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The fight against the COVID-19 pandemic seems to encompass a social media debate, possibly resulting in emotional contagion and the need for novel surveillance approaches. In the current study, we aimed to examine the flow and content of tweets, exploring the role of COVID-19 key events on the popular Twitter platform.
Using representative freely available data, we performed a focused, social media-based analysis to capture COVID-19 discussions on Twitter, considering sentiment and longitudinal trends between January 19 and March 3, 2020. Different populations of users were considered. Core discussions were explored measuring tweets’ sentiment, by both computing a polarity compound score with 95% Confidence Interval and using a transformer-based model, pretrained on a large corpus of COVID-19-related Tweets. Context-dependent meaning and emotion-specific features were considered.
We gathered 3,308,476 tweets written in English. Since the first World Health Organization report (January 21), negative sentiment proportion of tweets gradually increased as expected, with amplifications following key events. Sentiment scores were increasingly negative among most active users. Tweets content and flow revealed an ongoing scenario in which the global emergency seems difficult to be emotionally managed, as shown by sentiment trajectories.
Integrating social media like Twitter as essential surveillance tools in the management of the pandemic and its waves might actually represent a novel preventive approach to hinder emotional contagion, disseminating reliable information and nurturing trust. There is the need to monitor and sustain healthy behaviors as well as community supports also via social media-based preventive interventions.
Children differ in their response to environmental exposures, with some being more sensitive to contextual factors than others. According to theory, such variability is the result of individual differences in neurobiological sensitivity to environmental features, with some individuals generally more affected by both negative and/or positive experiences. In this exploratory study we tested whether left and right amygdala and hippocampus volumes (corrected for total brain size) account for individual differences in response to environmental influences in a sample of 62 boys. Cumulative general environmental quality, ranging from low to high, was measured across the first 9 years and child behavior was reported by teachers when boys were 12–13 years old. According to analyses, only the left amygdala volume – not any of the other brain volumes – emerged as an important brain region for sensitivity to positive environmental aspects. Boys with a larger left amygdala benefited significantly more from higher environmental quality than boys with a smaller left amygdala whilst not being more vulnerable to lower quality. Besides providing preliminary evidence for differences in environmental sensitivity due to brain structure, the results also point to the left amygdala as having a specific role regarding the response to environmental influences.
Metabolic syndrome and cardiovascular diseases are important causes of morbidity and mortality among patients with mental illness. Atypical antipsychotics are more associated with obesity, metabolic syndrome, abnormal glucose and lipid metabolism than first generation antipsychotics.
To identify risk factors related to glucose metabolism in short, medium and long time treatment and find out which are related to neuroleptic therapy and which depends on genetic background and lifestyle. To follow up clinical and self-rated variations of the psychiatric symptoms.
We included psychotic or bipolar patients in treatment with only one typical (haloperidol) or atypical (clozapine, olanzapine, risperidon, aripiprazole, paliperidon) neuroleptic, drug-naïve or after a wash-out from previous therapy. Patients will be evaluated five times (at baseline and after 1, 3, 6, 12 months) with a blood sample (haemocrome, glucose, insulin, Hb A1C, thyroid hormones, liver and pancreatic function), BMI, Basal Metabolic Rate (BMR), OGTT, HOMA index, familiar and pharmacological history, SIDE and CGI.
From blood exams and OGTT we will obtain data regarding variations of glucose metabolism and the possible relationship with neuroleptic medications. From SIDE questionnaire we will assess the impact of side-effects by the patient's perspective and with CGI the variations of symptom severity.
Our study will allow us to identify risk factors concerning glucose metabolism alterations related to antipsychotic medications.
Stroke represents the third most frequent cause of mortality in developed countries, following only coronary heart diseases and cancer. Post-Stroke Depression (PSD) is extremely common among stroke survivors, and it may have great burden on the likelihood of functional recovery and long-term outcomes. We hypothesized that PSD is related to a higher rate of mortality among people suffering from a stroke.
To estimate the risk of mortality among subjects suffering from PSD as compared with stroke survivors who did not suffer from PSD.
We performed a systematic review of papers indexed in Pubmed. Both fixed and random-effects methods for estimating association and time-to-event pooled effects were used. The presence and the level of heterogeneity were assessed using Q test and I2 statistic.
