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12 pages, 296 KiB

Open AccessArticle

Sleep Disturbances in Panic Disorder with Comorbid Complex PTSD: A Possible Relationship and Different Psychopathology?

by Elvira Anna Carbone, Giulia Menculini, Renato de Filippis, Martina D’Angelo, Leonardo Zebi and Luca Steardo, Jr.

Life 2023, 13(8), 1636; https://doi.org/10.3390/life13081636 - 27 Jul 2023

Cited by 2 | Viewed by 1425

Abstract

Background: Several studies have shown the possible link between trauma and sleep disturbances, particularly in anxiety disorders. This issue could be because sympathetic hyperarousal is central to both disorders, probably caused by a dysregulation of the noradrenergic system. This study aimed to establish [...] Read more.

Background: Several studies have shown the possible link between trauma and sleep disturbances, particularly in anxiety disorders. This issue could be because sympathetic hyperarousal is central to both disorders, probably caused by a dysregulation of the noradrenergic system. This study aimed to establish if the comorbidity with complex post-traumatic stress disorder (cPTSD) is associated with sleep disturbances in panic disorder (PD) and if the presence of poor sleep quality is associated with a higher psychopathological burden. Methods: Participants (N = 211) with PD completed the International Trauma Questionnaire concerning their most troubling experience, the Hamilton Anxiety Rating Scale (HAM-A), and the Pittsburgh Sleep Quality Index (PSQI) to assess anxiety symptoms and sleep disturbances, respectively. Results: The sample was divided into two subgroups based on the presence of cPTSD. No significant differences emerged in the bivariate analyses for what concerns sociodemographic features. As for the scores of the psychopathological scales, the analysis highlighted statistically significant differences between the subgroups. Subjects with cPTSD reported significantly higher HAM-A total scores. As for the disturbances in self-organization (DSO) and PSQI scores, these were all significantly higher in the cPTSD subsample. At the logistic regression, the presence of cPTSD was inserted as the dependent variable, while the PSQI scores of the subscales evaluating subjective sleep quality, sleep duration, sleep efficacy, and the use of hypnotics were used as independent variables. The presence of cPTSD was significantly associated with the PSQI subscores for subjective sleep quality and use of hypnotics. Conclusions: Patients with PD exhibit more severe sleep disturbances and a higher anxiety burden when experiencing prolonged trauma. Therapeutic advances are needed in this field to target these symptomatologic domains. Full article

(This article belongs to the Special Issue What Is New in Psychiatry and Psychopharmacology?)

13 pages, 514 KiB

Open AccessArticle

Decreased Levels of Vitamin D in Bipolar Patients

by Donatella Marazziti, Paola Mangiapane, Manuel Glauco Carbone, Florinda Morana, Alessandro Arone, Lucia Massa, Stefania Palermo, Miriam Violi, Giovanni Bertini, Leonardo Massoni, Sara Fantasia, Andrea Pozza, Federico Mucci and Benedetto Morana

Life 2023, 13(4), 883; https://doi.org/10.3390/life13040883 - 27 Mar 2023

Cited by 1 | Viewed by 4981

Abstract

Recently, vitamin D is considered a pleiotropic hormone, and as such, it has also become a topic of renewed interest in neuropsychiatry for its proposed role in the aetiology and pathophysiology of different psychiatric conditions, including mood disorders (MDs). This seems particularly crucial [...] Read more.

Recently, vitamin D is considered a pleiotropic hormone, and as such, it has also become a topic of renewed interest in neuropsychiatry for its proposed role in the aetiology and pathophysiology of different psychiatric conditions, including mood disorders (MDs). This seems particularly crucial while considering the relatively high and often neglected prevalence of hypovitaminosis D in the general population and in specific groups, such as patients suffering from the most common type of MDs, which are major depression (MDD) and bipolar disorders (BDs). Therefore, in view of the controversial literature and findings on this topic and its potential therapeutic implications, the present study aimed at evaluating vitamin D levels in the plasma of a sample of inpatients fulfilling the DSM-5 criteria for mood episodes within BDs. The clinical picture was assessed by means of specific rating scales. The results showed that the vitamin D levels (mean ± SD, nM/L) of the bipolar patients of our sample were significantly lower (14.58 ± 11.27 nmol/L) than the normative values (>30 nmol/L). Eleven patients had sufficient values and only 4 had optimal, while 19 showed insufficient, 18 critical, and 17 severely critical levels. No differences emerged according to different socio-demographic or clinical features. In our opinion, the present findings strengthen previous research highlighting decreased vitamin D levels in bipolar patients and support the role of this pleiotropic hormone in BDs. Nevertheless, further studies should follow to corroborate the data of this preliminary study and to address the potential benefits of vitamin D supplementation in the treatment of MDs. Full article

(This article belongs to the Special Issue What Is New in Psychiatry and Psychopharmacology?)

