ABSTRACT
BACKGROUND: Adverse events (AEs) contribute to poor outcome in patients affected by mental disorders. The aim of this case series is to describe how many antipsychotics-associated serious AEs could have been prevented if we had known in advance the genetic profile of the patient. SUBJECTS AND METHODS: Data of patients who required the prescription of an antipsychotic drug, with a history of a documented antipsychotics-associated serious AE and who underwent Neuropharmagen® test were retrospectively collected. RESULTS: Thirty-three subjects were selected for eligibility; two of them were excluded. Twelve subjects (38.7%) showed genetic polymorphisms most likely associated to an increased risk of AE, with pharmacokinetic variations being the most prevalent. Moreover, the 35.5% of the total sample revealed drug-drug interactions (pharmacodynamic/pharmacokinetic) associated with increased risk of AE. CONCLUSIONS: This case series highlights how pharmacogenetics testing with decision support tools, if applied earlier during the treatment with antipsychotics, could have led to identifying individuals at risk for serious AEs.
Subject(s)
Antipsychotic Agents , Antipsychotic Agents/adverse effects , Cytochromes , Humans , Polymorphism, Genetic/genetics , Research , Retrospective StudiesABSTRACT
Objective: To increase understanding of the influence of photoperiod variation in patients with bipolar disorders. Methods: We followed a sample of Italian bipolar patients over a period of 24 months, focusing on inpatients. All patients admitted to the Psychiatric Inpatient Unit of San Luigi Gonzaga Hospital in Orbassano (Turin, Italy) between September 1, 2013 and August 31, 2015 were recruited. Sociodemographic and clinical data were collected. Results: Seven hundred and thirty patients were included. The admission rate for bipolar patients was significantly higher during May, June and July, when there was maximum sunlight exposure, although no seasonal pattern was found. Patients with (hypo)manic episodes were admitted more frequently during the spring and during longer photoperiods than those with major depressive episodes. Conclusions: Photoperiod is a key element in bipolar disorder, not only as an environmental factor but also as an important clinical parameter that should be considered during treatment.
Subject(s)
Humans , Male , Female , Adult , Seasons , Sunlight/adverse effects , Bipolar Disorder/etiology , Bipolar Disorder/psychology , Photoperiod , Socioeconomic Factors , Sex Factors , Depressive Disorder, Major , Hospitalization/statistics & numerical data , Italy , Mental Disorders/classification , Mental Disorders/etiology , Mental Disorders/psychologyABSTRACT
OBJECTIVE: To increase understanding of the influence of photoperiod variation in patients with bipolar disorders. METHODS: We followed a sample of Italian bipolar patients over a period of 24 months, focusing on inpatients. All patients admitted to the Psychiatric Inpatient Unit of San Luigi Gonzaga Hospital in Orbassano (Turin, Italy) between September 1, 2013 and August 31, 2015 were recruited. Sociodemographic and clinical data were collected. RESULTS: Seven hundred and thirty patients were included. The admission rate for bipolar patients was significantly higher during May, June and July, when there was maximum sunlight exposure, although no seasonal pattern was found. Patients with (hypo)manic episodes were admitted more frequently during the spring and during longer photoperiods than those with major depressive episodes. CONCLUSIONS: Photoperiod is a key element in bipolar disorder, not only as an environmental factor but also as an important clinical parameter that should be considered during treatment.
Subject(s)
Bipolar Disorder/etiology , Bipolar Disorder/psychology , Photoperiod , Seasons , Sunlight/adverse effects , Adult , Depressive Disorder, Major , Female , Hospitalization/statistics & numerical data , Humans , Italy , Male , Mental Disorders/classification , Mental Disorders/etiology , Mental Disorders/psychology , Sex Factors , Socioeconomic FactorsABSTRACT
OBJECTIVE: Environmental conditions during early life may affect individual vulnerability to both physiological changes as well as psychiatric conditions, especially in those with a genetic susceptibility. Among all factors, sunlight exposure intensity has a crucial effect on affecting circadian functions high-risk individuals. A potential explanation of this relation is that excessive sunlight exposure is able to impair biological mechanisms, possibly through the dysregulation of serotonin and/or melatonin production/metabolism. The aim of this study was to evaluate the influence of excessive sunlight exposure in a sample of emergency psychiatry inpatients. METHODS: All subjects were consecutively recruited from the Psychiatric Inpatient Unit of San Luigi Gonzaga Hospital, Orbassano (University of Turin, Italy) from September 2013 to August 2015. Socio-demographic and clinical characteristics were carefully collected. RESULTS: We initially screened a sample of 900 patients; however, only 730 subjects voluntary accepted to participate in the study. Patients with admissions in spring/summer (a period in which daylight/darkness ratio is longer) showed a higher prevalence of involuntary admission, an earlier age at illness onset, a longer duration of hospitalization and admission for (hypo)manic episode. CONCLUSIONS: Excessive sunlight exposure may exert a fundamental role on psychopathological conditions presumably affecting biological vulnerability. A better understanding of its effect on the course of bipolar and other psychiatric disorders may assist in tailoring the adequate treatment for patients resulting in a shorter stay within hospitalized settings and a better treatment response.
