Hypochondriasis and obsessive-compulsive disorder in schizophrenic patients treated with clozapine vs other atypical antipsychotics.

OBJECTIVE: The aim of the study was to investigate the prevalence rates of obsessive-compulsive disorder (OCD) and hypochondriasis in schizophrenic patients treated with atypical antipsychotics (AAPs) and to investigate the different comorbidity rates of OCD and hypochondriasis between clozapine-treated patients and patients treated with other AAPs. METHODS: We therefore recruited 60 schizophrenic patients treated with clozapine or other AAPs. We assessed the prevalence rates of OCD or OC symptoms and hypochondriasis or hypochondriac symptoms in the whole group of patients and in clozapine-treated patients versus patients treated with other AAPs. RESULTS: Schizophrenic patients had a higher comorbidity rate of OCD (26.6% vs 1-3%) and hypochondriasis (20% vs 1%) than the general population. These comorbidities were more frequent in schizophrenic patients treated with clozapine versus patients treated with other AAPs (36.7% vs 16.7% and 33.3% vs 6.7%). Clozapine-treated patients showed a higher mean Y-BOCS and HY-BOCS score when compared to patients treated with other AAPs (10.90 vs 5.90, p = .099; 15.40 vs 8.93, p = .166). A statistical significant correlation was found between the Y-BOCS and HY-BOCS scores of the whole group (r = .378, p = 0.03). Furthermore, we found an inverse correlation between the global level of functioning and the diagnosis of hypochondriasis (p = .048) and the severity of hypochondriac symptoms (p = .047). CONCLUSIONS: Hypochondriasis could represent an important clinical feature of schizophrenic patients treated with atypical antipsychotics, and further research is needed in this field.

Ultrasonographic Investigation of Human Fetus Responses to Maternal Communicative and Non-communicative Stimuli.

During pregnancy fetuses are responsive to the external environment, specifically to maternal stimulation. During this period, brain circuits develop to prepare neonates to respond appropriately. The detailed behavioral analysis of fetus' mouth movements in response to mothers' speech may reveal important aspects of their sensorimotor and affective skills; however, to date, no studies have investigated this response. Given that newborns at birth are capable of responding with matched behaviors to the social signals emitted by the caregiver, we hypothesize that such precocious responses could emerge in the prenatal period by exploiting infants' sensitivity to their mother's voice. By means of a two-dimensional (2D) ultrasonography, we assessed whether fetuses at 25 weeks of gestation, showed a congruent mouthmotor response to maternal acoustic stimulation. Mothers were asked to provide different stimuli, each characterized by a different acoustic output (e.g., chewing, yawning, nursery rhymes, etc.) and we recorded the behavioral responses of 29 fetuses. We found that, when mothers sang the syllable LA in a nursery rhyme, fetuses significantly increased mouth openings. Other stimuli provided by the mother did not produce other significant changes in fetus' behavior. This finding suggests that fetuses are sensitive only to specific maternal vocalizations (LA) and that fetal matched responses are rudimentary signs of early mirroring behaviors that become functional in the postnatal period. In conclusion, fetuses seem to be predisposed to respond selectively to specific maternal stimuli. We propose that such responses may play a role in the development of behavioral and emotional attunement with their mothers long before birth.

Hatha-yoga as a psychological adjuvant for women undergoing IVF: a pilot study.

OBJECTIVES: To evaluate the influence of Hatha-yoga (HY) practice on distress of women before starting their first in vitro fertilization (IVF) cycle. STUDY DESIGN: We offered 143 consecutive women with couple infertility the opportunity to attend a free HY course lasting 3 months as a psychological support before starting their first IVF cycle. All women were asked to complete the State-Trait Anxiety Inventory-Y1 (STAY-Y1), Edinburgh Depression Scale (EDS) and General Health Questionnaire-12 (GHQ-12) at baseline (T1) and after 3 months (T2), to evaluate symptoms of anxiety, depression and distress, respectively. RESULTS: Of the 143 women, 120 completed all three questionnaires. Of these, 45 attended the HY course and 75 did not. At T1, EDS and GHQ-12 scores were significantly higher in the HY group than in the non-HY group. There were no group differences in STAI-Y1 scores. At T2 there were no group differences. When, in each group, the score of each questionnaire at T1 was compared to the score at T2, a significant T1 to T2 reduction was observed in the HY group (p<0.0001 for STAY-Y1 and GHQ-12, p<0.001 for EDS). CONCLUSIONS: Our data suggest that women who are more distressed are more likely to accept psychological support before starting an IVF cycle and that in these women HY practice is associated with distress reduction.