Evaluating the Efficacy of Mentalization-Based Treatment on Impulsivity and Self-Harm in Patients with Borderline Personality Disorder

reservedIl disturbo borderline di personalità (BPD) rappresenta un disturbo mentale grave e complesso (Guderson & Hoffman, 2005), che si caratterizza per un grande impoverimento del funzionamento psicosociale (Skodol, Gunderson, McGlashan, et al., 2002) e per un frequente ricorso a trattamenti psichiatrici (Bender, Dolan, Skodol, et al., 2001). Le caratteristiche principali di tale disturbo sono la paura dell’abbandono, l’instabilità relazionale, l’alterazione dell’identità, l’impulsività, comportamenti ricorrenti di suicidio o autolesivi, l’instabilità affettiva, una sensazione cronica di vuoto, rabbia inappropriata e difficoltà a controllarla e ideazione paranoide transitoria associata a stress o a sintomi dissociativi (APA, 2013). Il presente studio si focalizza in particolare sulla componente dell’impulsività e dei comportamenti autolesivi, prendendo come campione un gruppo di pazienti giovani adulti con disturbo borderline di personalità del Centro di Salute Mentale di Via Berchet, 16, Padova. Lo studio è quindi volto ad indagare se, attraverso l’utilizzo del Mentalization Based Treament for Adolescents (MBT-A) per 12 mesi, l’impulsività e le condotte autolesive possono diminuire. La mentalizzazione è stata definita da Allen e Fonagy (2006) come una forma di attività mentale immaginativa, ovvero la percezione e la comprensione del comportamento umano in termini di stati mentali intenzionali, come ad esempio i bisogni, i desideri, i sentimenti, le credenze, gli obiettivi, le intenzioni e le motivazioni (Allen & Fonagy, 2006). Per misurare la sintomatologia, l’impulsività e l’entità delle condotte autolesive sono stati somministrati diversi test all’inizio e alla fine del trattamento. I questionari presi in considerazione in questo studio sono l’Intervista Clinica Strutturata per i Disturbi di Personalità (SCID-5-PD), la Symptom Check List-90-R (SCL-90-R), la Barratt Impulsiveness Scale-11 (BIS-11), la Self-Injurious Thoughts and Behaviors Questionnaire-Nonsuicidal (SITBQ-NS). Per misurare l’andamento delle capacità di mentalizzazione sono state compilate dal clinico di riferimento la Mentalization Imbalance Scale (MIS) e la Modes of Mentalization Scale (MMS), ogni tre mesi per 12 mesi.The borderline personality disorder (BPD) represents a severe and complex mental disorder (Guderson & Hoffman, 2005), characterized by significant impairment in psychosocial functioning (Skodol, Gunderson, McGlashan, et al., 2002) and frequent utilization of psychiatric treatments (Bender, Dolan, Skodol, et al., 2001). The main features of this disorder include fear of abandonment, relational instability, identity disturbance, impulsivity, recurrent suicidal or self-injurious behaviors, affective instability, chronic feelings of emptiness, inappropriate anger and difficulty in its control, as well as transient paranoid ideation associated with stress or dissociative symptoms (APA, 2013). The present study focuses specifically on the impulsivity component and self-injurious behaviors, utilizing a sample of young adult patients with borderline personality disorder from the Mental Health Center of Via Berchet, 16, Padova. The study aims to investigate whether the implementation of Mentalization-Based Treatment for Adolescents (MBT-A) over a 12-month period can reduce impulsivity and self-injurious behaviors. Mentalization has been defined by Allen and Fonagy (2006) as a form of imaginative mental activity, involving the perception and understanding of human behavior in terms of intentional mental states, such as needs, desires, feelings, beliefs, goals, intentions, and motivations (Allen & Fonagy, 2006). To measure symptomatology, impulsivity, and the extent of self-injurious behaviors, several tests were administered at the beginning and end of the treatment. The questionnaires used in this study included the Structured Clinical Interview for Personality Disorders (SCID-5-PD), the Symptom Check List-90-R (SCL-90-R), the Barratt Impulsiveness Scale-11 (BIS-11), and the Self-Injurious Thoughts and Behaviors Questionnaire-Nonsuicidal (SITBQ-NS). To assess the changes in mentalization abilities, the clinician completed the Mentalization Imbalance Scale (MIS) and the Modes of Mentalization Scale (MMS) every three months for a period of 12 months

In Vitro Activity of Fosfomycin on Biofilm in Community-Acquired Staphylococcus aureus Isolates

WOS: 000493400900002Objective: Staphylococcus aureus (S. aureus) is a significant pathogen microorganism that can lead to serious infections. In this study, we researched the activity of biofilm formation and fosfomycin on biofilm in community-acquired S. aureus isolates that were drawn from human noses. Methods: Microtitration plate method was used to determine biofilm formation. The effect of fosfomycin on sessile cells was studied on biofilm matrix composed around plastic beads. The icaA, icaD, icaB, icaC, bap, eno, fnbA, fnbB, clfA, clfB, fib, ebpS, cna and mecA genes were screened by Polymerase Chain Reactions (PCR). Results: S. aureus was isolated from 87 samples (13.2%) out of a total 658 nasal samples. We found that 10 of these isolates (11.4%) were methicillin-resistant S. aureus (MRSA). A total of 86 isolates had the ability to form biofilm. The biofilm inhibitor concentration (BIC) and minimum biofilm eradication concentration (MBEC) of fosfomycin were determined as 8 mu g/ml and 32 mu g/ml, respectively. In the molecular detection results of biofilm-related genes of these isolates, ica-dependent genes were determined to be quite high. However, no bap gene was observed to be positive in any of the isolates. Among the other genes, the most frequent genes to be declared positive were eno (97.6%) and fnbA (94.1%). Conclusion: This study indicates that prevalence of biofilm genes in S. aureus isolates in nasal flora is high and fosfomycin is an effective anti-biofilm agent alone. However, to increase fosfomycin's efficiency, there is a need for more combination studies to make it more effective.Ahi Evran University Scientific Research Project UnitAhi Evran University [TIP.A3.16.011]This work was supported by Ahi Evran University Scientific Research Project Unit with TIP.A3.16.011 project number