Seven papers had data suitable for meta-analysis. The pooled association effect for mortality at follow-up in people with PSD were statistically significant (p< 0.05). The time-to-event estimation showed a statistically significant correlation exclusively under the fixed effect analysis.
These findings pointed out the potential burden of PSD on post stroke mortality. Further investigation is required to clarify the nature of PSD/mortality association.
People suffering from Severe Mental Illness (SMI) have a shorter life expectancy than general population. The excess of mortality may be primarily due to premature cardiovascular diseases. Subjects with a diagnosis of SMI may have an high prevalence of Metabolic Syndrome (MetS).
To estimate the risk of MetS among subjects with SMI compared to their counterpart without SMI.
A systematic review and meta-analysis of English and non-English articles using PubMed, Embase and PsycINFO was performed. ORs with related confidence intervals were used as association measures. All pooled analyses were based on random-effects models.
The pooled analysis showed a statistically significant association for MetS in people suffering from SMI. However, we found a consistent level of heterogeneity between the included studies. Subanalyses showed that both SCZ and BD had higher risk than general population without SMI. No statistical differences were found comparing SCZ and BD subjects.
People with SMI have significantly higher risk to having MetS than general population. Despite some limitations, the results of present meta-analysis emphasize the relevance of a continuous cardio-metabolic assessment in the SMI population. Longitudinal researches are needed in order to assess the impact of a regular cardiovascular screening, prevention and treatment on the improvement of health status and life expectancy among people suffering from SMI.
An analysis of the literature on eating disorders (ED) indicates that Eds are often comorbid with the diagnosis of Personality Disorder (PD). This seems to be a psychopathological feature, characteristic of this patient population. However, the double classification seems to be often insufficient when describing a very complex psychopathological picture. These observations have informed our intention to investigate these two distinct nosographic groups by means of a single construct.
The aim of this study is to identify and describe (through tests that evaluate defense mechanisms) the defensive styles that characterize the two groups of patients, in order to outline a defensive profile that can assimilate or differentiate the psychopathological groups.
Materials and methods
The study was carried at the Department of Psichiatry of the San Gerardo Hospital in Monza. The Defence Style Questionnaire-40 (Farma Cortinovis, 2000) was administered and analysed. The sample consisted of 40 participants with eating disorders, recruited among the outpatients for eating disorders, and 40 patients with personality disorders recruited from two Psychiatric Outpatient Services.
Results and conclusions
The data analysis showed a statistical significance in the use of Immature defense mechanisms and Neurotic defence mechanisms in both clinical samples.The patients with PD used a significantly higher number of psychotic defense mechanisms than patients with ED. These results may suggest that in ED patients, the symptoms can be themselves considered as defense mechanisms, or a defensive style that characterizes and makes specific the psychopathological picture.
Mrs. O. is a 57 years old secretary. Her past medical history is unremarkable relative to psychiatric disorders or other diseases. She came to the ER because of sudden and severe depressive symptoms, including thoughts of death. Moreover, at times she had brief episodes of confusion during which she displayed depersonalization and short periods of spatial and temporal disorientation.
She was hospitalized in the psychiatric ward and underwent routine blood tests, neurological exams and a MR brain scan, without showing any significant abnormalities. Notably, she presented a maculopapular rash compatible with herpes zoster. Thirteen days later, she was feeling much better and was sent home, with an indication of a psychiatric follow-up. A week later Mrs. O. returned to the ER, since she presented a mixed episode, again with psychotic symptoms. During this second period of hospitalization, Mrs. O. presented persistent mild fever, and more apparent brief moments of spatio-temporal disorientation were noted, accompanied by psychomotor slowness. The impression of an underlying process was further confirmed and a neurological consultation was asked for again. Suspecting viral encephalitis, the patient was admitted to the neurological department and started on acyclovir, demonstrating an initial improvement of the psychiatric symptoms. The follow-up MR brain scan was normal. A suspicion of acute inflammatory demyelinating polyradiculoneuropathy (AIDP) was formulated. Thirty days later Mrs. O.’s deficits in strength were improving steadily and she was transferred to the rehabilitation ward. The psychiatric symptoms had completely receded.
