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5. Suicide in obsessive-compulsive related disorders: Prevalence rates and psychopathological risk factors

Author

Albert, U., Luca Pellegrini, Maina, G., Atti, A-R, Ronchi, D., Rhimer, Z., Albert, U., Pellegrini, L., Maina, G., Atti, A. -R., De Ronchi, D., Rhimer, Z., Albert U., Pellegrini L., Maina G., Atti A.-R., De Ronchi D., and Rhimer Z.

Subjects
HD, Trichotillomania, Suicidal ideation, BDD, Skin Picking Disorder, Suicide attempts, Suicide attempt
Abstract

Objectives To estimate prevalence rates of suicide attempts and suicidal ideation in individuals with a principal diagnosis of obsessive-compulsive related disorders (OCRDs); 2. to identify predictors of suicide risk among subjects with OCRDs (where available). Methods The systematic review was conducted by searching PubMed from the date of the first available article to December 31, 2018. The search terms [suicide] OR [suicidality] OR [suicide attempts] OR [suicidal ideation] OR [suicidal thoughts] were combined with the following: [BDD] OR [body dysmorphic disorder]; [HD] OR [hoarding disorder]; [trichotillomania] OR [hair pulling disorder]; [excoriation disorder] OR [skin picking disorder]. Results In BDD, data concerning lifetime suicide attempts are consistent across studies: mean rate is 21.5% (range 9-30.3%). Mean rate of current suicidal ideation is 37.4% (range 26.5-49.7%) and mean rate of lifetime suicidal ideation is 74.5% (range 53.5-85%). BDD-specific factors such as early onset, severity, poor insight and muscle dysmorphia and comorbid disorders increase the risk of suicide attempts or suicidal ideation. Only 2 studies recruited individuals with DSM-5 HD: suicidality appears to be low, with rates of current suicidal ideation comprised between 5% and 10%, although 19% of individuals attempted suicide during their lifetime. Concerning the grooming disorders, lifetime rates of suicide attempts are low as compared to rates in other OCRDs; approximately 40% of individuals, however, reported lifetime suicidal ideation. Conclusions OCRDs taken together may be at risk for suicide attempts and suicidal ideation independently from comorbid disorders (and specifically independently from comorbid OCD); BDD remains the disorder more strongly associated with an increased risk for suicide, followed by HD and then the grooming disorders.

Published
2019

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

Author

Bonamici C., Guicciardi A., Curti A., Atti A. R., Balducci J., Mattei G., Valle L., Galeazzi G. M., Ferrari S., Bonamici C., Guicciardi A., Curti A., Atti A.R., Balducci J., Mattei G., Valle L., Galeazzi G.M., and Ferrari S.

Subjects
Psychiatry, Web survey, Off-label prescription, Psychotropic medication, Private practice
Abstract

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.

Published
2020

8. Familial aggregation of MATRICS Consensus Cognitive Battery scores in a large sample o outpatients with schizophrenia and their unaffected relatives

Author

Mucci A., Galderisi S., Green M. F., Nuechterlein K., Rucci P., Gibertoni D., Rossi A., Rocca P., Bertolino A., Bucci P., Hellemann G., Spisto M., Palumbo D., Aguglia E., Amodeo G., Amore M., Bellomo A., Brugnoli R., Carpiniello B., Dell'osso L., Di Fabio F., Di Giannantonio M., Di Lorenzo G., Marchesi C., Monteleone P., Montemagni C., Oldani L., Romano R., Roncone R., Stratta P., Tenconi E., Vita A., Zeppegno P., Maj M., Piegari G., Vignapiano A., Caputo F., Plescia G., Montefusco V., Mancini M., Attrotto M. T., Paladini V., Atti A. R., Barlati S., Galluzzo A., Mussoni C., Pinna F., Sanna L., Primavera D., Signorelli M. S., Minutolo G., Cannavo D., Acciavatti T., Santacroce R., Corbo M., Altamura M., La Montagna M., Carnevale R., Pizziconi G., Rossi R., Santarelli V., Giusti L., Malavolta M., Salza A., Murri M. B., Calcagno P., Bugliani M., Serati M., Orsenigo G., Gramaglia C., Gattoni E., Cattaneo C., Campagnola N., Ferronato L., Piovan C., Tonna M., Bettini E., Ossola P., Gesi C., Landi P., Rutigliano G., Biondi M., Girardi P., Buzzanca A., Zocconali M., Comparelli A., Mancinelli I., Niolu C., Ribolsi M., Siracusano A., Corrivetti G., Bartoli L., Diasco F., Bolognesi S., Goracci A., Fagiolini A., Bellino S., Cardillo S., Bracale N., Mucci, A., Galderisi, S., Green, M. F., Nuechterlein, K., Rucci, P., Gibertoni, D., Rossi, A., Rocca, P., Bertolino, A., Bucci, P., Hellemann, G., Spisto, M., Palumbo, D., Aguglia, E., Amodeo, G., Amore, M., Bellomo, A., Brugnoli, R., Carpiniello, B., Dell'Osso, L., Di Fabio, F., Di Giannantonio, M., Di Lorenzo, G., Marchesi, C., Monteleone, P., Montemagni, C., Oldani, L., Romano, R., Roncone, R., Stratta, P., Tenconi, E., Vita, A., Zeppegno, P., Maj, M., Piegari, G., Vignapiano, A., Caputo, F., Plescia, G., Montefusco, V., Mancini, M., Attrotto, M. T., Paladini, V., Atti, A. R., Barlati, S., Galluzzo, A., Mussoni, C., Pinna, F., Sanna, L., Primavera, D., Signorelli, M. S., Minutolo, G., Cannavo, D., Acciavatti, T., Santacroce, R., Corbo, M., Altamura, M., La Montagna, M., Carnevale, R., Pizziconi, G., Rossi, R., Santarelli, V., Giusti, L., Malavolta, M., Salza, A., Murri, M. B., Calcagno, P., Bugliani, M., Serati, M., Orsenigo, G., Gramaglia, C., Gattoni, E., Cattaneo, C., Campagnola, N., Ferronato, L., Piovan, C., Tonna, M., Bettini, E., Ossola, P., Gesi, C., Landi, P., Rutigliano, G., Biondi, M., Girardi, P., Buzzanca, A., Zocconali, M., Comparelli, A., Mancinelli, I., Niolu, C., Ribolsi, M., Siracusano, A., Corrivetti, G., Bartoli, L., Diasco, F., Bolognesi, S., Goracci, A., Fagiolini, A., Bellino, S., Cardillo, S., Bracale, N., and di Giannantonio, M.

Subjects
Attention, MCCB Italian standardization, reasoning and problem solving, social cognition, verbal learning, working memory, Proband, Adult, Male, Consensus, Psychometrics, Context (language use), social cognition, Verbal learning, working memory, 03 medical and health sciences, Attention, MCCB Italian standardization, reasoning and problem solving, verbal learning, Aged, Cognition, Cognitive Dysfunction, Family, Female, Humans, Middle Aged, Outpatients, Psychiatric Status Rating Scales, Schizophrenia, Schizophrenic Psychology, 0302 clinical medicine, Social cognition, medicine, Applied Psychology, Psychiatry and Mental Health, Family aggregation, medicine.disease, 030227 psychiatry, Settore MED/25, Psychology, MATRICS, Neurocognitive, 030217 neurology & neurosurgery, Clinical psychology
Abstract

BackgroundThe increased use of the MATRICS Consensus Cognitive Battery (MCCB) to investigate cognitive dysfunctions in schizophrenia fostered interest in its sensitivity in the context of family studies. As various measures of the same cognitive domains may have different power to distinguish between unaffected relatives of patients and controls, the relative sensitivity of MCCB tests for relative–control differences has to be established. We compared MCCB scores of 852 outpatients with schizophrenia (SCZ) with those of 342 unaffected relatives (REL) and a normative Italian sample of 774 healthy subjects (HCS). We examined familial aggregation of cognitive impairment by investigating within-family prediction of MCCB scores based on probands’ scores.MethodsMultivariate analysis of variance was used to analyze group differences in adjusted MCCB scores. Weighted least-squares analysis was used to investigate whether probands’ MCCB scores predicted REL neurocognitive performance.ResultsSCZ were significantly impaired on all MCCB domains. REL had intermediate scores between SCZ and HCS, showing a similar pattern of impairment, except for social cognition. Proband's scores significantly predicted REL MCCB scores on all domains except for visual learning.ConclusionsIn a large sample of stable patients with schizophrenia, living in the community, and in their unaffected relatives, MCCB demonstrated sensitivity to cognitive deficits in both groups. Our findings of significant within-family prediction of MCCB scores might reflect disease-related genetic or environmental factors.

Published
2018

10. Patterns of Internet Addiction in an Italian sample: 100% of the sample experience Nomophobia.

Author

Marcolini, F., De Ronchi, D., and Atti, A. R.

