Brain Network Underlying the Improvement of Social Functioning in Schizophrenic Patients After One-year Treatment with Social Skills Training.

PURPOSE: To assess changes in social and neuro-cognition and regional cerebral blood flow (rCBF) in schizophrenic patients with psychotic syndrome treated with Social Skill Training (SST). METHODS: 17 patients underwent two high resolution rCBF SPECT at rest before and after a one-year treatment with SST. Patients were assessed using a neuropsychological evaluation (W.A.I.S.-R, T.M.T, Verbal Fluency, W.C.S.T.). SPM8 was used to investigate rCBF changes from the pre- to the post-SST condition and the relationship between rCBF and clinical scores used as covariates of interest. RESULTS: All patients presented with an improvement in social perception, ability to deal with abstract social conventions, rules and judgments about people (Comprehension and Picture Completion sub-tests) and some neuro-cognitive functions sustaining the process of socially relevant information. The main effect of SST was to produce rCBF increases in precuneus, PCC, superior parietal lobules, PMC, pre-SMA, precentral gyrus, dmPFC, dlPFC, vmPFC, OFC (p<0.0001 uncorrected). The SPM analysis showed that Comprehension was supported by PMC, dmPFC, OFC and vmPFC, while the Picture Completion was supported by PMC and dmPFC (p<0.0001). CONCLUSION: SST in schizophrenic patients improves resting neural activity in cortical areas of the amigdala-based and non-amygdala networks of social brain, including dmPFC and vmPFC, and dlPFC, which are known to be part of default mode and task-positive networks and to be implicated in schizophrenia.

Full-mouth rehabilitation with immediate loading of implants inserted with computer-guided flap-less surgery: a 3-year multicenter clinical evaluation with oral health impact profile.

OBJECTIVE: The purpose of this report is to present the clinical outcomes and patients' satisfaction of full-mouth rehabilitation using computer-aided flapless implant placement and immediate loading of a prefabricated prosthesis. MATERIALS AND METHODS: The study included 30 consecutive fully edentulous patients who received 312 implants. Mandible and maxilla were treated in the same surgical session with computer-guided flapless approach using the NobelGuide protocol. Prefabricated screw-retained fixed prostheses were inserted at the end of surgery. Clinical and radiographic evaluations were assessed at 6, 12, and 36 months. At baseline and 6 months after surgery, patients answered Oral Health Impact Profile in Edentulous Adults questionnaire to assess satisfaction. RESULTS: The implant survival rate was 97.9%, whereas the average marginal bone loss was 1.9 ± 1.3 mm after 3 years. At 6 months, patients showed significantly greater satisfaction with their fixed rehabilitation when compared with conventional dentures. CONCLUSIONS: The results of this study confirm that rehabilitation with a prefabricated fixed prosthesis supported by implants placed with NobelGuide protocol is a viable and predictable treatment and increases patients' satisfaction and improves oral health-related quality of life.

Psychological impact of self-image dissatisfaction after orthognathic surgery: a case report.

AIMS: The number of patients who need treatment for dentofacial abnormalities has increased over the past 30 years. Facial alterations can influence both the patient's self-confidence and his interpersonal relationships, possibly generating emotional or physical handicaps. This qualitative study discusses a patient's psychological dissatisfaction with a postoperative outcome, despite the esthetic and functional success of the treatment. METHODS: The Oral Health Status Questionnaire, Post Surgical Satisfaction Questionnaire, Illness Behavior Questionnaire, and a clinical interview were used for the research methodology. RESULTS: Oral surgeons are encouraged to identify, presurgery, the patient's true motivation. An efficacious behavioral model is proposed that might help the patient transition through the consequences stages of the psychosocial changes associated with facial reconstructive surgery. CONCLUSION: Orthognathic surgery involves more than the correction of a physical problem. The psychological needs of the patient must be recognized and acknowledged, and communication between surgeons and patients is essential. It is important to understand that any surgical treatment that modifies body image could generate psychological disorders for some patients. Early surgical intervention and a referral for psychological counseling may reduce long-term morbidity. This case report should alert attending surgeons and orthodontists to possible unfavorable psychological sequelae.

Genitourinary cancer: psychological assessment and gender differences.

INTRODUCTION: The study of the psychological impact in patients diagnosed with cancer is an important topic. Cancer diagnosis can induce feelings of anxiety, depression, fear of recurrence and produce treatment side effects. Men and women tend to differ in their way of dealing with emotional distress and physical illness. The aim of this study is to investigate and evaluate the prevalence and detection of psychological disease in patients with genitourinary tumors and outline the eventual gender differences. MATERIALS AND METHODS: State-Trait Anxiety Inventory, Self-Rating Depression Scale and Illness Behavior Questionnaire were administered to 60 patients with genitourinary neoplasm. RESULTS: Most patients show symptoms of depression and anxiety during the hospitalization. We have observed a significant gender differences in the psycho-emotional assessment. CONCLUSION: Our study confirms the importance to make available for the patients a proper and continuous support in pre- and postsurgery period to prevent the generation of psychological disorders.

Psychoemotional assessment changes in patients treated with orthognathic surgery: pre- and postsurgery report.

AIM: To evaluate a sample of patients treated with orthognathic surgery, establishing the emotional and self-perception differences between the pre- and postsurgical assessment. MATERIAL AND METHODS: Several questionnaires (Body Dysmorphic Disorder Examination, State Trait Anxiety Inventory, Self-Rating Depression Scale, Oral Health Status Questionnaire, Post-Surgical Satisfaction Questionnaire) were administered to the sample of 30 patients; these were used to study the data related to body image, level of anxiety, eventual depressive status, quality of life, and postsurgical satisfaction. RESULTS: The longitudinal study results outline the impact of orthognathic surgery on the psychological and emotional well-being of the patient and the need for the specialist to understand the emotional status and expectations of the patient.