Alexithymia correlates with fundamental psychological traits of eating disorders in a complex causal model and high relapse rates which may be due to a lack of affect regulation. The literature does not reach definitive conclusions about the usefulness of this construct in the clinical field.
The purpose of this preliminary study was to evaluate the presence of alexithymia and its correlation with epidemiological variables, psychological characteristics, symptom severity, and general psychopathological dimensions.
Materials and methods
A sample of 125 patients with eating disorders was recruited from outpatient care for eating disorders at the San Paolo Hospital in Milan. Patients were administered the following scales: the TAS20, SCL-90 and EDI-2.
Results and conclusions
The results indicate that 38% of the sample were alexithymic, an underestimation when compared to literature; different types of ED did not differ in alexithymia scores. The TAS20 did not correlate with the epidemiological variables. Diagnoses of Axis II disorders predicted the presence of alexithymia, suggesting that it may contribute to affective dysregulation found in personality disorders. The TAS20 further correlated with EDI-2, in particular with the subscales relating to the body and the relational aspects, and with the level of general psychopathology on the SCL-90, indicating that alexithymia may be a dimension that extends across nosographies in disorders of affective dysregulation.
This study presents the first results of a project on alexythymia and emotional connections in a sample of 8 patients with EDs. The project aims to evaluate changes in emotional expressions through the language used, by means of the Italian measure of the referential process. Changes in the alexithymic condition will be examined through the outcome and qualitative analysis of the psychotherapeutic process.
25 verbatim transcribed psychotherapeutic sessions were analyzed and correlated with TAS20, EDI-2, PBI, BUT, SWAP200, and between these and the narrative indices of the IDAAP.
The relation between TAS20 and PBI supports a link between alexythymia and parenting styles: neglect and overprotection seem to contribute to difficulties in forming emotional connections. The positive correlation found between the TAS20 and some EDI2 subscales indicates a tendency to express misunderstood stimuli by means of the body. A positive correlation between MHIWRAD2 and TAS20 may suggest strong phases of emotional activation due to emotional dysregulation. The analysis of the significant correlations between the PBI and the RA measures indicate that parenting styles are related to language. A positive correlation between the IWRAD indices and maternal overprotectiveness was found: maternal overprotectiveness may be associated to strong emotional activation which is in turn characterized by emotional dysregulation. The associations between the narrative indices and the high functioning measure of the SWAP200 suggest that the reflexive components is related to high functioning; emotional dysregulation, as expressed by the variability in RA peaks, seems to be connected to low functioning.
– Define the scope of the study of Forensic Neuropsychiatry inherent in violent, criminal and corrupt behavior psychopathological processes;
– characterize to Neurocrimen;
– describe the neurobiological underpinnings of violence;
– analyze the corrupt behavior as a derivation of cognitive bias and distorting processes that lead to social maladjustment;
– propose therapeutic tools addressing violent, criminal and corrupt behavior.
Violent, criminal and corrupt behavior currently occupy an enormous preponderance in terms of distorting behaviors collevan degradation of the harmonic organization of social convicencia frequently appear in the media presented under the judicative and moral value, preventing a comprehensive analysis of this issue. We intend dilucidaar under this scenario if these behaviors have a neurobiological basis, or if we neuropathological arguments that lead us to interpret any of these processes in terms signosintomatológicos, and therefore be liable to approach from mental health. For this analysis we implement knowledge from cognitive neucociencia, specifically forensic neuropsychology and neuropsychiatry, the neurocrimen and neuroderecho.
Violent, criminal and corrupt behavior have a neurobiological support in statistical terms that allow us to infer distortionary neurobiological processes that result in changes in adaptation to social life. Many of these neurobiological aspects may be characterized in terms neuropathological and, therefore, make some of these behaviors in symptoms and signs. These findings implanted the need to revise legal conclusions static, although still insufficient to transform legal medical paradigms, but we require constant analysis and case by case ratification thereof.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
QTc interval prolongation is considered a risk factor for fatal polymorphic ventricular tachycardia, which can result in sudden cardiac death. Most psychotropic drugs have a dose-dependent potential to prolong the QTc interval. However, other factors require appropriate consideration, including: age; gender; other medications; electrolyte abnormalities; severe comorbid conditions, such as co-occurring alcohol or substances abuse/dependence.