Subjects
INTERNET addiction, CELL phones, TRAFFIC safety, INTERNET access, TRAFFIC accidents, ADDICTIONS
Abstract

Introduction: Internet Addiction Disorder, a concept introduced for the first time by Ivan Goldberg in 1995, is one of the most recently identified forms of addiction, but already considered a real psychosocial phenomenon, capable of having a profound impact on different aspects of social and psychological life of individuals. One of its most recently identified manifestations is Nomophobia, a neologism formed from the combination of terms such as "no mobile", "phone" and "phobia", which can be understood as the fear of feeling disconnected. It is today considered a situational phobia, characteristic of contemporary times. The most common symptoms include excessive cell phone use and constant anxiety at the thought of losing the internet connection. Others are, for example, "Ringxiety", ringing anxiety, or the "phantom vibration syndrome". Objectives: This study aims to examine the spread of Nomophobia in the Italian population, evaluating psychopathological correlations that can explain its diffusion. Methods: Between January and May 2023, an anonymous online questionnaire was randomly sent to the general population. Alongside with tests to evaluate psycho-social features, the instrument used to study Nomophobia was the Nomophobia Questionnaire (NMP-Q) (Yildrim et al. Comput Hum Behav. 2015; 49:130–7), in its Italian version (Adawi et al. JMIR MHealth UHealth. 2018;6:e24). Results: The sample consists of 308 people (189 F, 119 M), with an average age of 32 years (sd 14). In our sample, 100% of the subjects tested positive for Nomophobia. Values indicating a state of severe Nomophobia are found in 12.3% of the sample (F 15.9%, M 6.7%). The young population, between 18 and 25 years old, represents 54% of the affected population, but more than 60% of severe cases (95% confidence interval 50-65%). The severe cases correlate positively (p<0,05) with findings of high impulsiveness. There are no other studies that investigate the psychopathological correlates of Nomophobia among Italians. Conclusions: Despite possible biases, the data obtained are an alarming sign of the spread of internet addiction that characterizes our times, of which the excessive use of cell phones in the form of Nomophobia is an expression. Despite their now undisputed usefulness, mobile devices are capable of causing the onset of serious health problems, starting from exposure to radiation capable of causing dermatitis, tumors, and infertility. Furthermore, they dramatically interfere with driving safety, becoming a major cause of road accidents. Considering these consequences, it appears to be extremely important to characterize the phenomenon, as well as its psychosocial determinants, in order to proceed with its better definition and prevention. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Published
2024
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11. Changing drinking patterns among Italians: 7 out of 10 students experience Binge Drinking.

Author

Marcolini, F., De Ronchi, D., and Atti, A. R.

Subjects
UNSAFE sex, BINGE drinking, ALCOHOL drinking, ALCOHOLISM, DRUNK driving
Abstract

Introduction: The expression Binge Drinking (BD) refers to dysregulated alcohol consumption, characterized by the intake of large quantities of alcohol, regardless of their nature, consecutively in a limited period of time. BD is a significant public health problem in many European countries, including Italy. According to data from the Istituto Superiore di Sanità , dated 2020, over 4 million Italians exhibit episodic excessive alcohol consumption (compared to 2019 data, there was an increase of approximately 5,3%). Objectives: This study aims to examine alcohol consumption habits in the Italian population, evaluating psychopathological correlations that can explain its diffusion. Methods: Between January and May 2023, an anonymous online questionnaire was randomly sent to the general population. Alongside with tests to evaluate psycho-social features, to estimate the presence of alcohol abuse or dependence the AUDIT scale (Saunders et al. Addict Abingdon Engl. 1993; 88:791–804) was used. It included two specific questions to frame the phenomenon of BD (Cranford et al. Alcohol Clin Exp Res. 2006; 30:1896–905). No other study conducted in Italy has so far used the aforementioned validated questions. Results: The sample consists of 308 people (189 F, 119 M), with an average age of 32 years (sd 14). The AUDIT indicates a state of chronic alcohol consumption in 11,7% (95% confidence interval 8,5%-15,7%), of the recruited sample, positively correlating with the element of impulsivity (p <0,005) confirming what has already been reported in literature. BD prevalence reaches 56% (M 57%, F 55%) without any significant correlation with impulsivity, personality disorders, emotional dysregulation, or sensitivity to rejection. Among university students the prevalence of BD exceeds 70% (95% confidence interval 60%-76%), with a number of drinks reported for a single occasion reaching up to 25 units and a reported number of binge episodes, in a two-week span, ranging from 2 to 10. Conclusions: Despite possible biases, this study raises the relevant issue of the extremely high prevalence of BD disorder, which is particularly alarming in light of the numerous issues related to the behavior itself. A direct correlation with reduced school performance, an increase in risky sexual behavior, and an increase in cases of drunk driving have been evaluated. Considering these consequences, it is of primary importance on a medical, but even more social level, to best characterize this phenomenon in such a way as to be able to implement awareness-raising and prevention interventions. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Published
2024
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12. Low Crossover Polymer Electrolyte Membranes for Direct Methanol Fuel Cells

Author

Prakash, G. K. Surya, Smart, Marshall, Atti, Anthony R, Olah, George A, Narayanan, S. R, Valdez, T, and Surampudi, S

Subjects
Energy Production And Conversion
Abstract

Direct Methanol Fuel Cells (DMFC's) using polymer electrolyte membranes are promising power sources for portable and vehicular applications. State of the art technology using Nafion(R) 117 membranes (Dupont) are limited by high methanol permeability and cost, resulting in reduced fuel cell efficiencies and impractical commercialization. Therefore, much research in the fuel cell field is focused on the preparation and testing of low crossover and cost efficient polymer electrolyte membranes. The University of Southern California in cooperation with the Jet Propulsion Laboratory is focused on development of such materials. Interpenetrating polymer networks are an effective method used to blend polymer systems without forming chemical links. They provide the ability to modify physical and chemical properties of polymers by optimizing blend compositions. We have developed a novel interpenetrating polymer network based on poly (vinyl - difluoride)/cross-linked polystyrenesulfonic acid polymer composites (PVDF PSSA). Sulfonation of polystyrene accounts for protonic conductivity while the non-polar, PVDF backbone provides structural integrity in addition to methanol rejection. Precursor materials were prepared and analyzed to characterize membrane crystallinity, stability and degree of interpenetration. USC JPL PVDF-PSSA membranes were also characterized to determine methanol permeability, protonic conductivity and sulfur distribution. Membranes were fabricated into membrane electrode assemblies (MEA) and tested for single cell performance. Tests include cell performance over a wide range of temperatures (20 C - 90 C) and cathode conditions (ambient Air/O2). Methanol crossover values are measured in situ using an in-line CO2 analyzer.

Published
1996

13. Co-occurence of Substance Use and Personality Disorders: Epidemiology, Etiopathogenesis, and Treatment

Author

Casadio P., Olivoni D., Bonafede R., Atti A. R., Casadio P., Olivoni D., Bonafede R., and Atti A.R.

Subjects
Personality disorder, Prevalence, food and beverages, Addiction, Dual diagnosi, Substance use disorders
Abstract

A recent population study has shown that among people manifesting a disorder related to alcohol and other substances, 28.6% and 47.7% respectively had at least one personality disorder (PD). Numerous sample studies have highlighted the presence of PDs in the drug-addicted population, estimating prevalence rates ranging from 44% to 79%. The most frequent PDs in the clinical sample were antisocial, borderline, avoidant, and paranoid PDs. Various types of relationship between addiction and PDs can be hypothesized: a common etiology (biological or psychic), an etiological relationship (predisposed personality or self-medication hypothesis), or one that is influenced reciprocally. PD comorbidity is associated with a spectrum of substance-correlated disorders, which are more chronic and severe and require many long-term therapeutic programs. Various psychotherapeutic treatments have proven to be efficacious with respect to reducing personality pathology and improving social functioning. This is especially true for cognitive-behaviorally or psychodynamically oriented individual psychotherapies. Considering the models of services organization, dual diagnosis patients can be better treated by using an integrated model with approaches that bridge the gap between the psychiatric and addiction services.

Published
2016

14. Association between Sirtuin 2 gene rs10410544 polymorphism and depression in Alzheimer's disease in two independent European samples

Author

Porcelli, S. Salfi, R. Politis, A. Atti, A. R. Albani, D. Lia, L. Papadimitriou, G. N. De Ronchi, D. Serretti, A.

