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Diagnosis, Treatment, and Prognosis of Neuropsychiatric Disorders

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: 18 June 2024 | Viewed by 15674

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Special Issue Editors

Dr. Giulia Maria Giordano

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Guest Editor

Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
Interests: psychiatry; schizophrenia; negative symptoms; functioning; cognitive dysfunctions; EEG; MRI

Dr. Claudio Brasso

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Guest Editor

Department of Neuroscience “Rita Levi Montalcini”, University of Turin, Via Cherasco, 13, 10126 Turin, Italy
Interests: schizophrenia, psychoses; neuroimaging; omic science
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Special Issue Information

Dear Colleagues,

Neuropsychiatric disorders pose a significant burden for patients, family members, and the healthcare system. In fact, although the diagnosis and care of people suffering from these disorders has improved in the last several decades, they still remain a leading cause of disability and premature mortality.

The investigation of clinical correlates and pathophysiological bases of these disorders still represents a challenge since phenotypes within the same diagnosis are very heterogeneous in terms of different factors, such as psychopathological features, genetic and environmental risk factors, comorbidities, response to treatment, personal developmental trajectories, and neurobiological correlates. In addition, the picture is even more complex considering the overlap across different diagnoses. Within this frame, an intensive interaction and collaboration between researchers and different healthcare professionals with an in-depth knowledge on the field represents an urgent need.

The Special Issue on “Diagnosis, Treatment, and Prognosis of Neuropsychiatric Disorders” will provide new insights into opportunities for improving diagnosis, care, and outcomes of people suffering from neuropsychiatric disorders. The volume aims to collect original research, commentaries, and systemic or narrative reviews, opinion papers, and innovative protocols about the diagnosis, treatment, and prognosis of neuropsychiatric disorders, including (but not limited to) articles on genetic typing, neuroimaging findings, and artificial intelligence techniques to provide updates, new findings, and future perspectives of neuropsychiatric disorder research and care.

Dr. Giulia Maria Giordano
Dr. Claudio Brasso
Guest Editors

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Keywords

mental disorders
risk factors
treatment
outcome
trans-diagnosis
translational psychiatry

Published Papers (9 papers)

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Research

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13 pages, 946 KiB

Open AccessArticle

When Do Korsakoff Patients Justify Immoral Behaviors? The Influence of Premorbid Delinquency and Self-Other Perspectives in Moral Decision-Making and Moral Reasoning

by Nairobi Vlot, Albert Postma and Erik Oudman

J. Clin. Med. 2023, 12(19), 6257; https://doi.org/10.3390/jcm12196257 - 28 Sep 2023

Viewed by 768

Abstract

Korsakoff’s syndrome (KS) is a chronic neuropsychiatric disorder caused by a vitamin B1 deficiency. KS is characterized by profound amnesia and often accompanied by poor executive functioning, decreased social-cognitive abilities, and difficulties in behavioral regulation. As moral behaviors and attitudes may provide insight in socio-behavioral interactions, the current study aimed to evaluate everyday moral maturity by administering self- versus other-oriented moral dilemmas in a group of KS patients (n = 20) and healthy controls (n = 20). Responses were scored according to the Kohlberg stages of moral reasoning. Furthermore, we assessed premorbid delinquency and current neurocognitive functioning as possible relevant factors. Our results show that KS patients were prone to lower levels of moral maturity when confronted with moral dilemmas relating to themselves, compared to dilemmas relating to (un)personal others in KS patients, while healthy subjects showed an opposite pattern. Moral immaturity could find its origin already before the onset of the KS diagnosis, as suggested by the elevated premorbid levels of delinquent behavior and correlation between premorbid delinquency and moral maturity in KS. Lower moral maturity could therefore be a possible predisposing factor to both delinquency and later development of Korsakoff’s syndrome. Full article

(This article belongs to the Special Issue Diagnosis, Treatment, and Prognosis of Neuropsychiatric Disorders)

