SZ patients. Their levels were statistically higher than controls confirming their involvement in mental disorders. Antioxidant nutraceuticals and a healthy lifestyle could diminish oxidative stress and ameliorate SZ symptoms.


Assuntos
Produtos da Oxidação Avançada de Proteínas , Esquizofrenia , Biomarcadores , Produtos Finais de Glicação Avançada/metabolismo , Humanos , Estresse Oxidativo
6.
Brain Sci ; 12(2)2022 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-35204055

RESUMO

The consequences of the pandemic on mental health are among the most important side effects of COVID-19. Wide concerns have emerged both regarding vaccine hesitation in the general population, and the vaccine's implementation plan. The aim of this study is to evaluate how the scientific community has investigated the relationship between the COVID-19 vaccine and mental disorders. Contrary to expectations, having a full-blown psychiatric pathology seems to positively affect the attitude towards the vaccine, except for PTSD. The intense fear that accompanied the current world emergency has made this pandemic unique; we discuss how it might be one of the factors involved in this result. Further experimental investigations are needed to estimate how personality traits, hyperarousal, and negative emotions influence vaccine compliance both in the general population and in people living with mental disorders.

7.
Psychiatry Res ; 317: 114914, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-37732858

RESUMO

BACKGROUND: Internet addiction (IA) is an emerging psychopathological entity, often comorbid with a variety of psychiatric disorders. Subthreshold psychopathology has recently emerged as a new field of research, with solid evidence highlighting its role in causing psychological distress. AIMS: The study aimed to evaluate the presence of subthreshold psychopathological symptoms and IA in Italian adults recruited from the general population, searching for possible correlations between specific subclinical psychiatric disorders and internet abuse. METHODS: The study was conducted by an online survey released through social networks, web advertising, institutional and professional mailing lists, and messaging services. The General 5-Spectrum Measure (GSM-V) and the Internet Addiction Test (IAT) were chosen to assess subthreshold symptoms, and IA, respectively. RESULTS: Significant positive correlations between the total score of the IAT total scores and the multiple domains of GSM-5 (p <0.0001), except for the "Mania" dimension (p = 0.717). CONCLUSIONS: IA is very common in subjects unaffected by major psychiatric disorders and it is associated with subthreshold psychopathological dimensions. Further studies on larger samples and the inclusion of a dimensional framework in research settings and clinical practice are needed to better understand the nature and the reciprocal relationships between IA and subthreshold psychopathology.


Assuntos
Transtorno de Adição à Internet , Transtornos Mentais , Adulto , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Psicopatologia , Mania
8.
Health Care Women Int ; 43(1-3): 129-141, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34652261

RESUMO

The authors' purpose in the present study is to examine the role of subthreshold mental disorders as predictors of Postpartum Depression (PPD). 110 pregnancy women were evaluated as follow: the General 5-Spectrum Measure at 26 weeks of gestation; the Edinburgh Postnatal Depression Scale at 3/6 months after delivery. Only 4.5% of the sample developed PPD at 3/6 months after delivery. Agoraphobia/panic, depressed mood, social anxiety and eating problems relate positively to PPD at 3/6 months. Early identification of symptoms that could indicate the development of future mood problems in the mother is of crucial importance for mental health and prevention.


Assuntos
Depressão Pós-Parto , Ansiedade/psicologia , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Mães/psicologia , Período Pós-Parto , Gravidez , Escalas de Graduação Psiquiátrica , Fatores de Risco
9.
Brain Sci ; 11(10)2021 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-34679416

RESUMO

Amyloid precursor protein and its derivates represent a central factor in the process of neurodegeneration in Alzheimer's disease (AD). Since mental illnesses share with AD cognitive impairment, amyloid indicators have been used to explore the unknown pathophysiologic mechanisms underlining psychiatric illness. This work aims to compare the role of amyloid markers, together with tau proteins, among various mental disorders evaluating the possible role of altered amyloid metabolism in the onset and in the course of psychiatric diseases, considering the relationship with cognitive impairment in dementia. This review includes articles written in English, published between 1 January 2011 and 31 January 2021, which evaluated amyloid and tau proteins in psychiatric patients. After screening, 31 studies were included in the review. Results suggest that amyloid metabolism is altered in major psychiatric disorders and that it could be a marker of cognitive impairment. Nevertheless, the role of amyloid in mental diseases seems to be related to neurodevelopmental alteration as well as neurodegeneration processes, like in AD. The role of amyloid in the pathogenesis of mental disorders is still unknown. Amyloid should not be only considered as a marker of cognitive impairment in mental illness, but also for altered neurodevelopment.