Predictive value of cardiothoracic ratio as a marker of severity of aortic regurgitation and mitral regurgitation

Objective: In this study we compared cardiothoracic ratio on chest radiography and left ventricular dimensions from echocardiography in patients with left heart valvular regurgitation

Effects of Genetic Polymorphisms of Drug Transporter ABCB1 (MDR1) and Cytochrome P450 Enzymes CYP2A6, CYP2B6 on Nicotine Addiction and Smoking Cessation

Muderrisoglu, Ahmet/0000-0003-2954-360XWOS:000598127000001PubMed: 33329709Objectives To determine the effects of genetic polymorphisms of ABCB1 (MDR1), CYP2A6, CYP2B6 on smoking status, and clinical outcomes of smoking cessation therapies in a Turkish population. Methods 130 smokers and 130 non-smokers were recruited. Individuals who never smoked were described as non-smokers. 130 smokers were treated with nicotine replacement therapy (NRT) (n = 40), bupropion (n = 47), bupropion + NRT (n = 15), and varenicline (n = 28). Smokers were checked by phone after 12 weeks of treatment whether they were able to quit smoking or not. Genotyping and phenotyping were performed. Results Cessation rates were as follows; 20.0% for NRT, 29.8% for bupropion, 40.0% for bupropion + NRT, 57.1% for varenicline (p = 0.013). The frequency of ABCB1 1236TT-2677TT-3435TT haplotype was significantly higher in non-smokers as compared to smokers (21.5% vs. 10.8, respectively; p = 0.018). Neither smoking status nor smoking cessation rates were associated with genetic variants of CYP2A6 (p = 0.652, p = 0.328, respectively), or variants of CYP2B6 (p = 0.514, p = 0.779, respectively). Conclusion Genetic variants of the drug transporter ABCB1 and the 1236TT-2677TT-3435TT haplotype was significantly associated with non-smoking status. Neither ABCB1 nor CYP2A6, CYP2B6 genetic variants were associated with smoking cessation rates at the 12th week of drug treatment.Hacettepe University Research FundHacettepe University [TSA-2017-12810]This study was supported by Hacettepe University Research Fund (TSA-2017-12810)

Frequency and duration of smoking scenes in Turkish movies

BACKGROUND: Comprehensive tobacco control law in Turkey bans advertisement, promotion of tobacco products and sponsorship by the tobacco industry. Advertisement of tobacco products was banned on television, billboards and press media, but not on movie films. METHODS: To evaluate the frequency and duration of smoking in the movies, 60 most watched Turkish films which were on the vision during the second half of 2016 were determined for this descriptive study. Two young males having a university degree were trained on the aim and methodology of the study. Then the two observers viewed the films independently and recorded smoking scenes or direct appearance of tobacco products on a standard form. RESULTS: There were tobacco products or smoking views in 36 (60%) out of total 60 movies. In these movies there were 4.75 times tobacco occurrences as an average (median 3). Average duration of smoking occurrences was almost 3.5 min (198 s). Smokers were mostly main characters and smoking occurrences were mostly in exciting or romantic atmosphere, which are attractive for young people. DISCUSSION: In the light of Framework Convention on Tobacco Control (Article 13), smoking scenes in movies are considered as kind of tobacco advertisement and promotion, which influences smoking behavior particularly the young people. Therefore, control and prevention of smoking occurrences in movies are important for the protection of children and young people to start smoking. Some health warnings and anti-tobacco messages may be placed in the movies, to reduce tobacco views in the movies

Behavioural interventions to increase adherence to palivizumab prophylaxis in children with CHD

Objectives: Adherence to palivizumab prophylaxis programmes is crucial to protect infants with CHD against respiratory syncytial virus infections. We analysed the effectiveness of two nudge interventions in increasing adherence. Methods: Our study included 229 infants, and their caregivers, from five centers in Turkey in the 2020-2021 respiratory syncytial virus season. We randomly allocated caregivers to a control and two intervention groups. Caregivers in all groups were informed about the prophylaxis programme and provided a schedule. Additionally, caregivers in Intervention 1 were called two days before appointments (default bias) and were asked to plan the appointment day (implementation intention), whereas caregivers in Intervention 2 received biweekly text messages informing them about the programme's benefits (availability bias) and current adherence rate (social norm). Results: Caregivers in Intervention 1 had a significantly higher adherence rate than Control (97.3% versus 90.9%) (p = 0.014). Both interventions had a significant effect on participants in their first prophylaxis season (p = 0.031, p = 0.037). Families where the father was employed had a 14.2% higher adherence rate (p = 0.001). Every additional child was associated with a 2.2% decrease in adherence rate (p = 0.02). In control, ICU admission history was associated with an 18.8% lower adherence rate (p = 0.0001), but this association disappeared in intervention groups. Conclusion: This is the first prospective interventional study which, in the context of palivizumab prophylaxis, analyses the effectiveness of nudge interventions based on established cognitive biases by comparing randomly generated intervention and control groups. We found that default bias and implementation intention have significant effects on adherence