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Background: Medullary sponge kidney (MSK) disease is a rare and neglected congenital condition typically associated with nephrocalcinosis/nephrolithiasis, urinary concentration defects, and cystic anomalies in the precalyceal ducts that, although sporadic in the general population, is relatively frequent in renal stone formers. The physiopathologic mechanism associated with this disease is not fully understood, and omics technologies may help address this gap. Summary: The aim of this review was to provide an overview of the current state of the application of proteomics in the study of this rare disease. In particular, we focused on the results of our recent Italian collaborative studies that, analyzing the MSK whole and extracellular vesicle urinary content by mass spectrometry, have displayed the existence of a large and multifactorial MSK-associated biological machinery and identified some main regulatory biological elements able to discriminate patients affected by this rare disorder from those with idiopathic calcium nephrolithiasis and autosomal dominant polycystic kidney disease (including laminin subunit alpha 2, ficolin 1, mannan-binding lectin serine protease 2, complement component 4-binding protein β, sphingomyelin, ephrins). Key Messages: The application of omics technologies has provided new insights into the comprehension of the physiopathology of the MSK disease and identified novel potential diagnostic biomarkers that may replace in future expensive and invasive radiological tests (including CT) and select novel therapeutic targets potentially employable, whether validated in a large cohort of patients, in the daily clinical practice.

The GIANO Project Consortium, coordinated by Thales Alenia Space (TAS-I, Italy), with the support of DEIMOS Engenharia S.A. (Portugal), the Space Research Centre PAS in Poznan (Poland), Piktime System SP. Zoo (Poland) and Business Integration Partner S.p.a. (Italy), has been awarded a contract in the framework of the GSA’s “Fundamental Elements” program to develop a timing receiver for professional applications. The paper will report on the progress of the GIANO project, aiming to develop a high performance Galileo-Based Timing Receiver for Critical Infrastructure applications (Telco, Energy, Finance) with increased resilience. The robust, flexible and configurable GNSS receiver unit is able to track and process the Galileo (E1, E5), GPS (L1, L5) and SBAS L1/L5 signals. It includes jamming, spoofing multipath detection and mitigation functions, T-RAIM and OS-NMA support. The receiver will provide a highly accurate and stable 1PPS signal that can be synchronized to GST, GPST or UTC. The receiver includes a highly stable reference source and provides a variety of timing outputs, including NTP, PTP and IRIG-B codes, whose interfaces have been developed by Piktime. After the completion of the integration and preliminary internal tests, two GIANO receivers will be deployed for testing at different laboratories. The extensive final test campaign will take a few months and will include: • functional tests (including the absolute calibration of the receivers) performed by TAS-I. • receiver characterization on zero and short base lines (by installing one of the prototypes at a remote external facility) and performance verification when used in critical infrastructures applications and in scientific and metrological applications. All of these tests will be performed by the Space Research Centre PAS in Poznan (Poland). • tests to demonstrate the robustness and resilience of the receiver to jamming and spoofing of the GNSS signals will be performed at the European Joint Research Center (JRC, Italy) facilities. • timing validation, performed by installing one of the absolutely calibrated receivers at the Italian Metrology Institute (INRIM). The detailed verification process foreseen in the GIANO project will objectively provide evidence that the receivers are indeed fulfilling the specified requirements and characteristics necessary for operation in a difficult environment. The paper will present the preliminary results of the integration phase of the GNSS and timing modules that compose the GIANO platform. The testing plan of a timing receiver with network timing capabilities will be presented, with preliminary results of the test approach for NTP/PTP and IRIG-B protocols.