The objective was to study the potential mediating roles of alcohol/substances abuse on QTc prolongation.
The Italian research group STAR Network, in collaboration with the Young Italian Psychiatrists Association, aimed to evaluate the frequency of QTc interval prolongation in a sample of patients under treatment with psychotropic drugs through a cross-sectional national survey.
A sample of 2411 unselected patients were enrolled after performing an ECG during the recruitment period. Sociodemographic and clinical characteristics were collected from medical records. Collected data underwent statistical analysis.
A total of 11.2% of patients reported alcohol abuse, and only 8.9% psychotropic substances. According to the threshold, less than 20% of patients had a borderline value of QTc, and 1% a pathological value. Patients with co-occurring alcohol misuse and drug abuse were more likely to have longer QTc interval.
The present study describes the frequency of QTc prolongation in real-world clinical practice. Before prescribing a psychotropic drug, the physician should carefully assess its risks and benefits to avoid this type of adverse reaction, particularly when additional risk factors are present. The potential role of alcohol and substances on QTc length could be particularly useful in emergency settings.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The interaction between positive, negative and depressive symptoms experienced by people with schizophrenia is complex. We used longitudinal data to test the hypothesis that depressive symptoms mediate the links between positive and negative symptoms.
We analyzed data from the European Schizophrenia Cohort, randomly sampled from outpatient services in France, Germany and the UK (N = 1208). Initial measures were repeated after 6 and 12 months. Depressive symptoms were identified using the Calgary Depression Scale for Schizophrenia (CDSS), while positive and negative symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS). Latent variable structural equation modelling was used to investigate the mediating role of depression assessed at 6 months in relation to the longitudinal association between positive symptoms at baseline and negative symptoms at 12 months.
We found longitudinal associations between positive symptoms at baseline and negative symptoms at 12 months, as well as between both of these and CDSS levels at 6 months. However depression did not mediate the longitudinal association between PANSS scores; all the effect was direct.
Our findings are incompatible with a mediating function for depression on the pathway from positive to negative symptoms, at least on this timescale. The role of depression in schizophrenic disorders remains a challenge for categorical and hierarchical diagnostic systems alike. Future research should analyze specific domains of both depressive and negative symptoms (e.g. motivational and hedonic impairments). The clinical management of negative symptoms using antidepressant treatments may need to be reconsidered.
Eosinophilic granulomatosis with polyangiitis and granulomatosis with polyangiitis show variable otorhinolaryngological involvement. Up to 14 per cent of granulomatosis with polyangiitis patients have subglottis involvement; little is known about the laryngeal involvement in eosinophilic granulomatosis with polyangiitis.
A literature review was conducted, together with a prospective cross-sectional analysis of 43 eosinophilic granulomatosis with polyangiitis patients. All patients underwent fibre-optic laryngoscopy with narrow-band imaging, and completed health-related questionnaires.
The literature review showed only two cases of laryngeal involvement in eosinophilic granulomatosis with polyangiitis; in our cohort, no cases of subglottis stenosis were found, but local signs of laryngeal inflammation were present in 72 per cent of cases. Of the patients, 16.2 per cent had a pathological Reflux Finding Score (of 7 or higher).
Laryngeal inflammation in eosinophilic granulomatosis with polyangiitis is frequent. It is possibly due more to local factors than to eosinophilic granulomatosis with polyangiitis itself. However, ENT evaluation is needed to rule out possible subglottis inflammation. These findings are in line with current literature and worthy of confirmation in larger cohorts.
Since baseline executive dysfunction predicts worsening Instrumental Activities of Daily Living (i-ADL) over time and progression to Alzheimer's Disease (AD), we aimed to analyze the role of neuropsychological variables to outline which factors can contribute to functional impairment. Specific attention to executive functions (EFs) has been given.
A total of 144 subjects complaining of different cognitive deficits – ranging from “MCI likely due to AD” to “mild AD patients” – underwent an overall neuropsychological assessment. The Behavioral Assessment of the Dysexecutive Syndrome was used to analyze EFs. We conducted multiple linear regression analyses to study whether the level of independent living skills – assessed with the Lawton-scale – could be associated with cognitive and behavioral measurements.
