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The rationale for the following research was to analyse the response of sunflower hybrids to different sowing dates and to evaluate hybrid response to critical environmental conditions. The data used are from an experiment conducted in a location-year combination over a period of two years (2007–09) in southern Italy. Eleven hybrids were tested following a randomized complete block design with three replications at each location-year combination. Eight agronomic characters including seed oil content were recorded. Classification and ordination procedures were used to investigate hybrid performance in relation to three different sowing dates. Combined analysis of variance showed that hybrids, location-year combination, sowing date and their interactions were highly significant for all characters. Hybrid performances were classified by cluster analysis into groups that were differentiable in terms of means and stability. The first three components accounted for 74%, 82%, and 87% of the total variation for the first, second and third sowing date respectively. Plotting component one against component two along Euclidean axes should therefore provide a reasonable representation of the spatial arrangements of hybrid performances in the original multi-dimensional space. The applied statistical method gives full information on hybrid performances similarity.

Background: Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services., Methods/design: The Psychosis early Intervention and Assessment of Needs and Outcome (PIANO) trial is part of a larger research program (Genetics, Endophenotypes and Treatment: Understanding early Psychosis - GET UP) which aims to compare, at 9 months, the effectiveness of a multi-component psychosocial intervention versus treatment as usual (TAU) in a large epidemiologically based cohort of patients with FEP and their family members recruited from all public community mental health centers (CMHCs) located in two entire regions of Italy (Veneto and Emilia Romagna), and in the cities of Florence, Milan and Bolzano. The GET UP PIANO trial has a pragmatic cluster randomized controlled design. The randomized units (clusters) are the CMHCs, and the units of observation are the centers' patients and their family members. Patients in the experimental group will receive TAU plus: 1) cognitive behavioral therapy sessions, 2) psycho-educational sessions for family members, and 3) case management. Patient enrollment will take place over a 1-year period. Several psychopathological, psychological, functioning, and service use variables will be assessed at baseline and follow-up. The primary outcomes are: 1) change from baseline to follow-up in positive and negative symptoms' severity and subjective appraisal; 2) relapse occurrences between baseline and follow-up, that is, episodes resulting in admission and/or any case-note records of re-emergence of positive psychotic symptoms. The expected number of recruited patients is about 400, and that of relatives about 300. Owing to the implementation of the intervention at the CMHC level, the blinding of patients, clinicians, and raters is not possible, but every effort will be made to preserve the independency of the raters. We expect that this study will generate evidence on the best treatments for FEP, and will identify barriers that may hinder its feasibility in 'real-world' clinical settings, patient/family conditions that may render this intervention ineffective or inappropriate, and clinical, psychological, environmental, and service organization predictors of treatment effectiveness, compliance, and service satisfaction.

Abnormalities of platelet serotonin (5-HT) transporter, which are supposed to reflect similar dysfunctions in the central nervous system (CNS), have been reported in obsessive-compulsive disorder (OCD). Other platelet parameters altered in OCD are represented by phenolsulfotransferase (PST) activity, an enzyme involved in the catabolism of catecholic neuro-transmitters, and peripheral benzodiazepine receptors. Since no information is available on the behavior of these putative markers during antiobsessive treatments, the aim of the present study was to measure and compare 3H-imipramine (3H-IMI) binding, which labels the 5-HT transporter, PST activity, and 3H-PK 11,195 binding, which labels peripheral benzodiazepine receptors, in a group of 18 patients with obsessive-compulsive disorder (OCD) before and after a treatment with fluvoxamine versus clomipramine. The results showed that at baseline the patients had a decreased number of 3H-IMI binding sites, which correlated negatively with the Y-BOCS total score, an increased PST activity and no difference in 3H-PK 11,195 binding, as compared with healthy volunteers. After eight weeks of treatment with either clomipramine or fluvoxamine, which was effective in all patients, the number of 3H-IMI binding sites increased significantly toward normal values, while the PST showed no change. These findings suggest that the reduction in 3H-IMI binding sites in OCD may be related to the severity of the illness and possibly to a positive response to serotonin re-uptake inhibitors, and might be considered as a state-dependent marker, whereas the PST activity would seem to be a trait of the illness.