Over the last years the awareness about jamming and spoofing risks has been increasing, particularly in the timing community since they may cause the disruption of critical services and infrastructures in the Telecommunication, Energy and Finance sectors that rely on GNSS timing to operate. In order to overcome these hazards, the European GNSS Agency (GSA) has funded the development of timing receivers for professional applications, with the aim to address specifically the above vulnerabilities, improve the receiver robustness and the accuracy and reliability of time transfer. In this context the GIANO (Galileo-based timing Receiver for Critical infrastructures robustness) project consortium, coordinated by Thales Alenia Space (TAS) Italy and with the support of Deimos Engenharia S.A. (Portugal), the Space Research Centre PAS in Poznan (Poland), Piktime System SP. Zoo (Poland) and Business Integration Partner S.p.A. (Italy), has been awarded a contract in the framework of the GSA’s “Fundamental Elements” program to develop a timing receiver for critical infrastructure applications. Besides the implementation of some interference and spoofing detection and mitigation techniques, GIANO receiver makes use of Galileo’s authentication service OSNMA (Open Service Navigation Message Authentication), which can be employed as an added defense against some types of spoofing. OSNMA exploits TESLA (Time Efficient Stream Loss-tolerant Authentication) scheme, which is a protocol based on the transmission of message authentication codes generated with a key that is broadcast with some delay. The receiver authenticates the satellite messages through a Digital Signature algorithm and a public key known by the receivers, which also validates the root key of the TESLA chain, and through MACs (Message Authentication Codes) which are used to authenticate specific fields of the Navigation Message. The receiver will also support public key renewals over the air. In this paper, the OSNMA implementation within GIANO receiver, including the cryptographic operations required is presented. The GIANO OSNMA capability will be extensively tested and validated with the support of European Commission Joint Research Centre (Ispra, Italy).

Thales Alenia Space in Italy, with the contribution of Business Integration Partners in Italy, DEIMOS Engenharia in Portugal, the Space Research Centre and Piktime Systems in Poland has been awarded the contract in the framework of the GSA “Fundamental Elements” program. The receiver is based on the last generation of Thales Alenia Space GNSS multi-constellation/multi-frequency receivers with heritage coming from several operational ground receiver stations. The receiver is intended to serve the professional market to improve the resilience of critical infrastructures and allow a range of timing services to be commercially deployed. The receiver uses signals from Galileo and GPS constellations, providing dual frequency capability on L1/E1 and L5/E5a bands. Moreover, exploitation of the Navigation Message Authentication Service, provided by the Galileo Open Service, is foreseen to protect the transmitted code. The proposed timing platform provides a disciplined oscillator solution, tailoring the performance to the user application needs. Since the inclusion of a timing receiver in a certified time distribution system implies the certification of the receiver itself, a continuous self-calibration approach is being studied to allow monitoring of internal delays along the full signal path. In addition, to ensure integrity of the RF path, from antenna down to the receiver (which is important for certification purposes), availability of delay measurements allow to compensate fluctuations due to environmental changes. The development has started in Q1 2019 and is currently in the design/development phase. This paper addresses the main results from the users survey that is driving the development, the receiver architecture and main design choices and the framework in which testing will be performed with several functional and performance verifications being scheduled in the second half of 2020 at the Space Research Centre in Poland, at the EU Joint Research Center in Ispra (Italy) and at INRIM in Torino (Italy).

Psychotropic drugs can produce cardiovascular side effects associated with a degree of cardiotoxicity. The coexistence of a heart disease complicates the management of mental illness, can contribute to a reduced quality of life and a worse illness course. The co-occurrence of psychiatric disorders in cardiac patients might affect the clinical outcome and morbidity. Moreover, the complex underlying mechanism that links these two conditions remains unclear. This paper discusses the known cardiovascular complications of psychotropic drugs and analyzes the important implications of antidepressive treatment in patients with previous cardiac history.