Abstract

Among the several genes associated with late-onset Alzheimer's disease (LOAD), recently, Sirtuin genes have roused a growing interest because of their involvement in metabolic homeostasis and in brain aging. Particularly SIRT2 gene has been associated with Alzheimer's disease (AD) as well as with mood disorders. The aim of this study is to investigate the possible associations between Sirtuin 2 gene (SIRT2) rs10410544 polymorphism and AD as well as depression in AD. In addition, we performed some exploratory analyses to investigate possible associations between the rs10410544 genotype and clinical features. We investigated these associations in two independent samples: the first one was composed of 275 Greek inhabitants and 117 patients; the second sample counted 181 Italian people and 43 patients. All patients were affected by LOAD. We failed to find any association between rs10410544 genotype and AD in the two samples. On the other hand, we found an association between the single nucleotide polymorphism (SNP) and depressive symptomatology (in the total sample p = 0.002), which was modulated by the tumor necrosis factor (TNF) values. Particularly, TT genotype seems to be protective versus depression. Finally, in the exploratory analyses, we found that the TT genotype was associated with earlier AD onset and a longer duration of the illness. In conclusion, we confirmed the association between SIRT2 gene and mood disturbances, although in AD patients. Further, we provided evidence that the TT genotype may be protective versus depressive symptoms, allowing an easier and thus earlier diagnosis of AD. This awareness may lead to a more detailed approach to these patients concerning diagnosis and therapy. © 2013 Springer-Verlag Wien.

Published
2013

15. The missing link between philosophy and psychopathology.

Author

Scudellari, P., Valente, S., Maldini, M., Atti, A. R., and De Ronchi, D.

Subjects
PATHOLOGICAL psychology, PSYCHIATRY, SOCIAL sciences, COGNITIVE Strategy Instruction, CLINICAL trials
Abstract

Introduction. The uncertainty regarding the scientific status of psychiatry arises from psychiatry's involvement with some unsolved problems, or put in another way, from its enmeshment in certain points of transition of contemporary science. There is, in primis, the unsolved problem of the relationship between the mind and the body and, moreover, the intricate relationship of connection/disjunction among biology, social science, anthropology, philosophy, etc. To speak about what psychopathology can expect from philosophy is, above all, to immerse oneself in a debate about the conditions of possibility of psychiatry as a science. This debate is especially concerned with the models of knowledge that have, until now, been proposed to psychiatry. Those models oscillate between the Dilthey's paradigms of the "Science of Nature" and the "Science of Spirit". Methods. It is certain that psychopathology, as already indicated by Jaspers, is a discipline which is among the most involved regarding the use of the two different cognitive strategies. The first strategy concerns the concept of "explanation" and its rigid approach to the objective and ultimate cause of the phenomenon. The second strategy is the "comprehensive" approach. This model, which the hermeneutic thought defines "interpretative", theorizes the provisional character, the subjectiveness and the finiteness of every cognitive project. Results. The interest of the authors is orientated towards the hermeneutic side (comprehensive-interpretative) of psychiatry, that which deals with the specificity of every clinical history, with the continuity of sense, and with intrinsic narrative intelligibility of every human event, psychopathological or not. Discussion. This approach to psychopathology is based on the statement: "a clinical history is a text which must be interpreted". From this perspective, every clinical history should be perceived as a text to decipher but, above all, as a "text" to listen to, in the persevering expectation that it could disclose its particular "project of world". When speaking about psychiatry, we always face a problem which dominates all the others: the unsolved problem of the relationship between typicalness and singularity of subjective events. B.B. Mandelbrot, theorist of "fractals", sums this dilemma up clearly. He suggests that the innumerable variety of the configurations of Nature is a challenge to investigate the morphology of that which is "irregular" in order to discover in it, as far as possible, a rule. [ABSTRACT FROM AUTHOR]

Published
2018
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17. Consulenze, certificazioni e problematiche di genere

Author

Ferrari, Silvia, Moretti, Valentina, Pighi, Marcella, Atti, A. R., Martire, Lisa, Tedeschini, Enrico, and Rigatelli, Marco

Subjects
psichiatria di consultazione, certificazioni, sesso femminile
Published
2012

18. Violence against women and mental health

Author

Amorosi, M., Atti, A. R., Botter, V., Calo, P., Clemente, P., De Ronchi, D., Ferrari, S., Iacopini, P., Lorettu, L., Orru, G., Roncone, R., Zuccolin, M., and Martino, C.

Published
2012

22. Anti-edema drugs and short-term mortality in older patients with acute ischemic stroke

Author

Ranzini M., Atti A. R., Ble A., VaValle C., Di Todaro F., Benedetti C., Marinescu M. G., Fellin R., Cherubini A., Zuliani G., Ranzini M., Atti A.R., Ble A., VaValle C., Di Todaro F., Benedetti C., Marinescu M.G., Fellin R., Cherubini A., and Zuliani G.

Subjects
Glycerol, Ischemic stroke, Mannitol, Steroids, Short-term mortality
Abstract

Objectives: There are only few evidences concerning the possible effect of antiedema agents on stroke outcome. In this study we evaluated the effect of the treatment with intravenous (EV) glycerol or mannitol, and corticosteroids on short-term mortality (30 days) in a sample of older patients admitted to hospital for acute ischemic stroke. Methods: Data concerning 442 subjects (mean age 78.6 ± 8.9 years; 58.3% females) consecutively admitted to Internal Medicine and Geriatrics University Department for acute ischemic stroke have been collected with regard to clinical history, clinical and neurological examination, laboratory parameters, and brain computed tomography scan. Results: No reduction in the risk of death was observed in patients tre ated with EV glycerol; conversely, an increase in short-term mortality was observed in patients who were contemporary treated with EV corticosteroids. Mannitol treatment was not associated with a decrease in the risk of death too; the contemporary treatment with EV steroids was not associated with significant changes in mortality risk. The treatment with either glycerol or mannitol was not associated with a decrease in the risk of death, but the contemporary therapy with corticosteroids confirmed to be associated with an increased mortality risk. Conclusions: Our study does not support the effectiveness of EV glycerol or mannitol in reducing short-term mortality in older subjects with acute ischemic stroke; nevertheless, our data suggest a possible harmful effect of EV corticosteroids on short-term mortality.

Published
2006

23. Leukoaraiosis is associated with functional impairment in older patients with Alzheimer's disease but not vascular dementia

Author

Ble, A., Ranzini, M., Zurlo, A., Menozzi, L., Atti, A. R., Munari, M. R., Stefano Volpato, Scaramelli, G., Fellin, R., Zuliani, G., Ble A., Ranzini M., Zurlo A., Menozzi L., Atti A.R., Munari M.R., Volpato S., Scaramelli G., Fellin R., and Zuliani G.

Subjects
Aged, 80 and over, Male, Analysis of Variance, Dementia, Vascular, DISABILITY, DEMENTIA, LEUKOARAIOSIS, Brain, Severity of Illness Index, Cross-Sectional Studies, Logistic Models, Alzheimer Disease, Activities of Daily Living, Humans, ALZHEIMER, Female, Tomography, X-Ray Computed, Aged
Abstract

BACKGROUND: Leukoaraiosis (LA) is a common finding in older persons, and might be associated with reduced cognitive performance, gait abnormalities, and functional impairment. Although LA is more frequent in persons affected by dementia, scant data are available about its clinical consequences in this group of patients. OBJECTIVE: To study the association between presence of LA and functional performance in basic activities of daily living in a sample of older persons affected by dementia. DESIGN: We conducted a cross-sectional study on 214 patients; 77 affected by late onset Alzheimer's disease (LOAD), and 137 by vascular dementia (VD). Functional status was assessed using Barthel Index (BI). LA was assessed using computed tomography. RESULTS: In LOAD patients, LA (OR: 7.87; 1.26-48.94), and MMSE score (OR: 0.83; 0.71-0.98) were associated with the risk of severe disability, independent of age, gender, diabetes, hypertension, coronary heart disease, left ventricular hypertrophy, atrial fibrillation, and brain atrophy. In VD patients, MMSE score (OR: 0.77; 0.64-0.93), and CHD (OR: 7.41; 1.09-50.21), but not LA (OR: 2.07; 0.45-9.45) were associated with a severe functional impairment after multivariate adjustment. CONCLUSIONS: Our study suggests that LA might be associated with a worse functional status in basic activities of daily living in patients affected by LOAD but not VD. LA might act synergistically with cognitive and behavioural disturbances to the onset and progression of disability of these patients.

Published
2006

25. Fever increases the risk of death in elderly subjects with ischemic stroke

Author

Atti A. R., Ble A., Di Todaro F., Maraldi C., Ranzini M., Benedetti C., Ruggiero C., Cherubini A., Fellin R., Zuliani G., Atti A.R., Ble A., Di Todaro F., Maraldi C., Ranzini M., Benedetti C., Ruggiero C., Cherubini A., Fellin R., and Zuliani G.

