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1.
Public Health ; 214: 124-132, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36549021

RESUMEN

OBJECTIVES: This study aimed to (1) explore the changes in conspiracy mentality across the four waves of the COVID-19 pandemic; (2) assess the relationship between conspirative mentality and psychological/behavioural variables; (3) identify the predictors of conspirative mentality; and (4) explore the effect of conspirative mentality on COVID-19 protective behaviour. STUDY DESIGN: This was a multiwave survey. METHODS: A total of 10,013 Italian individuals, aged 18-70 years, were assessed across the four waves (from January to May 2021) through online survey. We collected information about the sociodemographic characteristics of participants, personal experiences of COVID-19 infection, trust, COVID-19 protective behaviours, COVID-19 risk perception, arousal, auto-efficacy, resilience and well-being. Conspiracy mentality was assessed with the Conspiracy Mentality Questionnaire. The statistical analyses included exploratory factorial analyses, Pearson correlations and multiple linear regressions. RESULTS: The conspiracy mentality score during the COVID-19 pandemic was medium-high (mean 59.0 on a 0-100 scale) and slightly increased from 58.2 to 59.9 across months, in parallel with a slight decrease in trust in health institutions and scientific informational sources. Individuals aged >35 years, poorly educated and particularly scared about their financial situation were at risk of showing higher levels of conspirative mentality. Higher levels of conspirative mentality were risk factors for low levels of COVID-19 protective behaviours. CONCLUSIONS: Clear and effective communication may improve trust in health institutions and informational sources, decrease conspirative theories and increase compliance with protective behaviour.


Asunto(s)
COVID-19 , Pandemias , Humanos , COVID-19/epidemiología , Conductas Relacionadas con la Salud , Italia/epidemiología , Confianza
2.
Arch Ital Biol ; 159(1): 3-20, 2021 Mar 31.
Artículo en Inglés | MEDLINE | ID: mdl-34159573

RESUMEN

Cortical thickness (CT) and local gyrification index (LGI) in psychotic disorders may show modifications that relate to clinical course. This observational study aimed to analyse such variables in patients with schizophrenia, compared to healthy controls (HCs). We compared CT and LGI of 18 patients with first-episode psychosis with that of 21 with multi-episode schizophrenia and 16 HCs. CT corrected for false-positive cases (Family-Wise Error Rate) showed a reduction in the multi-episode group compared to HCs in left temporal and parietal, and right temporal, parietal, occipital, and hippocampal cortices. Family-wise corrected LGI was increased in the left inferior and middle frontal cortices, and in the right fusiform gyrus, cingulate, lingual, and parahippocampal gyri in first onset patients compared to HCs. Increased LGI was absent from later stages of psychosis, suggesting that specific CT and LGI alterations may underlie different stages of illness.


Asunto(s)
Trastornos Psicóticos , Esquizofrenia , Grosor de la Corteza Cerebral , Corteza Cerebral/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Trastornos Psicóticos/diagnóstico por imagen , Esquizofrenia/diagnóstico por imagen
3.
Acta Psychiatr Scand ; 138(3): 253-266, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-29984409

RESUMEN

OBJECTIVE: The study aimed to explore premorbid academic and social functioning in patients with schizophrenia, and its associations with the severity of negative symptoms and neurocognitive impairment. METHOD: Premorbid adjustment (PA) in patients with schizophrenia was compared to early adjustment in unaffected first-degree relatives and healthy controls. Its associations with psychopathology, cognition, and real-life functioning were investigated. The associations of PA with primary negative symptoms and their two factors were explored. RESULTS: We found an impairment of academic and social PA in patients (P ≤ 0.000001) and an impairment of academic aspects of early adjustment in relatives (P ≤ 0.01). Patients with poor PA showed greater severity of negative symptoms (limited to avolition after excluding the effect of depression/parkinsonism), working memory, social cognition, and real-life functioning (P ≤ 0.01 to ≤0.000001). Worse academic and social PA were associated with greater severity of psychopathology, cognitive impairment, and real-life functioning impairment (P ≤ 0.000001). Regression analyses showed that worse PA in the academic domain was mainly associated to the impairment of working memory, whereas worse PA in the social domain to avolition (P ≤ 0.000001). CONCLUSION: Our findings suggest that poor early adjustment may represent a marker of vulnerability to schizophrenia and highlight the need for preventive/early interventions based on psychosocial and/or cognitive programs.


