Childhood trauma, primary emotional systems, and suicidal ideation in youths with bipolar disorders

Background: Bipolar disorders (BD) in youths are strongly associated with lifetime suicidal ideation. Nevertheless, primary emotional systems (PES) contributing to this association are poorly understood. Besides this, childhood trauma is a prominent environmental stressor associated with both BD diagnosis and suicide. The aim of this study was to investigate the distribution patterns of PES and childhood trauma in youths’ BD with and without suicidal ideation (BD-IS, BD-NIS). Methods: We assessed 289 participants, 103 youths with DSM-5 BD and 186 healthy controls (HCs). PES were obtained with the Affective Neuroscience Personality Scales (ANPS) and history of childhood trauma using the Childhood Trauma Questionnaire (CTQ). Suicidal ideation was assessed through the Columbia Suicide Scale for the Rating of Suicide Severity (C-SSRS). The associations with suicidal ideation were tested using two different multivariate models. Results: Over 48% of participants reported lifetime suicidal ideation. According to the first model (p<0.0001), BD-IS scored higher on the ANPS-ANGER and lower on ANPS-PLAY and ANPS-CARE than both HCs and BD-NIS, while BD-NIS reported higher and lower scores than HC. BD-IS and BD-NIS reported higher scores on ANPS-SEEK than HCs. BD-IS reported more emotional abuse, sexual abuse, physical abuse and emotional neglect than HCs, but only more emotional abuse than BD-NIS. ANPS-ANGER (OR: 1.13) and CTQ-Emotional abuse (OR:1.26) were independent predictors of suicidal ideation in youths with BD. Conclusions: Findings support the importance of assessing primary emotional systems and childhood trauma, in particular emotional abuse, in youths with BD at risk for suicide

The Gamblers' Temperament and Character Inventory (TCI) Personality Profile

Peer reviewe

Dorsal Prefrontal Cortex Impairment in Methoxetamine-Induced Psychosis: an 18F-FDG PET/CT Case Study

Submitted15 June 2018. Accepted 13 December 2018. Epub ahead of print 13 February 2019Novel psychoactive substances (NPSs) have currently become a major public health concern because of relatively easy accessibility to these compounds and difficulty in identifying them with routine laboratory techniques. Here, we report the 18 F-fluorodeoxyglucose positron emission tomography/computerized tomography ( 18 F-FDG PET/CT) case study of a 23-year-old man who developed a substance-induced psychotic disorder after having intravenously injected himself with an unspecified amount of methoxetamine (MXE), a ketamine derivative hallucinogen. From a clinical perspective, a blunted affective responsiveness with diminished social drive and sense of purpose, along with a profound detachment from the environment, was observed. Psychometric and neuropsychological assessments highlighted severe dissociative symptoms and lack of motivation, along with a mild impairment of verbal fluency, working memory, and attention. Patient’s 18 F-FDG PET/CT scans displayed a significant bilateral deficit of tracer uptake within the dorsolateral prefrontal cortex (DLPFC). DLPFC activity is critical to goal-oriented cognitive functions, including working memory and sustained attention. DLPFC is also involved in both the temporal integration across multiple sensory modes and in the volitional control of actions, leading to the possibility to construct logically coherent temporal configurations of thought, speech, and behavior. This report highlights that a single acute MXE intoxication may produce severe brain impairment.Peer reviewedFinal Accepted Versio

Climate change, biodiversity loss and mental health: a global perspective

Climate change can have various psychopathological manifestations which have been more actively addressed by scientific research only in recent years. Indeed, extreme weather events and environmental changes have been shown to be associated with a range of mental health problems. Following the destruction of ecosystems, biodiversity loss can cause mental distress and emotional responses, including so-called 'psychoterratic' syndromes arising from negatively felt and perceived environmental change. Studies investigating relationships between biodiversity and mental health reveal a complex landscape of scientific evidence, calling for a better understanding of this challenging issue

Serum 25-hydroxyvitamin D levels and psychological distress symptoms in patients with affective disorders during the COVID-19 pandemic