10.
Biomedicines ; 9(8)2021 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-34440271

RESUMO

BACKGROUND: The relevance of the association between mental disorders and other conditions might have been underestimated due to its complexity. Central Serous Chorioretinopathy (CSC) is an ophthalmological disorder associated with many psychiatric factors. The aim of this systematic review is to evaluate the association between mental disorders and CSC. METHODS: Articles about studies performed on humans on CSC published in peer-reviewed journals from 1 January 2010 to 31 December 2020 were included in the review. RESULTS: We selected 21 research papers. Nine studies measured stress and anxious depressive symptoms, which are associated with CSC onset and recurrences, emerging as a state marker of the disease. Four out of the five studies focused on sleep disorders suggested a reliable association with CSC. Four studies evaluated other various psychiatric factors. The role of psychopharmacological medication has still not been elucidated (three studies). CONCLUSION: Multiple pieces of evidence highlights that CSC might arise in the context of systemic disease. This notion, together with the increasing evidence supporting a link between psychiatric disorders and choroidal thickness, suggests that CSC and mental disorders may share some etiopathogenetic pathways. Further research is needed to better investigate possible common etiopathogenetic pathways, especially vascular, immunological and endocrinological systems.

11.
Medicina (Kaunas) ; 57(6)2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-34208694

RESUMO

Background and Objectives: to investigate the current state of art in the study of personality disorders in central serous chorioretinopathy (CSC), also taking into account the dimensional approach. Materials and Methods: this systematic review was conducted according to PRISMA guidelines. We included articles written in English or Italian, published in peer reviewed journals from 1 January 2010 to 31 December 2020. Results: after the screening, 10 studies were included. The results suggest that CSC patients are not characterized by the prevalence of a formal personality disorder, but they are better explained by typical personality traits that may alter their relationship with others. CSC patients seems to be characterized by high levels of aggressiveness and anxiety traits along with low sociability. We propose a model of disease where stress exacerbates prior specific traits in a vicious circle where some traits might be involved in disease progression and manifestation. Conclusions: maladaptive personality traits might be an essential feature of the disease and may represent a possible link between psychiatric symptoms, such as insomnia, anxiety, and depression, and endocrinological patterns. Further research should use a specific assessment scale evaluating both the level of interpersonal functioning and specific maladaptive traits.


Assuntos
Coriorretinopatia Serosa Central , Transtornos Mentais , Coriorretinopatia Serosa Central/diagnóstico , Humanos , Personalidade
12.
Medicina (Kaunas) ; 57(4)2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33810498

RESUMO

Mental disorders are common in the general population; every year about 25% of the total European population is affected by a mental condition. The prevalence of psychiatric disorders might be underestimated. Emerging evidence highlights the role of immune response as a key factor in MDs. Immunological biomarkers seem to be related to illness progression and to treatment effectiveness; several studies suggest strong associations among IL-6, TNFa, S100b, IL 1b, and PCR with affective or schizophrenic disorders. The purpose of this review is to examine and to understand the possible link between mental disorders and interleukin 33 to clarify the role of this axis in the immune system. We found 13 research papers that evaluated interleukin 33 or interleukin 31 levels in subjects affected by mental disorders. Eight studies investigated cytokines in affective disorders. Three studies measured levels of IL-33 in schizophrenia and two studies focused on patients affected by autism spectrum disorders. Alterations in brain structure and neurodevelopmental outcome are affected by multiple levels of organization. Disorders of the autoimmune response, and of the IL-33/31 axis, may therefore be one of the factors involved in this process. These results support the evidence that alarmins, particularly the IL-33/31 axis, need more consideration among researchers and practitioners.


Assuntos
Transtorno do Espectro Autista , Esquizofrenia , Biomarcadores , Citocinas , Humanos , Interleucina-33
13.
Int J Soc Psychiatry ; 67(5): 492-499, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32972293