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12 pages, 305 KiB

Open AccessArticle

Cognitive Fusion, Ruminative Response Style and Depressive Spectrum Symptoms in a Sample of University Students

by Mario Miniati, Sara Busia, Ciro Conversano, Graziella Orrù, Rebecca Ciacchini, Viarda Cosentino, Donatella Marazziti, Angelo Gemignani and Laura Palagini

Life 2023, 13(3), 803; https://doi.org/10.3390/life13030803 - 15 Mar 2023

Cited by 1 | Viewed by 1533

Abstract

Psychological inflexibility is related to depressive symptoms through the ‘ruminative response style’ (RR) and ‘cognitive fusion’ (CF). We aimed at exploring whether university students were more exposed to CF, RR and depressive symptoms because of their intellectual performance than non-university students of the [...] Read more.

Psychological inflexibility is related to depressive symptoms through the ‘ruminative response style’ (RR) and ‘cognitive fusion’ (CF). We aimed at exploring whether university students were more exposed to CF, RR and depressive symptoms because of their intellectual performance than non-university students of the same age. We compared university students (US) (n = 105) vs. non-university students (NUS) (n = 76) through online administration of the ‘Cognitive Fusion Questionnaire’ (CFQ-7), the ‘Depression-Zung Self-Assessment Scale’ (ZSDS) and the ‘Perseverative Thinking Questionnaire’ (PTQ) (study protocol #0077818/2022, approved by the Ethical Committee of the University of Pisa, Italy). University students scored significantly higher than non-university students in the CFQ-7 Total Score (27.5 ± 9.4 vs. 24.4 ± 9.5; p = 0.040), ZSDS Total Score (41.1 ± 7.7 vs. 39.0 ± 7.3; p = 0.031), PTQ Total Score (26.1 ± 13.1 vs. 21.8 ± 13.9; p = 0.029), PTQ ‘Repetitiveness’ (5.3 ± 2.8 vs. 4.5 ± 2.9; p = 0.034), ‘Intrusiveness’ (5.8 ± 3.0 vs. 4.8 ± 3.1; p = 0.046) and ‘Repetitive Negative Thinking capturing mental resources’ (5.0 ± 3.1 vs. 4.0 ± 3.0; p = 0.013) (MANOVA analysis). In a binary logistic regression analysis of US (with ZSDS scores < 44 vs. ≥44 as the dependent variable, and PTQ Total Score and dimensions, CFQ-7 Total Score, age and gender as the covariates), PTQ Total Score predicted the more severe depressive symptomatology (OR = 1.44, 95% CI: 1.017–2.039; p = 0.040). We believe that RR and CF should be specifically targeted through psychoeducational/psychotherapeutic interventions in university students. Full article

(This article belongs to the Special Issue What Is New in Psychiatry and Psychopharmacology?)

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7 pages, 348 KiB

Open AccessEditor’s ChoiceCase Report

A Case of Delirious Mania Treated with Electroconvulsive Therapy

by Beniamino Tripodi, Manuel Glauco Carbone, Irene Matarese, Lorenzo Lattanzi and Pierpaolo Medda

Life 2023, 13(7), 1544; https://doi.org/10.3390/life13071544 - 12 Jul 2023

Cited by 1 | Viewed by 1170

Abstract

(1) Background: Delirious mania is a neuropsychiatric condition characterized by the rapid onset of delirium, psychosis, and mania. Due to the presence of catatonic signs and symptoms, some authors considered this syndrome to be a specific excited catatonia subtype. Usually, delirious mania is [...] Read more.

