Endometriosis and pregnancy. a single institution experience

Endometriosis may compromise the physiological course of pregnancy. The aim of this prospective observational study was to evaluate whether endometriosis causes a higher prevalence of obstetric and neonatal complications as well as a higher risk of caesarean section and to detect a possible correlation between the presence, type, and location of endometriosis and obstetric complications, previous surgery, and pregnancy outcome, as well as the influence of pregnancy on the course of the disease. We compared two cohorts of women with spontaneous pregnancy, with and without endometriosis. Obstetric and neonatal outcomes, mode of delivery, presence, type, and location of endometriotic lesions and the effect of pregnancy on the disease were analyzed. A total of 425 pregnancies were evaluated: 145 cases and 280 controls. Patients with endometriosis showed a higher incidence of miscarriage, threatened miscarriage, threatened preterm labor, preterm delivery, placental abruption, and a higher incidence of caesarean section. A significant correlation with pregnancy-induced hypertension and preeclampsia was found in the presence of adenomyosis. No difference in fetal outcome was found. One case of hemoperitoneum during pregnancy was observed. Pregnancy in women with endometriosis carries a higher risk of obstetric complications, such as miscarriage, threatened miscarriage, preterm labor, preterm birth, and a higher caesarean section rate. Endometriosis does not seem to influence fetal well-being

Theory of mind and the whole brain functional connectivity: Behavioral and neural evidences with the Amsterdam Resting State Questionnaire

none11noMarchetti, Antonella; Baglio, Francesca; Costantini, Isa; Dipasquale, Ottavia; Savazzi, Federica; Nemni, Raffaello; Intra, Francesca Sangiuliano; Tagliabue, Semira; Valle, Annalisa; Massaro, Davide; Castelli, IlariaMarchetti, Antonella; Baglio, Francesca; Costantini, Isa; Dipasquale, Ottavia; Savazzi, Federica; Nemni, Raffaello; Intra, Francesca Sangiuliano; Tagliabue, Semira; Valle, Annalisa; Massaro, Davide; Castelli, Ilari

Clogging transition of vibration-driven vehicles passing through constrictions

We report experimental results on the competitive passage of elongated self-propelled vehicles rushing through a constriction. For the chosen experimental conditions, we observe the emergence of intermittencies similar to those reported previously for active matter passing through narrow doors. Noteworthy, we find that, when the number of individuals crowding in front of the bottleneck increases, there is a transition from an unclogged to a clogged state characterized by a lack of convergence of the mean clog duration as the measuring time increases. It is demonstrated that this transition-which was reported previously only for externally vibrated systems such as colloids or granulars-appears also for self-propelled agents. This suggests that the transition should also occur for the flow through constrictions of living agents (e.g., humans and sheep), an issue that has been elusive so far in experiments due to safety risks

Brain ageing in schizophrenia: evidence from 26 international cohorts via the ENIGMA Schizophrenia consortium

Schizophrenia (SZ) is associated with an increased risk of life-long cognitive impairments, age-related chronic disease, and premature mortality. We investigated evidence for advanced brain ageing in adult SZ patients, and whether this was associated with clinical characteristics in a prospective meta-analytic study conducted by the ENIGMA Schizophrenia Working Group. The study included data from 26 cohorts worldwide, with a total of 2803 SZ patients (mean age 34.2 years; range 18-72 years; 67% male) and 2598 healthy controls (mean age 33.8 years, range 18-73 years, 55% male). Brain-predicted age was individually estimated using a model trained on independent data based on 68 measures of cortical thickness and surface area, 7 subcortical volumes, lateral ventricular volumes and total intracranial volume, all derived from T1-weighted brain magnetic resonance imaging (MRI) scans. Deviations from a healthy brain ageing trajectory were assessed by the difference between brain-predicted age and chronological age (brain-predicted age difference [brain-PAD]). On average, SZ patients showed a higher brain-PAD of +3.55 years (95% CI: 2.91, 4.19; I2 = 57.53%) compared to controls, after adjusting for age, sex and site (Cohen's d = 0.48). Among SZ patients, brain-PAD was not associated with specific clinical characteristics (age of onset, duration of illness, symptom severity, or antipsychotic use and dose). This large-scale collaborative study suggests advanced structural brain ageing in SZ. Longitudinal studies of SZ and a range of mental and somatic health outcomes will help to further evaluate the clinical implications of increased brain-PAD and its ability to be influenced by interventions

Association between age of cannabis initiation and gray matter covariance networks in recent onset psychosis

