327 research outputs found
DYSPHORIA DIMENSIONS: A PRELIMINARY INPATIENTS STUDY TO DIFFRENTIATE BORDERLINE PERSONALITY AND BIPOLAR DISORDER SPECTRUM
Background: Differentiating Borderline Personality Disorder (BPD) from Bipolar Disorder (BD) represents a very difficult
challenge for clinicians. Dysphoria could be a possible key to differentiate these disorders. We currently define dysphoria as a
complex and disorganized emotional state with proteiform phenomenology, characterized by a multitude of symptoms. Among them
irritability, discontent, interpersonal resentment and surrender prevail. These dimensions can be detected using the Neapen
Dysphoria Scale - Italian version (NDS-I). Dysphoria role in BPD has been highlighted by the recent theorization of the
Interpersonal Dysphoria Model, according to which dysphoria could represent the âpsychopathological organizerâ of the BPD. On
the other side, dysphoria role in BD has not yet been established. This is simply considered as an aspect, and not fundamental, of the
symptomatology characterizing BD, especially in mixed states patients. The phenomenological analysis of the dimensional spectrum
of dysphoria within BPD and DB could provide a valuable aid in the differential diagnosis between BPD and BD.
Aims: The aim of this paper is to verify if the dimensional spectrum of dysphoria differs between Borderline Personality
Disorder (BPD) and Bipolar Disorder Spectrum (BD) through an observational comparative study
Subjects and methods: In this study, 65 adult patients, males and females between the ages of 18 and 65, were enrolled from the
Psychiatric Service of the Santa Maria della Misericordia Hospital in Perugia (PG), Italy, from January 1st 2018 to April 30th 2019.
We have formed 2 groups. A BPD group composed of 33 patients (19 female patients, representing approximately 57.6 % of the
sample) and a BD group composed of 32 patients (18 Female patients, representing approximately 56.2% of the sample). Patientâs
comorbid with BD and BPD have been excluded from the study. After a preliminary assessment to exclude organic and psychiatric
comorbidity, and after at least 72 hours from hospitalization, we administered them the Neapen Dysphoria Scale - Italian Version
(NDS-I), a specific dimensional test for dysphoria. Starting from the dataset, with the aid of the statistical program SPSS 20, we have
carried out a comparison between disorders groups selected and their NDS-I total score and subscales (irritability, discontent,
interpersonal resentment, surrender); For this we have used the Mann-Whitney U test, a nonparametric test with 2 independent
samples, by setting a significance level p<0.05.
Conclusions: This study allowed us to explore and analyze dysphoria dimensions expressions in BPD and BD. Despite the small
sample analyzed, the results show a significant different dimensional spectrum expression of the dysphoria between the two disorders.
In particular, Irritability and Interpersonal Resentment dimensions show greater interest in BPD than BD spectrum. Further
studies with a larger and stratified sample are needed to confirm these results
DYSPHORIA DIMENSIONS: A PRELIMINARY INPATIENTS STUDY TO DIFFRENTIATE BORDERLINE PERSONALITY AND BIPOLAR DISORDER SPECTRUM
Background: Differentiating Borderline Personality Disorder (BPD) from Bipolar Disorder (BD) represents a very difficult
challenge for clinicians. Dysphoria could be a possible key to differentiate these disorders. We currently define dysphoria as a
complex and disorganized emotional state with proteiform phenomenology, characterized by a multitude of symptoms. Among them
irritability, discontent, interpersonal resentment and surrender prevail. These dimensions can be detected using the Neapen
Dysphoria Scale - Italian version (NDS-I). Dysphoria role in BPD has been highlighted by the recent theorization of the
Interpersonal Dysphoria Model, according to which dysphoria could represent the âpsychopathological organizerâ of the BPD. On
the other side, dysphoria role in BD has not yet been established. This is simply considered as an aspect, and not fundamental, of the
symptomatology characterizing BD, especially in mixed states patients. The phenomenological analysis of the dimensional spectrum
of dysphoria within BPD and DB could provide a valuable aid in the differential diagnosis between BPD and BD.