Asunto(s)
Rendimiento Académico/psicología , Trastornos del Conocimiento/psicología , Disfunción Cognitiva/psicología , Esquizofrenia/diagnóstico , Rendimiento Académico/tendencias , Adulto , Anciano , Cognición/fisiología , Trastornos del Conocimiento/diagnóstico , Disfunción Cognitiva/diagnóstico , Depresión/epidemiología , Depresión/psicología , Femenino , Humanos , Masculino , Memoria a Corto Plazo/fisiología , Persona de Mediana Edad , Motivación , Escalas de Valoración Psiquiátrica/normas , Psicopatología , Esquizofrenia/epidemiología , Esquizofrenia/terapia , Psicología del Esquizofrénico , Índice de Severidad de la Enfermedad , Ajuste Social , Conducta Social
4.
Eur Child Adolesc Psychiatry ; 27(3): 309-318, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28918440

RESUMEN

Interpersonal sensitivity defines feelings of inner-fragility in the presence of others due to the expectation of criticism or rejection. Interpersonal sensitivity was found to be related to attenuated positive psychotic symptom during the prodromal phase of psychosis. The aims of this study were to examine if high level of interpersonal sensitivity at baseline are associated with the persistence of attenuated positive psychotic symptoms and general psychopathology at 18-month follow-up. A sample of 85 help-seeking individuals (mean age = 16.6, SD = 5.05) referred an Italian early detection project, completed the interpersonal sensitivity measure and the structured interview for prodromal symptoms (SIPS) at baseline and were assessed at 18-month follow-up using the SIPS. Results showed that individuals with high level of interpersonal sensitivity at baseline reported high level of attenuated positive psychotic symptoms (i.e., unusual thought content) and general symptoms (i.e., depression, irritability and low tolerance to daily stress) at follow-up. This study suggests that being "hypersensitive" to interpersonal interactions is a psychological feature associated with attenuated positive psychotic symptoms and general symptoms, such as depression and irritability, at 18-month follow-up. Assessing and treating inner-self fragilities may be an important step of early detection program to avoid the persistence of subtle but very distressing long-terms symptoms.


Asunto(s)
Relaciones Interpersonales , Trastornos Psicóticos/diagnóstico , Adolescente , Adulto , Niño , Diagnóstico Precoz , Femenino , Humanos , Masculino , Síntomas Prodrómicos , Adulto Joven
5.
Arch Ital Biol ; 156(1-2): 1-11, 2018 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-30039831

RESUMEN

BACKGROUND: Early emotional recognition impairment characterises rst-episode psychoses (FEP) and remains stable thereafter. Patients with FEP consistently show brain activation changes during emotional processing in functional neuroimaging studies. AIM AND METHODS: To identify and compare cerebral activation correlates of FEP patients and healthy controls (HCs) during emotional task performances, we performed an Activation Likelihood Estimation (ALE) meta-analysis of peer-reviewed functional magnetic resonance imaging (fMRI) studies. RESULTS: Five studies included 71 patients with FEP and 75 HCs. Within-group analyses showed that HCs activated during emotional task performance the bilateral inferior parietal lobule (BAs 39 and 40), left inferior frontal gyrus (BAs 9 and 47), right amygdala, left middle frontal gyrus (BA 9), right cingulate gyrus (BA 32), and right middle temporal gyrus (BA 21). FEP activations correlating with emotional tasks included the right cuneus (BA 17) and right angular gyrus (BA 39). CONCLUSIONS: During emotional task performance, FEP patients fail to activate an extensive brain network comprising emotional processing-related areas, including both cortical and subcortical areas.


Asunto(s)
Síntomas Afectivos/fisiopatología , Síntomas Afectivos/psicología , Emociones , Trastornos Psicóticos/fisiopatología , Trastornos Psicóticos/psicología , Síntomas Afectivos/etiología , Encéfalo/fisiopatología , Humanos , Funciones de Verosimilitud , Imagen por Resonancia Magnética , Red Nerviosa/fisiopatología , Trastornos Psicóticos/complicaciones
6.
Psychol Med ; 46(11): 2239-53, 2016 08.
Artículo en Inglés | MEDLINE | ID: mdl-27239944

RESUMEN

BACKGROUND: Among the myths that are often cited about suicide is that 'people who talk about killing themselves rarely die by suicide', but the evidence seems to contradict this statement. The aim of this study was to conduct a meta-analysis of studies reporting a prevalence of suicide communication (SC), and to examine the diagnostic accuracy of SC towards suicide in case-control reports. METHOD: Eligible studies had to examine data relative to completed suicides and report the prevalence of SC. Data relative to sample characteristics, study definition, modality and recipient of the SC were coded. RESULTS: We included 36 studies, conducted on a total of 14 601 completed suicides. The overall proportion of SC was 44.5% [95% confidence interval (CI) 35.4-53.8], with large heterogeneity (I 2 = 98.8%) and significant publication bias. The prevalence of SC was negatively associated with the detection of verbal communication as the sole means of SC and, positively, with study methodological quality. Based on seven case-control studies, SC was associated with an odds ratio of 4.66 for suicide (95% CI 3.00-7.25) and was characterized by sufficient diagnostic accuracy only if studies on adolescents were removed. CONCLUSION: Available data suggest that SC occurs in nearly half of subjects who go on to die by suicide, but this figure is likely to be an underestimate given the operational definitions of SC. At present, SC seems associated with overall insufficient accuracy towards subsequent suicide, although further rigorous studies are warranted to draw definite conclusions on this issue.


