A comprehensive perspective of autistic traits and catatonic symptoms in a patient with Fronto-Temporal Dementia and Bipolar Disorder: a case report.

BACKGROUND: Fronto-Temporal Dementia (FTD) is a neurodegenerative disorder featuring frontotemporal lobe atrophy which leads to profound changes in behavior and cognition in the affected subjects. Considering that the onset of this type of dementia is typically characterized by the development of affective symptoms, differential diagnosis between FTD and Bipolar Disorder (BD) is particularly difficult. An important overlapping feature between BD and FTD is the presence of catatonic symptoms: Catatonia is extremely frequent in FTD, and, on the other hand, BD is the psychiatric disease with the highest frequency of association with catatonic states. In this framework, it should be noted that also Autism Spectrum conditions have been reported to show high rates of comorbidity and overlapping features with BD. In addition, subjects with autistic traits were reported to show an increased vulnerability towards the development of mood and anxiety disorders, as well as increase the risk of mood episodes with mixed features, suicidal thoughts and catatonic symptoms. CASE PRESENTATION: We reported the case of a patient with a diagnosis of both BD and FTD who showed catatonic symptoms. OBJECTIVES: The aim of this case report is to evaluate the possible role of autistic traits in the illness trajectory of BD and FTD. CONCLUSION: This case confirms the presence of a continuum between psychiatric and neurological conditions, which should be considered as expressions of a same neurobiological system and further investigated in light of an integrative model.

Autistic traits and camouflaging behaviors: a cross-sectional investigation in a University student population.

BACKGROUND: Increasing research is stressing the importance of identifying autistic traits (ATs) in clinical and general populations. University students may be a group at higher risk for the presence of ATs. Recently, specific attention has been paid to camouflaging strategies used by subjects in the autism spectrum in order to cope with the social environment. The aim of this work was to evaluate the prevalence of ATs and camouflaging behaviors in a population of University students. METHODS: Subjects were requested to anonymously fill out through an online form the Adult Autism Subthreshold Spectrum and the Camouflaging AT Questionnaire. RESULTS: ATs were more represented among males and among students of specific fields of study. Camouflaging behaviors were significantly more frequent among subjects with more severe autism spectrum symptoms, without differences depending from sex. CONCLUSIONS: Our study confirms the strong association between ATs and camouflaging behaviors and the relationship between ATs, sex, and specific fields of study.

Novel Pharmacological Targets of Post-Traumatic Stress Disorders.

Post-traumatic stress disorder (PTSD) is a psychopathological condition with a heterogeneous clinical picture that is complex and challenging to treat. Its multifaceted pathophysiology still remains an unresolved question and certainly contributes to this issue. The pharmacological treatment of PTSD is mainly empirical and centered on the serotonergic system. Since the therapeutic response to prescribed drugs targeting single symptoms is generally inconsistent, there is an urgent need for novel pathogenetic hypotheses, including different mediators and pathways. This paper was conceived as a narrative review with the aim of debating the current pharmacological treatment of PTSD and further highlighting prospective targets for future drugs. The authors accessed some of the main databases of scientific literature available and selected all the papers that fulfilled the purpose of the present work. The results showed that most of the current pharmacological treatments for PTSD are symptom-based and show only partial benefits; this largely reflects the limited knowledge of its neurobiology. Growing, albeit limited, data suggests that the hypothalamic-pituitary-adrenal axis, opioids, glutamate, cannabinoids, oxytocin, neuropeptide Y, and microRNA may play a role in the development of PTSD and could be targeted for novel treatments. Indeed, recent research indicates that examining different pathways might result in the development of novel and more efficient drugs.

The Wicked Relationship between Depression and Metabolic Syndrome.

Major depressive disorder (MDD) constitutes a challenge in the field of mental disorders, given its high prevalence in the general population and its impact on the quality of life, while representing a major burden of health worldwide. Currently, much interest in the pathophysiology of MMD ìs also directed towards disentangling the possible biological mechanisms shared with that medical condition known as metabolic syndrome (MeS) that is frequent in the general population and often comorbid with MDD. Therefore, the aim of this paper was to summarize the evidence on the relationships between depression and MeS, and to comment on the common factors and mediators present in these two conditions. For this reason, some of the main databases of scientific literature were accessed, and all the papers fulfilling the goal of this review were selected. The results demonstrated the existence of common pathways between depression and metabolic syndrome involving several mediators, such as inflammation, the hypothalamus-pituitary-adrenal axis, oxidative stress, platelet functions, coronary heart disease and peripheral hormones, thus requiring strict attention from the scientific community. Indeed, such pathways may be targeted in the near future in order to pave the way to new treatment options for these disorders.

Autism Spectrum Disorder and Fetal Alcohol Spectrum Disorder: A Literature Review.

