COVID-19 related lockdown: a trigger from the pre-melancholic phase to catatonia and depression, a case report of a 59 year-old man

Background: The pre-melancholic model described by Tellenbach may provide a common model for understanding the psychological implications of the lockdown. In this case report, we describe a rare catatonic status as a psychological implication linked to the COVID-19 pandemic, a really unique global situation. Case presentation: B is a 59 year-old man with mute psychiatric anamnesis whose mother suffered from a major depressive disorder. As the lockdown began, he started to develop concerns about his family’s economic condition. According to his wife, he could see no end to the epidemic and no future at all. Moving from this, he started to show a severe and rapidly progressive depression and to develop mood congruent delusions. In addition, he had increasing anhedonia, apathy, starvation and insomnia. This turned in the end into a catatonic-like state, along with a deep desire to die. Admitted to the psychiatry ward in a state of mutism, he was discharged after 15 days with a diagnosis of “Major depressive disorder, single severe episode with no psychotic behavior”. He was treated with Sertraline, Olanzapine and Lorazepam. Conclusions: Our aim is to draw attention to the effect of the lockdown upon a Tellenbach-like personality structure. Identifying this type of pre-morbid personality structure could help clinicians understand and treat some cases of patients with severe major depressive disorders elicited by the COVID-19 pandemic

Gene variants with suicidal risk in a sample of subjects with chronic migraine and affective temperamental dysregulation

BACKGROUND: Risk factors for suicide are at least partially heritable and functional polymorphisms of targeted genes have been suggested to be implicated in the pathogenesis of this phenomenon. However, other studies examining the association between specific gene variants and suicide revealed inconsistent findings. We aims to evaluate the possible association between MAO-A3, CYP1A2*1F and GNB3 gene variants, hopelessness and suicidal risk in a sample of subjects with chronic migraine and affective temperamental dysregulation. METHODS: 56 women were genotyped for MAO-A3, CYP1A2*1F and GNB3 gene variants. Participants were also assessed using Beck Hopelessness Scale (BHS), the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego-Autoquestionnaire (TEMPS-A), and the Suicidal History Self-Rating Screening Scale (SHSS). RESULTS: Patients with higher total scores on affective dysregulated temperaments are more likely to have higher BHS (11.27 +/- 5.54 vs. 5.73 +/- 3.81; t19.20 = -3.57; p = 9 indicating high levels of hopelessness. No association was found between MAO-A3, CYP1A2*1F and GNB3 gene variants and suicidal risk as assessed by BHS and SHSS. CONCLUSIONS: This study did not sustain the association between MAO-A3, CYP1A2*1F and GNB3 gene variants and increased suicidal risk in patients with chronic migraine and affective temperamental dysregulation. Further studies investigating the gene-environment interaction or focusing on other genetic risk factors involved in suicidal behaviour are needed

O070. The association between temperament, depression, hopelessness and quality of life in medication-overuse headache patients

No abstract availabl

The role of new technologies to prevent suicide in adolescence. a systematic review of the literature

Background and objectives: Suicide in adolescents represents a major public health concern. To date, a growing number of suicide preventive strategies based on the use of new technologies are emerging. We aimed to provide an overview of the present literature on the use of new technologies in adolescent suicide prevention. Materials and methods: An electronic search was run using the following keywords: Technology OR Technologies OR APP OR Application OR mobile application) AND (Adolescent OR youth OR puberty) AND (Suicid* OR Self-harm OR self-destruction). Inclusion criteria were: English language, published in a peer-reviewed journal, suicide prevention with the use of new technologies among adolescents. Results: Our search strategy yielded a total of 12 studies on the use of telemedicine, 7 on mobile applications, and 3 on language detection. We also found heterogeneity regarding the study design: 3 are randomized controlled trials (RCT), 13 are open-label single group trials, 2 are randomized studies, and 1 is a cross-sectional study. Telemedicine was the most adopted tool, especially web-based approaches. Mobile applications mostly focused on screening of depressive symptoms and suicidal ideation, and for clinical monitoring through the use of text messages. Although telepsychiatry and mobile applications can provide a fast and safe tool, supporting and preceding a face-to-face clinical assessment, only a few studies demonstrated efficacy in preventing suicide among adolescents through the use of these interventions. Some studies suggested algorithms able to recognize people at risk of suicide from the exploration of the language on social media posts. Conclusions: New technologies were found to be well accepted and tolerated supports for suicide prevention in adolescents. However, to date, few data support the use of such interventions in clinical practice and preventive strategies. Further studies are needed to test their efficacy in suicide prevention among adolescents and young adults