Aims: The aim of this paper is to verify if the dimensional spectrum of dysphoria differs between Borderline Personality
Disorder (BPD) and Bipolar Disorder Spectrum (BD) through an observational comparative study
Subjects and methods: In this study, 65 adult patients, males and females between the ages of 18 and 65, were enrolled from the
Psychiatric Service of the Santa Maria della Misericordia Hospital in Perugia (PG), Italy, from January 1st 2018 to April 30th 2019.
We have formed 2 groups. A BPD group composed of 33 patients (19 female patients, representing approximately 57.6 % of the
sample) and a BD group composed of 32 patients (18 Female patients, representing approximately 56.2% of the sample). Patientâs
comorbid with BD and BPD have been excluded from the study. After a preliminary assessment to exclude organic and psychiatric
comorbidity, and after at least 72 hours from hospitalization, we administered them the Neapen Dysphoria Scale - Italian Version
(NDS-I), a specific dimensional test for dysphoria. Starting from the dataset, with the aid of the statistical program SPSS 20, we have
carried out a comparison between disorders groups selected and their NDS-I total score and subscales (irritability, discontent,
interpersonal resentment, surrender); For this we have used the Mann-Whitney U test, a nonparametric test with 2 independent
samples, by setting a significance level p<0.05.
Conclusions: This study allowed us to explore and analyze dysphoria dimensions expressions in BPD and BD. Despite the small
sample analyzed, the results show a significant different dimensional spectrum expression of the dysphoria between the two disorders.
In particular, Irritability and Interpersonal Resentment dimensions show greater interest in BPD than BD spectrum. Further
studies with a larger and stratified sample are needed to confirm these results
CIRCADIAN RHYTHMS DISRUPTIONS AND EATING DISORDERS: CLINICAL IMPACT AND POSSIBLE PSYCHOPATHOLOGICAL CORRELATES
Background: A link between abnormalities in circadian rhythms and the development of eating disorders was extensively
hypothesized, mainly in consideration of the influence of the circadian clock on eating behavior. The present review is aimed at
summarizing the evidence about biological rhythms disruptions in eating disorders, possibly clarifying their impact on the
psychopathological profile of such patients.
Methods: Electronic database MEDLINE/PubMed/Index Medicus was systematically searched for original articles examining
the prevalence of circadian rhythms disruptions in eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder).
Results: Studies included in the review confirmed the hypothesis of a high prevalence of circadian disruptions in eating
disorders. The analyzed research mainly focused on sleep-wake cycle, rest-activity abnormalities and hormonal secretion, whilst
literature about other circadian rhythms was scanty. Altered biological rhythms presented higher association with specific
psychopathological features, but such relationship was assessed in few studies.
Conclusions: Circadian rhythms disruptions were confirmed to be relevant aspects in the context of eating disorders. Further
research is needed in order to clarify the role of biological rhythms in such illnesses, in the attempt to address adjunctive treatment
strategies with the possible focus of circadian abnormalities
CIRCADIAN RHYTHMS DISRUPTIONS AND EATING DISORDERS: CLINICAL IMPACT AND POSSIBLE PSYCHOPATHOLOGICAL CORRELATES
Background: A link between abnormalities in circadian rhythms and the development of eating disorders was extensively
hypothesized, mainly in consideration of the influence of the circadian clock on eating behavior. The present review is aimed at
summarizing the evidence about biological rhythms disruptions in eating disorders, possibly clarifying their impact on the
psychopathological profile of such patients.
Methods: Electronic database MEDLINE/PubMed/Index Medicus was systematically searched for original articles examining
the prevalence of circadian rhythms disruptions in eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder).
Results: Studies included in the review confirmed the hypothesis of a high prevalence of circadian disruptions in eating
disorders. The analyzed research mainly focused on sleep-wake cycle, rest-activity abnormalities and hormonal secretion, whilst
literature about other circadian rhythms was scanty. Altered biological rhythms presented higher association with specific
psychopathological features, but such relationship was assessed in few studies.
