120 research outputs found
Tako-Tsubo cardiomyopathy and psychiatric disorders: Review of comorbidity
Background: In recent times, the connections between mental health and cardiac outcomes have been under increasing investigation.
Tako-Tsubo Cardiomyopathy (TTC) is also called “broken heart syndrome”, since it has been described to occur after emotionally
stressful events; it presents as an acute reversible coronary syndrome due to a transient failure of the left ventricle, in the absence of
obstructive coronary heart disease. It has a 10-timehigher prevalence in
postmenopausal women and may have a strong correlation with biopsycho-
social stress.
Aim: To review existing studies on TTC in comorbidity with psychiatric
disorders.
Method: Four PubMed literature searches performed during January
2015 (search terms: tako-tsubo AND psy*; tako-tsubo AND anxiety;
tako-tsubo AND depression; tako-tsubo AND mania) provided 9
references: 4 case reports, 2 reviews, 2 prospective studies and 1
case–control study.
Results: Not only chronic psychological stress (present in 2/3 of these
patients, on average), but also a high co-occurrence of anxiety
and depression (from 50 to 70% of patients with this cardiopathy),
panic attacks (diagnosed in almost 20% of women with tako-tsubo),
subthreshold and full-blown PTSD (co-morbid in almost 40% of patients
according to a 2-year prospective study) were associated with TTC. It
has been suggested that changes in circulating levels of catecholamines
combined to heart's abnormal response to these hormones could be at
the pathophysiological basis for such associations.
Conclusion: The present literature review confirms a high cooccurrence
of comorbid conditions with increased sympathetic
activity (in particular anxiety, depression and panic disorder), which
could be risk factors for TTC. More studies, especially longitudinal
ones, are needed to better clarify the causative pathways of this
usually reversible, but potentially lethal, syndrome, especially among
post-menopausal women
The impact on mental health of the economic recession in the district of Sassuolo (Modena): opinions of local occupational physicians.
INTRODUCTION The recent economic recession and the subsequent strategy of austerity have deceased
the amount of resources devoted to health care. They may also have contributed to the deterioration of the
population health.
AIM To assess the impact on mental health of the economic recession in the district of Sassuolo (Modena),
by collecting and analyzing opinions of local Occupational Physicians.
METHODS Qualitative survey, by focus groups, conducted in Sassuolo (Modena), industrial center of
ceramics, involving 8 Occupational Physicians active in the area. Rough descriptions analyzed
independently by GU and GM using MAXQDA, with the independent supervision of a third researcher (SF),
according to the principles of the General Grounded Theory. The second focus group was intendened as
respondent validation of the first, yet it gathered further data, up to theortical saturation.
RESULTS Two focus groups, about one hour long, attended by 8 Occupational Physicians, 7 during the first
focus group, 4 during the second (of these, 3 attending both focus groups). The coding process yielded 261
segments, divided into four main areas: "changes in contemporary world" (16 coded segments), "social
area" (82 coded segments), "medical area" (94 coded segments), "working area" (69 coded segments).
CONCLUSIONS The impact of the economic crisis on health produced mainly negative consequences,
locally, consistently with national data. Psychiatrists should work together with Occupational Physicians to
develop targeted interventions, addressing social, political and medical needs. A more structured liaison
between Psychiatry and Occupational Medicine is an interesting and useful tool for future action and
advocacy
Impact of anxiety-depressive symptoms on outpatients\u2019 quality of life: Preliminary results from an Italian observational study
Introduction Several studies have shown an association between
the Short-Form 36 (SF36) scores and anxiety-depressive symptoms,
suggesting that depression in particular could reduce Quality of
Life (QoL) to the same, and even greater, extent than chronic noncommunicable
diseases, such as diabetes and hypertension.
Aims To explore the relationshipamongQoL and anxiety, depressive
and anxiety-depressive symptoms in an outpatient sample.
Methods Cross-sectional study. Inclusion criteria: outpatients
aged 6540 years, without history for cancer, attending colonoscopy
after positive faecal occult blood test. Collected data: blood
pressure, blood glucose, lipid profile. Psychometric test: Hospital
Anxiety and Depression Scale (HADS). QoL was assessed with SF36.
Statistics performed with STATA13.
Results 54 patients enrolled (27 females). Sixteen patients
(30.2%) were positive for anxiety symptoms, ten (18.9%) for depressive
symptoms and five (9.4%) for anxiety-depressive symptoms.
The perceived QoL was precarious in twelve subjects (22.2%): eight
(15.9%) had low score ( 64 42) at \u201cMental Component Summary\u201d
(MCS) subscale, three (5.7%) at the \u201cMental Health\u201d item and one
patient (1.9%) at the \u201cVitality\u201d one. At the multiple regression
analysis, depressive (OR = 28.63; P = 0.01) and anxiety-depressive
symptoms (OR = 11.16; P = 0.02) were associated with MCS.