Previous studies on the comorbidity of Obsessive-Compulsive Disorder (OCD) have largely focused on comorbidity with major depressive and anxiety disorders. The present investigation deals with a more complex pattern of comorbidity involving bipolarity. Indeed, in a consecutive series of 315 OCD outpatients, 15.7% had such comorbidity (mostly with bipolar II disorder). Unlike non-bipolar OCD patients, these had a more gradual onset of their OCD which, nonetheless, pursued a more episodic course with a greater number of concurrent major depressive episodes. These bipolar OCD patients had a significantly higher rate of sexual and religious obsessions, and a significantly lower rate of checking rituals. OCD probands with non-bipolar major depressive comorbidity (34.8%) were then compared with the remainder of OCD. These 'unipolar' OCD were older, had a more chronic course with hospitalizations and suicide attempts, had greater comorbidity with generalized anxiety disorder and caffeine abuse; finally, they were more likely to have aggressive obsessions and those with a philosophical, superstitious or bizarre content. Our data suggest that when comorbidity occurs with bipolar and unipolar affective disorders it has a differential impact on the clinical characteristics, comorbidity and course of OCD. We submit that the presence of major depression in OCD is incidental, as OCD in such cases dominates the course and dictates treatment choice. By contrast, when bipolar and obsessive-compulsive disorders co-exist, bipolarity should take precedence in diagnosis, course and treatment considerations.

A double-blind trial was carried out to assess the efficacy and safety of fluvoxamine, a selective serotonin reuptake inhibitor, in comparison with clomipramine, a classical tricyclic antidepressant, in the treatment of obsessive-compulsive disorder. A total of 26 individuals with obsessive-compulsive disorder and with no comorbid disorders at baseline were included in the study. The obsessive-compulsive disorder symptom severity was rated using the Yale-Brown Obsessive-Compulsive Scale and the Clinical Global Impression Scale. The primary efficacy measures indicated an equal improvement in the two groups (38% in the patients taking fluvoxamine and 40% in those taking clomipramine, as compared with baseline values), but onset was faster in the clomipramine group. Side effects, in particular anticholinergic side effects, were more prominent in the clomipramine group. The present double-blind trial confirms an equal efficacy of clomipramine and fluvoxamine in obsessive-compulsive patients. Although clomipramine had a faster onset, fluvoxamine was better tolerated, so that it seems more suitable for long-term treatment of obsessive-compulsive patients.

The authors investigated the comorbidity between obsessive-compulsive disorder (OCD) and other psychiatric disorders in a group of 154 outpatients. The influence of an associate major depressive disorder (MDD) on the outcome of treatment with clomipramine was examined in a subgroup of 52 patients. The results showed that MDD was the most frequent disorder associated with OCD (almost 20% of the patients), followed by generalized anxiety and panic disorder. The co-presence of depression delayed the effect of clomipramine.

In an attempt to clarify the possible role of a serotonergic and dopaminergic dysfunction in obsessive-compulsive disorder (OCD), we measured platelet 3H-imipramine (3H-IMI) binding, serotonin uptake, and platelet sulfotransferase activity in 17 drug-free OCD patients and an equal number of healthy controls. Serotonin uptake and 3H-IMI binding sites in platelets have been shown to constitute peripheral markers of those present in presynaptic serotonergic neurons. Sulfotransferase, an enzyme involved in the catabolism of phenolic compounds and of cathecholamines such as dopamine, has similar kinetic characteristics in brain and platelets. Our results showed a lower number of 3H-IMI binding sites and a higher level of sulfotransferase activity in OCD patients compared with those in controls. These preliminary results suggest involvement of both the serotonin and dopamine systems in OCD.