Conclusions: Circadian rhythms disruptions were confirmed to be relevant aspects in the context of eating disorders. Further
research is needed in order to clarify the role of biological rhythms in such illnesses, in the attempt to address adjunctive treatment
strategies with the possible focus of circadian abnormalities
Metabolic Syndrome in Italian Obese Children and Adolescents: Stronger Association with Central Fat Depot than with Insulin Sensitivity and Birth Weight
Aim. To evaluate whether body fat distribution, birth weight, and family history for diabetes (FHD) were associated with metabolic syndrome (MetS) in children and adolescents. Methods. A total of 439 Italian obese children and adolescents (5â18 years) were enrolled. Subjects were divided into 2 groups: prepubertal and pubertal. MetS was diagnosed according to the adapted National Cholesterol Education Program criteria. Birth weight percentile, central obesity index (measured by dual-energy X-ray absorptiometry), insulin sensitivity (ISI), and disposition index were evaluated. Multivariate logistic regression models were used to determine variables associated with MetS. Results. The prevalence of MetS was 17%, with higher percentage in adolescents than in children (21 versus 12%). In the overall population, central obesity index was a stronger predictor of MetS than insulin sensitivity and low birth weight. When the two groups were considered, central fat depot remained the strongest predictor of MetS, with ISI similarly influencing the probability of MetS in the two groups and birth weight being negatively associated to MetS only in pubertal individuals. Neither FHD nor degree of fatness was a significant predictor of MetS. Conclusion. Simple clinical parameters like increased abdominal adiposity and low birth weight could be useful tools to identify European obese adolescents at risk for metabolic complications
Novel locally active estrogens accelerate cutaneous wound healing-part 2
Estrogen deprivation is associated with delayed healing, while estrogen replacement therapy (ERT) accelerates acute wound healing and protects against development of chronic wounds. However, current estrogenic molecules have undesired systemic effects, thus the aim of our studies is to generate new molecules for topic administration that are devoid of systemic effects. Following a preliminary study, the new 17β-estradiol derivatives 1 were synthesized. The estrogenic activity of these novel compounds was evaluated in vitro using the cell line ERE-Luc B17 stably transfected with an ERE-Luc reporter. Among the 17β-estradiol derivatives synthesized, compounds 1e and 1f showed the highest
transactivation potency and were therefore selected for the study of their systemic estrogenic activity. The study of these compounds in the ERE-Luc mouse model demonstrated that both compounds lack systemic effects when administered in the wound area. Furthermore, wound-healing experiments showed that 1e displays a significant regenerative and anti-inflammatory activity. It is therefore confirmed that this class of compounds are suitable for topical administration and have a clear beneficial effect on wound healing
PSYCHIATRIC COMORBIDITY IN BARIATRIC SURGERY: A RETROSPECTIVE STUDY IN A GENERAL HOSPITAL
Background: Candidates for bariatric surgery undergo a multidisciplinary evaluation in the pre-operative phase, including a
psychiatric visit aimed at the screening for psychiatric comorbidities, including feeding and eating disorders (FEDs), which are
shortcomings to the intervention or predictors of worse prognosis. The presence of FEDs, such as Binge Eating Disorder (BED) and
Bulimia Nervosa (BN), is associated with higher rates of other psychiatric disorders. Furthermore, there is evidence of the
association between obesity and Depressive Disorders, as well as B and C Cluster Personality Disorders. The aim of this study was
to evaluate the presence of psychiatric comorbidities among a population of candidates for bariatric surgery.
Subjects and methods: Subjects were recruited at the outpatient service of the Section of Psychiatry, Clinical Psychology and
Rehabilitation of the General Hospital/University of Perugia after being referred by surgeons. Psychiatric comorbidities were
investigated by means of the Structured Clinical Interview for DSM-5 Disorders. Subjects underwent specific assessment with scales
for the evaluation of FEDs, namely Binge Eating Scale, Obesity Questionnaire, Bulimia Test-Revised and Body Shape Questionnaire.
Results: The sample consisted of 101 subjects: 43 (42.6%) were diagnosed with at least one psychiatric disorder, including
FEDs. In particular, 30 subjects (29.7%) presented at least one FED, among which the most frequent were FED not otherwise
specified (24.1%) and BED (6.8%). Moreover, 26 subjects (25.7%) were diagnosed with at least one psychiatric disorder other than
FEDs, such as Personality Disorders (17.1%), with a higher prevalence of B and C Cluster Disorders. Depressive Disorders were
detected in 5% of the sample.
Conclusions: Subjects undergoing bariatric surgery often display psychiatric comorbidities, more frequently one or more FEDs.
The systematic screening of these conditions should be implemented in the clinical practice in order to provide early intervention
strategies and adequate monitoring
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