Background There is a growing interest for the effects of weather changes on both healthy and psychiatric individuals. This study aims to validate a short questionnaire (METEO-Q) for the detection of meteoropathy and meteorosensitivity. Methods The METEO-Q was administered to 1099 (528 men, 571 women) healthy subjects. Factor analyses, internal consistency, and item analysis were undertaken to examine the factorial structure of the questionnaire. Results The METEO-Q has satisfactory factorial structure and internal reliability. Our results demonstrate that women have higher scores than man and, therefore, women mostly have meteoropathy. Conclusions Our findings support the use of the METEO-Q for collecting information regarding the effects of weather changes on healthy subjects and potentially on psychiatric patients.

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Premenstrual dysphoric disorder (PMDD) is a complex clinical syndrome that is notoriously difficult to treat. The purpose of the present study was to provide preliminary data on the effectiveness of duloxetine in PMDD.Fifty-five women with PMDD were treated with a 60 mg/day dosage of duloxetine for two menstrual cycles. Responses were assessed at first and second treatment cycle.Outcome measures included a visual analogue scale, the Zung Self-rating Scale for Depression, the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale and the Clinical Global Impressions Scale.Fifty patients completed the trial. All had significant improvement of depression and anxiety and response, defined as a 50% decrease in daily symptom scores, occurred in 39 (78%) patients. The effects of active treatment were marked by the first active cycle of menstruation.Duloxetine 60 mg/day was effective in reducing PMDD symptoms and generally well tolerated. Limitations of the study were open-label design and lack of placebo control. However, the results appeared to be strong and consistent across measures. Adverse events (nausea, insomnia, poor appetite) were low. Further studies are needed to confirm these results.

Aims The behavioural-addiction perspective suggests that Internet addiction (IA) and pathological gambling (PG) could share similar characteristics with substance dependence. Despite the similarities between IA and PG, it is not clear whether these disorders share different or similar psychopathological conditions. The aim of the present study was to test whether IA patients presented different psychological symptoms, temperamental traits, coping strategies and relational patterns compared with PG patients. The hypothesis was that IA patients will show greater interpersonal disengagement than PG patients. Methods Two clinical groups (31 IA patients and 11 PG patients) and a control group (38 healthy subjects) matched with the clinical groups for gender and age were enrolled. The clinical groups were gathered in a psychiatric service for IA and PG in a hospital. Anxiety, depression, coping strategies, attachment, temperament, and global assessment of functioning were measured. MANOVAs, ANOVAs and post-hoc comparisons were carried out in order to test the hypothesis. Results Despite IA and PG showing similar differences with the control group on the levels of depression, anxiety and global functioning, the two clinical groups showed different temperamental, coping and social patterns. Specifically IA patients compared with the PG patients showed a greater mental and behavioural disengagement associated with an important interpersonal impairment. The two clinical groups shared an impulsive coping strategy and socio-emotional impairments. Conclusions Despite IA and PG patients presenting similar clinical symptoms, IA condition was characterised by a more relevant mental, behavioural, and social disengagement compared to PG condition.

The aims of the study were: (1) to study possible associations between temperament, personality dimensions, and psychopathological variables in a clinical sample of euthymic patients with bipolar disorder (BD) and cyclothymia; and (2) to assess how Cloninger's temperament and personality dimensions were associated with affective temperaments. Participants, consisting of 60 patients with BD (type I or II) and cyclothymia in the euthymic phase, completed Akiskal's Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A), and Cloninger's Temperament and Character Inventory-revised version (TCI-R). The diagnostic groups differed in past hospitalization, for age at onset of the disorder, and on two affective temperaments: the TEMPS-A Hyperthymia, and the TEMPS-A Irritability. There were six significant associations between affective temperaments and Cloninger's personality dimensions, ranging from 0.26 to 0.54. The measures of Akiskal and of Cloninger tap common behavioral features in patients with bipolar disorder and cyclothymia, yet the differences indicate that the two measures are not redundant. BD and cyclothymic patients differed significantly in temperament and personality, differences that may have important implications for treatment.