Subjects
Ischemic stroke, Fever, Body temperature, Short-term mortality
Abstract

Objective: In animal models with cerebral ischemia, an increase in body temperature is associated with a larger infarction size. In patients with acute ischemic stroke body temperature within normal values is associated with lower mortality and few neurological defects. The aim of our study is to verify whether an increase in body temperature is an independent predictor of short term mortality. Methods: Data concerning 359 old patients consecutively admitted to Internal Medicine ad Geriatrics university Department for "major" acute ischemic stroke have been collected with regard to clinical history, clinical and neurological examination, and laboratory parameters. Fever has been defined as a body temperature higher than 37° Celsius occurred within the first week after admission to the hospital. Short term mortality (within 30 days) was the main outcome of the study. Results: The overall short-term mortality was 28.3%. Among subjects with fever (136, 37.9%) occurred 52.9% of deceased. Fever was associated with mortality at the univariate logistic analysis (OR = 4.8 IC 95% 3.1-7.8; p = 0.001). After multivariate adjustment for potential confounders the risk of death was still double in subjects with high body temperature (OR = 2.1 IC 95%: 1.1-4.3; p = 0.002). Conclusions: Our study confirm the role of fever as predictor of short-term mortality in old subjects with ischemic stroke. This association seems to be independent of many conditions possibly related with fever or death.

Published
2004

26. Midlife overweight and obesity increase late-life dementia risk : a population-based twin study

Author

Xu, W. L., Atti, A. R., Gatz, M., Pedersen, N. L., Johansson, B., Fratiglioni, L., Xu, W. L., Atti, A. R., Gatz, M., Pedersen, N. L., Johansson, B., and Fratiglioni, L.

Abstract

Objective: The relation of overweight to dementia is controversial. We aimed to examine the association of midlife overweight and obesity with dementia, Alzheimer disease (AD), and vascular dementia (VaD) in late life, and to verify the hypothesis that genetic and early-life environmental factors contribute to the observed association. Methods: From the Swedish Twin Registry, 8,534 twin individuals aged ≥65 (mean age 74.4) were assessed to detect dementia cases (DSM-IV criteria). Height and weight at midlife (mean age 43.4) were available in the Registry. Data were analyzed as follows: 1) unmatched case-control analysis for all twins using generalized estimating equation (GEE) models and 2) cotwin matched case-control approach for dementia-discordant twin pairs by conditional logistic regression taking into account lifespan vascular disorders and diabetes. Results: Among all participants, dementia was diagnosed in 350 subjects, and 114 persons had questionable dementia. Overweight (body mass index [BMI] >25-30) and obesity (BMI >30) at midlife were present in 2,541 (29.8%) individuals. In fully adjusted GEE models, compared with normal BMI (20-25), overweight and obesity at midlife were related to dementia with odds ratios (ORs) (95% CIs) of 1.71 (1.30-2.25) and 3.88 (2.12-7.11), respectively. Conditional logistic regression analysis in 137 dementia-discordant twin pairs led to an attenuated midlife BMI-dementia association. The difference in ORs from the GEE and the matched case-control analysis was statistically significant (p = 0.019). Conclusions: Both overweight and obesity at midlife independently increase the risk of dementia, AD, and VaD. Genetic and early-life environmental factors may contribute to the midlife high adiposity-dementia association.

Published
2011
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28. Perceived insecurity, mental health and urbanization: Results from a multicentric study.

Author

Luciano, M., De Rosa, C., Del Vecchio, V., Sampogna, G., Sbordone, D., Atti, A. R., Bardicchia, F., Bertossi, F., Calò, S., Cava, L., Ciafone, M., De Fazio, P., Di Iorio, G., Fantini, E., Ferrari, S., Ginanneschi, A., Gotelli, S., Macina, A., Mulè, A., and Papanti, D.

Subjects
COMPETENCY assessment (Law), AFFECTIVE disorders, ATTITUDE (Psychology), METROPOLITAN areas, SENSORY perception, PESSIMISM, PSYCHOLOGICAL stress, UNCERTAINTY, ANXIETY disorders
Abstract

Aims: This article aims to (1) explore the levels of perceived insecurity in a sample of patients with mood or anxiety disorders and (2) assess whether living in ‘big cities’ can influence the levels of patients’ perceived insecurity and social contacts compared to living in a non-urbanized context. Methods: A total of 24 Italian mental health centers (MHCs) have been invited to participate. Twenty patients consecutively accessing the MHC have been recruited. All patients have been assessed using validated assessment tools. Results: The sample consisted of 426 patients, mostly female, with a mean age of 45 years. Globally, 52.2% of patients had a diagnosis of mood disorders, and 37.8% had anxiety disorders. Half of the sample declared that the main feeling toward life is uncertainty; higher levels of pessimistic views toward life have been detected in patients living in urban areas. A positive association between negative attitudes toward life and higher levels of depressive and anxiety symptoms, poor social functioning and higher levels of perceived psychological distress has been found. Conclusion: Our findings confirm the presence of a common sense of perceived uncertainty among our sample. Such attitude toward life can have a detrimental impact on patients’ psychological and physical well-being, contributing to high levels of distress. [ABSTRACT FROM AUTHOR]

Published
2016
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33. Eating disorders and diabetes: A meta-analysis.

Author

Mastellari, T., Speciani, M., Gelati, F. F., De Ronchi, D., Panariello, F., and Atti, A. R.

Subjects
EATING disorders, TYPE 2 diabetes, TYPE 1 diabetes, FOOD habits, GLYCEMIC control
Abstract

Introduction: Diabetic patients are asked to focus on their eating habits and calories intake. Together with individual factors, this could increase the risk of developing Eating Disorders (ED) associated with diabetes. A score of 20 points at the Diabetes Eating Problem Survey-Revised (DEPS-R) scale is considered as a valid threshold to identify Disordered Eating Behaviours (DEB) in diabetic patients. DEB can be considered as altered eating behaviours not fully meeting criteria for ED. As DEB are not formally recognised as specific ED in DSM-5, there is a great risk of not detecting them, thus underestimate their consequences. Objectives: To meta-analyse literature on ED and DEB, when in comorbidity with Type 1 and Type 2 Diabetes Mellitus, focusing on pathological medical consequences. Methods: PRISMA guidelines were followed for this meta-analysis. Articles were identified in literature by searching into PubMed, PsycINFO and Embase. Results: 1141 records were identified through database search. Figure 1 shows six studies comparing HbA1c % values for 2857 diabetic patients versus 752 diabetic patients with DEB. HbA1c % levels appear to be higher in patients with DEPS-R = 20, compared to those with DESP-R scores below 20. Conclusions: Routine screening for DEB using DEPS-R scale could favour early identification of diabetic individuals, at risk for progression into a proper ED. Clinicians should be vigilant about potential DEB when patients show poor long-term glycaemic control; similarly, patients with a DEPS-R score over 20 points may require more frequent glycaemic checks. This could help prevent serious medical complications. [ABSTRACT FROM AUTHOR]

Published
2021
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34. Antidepressant therapeutic drug monitoring by minimally-invasive techniques in eating disorders patients: preliminary results from a pilote study.

Author

Mastellari, T., Di Gianni, A., Marasca, C., Protti, M., Mercolini, L., Atti, A. R., and De Ronchi, D.

Subjects
DRUG monitoring, EATING disorders, PEDIATRIC urology, DRUG therapy, BULIMIA, BODY mass index, ANTIDEPRESSANTS
Abstract

Introduction: Therapeutic Drug Monitoring (TDM) has several indications in psychiatry including patients with physical comorbidities, suspected non-compliance, severe adverse effects and tailored pharmacotherapy. Antidepressants (AD) are frequently prescribed in patients with Eating Disorders (ED) to reduce binge-eating and compensatory behaviours or to treat comorbid depression and anxiety. Objectives: TDM by means of minimally-invasive biosampling approaches may represent a useful tool in this population, considering the limited efficacy of ED's pharmacological treatment and the high rate of adverse effects. Methods: Nineteen ED outpatients on AD treatment with a Body Mass Index (BMI) <20 kg/m2 or >30 kg/m2 agreed to take part in the present study. Participants were treated with Sertraline (N=5), Fluoxetine (N=5), Vortioxetine (N=5), Citalopram (N=2), Escitalopram (N=1), Fluvoxamine (N=1). Oral fluid samples were collected from patients, together with whole blood dried microsamples, obtained by finger puncture using Volumetric Absorptive Microsampling techniques. Results: Preliminary results showed a significant correlation between plasmatic and salivary concentrations for Vortioxetine only; moreover, extreme BMI did not seem to significantly influence the AD' plasmatic concentrations, when corrected for dosage. Conclusions: Further analyses may permit to validate for the first time the use of these recent microsampling procedures for AD treatment. By increasing the population size, we aim to demonstrate that TDM may represent a valid tool to better understand the limited efficacy of AD in ED patients. Minimally-invasive biosampling approach is well tolerated in patients with belenophobia and, in our experience, is highly appreciated by all patients: it may represent in future a valid support for Precision Medicine. [ABSTRACT FROM AUTHOR]

Published
2020

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

Author

Zuliani, Giovanni, Ble', Alessandro, Zanca, Rosanna, Munari, Maria Rosa, Zurlo, Amedeo, Vavalle, Chella, Atti, Anna Rita, Fellin, Renato, Zuliani, G, Ble', A, Zanca, R, Munari, M R, Zurlo, A, Vavalle, C, Atti, A R, and Fellin, R

Subjects
LIPOPROTEINS, OLDER people, VASCULAR dementia, ALZHEIMER'S disease, CHOLESTEROL
Abstract

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; no degrees: 60) or Late Onset Alzheimer's Disease (LOAD; no degrees: 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. [ABSTRACT FROM AUTHOR]

Published
2001
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39. Rates of comorbid obsessive-compulsive disorder in eating disorders: A meta-analysis of the literature

Author

Diana De Ronchi, Stefano Draghetti, Anna Rita Atti, Laura Mandelli, Umberto Albert, Mandelli, L., Draghetti, S., Albert, U., De Ronchi, D., Atti, A. -R., Mandelli L., Draghetti S., Albert U., De Ronchi D., and Atti A.-R.