Asunto(s)
Comunicación , Suicidio/estadística & datos numéricos , Humanos
7.
Psychol Med ; 46(4): 841-54, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26610039

RESUMEN

BACKGROUND: The use of cannabis with higher Δ9-tetrahydrocannabinol content has been associated with greater risk, and earlier onset, of psychosis. However, the effect of cannabis potency on brain morphology has never been explored. Here, we investigated whether cannabis potency and pattern of use are associated with changes in corpus callosum (CC) microstructural organization, in patients with first-episode psychosis (FEP) and individuals without psychosis, cannabis users and non-users. METHOD: The CC of 56 FEP (37 cannabis users) and 43 individuals without psychosis (22 cannabis users) was virtually dissected and segmented using diffusion tensor imaging tractography. The diffusion index of fractional anisotropy, mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity was calculated for each segment. RESULTS: Across the whole sample, users of high-potency cannabis had higher total CC MD and higher total CC AD than both low-potency users and those who never used (p = 0.005 and p = 0.004, respectively). Daily users also had higher total CC MD and higher total CC AD than both occasional users and those who never used (p = 0.001 and p < 0.001, respectively). However, there was no effect of group (patient/individuals without psychosis) or group x potency interaction for either potency or frequency of use. The within-group analysis showed in fact that the effects of potency and frequency were similar in FEP users and in users without psychosis. CONCLUSIONS: Frequent use of high-potency cannabis is associated with disturbed callosal microstructural organization in individuals with and without psychosis. Since high-potency preparations are now replacing traditional herbal drugs in many European countries, raising awareness about the risks of high-potency cannabis is crucial.


Asunto(s)
Trastornos Psicóticos Afectivos/diagnóstico por imagen , Cannabis , Cuerpo Calloso/diagnóstico por imagen , Fumar Marihuana/epidemiología , Trastornos Psicóticos/diagnóstico por imagen , Esquizofrenia/diagnóstico por imagen , Adolescente , Adulto , Trastornos Psicóticos Afectivos/epidemiología , Anisotropía , Estudios de Casos y Controles , Comorbilidad , Imagen de Difusión Tensora , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Trastornos Psicóticos/epidemiología , Esquizofrenia/epidemiología , Adulto Joven
8.
Psychol Med ; 46(13): 2717-29, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-27649341

RESUMEN

BACKGROUND: The study aimed to subtype patients with schizophrenia on the basis of social cognition (SC), and to identify cut-offs that best discriminate among subtypes in 809 out-patients recruited in the context of the Italian Network for Research on Psychoses. METHOD: A two-step cluster analysis of The Awareness of Social Inference Test (TASIT), the Facial Emotion Identification Test and Mayer-Salovey-Caruso Emotional Intelligence Test scores was performed. Classification and regression tree analysis was used to identify the cut-offs of variables that best discriminated among clusters. RESULTS: We identified three clusters, characterized by unimpaired (42%), impaired (50.4%) and very impaired (7.5%) SC. Three theory-of-mind domains were more important for the cluster definition as compared with emotion perception and emotional intelligence. Patients more able to understand simple sarcasm (⩾14 for TASIT-SS) were very likely to belong to the unimpaired SC cluster. Compared with patients in the impaired SC cluster, those in the very impaired SC cluster performed significantly worse in lie scenes (TASIT-LI <10), but not in simple sarcasm. Moreover, functioning, neurocognition, disorganization and SC had a linear relationship across the three clusters, while positive symptoms were significantly lower in patients with unimpaired SC as compared with patients with impaired and very impaired SC. On the other hand, negative symptoms were highest in patients with impaired levels of SC. CONCLUSIONS: If replicated, the identification of such subtypes in clinical practice may help in tailoring rehabilitation efforts to the person's strengths to gain more benefit to the person.


