La valutazione degli interventi di prossimità. Uno studio pilota

Nonostante negli ultimi anni le attività di prevenzione dell’addiction da sostanze e da comportamenti si siano moltiplicate, nella maggior parte dei casi per tali attività, e per gli interventi di prossimità in particolare, non vengono attuati adeguati processi di valutazione. Ciò anche a causa della mancanza di sistemi di valutazione e di modelli teorici di riferimento condivisi. Il presente studio costituisce il primo passo di un progetto di ricerca più ampio finalizzato alla valutazione degli effetti degli interventi di prossimità. Lo studio descrive, in particolare, i rapporti esistenti tra frequenza di assunzione della sostanza o di attuazione del comportamento problematico, stadio del cambiamento e fattori di vulnerabilità e di protezione. Lo studio dimostra, inoltre, che il sistema di valutazione adottato è in grado di rilevare le differenze esistenti tra momenti diversi del percorso di cambiamento, in cui la frequenza di attuazione del comportamento problematico assume significato in relazione a variabili psicologiche e di contesto

A Case of Schizophrenia Complicated in Subacute Combined Degeneration: How Nutrition Affects Physical Health in Psychotic Patients

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Lipoprotein profile in older patients with vascular dementia and Alzheimer's disease

BACKGROUND: Some alterations of the lipoprotein profile have been associated with cerebrovascular disease. Recently, it has been suggested that cerebrovascular disease might play a role in the pathogenesis of both vascular dementia (VD) and Alzheimer's disease (AD). Nevertheless, the possible association of dyslipidemias with VD or AD is still a controversial issue. METHODS: We investigated the lipoprotein profile in 100 older patients with vascular dementia (VD; n°: 60) or Late Onset Alzheimer's Disease (LOAD; n°: 40). The patients were compared with 54 community dwelling non-demented older controls. RESULTS: After adjustment for functional status, blood sedimentation rate, and serum albumin levels, no differences in lipoprotein profile emerged between the three groups, with the exception of HDL-C that was lower in VD compared with controls. Low HDL-C (< 45 mg/dL) was associated with VD (O.R.: 6.52, C.I. 95%: 1.42–30.70 vs controls, and 4.31, C.I. 95%: 0.93–19.82 vs LOAD), after multivariate adjustment. No differences in plasma lipid levels emerged between the three groups after stratification for apo E4 genotype. CONCLUSIONS: In this cross-sectional study low HDL-C levels are associated with VD, but not with LOAD, in a sample of older subjects

Factors associated with increased suicide risk in obsessive-compulsive disorder

Objectives: Obsessive-Compulsive Disorder (OCD) is in itself at greater risk for suicide (suicidal ideation, suicide attempts and completed suicide) as compared to the general population. However, the majority of individuals with OCD do not have current or lifetime suicidal ideation nor did attempt suicide in their lifetime. Methods: The present paper aims to provide an updated review on factors (socio-demographic and personal factors, OCD-related variables, comorbidities, emotion-cognitive factors, and biological variables) contributing to the increased suicide risk in patients with OCD. Results: Several factors have been found to be strongly associated with suicide risk in patients with OCD, such as the severity of OCD, the unacceptable thoughts symptom dimension, having a comorbid Axis I disorder (Bipolar Disorder, Major Depressive Disorder, Substance Use Disorder), the severity of comorbid depressive and anxiety symptoms, a previous history of suicide attempts, having high levels of alexithymia and hopelessness. Conclusions: Several contributing factors should be evaluated and identified in the clinical practice in order to improve early detection of suicide risk. Risk identification and stratification of risk remain essential components of suicide prevention and should guide the clinical approach to patients with OCD. Whether and how these risk factors for suicide in patients with OCD work together, and whether the specific factors act as moderators or mediators, remains to be fully clarified

Off-label prescription of psychotropic medications in a sample of Italian psychiatrists working in private practice: a cross sectional study

Background Off-label prescription refers to the use of a drug outside the terms of its Marketing Authorization. According to the literature, this practice is particularly common in clinical psychiatry. Objective To describe patterns of off-label prescription in a sample of Italian psychiatrists working in private practice. Methods An ad hoc questionnaire was developed and sent by e-mail to a sample of Italian psychiatrists working in private practice in the Region Emilia-Romagna. The questionnaire assessed frequency of off-label prescription, reasons associated with it, diagnostic categories more often associated with such practice, main sources of information used to support off-label prescription, and psychotropic agents most commonly prescribed off-label, as well as medical-legal implications. Data were analysed by means of univariate and multivariate ordered logistic regressions. Results Fifty psychiatrists (female: 44%) out of 129 who received the e-mail invitation responded (response rate: 39%). Off-label prescription was found to be inversely proportional to clinicians’ age (OR = 10.53 [95% CI 2.13-52.13]). Most commonly, second-generation antipsychotics (SGAs) were prescribed to patients diagnosed with personality disorders (PDs) (OR = 0.08 [95% CI 0.02-0.36]). A higher rate of off-label prescription was also associated to relying more on pharmaceutical sales representatives (OR = 0.58 [95%CI 0.01-0.30]) or personal professionals’ clinical experience (OR = 0.05 [95% CI 0.01-0.36]) and less on other colleagues’ experience (OR = 11.80 [95% CI 4.16-33.50]) as source of information. Conclusions Off-label prescription is common, especially among young psychiatrists, who frequently rely on previous personal clinical experience, especially when prescribing SGAs for treating patients with PDs. Respondents pointed to the need for further research and training on the topic addressed by the present study