Subjects
Obsessive-Compulsive Disorder, Anorexia Nervosa, Binge eating, Comorbidity, behavioral disciplines and activities, Feeding and Eating Disorders, 03 medical and health sciences, 0302 clinical medicine, mental disorders, Medicine, Humans, Feeding and Eating Disorder, Prospective Studies, Bulimia, Anorexia, Eating disorders, Obsessive-compulsive disorder, Cross-Sectional Studies, Cross-Sectional Studie, business.industry, Bulimia nervosa, Confounding, Eating disorder, Publication bias, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, Clinical Psychology, Prospective Studie, Anorexia nervosa (differential diagnoses), Meta-analysis, medicine.symptom, business, 030217 neurology & neurosurgery, Clinical psychology, Human
Abstract

Background The high comorbidity between Eating Disorders (EDs) and Obsessive-Compulsive disorder (OCD) is well known, as well as its implications in terms of worse outcome and need to adapt treatment. Estimates of OCD comorbidities in EDs are variable in different studies and poorly informative for clinical purposes. In this study, we sought to derive more consistent estimates, taking into account potential methodological and sampling confounding factors. Methods We searched published studies reporting lifetime and current rates of comorbid OCD in ED samples based on recent diagnostic criteria. Comorbidity rates were meta-analyzed using a binary random effects model. Heterogeneity among the studies and publication bias were systematically checked. Potential confounding factors were tested by meta-regression analysis and adjusted by sensitivity analysis. Results Globally, respectively 18% and 15% of all patients with an ED had a lifetime and current comorbidity with OCD. Rates were slightly higher in anorexia (19% and 14%) than in bulimia nervosa (13% and 9%), although only the current comorbid OCD was significantly higher in anorexia than in bulimia. Prospective follow-up studies provided considerably higher lifetime estimates (EDs 38%, anorexia 44%, bulimia 19%). Limitations Temporal/causal relationship between ED and OCD could not be defined. Conclusions OCD comorbidity in EDs is a relevant phenomenon, affecting almost one fifth of the patients in cross-sectional observations and up to nearly 40% in prospective follow-up studies. These data indicate the need for focused attention to non-food or body-shape related OCD symptoms, for better diagnostic and prognostic accuracy, and targeted treatment.

Published
2020

40. Is orthorexia nervosa a feature of obsessive–compulsive disorder? A multicentric, controlled study

Author

F Luisi, Gian Maria Galeazzi, A Cutino, Margherita Pinelli, Silvia Ferrari, Anna Rita Atti, G Vaccari, G Maina, Nina Giambalvo, Umberto Albert, S Navab Daneshmand, S Kaleci, Vaccari, G., Cutino, A., Luisi, F., Giambalvo, N., Navab Daneshmand, S., Pinelli, M., Maina, G., Galeazzi, G. M., Kaleci, S., Albert, U., Atti, A. R., Ferrari, S., Vaccari G., Cutino A., Luisi F., Giambalvo N., Navab Daneshmand S., Pinelli M., Maina G., Galeazzi G.M., Kaleci S., Albert U., Atti A.R., and Ferrari S.

Subjects
050103 clinical psychology, Obsessive-Compulsive Disorder, Diagnostic criteria, Psychometrics, 030309 nutrition & dietetics, Population, Health Behavior, Obsessive–compulsive disorder, Feeding and Eating Disorders, Eating disorders, Orthorexia nervosa, ORTO-15, ORTO-R, Psychopathology, 03 medical and health sciences, Surveys and Questionnaires, Post-hoc analysis, medicine, Humans, Surveys and Questionnaire, Feeding and Eating Disorder, 0501 psychology and cognitive sciences, education, 0303 health sciences, education.field_of_study, biology, business.industry, Athletes, 05 social sciences, Eating disorder, Regression analysis, Feeding Behavior, medicine.disease, biology.organism_classification, Psychiatry and Mental health, Clinical Psychology, Observational study, business, Psychometric, Clinical psychology, Human
Abstract

Purpose: The term orthorexia nervosa (ON) was coined to describe altered thoughts and behaviours related to healthy eating. The prevalence of ON was found to scale up to almost 90% among high-risk populations (ballet dancers, athletes, and health workers). ON seem to share psychopathological aspects with both Eating Disorders (ED) and Obsessive–Compulsive Disorder (OCD). The aim of the study was to analyse the frequency and intensity of ON symptoms among subjects diagnosed with OCD, hypothesising that they would be higher than in two control groups (subjects with anxiety-depressive disorders and general population). Methods: We conducted a multi-centre, observational, controlled study. Subjects filled in a socio-demographic questionnaire including questions related to life-style and two psychometric instruments: ORTO-15, for ON symptoms, and OCI-R, for OCD symptoms. Post hoc analysis of the dataset was performed using the revised version of ORTO-15, the ORTO-R. Results: In the final sample of 328 subjects, the overall prevalence of ORTO-15-ON was 59.5%, mean score 37.9 ± 4.2. The mean score at the ORTO-R was 16.6 ± 4.6. No statistically significant differences were found in the prevalence of ON or in the mean ORTO-15 score among OCD patients and the two control groups, and this was confirmed by the multiple regression analysis. At the ORTO-R re-scoring, OCD patients scored significantly lower than the two clinical subgroups (p =.0005) and a lower ORTO-R score was associated to positivity at the OCI-R, confirming the initial hypothesis of the study. Conclusions: ON symptoms do seem to be more prevalent among subjects suffering from OCD. The psychometric properties of tools available to calculate ON symptoms, namely ORTO-15 vs. ORTO-R, play a relevant role in explaining such finding. ORTO-R seems to be a valid alternative able to overcome such difficulties, though further studies are needed to confirm this.

Published
2021

41. The complex relationship between self-reported 'personal recovery' and clinical recovery in schizophrenia

Author

Rossi, A, Amore, M, Galderisi, S, Rocca, P, Bertolino, A, Aguglia, E, Amodeo, G, Bellomo, A, Bucci, P, Buzzanca, A, Carpiniello, B, Comparelli, A, Dell'Osso, L, Giannantonio, M, Mancini, M, Marchesi, C, Monteleone, P, Montemagni, C, Oldani, L, Roncone, R, Siracusano, A, Stratta, P, Tenconi, E, Vignapiano, A, Vita, A, Zeppegno, P, Maj, M, Rossetti, M, Rossi, R, Santarelli, V, Giusti, L, Malavolta, M, Salza, A, Palumbo, D, Patriarca, S, Chieffi, M, Attrotto, M, Colagiorgio, L, Andriola, I, Atti, A, Barlati, S, Deste, G, Galluzzo, A, Pinna, F, Deriu, L., Sanna, L, Signorelli, M., Minutolo, G, Cannavò, D, Martinotti, G, Acciavatti, T, Corbo, M, Altamura, M, Carnevale, R, Malerba, S, Murri, M, Calcagno, P, Bugliani, M, Serati, M, Bartolomeis, A, Gramaglia, C, Gattoni, E, Gambaro, E, Collantoni, E, Cremonese, C, Rossi, E, Ossola, P, Tonna, M, Panfilis, C, Rutigliano, G, Gesi, C, Carmassi, C, Biondi, M, Girardi, P, Brugnoli, R, Fabio, F, Pietro, S, Girardi, N, Niolu, C, Lorenzo, G, Ribolsi, M, Corrivetti, G, Pinto, G, Longobardi, N, Fagiolini, A, Goracci, A, Bolognesi, S, Bellino, S, Villari, V, Bracale, N, Rossi, A., Amore, M., Galderisi, S., Rocca, P., Bertolino, A., Aguglia, E., Amodeo, G., Bellomo, A., Bucci, P., Buzzanca, A., Carpiniello, B., Comparelli, A., Dell'Osso, L., Giannantonio, M. D., Mancini, M., Marchesi, C., Monteleone, P., Montemagni, C., Oldani, L., Roncone, R., Siracusano, A., Stratta, P., Tenconi, E., Vignapiano, A., Vita, A., Zeppegno, P., Maj, M., Rossetti, M. C., Rossi, R., Santarelli, V., Giusti, L., Malavolta, M., Salza, A., Palumbo, D., Patriarca, S., Chieffi, M., Attrotto, M. T., Colagiorgio, L., Andriola, I., Atti, A. R., Barlati, S., Deste, G., Galluzzo, A., Pinna, F., Deriu, L., Sanna, L., Signorelli, M. S., Minutolo, G., Cannavo, D., Martinotti, G., Acciavatti, T., Corbo, M., Altamura, M., Carnevale, R., Malerba, S., Murri, M. B., Calcagno, P., Bugliani, M., Serati, M., Bartolomeis, A., Gramaglia, C., Gattoni, E., Gambaro, E., Collantoni, E., Cremonese, C., Rossi, E., Ossola, P., Tonna, M., Panfilis, C. D., Rutigliano, G., Gesi, C., Carmassi, C., Biondi, M., Girardi, P., Brugnoli, R., Fabio, F. D., Pietro, S. D., Girardi, N., Niolu, C., Lorenzo, G. D., Ribolsi, M., Corrivetti, G., Pinto, G., Longobardi, N., Fagiolini, A., Goracci, A., Bolognesi, S., Bellino, S., Villari, V., and Bracale, N.