Asunto(s)
Inteligencia Emocional/fisiología , Expresión Facial , Reconocimiento Facial/fisiología , Esquizofrenia/fisiopatología , Percepción Social , Ingenio y Humor como Asunto , Adulto , Análisis por Conglomerados , Femenino , Humanos , Masculino , Persona de Mediana Edad
9.
Acta Psychiatr Scand ; 133(1): 34-43, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26096273

RESUMEN

OBJECTIVE: Nosological distinctions among schizoaffective disorder (SA), bipolar I disorder with psychotic features (BDp), and schizophrenia (SZ) remain unresolved. METHOD: We compared 2269 subjects with psychotic features in DSM-IV-TR diagnoses (1435 BDp, 463 SZ, 371 SA) from 8 collaborating international sites, by 12 sociodemographic and clinical measures, all between diagnostic pairs. RESULTS: In bivariate comparisons, SA was consistently intermediate between BDp and SZ for 11/12 features (except onset stressors), and SZ vs. BDp differed in all 12 factors. SA differed from both BDp and SZ in 9/12 factors: SA and BDp were similar in education and suicidal ideation or acts; SA and SZ were similar in education, onset stressors, and substance abuse. Meta-analytic comparisons of diagnostic pairs for 10 categorical factors indicated similar differences of SA from both SZ and BDp. Multivariate modeling indicated significantly independent differences between BDp and SZ (8 factors), SA vs. SZ (5), and BDp vs. SA (3). Measurement variance was similar for all diagnoses. CONCLUSION: SA was consistently intermediate between BDp and SZ. The three diagnostic groups ranked: BDp > SA > SZ related to lesser morbidity or disability. The findings are not consistent with a dyadic Kraepelinian categorization, although the considerable overlap among the three DSM-IV diagnostic groups indicates uncertain boundaries if they represent distinct disorders.


Asunto(s)
Trastorno Bipolar/psicología , Análisis Multivariante , Trastornos Psicóticos/psicología , Esquizofrenia/diagnóstico , Adulto , Demografía , Salud de la Familia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Sociológicos
10.
Eur Child Adolesc Psychiatry ; 25(1): 7-16, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25711287

RESUMEN

A personality trait that often elicits poor and uneasy interpersonal relationships is interpersonal sensitivity. The aim of the present study was to explore the relationship between interpersonal sensitivity and psychosocial functioning in individuals at ultra-high risk for psychosis as compared to help-seeking individuals who screened negative for an ultra-high risk of psychosis. A total sample of 147 adolescents and young adult who were help seeking for emerging mental health problems participated in the study. The sample was divided into two groups: 39 individuals who met criteria for an ultra-high-risk mental state (UHR), and 108 (NS). The whole sample completed the Interpersonal Sensitivity Measure (IPSM) and the Global Functioning: Social and Role Scale (GF:SS; GF:RS). Mediation analysis was used to explore whether attenuated negative symptoms mediated the relationship between interpersonal sensitivity and social functioning. Individuals with UHR state showed higher IPSM scores and lower GF:SS and GF:RS scores than NS participants. A statistically negative significant correlation between two IPSM subscales (Interpersonal Awareness and Timidity) and GF:SS was found in both groups. Our results also suggest that the relationship between the aforementioned aspects of interpersonal sensitivity and social functioning was not mediated by negative prodromal symptoms. This study suggests that some aspects of interpersonal sensitivity were associated with low level of social functioning. Assessing and treating interpersonal sensitivity may be a promising therapeutic target to improve social functioning in young help-seeking individuals.


Asunto(s)
Relaciones Interpersonales , Síntomas Prodrómicos , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Ajuste Social , Adolescente , Adulto , Femenino , Humanos , Masculino , Factores de Riesgo , Encuestas y Cuestionarios , Adulto Joven
11.
Acta Psychiatr Scand ; 128(4): 261-70, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23216145

RESUMEN

OBJECTIVE: To explore gray (GM) and white matter (WM) abnormalities and the relationships with neuropsychopathology in first-episode schizophrenia (FES). METHOD: Nineteen patients with first episode of non-affective psychosis and 18 controls underwent a magnetic resonance voxel-based morphometry. Additionally, WM fractional anisotropy (FA) was calculated. For correlative analysis, symptoms and neuropsychological performances were scored by PANSS and by a comprehensive neuropsychological assessment respectively. RESULTS: Patients showed significantly decreased volume of left temporal lobe and disarray of all major WM tracts. Disorganized PANSS factor was inversely related to left cerebellar GM volume (corrected P = 0.03) and to WM FA of the left cerebellum, inferior fronto-occipital fasciculi (IFOF), and inferior longitudinal fasciculi (corrected P < 0.05). PANSS negative factor was inversely related to FA in the IFOF and superior longitudinal fasciculi (corrected P < 0.05). Impairment in facial emotion identification showed associations with temporo-occipital GM volume decrease (corrected P = 0.003) and WM disarray of superior and middle temporal gyri, anterior thalamic radiation, and superior longitudinal fasciculi (corrected P < 0.05). Speed of processing and visual memory correlated with WM abnormalities in fronto-temporal tracts. CONCLUSION: These results confirm how the structural development of key brain regions is related to neuropsychopathological dysfunction in FES, consistently with a neurodevelopmentally derived misconnection syndrome.