RESUMO

BACKGROUND: Grief is a common reaction to the feeling of loss and it is considered a physiological and instinctive response. The 'normal' grief evolves into an 'integrated' phase within 1 year from death, and it is a non-pathological condition, that do not require specific therapeutic interventions. When this 'integrated phase' does not occur, the subject could reach pathological manifestations related to the grief. The Persistent Complex Bereavement Disorder (PCBD) is a new DSM5 clinical category characterized by symptoms related to the detachment and to the post-traumatic distress and it differs from normal and uncomplicated grief, for the disability caused by these reactions and their persistence and pervasiveness. AIM: The purpose of this work is the analysis of the pathways that led to this new definition, through a review of the main studies published in the last 20 years, with the aim to clarify the clinical utility of this new diagnostic category. METHOD: Relevant publications done in the last 20 years were identified via electronic searches of Pubmed, Embase, and Elsevier databases using the terms 'complicated grief' AND 'persistent', according to PRISMA guideline and PICO study design. RESULTS: PCBD results a new important clinical category showing specific symptoms, diagnostic criteria, and treatment. It presents many differences with other pathologies, that goes into differential diagnosis with PCBD, and it and can be treated with targeted therapeutic approaches. Diagnostic criteria for PCBD could allow an early diagnosis and a correct treatment avoiding underdiagnosis and misdiagnosis. CONCLUSION: Further researches could focus on the evaluation of more neurobiological aspects, new psychometric tools, for assessing susceptibility to this pathology, and on the cultural aspects that may influence mourning reactions, in an ethno-psychiatric perspective.


Assuntos
Luto , Pesar , Humanos , Classificação Internacional de Doenças , Psicometria
14.
J Clin Psychopharmacol ; 40(4): 381-385, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32639291

RESUMO

BACKGROUND: Given the wide implications of cognitive impairment for prognosis and outcome in schizophrenia, the research on pharmacological approaches aimed at addressing dysfunctional cognition has been extensive; nevertheless, there are no currently available licensed drugs, and the evidence in this field is still unimpressive. Vortioxetine is a multimodal antidepressant, which has been proposed as a suitable treatment option for cognitive symptoms in depression. METHODS: Twenty schizophrenia outpatients (mean age ± SD, 40.7 ±10.6 years) on stable clozapine treatment, assessed by neuropsychological (Wisconsin Card Sorting Test, Verbal Fluency, and Stroop task) and psychodiagnostic instruments (Positive and Negative Syndrome Scale [PANSS] and Calgary Depression Scale for Schizophrenia), received vortioxetine at the single daily dose of 10 mg/d until week 12; the dose was increased at 20 mg/d afterward, and this dosage was maintained unchanged until week 24. A physical examination, electrocardiogram with QTc measurement, and laboratory tests were also performed. RESULTS: Vortioxetine supplementation significantly improved Stroop test (P = 0.013) at week 12 and Stroop test (P = 0.031) and Semantic Fluency (P = 0.002) at end point. Moreover, a significantly reduction of PANSS domains "positive" (P = 0.019) at week 12 and of PANSS domains positive (P = 0.019) and total score (P = 0.041) and of depressive symptoms (Calgary Depression Scale for Schizophrenia, P = 0.032) at end point. There was no significant change in clinical, metabolic, and safety parameters, and no subject spontaneously reported adverse effects. CONCLUSIONS: Despite the limitations (open design, lack of a control group, small sample size, and short intervention period), our findings suggest for the first time that vortioxetine augmentation of clozapine may be a promising therapeutic strategy for addressing cognitive deficits in patients with schizophrenia.


Assuntos
Transtornos Cognitivos/complicações , Transtornos Cognitivos/tratamento farmacológico , Esquizofrenia/complicações , Esquizofrenia/tratamento farmacológico , Vortioxetina/uso terapêutico , Adulto , Antidepressivos/uso terapêutico , Antipsicóticos , Clozapina/uso terapêutico , Quimioterapia Combinada , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Projetos Piloto , Resultado do Tratamento , Vortioxetina/efeitos adversos , Adulto Jovem
15.
Int J Soc Psychiatry ; 66(1): 3-9, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31933422

RESUMO

BACKGROUND: The relationship between early trauma, hyperarousal and aberrant salience has been investigated exclusively in specific clinical samples, such as post-traumatic stress disorder (PTSD) and psychotic patients, and the results suggest that both dimensions are trauma-induced events, which may lead to the later onset, or increase the vulnerability to psychiatric disorders. The aim of the present research was to evaluate the possible relationships among early childhood trauma subtypes and the dimensions of hyperarousal and aberrant salience in an adult sample of psychiatric patients. MATERIALS AND METHODS: One-hundred psychiatric adult outpatients were assessed by Early Trauma Inventory Self Report-Short Form (ETISR-SF), Aberrant Salience Inventory (ASI) and Hyperarousal Scale (H-Scale). A linear regression analysis was performed in order to investigate which early traumatic events were a predictor of the aberrant salience and the hyperarousal. RESULTS: Regression analysis indicated that only ETISR-SF 'Emotional abuse' was the unique predictor of ASI 'Total score' (p < .0001) and H-Scale 'Total score' (p = .031), whereas other ETISR-SF variables did not give a significant additional contribution to the prediction of aberrant salience and the hyperarousal dimension. CONCLUSIONS: These findings support the role of emotional abuse as predictor of hyperarousal, a basic dimension associated with general vulnerability to mental illness. The awareness of the psychiatric consequences of early childhood trauma leads us to consider the need for better identification of children at risk, to develop effective interventions for the protection of minors from violent and/or inappropriate behaviors and to promote the development of protective resilience factors against re-victimization.