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16 pages, 527 KiB

Open AccessArticle

Predictors of Changes in Quality of Life of Patients with Major Depressive Disorder—A Prospective Naturalistic 3-Month Follow-Up Study

by Vlad Dionisie, Maria Gabriela Puiu, Mirela Manea and Ioana Anca Pacearcă

J. Clin. Med. 2023, 12(14), 4628; https://doi.org/10.3390/jcm12144628 - 12 Jul 2023

Cited by 1 | Viewed by 924

Abstract

Major depressive disorder (MDD) is one of the leading causes of disease burden worldwide and affected patients frequently report impairments in quality of life (QoL). Therefore, the present research aimed to identify predictors of domain-specific QoL changes in MDD patients following the acute phase of pharmacological treatment (3-month). This study is a prospective, naturalistic, and observational analysis on 150 patients. Depressive symptoms, QoL, overall pain intensity, and functionality were assessed using Hamilton Depression Rating Scale, World Health Organization Quality of Life scale—abbreviated version, Visual Analog Scale, and Sheehan Disability Scale, respectively. Reductions in symptom severity and disability were predictors of improvement across all domains of QoL. Pain intensity reduction was a predictor of increases in the physical aspect of QoL. A reduced number of psychiatric hospitalizations and being in a relationship predicted an improvement of QoL in the psychological domain whereas a positive history of suicidal attempts was associated with better social relationships QoL. The predictive models explained 41.2% and 54.7% of the variance in psychological and physical health domains of QoL, respectively. Awareness of sociodemographic and changes in clinical factors that impact the change in domain-specific QoL might help in shaping personalized treatment. Full article

(This article belongs to the Special Issue Diagnosis, Treatment, and Prognosis of Neuropsychiatric Disorders)

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12 pages, 284 KiB

Open AccessArticle

Exploring Personal Recovery in Schizophrenia: The Role of Mentalization

by Carmen Concerto, Alessandro Rodolico, Ludovico Mineo, Alessia Ciancio, Leonardo Marano, Carla Benedicta Romano, Elisa Vita Scavo, Riccardo Spigarelli, Laura Fusar-Poli, Rosaria Furnari, Antonino Petralia and Maria Salvina Signorelli

J. Clin. Med. 2023, 12(12), 4090; https://doi.org/10.3390/jcm12124090 - 16 Jun 2023

Cited by 1 | Viewed by 1317

Abstract

Recovery is a broadly debated concept in the field of psychiatry research and in schizophrenia. Our study aims to understand the correlation between personal recovery from schizophrenia and factors such as mentalization, disability, quality of life, and antipsychotic side effects; Methods: Participants with schizophrenia (according to DSM-5 criteria) were consecutively recruited from the Psychiatry Unit of the University of Catania, Italy. Participants were assessed with the Recovery Assessment Scale (RAS), the Multidimensional Mentalizing Questionnaire (MMQ), the brief version of the WHO Disability Assessment Schedule (WHO-DAS), the EuroQoL-5 dimensions-5 levels, the Insight Orientation Scale (IOS) and the Glasgow Antipsychotic Side Effect Scale (GASS); Results: 81 patients were included. Our findings showed a positive correlation between RAS total scores and MMQ scores, especially in “good mentalizing” subdomains. IOS scores also had a positive association with RAS and MMQ scores. In contrast, poor mentalizing abilities negatively correlated with WHO-DAS 2.0 scores. While antipsychotic side effects influenced functioning, they did not impact perceived recovery. Conclusions: The study’s results identified potential predictors of personal recovery from schizophrenia. These findings could contribute to creating tailored interventions to facilitate the recovery process. Full article

(This article belongs to the Special Issue Diagnosis, Treatment, and Prognosis of Neuropsychiatric Disorders)

