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A growing importance has been placed on the recognition and supervision of non-motor features of Parkinson's disease (PD). Depression has been estimated to affect one in three individuals with PD and can lead to worse health outcomes and decreased quality of life. Anxiety, apathy and anhedonia further complicate PD outcomes. In this double-blind, placebo-controlled trial, participants (individuals with mild to moderate PD; n = 24) were randomly assigned to treatment (800 mg/d docosahexaenoic acid (DHA) and 290 mg/d eicosapentaenoic acid, a precursor to DHA) or placebo (an equicaloric amount of corn oil). Treatment duration was 6 months. Treatment had no statistically significant effect on rate of change on either Unified Parkinson's Disease Rating Scale or Hoehn-Yahr Scale score. However, 75% of DHA-treated patients, reduced Hamilton Rating Scale for Depression total score by at least 50%, compared with only 25% into the placebo group. At the end of the six-month study, DHA integration reduced the depressive symptoms.

We report a case of a woman with a cryptic balanced translocation between chromosomes 5 and 17, suspected during genetic counseling. The woman had a history of previous fetal losses attributed to lissencephaly and intra uterine growth retardation (IUGR) and a daughter with dysmorphic features and mental retardation, previously attributed to a small deletion 5pter, detected years ago by a first generation CGH-array. This peculiar combination of personal and family history suggested the opportunity to carry out a FISH approach, focusing on chromosomes 5 and 17, based on the idea that a malsegregation secondary to a balanced translocation, might have escaped the first CGH array. This approach allowed the identification of a balanced translocation in the mother, FISH in the affected child confirmed the partial 5p deletion predicted by the previous CGH array and identified a new 17p duplication that had not been detected before. The described translocation opens the possibility of alternative imbalances that were probably responsible for previous fetal losses. The imbalances were confirmed by a new high resolution SNP array. We conclude that despite the availability of highly effective and sensitive genomic approaches a careful evaluation of medical history is highly recommended since it can suggest clinical hypothesis that can be confirmed by more classical and molecular cytogenetic based approaches.

Here we describe the case of a 35 year old male, with a harmonic phenotype, who sought medical assistance to assess the etiology of his infertility. As a result of clinical examination, karyotyping, FISH and molecular studies, we obtained the following karyotype: mos 45,X[18]/46,XY,idic(Y)q(11.2)[82]. Furthermore, the Y chromosome was characterized by the absence of the regions AZF2 (former AZFb, within the 11.22 band, and AZFc, within the 11.23 band), whereas the region AZF1 was conserved. Male infertility can be caused by several genetic alterations. Y chromosome aberrations are very frequent in infertile males. This case with an azoospermic patient carrying a complex karyotype demonstrated that cytogenetic and molecular profiling can be helpful to establish a diagnosis in cases of subjects with a normal gross phenotype.

Our study aims to assess the prevalence of behavioural addictions in an adolescent population, evaluating the effects of gender and age, and to assess the correlations among different behavioural addictions. 2853 high school students were assessed in order to evaluate the prevalence of behavioural addictions such as Pathological Gambling (PG), Compulsive Buying (CB), Exercise Addiction (EA), Internet Addiction (IA), and Work Addiction (WA), in a population of Italian adolescents. The South Oaks Gambling Screen-Revised Adolescent (SOGS-RA), the Compulsive Buying Scale (CBS), the Exercise Addiction Inventory (EAI), the Internet Addiction Test (IAT), and the Work Addiction Risk Test (WART), were compiled anonymously by the students. Overall prevalence was 7.0% for PG, 11.3% for CB, 1.2% for IA, 7.6% for WA, 8.5% for EA. PG and EA were more common among boys, while gender had no effect on the other conditions. CB was more common among younger (

