Delirium in heart failure.

Despite relative frequency of delirium in elderly hospitalized heart failure patients, skills and expertise in managing such complication are usually poor for physicians and nurses facing this clinical condition. International guidelines on heart failure do not provide detailed indication for such clinical condition, and evidence on this topic is limited. A multi-disciplinary approach (cardiologists, internists, geriatricians, psychologists, and psychiatrists) is often required; this review will therefore focus on diagnosis and clinical management of delirium in heart failure patients from a multidisciplinary point of view.

Sport Activity as Risk or Protective Factor in Feeding and Eating Disorder.

Emerging evidence suggests controversial results on the associations between sport activity and eating disorders (EDs). The aim of the present study was to investigate the relationship between sport activity in general, weight-dependent/independent sport activity particularly, and risk or protective factors in feeding and eating disorder (FED). The sample (n = 282, divided into two successive groups), included competitive athletes in the first analysis, non-competitive athletes, and sedentary peers; in the second analysis it has been divided into weight-dependent athletes, weight-independent athletes, non-competitive athletes, and sedentary peers. The participants were tested with Rosenberg Self-Esteem Scale, Profile of Mood State (POMS) questionnaire, Body Shape Questionnaire (BSQ), Eating Attitudes Test (EAT-26), and Body Uneasiness Test (BUT). The results show higher levels of self-esteem among athletes in general and particularly in weight-independent athletes (p = 0.0210). We found higher levels of image and body dissatisfaction among sedentary peers and weight-dependent athletes (0.0005 < p < 0.0015). Sedentary peers also reported higher levels of tension/anxiety, depression/dejection, confusion/bewilderment and fatigue/inertia (0.0001 < p < 0.0331). Dieting and oral control were found to be higher among weight-dependent athletes (0.0337 < p < 0.0400). The findings suggest that sedentary condition is associated with higher levels of body-image discomfort and higher level of psychological distress, whereas weight-dependent athletes may report dietary issues and bodily concerns. Sport activity should be promoted and specific trainings on diet and body-consciousness encouraged among athletes.

Alexithymia Predicts Attrition and Outcome in Weight-Loss Obesity Treatment.

Obesity is a psychosomatic condition characterized by a complex interaction of biological and psychological factors and a large body of research has aimed to identify variables limiting efficacy and determining high attrition rates in weight loss programs. In this study, we used the Diagnostic Criteria for Psychosomatic Research (DCPR), designed to broaden the clinician's perspective on patients' problems by providing additional clinical information not found in the more traditional psychiatric classification, to predict psychosomatic variables that may limit efficacy and determine attrition in clinical interventions with people with obesity. We evaluated 82 consecutive participants with obesity at baseline for psychopathology, psychosomatic correlates, psychological distress, and eating-related symptoms before entering a weight loss program. Regression models were used to assess attrition and outcome at a 6-month follow-up and per-protocol and intention-to-treat analyses were performed. DPCR alexithymia significantly predicted attrition (OR = 6.9), and unsuccessful weight-loss (OR = 11.3). These findings suggest that the identification of psychosomatic factors, in addition to psychological and psychopathological factors, may predict adherence to weight-loss programs.