Subjects
Adult, Male, Schizophrenia, Personal recovery, Clinical recovery, Insight, Recovery styles, Cluster analysis, Clinical recovery, Coping (psychology), Cross-sectional study, Recovery style, 03 medical and health sciences, Diagnostic Self Evaluation, 0302 clinical medicine, Cluster analysis, Recovery styles, Insight, Personal recovery, Schizophrenia, Cluster Analysis, Cross-Sectional Studies, Female, Humans, Psychiatric Status Rating Scales, Self Report, Recovery of Function, Schizophrenic Psychology, Cluster analysi, Self report, Settore MED/25 - Psichiatria, Biological Psychiatry, 030227 psychiatry, Psychiatry and Mental Health, Psychiatric status rating scales, Biological psychiatry, Psychology, 030217 neurology & neurosurgery, Clinical psychology
Abstract

Self-reported 'personal recovery' and clinical recovery in schizophrenia (SRPR and CR. respectively) reflect different perspectives in schizophrenia outcome, not necessarily concordant with each other and usually representing the consumer's or the therapist's point of view. By means of a cluster analysis on SRPR related variables, we identified three dusters. The first and third cluster included subjects with the best and the poorest clinical outcome respectively. The second cluster was characterized by better insight, higher levels of depression and stigma, lowest self-esteem and personal strength, and highest emotional coping. The first duster showed positive features of recovery, while the third duster showed negative features. The second cluster, with the most positive insight, showed a more complex pattern, a some-what 'paradoxical' mixture of positive and negative personal and clinical features of recovery. The present results suggest the need for a characterization of persons with schizophrenia along SRPR and CR dimensions to design individualized and integrated treatment programs aimed to improve insight and coping strategies, reduce stigma and shape recovery styles. (C) 2017 Elsevier B.V. All rights reserved.

Published
2018

42. Assessment of de novo copy-number variations in Italian patients with schizophrenia: Detection of putative mutations involving regulatory enhancer elements

Author

Piluso, Giulio, Monteleone, Palmiero, Galderisi, Silvana, Giugliano, Teresa, Bertolino, Alessandro, Rocca, Paola, Rossi, Alessandro, Mucci, Armida, Aguglia, Eugenio, Andriola, Ileana, Bellomo, Antonello, Comparelli, Anna, Gambi, Francesco, Fagiolini, Andrea, Marchesi, Carlo, Roncone, Rita, Sacchetti, Emilio, Santonastaso, Paolo, Siracusano, Alberto, Stratta, Paolo, Tortorella, Alfonso, Steardo, Luca Jr, Bucci, Paola, Nigro, Vincenzo, Maj, Mario, Italian Network for Research on Psychoses, Montefusco, Valentina, Plescia, Giuseppe, Piegari, Giuseppe, Merlotti, Eleonora, Cimmino, Monica, Savarese, Marco, D’Ambrosio, Enrico, Atti, Anna Rita, Valsecchi, Paolo, Signorelli, Maria Salvina, Acciavatti, Tiziano, Altamura, Mario, Arzani, Costanza, Callista, Gaetano, Pacitti, Francesca, Oldani, Lucio, Gramaglia, Carla, Tenconi, Elena, Camerlengo, Annalisa, Dell’Osso, Liliana, Brugnoli, Roberto, Di Fabio, Fabio, Niolu, Cinzia, Corrivetti, Giulio, Bolognesi, Simone, Montemagni, Cristina, Piluso, G., Monteleone, P., Galderisi, S., Giugliano, T., Bertolino, A., Rocca, P., Rossi, A., Mucci, A., Aguglia, E., Andriola, I., Bellomo, A., Comparelli, A., Gambi, F., Fagiolini, A., Marchesi, C., Roncone, R., Sacchetti, E., Santonastaso, P., Siracusano, A., Stratta, P., Tortorella, A., Steardo, L., Bucci, P., Nigro, V., Maj, M., Montefusco, V., Plescia, G., Piegari, G., Merlotti, E., Cimmino, M., Savarese, M., D'Ambrosio, E., Atti, A. R., Valsecchi, P., Signorelli, M. S., Acciavatti, T., Altamura, M., Arzani, Costanza., Callista, G., Pacitti, F., Oldani, L., Gramaglia, C., Tenconi, E., Camerlengo, A., Dell'Osso, L., Brugnoli, R., Di Fabio, F., Niolu, C., Corrivetti, G., Bolognesi, S., and Montemagni, C.

Subjects
family trios, Adult, Male, DNA Copy Number Variations, Schizophrenia (object-oriented programming), Schizophrenia, de novo CNV, enhancers, genetics, Schizophrenia, genetics, enhancers, de novo CNV, family trios, family trio, Biology, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, mental disorders, Humans, Genetic Predisposition to Disease, Copy-number variation, Enhancer, Gene, Biological Psychiatry, Enhancer Elements, Genetics, Middle Aged, 030227 psychiatry, Enhancer Elements, Genetic, Settore MED/25, Italy, Psychiatry and Mental Health, Mutation, Female, enhancer, genetic, Biological psychiatry
Abstract

Objectives: Variants appearing de novo in genes regulating key neurodevelopmental processes and/or in non-coding cis-regulatory elements (CREs), as enhancers, may increase the risk for schizophrenia. However, CREs involvement in schizophrenia needs to be explored more deeply. Methods: We investigated de novo copy-number variations (CNVs) in the whole-genomic DNA obtained from 46 family trios of schizophrenia probands by using the Enhancer Chip, a customised array CGH able to investigate the whole genome with a 300-kb resolution, specific disease loci at a ten-fold higher resolution, and which was highly enriched in probes in more than 1,250 enhancer elements selected from Vista Enhancer Browser. Results: In seven patients, we found de novo CNVs, two of which overlapped VISTA enhancer elements. De novo CNVs encompass genes (CNTNAP2, MAGI1, TSPAN7 and MET) involved in brain development, while that involving the enhancer element hs1043, also includes ZIC1, which plays a role in neural development and is responsible of behavioural abnormalities in Zic mutant mice. Conclusions: These findings provide further evidence for the involvement of de novo CNVs in the pathogenesis of schizophrenia and suggest that CNVs affecting regulatory enhancer elements could contribute to the genetic vulnerability to the disorder.

