Investigating the relationship between autistic traits and symptoms and Catatonia Spectrum.

BACKGROUND: In recent years, numerous studies have highlighted the overlap between autism spectrum disorder (ASD) and catatonia, both from a clinical and pathophysiological perspective. This study aimed to investigate the relationship between the autism spectrum (autistic traits and ASD signs, symptoms, and behavioral manifestation) and Catatonia Spectrum (CS). METHODS: A total sample of 376 subjects was distributed in four diagnostic groups. Subjects were assessed with the Structured Clinical Interview for DSM-5, Research Version, the Adult Autism Subthreshold Spectrum (AdAS Spectrum), and CS. In the statistical analyses, the total sample was also divided into three groups according to the degree of autism severity, based on the AdAS Spectrum total score. RESULTS: A statistically significant positive correlation was found between AdAS Spectrum and CS total score within the total sample, the gender subgroups, and the diagnostic categories. The AdAS Spectrum domains found to be significantly and strongly correlated with the total CS score were hyper-hypo reactivity to sensory input, verbal communication, nonverbal communication, restricted interests and rumination, and inflexibility and adherence to routine. The three groups of different autistic severity were found to be distributed across all diagnostic groups and the CS score increased significantly from the group without autistic traits to the group with ASD. CONCLUSIONS: Our study reports a strong correlation between autism spectrum and CS.

Imitation strategies in subjects with schizophrenia: a behavioural approach.

Imitation is a basic human ability, present early in life. Previous studies on control subjects and callosotomized patients showed that imitation occurred mainly in mirror-mode in both groups (60% controls, 66% patients) when they imitate without instructions (free sessions). In contrast, when asked to use the same or opposite limb as the model (driven sessions), controls used anatomical mode (93%), callosotomized patients mainly mirror strategy (61%). It has been suggested that callosotomized subjects prefer the mirror mode because of an impaired capacity for mental rotation, likely due to the lack of the corpus callosum (CC). The present research investigated the imitation strategies used by schizophrenic patients, who also could present anomaly in the interhemispheric connections. Fifteen hospitalized patients with diagnosis of schizophrenia participated in the study. They were asked to imitate upper limb intransitive meaningful and meaningless gestures performed by a model in a video. The results were compared with those from 20 healthy individuals. In driven imitation, controls answered in anatomical mode (95% of the responses), versus 63% of patients' responses. In free imitation sessions the answers in anatomical mode decreased to 39% in control subjects and to 46% in schizophrenic patients. In both driven and free imitation, the differences between the two proportions, conditioned to Diagnosis, resulted significantly different. The present data, in line with previous studies on psychotic and neurological patients showing impairments on imitation, suggest that the neural circuitry leading patients to perform differently from controls likely relates with the functional efficiency of the CC.

Postpartum pain in relation with Personal Meaning Organization.

AIM: The aim of this study was to investigate the relationship between postpartum pain and personality considered as Personal Meaning Organization (PMO). Pain diseases, not related to organic disorders, frequently occur in postpartum and may lead to severe consequences for women and their functions of caregiving. Emotions are usually experienced in the body and their expression is strictly related to individual personality. Considering personality as a process, each symptom expresses a need to maintain the sense of oneness and historical continuity. METHODS: One-hundred and five women were enrolled from the Department of Obstetrics and Gynecology and after delivery they presented postpartum pain not related to organic diseases. Women filled out a general information questionnaire assessing age, employment, marital status, education level, parity, type of delivery, attendance to a prepartum course, week of gestation. Their personality, as PMO, was evaluated using the Mini Questionnaire of Personal Organization (MQPO). RESULTS: Controller PMO perceived more pain compared to the Principle Oriented PMO (95% CIs [-0.09, -1.98]; Wald Z=-2.28; P<0.02), slightly more than contextualized patients (95% CIs [-0.09, -1.15]; Wald Z=-1.81, P<0.06) and more than those with a Detached PMO (95% CIs [-0.09, -2.10]; Wald Z=-1.84, P<0.06). CONCLUSION: The results suggest a role of PMO in influencing the perception of postpartum pain and no relation with the other general information assessed, particularly, within the controller women group in which the experience of physical pain might be a way to represent a subjective discomfort.

Adolescent depression: clinical features and therapeutic strategies.

