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

Is Pathological Trading an Overlooked Form of Addiction?

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Il doppio legame tra helping professions e relazioni coniugali: riflessioni criminologiche e canonistiche da una casistica peritale

This contribution deals with some reflections starting from an expert case study on the subject of matrimonial nullity, carried out on couples formed by at least one spouse - but sometimes by both - who carried out a profession of help, especially in the health sector (as a doctor, psychologist, nurse, social welfare operator). This is a very significant element, since, in the expert's office, on the one hand, he referred to the problem of the reasons for choosing these helping professions and, from above, demonstrated the plausible implications of the professions of help on the formation and functioning of the same nuptial couple, with all the likely consequences also in the criminological and canonical field. The motivations for choosing not only professional, but also affective-relational, especially as a couple, assume fundamental importance. In fact, when the option of professional help is dictated by individual and self-centered dynamics, rather than object and hetero-direct, the same clearly come into play not only at work, where perhaps the subject gets gratifications and awards that repair him. from wounds and shortcomings as remote as unsolved, but above all in his private life.Il presente contributo tratta di alcune riflessioni a partire da una casistica peritale in tema di nullità matrimoniale, eseguite su coppie formate da almeno un coniuge – ma talora da tutti e due – che svolge una professione di aiuto, specialmente in ambito sanitario (come medico, psicologo, infermiere, operatore socio-assistenziale); elemento questo molto significativo, poiché, in sede peritale, da un lato, richiama il problema delle motivazioni alla scelta di tali helping professions e, dall’alto, dimostra le plausibili implicazioni delle professioni di aiuto sulla formazione e sul funzionamento della stessa coppia nuziale, con tutte le verosimili conseguenze anche in ambito criminologico e canonistico. Infatti, quando l’opzione all’helping profession è dettata da dinamiche individuali ed auto-centrate, più che oggettuali ed etero-dirette, le stesse entrano chiaramente in gioco non solo sul lavoro, dove magari il soggetto ottiene gratificazioni e riconoscimenti che lo riparano da ferite e carenze tanto remote, quanto insolute, ma soprattutto nella sua vita privata

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

Posible especificidad de los síntomas tipo pánico inducidos por inhalantes: a propósito de un caso

La intoxicación aguda por inhalantes produce distintos síntomas psiquiátricos y se ha documentado daño orgánico cerebral por exposición crónica a los mismos. Describimos la aparición de un subgrupo específico de síntomas tipo pánico, tras la exposición a solventes volátiles, en una mujer de 36 años con historia de exposición profesional y adicción a los solventes volátiles que posteriormente desarrolló un trastorno de pánico comórbido con escasa respuesta al tratamiento antidepresivo. La paciente se evaluó mediante la administración del SCL-90-R, el WAIS y el test de Rorschach; también se le realizó RM de medio contraste. No se encontraron datos sólidos de daño cerebral, aunque sus síntomas de ansiedad cumplen criterios para el subtipo neurobiológico de trastorno de pánico no relacionado con miedo a asfixia. Este subgrupo de síntomas de ansiedad se atribuye al mecanismo de acción de los solventes volátiles, es decir, la neurotransmisión gabaérgica

Investigating the association between post-traumatic stress symptoms and satisfaction with life: Avoidance is significantly related to life satisfaction with the moderation of Mature defence mechanisms.

Abstract Background: Among the various components of subjective well-being, satisfaction with life attracts consider-able interest, and the research about the antecedents of this construct is a thriving field in the scientific literature. Therefore, the present study aimed at investigating the factor that may in-fluence satisfaction with life, by specifically focusing on post-traumatic stress symptoms and mature defence mechanisms, controlling for gender and age as covariates. Method: A sample of 703 Italian individuals (495 Women; 208 Men; Mage = 34.80 years; SD = 11.81) completed an online survey including the Satisfaction with Life Scale, Impact of event scale – revised, and the Forty Item Defense Style Questionnaire. Data were analysed by implementing two moderation models. Results: In the first moderation model, the total score of post-traumatic stress symptoms showed a significant and negative association with satisfaction with life, moderated by mature defences. Such data was further investigated, exploring the role of intrusion, avoidance, and hyperarousal sub-dimensions. Results showed that avoidance was significantly and negatively related to satisfaction with life, with the moderation of mature defences. Finally, age was found to interact with satisfaction with life, so younger subjects had lower levels of life satisfaction. Conclusions: The present study highlighted the negative association between post-traumatic stress symptoms (and specifically, avoidance) and satisfaction with life, highlighting the critical protective role of mature defences in this relationship. Such data may provide useful knowledge to implement tailored interventions

Sensitivity to Climate and Weather Changes in Euthymic Bipolar Subjects. Association With Suicide Attempts

Background: Climate and weather are known to affect multiple areas of human life, including mental health. In bipolar disorder (BD), seasonality represents an environmental trigger for mood switches, and climatic variables may contribute to recurrences. Several studies reported seasonal and climatic-related variations in the rate of suicide attempts. Suicide risk is relevant in BD, with approximately 25% of patients attempting suicide. Therefore, this study aimed to assess sensitivity to weather and climatic variations in BD subjects and its relationship with lifetime suicide attempts. Methods: Three hundred fifty-two euthymic BD and 352 healthy control subjects, homogeneous with respect to socio-demographic characteristics, were enrolled. All participants were administered the METEO-Questionnaire (METEO-Q) to evaluate susceptibility to weather and climatic changes. We also investigated the potential relationship between sensitivity to climate and weather and lifetime suicide attempts in BD patients. Results: METEO-Q scores and the number of subjects reaching the cut-off for meteorosensitivity/meteoropathy were significantly higher in BD patients. Within the clinical group, BD subjects with lifetime suicide attempts obtained higher METEO-Q scores, with no differences between BD-I and BD-II. The number of suicide attempts directly correlated with METEO-Q scores. The presence of suicide attempts was associated with the physical and psychological symptoms related to weather variations. Discussion: Our findings support the relevance of sensitivity to weather and climate variations in a large sample of BD subjects and point out the association of this feature with lifetime suicide attempts

Problematic mobile phone use in adolescence:a cross-sectional study

Aim: In recent years, mobile phone use has become increasingly common among Italian youth, while a growing scientific literature has been identifying the occurrence of a problematic mobile phone use which seems to share some features of other conditions often referred to as behavioural addictions. The study aimed to assess the prevalence of problematic mobile phone use in a population of Italian adolescents and its association with other behavioural addictions. Subjects and methods: The Mobile Addiction Test (MAT) was administered to 2,790 high school students from Barletta, an Italian town, together with the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA), the Compulsive Buying Scale (CBS), the Internet Addiction Test (IAT), the Exercise Addiction Inventory (EAI), the Work Addiction Risk Test (WART). Results: MAT scores fitted a Gaussian distribution model. Scores ≥ 17 was found as a cut-off value over which identifying problematic mobile phone users. Overall prevalence of problematic mobile phone use was 6.3%; this condition was associated with other behavioural addictions like compulsive buying. Conclusion: Problematic mobile phone use in adolescence should become a public health issue, and it could be a cause of health problems and social costs. © 2011 Springer-Verlag