Risk factors for incident depression in patients at first acute coronary syndrome

The association between depression and acute coronary syndrome (ACS) is well-established and the first seems to impact meaningfully on cardiac prognosis. Nonetheless only a few studies have evaluated the relationship between incident depression, defined as new cases in patients with no history of depression, and ACS. Therefore the aim of this study is to analyse the risk factors of incident depression in a sample of patients who were presenting their first ACS. 304 consecutive patients were recruited. The presence of major (MD) and minor (md) depression was assessed with the Primary Care Evaluation of Mental Disorders (PRIME-MD), whereas its severity was evaluated with the Hospital Anxiety and Depression Scale (HADS). Evaluations were collected both at baseline and at 1, 2, 4, 6, 9 and 12 month follow ups. Out of 304 subjects (80.6% males), MD was diagnosed in 15 (4.9%) and md in 25 patients (8.2%). At baseline risk factors for a post-ACS depressive disorder were being women (MD only), widowed (md only) and having mild anhedonic depressive symptoms few days after the ACS. Clinicians should keep in mind these variables when facing a patient at his/her first ACS, given the detrimental effect of depression on cardiac prognosis

Anhedonia in schizophrenia: The role of subjective experiences

Background High levels of anhedonia have been found in patients with schizophrenia; specifically they report higher levels of social anhedonia rather than physical anhedonia, and further, in the anticipatory rather than consummatory facets of pleasure. Nonetheless, contrasting results emerged regarding the underlying mechanisms of this deficit. Basic Symptoms (BS) disturb subjective experiences present for most of the illness' course; this impacts patients' daily lives leading to a loss of the ability to organize the experience of the self and the world in a fluid and automatic way. Considering the role played by negative emotions in the subjective evaluation of anhedonia, the aim of the study is to clarify the role of BS in the assessment of anhedonia in a sample of patients with schizophrenia (n = 53) compared with healthy controls (n = 46). Methods Participants completed a self-administered trait questionnaire evaluating social anhedonia (Revised-Social Anhedonia Scale), physical anhedonia (Physical Anhedonia Scale), and the consummatory and anticipatory pleasure experiences (Temporal Experience of Pleasure Scale). BS were evaluated with the Frankfurter Beschwerde-Frageboden (FBF) whereas psychopathology was assessed with the Positive and Negative Syndromes Scale. Results Patients scored higher than healthy controls in social, physical and anticipatory anhedonia, but not in consummatory anhedonia and these relationships were mediated by the FBF. Basic Symptoms of Memory, Overstimulation and Lack of Automatism were related to some facets of anhedonia, independently from depressive symptoms. Conclusions We hypothesize that a subjective cognitive deficit and a reduced ability in information processing, could prevent patients from retaining a positive experience from past pleasant activities. Therefore the lack of pleasure would be, at least in part, related to an avoidance of potentially stressful new scenarios

Social cognition in people with schizophrenia: A cluster-analytic approach

Background The study aimed to subtype patients with schizophrenia on the basis of social cognition (SC), and to identify cut-offs that best discriminate among subtypes in 809 out-patients recruited in the context of the Italian Network for Research on Psychoses. Method A two-step cluster analysis of The Awareness of Social Inference Test (TASIT), the Facial Emotion Identification Test and Mayer-Salovey-Caruso Emotional Intelligence Test scores was performed. Classification and regression tree analysis was used to identify the cut-offs of variables that best discriminated among clusters. Results We identified three clusters, characterized by unimpaired (42%), impaired (50.4%) and very impaired (7.5%) SC. Three theory-of-mind domains were more important for the cluster definition as compared with emotion perception and emotional intelligence. Patients more able to understand simple sarcasm (14 for TASIT-SS) were very likely to belong to the unimpaired SC cluster. Compared with patients in the impaired SC cluster, those in the very impaired SC cluster performed significantly worse in lie scenes (TASIT-LI <10), but not in simple sarcasm. Moreover, functioning, neurocognition, disorganization and SC had a linear relationship across the three clusters, while positive symptoms were significantly lower in patients with unimpaired SC as compared with patients with impaired and very impaired SC. On the other hand, negative symptoms were highest in patients with impaired levels of SC. Conclusions If replicated, the identification of such subtypes in clinical practice may help in tailoring rehabilitation efforts to the person's strengths to gain more benefit to the person

Radiolytic degradation of a new diglycol-diamide ligand for actinide and lanthanide co-extraction from spent nuclear fuel

