Alterations in circadian/seasonal rhythms and vegetative functions are related to suicidality in DSM-5 PTSD

Background: Alterations in rhythmicity and vegetative functions have been reported as correlates of suicidality, particularly in patients with mood disorders. No investigation has addressed their impact on patients with posttraumatic stress disorder (PTSD). Aim of the present study was to fulfill this gap. Methods: Sixty-five out- and inpatients with DSM-5 PTSD were assessed by using the Mood Spectrum-Self Report- Lifetime Version (MOODS-SR), a questionnaire for lifetime mood spectrum symptomatology including alterations in circadian/seasonal rhythms and vegetative functions. Six items of the MOODS-SR were combined and dichotomized to assess suicidal ideation and/or attempts. Results: Significant and positive associations were found between symptoms of lifetime dysregulations in rhythmicity and vegetative functions and suicidal ideation and/or attempts. All MOODS-SR sub-domains (rhythmicity, sleep, appetite/weight, sexual function, physical symptoms) were associated with an increased likelihood of suicidal ideation, but only changes in appetite/weight were associated with greater odd ratios of suicide attempts (OR = 2.099, 95% CI 1.148-3.841). Conclusions: Our results suggest that lifetime dysregulations in rhythmicity and vegetative functions may represent correlates of suicidality in patients with DSM-5 PTSD

Validation of the Italian version Inventory of Complicated Grief (ICG): a study comparing CG patients versus bipolar disorder, PTSD and healthy controls

Background. A minority (9-20%) of subjects facing bereavement may develop symptoms of unresolved grief associated with significant distress and impairment that have been recently identified as a distinct post-loss syndrome named complicated grief. The Inventory of Complicated Grief is a self-report instrument to assess complicated grief. Aim of this study was to: 1) validate the Italian version of the Inventory of Complicated Grief; 2) provide additional evidence of complicated grief diagnosis through analysis of complicated grief symptoms in a clinical data set consisting of bereaved individuals with complicated grief, Post-Traumatic Stress Disorder, bipolar disorder and healthy controls. Methods. 229 bereaved subjects were consecutively enrolled: 64 with complicated grief; 72 with post-traumatic stress disorder; 35 with bipolar disorder; 58 healthy controls. Assessments included: the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I/P) and the Italian version of the Inventory of Complicated Grief. Results. The mean total Inventory of Complicated Grief score was significantly different among the study groups [F(3.228)=94.19, p<.001]. Post-hoc Games-Howell comparisons indicated significantly lower scores in healthy controls compared to the other three groups, and significantly higher scores in complicated grief patients with respect to the other three groups. The scale demonstrated a high level of internal consistency: Cronbach’s alpha value computed on the whole sample was 0.947.Factor analyses demonstrated a single-factor solution. Conclusions. This study provides evidence of the validation of the Italian version of the ICG, tested in a large and well-characterized clinical help-seeking population. It also supports the proposition that complicated grief is an independent diagnosis

Skin antisepsis with chlorhexidine versus iodine for the prevention of surgical site infection: A systematic review and meta-analysis

Surgical site infection (SSI) is one of the most frequent health care-associated infections. One of the practices to reduce their incidence is preoperative skin antisepsis. Two of the most commonly active components used are chlorhexidine gluconate and povidone iodine. Of 3 reviews conducted between 2010 and 2012 comparing antiseptics, 2 were in favor of chlorhexidine; however, the latest was unable to draw conclusions