Assuntos
Experiências Adversas da Infância , Transtornos Mentais/psicologia , Trauma Psicológico/complicações , Resiliência Psicológica , Adulto , Nível de Alerta , Feminino , Humanos , Itália , Modelos Lineares , Masculino , Transtornos Mentais/etiologia , Pessoa de Meia-Idade , Risco , Autorrelato
16.
Clin Neuropsychiatry ; 17(5): 263-270, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34909002

RESUMO

OBJECTIVE: Comorbidity in psychiatric patients has been widely examined in the literature, enucleating the role in misinterpretation of symptom's root in a multi-disease background, as well as the impact on the quality of life, outcome, and health-care effects. This research aimed to examine, in an Italian population of psychiatric patients, the diagnostic continuum in the context of lifetime psychiatric comorbidity, assessing possible differences related to the onset disorder. METHOD: A retrospective analysis of medical records of 458 subjects, in which various psychiatric diagnoses were represented and categorized in 16 nosographic classes, was conducted. RESULTS: Results showed that "Bipolar disorder" (22.06%) was the most frequent diagnosis, "Eating disorder" had the earliest age onset (Mean age years = 16 ± 1.41), and "Schizophrenia" showed the longest disease duration (Mean years = 24.20±12.76). Moreover, 54,4% of the final sample presented at least one psychiatric comorbidity in disease history, while "Other personality disorders" was the most comorbidity-associated diagnosis, representing 29% of all the cases with more than 3 past diagnoses. Heterotypic transition was observed in fairly all considered onset diagnoses, exception made for "Schizophrenia" with 75% of the subjects showing homotypic progression. CONCLUSIONS: Our results suggest a tendency to make multiple diagnoses over psychiatric patients' lifetime in the majority of cases, often escaping from the original onset nosographic domain. More generally, our findings agree with a broad consensus that describes psychiatric symptomatic dimensions rather overlapped and correlated with each other, leading to a more transdiagnostic clinical approach.

17.
Front Psychiatry ; 10: 772, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31749717

RESUMO

Background: Duloxetine hydrochloride (DUL) is an antidepressant included in the pharmacological class of serotonin-norepinephrine reuptake inhibitors approved for the treatment of major depressive disorder, generalized anxiety disorder, diabetic peripheral neuropathic pain, fibromyalgia, and chronic musculoskeletal pain. The aim of this review was to elucidate current evidences on the use of DUL in the treatment of a variety of psychiatric disorders. Methods: This systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed database was searched from January 1, 2003, to September 30, 2018, using 11 key terms related to psychiatric disorders ("persistent depressive disorder," "dysthymic disorder," "bipolar disorder," "seasonal affective disorder," "obsessive-compulsive disorder," "social phobia," "panic disorder," "posttraumatic stress disorder," "schizophrenia," "eating disorders," "sexual disorders," "personality disorders") and one key term related to duloxetine ("duloxetine hydrochloride"). Article titles and abstracts were scanned to determine relevance to the topic. For additional studies, the authors also examined the reference lists of several of the included papers. Results: Duloxetine may be an effective treatment for mood spectrum disorders, panic disorder, several symptom clusters of borderline personality, and as add-on drug in schizophrenia. Modest or conflicting results have been found for the efficacy of duloxetine in obsessive-compulsive disorder, posttraumatic stress disorder, eating, and sexual disorders. Conclusion: Major limitations of the reviewed studies were short trial duration, small sample sizes, and the lack of control groups. Defining the potential role of DUL in the treatment of psychiatric disorders other than major depressive disorder and generalized anxiety disorder needs further randomized, placebo-controlled studies.

18.
Psychiatry Res ; 279: 323-330, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31164249

RESUMO

The inclusion of the Disruptive Mood Dysregulation Disorder (DMDD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), under the category of depressive disorders, provides a diagnosis for those children and adolescents with severe persistent irritability and temper outbursts, once misdiagnosed as Bipolar Disorders. The main and constantly present features of DMDD are chronic, non-episodic and persistent irritability, and temper tantrums disproportionate with the trigger. DMDD is characterized by high rates of comorbidity with other psychiatric disorders. Its main clinical manifestations overlap with Oppositional Defiant Disorder, Conduct Disorder, and Attention-Deficit/Hyperactivity Disorder. For this diagnostic overlap and the increasing use of pharmacological treatments in children and adolescents, the inclusion of DMDD diagnosis has been subjected to many criticisms. Since it is a new diagnostic entity, literature on DMDD prevalence, epidemiology, risk factors, and treatment guidelines, is still sparse and unclear. The aim of this review is to collect and analyze the literature on DMDD diagnostic criteria and main hallmarks, with particular attention to comorbidities and treatment options.