Cannabis use during adolescence is associated with an increased risk of developing psychosis. According to a current hypothesis, this results from detrimental effects of early cannabis use on brain maturation during this vulnerable period. However, studies investigating the interaction between early cannabis use and brain structural alterations hitherto reported inconclusive findings. We investigated effects of age of cannabis initiation on psychosis using data from the multicentric Personalized Prognostic Tools for Early Psychosis Management (PRONIA) and the Cannabis Induced Psychosis (CIP) studies, yielding a total sample of 102 clinically-relevant cannabis users with recent onset psychosis. GM covariance underlies shared maturational processes. Therefore, we performed source-based morphometry analysis with spatial constraints on structural brain networks showing significant alterations in schizophrenia in a previous multisite study, thus testing associations of these networks with the age of cannabis initiation and with confounding factors. Earlier cannabis initiation was associated with more severe positive symptoms in our cohort. Greater gray matter volume (GMV) in the previously identified cerebellar schizophrenia-related network had a significant association with early cannabis use, independent of several possibly confounding factors. Moreover, GMV in the cerebellar network was associated with lower volume in another network previously associated with schizophrenia, comprising the insula, superior temporal, and inferior frontal gyrus. These findings are in line with previous investigations in healthy cannabis users, and suggest that early initiation of cannabis perturbs the developmental trajectory of certain structural brain networks in a manner imparting risk for psychosis later in life

Brain ageing in schizophrenia: evidence from 26 international cohorts via the ENIGMA Schizophrenia consortium

Schizophrenia (SZ) is associated with an increased risk of life-long cognitive impairments, age-related chronic disease, and premature mortality. We investigated evidence for advanced brain ageing in adult SZ patients, and whether this was associated with clinical characteristics in a prospective meta-analytic study conducted by the ENIGMA Schizophrenia Working Group. The study included data from 26 cohorts worldwide, with a total of 2803 SZ patients (mean age 34.2 years; range 18-72 years; 67% male) and 2598 healthy controls (mean age 33.8 years, range 18-73 years, 55% male). Brain-predicted age was individually estimated using a model trained on independent data based on 68 measures of cortical thickness and surface area, 7 subcortical volumes, lateral ventricular volumes and total intracranial volume, all derived from T1-weighted brain magnetic resonance imaging (MRI) scans. Deviations from a healthy brain ageing trajectory were assessed by the difference between brain-predicted age and chronological age (brain-predicted age difference [brain-PAD]). On average, SZ patients showed a higher brain-PAD of +3.55 years (95% CI: 2.91, 4.19; I2 = 57.53%) compared to controls, after adjusting for age, sex and site (Cohen's d = 0.48). Among SZ patients, brain-PAD was not associated with specific clinical characteristics (age of onset, duration of illness, symptom severity, or antipsychotic use and dose). This large-scale collaborative study suggests advanced structural brain ageing in SZ. Longitudinal studies of SZ and a range of mental and somatic health outcomes will help to further evaluate the clinical implications of increased brain-PAD and its ability to be influenced by interventions

La socializzazione genitoriale delle emozioni ai tempi del Covid e l'adattamento psicosociale dei figli: un contributo empirico in un campione clinico di adolescenti

