Dysphoria Spectrum in the Evaluation of Suicide Risk: An Overview and Exploratory Study.

BACKGROUND: The aim of the present paper was to summarize the role of dysphoria in the development of suicidality. We performed an exploratory study to evaluate dysphoria dimensions in inpatients suffering from borderline personality disorder (BPD), mood disorders, and schizophrenia spectrum disorders who were evaluated due to suicidal ideation or suicide attempt. SUBJECTS AND METHODS: Subjects aged 18-70, diagnosed with BPD, mood disorders, or schizophrenia spectrum disorders according to the DSM-5 criteria who were hospitalized following suicidal ideation or suicidal attempt were recruited in the present study. Dysphoria was assessed by the Nepean Dysphoria Scale, Italian version (NDS-I), a 24-item auto-administered tool evaluating the different dimensions of dysphoria. Between-group comparisons were performed by means of the Chi-square and Mann-Whitney U test. RESULTS: In the present sample (n=30), 15 (50%) subjects were admitted following a suicide attempt and 15 (50%) presented suicidal ideation. There were no significant differences in the NDS-I scores between subjects who performed a suicide attempt and those who presented suicidal ideation, neither for the total score nor for the subscales. Subjects suffering from BPD scored significantly higher at the NDS-I than those who were diagnosed with a mood disorder or a schizophrenia spectrum disorder. The result was replicated for the NDS-I subscales, except for the one analyzing discontent. When comparing subjects suffering from mood disorders to those with a diagnosis schizophrenia spectrum disorders, the two subgroups did not differ except for the irritability subscale, where subjects with mood disorders scored significantly higher. CONCLUSIONS: The dimension of dysphoria should be evaluated when assessing subjects who display high suicide risk. Dysphoria could be reconsidered a third affective pole representing psychopathological correlate of suicidality in subjects suffering from BPD.

Neurotropism and Neuropsychiatric Symptomsi in Patients with COVID-19.

BACKGROUND: The Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2). Beyond the most common clinical features of COVID-19, mainly represented by respiratory symptoms, other systems may be interested by the infection. Among these, through a neurotropic pathway, the central nervous system (CNS) may be affected by the virus, leading to developing neuropsychiatric symptoms. Particularly, this study focuses on neurological symptoms determined by the Sars-CoV-2 infection, as well as on the underlying pathogenetic processes. METHODS: For the present review, we followed a narrative approach. A literature search was carried out concerning the neurological consequences of COVID-19. Papers were screened, focusing on the clinical manifestations interesting the CNS and on their possible role in the early diagnosis of the disease. RESULTS: We display the most significant neurological clinical manifestations of COVID-19. Common neurological manifestations (ageusia, anosmia, and encephalitis) are first described. Subsequently, we provide a focus on delirium and its possible pathogenetic and clinical correlates. Delirium is not only a possible resultant of the COVID-19 neurotropism, but it may also be precipitated by a number of environmental factors that assume further relevance during the pandemic. CONCLUSIONS: Neuropsychiatric symptoms, and particularly delirium, can help identifying the infection at an early stage. Tailored treatments should be identified in order to prevent complications.

Differential Gender Severity Expression of Symptoms in Patients with Dual Diagnosis: An In-Patient Observational Study.

BACKGROUND: The present retrospective study is aimed at exploring the impact of gender differences in a sample of inpatients with dual diagnosis. SUBJECTS AND METHODS: The study was carried out at the Psychiatric Service of the General Hospital/University of Perugia (Italy). Patients were recruited from January 2015 until December 2018. The sample consists of patients with dual diagnosis, divided into two subgroups based on gender; descriptive and bivariate statistics were performed (p<0.05). Male and females were compared according to socio-demographic, clinical and psychopathological features, measured by Clinical Global Impressions (CGI) and factor models of the Positive and Negative Syndrome Scale (PANSS) and the Brief Psychiatric Rating Scale (BPRS). RESULTS: In our sample (n=157), no significant differences in socio-demographic features were found between male (n=108, 68.8%) and female subjects (n=49, 31.2%). Women displayed a higher frequency of involuntary hospitalizations (53.1% vs 32.4%, p=0.022) and a higher score on the general psychopathology scale of the Positive and Negative Syndrome Scale (PANSS) (41.86±8.96 vs 36.54±10.38, p=0.041). CONCLUSIONS: Our study confirms the prevalence of dual diagnosis in the male gender. Female sex appears more frequently connected to some indices of clinical severity. We expect to enlarge our sample to confirm these results and further clarify the knowledge on the subject.