The role of pharmacogenetics in the treatment of major depressive disorder: a critical review

Pharmacological therapy represents one of the essential approaches to treatment of Major Depressive Disorder (MDD). However, currently available antidepressant medications show high rates of first-level treatment non-response, and several attempts are often required to find an effective molecule for a specific patient in clinical practice. In this context, pharmacogenetic analyses could represent a valuable tool to identify appropriate pharmacological treatment quickly and more effectively. However, the usefulness and the practical effectiveness of pharmacogenetic testing currently remains an object of scientific debate. The present narrative and critical review focuses on exploring the available evidence supporting the usefulness of pharmacogenetic testing for the treatment of MDD in clinical practice, highlighting both the points of strength and the limitations of the available studies and of currently used tests. Future research directions and suggestions to improve the quality of available evidence, as well as consideration on the potential use of pharmacogenetic tests in everyday clinical practice are also presented

Investigating the impact of the Broad Autism Phenotype in parents of children with Autism Spectrum Disorders: implications for psychiatric comorbidity and global functioning.

Background: Several studies in literature found in parents of children with Autism Spectrum Disorder (ASD) features qualitatively similar to those of their autistic offspring, such as poor social skills, communication difficulties, unusually strong interests, repetitive behaviours and specific personality characteristics. All these traits were grouped under the generic term of Broad Autism Phenotype (BAP) and were considered a milder manifestation of autism. Moreover, the parents of ASD children showed an higher rates of psychiatric disorders, when compared to the general population. The aim of the present work was to investigate the role of the BAP in determining vulnerability towards psychopathology. Furthermore, our project pointed to clarify the impact of BAP on social and occupational functioning of these individuals, with a specific focus on ruminative thinking. Methods: Parents of 60 ASD children were enrolled, for a total of 120 subjects, 60 males and 60 females. The individuals were assessed by the Structured Clinical Interview for DSM-5, the Adult Autism Subthreshold Spectrum (AdAS Spectrum), the Ruminative Response Scale (RRS) and the Social and Occupational Functioning Assessment Scale (SOFAS). Results: Subjects with at least one psychiatric disorder (39.2 %) showed significantly higher AdAS Spectrum and RRS scores. Subjects with a history of school difficulties and with language development alterations scored significantly higher on specific AdAS Spectrum domains. A significant negative correlation was found between SOFAS and AdAS Spectrum scores, as well as between SOFAS and RRS scores. AdAS Spectrum Non-verbal communication domain score was identified has a statistically predictive variable for the presence of psychiatric disorders and lower SOFAS scores. Finally, we found a significant indirect effect of AdAS total score on SOFAS score, which was fully mediated by RRS total score. Conclusions : The presence of the BAP in parents of ASD children seems to be associated with an higher vulnerability towards several psychiatric conditions and with a lower global functioning. Ruminative thinking may have a mediating role in the relationship between BAP and psychiatric disorders, as well as in the relationship between BAP and global functioning. In particular, our results seem to suggest a transnosographic role of rumination in the development of psychopathology and in the functional impairment