Conclusions The association emerging from the present study
between depressive/anxiety symptoms and the MCS component of
SF36 is consistent with available literature. Study design and small
sample size do not allow to generalize results, that need further
studies to be confirmed
RetinaNet Object Detector based on Analog-to-Spiking Neural Network Conversion
The paper proposes a method to convert a deep learning object detector into
an equivalent spiking neural network. The aim is to provide a conversion
framework that is not constrained to shallow network structures and
classification problems as in state-of-the-art conversion libraries. The
results show that models of higher complexity, such as the RetinaNet object
detector, can be converted with limited loss in performance.Comment: 5 pages, submitted to ISCMI 2021 conferenc
Stability of Psychiatric Diagnoses in Candidates to Liver Transplantation Referred to a Consultation-Liaison Psychiatry Service
Objective: To investigate the stability over time of the psychiatric diagnoses among
candidates to liver transplantation referred to a consultation-liaison psychiatric service. Method:
Descriptive study, carried out at the Consultation-Liaison Psychiatry Service (CLPS) placed at the
Modena (Italy) General University Hospital. All patients waiting for liver transplantation and
repeatedly referred to the CLPS were enrolled. The observation period was from 1 January 2008 to 31
December 2013. Pearson\u2019s coefficients were calculated to measure diagnostic stability (index referral
vs. last referral). Results: One hundred patients were assessed (males 67%; mean age 53 \ub1 7 years
old). The mean number of referrals for patients was 3 \ub1 2. The stability rate of psychiatric diagnosis
was 64%. The following diagnoses or conditions were all significantly stable (i.e., all featured by
r > 0.5 and p < 0.05): Adjustment disorder, depressive disorder, comorbid anxiety/depressive disorder,
substance use disorder (including alcohol), absence of any disorder, and presence of any disorder.
Conclusions: The good level of diagnostic stability displayed in the sample may be a function of
the clinical and organizational \u201cstyle\u201d of the CLPS, namely the focus on identifying the prevailing
personality traits, defensive mechanisms, and relational patterns
Efficacy of animal assisted therapy on people with mental disorders: an update on the evidence
INTRODUCTION: Animal assisted therapy (AAT) is a structured form of animal assisted intervention (AAI), which specifically adopts animals in healthcare services and education facilities, to achieve therapeutic goals. Although such interventions are widely used, nowadays, evidence supporting them is still largely lacking. A previously published review of the literature highlighted some promising effects of AAT on people presenting psychiatric disorders, though the quality of the studies included was generally low. In order to provide an update of recent evidence, the aim of this study was to systematically review randomized controlled trials (RCTs) published since 2000, involving people affected by mental disorders and receiving AAT.
EVIDENCE ACQUISITION: The following databases were searched: CINHAL, EBSCO Psychology and Behavioural Science Collection, PubMed and Web of Science. 115 papers were obtained and screened: 28 were from CINHAL, PsycINFO and Psychology and Behavioural Science Collection altogether, 15 from PubMed and 72 from Web of Science. In addition to this, grey literature and references of already published reviews and meta-analyses on the topic were searched, resulting in the addition of 6 further articles. After screening, 10 RCTs were included in this review.
EVIDENCE SYNTHESIS: Studies involving outpatients were more frequent than those involving inpatients; sample size was generally low. The majority of studies adopted scales routinely used in clinical trials, with a good level of validity and reliability. Five out of ten studies reported significant differences in the main outcomes favouring AAT. Most of the studies did not include any follow-up; yet, where prospective data were available, the benefits of AAT appeared long lasting. Drop-out rates were higher in studies involving outpatients. However, the only trial which enrolled both inpatients and outpatients showed a higher drop-out rate among the inpatients group, possibly due to their more severe psychopathology.
CONCLUSIONS: Though a paucity of available studies partly limits our findings, AAT seems to improve empathy, socialization and communication, and to favour therapeutic alliance among patients who have difficulties with therapeutic programs adherence. AAT appears to be a feasible and well-received intervention, potentially with few or no side effects reported. However there is a need for further studies with larger sample sizes and high-quality research standards
Neuroenhancer use amongst Italian medical students: a survey
Introduction.
Increasing use of substances by university students to improve cognitive performance ('neuroenhacement')
has been reported. This refers not only to over-the-counter supplements, energy drinks, coffee and tobacco,
but also to psychostimulants and modafinil. Little is known about this phenomenon in Italy.
Aims.
To explore prevalence of use of substances as cognitive enhancers by Italian medical students and their
attitudes towards prescription-only medication (methylphenidate, amphetamine, atomoxetine, modafinil)
used for this purpose.
Methods
An ad hoc questionnaire was distributed to 433 medical students of the University of Modena and Reggio
Emilia. Valid response rate was 83.8% (N=363).
