3 research outputs found
The Cold man. A clinical case of the cold sensation.
The lack of correlation between available knowledge and the current approach to Somatoform Disorders is highlighted.. Methods: the study, via the analysis of an unusual clinical case of an anomalous sensation of cold, examines various hypotheses on the physiopathology of somatization. Conclusions: a conceptualization would focus attention on the level of patientsā preoccupation with their symptoms, on the anomalies of the variations of perceptions and on patientsā hyperarousal. It could lead to a more harmonious position in psychiatry, between anthropologically-based understanding and interpretation of psychophysical information
Treating bipolar depression with esketamine: Safety and effectiveness data from a naturalistic multicentric study on esketamine in bipolar versus unipolar treatmentāresistant depression
Ā© 2023 The Authors. Bipolar Disorders published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives. https://creativecommons.org/licenses/by-nc-nd/4.0/Background: Bipolar depression accounts for most of the disease duration in type I and type II bipolar disorder (BD), with few treatment options, often poorly tolerated. Many individuals do not respond to firstāline therapeutic options, resulting in treatmentāresistant bipolar depression (BāTRD). Esketamine, the Sāenantiomer of ketamine, has recently been approved for treatmentāresistant depression (TRD), but no data are available on its use in BāTRD. Objectives: To compare the efficacy of esketamine in two samples of unipolar and bipolar TRD, providing preliminary indications of its effectiveness in BāTRD. Secondary outcomes included the evaluation of the safety and tolerability of esketamine in BāTRD, focusing on the average risk of an affective switch. Methods: Thirtyāfive BāTRD subjects treated with esketamine nasal spray were enrolled and compared with 35 TRD patients. Anamnestic data and psychometric assessments (MontgomeryāAsberg Depression Rating Scale/MADRS, Hamiltonādepression scale/HAMāD, Hamiltonāanxiety scale/HAMāA) were collected at baseline (T0), at one month (T1), and three months (T2) follow up. Results: A significant reduction in depressive symptoms was found at T1 and T2 compared to T0, with no significant differences in response or remission rates between subjects with BāTRD and TRD. Esketamine showed a greater anxiolytic action in subjects with BāTRD than in those with TRD. Improvement in depressive symptoms was not associated with treatmentāemergent affective switch. Conclusions: Our results supported the effectiveness and tolerability of esketamine in a realāworld population of subjects with BāTRD. The low risk of manic switch in BāTRD patients confirmed the safety of this treatment.Peer reviewe