Virtual Reality Frontiers in Bipolar Disorders: A Recovery Oriented Cognitive Rehabilitation tool.

Background: Cognitive impairment is a fundamental rehabilitation outcome for people with mental disorders. This represents a barrier to achieve clinical, personal and social outcomes essential for a good quality of life. In line with the WHO innovation objective are increasing the use of technologies for treatment of mental disorders. This study aims at evaluating the feasibility and preliminary effectiveness of the first Cognitive Remediation Virtual Reality Program for people with bipolar disorder. Methods: Feasibility randomized controlled cross-over clinical study; we randomized 50 people from the Consultation and Psychosomatic Psychiatry Center of the University Hospital of Cagliari with a diagnosis of bipolar disorder. We proposed a CR/VR recoveryoriented program, 3 months with 2 weekly sessions, for the experimental group and a usual care program for the control group (psychiatric visit and/or psychotherapy). Results: We observed a significant feasibility outcome and clinical outcomes, both cognitive and personal and social functioning. In particular in memory (Ray’s Word Test p<0.003), attention (Matrix Test p<0.002), verbal fluency (FAS Test p<0.010), executive function in terms of cognitive esteem function (CET p<0.003), depressive symptoms (PHQ-9 p< 0.030), alexithymia (TAS-20 p<0.007) and in biological rhythms (BRIAN è<0.029). Conclusion: This RCT aims, with regards to it feasibility and design, to inform a confirmatory trial that evaluates the effectiveness of a VR CR program in psychiatric rehabilitation for the treatment of cognitive dysfunction in people with bipolar disorder. The results could have an impact on psychiatric rehabilitation research with a focus on improving the application of technologies for mental health

1h nmr brain metabonomics of scrapie exposed sheep

While neurochemical metabolite modifications, determined by different techniques, have been diffusely reported in human and mice brains affected by transmissible spongiform encephalopathies (TSEs), this aspect has been little studied in the natural animal hosts with the same pathological conditions so far

Danon disease in a Sardinian family: different aspects of the same mutation-a case report

Background Danon disease (DD) is a rare X-linked disorder due to mutations in the lysosome-associated membrane protein 2 gene. It is characterized by a clinical triad of hypertrophic cardiomyopathy, skeletal myopathy, and a variable degree of intellectual disability. Case summary In this case series, we describe a mother and her son affected by DD, highlighting consistent clinical severity despite the expected variability related to gender. The mother (Case 1) presented isolated cardiac involvement, with an arrhythmogenic phenotype that evolved into severe heart failure requiring heart transplantation (HT). Danon disease was diagnosed 1 year after this event. Her son (Case 2) showed an earlier age onset of symptoms with complete atrioventricular block and fast progression of cardiac disease. Diagnosis was established 2 years after clinical presentation. He is currently listed for HT. Discussion In both of our patients, diagnostic delay was extremely long and could have been avoided by emphasizing the relevant clinical red flags. Patients affected by DD may present clinical heterogeneity in terms of natural history, age of onset, and cardiac and extracardiac involvement, even in the same family. Early diagnosis that phenotypic sex differences may impact is a crucial factor in managing patients with DD. Considering the rapid progression of cardiac disease and the poor prognosis, early diagnosis is important and close surveillance should be mandatory during follow-up

The Impact on Anxiety Symptoms of an Immersive Virtual Reality Remediation Program in Bipolar Disorders: A Randomized Clinical Trial

: Background: The objective of this work is to investigate the effectiveness of a cognitive remediation intervention on anxiety symptoms in people with bipolar disorder and the therapeutic effect on people whose anxiety symptoms were above the threshold for a screener and whose comorbidity could be identified as an anxiety disorder. Methods: The experimental intervention included 24 sessions (around 45 min each), two for each week over three months. The entire program was inspired by user-centered rehabilitation principles in a recovery-oriented perspective and an approach to bipolar disorder in an evolutionary and non-discriminating vision. The primary outcomes measure the score of the Zung Self-Rating Anxiety Scale (SAS), hypothesizing a higher decrease in the experimental group than in the control group. The survey has been conducted per the CONSORT guidelines for feasibility studies. Results: We evaluate a decrease in the overall SAS score from T0 to T1 to be higher in the experimental group compared to the control group, indicating an improvement in anxiety symptoms (p &lt; 0.0001). Conclusions: The study suggests that virtual reality could have a role in treating anxiety symptoms and disorders in young adults with bipolar disorders or anxiety symptoms in people with hyperactivity and novelty-seeking behaviorsunder stress and high risk for bipolar disorder