In recent years, mobile phone use has become increasingly common among Italian youth, while a growing scientific literature has been identifying the occurrence of a problematic mobile phone use which seems to share some features of other conditions often referred to as behavioural addictions. The study aimed to assess the prevalence of problematic mobile phone use in a population of Italian adolescents and its association with other behavioural addictions. The Mobile Addiction Test (MAT) was administered to 2,790 high school students from Barletta, an Italian town, together with the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA), the Compulsive Buying Scale (CBS), the Internet Addiction Test (IAT), the Exercise Addiction Inventory (EAI), the Work Addiction Risk Test (WART). MAT scores fitted a Gaussian distribution model. Scores ≥ 17 was found as a cut-off value over which identifying problematic mobile phone users. Overall prevalence of problematic mobile phone use was 6.3%; this condition was associated with other behavioural addictions like compulsive buying. Problematic mobile phone use in adolescence should become a public health issue, and it could be a cause of health problems and social costs.

Introduction:Adolescence seems to be a critical period of addiction vulnerability, based on both neurobiological, social, and familiar factors. The earlier onset of behavioural/substance dependence seems to predict greater addiction severity, morbidity, and multiple addictive disorders. The aim of this study was to assess the presence of multiple addictions in an Italian adolescent high-school population.Methods:Data were collected from a sample of 2907 high school students recruited in the area of Barletta (Puglia) and Latina (Lazio). The sample had an average age of 16.69+/-1.89 years. Through different multi-item scales we evaluated different behavioural addictions: Pathological Gambling, Internet Addiction, Compulsive Buying, Sexual Addiction, Relationship Addiction, Mobile Phone Addiction, Exercise Addiction, Work Addiction.Results:the presence of pathological gambling was found in 4.4%, compulsive buying in 8.3%, internet addiction in 1.1%, work addiction in 7.2%, exercise addiction in 6.7% of the subjects. Males showed higher scores (p

Background and Aims Internet Gambling has become one of the most popular and lucrative internet business. The recent improvements in technology have changed betting habits with online poker, casinos, sport betting, bingo and lotteries. Liberalization of the Italian online gambling market gradually started in 2006, but only in 2010 foreign gambling operators have been able to launch online real money games. Our aim is to study the impulsivity and personality traits of an Italian sample of Pathological Gamblers (PG), showing the peculiarities of Online Gambling (OG). Methods 69 patients affected by PG, who accessed to our clinical center, were asked to fill the following questionnaires: - Temperament and Character Inventory-Revised (TCI-R) - Europ-ASI (Addiction Severity Index) - Barratt Impulsiveness Scale (BIS-11) Results we found significant statistical correlations between OG and: younger age (p Conclusions internet gamblers’ young age could explain the correlations between OG and higher scores in NS1, HA2 and ST3, and consequently risky behaviours and less spiritual believes/acceptance. Higher scores in Persistence indicate perseverance in spite of fatigue or frustration. Cloninger's research found that Persistence, like the other temperament traits, is highly heritable.

IntroductionThis issue of the Journal of Public Health presents articlesrelating to different fields in public health research, fromthe organization of humanitarian aid action to the preven-tion of infectious diseases, the diffusion of problematicbehaviors, and the management of chronic conditions. Mostof the contributors underline the importance of the diffusionof knowledge and information among the general popula-tion for the primary prevention of diseases, and the role ofcommunication and patient education in the management ofchronic conditions.Human behavior can in fact influence the spread ofinfectious diseases, and it is based on the individuals’knowledge as well as on the information received aboutsuch conditions (Funk et al. 2010). In turn, a correctevaluation of the benefits obtained from immunization, andof the risks and the adverse effects related to the vaccineswould facilitate a wider diffusion of vaccinations (Baejens2010). Some of the papers in this issue are in line with theafore-mentioned hypotheses: Al-lela et al., who developed aquestionnaire on knowledge, attitude and practice aboutimmunization among Iraqi parents, suggest that parentswho have adequate information on this field also have apositive attitude and practices towards immunization;Kamal et al. assessed the knowledge, attitude and practicetowards the pandemic H1N1 influenza virus among El-MiniaUniversity students in Egypt, and maintain that adequateacquaintance with the problem is associated with a betterwillingness to comply with preventive measures; Naing andTan focused on the knowledge of pandemic influenza A andon the willingness to be vaccinated among a sample of 264medical students in Kuala Lumpur, Malaysia, and underlinethenecessitytostrengthenevidence-basedhealtheducationinorder to help people adopting effective preventive behaviorsand vaccination.One of the main factors contributing to the spread ofbacterial resistance is the misuse of antibiotics. Educationalprograms for both health professionals and the generalpopulation are strongly needed: reducing misconceptionsabout the utility of antibiotics in minor ailments andimprovingthegeneralpublicawarenessoftheriskscorrelatedwiththeirimproperusewouldbeakeycomponentonpoliticsaimed to control the diffusion of antibiotic resistance(Grigoryan et al. 2010). Two studies focus respectively onthe topic of the diffusion of antibiotic-resistant bacteria andon the knowledge of MRSA in both medical students and thegeneral population: Sathiamoorthi et al. describe the preva-lence of multidrug-resistant Salmonella enterica typhi andparatyphi among 368 human cases of typhoid and paraty-phoid fever from the Tiruchirappalli district in India, whileDe Giusti et al. report a survey conducted on a sample ofstudents attending an Italian Faculty of Medicine and ontheir cohabitants, focusing on their knowledge on MRSA, its