Asunto(s)
Encéfalo/patología , Encéfalo/fisiopatología , Esquizofrenia/patología , Esquizofrenia/fisiopatología , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Pruebas Neuropsicológicas , Adulto Joven
12.
Int J Clin Pract ; 67(12): 1311-6, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24246209

RESUMEN

INTRODUCTION: Research has demonstrated that patients with insomnia are at an increased risk of experiencing suicidal ideation and/or making a suicide attempt. OBJECTIVES: To evaluate the relation between insomnia and suicidal behaviour. AIMS: To examine factors associated with a diagnosis of insomnia in patients admitted to an Emergency Department (ED) and assessed by the psychiatrist in charge. METHODS: Participants were 843 patients consecutively admitted to the ED of Sant'Andrea Hospital in Rome, between January 2010 and December 2011. All patients admitted were referred to a psychiatrist. A clinical interview based on the Mini International Neuropsychiatric Interview (MINI) and a semi-structured interview was conducted. Patients were asked about 'ongoing' suicidal ideation or plans for suicide. RESULTS: Forty-eight percent of patients received a diagnosis of bipolar disorder (BD), major depressive disorder (MDD) or an anxiety disorder; whereas, 17.1% were diagnosed with Schizophrenia or other non-affective psychosis. Patients with insomnia (compared to patients without insomnia) more frequently had a diagnosis of BD (23.9% vs. 12.4%) or MDD (13.3% vs. 9.5%; p < 0.001). Moreover, patients with insomnia less frequently had attempted suicide in the past 24 h (5.3% vs. 9.5%; p < 0.05) as compared with other patients, but those patients with insomnia who attempted suicide more frequently used a violent method (64.3% vs. 23.6%; p < 0.01) compared to other suicide attempters. CONCLUSIONS: Our results do not support an association between insomnia and suicidal behaviour. However, suicide attempters with insomnia more frequently used violent methods, and this phenomenon should be taken into serious consideration by clinicians.


Asunto(s)
Trastornos del Inicio y del Mantenimiento del Sueño/complicaciones , Intento de Suicidio/psicología , Trastorno Bipolar/complicaciones , Trastorno Depresivo Mayor/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ciudad de Roma , Esquizofrenia/complicaciones , Ideación Suicida , Intento de Suicidio/estadística & datos numéricos
13.
Eur Respir J ; 39(4): 883-92, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22005911

RESUMEN

The prevalence of asthma increased worldwide until the 1990s, but since then there has been no clear temporal pattern. The present study aimed to assess time trends in the prevalence of current asthma, asthma-like symptoms and allergic rhinitis in Italian adults from 1990 to 2010. The same screening questionnaire was administered by mail or phone to random samples of the general population (age 20-44 yrs) in Italy, in the frame of three multicentre studies: the European Community Respiratory Health Survey (ECRHS) (1991-1993; n = 6,031); the Italian Study on Asthma in Young Adults (ISAYA) (1998-2000; n = 18,873); and the Gene Environment Interactions in Respiratory Diseases (GEIRD) study (2007-2010; n = 10,494). Time trends in prevalence were estimated using Poisson regression models in the centres that repeated the survey at different points in time. From 1991 to 2010, the median prevalence of current asthma, wheezing and allergic rhinitis increased from 4.1% to 6.6%, from 10.1% to 13.9% and from 16.8% to 25.8%, respectively. The prevalence of current asthma was stable during the 1990s and increased (relative risk 1.38, 95% CI 1.19-1.59) from 1998-2000 to 2007-2010, mainly in subjects who did not report allergic rhinitis. The prevalence of allergic rhinitis has increased continuously since 1991. The asthma epidemic is not over in Italy. During the past 20 yrs, asthma prevalence has increased by 38%, in parallel with a similar increase in asthma-like symptoms and allergic rhinitis.


