The influence of mother’s personality on the decision about the elective cesarean section: a pilot study with a sample of 16 new mothers

To investigate the psychological profile of a sample of new mothers, who requested an elective caesarean section (CS), compared with a group of women who had a CS in emergency. Women who chose CS without medical indications showed more somatic anxiety levels, expressed with a hypochondriac rumination and an obsessive way to control their body. This seems associated with more neuroticism and more symptoms of depression which may lead to a higher risk of develop postnatal depression

Comparison of cerebellar grey matter alterations in bipolar and cerebellar patients: evidence from voxel-based analysis

The aim of this study was to compare the patterns of cerebellar alterations associated with bipolar disease with those induced by the presence of cerebellar neurodegenerative pathologies to clarify the potential cerebellar contribution to bipolar affective disturbance. Twenty-nine patients affected by bipolar disorder, 32 subjects affected by cerebellar neurodegenerative pathologies, and 37 age-matched healthy subjects underwent a 3T MRI protocol. A voxel-based morphometry analysis was used to show similarities and differences in cerebellar grey matter (GM) loss between the groups. We found a pattern of GM cerebellar alterations in both bipolar and cerebellar groups that involved the anterior and posterior cerebellar regions (p = 0.05). The direct comparison between bipolar and cerebellar patients demonstrated a significant difference in GM loss in cerebellar neurodegenerative patients in the bilateral anterior and posterior motor cerebellar regions, such as lobules I−IV, V, VI, VIIIa, VIIIb, IX, VIIb and vermis VI, while a pattern of overlapping GM loss was evident in right lobule V, right crus I and bilateral crus II. Our findings showed, for the first time, common and different alteration patterns of specific cerebellar lobules in bipolar and neurodegenerative cerebellar patients, which allowed us to hypothesize a cerebellar role in the cognitive and mood dysregulation symptoms that characterize bipolar disorder

Aberrant cerebello-cerebral connectivity in remitted bipolar patients 1 and 2: new insight into understanding the cerebellar role in mania and hypomania

Bipolar disorder (BD) is a major mental illness characterized by periods of (hypo) mania and depression with inter-episode remission periods. Functional studies in BD have consistently implicated a set of linked cortical and subcortical limbic regions in the pathophysiology of the disorder, also including the cerebellum. However, the cerebellar role in the neurobiology of BD still needs to be clarified. Seventeen euthymic patients with BD type1 (BD1) (mean age/SD, 38.64/13.48; M/F, 9/8) and 13 euthymic patients with BD type 2 (BD2) (mean age/SD, 41.42/14.38; M/F, 6/7) were compared with 37 sex- and age-matched healthy subjects (HS) (mean age/SD, 45.65/14.15; M/F, 15/22). T1 weighted and resting-state functional connectivity (FC) scans were acquired. The left and right dentate nucleus were used as seed regions for the seed based analysis. FC between each seed and the rest of the brain was compared between patients and HS. Correlations between altered cerebello-cerebral connectivity and clinical scores were then investigated. Different patterns of altered dentate-cerebral connectivity were found in BD1 and BD2. Overall, impaired dentate-cerebral connectivity involved regions of the anterior limbic network specifically related to the (hypo)manic states of BD. Cerebello-cerebral connectivity is altered in BD1 and BD2. Interestingly, the fact that these altered FC patterns persist during euthymia, supports the hypothesis that cerebello-cerebral FC changes reflect the neural correlate of subthreshold symptoms, as trait-based pathophysiology and/or compensatory mechanism to maintain a state of euthymia

Depressione perinatale: fattori psicosociali e personalità della madre come fattori di vulnerabilità psicopatologica

Per studiare i fattori psicosociali e la personalità delle donne che sviluppano una depressione perinatale (DPN), sono state reclutate presso l’ambulatorio dei disturbi dei Post-Partum della UOC di Psichiatria del Policlinico Umberto I di Roma, 170 donne tra il 7° mese di gestazione e il 1° mese post-partum, tra i 18 e i 45 anni. Il Big Five e l'EPDS sono stati gli strumenti principali per valutare la presenza di depressione e l'organizzazione di personalità

Can Executive Dysfunction Explains Loss of Social Roles? A focus on Bipolar Disorder

Neuropsychological impairment is a core feature of schizophrenia and bipolar disorder (BD). Deficits in attention, memory and executive functions are not consequent to psychopathology, because they are often detectable also in unaffected relatives of probands. Also impairments in concept formation and reasoning are common features in patients with severe mental illness (SMI). Different domains of social functioning are involved in cognition and maintenance of social roles (vocational role) may need an adequate functioning in executive performances. In this study, performed in BD patients, we pursued the existence of a correlation between cognitive ability and functional capacity in a specific domain: maintenance of social roles. Fifty-one consecutive euthimic BD patients (age 20-60) were assessed in this study. Patient’s clinical symptoms were evaluated with Symptom Checklist-90 Revised (SCL -90R), Young Mania Rating Scale (YMRS) and Hamilton Rating Scale for Depression (HRSD-17).All partecipants completed a comprehensive battery of neuropsychological subtests for memory, executive functions and attention, using Rey Auditory Verbal Learning Test (RAVLT ), Rey Complex Figure Test (RCFT ), Digit Span Test (DST ), Wisconsin Card Sorting Test (WCST ), Verbal Fluency (FPL), Stroop Test, Visual Search, Trail Making Test (TMT). Life Skills Profile (LS P), Disability Scale (DISS ) and World Health Organization Disability Assessment Schedule-II (WHODAS -II) were used to evaluate psychosocial functioning and social roles. Results showed that euthimic BD patients of our group, displayed many impairments across several domains of neurocognition and social functioning. Significant associations were observed between executive functions and loss of social roles (occupational functioning) in euthimic bipolar patients. These results show that in BD patients, specific cognitive functions are associated with functional outcome. The assessment of these measures may therefore represent an important step in studies on psychosocial outcomes. This study contributed to identify some specific targets for treatment or remediation in BD