Published
2017

43. Never too late to be anxious: Validation of the geriatric anxiety inventory, Italian version

Author

Ferrari, S, Signorelli, M. S, Pingani, L, Massimino, M, Bonasegla, P, Arcidiacono, E, Rigatelli, M, Aguglia, E, CERRATO, FERDINANDO, VALENTE, STEFANO, FORLANI, MARTINA, DE RONCHI, DIANA, ATTI, ANNA-RITA, Ferrari, S, Signorelli, M S, Cerrato, F, Pingani, L, Massimino, M, Valente, S, Forlani, M, Bonasegla, P, Arcidiacono, E, De Ronchi, D, Rigatelli, M, Aguglia, E, and Atti, A R

Subjects
Male, validity, Psychogeriatric, Psychogeriatrics, Psychometrics, Old age, Anxiety, Consultation-liaison psychiatry, Screening, Validity, Aged, Aged, 80 and over, Female, Humans, Italy, Language, Reproducibility of Results, Sensitivity and Specificity, Psychiatric Status Rating Scales, 80 and over, old age, screening, psychogeriatrics, consultation-liaison, psychiatry
Abstract

AIM: The aim of this work was to validate the Italian version of GAI (GAI-It) and its short form (GAI-It SF) in an over 65-population. METHODS: In 3 recruitment areas across Italy, two raters reciprocally blind to results assessed eligible subjects; a semi-structured diagnostic clinical interview was performed by a psychiatrist. RESULTS: Among the 76 enrolled subjects (mean age 72.7±6.8 years), anxiety symptoms were very common: 69.7% (moderate/ severe HADS-Anxiety), 76.3% (moderate/severe STAI-state), 71.0% (moderate/severe STAI-trait), 61.8% (GAI), 55.3% (GAI-SF). Sensitivity, specificity and positive predictive value of GAI confirmed a good reliability of the Italian version, with Cronbach's Alpha equal to 0.93 for GAI-It and to 0.77 for GAI-It SF, indicating a very good and good construct validity, respectively, of the scales. The Pearson correlation index demonstrated a moderately positive correlation among GAI, GAI-SF and STAI. CONCLUSIONS: Our data confirm the validity of GAI-It as a valuable instrument to assess anxiety in an elderly population, for clinical and research purposes.

Published
2017

44. Perceived insecurity, mental health and urbanization: Results from a multicentric study

Author

Antonio Ventriglio, C. De Rosa, Giuseppe Carrà, Francesco Catapano, P De Fazio, D. Sbordone, Gaia Sampogna, Andrea Fiorillo, Mario Luciano, Francesco Bardicchia, Anna Rita Atti, Federica Pinna, L Cava, Silvia Ferrari, Salvatore Calò, Massimiliano Piselli, Ilaria Tarricone, A Ginanneschi, Luca Pingani, Lorenzo Tarsitani, Simona Gotelli, D Papanti, F Bertossi, Signorelli, Alice Mulè, V. Del Vecchio, M Ciafone, A Macina, E Fantini, G Di Iorio, Luciano, Mario, De Rosa, C., Del Vecchio, V., Sampogna, G., Sbordone, D., Atti, A. R., Bardicchia, F., Bertossi, F., Calò, S., Cava, L., Ciafone, M., De Fazio, P., Di Iorio, G., Fantini, E., Ferrari, S., Ginanneschi, A., Gotelli, S., Macina, A., Mulè, A., Papanti, D., Pingani, L., Pinna, F., Piselli, M., Signorelli, M. S., Tarricone, I., Tarsitani, L., Ventriglio, A., Carrà, G., Catapano, Francesco, Fiorillo, Andrea, Luciano, M, DE ROSA, S, Del Vecchio, V, Sampogna, G, Sbordone, D, Atti, A, Bardicchia, F, Bertossi, F, Calo', S, Cava, L, Ciafone, M, De Fazio, P, Di Iorio, G, Fantini, E, Ferrari, S, Ginanneschi, A, Gotelli, S, Macina, A, Mulè, A, Papanti, D, Pingani, L, Pinna, F, Piselli, M, Signorelli, M, Tarricone, I, Tarsitani, L, Ventriglio, A, Carra', G, Catapano, F, Fiorillo, A, Atti, A.R., Signorelli, M.S., Catapano, F., and Fiorillo, A.

Subjects
Adult, Hospitals, Psychiatric, Male, social cohesion, urban mental health, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Perceived insecurity, uncertainty, urbanization, Anxiety Disorders, Female, Humans, Italy, Middle Aged, Mood Disorders, Perception, Psychiatric Status Rating Scales, Quality of Life, Surveys and Questionnaires, Urban Health, Urbanization, Mental Health, Uncertainty, Rating scale, medicine, 030212 general & internal medicine, medicine.disease, Mental health, Hospitals, 030227 psychiatry, Psychiatry and Mental health, Mood, Mood disorders, Psychiatry and Mental Health, Schizophrenia, Anxiety, Psychiatric, medicine.symptom, Psychology, Clinical psychology
Abstract

Aims: This article aims to (1) explore the levels of perceived insecurity in a sample of patients with mood or anxiety disorders and (2) assess whether living in ‘big cities’ can influence the levels of patients’ perceived insecurity and social contacts compared to living in a non-urbanized context. Methods: A total of 24 Italian mental health centers (MHCs) have been invited to participate. Twenty patients consecutively accessing the MHC have been recruited. All patients have been assessed using validated assessment tools. Results: The sample consisted of 426 patients, mostly female, with a mean age of 45 years. Globally, 52.2% of patients had a diagnosis of mood disorders, and 37.8% had anxiety disorders. Half of the sample declared that the main feeling toward life is uncertainty; higher levels of pessimistic views toward life have been detected in patients living in urban areas. A positive association between negative attitudes toward life and higher levels of depressive and anxiety symptoms, poor social functioning and higher levels of perceived psychological distress has been found. Conclusion: Our findings confirm the presence of a common sense of perceived uncertainty among our sample. Such attitude toward life can have a detrimental impact on patients’ psychological and physical well-being, contributing to high levels of distress.

Published
2016

45. Beyond the surface: Understanding obsessive symptoms and body perceptions, from shape concerns to fear of blushing.

Author

Tempia Valenta S, Campanile G, Albert U, Marcolini F, Faedi G, De Ronchi D, and Atti AR

Subjects
Humans, Adult, Female, Male, Young Adult, Feeding and Eating Disorders psychology, Feeding and Eating Disorders diagnosis, Adolescent, Psychometrics instrumentation, Psychometrics methods, Middle Aged, Body Dysmorphic Disorders psychology, Body Dysmorphic Disorders diagnosis, Obsessive-Compulsive Disorder psychology, Obsessive-Compulsive Disorder diagnosis, Body Image psychology, Fear psychology
Abstract

Introduction: Recent reclassifications have expanded the understanding of Obsessive-Compulsive Disorders (OCDs), now incorporated into a broader category known as Obsessive-Compulsive Disorder and Related Disorders (OCRDs). This study sought to assess obsessive-compulsive symptoms and body uneasiness among outpatients seeking treatment for Eating Disorders (ED). Additionally, we aimed to explore associations and potential mediation effects between obsessive-compulsive symptoms and body uneasiness. This investigation extended beyond concerns related solely to body shape and weight, encompassing fears associated with specific body components (such as facial features, abdominal region, and limbs) or functions (including sweating, blushing, emitting noises, and releasing odors)., Methods: Psychometric assessments included the Obsessive-Compulsive Inventory-Revised (OCI-R) and the Body Uneasiness Test (BUT). Statistical analyses involved bivariate correlations, linear regression, and mediation analysis to explore the associations and potential mediation effects between obsessive-compulsive symptoms and different manifestations of body uneasiness., Results: The sample (N = 210) demonstrated substantial obsessive-compulsive symptoms and notable body discomfort. OCI-R scores positively correlated with various dimensions of body dissatisfaction, including shape, weight, and specific body components or functions. Linear regression revealed significant associations between OCI-R scores and overall body uneasiness (BUT-A) as well as concerns about body components or functions (BUTB). Mediation analysis indicated that BUT-A mediated the relationship between obsessive-compulsive symptoms and BUTB., Conclusion: This study offers new insights into the comprehensive landscape of OCRDs. It specifically emphasizes the association between obsessive-compulsive symptoms and body uneasiness, embracing not only concerns about body shape and weight but also extending to body components and functions., Competing Interests: Declaration of competing interest The authors have no relevant financial or nonfinancial interests to disclose., (Copyright © 2023. Published by Elsevier Inc.)

Published
2024
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46. The missing link between philosophy and psychopathology.

Author

Scudellari P, Valente S, Maldini M, Atti AR, and De Ronchi D

Subjects
Humans, Knowledge, Philosophy, Psychiatry, Psychopathology
Abstract

Introduction: The uncertainty regarding the scientific status of psychiatry arises from psychiatry's involvement with some unsolved problems, or put in another way, from its enmeshment in certain points of transition of contemporary science. There is, in primis, the unsolved problem of the relationship between the mind and the body and, moreo- ver, the intricate relationship of connection/disjunction among biology, social science, anthropology, philosophy, etc. To speak about what psychopathology can expect from philosophy is, above all, to immerse oneself in a debate about the conditions of possibility of psychiatry as a science. This debate is especially concerned with the models of knowledge that have, until now, been proposed to psychiatry. Those models oscillate between the Dilthey's paradigms of the "Science of Nature" and the "Science of Spirit"., Methods: It is certain that psychopathology, as already indicated by Jaspers, is a discipline which is among the most involved regard- ing the use of the two different cognitive strategies. The first strategy concerns the concept of "explanation" and its rigid approach to the objective and ultimate cause of the phenomenon. The second strategy is the "comprehensive" approach. This model, which the hermeneutic thought defines "interpretative", theorizes the provisional character, the subjectiveness and the finiteness of every cognitive project., Results: The interest of the authors is orientated towards the hermeneutic side (comprehensive-interpretative) of psychiatry, that which deals with the specificity of every clinical history, with the continuity of sense, and with intrinsic narrative intelligibility of every human event, psychopathological or not., Conclusions: This approach to psychopathology is based on the statement: "a clinical history is a text which must be interpreted". From this perspective, every clinical history should be perceived as a text to decipher but, above all, as a "text" to listen to, in the persevering expectation that it could disclose its particular "project of world". When speaking about psychiatry, we always face a problem which dominates all the others: the unsolved problem of the relation- ship between typicalness and singularity of subjective events. B.B. Mandelbrot, theorist of "fractals", sums this dilemma up clearly. He suggests that the innumerable variety of the configurations of Nature is a challenge to investigate the morphology of that which is "irregu- lar" in order to discover in it, as far as possible, a rule.

