Treatment of obese patients with binge eating disorder using topiramate: a review

Topiramate is an anticonvulsant drug used for the treatment of epilepsy and prophylaxis of migraine. Some authors have proposed its use as a mood stabilizer and have reported its efficacy in reducing impulsiveness and improving mood regulation, possibly via its antagonism to glutamatergic transmission in the lateral hypothalamus, although this indication is still controversial. Weight loss is a side effect consistently reported in the medical literature in patients treated with topiramate. Given its potential role in stabilizing mood and reducing impulse control problems and weight, topiramate has been proposed as a treatment for obese patients with binge eating disorder (BED). The aim of this paper is to review published data on the efficacy and safety of topiramate for the treatment of obese subjects with BED. Although the evidence is preliminary, topiramate appears to be a relatively safe and effective treatment for obese subjects with BED. Limitations of the studies and future directions for research are discussed

Interagire a distanza per insegnare la relazione. Un approccio alla DAD nel corso di Laurea in Medicina

Introduction: distance education has brought to light the advantages and criticalities of online education, confirming what many scholars have been arguing for some time: the need to build a didactic system that is as integrated as possible, focused on the student and which sees technologies as resources and educational potential. The paper aims to offer some points of reflection on distance education. The experience in the degree course on the medical-patient relationship at the University of Turin will be reported. Methods: course involved several initial design phases, the topics of which were constructed starting from the guidelines for the creation of autonomous learning objects (the minimal elements that constitute an online course). The research sample consisted of 400 students who attended this course between October and November 2020. Tools: we used communication platforms, apps, and software to stimulate interaction. In addition, a pre- and post-course questionnaire was administered regarding the students' general experience of distance learning during the year. Results and discussion: first part of results concerns the course design, specifically the activities carried out (interaction modalities, brainstorming activities, and the multimedia material) the second part focuses on the data about the questionnaire, in which, the issues related to technologies and the modes of teaching greatly affect the interaction between students and teachers.Introduzione: La DAD ha portato alla luce i vantaggi e le criticità dell’online, confermando ciò che molti studiosi sostengono da tempo: la necessità di costruire una didattica il più possibile integrata, incentrata sullo studente e che veda le tecnologie come risorse e potenzialità educative. Il contributo vuole offrire degli spunti di riflessione sulla DAD, in particolare, verrà riportata l’esperienza fatta nell'insegnamento sulla relazione medico paziente all'interno del Corso di Laurea in Medicina e Chirurgia dell’Università di Torino.Metodi: l’erogazione del corso ha previsto diverse fasi di progettazione iniziale, i cui argomenti sono stati costruiti partendo dalle linee guida relative alla creazione di oggetti autonomi di apprendimento (gli elementi minimali che costituiscono un corso online). Il campione della ricerca è stato costituito dai circa 400 studenti che hanno frequentato tale corso nel periodo tra ottobre e novembre 2020. Strumenti: sono stati impiegati piattaforme di comunicazione, app e software per stimolare l’interazione. Inoltre, è stato somministrato un questionario pre e post corso, relativo all’esperienza in generale di didattica a distanza vissuta dagli studenti durante l’anno. Risultati e discussioni: una prima parte dei risultati riguarda ciò che è emerso dalla progettazione del corso, nello specifico le attività portate avanti (le modalità di interazione, le attività di brainstorming, e il materiale multimediale impiegato durante le lezioni); la seconda si focalizza sui dati relativi al questionario, in cui, le problematiche legate alle tecnologie e le modalità di didattiche influiscono notevolmente sull’interazione fra studenti e docenti

Harm Avoidance and Self-Directedness Characterize Fibromyalgic Patients and the Symptom Severity