15 pages, 4792 KiB

Open AccessArticle

Alteration of the Functional Connectivity of the Cortical Areas Characterized by the Presence of Von Economo Neurons in Schizophrenia, a Pilot Study

by Claudio Brasso, Mario Stanziano, Francesca Marina Bosco, Rosalba Morese, Maria Consuelo Valentini, Alessandro Vercelli and Paola Rocca

J. Clin. Med. 2023, 12(4), 1377; https://doi.org/10.3390/jcm12041377 - 09 Feb 2023

Cited by 2 | Viewed by 1405

Abstract

Von Economo neurons (VENs) are rod, stick, or corkscrew cells mostly located in layer V of the frontoinsular and anterior cingulate cortices. VENs are projection neurons related to human-like social cognitive abilities. Post-mortem histological studies found VEN alterations in several neuropsychiatric disorders, including schizophrenia (SZ). This pilot study aimed to evaluate the role of VEN-containing areas in shaping patterns of resting-state brain activation in patients with SZ (n = 20) compared to healthy controls (HCs; n = 20). We performed a functional connectivity analysis seeded in the cortical areas with the highest density of VENs followed by fuzzy clustering. The alterations found in the SZ group were correlated with psychopathological, cognitive, and functioning variables. We found a frontotemporal network that was shared by four clusters overlapping with the salience, superior-frontal, orbitofrontal, and central executive networks. Differences between the HC and SZ groups emerged only in the salience network. The functional connectivity of the right anterior insula and ventral tegmental area within this network were negatively correlated with experiential negative symptoms and positively correlated with functioning. This study provides some evidence to show that in vivo, VEN-enriched cortical areas are associated with an altered resting-state brain activity in people with SZ. Full article

(This article belongs to the Special Issue Diagnosis, Treatment, and Prognosis of Neuropsychiatric Disorders)

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12 pages, 1200 KiB

Open AccessArticle

The Role of Cognitive Deficits in Borderline Personality Disorder with Early Traumas: A Mediation Analysis

by Paola Bozzatello, Cecilia Blua, Claudio Brasso, Paola Rocca and Silvio Bellino

J. Clin. Med. 2023, 12(3), 787; https://doi.org/10.3390/jcm12030787 - 18 Jan 2023

Cited by 1 | Viewed by 3904

Abstract

(1) Background: although studies of cognitive functions are still limited in borderline personality disorder (BPD), the initial evidence suggested that BPD patients have deficits of executive functions and social cognition. In addition, patients who report physical and psychic traumatic experiences in childhood and adolescence show considerable neurocognitive impairment and severe BPD symptoms. The present study has a twofold aim: (1) to evaluate the differences in neurocognitive performances between BPD patients and healthy controls and (2) to verify in the BPD patients group whether neurocognitive deficits have the role of mediating the effect of early traumas on BPD psychopathology. (2) Methods: 69 subjects were enrolled: 38 outpatients with a diagnosis of BPD (DSM-5) and 31 healthy controls. BPD patients were tested with the Borderline Personality Disorder Severity Index (BPDSI), and the Childhood Trauma Questionnaire–Short Form (CTQ-SF). All subjects were evaluated with the Iowa Gambling task (IGT), the Berg card sorting test (BCST), the Tower of London task (ToL), and the Reading-the-mind-in-the-eyes-test (RMET). Statistical analysis was performed with the analysis of variance to compare the cognitive performances between BPD patients and controls. A mediation analysis was conducted with the Sobel Test in the BPD patients group. The significance level was p ≤ 0.05. (3) Results: significant differences between the two groups were found for several parameters of all the cognitive tests examined: BCST, IGT, ToL, and RMET. Mediation analysis with the Sobel test demonstrated that the percentage of correct answers in the BCST (BCSTc) and the RMET score significantly mediated the relation between the CTQ total score and BPDSI total score. (4) Conclusions: BPD patients showed an impairment of the following executive functions: set shifting, decision making, planning and problem solving, and social cognition abilities, in comparison with controls. Our results suggested that the effect of early trauma on BPD psychopathology was mediated by a deficit in two cognitive domains: cognitive flexibility and social cognition. Full article