Further insights into the beck hopelessness scale (BHS). Unidimensionality among psychiatric inpatients

Short versions of the Beck Hopelessness Scale have all been created according the Classical Test Theory, but the use and the application of this theory has been repeatedly criticized. In the current study, the Item Response Theory approach was employed to refine and shorten the BHS in order to build a reasonably coherent unidimensional scale whose items/symptoms can be treated as ordinal indicators of the theoretical concept of hopelessness, scaled along a single continuum. In a sample of 492 psychiatrically hospitalized, adult patients (51.2% females), predominantly with a diagnosis of Bipolar Disorder type II, the BHS was submitted to Mokken Scale Analysis. A final set of the nine best-fitting items satisfied the assumptions of local independency, monotonicity, and invariance of the item ordering. Using the ROC curve method, the IRT-based 9-item BHS showed good discriminant validity in categorizing psychiatric inpatients with high/medium suicidal risk and patients with and without suicide attempts. With high sensitivity (>.90), this newly developed scale could be used as a valid screening tool for suicidal risk assessment in psychiatric inpatients

Traumatic brain injury and suicide risk

Among the various consequences of traumatic brain injury (TBI), evidence supports the notion that individuals exposed to such events may be at higher risk of suicide. We therefore aim at reviewing the literature by focusing on possible association between TBI and features of the suicidal spectrum, such as suicidal ideation, suicide attempts and completed suicides. We carried out a computerized search for reports of studies involving TBI and suicide risk. A total of 35 reports provide data with preliminary support of this association. Seven articles showed a direct correlation between TBI and completed suicides. Thirteen articles have shown a direct relationship between TBI and suicide attempts; five articles demonstrated a positive correlation with suicidal ideation and suicidality. We also found negative results failing to show a correlation between TBI and completed suicides (one article), suicide attempts (one article) and suicidality (one article). In addition, one article showed that patients who received psychological treatment (CBT therapy) after suffering a head injury showed a significant reduction in suicidal ideation. These preliminary findings encourage further testing of the association between TBI and suicide risk regardless of the psychiatric history. Furthermore, those who have a history of psychiatric illness before the TBI present a greater risk of suicide than those who do not have psychiatric precedents

clinical and functional outcome in a subject with bipolar disorder and severe white matter hyperintensities

Background and Objectives: Neuroimaging studies have found higher rates of white matter hyperintensities (WMHs) in patients with bipolar disorder (BD) of all ages, although whether BD is associated with increased rates of WMHs independently from age and cerebrovascular risk factors is still matter of debate. The outcome of BD associated with severe WMHs is generally poor, but several authors have suggested that some factors could have a protective role in BD. The aim of the present study was to report the two-year follow-up of a woman with BD type I and severe WMH/PWMH lesions who was taking high concentrations of vitamin-D in her nutrition, as well as taking lithium and haloperidol as treatment. Case presentation: A 76-year-old woman was hospitalized for a mixed state BD. She had severe WMHs. She took lithium and haloperidol during the hospitalization and was euthymic at discharge as well as after two-years of follow-up. Her nutrition had a high concentration of Vitamin-D. Unfortunately, it was not possible to give her a second MRI. Conclusions: Although there was probable persistence of WMHs, the patient improved in both mood and quality of life. The possible protective effect of lithium and Vitamin-D is discussed. Received: 12 January 2010 Revised: 5 August 2010 Accepted: 14 September 2010 Short report 42 GIANLUCA SERAFINI ET AL. Background and objectives Neuroimaging studies have found higher rates of WMHs in patients of all ages with bipolar disorder (BD), most frequently localized in the frontal lobes and the frontal/parietal junction1. WMHs may indicate astrogliosis, demyelination and loss of axons and may be relatively more common in older patients with BD, reflecting an interaction of the disease with processes of normal aging. However, WMHs are also associated with several pathological conditions among older individuals2. As a result of this, the meaning of these lesions in BD is still unclear. Although there have been inconsistent results in the research on this issue, WMHs are considered to be negative prognostic factors, associated with treatment resistance, increased hospitalization rates, cognitive impairment and increased suicide risk in individuals with BD3,4. However, several other factors may play a protective role in BD. Tsai et al.5 reported that psychiatric treatment, including medication with antipsychotics or lithium, could be a protective factor against early natural death. Here, we present the case of a 76year-old woman who had had a BD for twenty-one years and had, in addition, severe WMH/PWMH lesions, who was admitted to our psychiatric hospital for a mixed state. The patient gave written consent before being included in the study

