Anxiety and Depression: A Key to Understanding the Complete Expression of Personality Disorders.

ABSTRACT: Anxiety and depressive disorders affect one fourth of the population. Personality disorders often present comorbid with anxiety and depressive disorders during the lifetime course of the illness. To fully explore the interplay between personality disorders and anxiety or depression, 179 patients, consecutively admitted to the Anxiety and Depression Outpatient Department, were clinically evaluated and tested with the Mini-International Neuropsychiatric Interview and the Iowa Personality Disorder Screening. Twenty-six percent of the total sample was affected only by personality disorders (PDs), and 21% had a comorbidity between a personality, anxiety, and/or depressive disorder (Comorbidity). Compared with PDs, Comorbidity used more antipsychotics and benzodiazepines (4.3% vs. 9.6%, χ2 = 0.267; 43.4 vs. 72.6, p = 0.004), showing a worse clinical picture, and expressed more personality traits even without statistical significance (6.863 ± 2.328 vs. 7.609 ± 1.674, p = 0.105). The different impact of personality disorders compared with anxiety and/or depression has to be further analyzed in terms of economic load and resource allocation.

Agreement between DSM-IV and DSM-5 criteria for alcohol use disorder among outpatients suffering from depressive and anxiety disorders.

BACKGROUND AND OBJECTIVES: Since significant differences have been reported, we estimated agreement between DSM-5 and DSM-IV criteria for alcohol use disorder (AUD). METHODS: We assessed 327 outpatients (mean age: 45.2 ± 13.4) with depressive or anxiety disorders. RESULTS: Absolute differences in prevalence rates between DSM-5 and DSM-IV AUD ranged from -1.1% (subjects with anxiety disorders) to +1.8% (tobacco smokers). The agreement was excellent (k = 0.88), also accounting for specific subgroups (relevant k coefficients >0.80). DISCUSSION AND CONCLUSIONS: DSM-5 criteria did not inflate AUD rates. SCIENTIFIC SIGNIFICANCE: Our results have epidemiological significance since, unlike previous reports, we found diagnostic stability between new and old AUD criteria in this clinical population. (Am J Addict 2017;26:53-56).

A rapid screening tool for anorectic/bulimic risk in online settings: a pilot-study on the DiCA33 validation in Italian young female students.

The early identification of anorexia (AN) and bulimia nervosa (BN) in the general population represents a crucial strategy to avoid their chronicization and clinical worsening. This pilot-study aims to test the validity of a new screening tool (DiCA33) dedicated AN/BN risk in online settings, based on the Italian version of EAT-26, a self-report questionnaire for measuring AN/BN symptoms. First analyses excluded the effect of demographic factors on results and suggested a limited explanation power of the mere total scores of DiCA33 for risk detection. Alternatively, a selection of risked items from the DiCA33 checklists (as evidenced on EAT-26 scores), then combined in a subscale, showed a necessary sensitivity for screening purposes. The DiCA33-subscale constitutes a reliable and useful index for the early and quick detection of AN/BN risk in young Italian female population, composed mainly by students. Considering the non-diagnostic nature of this tool, subsequent rigorous and psychiatric evaluations are necessary for positive cases to confirm the risk. Further studies may validate the tool even recruiting patients with eating disorders to improve tool specificity.

Food semantics on pro-anorexia websites in Italy.

INTRODUCTION: The term pro-ana (pro-anorexia) means the spread of restrictive eating behaviors and anorectic advices in virtual spaces written by teenagers. The purpose of this pilot study consists in a qualitative and quantitative analysis of foods contained in a linguistic corpus made up of users' comments on pro-ana websites. METHOD: The corpus of pro-ana websites was analyzed through the T2K tool based on word-frequency processing. RESULTS: The results show conversations regarding beverages, products of vegetable origin (fruit, vegetables) and low-calorie foods, with a tendency to limit the fear linked to the choice of high-calorie foods through reassuring and reconcilable language labels ("light", "sugar free"). CONCLUSIONS: These findings specify the food semantics on pro-ana websites associated to an anorectic vocabulary with restrictive diets. The results could be used to characterize the most common food as risk factors within the eating disorders framework.

Attention to detail in Italian parents of women with anorexia nervosa: a comparative study.

Aim: Anorexia nervosa (AN) and autistic spectrum disorder (ASD) may share traits such as mental rigidity and attention to detail, some of which might be familial. We aimed to investigate the distribution of autistic traits among parents of daughters suffering from eating disorders (anorexia or bulimia nervosa), comparing them with control parents. Methods: As a whole, 40 parents of women with eating disorders (60% AN, 40% BN) and 33 control parents were recruited and accepted an examination through the administration of the autism spectrum quotient (AQ). The effects of eating disorders and other psychiatric traits were excluded by using EAT-26 and SCL-90-R respectively, while decision making skills were ruled out by using the cognitive estimation task (CET). Results: AQ scores revealed a between-groups difference for a specific trait, showing a reduction in attention to detail among ED family members, especially AN parents. Discussion: These findings suggest a preference for global processing in AN parents in contrast to what found in AN patients. Our findings support the role of a candidate trait in AN parents, supporting the need of further studies on the role of attention to detail as a family marker. Conclusion: This study identified a global processing preference in AN parents, suggesting a role of attention to detail as an ideal marker to be included in a wider clinical assessment for AN patients and their families. Considering some study limitations, further research is needed.

Psychotherapeutic treatment of eating disorders improve dissociative experiences and impulse regulation but not alexithymia. A case series report.

AIM: Eating disorders (EDs) are complex conditions associated with disability and a high rate of mortality. Typical characteristics of these diseases are dissociation, alexithymia and impulse dysregulation, all strategies dealing with negative emotions and regulate negative affect and anxiety. Our study aimed to assess the effectiveness of intensive psychological treatment for EDs, with particular reference to the above mentioned clinical characteristics. METHODS: Eight outpatients with eating disorders in psychotherapeutic treatment were evaluated in two stages after one year (T1 and T2), using the Eating Disorder Inventory II, the Toronto Alexithymia Scale 20, and the Dissociative Experiences Scale. RESULTS: Wilcoxon test showed significant reductions in DES score as well as in two subscales of the EDI-2, Impulse Regulation and Body Dissatisfaction (I-EDI2 and BD-EDI2), while alexithymia levels did not show any difference. CONCLUSIONS: We can confirm the effectiveness of psychotherapy in people with EDs as regards dissociative moments, impulsivity and body dissatisfaction. However, alexithymia remains unchanged, possibly because of its deep emotional nature.

Pseudomixoma peritoneal: primeros casos tratados en Colombia con peritonectomía radical y quimioterapia intraperitoneal hipertérmica / Pseudomyxoma peritonei: first cases treated by radical cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

El pseudomixoma peritoneal es una enfermedad infrecuente caracterizada por ascitis mucinosa acompañada de implantes tumorales peritoneales y sobre el epiplón. La etiología de esta entidad es desconocida y, según la histología, se divide en dos grandes grupos: la adenomucinosis y la carcinomatosis mucinosa peritoneal.Tradicionalmente, el tratamiento quirúrgico recomendado es la citorreducción parcial que se repite regularmente para controlar los síntomas hasta que no se encuentre ningún beneficio adicional. A pesar de la controversia, en la actualidad, la evidencia favorece la realización de la peritonectomía radical más quimioterapia intraperitoneal hipertérmica, seguidas de quimioterapia intraperitoneal posoperatoria temprana (en los 7 días siguientes al procedimiento).A continuación se presentan los dos primeros casos tratados con esta técnica en Colombia y se revisa detalladamente la información publicada al respecto.