(This article belongs to the Special Issue Diagnosis, Treatment, and Prognosis of Neuropsychiatric Disorders)

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Review

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32 pages, 2428 KiB

Open AccessReview

Second Generation Long-Acting Injectable Antipsychotics in Schizophrenia: The Patient’s Subjective Quality of Life, Well-Being, and Satisfaction

by Claudio Brasso, Silvio Bellino, Paola Bozzatello, Cristiana Montemagni, Marco Giuseppe Alberto Nobili, Rodolfo Sgro and Paola Rocca

J. Clin. Med. 2023, 12(22), 6985; https://doi.org/10.3390/jcm12226985 - 08 Nov 2023

Viewed by 1379

Abstract

Schizophrenia (SZ) is among the twenty most disabling diseases worldwide. Subjective quality of life, well-being, and satisfaction are core elements to achieving personal recovery from the disorder. Long-acting injectable second-generation antipsychotics (SGA-LAIs) represent a valid therapeutic option for the treatment of SZ as they guarantee good efficacy and adherence to treatment. The aim of this rapid review is to summarize the evidence on the efficacy of SGA-LAIs in improving subjective quality of life, well-being, and satisfaction. The PubMed database was searched for original studies using SGA, LAI, risperidone, paliperidone, aripiprazole, olanzapine, SZ, and psychosis as keywords. Twenty-one studies were included: 13 clinical trials, 7 observational studies, and 1 post hoc analysis. It has been shown that SGA-LAIs bring an improvement to specific domains of subjective and self-rated quality of life, well-being, or satisfaction in prospective observational studies without a control arm and in randomized controlled trials versus placebo. The superiority of SGA-LAIs as compared with oral equivalents and haloperidol-LAI has been reported by some randomized controlled and observational studies. Although promising, the evidence is still limited because of the lack of studies and several methodological issues concerning the choice of the sample, the evaluation of the outcome variables, and the study design. New methodologically sound studies are needed. Full article

(This article belongs to the Special Issue Diagnosis, Treatment, and Prognosis of Neuropsychiatric Disorders)

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Other

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25 pages, 860 KiB

Open AccessSystematic Review

Correlations between Negative Symptoms and Cognitive Deficits in Individuals at First Psychotic Episode or at High Risk of Psychosis: A Systematic Review

by Antonio Melillo, Edoardo Caporusso, Giulia Maria Giordano, Luigi Giuliani, Pasquale Pezzella, Andrea Perrottelli, Paola Bucci, Armida Mucci and Silvana Galderisi

J. Clin. Med. 2023, 12(22), 7095; https://doi.org/10.3390/jcm12227095 - 14 Nov 2023

Cited by 1 | Viewed by 910

Abstract

The present review aims to identify correlations between negative symptoms (NS) and deficits in neurocognition and social cognition in subjects with first-episode psychosis (FEP) and at-high-risk populations (HR). A systematic search of the literature published between 1 January 2005 and 31 December 2022 was conducted on PubMed, Scopus, and PsycInfo. Out of the 4599 records identified, a total of 32 studies met our inclusion/exclusion criteria. Data on a total of 3086 FEP and 1732 HR were collected. The available evidence shows that NS correlate with executive functioning and theory of mind deficits in FEP subjects, and with deficits in the processing speed, attention and vigilance, and working memory in HR subjects. Visual learning and memory do not correlate with NS in either FEP or HR subjects. More inconsistent findings were retrieved in relation to other cognitive domains in both samples. The available evidence is limited by sample and methodological heterogeneity across studies and was rated as poor or average quality for the majority of included studies in both FEP and CHR populations. Further research based on shared definitions of first-episode psychosis and at-risk states, as well as on more recent conceptualizations of negative symptoms and cognitive impairment, is highly needed. Full article

(This article belongs to the Special Issue Diagnosis, Treatment, and Prognosis of Neuropsychiatric Disorders)