Asunto(s)
Asma/epidemiología , Rinitis Alérgica Perenne/epidemiología , Rinitis Alérgica Estacional/epidemiología , Adulto , Estudios Transversales , Femenino , Humanos , Italia/epidemiología , Masculino , Prevalencia , Ruidos Respiratorios , Fumar/epidemiología , Encuestas y Cuestionarios , Adulto Joven
14.
Psychol Med ; 42(9): 1835-45, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22225783

RESUMEN

BACKGROUND: Interpersonal sensitivity is a personality trait described as excessive awareness of both the behaviour and feelings of others. Although interpersonal sensitivity has been found to be one of the vulnerability factors to depression, there has been little interest in its relationship with the prodromal phase of psychosis. The aims of this study were to examine the level of interpersonal sensitivity in a sample of individuals with an at-risk mental state (ARMS) for psychosis and its relationship with other psychopathological features. METHOD: Sixty-two individuals with an ARMS for psychosis and 39 control participants completed a series of self-report questionnaires, including the Interpersonal Sensitivity Measure (IPSM), the Prodromal Questionnaire (PQ), the Ways of Coping Questionnaire (WCQ) and the Depression and Anxiety Stress Scale (DASS). RESULTS: Individuals with an ARMS reported higher interpersonal sensitivity compared to controls. Associations between interpersonal sensitivity, positive psychotic symptoms (i.e. paranoid ideation), avoidant coping and symptoms of depression, anxiety and stress were also found. CONCLUSIONS: This study suggests that being 'hypersensitive' to interpersonal interactions is a psychological feature of the putatively prodromal phase of psychosis. The relationship between interpersonal sensitivity, attenuated positive psychotic symptoms, avoidant coping and negative emotional states may contribute to long-term deficits in social functioning. We illustrate the importance, when assessing a young client with a possible ARMS, of examining more subtle and subjective symptoms in addition to attenuated positive symptoms.


Asunto(s)
Ansiedad de Separación , Relaciones Interpersonales , Síntomas Prodrómicos , Trastornos Psicóticos/fisiopatología , Autoimagen , Adaptación Psicológica , Adolescente , Adulto , Ansiedad , Estudios de Casos y Controles , Depresión , Femenino , Humanos , Masculino , Personalidad
15.
Eur Rev Med Pharmacol Sci ; 16(10): 1389-98, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23104655

RESUMEN

BACKGROUND: Risk factors for suicide are at least partially heritable and functional polymorphisms of targeted genes have been suggested to be implicated in the pathogenesis of this phenomenon. However, other studies examining the association between specific gene variants and suicide revealed inconsistent findings. We aims to evaluate the possible association between MAO-A3, CYP1A2*1F and GNB3 gene variants, hopelessness and suicidal risk in a sample of subjects with chronic migraine and affective temperamental dysregulation. METHODS: 56 women were genotyped for MAO-A3, CYP1A2*1F and GNB3 gene variants. Participants were also assessed using Beck Hopelessness Scale (BHS), the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego-Autoquestionnaire (TEMPS-A), and the Suicidal History Self-Rating Screening Scale (SHSS). RESULTS: Patients with higher total scores on affective dysregulated temperaments are more likely to have higher BHS (11.27+/=5.54 vs. 5.73+/=3.81; t19.20 = -3.57; p < 0.01) and higher SHSS total scores (4.79+/=3.31 vs. 1.05±2.31; t17.74 = -3.90; p < 0.001) than those with lower total scores. 67% of patients in the dysregulated group has BHS total scores >= 9 indicating high levels of hopelessness. No association was found between MAO-A3, CYP1A2*1F and GNB3 gene variants and suicidal risk as assessed by BHS and SHSS. CONCLUSIONS: This study did not sustain the association between MAO-A3, CYP1A2*1F and GNB3 gene variants and increased suicidal risk in patients with chronic migraine and affective temperamental dysregulation. Further studies investigating the gene-environment interaction or focusing on other genetic risk factors involved in suicidal behaviour are needed.  


Asunto(s)
Síntomas Afectivos/genética , Variación Genética , Trastornos Migrañosos/genética , Suicidio , Temperamento , Adulto , Síntomas Afectivos/complicaciones , Anciano , Enfermedad Crónica , Citocromo P-450 CYP1A2/genética , Femenino , Proteínas de Unión al GTP Heterotriméricas/genética , Humanos , Persona de Mediana Edad , Trastornos Migrañosos/complicaciones , Monoaminooxidasa/genética , Riesgo
16.
Psychol Med ; 41(4): 779-88, 2011 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-20667170