BACKGROUND: Mixed mood states, even in their sub-threshold forms, may significantly affect the course and outcome of bipolar disorder (BD). AIM: To compare two samples of BD patients presenting a major depressive episode and a sub-threshold mixed state in terms of global functioning, clinical outcome, social adjustment and quality of life during a 1-year follow-up. METHODS: The sample was composed by 90 subjects (Group 1, D) clinically diagnosed with a major depressive episode and 41 patients (Group 2, Mx) for a sub-threshold mixed state. All patients were administered with a pharmacological treatment and evaluated for depressive, anxious and manic symptoms by common rating scales. Further evaluations included a global assessment of severity and functioning, social adjustment and quality of life. All evaluations were performed at baseline and after 1, 3, 6 and 12 months of treatment. RESULTS: The two groups were no different for baseline as well as improvement in global severity and functioning. Though clearly different for symptoms severity, the amount of change of depressive and anxiety symptoms was also no different. Manic symptoms showed instead a trend to persist over time in group 2, whereas a slight increase of manic symptoms was observed in group 1, especially after 6 months of treatment. Moreover, in group 1, some manic symptoms were also detected at the Young Mania Rating Scale (n = 24, 26.6%). Finally, improvement in quality of life and social adjustment was similar in the two groups, though a small trend toward a faster improvement in social adjustment in group 1. CONCLUSIONS: Sub-threshold mixed states have a substantial impact on global functioning, social adjustment and subjective well-being, similarly to that of acute phases, or at least major depression. In particular, mixed features, even in their sub-threshold forms, tend to be persistent over time. Finally, manic symptoms may be still often underestimated in depressive episodes, even in patients for BD.

Objectives . To compare two samples of Bipolar (BD) patients presenting “ pure ” (D) and mixed (Mx) depression to assess any difference in terms of clinical outcome, social functioning and quality of life during a 1-year follow-up. Methods . A total of 114 depressed outpatients (HDRS 13) were included. “ Pure ” depressed (D, n 76) were divided from “ mixed ” depressed (Mx, n 38) by the number of concomitant manic symptoms. All patients were evaluated by the Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS), the Young Mania Rating Scale (YMRS), the Global Assessment of Functioning (GAF), the Social Adjustment Self-reported Scale (SASS) and the Quality of Life Scale (QoL), at baseline and after 1, 3, 6 and 12 months of treatment. Results . Mx patients were signifi cantly younger at the onset of BD. Manic features persisted signifi cantly higher in Mx than in D patients all over the follow-up period. Axis I comorbidities had a negative impact on the course of social functioning over the medium term period, while Mx patients showed a faster improvement in social adjustment than “ pure ” depressed patients. Conclusions . Mixed features may persist relatively stable throughout a depressive episode, having a negative impact over clinical and functional outcome, but not on social adjustment.

Introduction There is a lack of studies regarding sexuality and sexual behavior in women with bipolar disorder. The aim of this study is to investigate sexual behavior in women affected by bipolar disorder in order to stimulate interest and debate in this area of care. Methods Sixty women (30 BD I and 30 BD II) consent to participate in the study and were included in the sample. Moreover, sixty female healthy subjects without histories of psychiatric disorders were recruited as normal controls. Patients and healthy subjects were given the Sexual Interest and Sexual Performance Questionnaire, a questionnaire devised to explore various aspects of sexual behavior. Results The results of the present study suggest an increase of sexual interest in patients with BD I as compared both with BD II patients and healthy controls. In women with BD I such increase of interest was detected on some items of section I of the Sexual Interest and Sexual Performance Questionnaire, in particular “Actual Value of Sexuality” and “Implicit Sexual Interest”, which implicitly explore sexual interest without overtly focusing upon sexual problems. Moreover, we observed a higher desired frequency of intercourse in women with BD I than BD II and a higher occurrence of repeated sexual intercourse in women with BD I than BD II. Conclusions The main finding of the present study was an increase of sexual interest in BD I as compared with BD II female patients and normal controls. This result was detected when sexual interest was explored implicitly. Our study is limited by the small size of our subject groups. Further investigations on larger subject samples are needed to better clarify particular aspects of sexual behavior of BD patients.