The need for a specific therapeutic-rehabilitative group for cocaine addicted patients rises up both from the progressive increase of cocaine use in the general population and from peculiar personality traits and associated psychopathology of these clients. Moreover, it is difficult to mantain a compliance to therapy, because there are no specific anticraving or antidothic drugs for cocaine addiction.Therefore our equipe developed a short integrated treatment (ten weeks), of “group concelling” and “psychodinamic group therapy” in association. The group is open and composed by a maximum of eight participants.The novelties of this model are: (1) hospital setting, (2) a short duration and (3) synergy between two different approaches: Minnesota 12 steps model (one sessions weekly, held by a councellor on addiction), and a psychodinamic group therapy (one session weekly).Main success is the retention of patinets in therapy for a long time. In twenty months (March 2005- October 2006), fourty cocaine-addicted patients started this program: only 30% of them dropped out, while 70% of patients completed the treatment. 64% of the latter where completely abstinent, while 36% relapsed during the therapy. All of them are still continuing some therapy at the moment: 46% individual psychotherapy, 25% individual psychotherapy and pharmacological therapy, 14% narcotics anonymous attendance, 11% N.A. groups and pharmacological therapy, 4% is in a T. C.

Introduction Different questionnaires were formulated in order to assess the severity of gambling. The most used questionnaire is the South Oaks Gambling Screen (SOGS), based on DSM-III criteria for gambling, even though it has poor specificity, because overestimates the prevalence of the disorder when used in general population. Objectives Try to overcome SOGS limits using a questionnaire based on DSM-IV criteria for gambling. Aims Validate the questionnaire based on DSM-IV criteria, using as gold standard the clinical interview developed through the SOGS. Methods The sample used is formed by 71 subjects, 58 men (81.7%) and 13 women (18.3%), recruited from the Psychiatric Department of Gemelli General Hospital in Rome, who were asked to fill out both questionnaires. Results The sensitivity of our questionnaire was 93% (compared to 100% in the SOGS); the specificity was 100% (97.1% in the SOGS). False negatives were 7%, while they were absent in the SOGS ; false positives were absent in the DSM-IV questionnaire, while they were 2.9% in the SOGS. We also determined the prevalence of each item of DSM-IV questionnaire in all gamblers identified (66 subjects): the most relevant item was “chasing one's losses”(item6), instead the least one was “committing illegal acts such as forgery, fraud, theft, or embezzlement to finance gambling”(item8). Conclusions Our data confirm the greater specificity of the questionnaire of DSM-IV criteria for gambling compared to the SOGS. We suggest its use for the identification of gamblers in a sample formed by general population.

