Changes in attitude towards LAI antipsychotic maintenance treatment: A two-year follow-up study.

AbstractBackground:To present real-world evidence on the effects of switching from oral to long-acting injectable (LAI) antipsychotic maintenance treatment (AMT) in a sample of clinically stable patients with schizophrenia, with regard to subjective experience of treatment, attitude towards drug and quality of life.Methods:50 clinically stable adult schizophrenic outpatients were recruited. At the time of enrolment (T0), all patients were under a stabilized therapy with a single oral second-generation antipsychotic (SGA) and were switched to the equivalent maintenance regimen with the long-acting formulation of the same antipsychotic. 43 patients completed the 24-month prospective, longitudinal, open-label, observational study. Participants were assessed at baseline (T0), after 12 (T1) and 24 months (T2), using psychometric scales (PANSS, YMRS and MDRS) and patient-reported outcome measures (SWN-K, DAI-10 and SF-36).Results:The switch to LAI-AMT was associated with a significant clinical improvement at T1 and T2 compared to baseline (T0). All of the psychometric indexes, as well as patients' subjective experience of treatment (SWN-K), and quality of life (SF-36) showed a significant improvement after one year of LAI-AMT, with stable results after two years. Patients' attitude towards drug (DAI-10) increased throughout the follow-up period, with a further improvement during the second year.Conclusions:The switch to LAI-AMT may help to address the subjective core of an optimal recovery in stabilized schizophrenic patients. A sustained improvement in patients' attitude towards drug may help to achieve patient's compliance. The size of this study needs to be expanded to produce more solid and generalizable results

Gender differences in DSM-5 versus DSM-IV-TR PTSD prevalence and criteria comparison among 512 survivors to the L׳Aquila earthquake

Background: Post-traumatic StressDisorder(PTSD)hasdemonstratedgender-specific prevalenceand expressionsacrossthedifferentDSMdefinitions, sinceits first introductioninDSM-III.TheDSM-5 recentlyintroducedimportantrevisionstoPTSDsymptomatologicalcriteria.Aimofthepresentstudyis to explorewhethergendermoderatesratesofDSM-5PTSDexpressioninanon-clinicalsampleof survivorstoamassiveearthquakeinItaly. Methods: 512survivorsoftheL'Aquila2009earthquake,previouslyinvestigatedforthepresence DSM-IV-TRPTSD,werereassessedaccordingtoDSM-5criteriainordertoexploregenderdifferences. All subjectscompletedtheTraumaandLossSpectrum-SelfReport(TALS-SR). Results: Femalesshowedsignificantly higherDSM-5PTSDratesandratesofendorsementofalmostall DSM-5 PTSDcriteria.Significant genderdifferencesemergedinalmosthalfofPTSDsymptomatological criteria withwomenreportinghigherratesin8ofthem,whilemeninonlyone(anewsymptominDSM- 5: recklessorself-destructivebehavior). ConsideringtheimpactofthethreenewDSM-5symptomsonthe diagnosis, significant genderdifferencesemergedwiththesebeingcrucialinalmosthalfofthePTSD diagnoses inmalesbutinaboutone-fourthinfemales.ByusingROCcurves,DSM-5criteriaEandD showedthehighestAUCvaluesinmales(.876)andfemales(.837),respectively. Limitations: The useofself-reportinstrument;noinformationoncomorbidity;homogeneityofstudy sample; lackofassessmentonfunctionalimpairment. Conclusions: This studyprovidesacontributiontotheongoingneedforreassessmentonhowgender moderatesratesofexpressionofparticulardisorderssuchasPTSD

Impact of Mood Spectrum Spirituality and Mysticism Symptoms on Suicidality in Earthquake Survivors with PTSD

The aim of the present study was to explore the correlations between Spirituality/Mysticism/Psychoticism symptoms and suicidality in young adult survivors of the L’Aquila earthquake. The sample included 475 subjects recruited among high school seniors who had experienced the April 6, 2009, earthquake. Assessments included: Trauma and Loss Spectrum–Self Report and Mood Spectrum–Self Report (MOODS-SR). Mysticism/Spirituality dimension and suicidality were evaluated by means of some specific items of the MOOD-SR. The Spirituality/Mysticism/Psychoticism MOODS-SR factor score was significantly higher among subjects with PTSD diagnosis with respect to those without. Similarly, subjects with suicidal ideation, as well as those who committed a suicide attempt, reported significantly higher scores than those without

Subthreshold autism spectrum disorder in patients with eating disorders

Aim Increasingly data suggest a possible overlap between psychopathological manifestations of eating disorders (EDs) and autism spectrum disorders (ASD). The aim of the present study was to assess the presence of subthreshold autism spectrum symptoms, by means of a recently validated instrument, in a sample of participants with EDs, particularly comparing participants with or without binge eating behaviours. Methods 138 participants meeting DSM-5 criteria for EDs and 160 healthy control participants (HCs), were recruited at 3 Italian University Departments of Psychiatry and assessed by the SCID-5, the Adult Autism Subthreshold Spectrum (AdAS Spectrum) and the Eating Disorders Inventory, version 2 (EDI-2). ED participants included: 46 with restrictive anorexia (AN-R); 24 with binge-purging type of Anorexia Nervosa (AN-BP); 34 with Bulimia Nervosa (BN) and 34 with Binge Eating Disorder (BED). The sample was split in two groups: participants with binge eating behaviours (BEB), in which were included participants with AN-BP, BN and BED, and participants with restrictive behaviours (AN-R). Results participants with EDs showed significantly higher AdAS Spectrum total scores than HCs. Moreover, EDs participants showed significantly higher scores on all AdAS Spectrum domains with the exception of Non verbal communication and Hyper-Hypo reactivity to sensory input for AN-BP participants, and Childhood/Adolescence domain for AN-BP and BED participants. Participants with AN-R scored significantly higher than participants with BEB on the AdAS Spectrum total score, and on the Inflexibility and adherence to routine and Restricted interest/rumination AdAS Spectrum domain scores. Significant correlations emerged between the Interpersonal distrust EDI-2 sub-scale and the Non verbal communication and the Restricted interest and rumination AdAS Spectrum domains; as well as between the Social insecurity EDI-2 sub-scale and the Inflexibility and adherence to routine and Restricted interest and rumination domains in participants with EDs. Conclusions Our data corroborate the presence of higher subthreshold autism spectrum symptoms among ED participants with respect to HCs, with particularly higher levels among restrictive participants. Relevant correlations between subthreshold autism spectrum symptoms and EDI-2 Subscale also emerged