(1) Background: Delirious mania is a neuropsychiatric condition characterized by the rapid onset of delirium, psychosis, and mania. Due to the presence of catatonic signs and symptoms, some authors considered this syndrome to be a specific excited catatonia subtype. Usually, delirious mania is responsive to intravenous benzodiazepines (BZDs) or to electroconvulsive therapy (ECT). (2) Methods: In the present study, we describe the case of a 64-year-old woman with a diagnosis of recurrent major depressive disorder. We assessed the severity of the clinical picture and the response to ECT treatment with the Bush–Francis Catatonia Rating Scale (BFCRS). (3) Results: After eleven sessions of ECT, the patient presented a reduced BFCRS total score, with a resolution of the autonomic abnormalities (temperature, respiratory, and heart rate). (4) Conclusions: These data demonstrate how important it is to diagnose this syndrome as soon as possible to set up an effective therapy, avoiding the use of antipsychotic drugs and preventing potentially fatal complications. The initial administration of BZDs IV and the subsequent ECT application, associated with intensive care of life-threatening general medical conditions, guaranteed us a good level of efficacy in obtaining a complete resolution of the clinical picture. Full article

(This article belongs to the Special Issue What Is New in Psychiatry and Psychopharmacology?)

15 pages, 2649 KiB

Open AccessSystematic Review

Will Transcranial Magnetic Stimulation Improve the Treatment of Obsessive–Compulsive Disorder? A Systematic Review and Meta-Analysis of Current Targets and Clinical Evidence

by Giacomo Grassi, Corinna Moradei and Chiara Cecchelli

Life 2023, 13(7), 1494; https://doi.org/10.3390/life13071494 - 01 Jul 2023

Cited by 1 | Viewed by 2026

Abstract

Background: Although in 2017 a repetitive transcranial magnetic stimulation (rTMS) protocol received Food and Drug Administration approval for the first time for the treatment of obsessive–compulsive disorder (OCD), which neural target and which protocol should be used for OCD are still debated. The [...] Read more.

Background: Although in 2017 a repetitive transcranial magnetic stimulation (rTMS) protocol received Food and Drug Administration approval for the first time for the treatment of obsessive–compulsive disorder (OCD), which neural target and which protocol should be used for OCD are still debated. The aim of the present study was to perform a systematic review and meta-analysis of the available open and sham-controlled trials. Methods: The primary analysis included a pairwise meta-analysis (over 31 trials), and then subgroup analyses were performed for each targeted brain area. Meta-regression analyses explored the possible moderators of effect size. Results: The pairwise meta-analysis showed a significant reduction in OCD symptoms following active rTMS (g = −0.45 [95%CI: −0.62, −0.29]) with moderate heterogeneity (I² = 34.9%). Subgroup analyses showed a significant effect of rTMS over the bilateral pre-SMA (supplementary motor area), the DLPFC (dorsolateral prefrontal cortex), the ACC/mPFC (anterior cingulate cortex and medial prefrontal cortex), and the OFC (orbitofrontal cortex). No moderators of the effect size emerged. Conclusions: TMS of several brain targets represents a safe and effective treatment option for OCD patients. Further studies are needed to help clinicians to individualize TMS protocols and targets for each patient. Full article

(This article belongs to the Special Issue What Is New in Psychiatry and Psychopharmacology?)

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15 pages, 1389 KiB

Open AccessSystematic Review

Pramipexole Augmentation for Treatment-Resistant Unipolar and Bipolar Depression in the Real World: A Systematic Review and Meta-Analysis

by Antonio Tundo, Sophia Betro’, Rocco de Filippis, Fulvia Marchetti, Daniele Nacca, Roberta Necci and Marica Iommi

Life 2023, 13(4), 1043; https://doi.org/10.3390/life13041043 - 19 Apr 2023

Cited by 3 | Viewed by 3882

Abstract

Background: Pramipexole is a dopamine full agonist approved for the treatment of Parkinson’s disease and restless legs syndrome. Its high affinity for the D3 receptor and neuroprotective, antioxidant, and anti-inflammatory activity provides a rationale for the treatment of depression. In this paper, we [...] Read more.

Background: Pramipexole is a dopamine full agonist approved for the treatment of Parkinson’s disease and restless legs syndrome. Its high affinity for the D3 receptor and neuroprotective, antioxidant, and anti-inflammatory activity provides a rationale for the treatment of depression. In this paper, we review studies on the effectiveness and safety of antidepressant pramipexole augmentation in treatment-resistant depression. Methods: This comprehensive systematic review and meta-analysis of observational studies on pramipexole–antidepressant augmentation included patients with resistant unipolar and bipolar depression. The primary outcome measure was the treatment response, measured at the study endpoint. Results: We identified 8 studies including 281 patients overall, 57% women and 39.5% with bipolar disorder and 60.5% with major depressive disorder. The mean follow-up duration was 27.3 weeks (range 8–69). The pooled estimate of treatment response was 62.5%, without significant differences between unipolar and bipolar depression. Safety was good, with nausea and somnolence the most frequent side effects. Conclusions: The findings of this systematic review, needing further confirmation, show that off-label use of pramipexole as augmentation of antidepressant treatment could be a useful and safe strategy for unipolar and bipolar treatment-resistant depression. Full article

(This article belongs to the Special Issue What Is New in Psychiatry and Psychopharmacology?)