BACKGROUND: Major depressive disorder (MDD) is a common disorder during adolescence and it is associated with an increased risk of suicide, poor school performance, impaired social skills, social withdrawal and substance abuse. Further, as many depressive episode in adolescents do not reach the diagnostic threshold for MDD, the disorder remains undetected. AIM: This review aims to provide an update of clinical features of adolescent MDD and to focus on the most appropriate therapeutic strategies to adopt in clinical practice. MATERIALS AND METHODS: We reviewed the international literature to identify studies focusing on clinical features and therapeutic options in adolescents affected by MDD. PubMed, Medline and Cochrane Library databases were searched for English language papers. RESULTS: The clinical picture of depression is variable with sex and age. Somatic complaints, particularly headache and fatigue, are a common presentation in adolescent MDD. Irritability is present most frequently in female and it is related to the severity of MDD. Adolescent MDD is also characterized by a high rates of suicides. The therapeutic strategy in adolescent depression includes psychotropic medications, psychotherapy or a combination of both treatments, with selection of the most appropriate strategy depending on symptom severity. As first-line treatment the traditional cognitive behavioural therapy (CBT), as well as the cognitive Post-Rationalist (PR) approach, are so far considered the goal standard. CONCLUSIONS: The therapeutic approach to the adolescent affected by MMD should respect the person in his/her psycho-physical entirety. The intervention may help the subject in seeking a more stable and adaptable identity. It is relevant to have a good knowledge of the peculiar clinical picture of adolescent MDD in order to make an early identification of the disorder and to define an appropriate personalized therapeutic program.

[Clinical investigation on depression on a randomized and stratified sample in an elderly population]. / Indagine clinica sulla depressione in un campione randomizzato e stratificato di popolazione anziana.

The prevalence of depression in the elderly was investigated in a random stratified sample of 100 subjects from the general population of Appignano (Macerata, Regione Marche, Italy). After sampling with the simple random method, each subject underwent a diagnostic work-up including: a) three psychodiagnostic tests (Short Scale for the Assessment of Mental Health--SSAMH, Geriatric Depression Scale--GDS, and Scale for the Self-evaluation of Depression from the Psychogeriatric Interview--PGI) and b) psychiatric evaluation (according to DSM-III-R diagnostic criteria). Results were as follows: a) all the 3 tests (SSAMH, GDS, PGI) were suitable for the goals of this research, with a sensibility of 95.4%, 90.9%, and 95.4%, and a specificity of 90.4%, 88.9%, and 90.5%, respectively; b) the prevalence of depression in the sample was 25.9% (26.1% in females and 25.6% in males); c) the most common disorder was dysthymia, with higher percentage in females than in males (75% and 50% of all the depressive syndromes, respectively); d) the prevalence of depression was higher in females 60-69 years old and in males 70-79 years old.

[Psychologic reactions of patients undergoing magnetic resonance imaging. Preliminary study]. / Reazioni psicologiche di pazienti sottoposti a imaging con risonanza magnetica. Studio preliminare.

MR imaging, like other imaging techniques, can cause emotional and psychological reactions in the patients. Although reversible, these reactions sometimes lead the patient to absolutely refuse the examination or to make it impossible to carry it through. To investigate the patients' emotional distress, a study group of 28 subjects was examined. They were heterogeneous in sex, age, and pathologic condition. The main psychological reactions were analyzed, and anxiety--both of state and of trait. The anxiety parameter was evaluated as a specific index in the psycho-behavioral modifications induced by MR examination. The influence was also considered of the "fantasies" related to examination results on the patients' psyche. Talks and STAI X1 and STAI X2 were employed to this purpose, to identify possible disturbing elements related to both patients' character and examination situations. Our results point to anxiety as the major reaction observed in the subjects undergoing MR examination; it seems to be related to different parameters, which are difficult to identify. Claustrophobia, pathofobia, and the fear of an unknown examination play a major role. Talking to the patients and informing them of the characteristics of the examination proved useful to significantly reduce their emotional distress.

[Acute and long-term effects of captopril in patients with left ventricular dysfunction and dilatation: evaluation of function and work capacity]. / Effetti acuti e a lungo termine del captopril in soggetti con disfunzione e dilatazione ventricolare sinistra: valutazione funzionale e capacità lavorativa.