Quality of Life of Sardinian Immigrants in Buenos Aires and of People Living in Italy and Sardinia: Does the Kind of Care have a Role for People with Depression?

Background / Objectives: The aim of the study was to compare the Quality of Life (QoL) of Sardinian immigrants to Argentina with Sardinians residing in Sardinia. The hypothesis was that a different availability of effective treatments for mood disorders may impact the well being of persons with these disorders. Methods: One out of five families of Sardinian origin was randomly selected. An Italian study (including Sardinia) was adopted as the control. The Mood Disorder Questionnaire was used for screening mania/hypomania; the diagnosis of Current Major Depressive Disorder was conducted by means of the Patient Health Questionnaire in immigrants and by means of a clinical interview in the control study and in an immigrant subsample (to verify comparability); the Short-Form Health Survey-12 was applied to measure QoL. Results: The Sardinian immigrants showed a higher QoL than Italians in Italy (but not with Sardinians residing in Sardinia). On the contrary, the attributable burden worsening QoL due to lifetime manic/hypomanic episodes, as well as to current depressive episodes, was found higher among Sardinian immigrants with respect to both Sardinian residents in Sardinia and the total Italian sample. The use of effective treatment for mood disorder was higher in Italy. Conclusion: The study found that in a sample of Sardinian immigrants in Buenos Aires the impact of a mood disorder affects QoL more incisively than in Sardinians residing in Sardinia. The suggested hypothesis of a possible role of beliefs guiding the search for treatments will be verified in future studies

Mouthwash Formulation Co-Delivering Quercetin and Mint Oil in Liposomes Improved with Glycol and Ethanol and Tailored for Protecting and Tackling Oral Cavity

: The aim of this work was the simultaneous loading of quercetin and mint essential oil (mint oil) in phospholipid vesicles specifically tailored to obtain an antibacterial and antioxidant mouthwash. The vesicles were prepared using soy lecithin and Tween 80 as bilayer components, and a mixture of phosphate buffer solution (33%), propylene glycol (33%) and ethanol (33%) as dispersing phase. The formation of regularly shaped, spherical and unilamellar vesicles was confirmed by cryogenic transmission electron microscopy analyses. Similarly, light scattering results disclosed that the size of the vesicles increased by increasing the concentration of mint oil, but at the same time the high amount of mint oil ensured high stability, as the size of these vesicles remained unchanged during 12 months of storage. All tested formulations were highly biocompatible towards epithelial cells and capable of counteracting oxidative cell damages caused by hydrogen peroxide. Moreover, the vesicles prepared with the highest concentration of mint oil inhibited the proliferation of the cariogenic Streptococcus mutans (S. mutans) and Lactobacillus acidophilus (L. acidophilus)

The tattooed population in Italy: a national survey on demography, characteristics and perception of health risks