Introduzione Da quando è scoppiata la pandemia da COVID è aumentato il rischio per i giovani di incorrere in problemi di adattamento psicosociale. Questo studio intende contribuire ad una migliore comprensione del ruolo della socializzazione genitoriale delle emozioni e della regolazione delle emozioni dei figli rispetto all’adattamento psicosociale dei figli adolescenti. Inoltre, verrà indagato se dall’inizio della pandemia c’è stato un peggioramento nel grado di supporto dei genitori alle reazioni emotive dei figli e nell’adattamento psicosociale dei figli. Per socializzazione genitoriale delle emozioni si intende l’insieme di strategie messe in atto dai genitori in risposta alle reazioni emotive dei figli. In linea con quanto emerso in studi precedenti (con campioni normativi e clinici), si ipotizza che strategie genitoriali supportive in risposta alle reazioni emotive dei figli si associno a un buon adattamento emotivo e sociale dei loro figli. Metodo Al tempo 1, hanno partecipato allo studio un campione clinico di 74 ragazzi/e (età media = 15.06, DS = 2,28; 44,4% ragazze), 74 madri e 62 padri. Criteri di inclusione sono stati una diagnosi di disturbo dell’umore, di ansia, dell’apprendimento e della condotta. La raccolta dati si è conclusa a dicembre 2019 (prima della pandemia da COVID19). Le valutazioni dei genitori sulla socializzazione delle emozioni dei figli (Emotion as a Child Scale; EAC; Malagai, 1996) e sull’adattamento psicosociale dei figli (CBCL; Achenbach, 1991) sono state indagate in remoto. L’autovalutazione dei figli sulla loro regolazione emotiva è stata indagata attraverso la scala DERS (Gratz & Romer, 2004) in remoto e tramite la raccolta di campioni salivari al fine di indagare la cortisol awakening response – CAR, un ottimo indicatore di buon funzionamento psicosociale (Carnevali et al., 2014). Al tempo 2 sono state indagate in remoto le valutazioni dei genitori (scale EAC, DERS e CBCL) circa i comportamenti loro e dei figli sin dall’inizio della pandemia (N madri = 45; N padri = 21). La raccolta dati è iniziata in agosto 2020 ed è ancora in corso. Risultati Da una serie di Test-T per campioni appaiati è emersa una diminuzione sia nei comportamenti genitoriali supportivi in risposta a reazioni di rabbia e tristezza dei figli (Tempo 1 M=3.63, DS=.55; Tempo 2 M=3.27, DS=.67; Test-T =3.09, p<.01), sia nei sintomi internalizzanti (Tempo 1 M=1.39, DS=.24; Tempo 2=1.28, DS=.20; Test-T =2.63, p<.5). Dalle correlazioni r di Pearson è emerso che comportamenti genitoriali non supportivi in risposta a reazioni di rabbia e tristezza dei figli al Tempo 1 si associano a maggiore disregolazione emotiva dei figli e a maggiori sintomi internalizzanti ed esternalizzanti al Tempo 2 (r = .45, p<.01; r = .44, p<.01; r = .65, p<.01, rispettivamente). Inoltre, al Tempo 1, una maggiore disregolazione emotiva dei figli si associa a maggiori sintomi internalizzanti dei figli (r = .34, p<.01). Al Tempo 2, una maggiore disregolazione emotiva dei figli si associa sia a maggiori sintomi internalizzanti (r = .76, p<.01), che esternalizzanti dei figli (r = .57, p<.01). Conclusioni Questi risultati invitano ad una riflessione cauta circa le conseguenze che la pandemia e la quarantena hanno avuto sul funzionamento familiare. In particolare, i dati del presente studio mostrano che la vita familiare ai tempi del COVID19 (più tempo passato in famiglia, minori interazioni sociali al di fuori della famiglia) ha determinato una diminuzione dei comportamenti genitoriali di supporto allo sviluppo emotivo dei figli, ma anche una diminuzione nella sintomatologia internalizzante dei figli. Questi risultati andrebbero interpretati alla luce di una serie di fattori (tra cui la severità della sintomatologia dei figli prima della pandemia). Inoltre, in linea con la letteratura precedente, comportamenti genitoriali non supportivi in risposta ad una reazione di rabbia o di tristezza da parte dei figli (ad esempio, punire o ignorare i figli per la loro reazione emotiva) si associano con maggiori difficolta dei figli nella gestione di tali emozioni, e con maggiori sintomi internalizzanti ed esternalizzanti. Questi risultati contribuiscono a migliorare la comprensione di come la socializzazione parentale delle emozioni abbia un ruolo cruciale per il buon adattamento dei figli. Infine, essi suggeriscono che lavorare sulla socializzazione parentale delle emozioni potrebbe favorire l’efficacia del lavoro dei professionisti che operano a supporto della genitorialità e dello sviluppo adattivo in adolescenza, soprattutto in un contesto sfidante come quello delle relazioni genitori - figli ai tempi del COVID19

High prevalence of autoimmune diseases in women with endometriosis. a case-control study

The immune system seems to be involved in the pathogenesis of endometriosis. Peritoneal chronic inflammation is present and natural killer cells and macrophages abnormalities have been reported in women with the disease. Moreover, a higher production of serum autoantibodies has been found, which could be related to various factors; some still need to be clarified. The correlation between endometriosis and autoimmune diseases is still unclear with few and conflicting available data. The aim of this study was to evaluate the prevalence of autoimmune diseases, as conditions with a possible common pathogenetic factor, in women affected by endometriosis, in order to address future research on its pathogenesis. This retrospective case-control study includes one hundred and forty-eight women with endometriosis and 150 controls. All women were aged between 18 and 45. Informed consent was obtained from all participants of the study. Considered autoimmune diseases include systemic lupus erythematosus (SLE), celiac disease (CD), inflammatory bowel disease (IBD), and autoimmune thyroiditis. Statistical comparison of patients and control group was performed by means of chi-square test or Fisher’s exact test as appropriate. Statistical comparison of parametric variable (age) among the groups was performed by t-test for unpaired data. Age was expressed as mean. A value of.05 or less was considered as significant. In the case group, five patients were affected by IBD, while the disease was not observed in the control group (p =.07). SLE was found in eight patients in the case group, while only one was found in the control group (p =.01). Fifteen women in the case group were affected by CD, while the disease was present only in one woman in the control group (p<.0001). A significant correlation was also found between endometriosis and autoimmune thyroiditis: 80 patients with endometriosis had thyroid diseases versus 14 patients in the control group (p<.0001). Our study reports an association between endometriosis and autoimmune disorders, showing a higher prevalence of autoimmune diseases in women affected by endometriosis. These results support a possible autoimmune pathogenesis of endometriosis