To assess acute hemodynamic effects and exercise capacity of an intravenously administered single dose of captopril and to compare the acute response with chronic variation in hemodynamic and functional parameters after long-term oral administration, (in order to determine the profile of responders and non-responders) we studied 12 patients with chronic congestive heart failure due to primary dilated cardiomyopathy (11 pts) and ischemic heart disease (1 pt). Hemodynamic response was assessed using transthoracic electric impedance with cardiac output measurement. The exercise capacity was determined using multistage bicycle ergometer symptoms limited stress test. The hemodynamic and functional evaluation--resting cardiac output, exercise capacity (Ex. Dur.) and cardiac output rise at maximum workload (% CO)--were investigated at first as a control; after i.v. captopril administered in 10 min (25 mg) (acute); after captopril per os (25-75 mg for 30 days) (chronic) and after 5 days of withdrawal (wash out). (Table: see text). Improvement of left ventricular performance mainly during exercise after acute and chronic administration of captopril occurred, as evidenced from cardiac output increase at maximum work load, and rise of exercise duration. Moreover, our data suggest that captopril may have a sustained beneficial effect, for a few days, even after drug withdrawal. Nevertheless, the lack of correlation in single cases between acute and chronic response, also indicates that captopril deserves further study to determine its role in acute and/or chronic management of congestive heart failure in order to choose the ideal strategy.

Integrated neuropsychopathological approach in patients affected by amenorrhea.

A compared study of neurovegetative modifications (following stress stimula) and of psychopathological aspects in patients affected by amenorrhea was carried out. Such an integrated approach is useful for a better definition of clinical characteristic and for a selection of a suitable therapeutic approach.

[Growth hormone after baclofen in normal and acromegalic subjects]. / Ormone della crescita dopo baclofene in soggetti normali ed acromegalici.

Serum growth hormone (GH) levels in basal conditions (two samples) and 30, 60, 90, 120, 150 and 180 minutes after oral administration of baclofen (20 mg) were evaluated in 6 healthy subjects and in 6 acromegalic patients. The effect of cimetidine (400 mg i.v.) administrated 45 minutes after baclofen (20 mg by mouth) were evaluated in 9 healthy women. Baclofen was able to significantly rise serum GH levels in normal subjects but no in acromegalic patients. Cimetidine suppress GH increase induced by baclofen. It was concluded that: 1) baclofen, GABAb receptor agonist, stimulate GH secretion by inhibition of GIF secretion or by stimulation of GRF secretion; 2) istamine, through H2 receptors in the hypothalamus, is important to mediate GH release induced by stimulation of GABAb receptors.

[Prolactin after baclofen in healthy subjects and prolactinoma patients]. / Prolattina dopo baclofene in soggetti normali e con prolattinoma.

Serum prolactin (PRL) levels in basal conditions (two samples) and 30, 60, 90, 120, 150 e 180 minutes after oral administration of baclofen (20 mg) were evaluated in 6 healthy subjects and in 10 patients with prolactinoma. The effect of baclofen (20 mg by mouth) on the PRL secretion cimetidine (400 mg i.v.) or domperidone (20 mg i.v.) induced were evaluated in 9 healthy women by administration of baclofen 60 minutes before cimetidine or domperidone. Baclofen was unable to significantly rise serum PRL levels in healthy subjects and in patients affected by prolactinoma and furthermore did not interfere with PRL rise domperidone induced. On the contrary baclofen decreased PRL rise cimetidine induced. It was concluded that: in basal condition, GABAb receptor don't play an obvious role in modulation of PRL secretion; when H2 istaminergic inhibition on PRL secretion is blocked (at an hypothalamic site), a GABA inhibition, b receptor mediated, on PRL secretion became more clear; the domperidone blockade of hypophysial dopaminergic receptors suggests that GABAb modulation of prolactin secretion don't obtain itself by dopaminergic pathways.

Infant feeding and women's work in Western Samoa: a hypothesis, some evidence and suggestions for future research.

This paper argues that a key reason for the decline in the age of weaning in 3rd world countries may be an increasing workload for women associated with increasing involvement in the cash economy. This hypothesis is considered in light of data collected in an anthropological field study of a rural village in Western Samoa. Methods used were a village census, a household survey with fertility histories and questions on household economy, a questionnaire on breastfeeding, key informant interviews, observations made during residence in the village, and archival research. The ethnographic data suggest the possibility of a causal relationship between a decline in the age of weaning and an increasing workload for women in Western Samoa. In addition, other factors thought to account for a decline in the age of weaning, such as bottle feeding and urbanization, are unimportant in rural Western Samoa.

[Microbiological dosage of the antitumoral drugs (author's transl)]. / Il dosaggio microbiologico dei farmaci antitumorali.

The AA. give a complete list of now available microbiological methods to titrate chemo-cytostatic drugs in organic fluids. The described techniques are of particular interest for many reasons: they are easy, inexpensive and rapid; they are reproducible, very sensible and specific. The latter quality privileges the microbiological test in comparison with RIA methods. The introduction into clinical practice of chemotherapy routine monitoring will improve the handling of so active drugs as cytostatics and, toward a more rational treatment of the patients and a better definition of individual minimum active doses.