Background. In recent years, Italy has seen a constant upward trend in the practice of tattooing. The Italian National Health Institute has conducted a national survey to determine the prevalence of tattooed people in Italy and to study related features of the phenomenon. Aim. Establish the prevalence and characteristics of the tattooed population and evaluate awareness of the risks associated with tattoos, which can contribute to consumer health protection. Methods. Computer-assisted telephone interviews and computer-assisted web interviews were completed by a sample of the general population; 7608 people aged between 12 and 75+. Results. The prevalence of tattooed people was 12.8% of the general population in Italy (95% CI: 12.05%-13.55%), equivalent to an estimated 6 900 000 tattooed individuals. Tattoos were more prevalent among women, at 13.8%, while tattooed men accounted for 11.8%. The vast majority of tattooed subjects had decorative tattoos of small dimensions, with a higher prevalence of monochromatic tattoos. Only a minority of tattooed participants reported having cosmetic tattoos (3.0%) or medical tattoos (0.5%). According to the data, 3.3% of tattooed subjects claimed complications or reactions; of these, only 21.3% consulted a dermatologist/general practitioner; more than half (51.3%) did not consult anyone. In general, only 58.2% of the sample were aware of health risks. The Italian survey showed that 36.7% of all tattoos had been performed in the last five years prior to the interview. Conclusions. The estimated prevalence of tattoos in Italy is in agreement with the statistics of the European Union. The prevalence in the age group 35-44 years is almost double that of the Italian population and it is higher in women than in men. Tattooing is relevant to public health. The high number of tattooed Italians, the potential long-term effects on health and the reported complications call for the awareness of health authorities. Appropriate intervention should ensure safer tattooing by reinforcing the training of tattooists, by improving surveillance and by providing information to raise public awareness of the risks and contraindications of tattooing.

Improving Social and Personal Rhythm Dysregulation in Young and Old Adults with Bipolar Disorder: Post-Hoc Analysis of a Feasibility Randomized Controlled Trial Using Virtual Reality-Based Intervention

Introduction: Rehabilitative interventions employing technology play a crucial role in bipolar disorder (BD) treatment. The study aims to appraise the virtual reality (VR)-based cognitive remediation (CR) and the interpersonal rhythm approaches to treatment outcomes of BD across different age groups. Methods: Post-hoc analysis of a 12-week randomizedcontrolled cross-over feasibility trial involving people with mood disorders (BD, DSM-IV) aged 18–75 years old: thirty-nine exposed to the experimental VR-based CR vs 25 waiting list controls. People with BD relapse, epilepsy or severe eye diseases (due to the potential VR risks exposure) were excluded. Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) was used to measure the outcome. Results: Cases and controls did not statistically significantly differ in age and sex distributions. Personal rhythm scores improved over the study follow-up in the experimental vs the control group (APC = 8.7%; F = 111.9; p &lt; 0.0001), both in young (18–45 years) (APC = 5.5%; F = 70.46; p &lt; 0.0001) and, to a lesser extent, older (&gt;46 years) adults (APC = 10.5%; F = 12.110; p = 0.002). Conclusions: This study observed improved synchronization of personal and social rhythms in individuals with BD after a virtual reality cognitive remediation intervention, particularly in social activity, daily activities, and chronotype, with greater benefits in the younger population

The Stability of Social and Behavioral Rhythms and Unexpected Low Rate of Relevant Depressive Symptoms in Old Adults during the COVID-19 Pandemic

Background: The disruption of social rhythms was found to be associated with depressive disorders during the COVID-19 pandemic; lower rates of these disorders were surprisingly found in old adults. The present study aims to verify the stability of social rhythms during lockdown in a sample of elderly people. Methods: Controlled cohort study (secondary analyses) of a previous randomized-controlled trial with the first evaluation in April 2019 (T0) and then 48 weeks later (T1) during the lockdown. The regulation of social and behavioral rhythms was measured through the Brief Social Rhythms Scale (BSRS); the Patient Health Questionnaire-9 (PHQ9) was adopted to detect relevant depressive symptoms. Results: 93 elderlies (73.36 +/- 4.97 years old, 50.5% females) were evaluated at T0 and T1. Neither the total score of BSRS nor any of the 10 items showed a statistically significant difference comparing the two survey periods. The frequency of relevant depressive symptoms was 5.3% at T0 and 6.4% at T1 (OR = 0.8, CI95% 0.2-24). Conclusions: Among elderlies who did not show an increased risk of depression during the lockdown, social and behavioral rhythms remained exceptionally stable during the same period. Considering previous evidence about rhythms dysregulation preceding depression, their stability may be considered a factor of resilience