Within the Partitioning and Transmutation strategies, great efforts have been devoted in the last decades to the development of lipophilic ligands able to co-extract trivalent Lanthanides (Ln) and Actinides (An) from spent nuclear fuel. Because of the harsh working conditions these ligands undergo, it is important to prove their chemical and radiolytic stability during the counter-current multi-stage extraction process. In the present work the hydrolytic and radiolytic resistance of the freshly prepared and aged organic solutions containing the new ligand (2,6-bis[(N-methyl-N-dodecyl)carboxamide]-4-methoxy-tetrahydro-pyran) were investigated in order to evaluate the impact on the safety and efficiency of the process. Liquid-liquid extraction tests with spiked solutions showed that the ligand extracting performances are strongly impaired by storing the samples at room temperature and in the light. Moreover, the extracting efficiency of the irradiated samples resulted to be influenced by gamma irradiation, while selectivity remains unchanged. Preliminary mass spectrometric data showed that degradation is mainly due to the acid-catalysed reaction of the ligand carboxamide and ether groups with the 1-octanol present in the diluent

2,6-Bis(1-alkyl-1H-1,2,3-triazol-4-yl)-pyridines: selective lipophilic chelating ligands for minor actinides

Starting from the promising minor actinides (MA) affinity showed by the water-soluble ligands (PyTri-polyols) with the 2,6-bis[1H-1,2,3-triazol-4-yl]-pyridine chelating unit, different attempts were made to functionalize the same N-3-donor set with alkyl chains in the 1-position of triazole nuclei to obtain novel lipophilic extractants endowed with comparable MA selectivity. Solubility in organic diluents was found to be the main limitation to the development of efficient lipophilic ligands, thus resulting in less efficient extractants with respect to their hydrophilic analogues and sometimes impairing the selectivity evaluation. Interestingly, the ethyl hexyl derivative (PTEH) showed adequate extraction capability and a MA selectivity comparable to that of the hydrophilic PyTri family

Actinide–lanthanide co-extraction by rigidified diglycolamides

<p>Within the actinide and lanthanide co-extraction strategy, three rigidified diglycolamides, namely 2,6-bis (<i>N</i>-dodecyl-carboxamide)-4-oxo-4<i>H</i>-pyran (<b>1</b>), 2,6-bis-[<i>N</i>-(4-<i>tert</i>-butylphenyl)carboxamide]-4-oxo-4<i>H</i>-pyran (<b>2</b>), 2,6-​bis[(<i>N</i>-docecyl-<i>N</i>-methyl)carboxamide]-​4-methoxy-​tetrahydro-pyran (<b>3</b>), were synthesized. Moreover, the effect of structural rigidification on Am(III) and Eu(III) extraction under different conditions was investigated. The carboxamide extractant <b>3</b> resembles the extracting behavior of <i>N,N,N</i>′,<i>N</i>′‐tetraoctyl diglycolamide (TODGA) in terms of efficiency and affinity within the lanthanide family, together with fast kinetics and satisfactory cation back-extraction. The presence of 1-octanol in the diluent mixture strongly affects the ligand stability. Moreover, despite the low extraction efficiency showed by <b>1</b> and <b>2</b>, all the three ligands exhibit a higher affinity for Am with respect to TODGA, resulting in a lower lanthanide/Americium separation factor, of around 4 for ligand <b>3</b> and close to 1 for ligands <b>1</b> and <b>2</b>.</p

The influence of illness-related variables, personal resources and context-related factors on real-life functioning of people with schizophrenia

In people suffering from schizophrenia, major areas of everyday life are impaired, including independent living, productive activities and social relationships. Enhanced understanding of factors that hinder real-life functioning is vital for treatments to translate into more positive outcomes. The goal of the present study was to identify predictors of real-life functioning in people with schizophrenia, and to assess their relative contribution. Based on previous literature and clinical experience, several factors were selected and grouped into three categories: illness-related variables, personal resources and context-related factors. Some of these variables were never investigated before in relationship with real-life functioning. In 921 patients with schizophrenia living in the community, we found that variables relevant to the disease, personal resources and social context explain 53.8% of real-life functioning variance in a structural equation model. Neurocognition exhibited the strongest, though indirect, association with real-life functioning. Positive symptoms and disorganization, as well as avolition, proved to have significant direct and indirect effects, while depression had no significant association and poor emotional expression was only indirectly and weakly related to real-life functioning. Availability of a disability pension and access to social and family incentives also showed a significant direct association with functioning. Social cognition, functional capacity, resilience, internalized stigma and engagement with mental health services served as mediators. The observed complex associations among investigated predictors, mediators and real-life functioning strongly suggest that integrated and personalized programs should be provided as standard treatment to people with schizophrenia