24 research outputs found
DIFFERENTIAL GENDER SEVERITY EXPRESSION OF SYMPTOMS IN PATIENTS WITH DUAL DIAGNOSIS: AN IN-PATIENT OBSERVATIONAL STUDY
Background: The present retrospective study is aimed at exploring the impact of gender differences in a sample of inpatients
with dual diagnosis.
Subjects and methods: The study was carried out at the Psychiatric Service of the General Hospital/University of Perugia
(Italy). Patients were recruited from January 2015 until December 2018. The sample consists of patients with dual diagnosis, divided
into two subgroups based on gender; descriptive and bivariate statistics were performed (p<0.05). Male and females were compared
according to socio-demographic, clinical and psychopathological features, measured by Clinical Global Impressions (CGI) and
factor models of the Positive and Negative Syndrome Scale (PANSS) and the Brief Psychiatric Rating Scale (BPRS).
Results: In our sample (n=157), no significant differences in socio-demographic features were found between male (n=108,
68.8%) and female subjects (n=49, 31.2%). Women displayed a higher frequency of involuntary hospitalizations (53.1% vs 32.4%,
p=0.022) and a higher score on the general psychopathology scale of the Positive and Negative Syndrome Scale (PANSS)
(41.86±8.96 vs 36.54±10.38, p=0.041).
Conclusions: Our study confirms the prevalence of dual diagnosis in the male gender. Female sex appears more frequently
connected to some indices of clinical severity. We expect to enlarge our sample to confirm these results and further clarify the
knowledge on the subject
INVOLUNTARY HOSPITALIZATION AND VIOLENT BEHAVIORS: MEDICAL ACT OR SOCIAL CONTROL? A 3-year retrospective analysis
Background: The present retrospective study is aimed at assessing the clinical and psychopathological correlates of violent
behaviors in a sample of acute involuntary committed inpatients.
Subjects and methods: Involuntary inpatients were retrospectively assessed for the presence of violent behaviors. Patients with
and without overt hetero-aggressive behaviors were compared according to socio-demographic, clinical and psychopathological
features. A stepwise backward logistic regression was performed in order to assess the variables most associated with the
perpetration of violent acts. The sample of violent patients was then divided in two subgroups on the basis of the presence/absence of a serious mental illness (SMI). Bivariate analyses were performed between SMI and non-SMI violent patients.
Results: In the present sample of 160 inpatients, 88 (55%) perpetrated violent acts. Subjects who performed violence presented a higher rate of mood stabilizers prescription (p=0.038). The PANSS-excited component was positively associated with violent
behaviors (p=0.027, Odds Ratio (OR)=1.14, Confidence Interval (CI) 1.01-1.28), whilst the PANSS-depressed/anxiety factor
displayed a negative association (p=0.015, OR=0.78, CI 0.64-0.95). Violent inpatients diagnosed with SMI presented higher
rehospitalization rate (p=0.009), longer length of stay (p=0.005), more frequent long-acting injectable antipsychotics prescription (p<0.001) and a higher positive symptoms severity as measured by the PANSS-positive factor (p=0.049).
Conclusions: The clinical population of acute psychiatric inpatients performing violent behavior represents a specific and
heterogeneous subgroup of patients for which prevention and treatment strategies should be addressed
INVOLUNTARY HOSPITALIZATION AND VIOLENT BEHAVIORS: MEDICAL ACT OR SOCIAL CONTROL? A 3-year retrospective analysis
Background: The present retrospective study is aimed at assessing the clinical and psychopathological correlates of violent
behaviors in a sample of acute involuntary committed inpatients.
Subjects and methods: Involuntary inpatients were retrospectively assessed for the presence of violent behaviors. Patients with
and without overt hetero-aggressive behaviors were compared according to socio-demographic, clinical and psychopathological
features. A stepwise backward logistic regression was performed in order to assess the variables most associated with the
perpetration of violent acts. The sample of violent patients was then divided in two subgroups on the basis of the presence/absence of a serious mental illness (SMI). Bivariate analyses were performed between SMI and non-SMI violent patients.
Results: In the present sample of 160 inpatients, 88 (55%) perpetrated violent acts. Subjects who performed violence presented a higher rate of mood stabilizers prescription (p=0.038). The PANSS-excited component was positively associated with violent
behaviors (p=0.027, Odds Ratio (OR)=1.14, Confidence Interval (CI) 1.01-1.28), whilst the PANSS-depressed/anxiety factor
displayed a negative association (p=0.015, OR=0.78, CI 0.64-0.95). Violent inpatients diagnosed with SMI presented higher
rehospitalization rate (p=0.009), longer length of stay (p=0.005), more frequent long-acting injectable antipsychotics prescription (p<0.001) and a higher positive symptoms severity as measured by the PANSS-positive factor (p=0.049).
Conclusions: The clinical population of acute psychiatric inpatients performing violent behavior represents a specific and
heterogeneous subgroup of patients for which prevention and treatment strategies should be addressed
CANNABINOID-INDUCED PSYCHOSIS: A CROSS-SECTIONAL GENDER STUDY
Background: Gender is a crucial factor in the development of mental illnesses, with an essential influence on clinical characteristics
and not only on the prevalence of each disorder. Gender differences in cannabinoid-related disorders are highlighted by
different research fields (preclinical, clinical, socio-demographic studies), but few studies focused on differential symptom expression
in cannabinoid-induced psychosis. This study aims at investigating qualitative and quantitative gender differences in specific
psychopathological domains in a clinical sample of subjects affected by cannabinoid-induced psychotic disorder, without psychiatric
comorbidity.