Imparare ad assumere il punto di vista epistemico dell\u2019altro: uno studio di training sulla falsa credenza di II ordine

La Teoria della Mente (ToM), capacit\ue0 di rappresentarsi gli stati mentali propri e altrui per comprendere e prevedere il comportamento, costituisce un costrutto psicologico multisfaccettato, classicamente studiato attraverso l\u2019utilizzo dei compiti di falsa credenza, ritenuti la \u201ccartina-al- tornasole\u201d di tale sviluppo in et\ue0 evolutiva (Wellman, Cross, Watson, 2001). Accanto ai numerosi lavori relativi all\u2019individuazione delle tappe evolutive della ToM, iniziano a essere presenti studi di training, da cui emerge che l\u2019impiego di feedback correttivi (Clements et al., 2000), di stimoli di natura verbale (Lohmann, Tomasello, 2003) e di conversazioni ricche di lessico psicologico (Ornaghi et al., 2011 Bianco et al., 2015; 2016) rafforzi la comprensione dei contenuti mentali, essenziali per promuovere la ToM. Tuttavia, l\u2019efficacia degli elementi specifici di tali training in bambini di et\ue0 scolare \ue8 ancora da approfondire. Per questo scopo, \ue8 stato realizzato un conversation-based training focalizzato su un aspetto specifico della ToM, quale la comprensione della falsa credenza, stato mentale epistemico complesso. Partecipanti: 24 bambini (et\ue0 media= 10 anni, 6 mesi, ds=3.36 mesi, bilanciati per genere) di madrelingua italiana, in condizioni di sviluppo tipico e omogenei per status socio-economico. I partecipanti sono stati suddivisi equamente e casualmente in due gruppi: gruppo sperimentale, sottoposto a un training sulla ToM (false credenze a complessit\ue0 crescente e conversazioni relative agli stati epistemici) e gruppo di controllo, sottoposto a un training senza riferimento alla ToM. Entrambi i gruppi sono stati testati con una batteria di compiti classici ToM in una fase di pre- e post-training, al fine di verificare l\u2019efficacia del training ToM. I risultati mostrano che i bambini del gruppo sperimentale presentano un miglioramento statisticamente significativo nella comprensione della falsa credenza di secondo ordine rispetto a quelli del gruppo di controllo (t= 2.331, p < .05), a supporto dell\u2019efficacia del training proposto. Il presente studio, in linea con quelli a campione pi\uf9 numeroso presenti in letteratura (Bianco et al., 2015; 2016), contribuisce a dimostrare che \ue8 possibile potenziare specifiche componenti della ToM (comprensione della falsa credenza) attraverso discussioni e riflessioni di gruppo focalizzate sul riconoscimento delle differenti prospettive epistemiche che le persone possono avere sul medesimo dato di realt\ue0, e sulla comprensione di come tali differenti prospettive guidino il comportamento. Supportare lo sviluppo di questa consapevolezza mentalistica dovrebbe avere ricadute positive sulle competenze sociali e relazionali che il bambino utilizza nelle interazioni quotidiane

Lifestyle in patients with severe mental disorders: a new target for psychosocial interventions?

INTRODUCTION: Patients with severe mental disorders (namely schizophrenia, major depression and bipolar disorder) have a reduced life expectancy of at least 10 to 25 years compared with the general population. This mortality gap is due to the higher prevalence of comorbid physical disorders (such as diabetes, hypertension and cardiovascular diseases) in these patients compared to the general population. Factors contributing to the mortality gap include lack of access to primary care services, severity of clinical symptoms, internalized stigma and discrimination by healthcare professionals, pharmacological treatments and unhealthy lifestyle behaviours. Several international studies have highlighted the high prevalence of unhealthy lifestyle behaviours in patients with severe mental disorders, but a few data are available from Italian real-world settings. AIM: The present study aims to: 1) describe the lifestyle behaviours adopted by a sample of real-world patients affected by severe mental disorders; 2) identify differences in lifestyle behaviours according to diagnostic category. MATERIALS: The final sample consisted of 402 patients, mainly female (57%), with a mean age of 45.8±11.8 years. 35% of them suffers from moderate obesity and 40% of them is affected by hyperinsulinemia, hypercolestereloemia and hypertrygliceridemia. 70% of patients has sedentary behaviours. Moderate to severe nicotine dependence is reported by 42% of patients. Patients with bipolar disorders are more frequently smokers compared to other patients. No significant differences in lifestyle behaviours have been found among the three diagnostic groups. RESULTS AND CONCLUSIONS: Our data confirm that patients with severe mental disorders adopt unhealthy lifestyle behaviours, regardless their diagnosis. New psychosocial interventions, including motivational and psychoeducational components and targeting lifestyle behaviours, should be developed and disseminated in order to reduce the mortality gap