RESUMEN

BACKGROUND: The Met allele of the catechol-O-methyltransferase (COMT) valine-to-methionine (Val158Met) polymorphism is known to affect dopamine-dependent affective regulation within amygdala-prefrontal cortical (PFC) networks. It is also thought to increase the risk of a number of disorders characterized by affective morbidity including bipolar disorder (BD), major depressive disorder (MDD) and anxiety disorders. The disease risk conferred is small, suggesting that this polymorphism represents a modifier locus. Therefore our aim was to investigate how the COMT Val158Met may contribute to phenotypic variation in clinical diagnosis using sad facial affect processing as a probe for its neural action. METHOD: We employed functional magnetic resonance imaging to measure activation in the amygdala, ventromedial PFC (vmPFC) and ventrolateral PFC (vlPFC) during sad facial affect processing in family members with BD (n=40), MDD and anxiety disorders (n=22) or no psychiatric diagnosis (n=25) and 50 healthy controls. RESULTS: Irrespective of clinical phenotype, the Val158 allele was associated with greater amygdala activation and the Met158 allele with greater signal change in the vmPFC and vlPFC. Signal changes in the amygdala and vmPFC were not associated with disease expression. However, in the right vlPFC the Met158 allele was associated with greater activation in all family members with affective morbidity compared with relatives without a psychiatric diagnosis and healthy controls. CONCLUSIONS: Our results suggest that the COMT Val158Met polymorphism has a pleiotropic effect within the neural networks subserving emotional processing. Furthermore the Met158 allele further reduces cortical efficiency in the vlPFC in individuals with affective morbidity.


Asunto(s)
Alelos , Amígdala del Cerebelo/fisiopatología , Trastorno Bipolar/genética , Trastorno Bipolar/fisiopatología , Catecol O-Metiltransferasa/genética , Emociones/fisiología , Expresión Facial , Genotipo , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Oxígeno/sangre , Reconocimiento Visual de Modelos/fisiología , Corteza Prefrontal/fisiopatología , Adulto , Trastornos de Ansiedad/genética , Trastornos de Ansiedad/fisiopatología , Trastornos de Ansiedad/psicología , Trastorno Bipolar/psicología , Trastorno Depresivo Mayor/genética , Trastorno Depresivo Mayor/fisiopatología , Trastorno Depresivo Mayor/psicología , Dominancia Cerebral/genética , Dominancia Cerebral/fisiología , Femenino , Predisposición Genética a la Enfermedad/genética , Predisposición Genética a la Enfermedad/psicología , Humanos , Recién Nacido , Masculino , Persona de Mediana Edad , Red Nerviosa/fisiopatología , Tiempo de Reacción/fisiología , Adulto Joven
17.
Neuropsychobiology ; 64(2): 61-85, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21701225

RESUMEN

BACKGROUND AND AIM: Obsessive-compulsive disorder (OCD) is a severe, highly prevalent and chronically disabling psychiatric disorder that usually emerges during childhood or adolescence. This paper aims to review the literature on functional neuroimaging in OCD, analysing the reported dysfunctional connectivity in the corticostriatothalamocortical circuitry. METHOD: This study included papers published in peer-reviewed journals dealing with functional imaging in OCD. RESULTS: Striatal dysfunction, mainly of the caudate nucleus, leads to inefficient thalamic gating, resulting in hyperactivity within the orbitofrontal cortex (intrusive thoughts) and the anterior cingulate cortex (non-specific anxiety). Compulsions consist of ritualistic behaviours performed to recruit the inefficient striatum and neutralise unwanted thoughts and anxiety. Functional neuroimaging findings are discussed against the background of specific cognitive impairments, mainly regarding visuospatial processing, executive functioning and motor speed. Cognitive deficits are partial and specific, matching imaging data. CONCLUSIONS: Several studies have targeted brain regions hypothesised to be involved in the pathogenesis of OCD, showing the existence of dysfunctional connectivity in the corticostriatothalamocortical circuitry. Improvements in spatial resolution of neuroimaging techniques may contribute to a better understanding of the neurocircuitry of OCD and other anxiety disorders.


Asunto(s)
Encéfalo , Diagnóstico por Imagen , Trastorno Obsesivo Compulsivo/diagnóstico , Encéfalo/diagnóstico por imagen , Encéfalo/metabolismo , Encéfalo/patología , Bases de Datos Factuales/estadística & datos numéricos , Humanos , Trastorno Obsesivo Compulsivo/epidemiología , Cintigrafía
18.
Int J Clin Pract ; 65(9): 976-84, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-21627738