Subjects and methods: The study was carried out at the Psychiatric Inpatient Service of General Hospital of Perugia (Italy). In
this cross-sectional gender study, 28 inpatients were enrolled, 14 males (M) and 14 females (F). Participants were administered a
psychometric battery consisting of 7 tests (PANSS, NDS-I, YMRS, HAM-D, HAM-A, AQ, SSI) in order to investigate 7 psychopathological
domains (Psychosis, Dysphoria, Mania, Depression, Anxiety, Aggressive Behaviour and Suicide Ideation). Scores
obtained at each test were compared between male and females by using Mann-Whitney U test (p<0.05).
Results: In this study, we observed that males present higher severity of psychotic symptoms, with prominent scores in PANSS
positive and general psychopathology scale (p<0.001), and an important expression of aggressive behavior (p<0.001) compared
with females. Female sample, instead, shows a greater expression of dysphoria and depressive domains (p<0.001) and a lower, but
statistically significant, prevalence in the anxiety domains expression (p=0.01). By these observations, we could assert that in male group thought disorders are prominent. On the other hand, in female group affective disorder are prominent.
Conclusions: This study confirmed how gender influences the phenomenic expression of psychiatric disorders. In line with the
precision medicine paradigm, a further clarification of different clinical profiles based on gender would allow the choice of a
personalized treatment plan with better efficacy and accuracy indices
DYSPHORIA DIMENSIONAL MODEL FOR FEEDING AND EATING DISORDERS: A PRELIMINARY STUDY
Background: Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED) are severe psychiatric illnesses
which represent the main expression of Feeding and Eating Disorders (FED). Clinicians agree that emotional and behavioural
dysregulation play a crucial role in FED. Dysphoria could help us to better understand these components. Indeed, we define
dysphoria as a generic state of dissatisfaction and emotional instability, without any specific features. Among the multitude of
symptoms, we find that irritability, discontent, interpersonal resentment and surrender prevail. These dimensions correspond to the
four subscales of Neapean Dysphoria Scale - Italian version (NDS-I). Dysphoria role in FED has not yet been investigated. Using
this test, we can characterize dysphoria both in quantitative and qualitative terms. Accordingly, domain evaluation could
discriminate these disorders allowing us to assess possible differential phenomenological expressions.
Aims: The aim of this paper is to understand in which way the dimensional spectrum that composes dysphoria differs between
Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorders through an observational comparative study.
Subjects and methods: The enrolled sample (30 patients) is represented by patients with a history of FED (AN, BN or BED).
Patients were males and females between the ages of 13 and 45 with a good knowledge of Italian language. Patients with severe
cognitive impairment (MMSE <19) and civil incapacitation were excluded. Patients were recruited from the Psychiatric Service of
the Santa Maria della Misericordia Hospital in Perugia (PG), and other residential and semi residential structures specialized in
FED treatment (FED specialized center at Palazzo Francisci in Todi (PG), Nido delle Rondini in Todi (PG), BED (Binge Eating
Disorders) center in Città della Pieve (PG) and ambulatory services for FED in Umbertide (PG)). We administered them the Neapen
Dysphoria Scale – Italian Version (NDS-I), a specific dimensional test for dysphoria. Starting from the dataset, with the aid of the
statistical program SPSS 20, we have carried out a comparison between disorders groups selected and NDS-I total score and
subscales (irritability, discontent, interpersonal resentment, surrender). For this we have used the Mann-Whitney U test, a
nonparametric test with 2 independent samples, by setting a significance level p<0.05.
Conclusions: This study allowed us to better understand and characterize the most common Eating Disorders. Beyond that,
despite the small sample size, we found in our analysis statistically significant difference in the expression of various dysphoria
dimension spectrum inside our 3 groups
An international registry of patients with plasminogen deficiency (HISTORY)
Plasminogen deficiency is an ultra-rare multisystem disorder characterized by the development of fibrin-rich pseudomembranes on mucous membranes. Ligneous conjunctivitis, which can result in vision impairment or loss, is the most frequent symptom reported. Affected systems may also include the respiratory tract, oropharynx, female reproductive tract, gingiva, middle ear, renal collecting system, skin and central nervous system. Untreated, plasminogen deficiency may result in significant reduction in quality of life and morbidity with potential life-threatening complications. Non-specific therapies are inadequate and plasminogen concentrates are not commercially available. The current understanding of plasminogen deficiency and management of disease symptoms and its progression are based on case reports/series and two small clinical trials. To date there has never been a comprehensive, international study to examine the natural history or optimal therapeutic intervention; knowledge gaps include identification of contributing factors and triggers of disease manifestations, inability to predict disease course, and insufficient real-world data for use of therapeutics. We have created an international, observational study (HISTORY) in a large cohort of persons with plasminogen deficiency and first-degree family members to address these gaps and to advance knowledge and care. HISTORY will build upon the established relationship between the Indiana Hemophilia and Thrombosis Center and the Fondazione Angelo Bianchi Bonomi, IRCCS Ca’ Granda Ospedale Maggiore Policlinico - University of Milan and will utilize a modified version of the Prospective Rare Bleeding Disorders Database (PRO-RBDD). A biorepository containing samples from subjects with plasminogen deficiency will be established. This article describes the rationale behind the study and efforts towards its goals