Towards the Abandonment of Surgical Castration in Pigs: How is Immunocastration Perceived by Italian Consumers?

Immunocastration of pigs represents an alternative method to surgical castration, being more respectful of animal welfare. However, this new technology may not be accepted by consumers due to their perception of possible risks tied to the use of the product, thus representing a concern for the production sector. The study aimed at verifying the attitude of Italian consumers towards immunocastration and to assess whether their perception can be affected by science-based information on advantages and disadvantages of immunocastration. A total of 969 consumers (divided in three groups representative of the Italian population) were contacted and asked to complete an online questionnaire. Only technical (neutral) information on immunocastration was provided to the first group; the second and the third group received information on the advantages (+) and disadvantages (-) of the technique, shown in reverse order (+/- and -/+, respectively). The level of information did not affect consumers' perception of immunocastration. Overall, immunocastration is perceived in a predominantly positive manner (54.5%), with a relatively low level of risk perception (34.2%), and a good willingness to pay more for meat deriving from immunocastrated pigs (+18.7%).

Phenomenology and prognostic significance of delusions in major depressive disorder: a 10-year prospective follow-up study.

OBJECTIVE: The study explored the phenomenology and prognostic significance of delusions in major depressive disorder. METHOD: From 452 patients with DSM-III major depression, we selected those with at least one belief fulfilling both DSM-III prerequisites for a delusion (i.e., being of "delusional proportions" and being maintained with "delusional intensity"). These patients were compared to the others with respect to demographic, historical, and index episode features; time spent in a depressive episode during a prospective observation period; and 10-year outcome. The same comparisons were made between patients with mood-incongruent delusions and those with mood-congruent delusions only. The study covered the period between January 1, 1978, and December 31, 2005. RESULTS: About 20% of patients had at least one delusion in their index episode. An additional 5.3% had a belief fulfilling only one of the DSM-III prerequisites for a delusion. In about one quarter of delusional patients, the index episode was not "severe." Almost 10% of delusional patients had both mood-congruent and mood-incongruent delusions. In patients with delusions, time to syndromal recovery from index episode was longer and antipsychotic medication was more frequently used (both p < .0001). The presence of delusions predicted a higher depressive morbidity during the prospective observation period (p < .05), but not a poorer 10-year outcome. No variable discriminated patients with mood-incongruent delusions from those with mood-congruent delusions only. CONCLUSION: The presence of delusions in a major depressive episode has significant therapeutic and short-term prognostic implications. However, the boundary between delusions and nondelusional sustained preoccupations is somewhat fuzzy, and some DSM-IV assumptions concerning psychotic depression (i.e., that this depression is always "severe"; that in an individual patient, delusions will be either all congruent or all incongruent with depressed mood; and that mood-incongruent delusions are associated with a poorer prognosis) may be unwarranted.

Agitated "unipolar" major depression: prevalence, phenomenology, and outcome.

OBJECTIVE: This study aimed to explore how prevalent agitated "unipolar" major depression is, whether it belongs to the bipolar spectrum, and whether it differs from nonagitated "unipolar" major depression with respect to course and outcome. METHOD: The study was conducted from January 1, 1978, to December 31, 1996. From 361 patients with major depressive disorder, the authors selected those fulfilling Research Diagnostic Criteria for agitated depression. These 94 patients were compared to 94 randomly recruited patients with nonagitated major depressive disorder regarding demographic and historical features, the clinical characteristics of the index episode, the percentage of time spent in an affective episode during a prospective observation period, and the 5-year outcome. Patients with agitated major depressive disorder who had at least 2 manic/hypomanic symptoms in their index episode were compared to the other patients with agitated major depressive disorder with respect to the same variables. RESULTS: Patients with agitated major depressive disorder were more likely to receive antipsychotics during their index episode and spent a higher proportion of time in an affective episode during the observation period compared with patients with nonagitated major depressive disorder. The presence of at least 2 manic/hypomanic symptoms in the index episode was associated with a higher rate of family history of bipolar I disorder, a higher score for suicidal thoughts during the episode, a longer duration of the episode, and a higher affective morbidity during the observation period. CONCLUSION: The diagnosis of agitated major depressive disorder is not uncommon and has significant therapeutic and prognostic implications. The subgroup of patients with at least 2 manic/hypomanic symptoms may suffer from a mixed state and/or belong to the bipolar spectrum.