Comorbid conditions are frequent in Bipolar disorder (BD) and may complicate the treatment and course of illness. We investigated the role of Substance use disorder (SUD), axis II Personality disorders (PD) and continuous personality traits on the medium-term outcome (6 months) of treatment for bipolar depression. One-hundred and thirty-nine BD patients meeting criteria for a depressive episode were included in the study. Fifty-six patients were diagnosed for antecedent SUD and 61 for PD. Personality dimensions were evaluated by the Temperament and Character Inventory (TCI-R). Depressive severity over time was evaluated by the Hamilton Rating Scales for Depression (HAMD). Neither PD nor SUD influenced the outcome of depression, though relapse in SUD was concurrent with a slight worsening of depressive symptoms. Variables independently associated with a poor outcome were a high baseline severity and high scores at the temperamental trait of Harm avoidance. Results did not confirm SUD and PD as complicating factors for the medium-term treatment of depression in BD patients. Though several limitations characterize the present study, neurotic personality traits are supposed to be associated with a slower recovery from depressive symptoms in BD, independently from their initial severity.

Behavioural addictions (BAs) can be understood as disorders characterized by repetitive occurrence of impulsive and uncontrolled behaviours. Very few studies have investigated their association with mood disorders. The present study was undertaken to determine the prevalence of the main behavioural addictions in a sample of bipolar outpatients in euthymic phase or stabilised by medications and to investigate the role of impulsivity and temperamental and character dimensions.One-hundred-fifty-eight Bipolar Disorder (BD) (DSM-IV) outpatients were assessed with tests designed to screen the main behavioural addictions: pathological gambling (SOGS), compulsive shopping (CBS), sexual (SAST), Internet (IAD), work (WART) and physical exercise (EAI) addictions. TCI-R and BIS-11 were administered to investigate impulsivity and personality dimensions mainly associated with BAs. The clinical sample has been compared with 200 matched healthy control subjects.In bipolar patients, 33% presented at least one BA respect to the 13% of controls. Significantly higher scores at the scales for pathological gambling (p.001), compulsive buying (p.05), sexual (p.001) and work addictions (p.05) have been found. Self-Directness (p=.007) and Cooperativeness (p=.014) scores were significantly lower while impulsivity level was significantly higher (p=.007) in bipolar patients with BA than those without BA.To our knowledge, this is the first study investigating the prevalence of behavioural addictions in BD showing a significant association of these disorders. BAs are more frequent in bipolar patients than in healthy controls and are related to higher impulsivity levels and character immaturity.

In the context of the increasing demand in high-speed data link for scientific, planetary exploration and earth observation missions, the Italian Space Agency (ASI), involving Thales Alenia Space as prime, the Polytechnic of Turin and other Italian partners, is developing a program for feasibility demonstration of optical communication system with the goal of a prototype flight mission in the next future. We have designed and analyzed a ground level bidirectional Free Space Optical Communication (FSOC) Breadboard at 2.5Gbit/s working at 1550nm as an emulator of slant path link. The breadboard is full-working and we tested it back-toback, at 500m and 2.3km during one month. The distances were chosen in order to get an equivalent slant path cumulative turbulence in a ground level link. The measurements campaign was done during the day and the night time and under several weather conditions, from sunny, rainy or windy. So we could work under very different turbulence conditions from weak to strong turbulence. We measured the scintillation both, on-axis and off-axis by introducing known misalignments at the terminals, transmission losses at both path lengths and BER at both receivers. We present simulations results considering slant and ground level links, where we took into account the atmospheric effects; scintillation, beam spread, beam wander and fade probability, and comparing them with the ground level experimental results, we find a good agreement between them. Finally we discuss the results obtained in the experimentation and in the flight mission simulations in order to apply our experimental results in the next project phases.