Results
271 students (74.7%) reported use of substances to improve cognition in the last 30 days. Coffee (73%,
N=265) and tea (33.3%, N=121) were the most used, followed by caffeinated sodas (15.7%, N=57), tobacco
(10.2%, N=37) and vitamin B supplements (8.8%, N=32). Prescription-only medicines were used by 2
students (0.6%) and, overall, only 4 students reported lifetime use (1.2%). 295 (83.3% ) students mentioned
concerns about safety and side effects as main reasons not to use. Use of cognitive enhancers as a group
in the last 30 days slightly correlated with alcohol (r = 0.124; p = 0.023) and cannabis use (r = 0.114; p =
0.036).
Conclusions
Italian medical students use many substances as cognitive enhancers, but this seems not to apply to
psychostimulants and modafinil. Cultural and regulatory differences may underlie this difference with other
Countries, which warrants further research
Association between symptoms of anxiety and depression and BMI in Primary Care patients: a cross sectional study
Background: Metabolic syndrome (MetS) is a heterogeneous entity
represented by the coexistence of multiple alterations: abdominaladiposity, impaired glucose tolerance, hypertriglyceridemia, HDL
hypocolesterolemia and hypertension. Symptoms of anxiety and
depression are frequently comorbid with MetS. Aim of the present
study was to measure the association between symptoms of anxiety
and depression with the five criteria of MetS in outpatients attending
GPs' practices.
Method: This is a cross-sectional study, involving male and female
patients aged 40–80 attending five GPs' practices within one month
in Modena, Northern Italy approved by the local Ethical Committee.
All patients were screened for the presence of MetS and depressive/
anxiety symptoms, using the Hospital Anxiety and Depression Scale.
Exclusion criteria: age b40 or N80; use of antidepressants or
antipsychotics; previous stroke, heart attack or cardiovascular
disease; diagnosed psychotic or mood disorder (according to the
DSM-IV-TR); diabetes; pregnancy; hereditary disease linked to
obesity. All data were adjusted for socio-demographic confounders.
Multiple logistic analysis performed with STATA 13.0.
Results: 128 subjects were enrolled in the study (55 men and 73
women), 48 presented with MetS (ATP-III-Revised criteria). MetS
was associated with depression only in the female group (OR =6.33,
p= 0.01), also when adjusting for age (OR =5.13, p= 0.02). MetS
was not associated with anxiety in both males and females, and with
depression in men. Among the individual components of MetS,
only waist circumference was associated with anxiety in the female
group (OR=4.40, p=0.04) also when adjusting for age (OR=4.34,
p=0.04).
Conclusion: Women aged between 40 and 60, presenting with MetS
and attending the primary care services should been regularly
screened for the presence of depression. Chronic systemic inflammation
could represent the biological link between MetS and
psychological symptoms. Further researches are needed to better
clarify this possible relation
Is hyperglycemia associated with anxious-depressive symptoms? An Italian study in primary care setting
Background: Recent researches exploring the relationship between
impaired glucidic tolerance, hyperglycemia or frank type II diabetes
mellitus and symptoms of anxiety and depression, mostly conducted
on in-patients or highly selected samples and on foreign populations,
have reported conflicting results. Nevertheless, these medical and
mental conditions are often comorbid in clinical practice. Chronic
and systemic inflammation could represent the trait d\'union
between these conditions. Primary care represents an interesting
setting for exploring this comorbidity, given the high prevalence of
psychiatric symptoms displayed by patients. The aims of this
research was to measure the association between hyperglycemia
and symptoms of anxiety and/or depression in out-patients, and to
fill the lack of studies on comorbidity between depression and
anxiety disorders and medical conditions in Primary Care services.
Method: The present was a cross-sectional study. We evaluated all
consecutive patients undergoing a GP consultation in a Northern
Italy practice. Exclusion criteria: age b40 or N80; use of antidepressants
or antipsychotics medication; psychosis (schizophrenia, schizoaffective,
bipolar, organic, or tall as psychotic disorder by DSM IV-TR) or major
depression; pregnancy; previous stroke or heart attack; type I diabetes
mellitus. The psychometric assessment was done by HADS (Hospital
Anxiety and Depression Scale). Blood Glucose measurements (BM) in
the last 6 months were considered in our analysis. Hyperglycemia cutoff:
blood glucose N100 mg/dl. The statistical analysis was performed
using STATA with multiple linear regressions.
Results: 209 subjects were recruited in our study (84 men and
125 women). Of those, 48 (22.9%) were affected by hyperglycemia:
22 were men and 26 women. Hyperglycemia was related to HADS-D
score in the men sample (β = .44, p = .01). No association was
found between hyperglycemia and HADS-A, either in men or in
women.
Conclusion: The presence of hyperglycemia, well-known cardiovascular
risk factor, may have a clinical value in predicting the presence
of depressive symptoms, especially in men. Further studies should
examine whether our results are generalizable to other populations
and whether they are applicable to clinical depression. Molecular
researches could focus on clarifying the pathophysiological reasons
for such association, also exploring reasons for sex differences
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