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The strong comorbidity between metabolic diseases and severe psychiatric disorders, although object of extensive scientific literature in recent years, is still a challenge for researchers, in order to clarify the pathogenic mechanisms that underlie this relationship, and for clinicians, in order to optimize strategies for prevention and early interventions. Particular attention is linked to insulin resistance, which can represent a primum movens able to adversely affect the course of the dysmetabolic and psychiatric frameworks. Through extensive review of the scientific literature on PubMed, we analyze the latest scientific findings about the bidirectional nature of this comorbidity. Our aim is also to identify an instrument applicable on a large scale in psychiatric populations, able to quickly recognize the insulin resistance. In particular, the HOMA (Homeostasis Model Assessment) index for its features of high specificity, sensitivity, low-cost and easy execution of the method, can be a useful tool, predictive and diagnostic at the same time, which can significantly improve the quality of life and the course of disease for these patients.

In PTSD, sleep disorders represent an important symptoms dimension which is associated with more severe PTSD and increased risk of relapse. The basic treatment for PTSD is not always associated to an improvement of sleep disturbances and nightmares. Alpha-blockers, and more specifically Prazosin, have shown a specific action on sleep disorders in PTSD. We report the clinical case of a young women with PTSD, who was suffering from severe sleep disorder and distressing nightmare. The patient was treated with Terazosin, a conger of Prazosin, and has shown symptom remission. Further studies on the use of alpha-blokers might reveal new therapeutic options in PTSD.