RESUMEN

AIM: The aims of the study were to study: (i) affective temperaments in open-angle glaucoma (OAG) patients with some degree of functional visual impairment; (ii) psychological well-being and perceived disability, and their associations with affective temperaments; and (iii) associations between visual impairment, affective temperaments and psychological well-being. METHOD: Participants were 91 outpatients (39 women, and 52 men) with open-angle glaucoma (OAG) who were assessed for Visual Field Index, Mean Defect and Pattern Standard Deviation. Patients were also administered the Beck Hopelessness Scale, the TEMPS-A (Rome), the Gotland Male Depression Scale, the Emotional Well-being Scale, the Perceived Disability Questionnaire and the Suicidal History Self-Rating Screening Scale. RESULTS: Open-angle glaucoma patients (compared with a non-clinical sample of university students) had higher scores on the TEMP-A dysthimic and hyperthimic traits and lower scores on cyclothimic, irritability and anxiety traits. Such temperament variability was not linked to differences in severity of glaucoma. We did not find strong evidence supporting the fact that measures of visual impairment were linked to emotional well-being and depression. However, logistic regression analysis revealed that patients may have different patterns related to their illness according to specific temperaments. CONCLUSION: Patients with OAG may have different temperament profiles than non-clinical individuals. Such categorisation may be useful for predicting how they face the illness, for providing better care as well as for early recognition of mood disorders symptoms.


Asunto(s)
Actitud Frente a la Salud , Personas con Discapacidad/psicología , Glaucoma de Ángulo Abierto/psicología , Temperamento , Anciano , Atención Ambulatoria , Estudios de Casos y Controles , Análisis por Conglomerados , Trastorno Distímico/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos de la Visión/psicología
19.
Acta Psychiatr Scand ; 122(6): 481-7, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20560901

RESUMEN

OBJECTIVE: To investigate the effect of lithium, anticonvulsants and antipsychotics on brain structure in bipolar disorder (BD). METHOD: A cross-sectional structural brain magnetic resonance imaging study of 74 remitted patients with BD, aged 18-65, who were receiving long-term prophylactic treatment with lithium or anticonvulsants or antipsychotics. Global and regional grey matter, white matter, and cerebrospinal fluid volumes were compared between treatment groups. RESULTS: Grey matter in the subgenual anterior cingulate gyrus on the right (extending into the hypothalamus) and in the postcentral gyrus, the hippocampus/amygdale complex and the insula on the left was greater in BD patients on lithium treatment compared to all other treatment groups. CONCLUSION: Lithium treatment in BD has a significant effect on brain structure particularly in limbic/paralimbic regions associated with emotional processing.


Asunto(s)
Anticonvulsivantes/farmacología , Antimaníacos/farmacología , Trastorno Bipolar/tratamiento farmacológico , Encéfalo/efectos de los fármacos , Litio/farmacología , Adolescente , Adulto , Anciano , Anticonvulsivantes/uso terapéutico , Antimaníacos/uso terapéutico , Encéfalo/patología , Mapeo Encefálico/métodos , Estudios Transversales , Femenino , Humanos , Litio/uso terapéutico , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Adulto Joven
20.
Pharmacopsychiatry ; 43(2): 66-72, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20099224

RESUMEN

INTRODUCTION: A long-acting, injected, carbohydrate-microsphere preparation of risperidone (RLAI; Risperdal Consta ((R))) is reported to be safe and effective in chronic psychotic illnesses but, as its long-term and comparative efficacy remain unclear, this study compared clinical status during oral antipsychotic treatment versus conversion to RLAI. METHODS: Psychotic patients (n=88; initial BPRS=93+/-5) were treated for 6 months with clinically chosen oral medication and then converted to biweekly RLAI for the first 6 months (6-6 months matched mirror comparison) and then for another 18 months. Clinical status in the two treatment periods and in the 18 months of follow-up was compared with measures including BPRS improvement (primary outcome), CGI variants and SF-36 ratings. RESULTS: RLAI (at a mean dose of 47 mg/2 weeks at six and up to 23.1+/-3.3 months) was associated with major improvements in all outcome measures (p<0.001). Initial BPRS scores fell by an average of 50% within six months; hospitalizations declined from 19.8% to 0%, and rates of adverse events were reduced by 2.5- to 7.4-fold. Such benefits were sustained during 18 months of follow-up with RLAI-treatment. CONCLUSIONS: The findings are limited by the lack of a parallel control treatment, such as with oral risperidone or another antipsychotic, lack of blinded assessments, and a moderate number of subjects. Nevertheless, the findings add to indications that RLAI can be an effective and well-tolerated treatment-option for chronically psychotic patients.


Asunto(s)
Antipsicóticos/administración & dosificación , Antipsicóticos/uso terapéutico , Trastornos Psicóticos/tratamiento farmacológico , Risperidona/administración & dosificación , Risperidona/uso terapéutico , Administración Oral , Adulto , Anciano , Carbohidratos , Enfermedad Crónica , Preparaciones de Acción Retardada , Femenino , Estudios de Seguimiento , Hospitalización , Humanos , Inyecciones , Masculino , Microesferas , Persona de Mediana Edad , Estudios Prospectivos , Escalas de Valoración Psiquiátrica , Trastornos Psicóticos/terapia , Resultado del Tratamiento , Adulto Joven
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