[Proposal for a new funding system for mental health departments. Results from an evaluative multicentre Italian study (I-psycost)]. / Proposta per un nuovo sistema di finanziamento dei dipartimenti di salute mentale. Risultati di uno studio valutativo multicentrico nazionale (I-psycost study).

AIMS: To obtain a new, well-balanced mental health funding system, through the creation of (i) a list of psychiatric interventions provided by Italian Community-based Psychiatric Services (CPS), and associated costs; (ii) a new prospective funding system for patients with a high use of resources, based on packages of care. METHODS: Five Italian Community-based Psychiatric Services collected data from 1250 patients during October 2002. Socio-demographical and clinical characteristics and GAF scores were collected at baseline. All psychiatric contacts during the following six months were registered and categorised into 24 service contact types. Using elasticity equation and contact characteristics, we estimate the costs of care. Cluster analysis techniques identified packages of care. Logistic regression defined predictive variables of high use patients. Multinomial Logistic Model assigned each patient to a package of care. RESULTS: The sample's socio-demographic characteristics are similar, but variations exist between the different CPS. Patients were then divided into two groups, and the group with the highest use of resources was divided into three smaller groups, based on number and type of services provided. CONCLUSIONS: Our findings show how is possible to develop a cost predictive model to assign patients with a high use of resources to a group that can provide the right level of care. For these patients it might be possible to apply a prospective per-capita funding system based on packages of care.

Depressive symptoms, neurocognitive impairment, and adherence to highly active antiretroviral therapy among HIV-infected persons.

The association of depressive symptoms, neurocognitive impairment, and adherence to highly active antiretroviral therapy (HAART) was evaluated in 135 HIV-infected persons. Thirty percent reported nonadherence to HAART. Depressive symptoms (assessed with the Montgomery-Asberg Depression Rating Scale) and neurocognitive impairment (assessed with a neuropsychological test battery) were documented in 24% and 12%, respectively, of the study participants. Nonadherence to HAART was independently associated with worse depression rating scale scores (odds ratio=1.05, 95% confidence interval [CI]=1.00-1.10), acquisition of HIV through injection of drugs (odds ratio=2.59, 95% CI=1.05-6.39), and complaints about impairment of sexual activity (odds ratio=6.62, 95% CI=1.16-37.6). The presence of depressive symptoms, but not neurocognitive impairment, was associated with nonadherence.

Agitated depression in bipolar I disorder: prevalence, phenomenology, and outcome.

OBJECTIVE: The study aimed to explore how prevalent agitated depression is in bipolar I disorder, whether it represents a mixed state, and whether it differs from nonagitated depression with respect to course and outcome. METHOD: From 313 bipolar I patients with an index episode of major depression, the authors selected those fulfilling Research Diagnostic Criteria for agitated depression. These 61 patients were compared to 61 randomly recruited bipolar I patients with an index episode of nonagitated depression and 61 randomly recruited bipolar I patients with an index episode of mania regarding demographic, historical, and clinical features. The two depressive groups were also compared regarding time to recovery from the index episode, treatment received for that episode, percentage of time spent in an affective episode during a prospective observation period, and 5-year outcome. RESULTS: Patients with agitated depression were consistently not elated or grandiose, but one-fourth had the cluster of symptoms with racing thoughts, pressured speech, and increased motor activity, and one-fourth had the paranoia-aggression-irritability cluster. Compared to patients with nonagitated depression, they had a longer time to 50% probability of recovery from the index episode, were more likely to receive standard antipsychotic drugs during that episode, and spent more time in an affective episode during the observation period. CONCLUSIONS: The occurrence of agitated depression in bipolar I disorder is not rare and has significant prognostic and therapeutic implications. Whether the co-occurrence of a major depressive syndrome with one or two of these symptomatic clusters makes up a "mixed state" remains unclear.