We found a significant association between i-ADL and specific EFs measured by Rule Shift Cards (p = 0.04) and Modified Six Elements (p = 0.02). Moreover, considering i-ADL scores, we observed an involvement of mood changes and a reduced awareness of deficits in terms of Hamilton Depression Rating Scale (p = 0.02) and Awareness of Deficit Questionnaire – Dementia scale (p < 0.0001), respectively.
Our results suggest the importance of considering the association between a reduction in i-ADL and executive dysfunction in patients who have AD etiopathology, for which the ability to inhibit a response, self-monitoring, set-shifting and mood deflection play a key role. Besides, no straightforward associations between i-ADL scores and global cognition, memory, language comprehension, attention, and perspective taking abilities were found.
This work presents the results of physiological studies developed to understand modifications linked to the reduction of seed dormancy provoked by domestication processes. The experiments performed compared wild and domesticated Cucurbita subspecies and their hybrids developed by reciprocal crossings. Seeds of two accessions of the wild subspecies presented dormancy, but it was largely reduced in seeds from the domesticated genotype, and partially reverted in hybrids, especially in those obtained when the domesticated genotype was used as the mother plant. In addition, naked embryos of all subspecies did not display dormancy when incubation was performed at 28°C, but embryo germination was progressively reduced only in the wild genotype under decreasing incubation temperatures (22 and 16°C). In the embryos, abscisic acid (ABA) concentrations were similar in both domesticated and wild subspecies, whereas in the seed coat, it was threefold higher in the wild subspecies. The naked embryos from the wild subspecies were far more responsive to ABA than those from the domesticated subspecies. These results indicate that dormancy in the wild subspecies is imposed by the seed coat tissues and that this effect is mediated by their high ABA content and the sensitivity of the embryos to ABA. These physiological aspects were apparently removed by domestication along with the temperature-dependent response for germination.
Since bipolar disorder seems to be associated with purinergic system dysfunction, allopurinol might be effective in treating symptoms of mania.
To estimate the efficacy and tolerability of allopurinol as adjunctive treatment for mania symptoms in people with bipolar affective disorder.
We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) comparing the effects of adjunctive allopurinol and placebo on mania symptom changes.
Five RCTs were included in the meta-analysis. Participants with allopurinol augmentation had a significantly greater decrease in mania symptoms than those with placebo (SMD= −0.34, P = 0.007), especially in people with the most severe forms of mania. Remission rates, although based on only two studies (n = 177), were significantly higher among individuals receiving allopurinol, whereas for discontinuation and side-effects no difference was found.
Our finding of a small to moderate effect size and overall low evidence for add-on allopurinol in reducing mania symptoms indicate that its use in routine practice needs further elucidation.
“Reversible molecular interactions are at the heart of the dance of life.” Lubert Stryer
Biochemical systems, their communication pathways, and the related transformations that take place are based on molecular interactions, so we may safely say that these regulate life at a molecular level. For basic science studies or for therapeutic purposes, we can perturb these systems with chemical manipulations. Because of the accumulated knowledge in the fields of organic chemistry and molecular recognition, our investigative instruments have become increasingly powerful. During the last fifty years, there has been a continuous evolution in chemical approaches to interact with biological systems, and fragment-based drug discovery can be considered one of the products of this evolution . In short, fragment-based ligand discovery (FBLD) may be described as the search for a ligand for a macromolecule, which may constitute a lead for a medicinal chemistry program, through the use of very small molecules. This approach, as we will see, may provide a number of advantages over the classical approaches together with the logical consequence that the observed affinities for a good lead compound will fall in the micromolar-millimolar range rather than in the nanomolar range, necessitating that chemists and biologists leave behind the high-affinity paradigm.
This chapter discusses in detail the historical background, key concepts, and basis for the FBLD approach. An illustration of the technology involved will follow, together with a selection of practical and successful applications.
Nine european national metrology institutes (NMIs) are collaborating in a new project funded by the european metrology research programme (EMRP) to establish traceable dynamic measurement of the mechanical quantities force, pressure, and torque. The aim of this joint research project (JRP) is to develop appropriate calibration methods, mathematical models, and uncertainty evaluation. The duration of the project is 3 years for a global amount of €3.6 million. It began in September 2011.