Prevalence and Correlates of Vitamin D Deficiency in a Sample of 290 Inpatients With Mental Illness.

Introduction: Vitamin D inadequacy or deficiency (VDID) has been reported in a high percentage of otherwise healthy individuals. Factors that may contribute to the high prevalence of VDID in people with mental disorders include diet low in vitamin D, poor sunlight exposure, decrease in cutaneous vitamin D synthesis, intake of certain medications, poor mobility, excessive alcohol intake, and tobacco smoking. VDID has been correlated to a host of adverse conditions, including rickets, osteoporosis, osteomalacia, muscle diseases, depression, cognitive dysfunction, and even certain cancers. Objectives: The purpose of this study was to report the prevalence and correlates of vitamin D inadequacy in a sample of 290 psychiatric patients admitted to inpatient or day hospital treatment at the University of Siena Medical Center. Methods: We retrospectively evaluated the prevalence of VDID in 290 psychiatric inpatients' medical records during the year 2017 and evaluated the correlates of VDID in patients with mental illness. Results: Two hundred and seventy two out of two hundred and ninety patients (94%) showed VDID. Physical activity and regular diet were positively correlated with vitamin D levels whereas age, tobacco smoking, PTH, alkaline phosphatase levels were negatively correlated. Statistically significant differences were found among smokers and non-smokers in all study groups. Conclusions: VDID was highly prevalent in our sample. In addition to vitamin D supplementation, psychosocial intervention able to promote and help sustain physical activity, appropriate diet, quitting smoking and sensible sun exposure to prevent and treat VDID in patients with mental health should be implemented, tested, and introduced in our clinical practice.

Pharmacotherapeutic strategies for treating binge eating disorder. Evidence from clinical trials and implications for clinical practice.

INTRODUCTION: Binge eating disorder (BED) is the most common eating disorder and was newly recognized in 2013 in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). BED is frequently associated with obesity and the metabolic syndrome, as well as with other psychiatric diseases, such as mood (49%), anxiety (41%), and substance use (22%) disorders. BED is highly prevalent and carries a high burden of mental and physical illness and disability. However, BED is frequently under-recognized and under-treated. AREAS COVERED: This paper reviews the main pharmacological treatments for BED and provides an expert opinion based on the available evidence and on the authors' clinical experience with patients affected by BED. EXPERT OPINION: Several medications have proven to be effective for the treatment of BED, including Lisdexamfetamine (LDX), topiramate as well as anti-anxiety and antidepressant medications. To date, LDX is the only FDA approved medication for BED. Consequently, as a general rule, the use of an FDA approved medication should always be preferred. However, when in the presence of concomitant psychiatric conditions such as anxiety or depression, other medications that have proven efficacy in those comorbid conditions can be used and may contextually provide a benefit for BED.

Epidemiology of central nervous system tumors in Labin area, Croatia, 1974-2001.

AIM: To establish the incidence of tumors of the central nervous system (CNS) in the population of Labin area in Istria, Croatia, characterized by very little population migration. METHOD: We retrospectively analyzed data on 175 patients (102 men and 73 women) diagnosed with CNS tumor according to the World Health Organization's diagnostic criteria in the period 1974-2001. Patient data were retrieved from multiple sources: files of general practitioners in Labin area; registers of admissions and discharges of the Pula General Hospital and Rijeka University Hospital Center; and medical records of the Hospital Departments of Neurology, Surgery, Neurosurgery, Oncology and Radiotherapy, and Pathology. Annual incidence, anatomic location, and pathohistological classification of CNS tumors were determined, as well as age at disease onset. RESULTS: Out of 175 subjects, 95 had primary CNS tumors and 80 had metastases. Intracranial tumors were found in 88.4% of patients with primary CNS tumors (annual incidence, 11.8/100000 population) and intraspinal in 11.6% of patients (annual incidence, 1.6/100000). Similar distribution was observed for CNS metastases (70 intracranial vs 10 intraspinal), with annual incidence of 9.9 and 1.4/100000, respectively. The most frequent intracranial tumors were those of neuroepithelial tissue, accounting for 58.3% of all CNS neoplasms (annual incidence, 6.9/100000 population). The most frequent intraspinal tumors were tumors of the meninges (54.5%). There was no particular temporal clustering of CNS tumors. The age at disease onset corresponded with that reported in the literature: 50.5+/-17.0 years for primary intracranial tumors, and 59.7+/-12.2 years for primary intraspinal tumors. CONCLUSION: Primary CNS tumors showed high, but temporally stable incidence in population of Labin area over the last 27 years, indicating that the alleged increase in CNS tumors incidence was not true.