Fetal alcohol spectrum disorders (FASD) are a group of conditions associated with the effects of prenatal alcohol exposure and characterized by somatic and neuropsychological alterations. On the other hand, autism spectrum disorder (ASD) is characterized by a multifaceted neurobehavioral syndrome. Since alcohol can affect every stage of brain development, some authors hypothesized that in utero alcohol exposure might be linked to an increased risk of ASD in subjects with genetic vulnerability. The present review aimed to summarize the available literature on the possible association between FASD and ASD, also focusing on the reported clinical overlaps and on the possible shared pathogenic mechanisms. Studies in this field have stressed similarities and differences between the two conditions, leading to controversial results. The available literature also highlighted that both the disorders are often misdiagnosed or underdiagnosed, stressing the need to broaden the perspective, paying specific attention to milder presentations and sub-syndromic traits.

Investigating Orthorexia Nervosa With the ORTO-R in a Sample of University Students With or Without Subthreshold Autism Spectrum: Focus on Dietary Habits and Gender Differences.

Background: The aim of the present study was to investigate the presence of Orthorexia (ON) symptoms in a sample of University students with or without autistic traits (AT), specifically focusing on evaluating the role of gender and of dietary habits in the association between ON and autism spectrum. Methods: Subjects were requested to anonymously fill out the questionnaires through an online form. Results: Two thousand one hundred forty students participated in the study. Subjects with significant AT, measured by means of the Adult Autism Sub-threshold spectrum (AdAS Spectrum) reported significantly higher ON symptoms, as measured by ORTO-R scores, than subjects with low AT. Females and subjects following a vegetarian/vegan diet reported significantly higher ORTO-R scores than males and than subjects following an omnivorous diet, respectively. Significant positive correlations were found between ORTO-R and AdAS Spectrum scores. A decision tree model, with gender, type of diet and presence of high AT as independent variables and ORTO-R score as dependent variable, showed in the first step the presence of significantly higher ORTO-R scores among females than among males, and in the second step showed in both genders the presence of higher ORTO-R scores among subjects with high AT than in those with low AT. A significant interaction of gender and presence/absence of high AT was reported on ORTO-R score, with a higher increasing trend of ORTO-R score with the increase of AdAS Spectrum score among females than among males. Conclusions: Our results further highlighted the association between AT and ON, in particular among females.

Catatonia Spectrum: Validation of a Questionnaire Investigating Catatonia Spectrum.

Aim: A growing body of literature has demonstrated the utility of a dimensional perspective on mental disorders. The current study aims to determine the psychometric properties of the Catatonia Spectrum (CS), a new questionnaire specifically tailored to assess the spectrum of catatonia, from full blown forms to subthreshold ones. Methods: 86 adults with at least three symptom criteria for catatonia according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 81 adults affected by borderline personality disorder (BPD), 104 adults with a diagnosis of major depressive disorder (MDD), and 105 subjects without mental disorders (CTL), were recruited from six Italian University Departments of Psychiatry and administered the: Bush-Francis Catatonia Rating Scale (BFCRS), Bush-Francis Catatonia Screening Instrument (BFCSI), and CS. Results: CS scale demonstrated a high level of internal consistency and excellent test-retest reliability for total and domain scores. CS domain scores were positively and significantly correlated with each other (p < 0.001) with Pearson's coefficients ranging from 0.337 to 0.663. All the CS domain scores were highly correlated with the CS total score. The correlation coefficients between CS and alternative measures of catatonia appeared all significant and positive. Significant differences among diagnostic groups on both CS domains and total scores were found. CS total scores increased significantly and progressively from the CTL, to the MDD and the BDP group, up to the catatonia group, which reported the highest value. Conclusion: The CS showed excellent internal consistency and test-retest reliability and strong convergent validity with alternative dimensional measures of catatonia. The questionnaire performed differently across the four diagnostic groups, with an increasing score gradient from healthy controls to patients with MDD, BPD and up to the catatonia group.

Climate change, environment pollution, COVID-19 pandemic and mental health.

Converging data would indicate the existence of possible relationships between climate change, environmental pollution and epidemics/pandemics, such as the current one due to SARS-CoV-2 virus. Each of these phenomena has been supposed to provoke detrimental effects on mental health. Therefore, the purpose of this paper was to review the available scientific literature on these variables in order to suggest and comment on their eventual synergistic effects on mental health. The available literature report that climate change, air pollution and COVID-19 pandemic might influence mental health, with disturbances ranging from mild negative emotional responses to full-blown psychiatric conditions, specifically, anxiety and depression, stress/trauma-related disorders, and substance abuse. The most vulnerable groups include elderly, children, women, people with pre-existing health problems especially mental illnesses, subjects taking some types of medication including psychotropic drugs, individuals with low socio-economic status, and immigrants. It is evident that COVID-19 pandemic uncovers all the fragility and weakness of our ecosystem, and inability to protect ourselves from pollutants. Again, it underlines our faults and neglect towards disasters deriving from climate change or pollution, or the consequences of human activities irrespective of natural habitats and constantly increasing the probability of spillover of viruses from animals to humans. In conclusion, the psychological/psychiatric consequences of COVID-19 pandemic, that currently seem unavoidable, represent a sharp cue of our misconception and indifference towards the links between our behaviour and their influence on the "health" of our planet and of ourselves. It is time to move towards a deeper understanding of these relationships, not only for our survival, but for the maintenance of that balance among man, animals and environment at the basis of life in earth, otherwise there will be no future.