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8 pages, 1032 KiB

Open AccessBrief Report

Plasma CHI3L1 in Amyotrophic Lateral Sclerosis: A Potential Differential Diagnostic Biomarker

by Alessandro Bombaci, Umberto Manera, Giovanni De Marco, Federico Casale, Paolina Salamone, Giuseppe Fuda, Giulia Marchese, Barbara Iazzolino, Laura Peotta, Cristina Moglia, Andrea Calvo and Adriano Chiò

J. Clin. Med. 2023, 12(6), 2367; https://doi.org/10.3390/jcm12062367 - 19 Mar 2023

Cited by 1 | Viewed by 1313

Abstract

(1) Background: Motor neuron diseases (MNDs) are fatal neurodegenerative diseases. Biomarkers could help with defining patients’ prognoses and stratifications. Besides neurofilaments, chitinases are a promising family of possible biomarkers which correlate with neuroinflammatory status. We evaluated the plasmatic levels of CHI3L1 in MNDs, MND mimics, and healthy controls (HCs). (2) Methods: We used a sandwich ELISA to quantify the CHI3L1 in plasma samples from 44 MND patients, 7 hereditary spastic paraplegia (HSP) patients, 9 MND mimics, and 19 HCs. We also collected a ALSFRSr scale, MRC scale, spirometry, mutational status, progression rate (PR), blood sampling, and neuropsychological evaluation. (3) Results: The plasma levels of the CHI3L1 were different among groups (p = 0.005). Particularly, the MND mimics showed higher CHI3L1 levels compared with the MND patients and HCs. The CHI3L1 levels did not differ among PMA, PLS, and ALS, and we did not find a correlation among the CHI3L1 levels and clinical scores, spirometry parameters, PR, and neuropsychological features. Of note, the red blood cell count and haemoglobin was correlated with the CHI3L1 levels (respectively, p < 0.001, r = 0.63; p = 0.022, and r = 0.52). (4) Conclusions: The CHI3L1 plasma levels were increased in the MND mimics cohort compared with MNDs group. The increase of CHI3L1 in neuroinflammatory processes could explain our findings. We confirmed that the CHI3L1 plasma levels did not allow for differentiation between ALS and HCs, nor were they correlated with neuropsychological impairment. Full article

(This article belongs to the Special Issue Diagnosis, Treatment, and Prognosis of Neuropsychiatric Disorders)

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12 pages, 648 KiB

Open AccessSystematic Review

A Systematic Review on Add-On Psychotherapy in Schizophrenia Spectrum Disorders

by Martina Nicole Modesti, Jan Francesco Arena, Natalia Palermo and Antonio Del Casale

J. Clin. Med. 2023, 12(3), 1021; https://doi.org/10.3390/jcm12031021 - 28 Jan 2023

Cited by 2 | Viewed by 2982

Abstract

Schizophrenia spectrum disorders represent a varied class of mental illnesses characterised by psychosis. In addition to negative and positive symptoms, a significant lack of insight often hinders the therapeutic process. We performed an overview of the existing literature concerning these disorders to summarise the state of knowledge in the psychotherapies applied to treating psychotic symptoms. We searched the PubMed database, including randomised controlled and clinical trials, including 17 studies conducted on 1203 subjects. Psychotherapy of schizophrenia spectrum disorders can improve social functioning and positive symptoms, as well as many other symptomatic areas, and could therefore be considered a helpful adjunctive treatment of schizophrenia spectrum disorders. Among cognitive-behavioural therapies and the newest derived approaches, there is evidence that they can improve different psychotic symptoms. On the other hand, psychodynamic psychotherapies can have a positive influence on psychotic symptoms as well. Further studies are needed to identify better-tailored treatment protocols for schizophrenia spectrum disorders. Full article

(This article belongs to the Special Issue Diagnosis, Treatment, and Prognosis of Neuropsychiatric Disorders)

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