Schizotypy and individual differences in peripersonal space plasticity.

The space surrounding our body, defined as peripersonal space (PPS), is dynamically shaped by our motor experiences. For instance, PPS extends after using a tool to reach far objects. Several studies have demonstrated how PPS size varies across people, depending on different individual characteristics, including schizotypy. Coherently, narrower PPS boundaries have been reported among high schizotypal individuals and schizophrenia patients. However, little is known about the relationship between PPS plasticity and personality traits like schizotypy. To this purpose, the present study has investigated the individual PPS plasticity, after two different motor trainings, along the schizotypal continuum. Specifically, PPS plasticity was tested after using a tool (Experiment 1) and after the mere observation of another person using the same tool (Experiment 2). Indeed, previous evidence has shown that tool-use observation influences visual distance judgments, extending the representation of PPS. To date, however, there is no study investigating whether observation of tools action could also affect multisensory PPS tasks. Experiment 1 has shown that PPS boundaries extended after using the tool; on the other hand, Experiment 2 has revealed the absence of PPS expansion. Moreover, greater PPS expansion emerged in the relatively-low schizotypal group than in the relatively-high one, regardless of the type of motor training performed. The absence of PPS modulation after the observation task is discussed in relation to recent findings showing that intentional action and/or the goal of the action represent potentially crucial elements to trigger PPS plasticity. Finally, these new results extend previous evidence underlining a potential general functional alteration of PPS with the increase of schizotypal level.

Depression as an independent prognostic factor for all-cause mortality after a hospital admission for worsening heart failure.

BACKGROUND: Depression is associated with increased mortality amongst patients with chronic heart failure (HF). Whether depression is an independent predictor of outcome in patients admitted for worsening of HF is unclear. METHODS: OPERA-HF is an observational study enrolling patients hospitalized with worsening HF. Depression was assessed by the Hospital Anxiety and Depression Scale (HADS-D) questionnaire. Comorbidity was assessed by the Charlson Comorbidity Index (CCI). Kaplan-Meier and Cox regression analyses were used to estimate the association between depression and all-cause mortality. RESULTS: Of 242 patients who completed the HADS-D questionnaire, 153, 54 and 35 patients had no (score 0-7), mild (score 8-10) or moderate-to-severe (score 11-21) depression, respectively. During follow-up, 35 patients died, with a median time follow-up of 360days amongst survivors (interquartile range, IQR 217-574days). In univariable analysis, moderate-to-severe depression was associated with an increased risk of death (HR: 4.9; 95% CI: 2.3 to 10.2; P<0.001) compared to no depression. Moderate-to-severe depression also predicted all-cause mortality after controlling for age, CCI score, NYHA class IV, NT-proBNP and treatment with mineralocorticoid receptor antagonist, beta-blocker and diuretics (HR: 3.0; 95% CI: 1.3 to 7.0; P<0.05). CONCLUSIONS: Depression is strongly associated with an adverse outcome in the year following discharge after an admission to hospital for worsening HF. The association is only partly explained by the severity of HF or comorbidity. Further research is required to demonstrate whether recognition and treatment of depression improves patient outcomes.