Introduction Bipolar disorder patients (BP) with comorbid Substance Use Disorder (SUD) may present clinical features that could compromise adherence and response to pharmacological treatment. The purpose of this study was to examine clinical and psychopathological features of BP with and without comorbid SUD in a real-world setting. Methods The sample was composed by 131 affective patients. Sixty-five patients were affected by Bipolar Disorder I (BP-I, 49.2%), 29 by Bipolar Disorder II (BP-II, 22.3%) and 37 by Cyclothymic Disorder (CtD, 28.5%), according to DSM-IV. Sixty-six patients were diagnosed for a comorbid SUD. All patients have been submitted to psychometric assessment with Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Young Mania Rating Scale (YMRS), Global Assessment Scale (GAS), Social Adjustment Self-reported Scale (SASS), Quality of Life Scale (QoL), at baseline and repeated follow-up periods (1, 3, 6, 12 months). Results BP comorbid for SUD were more likely diagnosed as BP-II and CtD and were less likely to present a moderate–severe manic symptomatology. Furthermore, personality disorders were more frequent in SUD patients than in non-comorbid BP. BP with SUD were not different for primary outcome measure (HDRS, HARS, YMRS, GAS) from non-comorbid BP; however, BP with SUD were significantly more impaired in social functioning (SASS) at any stage of the follow-up and poor functioning increased the risk of relapse in substance use during treatment. Finally, SUD comorbidity did not represent a risk factor for treatment drop-out, while in our sample young age, low treatment dosage and BP-I diagnosis were significantly associated with drop-out. Discussion The primary finding of this work is that BP with comorbid SUD are significantly more compromised in social functioning. Second, these patients were less likely to be diagnosed for BP-I and to present a severe manic symptomatology. Finally, we found that the diagnosis of SUD, but young age, low treatment dosage and BP-I diagnosis to be risk factors for treatment drop-out. Physicians should be alert to these differences in their clinical practice.

In the frame of a study funded by the Italian space agency (ASI), Thales Alenia Space Italia has developed the R.O.S.A. instrument (Radio Occultation Sounder Antenna for the atmosphere), to be installed aboard OCEANSAT-2, an ISRO satellite. The R.O.S.A. antenna subsystem is made of two independent linear arrays, assembled side by side. (6 pages)

ROSA (Radio Occultation Sounder of Atmosphere) is a space instrument which uses the Radio Occultation Technique to provide highly accurate measurements of the atmospheric refractive indexes from which it is possible to derive, atmospheric vertical profiles of temperature, pressure and humidity, as well as profiles of electron content in the ionosphere. The measurements, generally, are made by using meteorological balloons, able to give a very detailed atmospheric profiles but only on a local scale. From the space, ROSA, flying on a LEO orbit, is able to perform more than 500 atmospheric profiles per day on a global scale, The ROSA instrument is the core of a scientific program, of the same name, promoted by the Italian Space Agency (ASI) to contribute to a better understanding of Climate Change. This program foresees the installation of the ROSA instruments on several space missions and the developments of an ad hoc Ground Segment for the acquisition and processing of the data. The ISRO (Indian Space Research Organization) mission OCEANSAT-2 will be the first mission that will embark ROSA. OCEANSAT-2 is an operative mission for the study of the Ocean that will be launched next July 2007.

