A randomised controlled trial comparing duloxetine and acetyl L-carnitine in fibromyalgic patients: preliminary data.

OBJECTIVES: Fibromyalgia syndrome (FMS) is a chronic disorder characterised by widespread musculoskeletal pain, troubled sleep, disturbed mood, and fatigue. Recently published reviews have demonstrated that it is influenced by various psychological aspects, and antidepressants are now considered the treatment of choice for most patients. The aim of this randomised controlled trial was to compare the effects of duloxetine and acetyl L-carnitine on pain, depression, anxiety and well-being in FMS patients. METHODS: Sixty-five female outpatients with FMS diagnosed by a rheumatologist were recruited between January 2011 and May 2012, and randomised to receive duloxetine 60 mg/day or acetyl L-carnitine 1500 mg/day (500 mg t.i.d.). Drug efficacy and side effects were assessed by the same psychiatrist at baseline, and four and 12 weeks later. RESULTS: Both drugs led to a general clinical improvement, with positive effects on pain and depressive symptoms; but neither induced a significant improvement in anxiety. Both drugs had a positive effect on the physical component of the quality of life, but only duloxetine improved the psychological component. CONCLUSIONS: Although they need to be confirmed by further studies, these preliminary findings confirm the efficacy of duloxetine, and suggest that acetyl L-carnitine is also efficacious in improving depressive symptoms, pain, and the quality of life of FMS patients.

Attitudes of medical students toward the care of the dying in relation to personality traits: harm avoidance and self-directedness make a difference.

Caring for dying patients requires specific attitudes. Medical students often feel unprepared to cope with issues related to end-of-life care. Little is known about the relationships between personality and attitudes toward the dying; consequently, it is difficult for medical educators to devise training that is best suited to prepare students for practicing palliative medicine. The study aimed to investigate the role of personality in predicting students' attitudes toward the care of the dying. The study findings suggest a significant link between more self-directed and less harm-avoidant personality profiles and more developed attitudes toward the dying. Personality assessment in medical curricula is important, not merely to help teachers plan tailored training but also to foster in future doctors the propensity to develop a patient-centered practice.

Measurement properties and confirmatory factor analysis of the Jefferson Scale of Empathy in Italian medical students.

Medical educators agree that empathy is essential for physicians' professionalism and most studies on the patient-physician relationship demonstrate that this attitude has a key role in improving clinical outcomes. Literature findings show conflicting views in defining and measuring empathy. Nevertheless, the Jefferson Scale of Empathy (JSE) is a psychometric tool now widely used. Therefore, the aim of this study was to examine psychometrics and confirm factor structure of the Italian version of the JSE in Italian medical students (JSE S-Version). During 2012, 257 second-year Italian medical students completed the JSE S-Version. Internal consistency and test-retest reliability were assessed. A confirmatory factor analysis was performed to test the factor structure. The Italian JSE S-Version showed an acceptable internal consistency (r = 0.76) and test-retest reliability (r = 0.72). Confirmatory factor analysis found that the factor structure proposed by the developers of the tool provides an acceptable data fit. In this sample, female medical students showed a higher mean empathy score than did males. The present study provides evidence confirming the structural validity and reliability for the Italian JSE S-Version. Further studies are needed to confirm these findings and to explore cross-cultural differences and their implications.