Eating Disorders and Disturbed Eating Behaviors Underlying Body Weight Differences in Patients Affected by Endometriosis: Preliminary Results from an Italian Cross-Sectional Study

Abstract: This study aimed to characterize the prevalence of eating disorders(EDs), disturbed eating behaviors (DEBs), and emotional eating attitudes (EEAs) among patients affected by endometriosis in order to understand a potential crosslink between this impacting gynecological disease and a Body Mass Index shift. A total of 30 patients were recruited at an endometriosis outpatient clinic in Bologna and were assessed by using standardized instruments and specific questionnaires for EDs, DEBs, and EEAs. Sociodemographic information and endometriosis clinical features and history information were collected by adopting a specific questionnaire. Retrospective reports of lifetime Body Mass Index (BMI) changes, current BMI, peak pain severity during the last menstrual period, and the average of pain intensity during the last intermenstrual period were used for a correlation with the mean score from eating-behavior scales’ assessment. The preliminary results indicate that, although only 3.33% of endometriosis patients are affected by ED, statistically significant differences at the mean scores of DEBs and EEAs assessment scales were found by strati-fying patients on the basis of BMI levels at risk for infertility and coronary heart disease and on the basis ofmoderate/severe pain levels. The enrichment of the sample size and the recruitment of the control group to complete the study enrollment will allow us to investigate more complex and strong correlation findings and to assess the prevalence of EDs among endometriosis patients. Keywords: endometriosis; BMI; pain; eating disorders;disturbed eating behaviors; emotional eating attitude

Eating disorders in narcolepsy type 1: Evidence from a cross-sectional Italian study

: Narcolepsy type 1 is a chronic central disorder of hypersomnolence, and it is frequently accompanied by overweight, but the association between narcolepsy type 1 and eating disorders is controversial. Our study aims to compare patients with narcolepsy type 1 and controls on the symptomatology of eating disorders and to evaluate the association between clinical factors. This is a cross-sectional study, with consecutive recruitment of patients with narcolepsy type 1 attending the Outpatient Clinic for Narcolepsy at the IRCCS Istituto delle Scienze Neurologiche di Bologna (Italy) for routine follow-up visits. Healthy subjects from general populations were recruited as controls. Patients underwent a questionnaire-based assessment using the Eating Disorder Examination Questionnaire (EDE-Q), Binge Eating Scale (BES), Italian Night Eating Questionnaire (I-NEQ), Epworth Sleepiness Scale (ESS), and Narcolepsy Severity Scale (NSS). One hundred and thirty-eight patients with narcolepsy type 1 and 162 controls were enrolled. This study showed that individuals with narcolepsy type 1 reported higher scores on the EDE-Q, I-NEQ, and a higher body mass index (BMI) than the controls. The logistic regression analysis results, with EDE-Q positivity as a dependent variable, demonstrate a significant association with antidepressant drugs, female sex, and the use of sodium oxybate. We found an association between antidepressant drug consumption, the NSS total score, and female sex with BES positivity as the dependent variable. The logistic regression analysis for I-NEQ positivity found an association with antidepressant drug use. This study shows that patients with narcolepsy type 1 frequently present with comorbid eating disorder symptomatology, mainly night eating syndrome. Investigating the possible presence of eating disorders symptomatology through questionnaires is fundamental during the assessment of patients with narcolepsy type 1

Induction of immune response after SARS-CoV-2 mRNA BNT162b2 vaccination in healthcare workers

[no abstract available

Sudden Unexpected Deaths and Vaccinations during the First Two Years of Life in Italy: A Case Series Study

Background The signal of an association between vaccination in the second year of life with a hexavalent vaccine and sudden unexpected deaths (SUD) in the two days following vaccination was reported in Germany in 2003. A study to establish whether the immunisation with hexavalent vaccines increased the short term risk of SUD in infants was conducted in Italy. Methodology/Principal Findings The reference population comprises around 3 million infants vaccinated in Italy in the study period 1999–2004 (1.5 million received hexavalent vaccines). Events of SUD in infants aged 1–23 months were identified through the death certificates. Vaccination history was retrieved from immunisation registries. Association between immunisation and death was assessed adopting a case series design focusing on the risk periods 0–1, 0–7, and 0–14 days after immunisation. Among the 604 infants who died of SUD, 244 (40%) had received at least one vaccination. Four deaths occurred within two days from vaccination with the hexavalent vaccines (RR = 1.5; 95% CI 0.6 to 4.2). The RRs for the risk periods 0–7 and 0–14 were 2.0 (95% CI 1.2 to 3.5) and 1.5 (95% CI 0.9 to 2.4). The increased risk was limited to the first dose (RR = 2.2; 95% CI 1.1 to 4.4), whereas no increase was observed for the second and third doses combined. Conclusions The RRs of SUD for any vaccines and any risk periods, even when greater than 1, were almost an order of magnitude lower than the estimates in Germany. The limited increase in RRs found in Italy appears confined to the first dose and may be partly explained by a residual uncontrolled confounding effect of age