Background A significant comorbidity between attention-deficit/hyperactivity disorder (ADHD) and affective disorders has been consistently reported in adults. Less data regarding the role of personality traits, and the influence of ADHD co-occurrence on clinical characteristics and outcome of mood disorders are currently available. Methods The sample consisted of 296 subjects, divided into three homogeneous groups according to demographic characteristics: 106 subjects diagnosed with major depressive disorder, 92 with bipolar disorders and 98 healthy controls. ADHD diagnosis was based on DSM-IV-TR criteria. Childhood and adult ADHD features were measured with the Wender Utah Rating Scale (WURS), the Adult ADHD Self-rating Scale (ASRS) and the Brown Attention Deficit Disorder Scale (ADD). The Hospital Anxiety and Depression Scale (HAD) and the Revised NEO Personality Inventory (NEO-PI-R) were also administered to the clinical groups, in order to investigate depressive/anxious symptoms and personality dimensions. Results The prevalence of adult ADHD in subjects with bipolar disorders or major depressive disorder was 22.0% and 8.5% respectively (p Discussion The present study emphasises the close relationship between affective disorders, especially bipolar disorders, and ADHD in adults. Our findings support the need to assess subjects with mood disorders in the clinical setting for possible co-existing ADHD and to further investigate personality traits to better understand the etiology of affective disorders and ADHD co-occurrence.

ObjectivesThe aim of our study is the investigation of burn-out indexes in public mental health services employees (psychiatrists, psychologists, nursing staff, care providers) working with patients affected by Bipolar Disorder in order to correlate them with patients’ indexes of satisfaction about received treatment and care.MethodsA sample of 20 employees of mental health services (psychiatrists, psychologists, nurses) and one consisting of 22 patients with a diagnosis of Bipolar Disorder have been recruited at the Bipolar Disorders Unit of the Day Hospital of Psychiatry of the A. Gemelli Hospital in Rome. Operators have been submitted the Maslach Burnout Inventory (Emotional distress, Depersonalization, Personal satisfaction/achievement/fulfilment) while patients have been submitted the Questionnaire on Satisfaction of patient (QS)ResultsBy calculating the Spearman Correlation Coefficient the Depersonalization dimension proves highly correlated with the three subscales of QS: Doctor-Patient relationship quality (-.51); Information Quality and Doctor's therapeutic competence (-.48); Efficiency of service organization (-.58)ConclusionsIn our sample high levels of Depersonalization are correlated to a low satisfaction of patients. We therefore expect low levels of Depersonalization to be correlated with a higher satisfaction of the patient. Although it is not possible to generalize these results we can hypothesize that burn out negatively influences patients’ satisfaction.

IntroductionThe purpose of this study is to contribute to the knowledge of the clinical characteristics of the bipolar spectrum by examining factors associated to course of symptoms in BP patients. We evaluated differences between acutely depressed versus subthreshold mixed patients.Methods90 depressed patients (Group 1, HDRS: 18.2±4.6, YMRS: 1.4±2.9) and 41 patients presenting a mixed subthreshold symptomathology (Group 2, HDRS: 9.1±3.2, YMRS: 9.6±6.4) were included in the study. All patients underwent structured diagnostic interviews for axis I and axis II disorders (SCID-I, SCID-II) and have been submitted to psychometric assessment with Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Young Mania Rating Scale (YMRS), Global Assessment Scale (GAS), Social Adjustment Self-reported Scale (SASS), Quality of Life Scale (QoL), at baseline and repeated follow-up (1, 3, 6, 12 months). Personality dimensions were evaluated by Temperament and Character Inventory (TCI-R).ResultsThe most important result is the slight increase in depressive symptoms in subthreshold mixed patients after 3 months of treatment. These patients were more likely diagnosed as BP-I, were non-SUD patients and/or non-comorbid for axis II personality disorders and had a shorter duration of current episode prior intake. Measures of social and functional adjustment were not different in the two groups, though a slight trend for depressed patients to report a poorer quality of life. No difference in personality traits were observed among the two samples.ConclusionsOur study confirms the importance of considering subthreshold symptoms in the evaluation and treatment of patients with Bipolar Disorder.