AbstractObjective: Evidence in the literature suggests peculiar personality traits for fibromyalgic patients, and it has been suggested that personality characteristics may be involved in patients' different symptomatic events and responses to treatment. The aim of the study is to investigate the personality characteristics of Italian FM patients and to explore the possibility of clustering them considering both personality traits and clinical characteristics.Design: The study used a cross-sectional methodology and involved a control group. A self-assessment procedure was used for data gathering. The study included 87 female FM patients and 83 healthy females. Patients were approached and interviewed in person during a psychiatric consultation. Healthy people were recruited from general practices with previous telephone contact.Main Outcome Measures: Participants responded to the Hospital Anxiety and Depression Scale (HADS), the Temperament and Character Inventory (TCI), the Fibromyalgia Impact Questionnaire (FIQ) and the Short-Form-36 Health Survey (SF-36).Results: FM patients scored significantly different from healthy participants on the Harm-Avoidance (HA), Novelty Seeking (NS) and Self-Directedness (SD). Two clusters were identified: patients in Cluster 1 (n=37) had higher scores on HA and lower scores on RD, SD and Cooperativeness and reported more serious fibromyalgia and more severe anxious-depressive symptomatology than did patients in Cluster 2 (n=46).Conclusion: This study confirms the presence of certain personality traits in the FM population. In particular, high levels of Harm Avoidance and low levels of Self-Directedness characterize a subgroup of FM patients with more severe anxious-depressive symptomatology. According to these findings, personality assessment could be useful in the diagnostic process to tailor therapeutic interventions to the personality characteristics

The Impact of COVID-19 on Mental Health in Medical Students: A Cross-Sectional Survey Study in Italy

Background: This study aimed to assess the impact of the COVID-19 pandemic in terms of the prevalence of anxiety, depression and stress symptoms in Italian medical students and to identify the associated factors. Design and Methods: A cross-sectional online survey was administered to second-sixth year medical students of the University of Torino, collecting data on the students’ sociodemographics, COVID-19 exposure, anxiety, depression and stress symptoms. Three hierarchical regressions adjusted for age, gender and year of study were executed. Results: The sample size was 1359. The prevalence of anxiety, depression symptoms, moderate perceived stress and severe perceived stress was 47.8%, 52.1%, 56.2% and 28.4%, respectively. The factors associated with mental health symptoms were: being a woman, a family history of psychiatric disorders, living off-site, competitive/hostile climates and unsatisfying friendships among classmates, poor relationships with cohabitants, negative judgment of medical school choice, fear of COVID-19 infection, feelings of loneliness, distressing existential reflections, and a worsening psychological condition related to the pandemic. Being in the fourth or sixth year constituted a protective factor for depression symptoms. Conclusions: Mental health in medical students was associated with both COVID-independent and COVID-related factors. Accessibility to effective interventions must be increased to counteract these changes

The Consequences of the Pandemic on Medical Students' Depressive Symptoms and Perceived Stress: A Repeated Cross-Sectional Survey with a Nested Longitudinal Subsample

This study aimed to explore the impact of the pandemic on medical students’ mental health in Italy using a repeated cross-sectional survey with a nested longitudinal subsample (first timepoint: 2018; second: 2020/2021). Three research questions (RQs) were investigated. Study 1 (longitudinal sub-sample) explored whether medical students had higher levels of depressive symptoms and stress during the pandemic compared with a pre-pandemic period (RQ1) and what variables were associated with these conditions during the pandemic adjusting for baseline levels (RQ2). Study 2 (repeated cross-sectional data) aimed to examine whether medical students had higher levels of these conditions during the pandemic compared with their same-year peers during a pre-pandemic period (RQ3). In Study 1, higher levels of depressive symptoms and stress were shown during the pandemic (RQ1). Multivariable models highlighted associations between poor mental health and worsening of the judgment of medical school choice, worsened psychological condition due to the pandemic, economic repercussions due to the pandemic, and baseline levels of symptoms (RQ2). In Study 2, our findings reported higher levels of depressive symptoms and stress during the pandemic, also adjusting for other variables (RQ3). In conclusion, depressive symptoms and stress were greater during the pandemic. The most relevant variables were pandemic-related items and medical school choice judgment