Cerebral cortical thickness and gyrification changes in first-episode psychoses and multi-episode schizophrenia.

Cortical thickness (CT) and local gyrification index (LGI) in psychotic disorders may show modifications that relate to clinical course. This observational study aimed to analyse such variables in patients with schizophrenia, compared to healthy controls (HCs). We compared CT and LGI of 18 patients with first-episode psychosis with that of 21 with multi-episode schizophrenia and 16 HCs. CT corrected for false-positive cases (Family-Wise Error Rate) showed a reduction in the multi-episode group compared to HCs in left temporal and parietal, and right temporal, parietal, occipital, and hippocampal cortices. Family-wise corrected LGI was increased in the left inferior and middle frontal cortices, and in the right fusiform gyrus, cingulate, lingual, and parahippocampal gyri in first onset patients compared to HCs. Increased LGI was absent from later stages of psychosis, suggesting that specific CT and LGI alterations may underlie different stages of illness.

Familial aggregation of MATRICS Consensus Cognitive Battery scores in a large sample of outpatients with schizophrenia and their unaffected relatives.

BACKGROUND: The increased use of the MATRICS Consensus Cognitive Battery (MCCB) to investigate cognitive dysfunctions in schizophrenia fostered interest in its sensitivity in the context of family studies. As various measures of the same cognitive domains may have different power to distinguish between unaffected relatives of patients and controls, the relative sensitivity of MCCB tests for relative-control differences has to be established. We compared MCCB scores of 852 outpatients with schizophrenia (SCZ) with those of 342 unaffected relatives (REL) and a normative Italian sample of 774 healthy subjects (HCS). We examined familial aggregation of cognitive impairment by investigating within-family prediction of MCCB scores based on probands' scores. METHODS: Multivariate analysis of variance was used to analyze group differences in adjusted MCCB scores. Weighted least-squares analysis was used to investigate whether probands' MCCB scores predicted REL neurocognitive performance. RESULTS: SCZ were significantly impaired on all MCCB domains. REL had intermediate scores between SCZ and HCS, showing a similar pattern of impairment, except for social cognition. Proband's scores significantly predicted REL MCCB scores on all domains except for visual learning. CONCLUSIONS: In a large sample of stable patients with schizophrenia, living in the community, and in their unaffected relatives, MCCB demonstrated sensitivity to cognitive deficits in both groups. Our findings of significant within-family prediction of MCCB scores might reflect disease-related genetic or environmental factors.

[Phenelzine: legacy or current psychiatric practice?]. / Fenelzina: retaggio o attualità nella pratica psichiatrica?

Monoamine oxidase inhibitors (MAO-I) are the first drugs of antidepressant classes discovered. Phenelzine is a worldwide prescribed MAO-I, studied in a variety of mood and anxiety disorders. Purpose of the present paper is to critically review the results reported in the scientific international literature focusing on efficacy and safety of phenelzine in clinical psychiatric practice, in order to achieve a better understanding of the relationship between pharmacological data, therapeutic approach and side or adverse effects. We performed a careful PubMed (1980-2012) search on clinical pharmacology and clinical use of phenelzine in various psychiatric disorders. We reported our findings discussing separately clinical pharmacology data and systematic controlled, randomised and not randomised, clinical studies.

Behavior therapy for spasmodic torticollis: a case study suggesting a causal role for anxiety.

A 29-year old male with an 8-month history of spasmodic torticollis was treated after three baseline assessments with progressive relaxation, positive practice, and visual feedback. Subjective, behavioral, and physiological (EMG) data indicated that EMG declined across baseline assessments and treatment, while substantial changes in subjective and behavioral data occurred with treatment. Improvement on all dependent measures also was found at a 2-year follow-up. The data are discussed in terms of the non-specific effects of treatment, and the utility and economy of these primarily self-administered procedures.

[Photoplethysmography as a means of early diagnosis of changes in the microcirculation of children and adolescents with type I diabetes. Preliminary study]. / La fotopletismografia come mezzo di diagnosi precoce di alterazioni del microcircolo in bambini e ragazzi affetti da diabete di tipo I. Studio preliminare.

Recent progress in non invasive diagnostic techniques for the study of the microcirculation, evoked a great interest in the screening of the patients with a diabetic microangiopathy. The authors, in this paper, wanted to evaluate the usefulness of photoplethysmography in the study of the microcirculation in children affected by type I diabetes; this technique was proposed as very reliable, non invasive and easily repeatable. 42 diabetic patients, with an age from 6 to 18 years, and a group of 12 healthy subjects of the same age, as a control group, were considered. Two particular points of interest were found: the statistical correlation between familial pathology for a vascular disease and the photoplethysmographic findings and the significant correlation between the age of the pathology and the beginning of the microcirculation disease. The authors, from their experience, evaluate the photoplethysmography as a reliable technique in the screening of all the diabetic subjects, children and adults, to evidence, as soon as possible, eventual lesions of the microcirculation for the beginning of an adequate therapy.

A double-blind study of fluoxetine and imipramine in major depression.

Eighteen outpatients with major depression (diagnosis was made according to DSM-III criteria) were treated in a 5-week double-blind parallel group comparison of the new antidepressant fluoxetine with imipramine. From these results it can be shown that the drugs were comparable in efficacy, although because of the small sample size a moderate clinical difference between treatments may not have been detected. Imipramine and fluoxetine have already been compared in other studies, but never at such a low dosage (20 mg) for fluoxetine. At this dosage the fluoxetine safety profile seems to be very different from previous scheduled studies with higher dosages. In fact clinical efficacy seems to remain comparable while side-effects are significantly less frequent.

Depression in elderly people treated with amineptine (Survector 100): a synopsis.

Aging is one of the most important current problems. In fact, according to statistics, the elderly population of the world is continuously increasing, and depression represents the most frequent psychiatric problem in the aged. It is well known that the antidepressive treatment of the aged imposes particular problems because of the frequent presence of cardiovascular problems, ocular hypertension, and prostatic hypertrophia. Amineptine (Survector 100) is devoid of anticholinergic and cardiotoxic effects. For this reason we have studied it in the treatment of elderly depressed patients. This study comes from a multicenter clinical trial (32 hospital centers) in which 324 patients were recruited; it includes 63 depressed patients over the age of 60 years. The diagnosis of depression was stated according to DSM-III diagnostic criteria and INSERM classification, and assessed by Hamilton Depression Rating Scale (HDRS) (26 items). The patients were treated with amineptine (200 mg/day) for 39.3 days (mean). The overall clinical efficacy was positive in 68% of cases; the clinical judgment was confirmed by a decrease in the mean score of HDRS (after the 7th day). The good acceptability (clinical, cardiovascular) was also confirmed. The different biochemical parameters were generally not modified during the treatment. Amineptine appeared to be an antidepressant treatment that combines efficacy and a very good level of safety, essential qualities for the treatment of elderly depressed patients.