ObjectivesBehavioural addictions (BAs) can be understood as disorders characterized by repetitive occurrence of impulsive and uncontrolled behaviours. Very few studies have investigated their association with mood disorders. The present study was undertaken to determine the prevalence of the main behavioural addictions in a sample of bipolar outpatients in euthymic phase or stabilised by medications and to investigate the role of impulsivity and temperamental and character dimensions.MethodsOne-hundred-fifty-eight Bipolar Disorder (BD) (DSM-IV) outpatients were assessed with tests designed to screen the main behavioural addictions: pathological gambling (SOGS), compulsive shopping (CBS), sexual (SAST), internet (IAD), work (WART) and physical exercise (EAI) addictions. TCI-R and BIS-11 were administered to investigate impulsivity and personality dimensions mainly associated with BAs. The clinical sample has been compared with 200 matched healthy control subjects.ResultsIn bipolar patients, 33% presented at least one BA respect to the 13% of controls. Significantly higher scores at the scales for pathological gambling (p< .001), compulsive buying (p< .05), sexual (p< .001) and work addictions (p< .05) have been found. Self-Directness (p=.007) and Cooperativeness (p=.014) scores were significantly lower while impulsivity level was significantly higher (p=.007) in bipolar patients with BA than those without BA.ConclusionsTo our knowledge, this is the first study investigating the prevalence of behavioural addictions in BD showing a significant association of these disorders. BAs are more frequent in bipolar patients than in healthy controls and are related to higher impulsivity levels and character immaturity.

ObjectivesThe aim of the present study was to thoroughly investigate the existing comorbidity between Axis II and Bipolar Disorder (BD) pointing out as well the meaningful existing comorbidity between Personality Disorders and Cyclothymia.Materials and methodsA study group composed of 70 patients affected by Bipolar Disorder (Type I, Type II, and Cyclothymia) was enrolled at the Bipolar Disorders Unit of the Catholic University of the Sacred Heart of Rome. Axis I diagnosis was made by SCID-I; Axis II diagnosis was made by SCID-II.ResultsIn a sample of 70 patients in euthymic phase, 39 patients (55.7%) showed comorbidity with Axis II Disorders. Clusters were represented as follows: 2 patients (5.1%) fell within cluster A; 24 patients (61.5%) within cluster B; 9 patients (23%) within cluster C; and 4 patients (10.4%) turned out to be affected by NAS Personality Disorders. On the whole 39 patients - 24 patients (61.5%) affected by BD I, 6 patients (15.3%) affected by BD II, and 9 patients (23.0%) affected by Cyclothymia were found to have comorbidity with Axis II Disorders. Besides, in our sample there was a significant comorbidity between Cyclothymia and Personality Disorders.DiscussionMore than half of patients (55.7%) showed comorbidity with Axis II Disorders. Moreover most of patients turned out to be affected by Personality Disorders falling within cluster B while 23% of Cyclothymic patients were found to have comorbidity with Axis II Disorders.

Introdution:Our study represents a pilot evaluation about how the MOOD-SR recognizes subthreshold manifestations that may be associated with clinical symptomatology in a group of bipolar patients.Methods:At Day Hospital of Psychiatry, Policlinico “A. Gemelli”, Bipolar Disorders Unit, it has been conducted an experimental study on a heterogeneous sample of 24 patients with a diagnosis of Bipolar Disorder type I. Patients have been assessed with the MOOD-SR, a clinical self-reported interview, that is specific for the spectrum of subthreshold pathology, and with the Quality of Life (QoL), that investigates the patient's quality of life.Results:We have found that 16 patients on 24 report a score higher than 60 (68,4%). Among these, 10 female patients on 15 have a total score higer than 61 (68.75%) while 6 male patients on 9 obtain a total score higher than 60 (62,5%). However, these results have only preliminary value, further studies are needed in order to obtain a deeper evaluation.Conclusion:Spectrum manifestations are both indicator of course and response to treatment and predictive for relapse. This finding may represent an important preventive instrument for maniacal relapse in patients with Bipolar Disorder, that is often underdiagnosed or confused for Unipolar Depression. By adequately recognizing the problem we will be able to refine diagnosis and individualize therapy.