Assessing Mental Pain as a Predictive Factor of Suicide Risk in a Clinical Sample of Patients with Psychiatric Disorders

According to contemporary suicidology, mental pain represents one of the main suicide risk factors, along with more traditional constructs such as depression, anxiety and hopelessness. This work aims to investigate the relationship between the levels of mental pain and the risk to carry out suicide or suicide attempt in the short term in order to understand if a measurement of mental pain can be used as a screening tool for prevention. For this purpose, 105 outpatients with psychiatric diagnosis were recruited at the university hospital of Varese during a check-up visit and were assessed by using psychometric scales of mental pain levels, hopelessness, anxiety and depression. Clinical and sociodemographic variables of the sample were also collected. A period of 18 months following the recruitment was observed to evaluate any suicides or attempted suicides. Subjects numbering 11 out of 105 committed an attempted suicide. From statistical analyses, high values of the Beck Depression Inventory (BDI-II), Mental Pain Questionnaire (OMMP) and Hamilton Rating Scale for Depression (HAM-D) scales showed a significant association with the risk of carrying out a suicide attempt and, among these, OMMP and BDI-II showed characteristics of good applicability and predictivity proving suitable to be used as potential tools for screening and primary prevention of suicidal behavior

Off-label long acting injectable antipsychotics in real-world clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study

Introduction Information on the off-label use of Long-Acting Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with on- vs off-label LAIs and predictors of off-label First- or Second-Generation Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice. Method In a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on off- or on-label prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the off-label group. Results SGA LAIs were more commonly prescribed in everyday practice, without significant differences in their on- and off-label use. Approximately 1 in 4 patients received an off-label prescription. In the off-label group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale. Conclusion Our study is the first to identify predictors of FGA vs SGA choice in patients treated with off-label LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use co-morbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns

Revisione tassonomica della collezione osteologia del \u201cDott. Daniele Benfatti\u201d

Sono stati presi in esame un centinaio di pezzi provenienti dalla collezione osteologica del dott. Daniele Benfatti, recentemente scomparso. I reperti ossei sono stati raccolti tra aprile e settembre 2003 durante il periodo di secca del fiume Po, nei territori di Quingentole, Ostiglia e Sermide (Mantova). Essi forniscono informazioni sulla fauna vertebrata della Pianura Padana di epoche passate. interessante la presenza dell'alce (Alces alces), del bisonte (Bison sp.) e del ghiottone (gulo gulo), caratteristici di un paleoambiente completamente diverso dall'attuale

I reperti faunistici

Studio archeozoologico di un campione faunistico proveniente dallo scavo effettuato piazza Anita Garibaldi (Ravenna) nel 2011 per la costruzione di isole ecologiche interrate. Le indagini hanno permesso di osservare lo sfruttamento della fauna domestica nelle diverse fasi abitative di un'unica area dal periodo Romano Medio Imperiale fino ai secoli XVIII-XIX. Nonostante la ricerca abbia interessato un arco cronologico molto ampio la composizione faunistica rimane sostanzialmente invariata e indica un'economia domestica basata soprattutto sull'apporto carneo di suini e caprovini predominanti sui bovini

Reperti ossei recuperati nell'alveo del fiume Po e conservati presso il "Museo Archeologico" di Ostiglia (MN). Riconoscimento e determinazione tassonomica

Sono stati analizzati circa 200 reperti ossei raccolti dal gruppo Archeologico Ostigliense (G.A.O.) durante i periodi di secca del fiume Po, in una vasta area compresa tra Correggio Micheli e Isola Bianchi (Mn), dagli anni '90 al 2005. Il materiale osteologico informa sulla fauna della Pianura Padana, costituita da specie principalmente domestiche e in accordo con il panorama faunistico attuale, fatta eccezione per un reperto appartenebte alla specie Alces alces

A case of reversible splenial lesion syndrome (Resles) related to neuroleptic malignant syndrome in a schizophrenic patient

Objective: Reversible splenial lesion syndrome (RESLES) is a rare clinico-radiological condition characterized by a transient lesion in the splenium of the corpus callosum. Method: A systematic search of the literature has highlighted a possible correlation between this rare condition and neuroleptic malignant syndrome (NMS) despite only few cases have been reported. Results: This paper reports a case of RESLES syndrome in a 36-years old male patient with NMS who was undergoing psychiatric treatment for schizophrenia. Conclusions: The reported clinical case highlights the possibility of including NMS as one of the differential diagnosis in RESLES syndrome

Efficacy of short-term psychodynamic psychotherapy (STPP) in depressive disorders: A systematic review and meta-analysis

Introduction: Depression is a common illness worldwide and can severely interfere with daily and work functioning. Both pharmacological and psychotherapeutics interventions are used for adult depression. The aim of the review is to evaluate the efficacy of short-term psychodynamic psychotherapy (STPP) comparing with different types of intervention. Materials and methods: A systematic review with meta-analysis on the efficacy of STPP in depressive disorders was conducted. Results: Meta-analysis results confirm the superiority of STPP versus no interventions. The average effect size of depressive symptoms severity at the end of the treatment is -0.91 (95 % CI: -1.49 - -0.33) in favor of STPP, while for clinical improvement of depressive symptoms is -0.78 (95 % CI: -1.56 - 0.01). Results confirm a net superiority of STPP to usual treatments unstructured. A mild superiority of efficacy of STPP on support psychotherapy emerged. Comparison of the efficacy of STPP vs cognitive-behavioral psychotherapy (CBT) shows little superior in case of STPP. No substantial differences in efficacy in case of STPP than control interventions emerged. Antidepressant pharmacotherapy is resulted to be slightly more effective to STPP. Discussion: While all the other results confirm current literature, this review shows no superiority of combined treatment than STPP only. Limitations: The review has some limitations such as the lack of moderation analysis and the high heterogenicity of the type of the studies. Conclusions: The results confirm the efficacy of STPP in depressive disorders endorsing the guidelines of National Institute for Health and Clinical Excellence

Pharmacogenetic Tests in Reducing Accesses to Emergency Services and Days of Hospitalization in Bipolar Disorder: A 2-Year Mirror Analysis

Despite the enormous costs associated to mood disorders\u2019, few studies evaluate potential cost saving from the use of pharmacogenetic tests (PGT). This study compares 12 months before the execution of the PGT versus 12 months after, in terms of number and days of hospitalization and accesses to emergency services, in a sample of 30 patients affected by bipolar disorder. Secondarily, the study gives an economic value to the data based on the diagnosis-related group (DRG). Patients included in the study were required to be aged 6518 years, sign an informed consent, have a score of Clinical Global Impression item Severity (CGIs) 653, and have a discordant therapy compared to the PGT in the 12 months preceding it and a therapy consistent with it for the following 12 months. Cost saving has been evaluated by paired t-tests in a mirror analysis. Statistically significant differences in all the comparisons (p < 0.0001) emerged. Important cost saving emerged after the use of PGT (\u20ac148,920 the first year versus \u20ac39,048 the following year). Despite the small sample size and lack of a control group in this study, the potential role of PGT in cost saving for the treatment of bipolar disorder treatment emerged. To confirm this result, larger and clinical trials are needed