Disturbo dissociativo d'identità, auto-ipnosi e sintomi simil-psicotici. da un caso clinico a un problema di diagnosi differenziale

We report a case of a forty-nine-year-old patient suffering from his first psychiatric episode, who required hospitalization in a psychiatric unit. The presence of mood alterations with Schneiderian first-rank symptoms could have suggested an initial diagnosis of bipolar disorder (BD) with psychotic symptoms, directing the patient towards a definite therapeutic process. However, we hypothesized that the presence of a clear dissociative state similar to the hypnotic trance preceded by an uncontrolled self-hypnosis process, the presence of ‘inner voices’ and a high vulnerability to dissociation, were all elements that may reasonably lead to a diagnosis of Dissociative Identity Disorder (DID). Several authors have reported the presence of psychotic-like symptoms in patients with DID. However, in clinical practice there is a tendency not to acknowledge the possibility of dissociative disorders diagnoses, in favor of others more frequent psychiatric disorders. This paper aims to highlight some etiopathogenetic and psychopathological features that might help clinicians in identifying a DID

Personality traits in a sample of Italian filicide mothers

Several studies focused on mothers' psychopathological and environmental risk factors linked to filicide, to understand the genesis of this violent act. Considering the transition to motherhood a critical period for any woman, requiring the activation of deep personality resources, the aim of this study was to detect, in a sample of 16 filicide women hospitalized in Italian Forensic Psychiatric Hospitals, the recurrent characteristics with a specific focus on personality traits. Women were assessed using Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Big Five Inventory (BFI) and Temperament and Character Inventory (TCI). The BFI and TCI profiles seem to overlap showing a personality profile characterized by a rigid control of aggressive impulses, the avoiding of unconscious fears and the masking of feelings of negativity. Examining the mother's mental state with respect to personality traits, could help clinicians to detect specific temperament patterns that may carry out impulsive violent behaviors, if correlated with other psychopathological and environmental factors

Violence and Motherhood: A Case Study about the Personality Profile and Attachment Style of a Filicide Woman

Several studies focused on mothers’ psychopathological and environmental risk factors linked to filicide, but few studies explored personality characteristics of these women. Considering that the transition to motherhood requires the activation of deep personality resources, aim of this report is to describe the personality profile and attachment style of a woman who killed her 5-year-old son and tried to kill her 3-months-old daughter. The woman was assessed using Structured Clinical Interview for DSM-IV Axis I (SCID-I), Graphical Tests, Big Five Inventory (BFI), Temperament and Character Inventory (TCI), Adult Attachment Interview (AAI) and Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Test results showed a profile characterized by emotional instability, inner fragility and tendency to experience negative emotions, with the possibility of apparently unmotivated hostile behaviors and a tendency towards complacency. AAI results showed a distancing attachment style shading light into the importance of the internalized maternal figure. Examining the mother’s mental state, with attention on personality traits and attachment style, could help clinicians to detect specific temperament patterns that may carry out violent behaviours

The role of stress and psychiatric comorbidities as targets of non-pharmacological therapeutic approaches for migraine

This narrative review addresses the interconnections among stress, mental disorders and migraine with a specific focus on non-pharmacological interventions that may be effective in improving both migraine and the psychiatric comorbidity. Migraine is often comorbid with depression, anxiety, personality disorders, and sleep disorders. Subjective stress and stressors are common triggers for migraine attacks and are risk factors for chronification, whilst mental disorders and stress responses are closely linked in a bidirectional relation. Recent studies show that psychiatric comorbidity is associated with migraine severity, worse outcomes, increased disability and reduce quality of life. Numerous studies on non-pharmacological interventions for migraine were published and behavioural treatments included biofeedback, cognitive-behavioural therapy, relaxation training, stress management and brief psychodynamic psychotherapy. Taken together, psychological interventions proved to be effective in migraine treatment and a combination of pharmacological and psychological treatment appear to be more effective than either medication or psychotherapy alone. Non-pharmacological interventions effectiveness should be due to the improvement of migraine, stress-related vulnerability and mental disorders together and the combined treatment could prevent the chronification circuit of migraine. Well-designed long-term studies are needed to clarify comparative effectiveness of non-pharmacological techniques in the treatment and the prevention of migraine