Introduction Pathological gambling (PG) disorder occurs when a person gambles repetitively despite severe negative effects on important aspects of life. PG tends to be a heterogonous disorder in which patients differ with respect to type and intensity of gambling behavior, psychiatric comorbidity, family history, age at onset and gender. Gamblers may accordingly be classified into three subtypes: the “impulsive”, “obsessive-compulsive” and “addicted” subtypes. Aims to characterize a sample of Italian PG pathological gamblers and assess the prevalence of the various gambling subtypes in this population. Methods 52 outpatients (44 men, 9 women), diagnosed with PG according to DSM IV-TR and SOGS criteria, were administered the Dannon Ainhold Gambling Scale (DAGS), which assesses the presence of the disorder and is useful for patient subtyping. Results 37 gamblers enrolled in our study played one specific kind of game, while 15 played multiple games. 30 patients played slot machines, 18 sport betting, 11 casino and card games, 14 bingo and scratch cards. According to DAGS, 5 (9,6%) patients belonged to the “addicted” subtype, 4 (7,7%) to the “obsessive-compulsive” subtype and 9 (17,3%) to the “impulsive” subtype. 15 (28,8%) gamblers were classified as “addicted-impulsive” subtype, 10 (19,2%) as “addicted-obsessive-impulsive” subtype, while 9 (17,3%) did not belong to any specific subtype though they displayed a tendency for one of the subtypes. Conclusion DAGS allows to identify three major subtypes of gamblers and also considers possible combinations between the different subtypes. An evaluation of these aspects could be useful in treatment options based on patient subtype.

Introduction Pathological gambling refers to the uncontrollable impulse to gamble, irrespective of the interference the behaviour has on the individual's life. It often results in disrupted relationships, financial problems, criminal behaviour and yet the individual is unable to refrain. Aims Our aim is to evaluate the relationship among impulsivity traits, personality assessment and psychiatric comorbidity in a sample of pathological gamblers. Methods 78 pathological gamblers were evaluated with the following instruments: MINI to evaluate psychiatric comorbidity; TCI to evaluate personality traits, and BIS-11 to evaluate impulsivity. Pathological gambling was assessed with DSM-IV-TR criteria. Results In our sample we found an average score of BIS-11 (66,9) slightly higher than the score of the general population (63,8). The scores of TCI, compared with the mean scores of the general population, differ significantly with regard to NS, RD, C, ST. As to MINI, it reveals a significant prevalence of Major Depressive Episode, Dysthymia, GAD, and risk of suicide. We identified two groups at high and low impulsivity and we conducted an analysis in relation to personality traits measured by TCI and incidence of psychiatric comorbidity measured by the MINI. The group with high impulsivity was associated with significantly higher scores of NS and HA, and lower RD and SD. Also in this group there was a higher incidence of Major Depressive Episode and GAD. Conclusions The analysis allows to identify the impulsive trait as a discriminating factor of two different types of players in relation to personality characteristics and psychiatric comorbidity.

Since November 2005 our Institute has been developing a group therapy program for pathological gamblers, alternating a counselling/rehabilitation and a group psychotherapy session each week. For a better understanding of psychodynamic aspects of our patients we have started to assess them through Rorschach test according to Klopfer signing and with TAS-20 (Toronto Alexithymia Scale, Taylor et al., 1990). Preliminary results regarding ten patients have shown the following features: a discrepancy between high ambition and real intellectual skills; a psychic life condition dominated by immature resources and impulses; an inappropriate self-control which is performed through emotional distance and experiences of deep anguish. These features can be indicative of a difficulty in expression of emotions, according to alexithymia construct. Most of the patients were found to have significantly higher levels of alexithymia at Tas-20. This outcome is in accordance with previous works on the topic.Our preliminary observations suggest to focus group therapy not only on communication contents, but also on the communication style of the patient. These results also suggest that could be important to help patient to recognize and discriminate emotional conditions to prevent relapses due to out of control or repressed emotions.[1]. Parker J.D., Wood L.M., Bond B.J., Shaughnessy P. (2005) Alexithymia in young adulthood: a risk factor for pathological gambling. Psychother. Psychosom. 74(1): 51-5.