Topiramate plus citalopram in the treatment of Compulsive-Impulsive Sexual Behaviors

Compulsive-Impulsive Sexual Behaviors (C-ISBs) include repetitive sexual acts and compulsive sexual thoughts which occur so frequently and with such intensity that they interfere with sexual intimacy and interpersonal and occupational functioning and whose categorization and effective treatments are still unclear. We report the case of a patient affected by C-ISBs and bipolar disorder of type II who improved dramatically after three months' addition of topiramate to citalopram. Topiramate is a powerful anticonvulsant which has recently been proposed also for the treatment of migraine, bipolar disorder and binge eating disorder. This case-report suggests that topiramate might be beneficial in augmentation with citalopram in patients suffering from C-ISBs, although controlled studies to confirm our findings are needed

Cyberchondria as an emerging trans-diagnostic digital compulsive syndrome: An updated systematic review and clinical case report

Non peer reviewe

Comorbidity issues in the pharmacological treatment of pathological gambling: a critical review

BACKGROUND: Pathological Gambling (PG) is an impulse control disorder often comorbid with other psychopathology, particularly bipolar spectrum disorders, attention deficit/hyperactivity disorder, obsessive-compulsive disorder (OCD) and substance abuse. This paper reviews the published literature on the pharmacological management of PG, highlighting how clinical and subclinical comorbid psychopathology influences the choice of pharmacological treatment. METHODS: Using Medline, the authors reviewed relevant articles published on this topic from1995 to 2005, focusing on the best-designed studies for inclusion. RESULTS: Much of the literature on PG-treatment presupposes different theories regarding this disorder. Data suggest the utility of differentiating the pharmacotherapy of pathological gamblers in light of their comorbid profile, specifically assessing for comorbid bipolar, ADHD, OCD, and substance abuse disorders. CONCLUSION: Decisions about pharmacological treatment of PG should take into account current and previous comorbid disorders which influence treatment selection

Is Cyberchondria a New Transdiagnostic Digital Compulsive Syndrome? A Systematic Review of the Evidence

© 2020 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Background. Cyberchondria (CYB) has been described relatively recently as a behaviour characterized by excessive online searching for medical information that is associated with increasing levels of health anxiety. Although CYB has received some attention from researchers, there is no consensus about many of its aspects. Aims. We describe one of the first reported cases of a treatment-seeking patient with CYB. We review the published literature on the definition of CYB, its assessment, epidemiology, cost and burden, psychological models and mechanisms associated with CYB, relationships between CYB and mental disorders and prevention and treatment strategies. Methods: Systematic review of all peer-reviewed papers published within the PubMed, PsycINFO, and Cochrane Library databases. Results. 61 articles were selected. Nearly all the studies were descriptive and cross-sectional recruiting sample mainly from the general/university student population and collecting self-report data via online surveys. Data on epidemiology, clinical features, course, comorbidity and therapeutic interventions were scarce. CYB showed a self-reported association with health anxiety, hypochondriasis and obsessive-compulsive disorder (OCD) as well as other forms of problematic usage of the internet (PUI) The psychological mechanisms associated with CYB include low self-esteem, anxiety sensitivity, intolerance of uncertainty, pain catastrophizing and certain meta-cognitive beliefs. Conclusion: A working definition of CYB includes excessive online health searches that are compulsive and may serve the purpose of seeking reassurance, whilst leading to a worsening of anxiety or distress and further negative consequences. CYB represents a clinically relevant transdiagnostic compulsive behavioural syndrome, closely related to PUI and usually presenting in association with health anxiety, hypochondriasis and/or OCD. CYB is clearly in need of further study and we identify key areas for future research.Peer reviewe

Aripiprazole causing false positive urine amphetamine drug screen in an adult patient with bipolar disorder.

There has been only a few reports regarding aripiprazole causing false positive urine amphetamine drug screens, exclusively on children accidently ingesting aripiprazole.Herein, we present the first reported case of a 40 year old woman affected by Bipolar I Disorder, treated with aripirazole at therapeutic oral dose ranging from 15 mg/day to 30 mg/day, in the context of a depressive episode with mixed and psychotic features, showing a false positive urine amphetamine drug screen. We document the relationship between aripiprazole-dose, plasma concentration and amphetamines values in toxicologic urine examinations over time. Awareness of potential false positive urine amphetamine drug screens during aripiprazole treatment can condition therapeutic choices and prevent legal implications. Keywords: Aripiprazole, False positive, Urine drug scree

Pain and psychiatry: a critical analysis and pharmacological review

Pain is one of the most difficult medical problems to diagnose and treat and can be a common symptom of several psychiatric disorders. Pain-related issues are heterogeneous and often underestimated or misinterpreted, with the result that psychiatric interventions, which might have been beneficial from the outset, are often delayed or requested only as a last measure. Several problems arise from the definition, classification and assessment of pain, when documented according to the different scales which are commonly used, since these attempt to cover a multitude of analytical requirements, without really succeeding. An area of constant debate regards the connection between pain and various psychiatric disorders, and the difficulty in the classification of pain disorders within the currently existing framework. The pharmacological treatment of pain is complex and implies a variety of different compounds, from opioids to psychotropic medications like antidepressants and anticonvulsivants. This paper explores the mutual and reciprocal influence between pain and psychiatric disorders reviewing the latest developments in the definition, assessment and treatment of pain, with special emphasis on the impact of pain on psychiatric disorders (and vice versa), and on the use of psychotropic drugs in the treatment of pain syndromes