Background. The COVID-19 pandemic has given rise to stress worldwide, especially in vulnerable people like those suffering from mental illness. This study aims to investigate the psychological distress perceived by a cohort of patients with Major Depressive Disorder (MDD) or Bipolar Disorder (BD) after a seven-week period of lockdown measures, and to analyze serum 25-hydroxyvitamin D [25(OH)D] levels as a potential predictor of distress severity. Methods. Fifty-nine remitted MDD and fifty-three euthymic BD patients were enrolled. An online dedicated survey was administered to obtain lockdown-related information and to evaluate COVID-19 related distress by using the Kessler 10 Psychological Distress Scale (K10). Patients\u2019 medical records were reviewed to collect sociodemographic and clinical data, including serum 25(OH)D levels dosed in the three months preceding the outbreak. A multivariate general linear model was adopted to test the effect of factors of interest on psychological distress. Results. In our sample (n = 112), 29 subjects (25.9 %) reported no likelihood of psychological distress, whereas 35 (31.2 %) and 48 (42.9 %) displayed mild and moderate-to-severe likelihood of psychological distress, respectively. Low serum 25(OH)D levels (p = 0.005) and MDD diagnosis (p = 0.001) specifically predicted the severity of psychological distress. Living alone during the lockdown, a longer duration of illness, and smoking habits were more frequently detected in subjects with COVID-19 related distress. Conclusions. Low serum 25(OH)D levels and MDD diagnosis predicted an increased vulnerability to the stressful impact of the COVID-19 outbreak. Our results suggest that vitamin D may represent a biological factor mediating the psychological response to stress in individuals with affective disorders and provide further insight into tailoring intervention strategies

Which comes first? New insights on comorbidity between eating disorders and bipolar disorders.

Abstract Aims : Bipolar disorders (BDs) and eating disorders (EDs) are both common and severe mental illness and present wide areas of symptomatological overlap. The present study aims to focus on the most significant aspects of this comorbidity. Methods This review summarizes epidemiology, aethiopathology, prognostic impact, assessment, treatment of comorbidity between BDs and EDs, and comorbidity between bipolar or eating disorders and other psychiatric disorders. We have reviewed articles published in PubMed/Medline, Scopus, Embase, ScienceDirect from 2005 to 2020 concerning comorbidity between eating and bipolar disorders, and systematic reviews or metanalysis on comorbidities between EDs or BDs and other psychiatric disorders. Results Studies that specifically evaluate the prevalence of EDs in patients with bipolar disorder are more than the studies that investigate the opposite. In BDs, binge eating disorder (BED) represents the most common eating disorder with a prevalence ranging from 8,8% to 28,8%, whereas BN has a prevalence ranging from 4,8% to 10%, and AN from 1% to 7,4%. Instead, in ED patients, prevalence of bipolar disorders ranges from 11,5% to 68.1%. The relationship between EDs and BDs has not been yet investigated enough and consequently has not been totally understood. The presence of EDs has been considered as a marker of clinical severity in patients with bipolar disorders, whereas the presence of bipolar disorder in patients with EDs seems not to have a considerable effect on the age at onset of ED symptoms and on their severity. Comorbidities between EDs or BDs and other psychiatric disorders were also examined. Discussion Given the strong co-occurrence of eating and bipolar disorder, the treatment for one of these should consider that the other one may co-exist, and therefore should focus on both of them. In patients suffering from one of these disorders, the early screening for the other one should be made. As for pharmacological treatment, it is mandatory to consider that pharmacological treatment effective for one of the two disorders could worsen symptoms of the other, for instance many psychotropic medications could cause weight gain. Further studies are needed to reach an early diagnosis through the development of screening tools, and to deepen aspects of this comorbidity that remain still unknown with particular regard to pharmacological treatment and to biopsychological aspects that might be useful in determining the aetiopathology

Sense of agency and its disturbances: A systematic review targeting the intentional binding effect in neuropsychiatric disorders

Sense of agency (SoA) indicates a person's ability to perceive her/his own motor acts as actually being her/his and, through them, to exert control over the course of external events. Disruptions in SoA may profoundly affect the individual's functioning, as observed in several neuropsychiatric disorders. This is the first article to systematically review studies that investigated intentional binding (IB), a quantitative proxy for SoA measurement, in neurological and psychiatric patients. Eligible were studies of IB involving patients with neurological and/or psychiatric disorders. We included 15 studies involving 692 individuals. Risk of bias was low throughout studies. Abnormally increased action-outcome binding was found in schizophrenia and in patients with Parkinson's disease taking dopaminergic medications or reporting impulsive-compulsive behaviors. A decreased IB effect was observed in Tourette's disorder and functional movement disorders, whereas increased action-outcome binding was found in patients with the cortico-basal syndrome. The extent of IB deviation from healthy control values correlated with the severity of symptoms in several disorders. Inconsistent effects were found for autism spectrum disorders, anorexia nervosa, and borderline personality disorder. Findings pave the way for treatments specifically targeting SoA in neuropsychiatric disorders where IB is altered