Correlations between negative symptoms and peripheral G protein levels in mononuclear leukocytes of deficit and nondeficit schizophrenics. Preliminary results.

Receptor-coupled G proteins were measured in mononuclear leukocytes (MNL) of 17 drug-treated patients with deficit schizophrenia (DS) and 16 drug-treated patients with nondeficit schizophrenia (NDS). No significant difference was found in MNL levels of G(alphas), G(alphai), G(alphaq) and G(beta) proteins between the two groups; however, MNL levels of G(alphas) were inversely correlated to the severity of negative symptoms in DS patients, while MNL levels of G(alphaq) were positively correlated to negative symptoms in NDS patients. Since G(alphas) and G(alphaq) are coupled to D-1 and 5-HT(2) receptors, respectively, these findings may support the hypothesis that a prevalent dysfunction of D-1 receptors is involved in the pathophysiology of negative symptoms in DS, whereas a prevalent dysfunction of 5-HT(2) receptors underlies negative symptoms in NDS. These results must be regarded as preliminary because of the possible interference of antipsychotic drugs on the explored parameters.

The prognostic significance of "switching" in patients with bipolar disorder: a 10-year prospective follow-up study.

OBJECTIVE: This study explored whether "switching" (i.e., the direct transition from one mood polarity to the other) has significant prognostic implications in patients with bipolar disorder. METHOD: Bipolar disorder patients (N=97) whose first prospectively observed episode included at least one mood polarity switch and 97 bipolar disorder patients whose index episode was monophasic were compared with respect to several demographic and historical variables, symptomatic features of the index episode, time to recovery from the index episode, time spent in an affective episode during a prospective observation period, and psychopathological and psychosocial outcome at a 10-year follow-up interview. RESULTS: Patients whose index episode included at least two mood polarity switches spent significantly more time in an affective episode during the observation period and had a significantly worse psychopathological and psychosocial outcome 10 years after recruitment than those whose index episode included only one mood polarity switch or was monophasic. Patients whose polyphasic index episode started with depression spent a significantly higher proportion of time in an affective episode and had a significantly worse 10-year outcome than those whose polyphasic index episode started with mania or hypomania. Retention of the switching pattern throughout the observation period was seen in 42.4% of patients whose index episode started with mania and in 65.2% of those whose index episode started with depression. CONCLUSIONS: An index episode including at least two mood polarity switches, especially if starting with depression, is associated with a poor long-term outcome in patients with bipolar disorder. This pattern represents a significant target for new pharmacological and psychosocial treatment strategies.

Long-term outcome of lithium prophylaxis in bipolar disorder with mood-incongruent psychotic features: a prospective study.

BACKGROUND: No study has assessed systematically up to now the long-term outcome of lithium prophylaxis in bipolar patients with vs. without mood-incongruent psychotic features. METHODS: All bipolar patients with mood-incongruent psychotic features who started lithium prophylaxis at a lithium clinic during 14 years were followed up prospectively for 5 years, along with a control group of non-psychotic bipolars. RESULTS: Psychotic patients were significantly less likely than controls to be still on lithium after 5 years, and to present a reduction of at least 50% of time spent in hospital during the lithium treatment period compared with a pre-treatment period of the same duration. The time to 50% risk of readmission was significantly increased among both groups during lithium treatment. 39.6% of prospective episodes in psychotic patients did not include mood-incongruent psychotic features. LIMITATIONS: This is a naturalistic study carried out at a lithium clinic. No control group of bipolar patients who did not receive lithium was available. CONCLUSIONS: Lithium exerts a significant impact on the course of bipolar disorder with mood-incongruent psychotic features, although this impact is less pronounced than in classical manic-depressive illness.