Lifestyle interventions and prevention of suicide

Over the past years, there has been a growing interest in the association between lifestyle psychosocial interventions, severe mental illness, and suicide risk. Patients with severe mental disorders have higher mortality rates, poor health states, and higher suicide risk compared to the general population. Lifestyle behaviors are amenable to change through the adoption of specific psychosocial interventions, and several approaches have been promoted. The current article provides a comprehensive review of the literature on lifestyle interventions, mental health, and suicide risk in the general population and in patients with psychiatric disorders. For this purpose, we investigated lifestyle behaviors and lifestyle interventions in three different age groups: adolescents, young adults, and the elderly. Several lifestyle behaviors including cigarette smoking, alcohol use, and sedentary lifestyle are associated with suicide risk in all age groups. In adolescents, growing attention has emerged on the association between suicide risk and internet addiction, cyberbullying and scholastic and family difficulties. In adults, psychiatric symptoms, substance and alcohol abuse, weight, and occupational difficulties seems to have a significant role in suicide risk. Finally, in the elderly, the presence of an organic disease and poor social support are associated with an increased risk of suicide attempt. Several factors may explain the association between lifestyle behaviors and suicide. First, many studies have reported that some lifestyle behaviors and its consequences (sedentary lifestyle, cigarette smoking underweight, obesity) are associated with cardiometabolic risk factors and with poor mental health. Second, several lifestyle behaviors may encourage social isolation, limiting the development of social networks, and remove individuals from social interactions; increasing their risk of mental health problems and suicide

Seasonal and interannual variability of the surface circulation in the eastern Gulf of Cadiz (SW Iberia)

11 páginas, 6 figuras, 1 tabla.An 11-year (1996–2007) time series of current meter observations representative of the open sea circulation; a 4-year (2001–2005) time series of current meter records over the continental shelf and in situ data during different seasons have been compared in order to study the seasonal and interannual variability of the surface circulation in the eastern Gulf of Cadiz. The open sea velocity observations indicate southeastward flow along the northern continental slope of the Gulf of Cadiz, compatible with anticyclonic circulation, during most of the year and more intense during summer months. Flow reversals (northwestward circulation) at seasonal time scales in late autumn and early winter (preferably December and January) are a rather recurrent feature with variable intensity depending on the year. Anticyclonic circulation is associated with westerlies, whereas flow reversals usually take place under easterly episodes, suggesting wind-driven circulation. Negative North Atlantic Oscillation indices (indicative of southward displacement of the Azores high) are also linked to the reversals. Changes in this mainly wind-driven large-scale surface circulation are echoed by the shelf circulation: the coastal countercurrent that closes the mesoscale cyclonic cell over the eastern shelf in spring-summer (upwelling season) is replaced by and eastward current in autumn and winter.We acknowledge CANIGO (MAS3-PL95-0443) European-funded project and, particularly, Guillermo Díaz Del Río for CTD data and the UIB-IMEDEA (Special Action CICYT, REN2000-2599-E) for the software used for the optimal interpolation. Partial support from CTM2006–02326 (Ministry of Science and Technology) and P07-RNM-02938 (Junta de Andalucía) Spanish-funded projects and the Consejeria de Agricultura y Pesca of the Junta de Andalucia are also acknowledged.Peer reviewe

Intense terahertz pulses from SPARC-LAB coherent radiation source

The linac-based Terahertz source at the SPARC_LAB test facility is able to gene rate highly intense Terahertz broadband pulses via coherent transition radiation (CTR) from high brightness electron beams. The THz pulse duration is typically down to 100 fs RMS and can be tuned through the electron bunch duration and shaping. The measured stored energy in a single THz pulse has reached 40 μ J, which corresponds to a peak electric field of 1.6 MV/cm at the THz focus. Here we present the main features, in particular spatial and sp ectral distributions and energy characterizations of the SPARC_LAB THz source, which is very competitive for investigations in Condensed Matter, as well as a valid tool for electron beam longitudinal diagnostics