Restoring bottom-up communication in brain-heart interplay after trauma-focused psychotherapy in breast cancer patients with post-traumatic stress disorder.

BACKGROUND: The psychological impact of breast cancer (BC) is substantial, with a significant number of patients (up to 32 %) experiencing post-traumatic stress disorder (PTSD). Exploring the emotional aspects of PTSD through the functional brain-heart interplay (BHI) offers valuable insights into the condition. BHI examines the functional interactions between cortical and sympathovagal dynamics. This study aims to investigate changes in functional directional BHI after trauma-focused (TF) psychotherapy, specifically Eye Movement Desensitization and Reprocessing (EMDR), in comparison to treatment as usual (TAU) among BC patients with PTSD. To our knowledge, this study represents the first examination of such changes. METHODS: We enrolled thirty BC patients who met the criteria for a PTSD diagnosis, with fourteen receiving EMDR and fifteen receiving TAU over a two- to three-month period. We analyzed changes in the emotional response during a script-driven imagery setting. Quantification of the functional interplay between EEG and sympathovagal dynamics was achieved using the synthetic data generation model (SDG) on electroencephalographic (EEG) and heartbeat series. Our focus was on the difference in the BHI index extracted at baseline and post-treatment. RESULTS: We found statistically significant higher coupling in the heart-to-brain direction in patients treated with EMDR compared to controls. This suggests that the flow of information from the autonomic nervous system to the central nervous system is restored following EMDR-induced recovery from PTSD. Furthermore, we observed a significant correlation between improvements in PTSD symptoms and an increase in functional BHI after EMDR treatment. CONCLUSIONS: TF psychotherapy, particularly EMDR, appears to facilitate the restoration of the bottom-up flow of interoceptive information, which is dysfunctional in patients with PTSD. The application of BHI analysis to the study of PTSD not only aids in identifying biomarkers of the disorder but also enhances our understanding of the changes brought about by TF treatments.

Age of onset of mood disorders and complexity of personality traits.

Objective. The aim of the present study is to evaluate the link between the age of onset of mood disorders and the complexity of the personality traits. Methods. 209 patients with major depressive or manic/hypomanic episodes were assessed using the Structured Clinical Interview for DSM Axis I diagnoses and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Results. 17.2% of the patients had no elevated MCMI-III scores, 45.9% had one peak, and 36.9% had a complex personality disorder with two or more elevated scores. Mood disorders onset of 29 years or less was the variable most related to the complexity of personality disorders as indicated from a recursive partitioning analysis. Conclusions. The relationship between mood disorders and personality traits differ in reference to age of onset of the mood disorder. In younger patients, maladaptive personality traits can evolve both in a mood disorder onset and in a complex personality disorder, while the later development of a severe mood disorder can increase the personality symptomatology. Our results suggest a threshold of mood disorder onset higher compared to previous studies. Maladaptive personality traits should be assessed not only during adolescence but also in young adults to identify and treat potential severe mood disorders.

Lack of interaction between a polymorphism in the dopamine D2 receptor gene and the clinical features of migraine.

The purpose of this study was to evaluate whether a particular genotype of the dopamine D2 receptor (DRD2) gene would affect the clinical features of migraine. In a group of 118 migraineurs (55 migraine with aura and 63 migraine without aura patients), we tested the association of the biallelic C/T NcoI DRD2 polymorphism with several characteristics of the disease. Genotype and allele frequencies resulted similarly distributed in migraine with aura and migraine without aura patients (chi2 = 1.58, P = 0.45 and chi2 = 0.09, P = 0.77, respectively). The different DRD2 genotypes (C/C, C/T and T/T) had no significant effects on age at onset of migraine, presence of premonitory phenomena, frequency of headache attacks, associated symptoms, psychological features and quality of life of our migraine patients. The results of our study do not support a role for the DRD2 gene in modifying the clinical features of migraine.

[Psychosexual problems in patients with neoplasms]. / Problematiche psicosessuologiche nei pazienti neoplastici.

The Author's aim is to highlight the importance of psychic dynamics which play a role when a patient, suffering from cancer, turns to a therapist for sexual rehabilitation.

[The "small penis": considerations about subjective penile deficiency]. / Il "pene piccolo": considerazioni sulla difettualità soggettiva del pene.

In sexology clinical practice you can see quite frequently patients who make complaints about their penis not being big enough. The Authors suggest that the subjective feeling of penis deficiency is a symptom which needs to be properly diagnosed and understood, in order to be able to make effective therapeutic interventions, from a psychotherapeutic, psychopharmacologic or surgical point of view.

[Psychosexual interventions combined with biologic therapy of erectile dysfunction]. / Considerazioni sull'intervento psicosessuologico in associazione alle terapie biologiche della disfunzione erettile.

The authors, beginning from che concept of erectile disorder with mixed pathogenesis, describe its clinical dimension. The psychic variables which prevent the use of biologic-andrologic therapy (FIC, penis prosthesis) are then considered: 1) psycho-sexual difficulties before the onset of the organic lesion; 2) the partner's relationship with the biologic-andrologic therapy; 3) the patients' relationship with the biologic therapy. A model of intervention (Group Psycho-sexologic Intervention) on the psychic variables interfering with the use of the biologic-andrologic therapy is then described. The authors end by considering the psychological impact and the possible psychoiatrogenicity of biologic-andrologic therapies.