The Impact of COVID-19 Pandemic on searching for health-related information and cyberchondria on the general population in Italy

Objectives: The Internet has become one of the most common sources people use to search for health-related information, a behavior rapidly increased during the novel Coronavirus disease 2019 (COVID-19). The present study aimed to investigate behavioral patterns in the online health-related searches and Cyberchondria (CYB) during the COVID-19 pandemic time, in order to explore socio-demographic and psychopathological factors related to CYB. Methods: During the third wave of the COVID-19 pandemic in Italy, a cross-sectional online survey collected the main socio-demographic variables and habits related to Internet use of 572 participants. CYB was measured by the Cyberchondria Severity Scale-Short Version and different psychopathological factors were measured by specific questionnaires: the Coronavirus Anxiety Scale, the Hospital Anxiety and Depression Scale, the Short Health Anxiety Inventory, the Meta-Cognitions about Health Questionnaire, the Internet Addiction Test, the Maudsley Obsessional-Compulsive Questionnaire-Short Version, the Rosenberg's Self-Esteem Scale, and the WHO Quality of Life-BREF. Descriptives, non-parametric ANOVAs, and Spearman correlations were performed. Results: In the present sample, the Internet was the main source participants used to search for health-related information and nearly one-third increased this habit during the pandemic. Higher expression of CYB emerged in females, in younger participants, in students, and in those suffering from a physical/psychiatric illness. CYB showed a positive correlation with different phenomenology of anxiety (i.e., anxiety about COVID-19, health anxiety, general anxiety, metacognitive believes about anxiety) and with depression, obsessive-compulsive symptoms, and problematic usage of the Internet. Conversely, quality of life and self-esteem showed a negative correlation with CYB. Conclusion: During the COVID-19 pandemic, the use of the Internet for health-related information and CYB contribute to the psychological stress affecting individuals and society. Delineating subjects more vulnerable to CYB and associated psychopathological factors will help to elaborate operational indications for prevention and psychological support

Balancing benefits and harms of treatments for acute bipolar depression

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Functional Interventions as Augmentation Strategies for Obsessive-Compulsive Disorder (OCD) : Scoping Review and Expert Survey from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS)

© 2021 Taylor & Francis. This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal of Psychiatry in Clinical Practice on 27/01/2021, available online: https://dx.doi.org/10.1080/13651501.2021.1872646.Background. Patients with obsessive-compulsive disorder (OCD) commonly exhibit a range of functional difficulties, presumed linked to neurocognitive changes. Evidence-based first-line treatments have limited effect on improving these cognitive-functional problems. Candidate interventions could be used to augment evidence-based treatments by the multi-professional mental health team. Methods. A scoping review was performed to identify any intervention with at least one peer-reviewed report of clinical improvement in any of the 13 functional domains of the Cognitive Assessment Instrument of Obsessions and Compulsions (CAIOC-13). Next, an online survey of experts of the International College of Obsessive-Compulsive Spectrum Disorders was conducted.Results. Forty-four studies were identified reporting a positive outcome for 27 different kinds of intervention. Twenty-six experts from 12 different countries, including at least one expert from each continent, completed the opinion survey. Five interventions were identified as ‘highly promising’, none of which was moderated by rater-related factors, suggesting global applicability. Conclusion. Patients with OCD may benefit from a detailed functional assessment, to identify areas of unmet need. A variety of interventions show theoretical promise for treating the complex functional difficulties in OCD as adjuncts to first-line treatments, but the published evidence is weak. Randomised controlled trials are needed to determine the clinical effectiveness of these interventions.Peer reviewe

A relationship between oxytocin and anxiety of romantic attachment

The formation of social bonding is fundamental for several animals, including humans, for its relevant and obvious impact upon reproduction and, thus, survival of the species. Recent data would suggest that oxytocin might be one of the mediators of this process. Given the paucity of data on the possible involvement of oxytocin in human attachment, the present study was aimed to explore the possible relationships between the plasma levels of this neuropeptide and romantic attachment in healthy subjects. Forty-five healthy subjects who volunteered for the study, were included in the study. The romantic attachment was assessed using the Italian version of the so-called "Experiences in Close Relationships" (ECR), a self-report questionnaire for measuring this parameter in adults. The results showed that attachment anxiety and oxytocin are positively linked in romantic attachment to a statistically significant degree (r = 0.30, p = 0.04), that is, the higher the oxytocin levels the higher the score on the anxiety scale of the ECR. The authors suggest the hypothesis that this link represents one of the biological processes resulting in those rewarding emotions related to romantic attachment