Assuntos
Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos do Humor/diagnóstico , Transtornos do Humor/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/psicologia , Comorbidade , Transtorno da Conduta/diagnóstico , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/psicologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Diagnóstico Diferencial , Erros de Diagnóstico/prevenção & controle , Erros de Diagnóstico/psicologia , Humanos , Humor Irritável/fisiologia , Transtornos do Humor/epidemiologia , Prevalência , Fatores de Risco
19.
J Clin Psychopharmacol ; 39(3): 210-213, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30921099

RESUMO

BACKGROUND: Cognitive deficits (CDs) in schizophrenia affect poor outcome and real-world community functioning. Because redox imbalance has been implicated, among other factors, in the pathophysiology of CDs, antioxidant compounds may have a beneficial effect in their treatment. Red yeast rice (RYR), besides its lipid-lowering effect, exhibit antioxidant and anti-inflammatory. METHODS: Thirty-five schizophrenia outpatients (age range, 18-60 years) on stable antipsychotic treatment and assessed by neuropsychological (Wisconsin Card Sorting Test [WCST], Verbal Fluency, and Stroop task) and psychodiagnostic instruments (Brief Psychiatric Rating Scale) received RYR at daily dosage of 200 mg/d (total monacolin K/capsule content, 11.88 mg) for 12 weeks. RESULTS: Red yeast rice supplementation significantly improved WCST "perseverative errors" (P = 0.015), "total errors" (P = 0.017, P = 0.001), and phonemic fluency test (P = 0.008); a trend for improvement on other WCST variables ("nonperseverative errors," "perseverative responses," and "categories") was observed. Effect sizes, according to Cohen's suggestions, were small in all explored cognitive dimensions. There were no significant change in clinical symptoms and no subject-reported adverse effects. CONCLUSIONS: Despite several limitations (open design, lack of a control group, short period of observation, small sample size, mode of controlling patients' compliance, the lack of assessment of patients' functional improvement), results suggest that RYR supplementation may be a potentially promising strategy for addressing CDs in schizophrenia; further randomized, placebo-controlled studies are needed to better evaluate the potential role of RYR for the treatment of CDs in schizophrenia.


Assuntos
Produtos Biológicos/administração & dosagem , Transtornos Cognitivos/tratamento farmacológico , Cognição/efeitos dos fármacos , Esquizofrenia/tratamento farmacológico , Adolescente , Adulto , Antioxidantes/administração & dosagem , Antioxidantes/efeitos adversos , Antioxidantes/farmacologia , Produtos Biológicos/efeitos adversos , Produtos Biológicos/farmacologia , Transtornos Cognitivos/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Projetos Piloto , Escalas de Graduação Psiquiátrica , Esquizofrenia/fisiopatologia , Resultado do Tratamento , Adulto Jovem
20.
J Clin Med ; 8(1)2019 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-30646527

RESUMO

Autism Spectrum Disorder (ASD) is a category of neurodevelopmental disturbances seriously affecting social skills, to which the scientific community has paid great attention in last decades. To date, their pathogenesis is still unknown, but several studies highlighted the relevance of gene-environment interactions in the onset of ASD. In addition, an immune involvement was seen in a wide number of ASD subjects, leading several researchers to hypothesize a possible common pathogenesis between ASD and immune disturbances, including Atopic Dermatitis (AD). In general, among potential contributing factors, microRNAs (miRNAs), small molecules capable of controlling gene expression and targeting mRNA transcripts, might represent one of the major circulating link, possibly unraveling the connections between neurodevelopmental and immune conditions. Under such premises, we conducted a systematic literature review, under the PRISMA guidelines, trying to define the panel of common miRNAs involved in both ASD and AD. The review retrieved articles published between January 1, 2005, and December 13, 2018, in PubMed, ScienceDirect, PsycARTICLES, and Google Scholar. We found a handful of works dealing with miRNAs in ASD and AD, with the most overlapping dysregulated miRNAs being miR-146 and miR-155. Two possible compounds are abnormally regulated in both ASD and AD subjects, possibly cross-contributing to the interactions between the two disorders, setting the basis to investigate more precisely the possible link between ASD and AD from another, not just clinical, perspective.

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