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11 pages, 1306 KiB

Open AccessOpinion

An Overview of the Putative Structural and Functional Properties of the GHBh1 Receptor through a Bioinformatics Approach

by Casper J. H. Wolf, Hanka Venselaar, Marcia Spoelder, Harmen Beurmanjer, Arnt F. A. Schellekens and Judith R. Homberg

Life 2023, 13(4), 926; https://doi.org/10.3390/life13040926 - 31 Mar 2023

Viewed by 1196

Abstract

The neurotransmitter γ-hydroxybutyric acid (GHB) is suggested to be involved in neuronal energy homeostasis processes, but the substance is also used as a recreational drug and as a prescription medication for narcolepsy. GHB has several high-affinity targets in the brain, commonly generalized as [...] Read more.

The neurotransmitter γ-hydroxybutyric acid (GHB) is suggested to be involved in neuronal energy homeostasis processes, but the substance is also used as a recreational drug and as a prescription medication for narcolepsy. GHB has several high-affinity targets in the brain, commonly generalized as the GHB receptor. However, little is known about the structural and functional properties of GHB receptor subtypes. This opinion article discusses the literature on the putative structural and functional properties of the GHBh1 receptor subtype. GHBh1 contains 11 transmembrane helices and at least one intracellular intrinsically disordered region (IDR). Additionally, GHBh1 shows a 100% overlap in amino acid sequence with the Riboflavin (vitamin B2) transporter, which opens the possibility of a possible dual-function (transceptor) structure. Riboflavin and GHB also share specific neuroprotective properties. Further research into the GHBh1 receptor subtype may pave the way for future therapeutic possibilities for GHB. Full article

(This article belongs to the Special Issue What Is New in Psychiatry and Psychopharmacology?)

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22 pages, 601 KiB

Open AccessEditor’s ChoiceSystematic Review

A Critical Review of the Psychomotor Agitation Treatment in Youth

by Beniamino Tripodi, Irene Matarese and Manuel Glauco Carbone

Life 2023, 13(2), 293; https://doi.org/10.3390/life13020293 - 20 Jan 2023

Cited by 1 | Viewed by 2398

Abstract

(1) Background: To systematically review evidence on the safety and efficacy of psychopharmacological treatments available for psychomotor agitation (PA) in children and adolescents. (2) Methods: Studies assessing the safety and efficacy of psychopharmacological treatments for acute PA in children and adolescents that were [...] Read more.

(1) Background: To systematically review evidence on the safety and efficacy of psychopharmacological treatments available for psychomotor agitation (PA) in children and adolescents. (2) Methods: Studies assessing the safety and efficacy of psychopharmacological treatments for acute PA in children and adolescents that were published between January 1984 and June 2022 on PubMed were systematically reviewed. We included: (i) papers that presented a combination of the search terms specified in the “Search strategy” sub-paragraph; (ii) manuscripts in English; (iii) original papers; (iv) prospective or retrospective/observational studies and experimental or quasi-experimental reports. The exclusion criteria were: (i) review papers; (ii) non-original studies including editorials and book reviews; (iii) studies not specifically designed and focused on the selected topic. (3) Results: We selected 42 papers: 11 case series (11/42, 26.19%), 8 chart reviews (8/42, 19.05%), 8 case reports (8/42, 19.05%), 6 double-blind placebo-controlled randomized studies (6/42, 14.29%), 4 double-blind controlled randomized studies (4/42, 9.52%), 4 open-label trials (4/42, 9.52%) and 1 case control (1/42, 2.38%). (4) Conclusions: The drugs most frequently used to treat agitation in children and adolescents were ziprasidone, risperidone, aripiprazole, olanzapine and valproic acid. Further studies are needed to evaluate the efficacy/safety ratio, considering the limited number of observations in this field. Full article

(This article belongs to the Special Issue What Is New in Psychiatry and Psychopharmacology?)

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