Published
2018
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47. Never too late to be anxious: validation of the Geriatric Anxiety Inventory, Italian version.

Author

Ferrari S, Signorelli MS, Cerrato F, Pingani L, Massimino M, Valente S, Forlani M, Bonasegla P, Arcidiacono E, De Ronchi D, Rigatelli M, Aguglia E, and Atti AR

Subjects
Aged, Aged, 80 and over, Female, Humans, Italy, Language, Male, Psychometrics, Reproducibility of Results, Sensitivity and Specificity, Anxiety diagnosis, Psychiatric Status Rating Scales
Abstract

Aim: The aim of this work was to validate the Italian version of GAI (GAI-It) and its short form (GAI-It SF) in an over 65-population., Methods: In 3 recruitment areas across Italy, two raters reciprocally blind to results assessed eligible subjects; a semi-structured diagnostic clinical interview was performed by a psychiatrist., Results: Among the 76 enrolled subjects (mean age 72.7±6.8 years), anxiety symptoms were very common: 69.7% (moderate/ severe HADS-Anxiety), 76.3% (moderate/severe STAI-state), 71.0% (moderate/severe STAI-trait), 61.8% (GAI), 55.3% (GAI-SF). Sensitivity, specificity and positive predictive value of GAI confirmed a good reliability of the Italian version, with Cronbach's Alpha equal to 0.93 for GAI-It and to 0.77 for GAI-It SF, indicating a very good and good construct validity, respectively, of the scales. The Pearson correlation index demonstrated a moderately positive correlation among GAI, GAI-SF and STAI., Conclusions: Our data confirm the validity of GAI-It as a valuable instrument to assess anxiety in an elderly population, for clinical and research purposes.

Published
2017
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48. A systematic review of metabolic side effects related to the use of antipsychotic drugs in dementia.

Author

Atti AR, Ferrari Gozzi B, Zuliani G, Bernabei V, Scudellari P, Berardi D, De Ronchi D, Tarricone I, and Menchetti M

Subjects
Aged, Antipsychotic Agents therapeutic use, Dementia metabolism, Glucose Metabolism Disorders chemically induced, Homeostasis drug effects, Humans, Lipids blood, Metabolism drug effects, Weight Gain drug effects, Antipsychotic Agents adverse effects, Dementia drug therapy, Lipid Metabolism drug effects, Metabolic Diseases chemically induced
Abstract

Background: In clinical practice, Second Generation Antipsychotics (SGAs) are often used as first-line treatment for the Behavioral and Psychological Symptoms of Dementia (BPSD) in older adults due to their fewer neurological adverse events and similar effectiveness compared with First Generation Antipsychotics (FGAs). SGAs, however, are associated with more severe metabolic side effects (weight gain, hyperglycemia, diabetes risk, and hyperlipidemia) than FGAs are. In general, older patients, especially those affected by dementia, are at increased risk for malnutrition, and tend to have lower basal metabolism and reduced liver and kidney function. However, little is known about the metabolic side effects of antipsychotic drugs in this population., Methods: A comprehensive review of the literature published between January 1996 and December 2012 investigating the metabolic side effects related to FGAs and SGAs use in old patients affected by dementia., Results: Antipsychotic drugs currently used to treat BPSD in subjects with mild to moderate dementia are associated with weight gain. Currently, there are insufficient data to support a causal relationship between the use of FGAs and SGAs and changes in glucose homeostasis or lipid metabolism in older persons affected by severe dementia (MMSE <14)., Conclusion: A possible association between antipsychotic drugs use and weight gain might exist, in particular in subjects with mild to moderate dementia whereas no significant effects are demonstrated regarding glucose homeostasis and lipid metabolism. The antipsychotic drugs potential for causing metabolic abnormalities in older patients requires further specifically designed studies. Clinicians must be aware of this possibility even if the shorter periods of treatment administered in late-life might not be as harmful as it is in younger individuals.

Published
2014
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49. Animal-assisted interventions for elderly patients affected by dementia or psychiatric disorders: a review.

Author

Bernabei V, De Ronchi D, La Ferla T, Moretti F, Tonelli L, Ferrari B, Forlani M, and Atti AR

Subjects
Aged, Animal Assisted Therapy standards, Animal Assisted Therapy trends, Animals, Humans, Animal Assisted Therapy methods, Dementia therapy, Mental Disorders therapy
Abstract

Objective: The aim of this literature review was to assess the effects of Animal-Assisted Interventions (AAI) on elderly patients with dementia or various psychiatric disorders., Methods: We conducted a comprehensive literature search using the online PubMed network of the US National Library of Medicine & National Institutes of Health, Embase, PsycINFO, with the purpose of investigating AAI effects on cognitive functions, mood, and behaviour., Results: A total of 18 articles on dementia and 5 on psychiatric disorders were included in the present review. AAI were found to have positive influences on demented patients by reducing degree of agitation and by improving degree and quality of social interaction. Few studies have assessed the effects of AAI on mood, and even fewer have assessed its consequences on cognitive functions. The results that are available indicate a positive effect on communication and coping ability, but none on cognitive performance. A substitute pet robot yielded encouraging results, but its use requires further investigation. The few studies conducted for elderly patients presenting a variety of psychiatric diagnoses produced controversial findings., Conclusions: In spite of the encouraging results of AAI, much more research examining the issue of optimal AAI duration, frequency of sessions, and suitable target group is needed., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Published
2013
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50. Plasma cytokines profile in older subjects with late onset Alzheimer's disease or vascular dementia.

Author

Zuliani G, Ranzini M, Guerra G, Rossi L, Munari MR, Zurlo A, Volpato S, Atti AR, Blè A, and Fellin R

Subjects
Aged, Aged, 80 and over, Alzheimer Disease diagnosis, Alzheimer Disease psychology, Cerebrovascular Disorders diagnosis, Cerebrovascular Disorders immunology, Cerebrovascular Disorders psychology, Dementia, Vascular diagnosis, Dementia, Vascular psychology, Female, Humans, Inflammation diagnosis, Inflammation immunology, Interleukin-10 blood, Interleukin-1beta blood, Interleukin-6 blood, Likelihood Functions, Logistic Models, Male, Mental Status Schedule, Reference Values, Risk Factors, Tumor Necrosis Factor-alpha metabolism, Alzheimer Disease immunology, Cytokines blood, Dementia, Vascular immunology
Abstract

Some cytokines have been involved in the pathogenesis of late onset Alzheimer's disease (LOAD). A possible increase in plasma cytokines levels has been reported in LOAD and vascular dementia (VD), but the results of previous studies are conflicting. We evaluated the plasma levels of IL-6, TNF-alpha, IL-1beta, and IL-10 in four groups of older individuals: 60 patients with LOAD, 80 patients with VD, 40 subjects with cerebrovascular disease but without dementia (CDND), and 42 controls (C). By analysis of covariance (adjustment for age, gender, coronary heart disease, diabetes, hypertension, smoking, and alcohol consumption) we found that: *IL-1beta was higher in VD, LOAD, and CDND compared with controls (p<0.005). *TNF-alpha was higher in VD and LOAD compared to C (p<0.05), and in VD compared to LOAD (p<0.03). *IL-6 was higher in VD compared with LOAD (p<0.03). No differences in IL-10 values were found (Kruskal-Wallis, Asymp. Sig. 0.14). By logistic regression analysis, we demonstrated that high levels (defined as above the median) of IL-1beta and TNF-alpha, but not of IL-6, were associated with increased likelihood of having VD and LOAD compared to C, while high IL-6 levels were associated with a increased probability of having VD, compared with LOAD. Our study support the notion of a low-grade systemic inflammation in older patients with LOAD or VD, characterized by an increase in plasma IL-1beta and TNF-alpha levels. The high IL-6 levels found in VD might be not a specific finding, as it might come from several conditions including atherosclerosis and related vascular risk factors, comorbidity, and frailty.

Published
2007
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