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The vulnerability-stress model assumes that psychotic symptoms emerge from the interaction between stress, basic symptoms and information processing deficits. Despite the large amount of data on first episode psychosis, this particular topic has been investigated to a minor extent in patients readmitted to acute psychiatric wards.
To assess the association between basic symptoms and subjective stress, life events, and executive functions.
To identify the factors associated to basic symptoms during relapses.
Patients affected by schizophrenia, schizoaffective and bipolar disorder according to DSM-IV TR were recruited from the acute psychiatric wards of two University Hospitals in Rome. They were evaluated through: a) Frankfurt Complaint Questionnaire (FCQ); b) Stress-related Vulnerability Scale (SVS); c) Paykel Interview for Recent Life Events (IRLE); d) Wisconsin Card Sorting Test (WCST).
Forty-nine patients were enrolled (65% women; mean age 42.7 ± 10.5 years; education 12.4 ± 3.2 years; disease duration 17.6 ± 11.4; 63% affected by bipolar disorder). Basic symptoms were positively associated to SVS total score (rho = 0.66, p < 0.01), IRLE marital subscale (rho = 0.3, p < 0.05), while negatively associated to WCST number of completed categories (rho = −0.32, p < 0.05).
Preliminary results of this study show that basic symptoms are positively associated to perceived stress and marital life events, while negatively associated to executive functions, during psychotic relapses.
The clinical vignette aims to provide how PM could assist psychiatry treatment.
A 43-years-old woman with a 12-years history of Multiple Chemical Sensitivity (MCS), also affected by celiac disease and gastroesophageal reflux. In 2011, she was diagnosed with breast cancerin a surgically treatable stage. Due to previous severe drug adverse events, with undefined cause, no medical team accepted to take care her. Then she developed a depressive syndrome with hypochondriac features, based on DSM-IV-TR criteria.
Pharmacogenomic testing for the main enzymes involved in drugs metabolism (fig. 1) was performed and database interrogation was used to select the safer drug combination, based on the personal genomic profile. Illness progression was evaluated by Ham-A, Ham-d, BPRS, VGF and MMPI-2 scales (fig.2).
Genomic profile (fig. 1) was compatible with reported previous toxic effects following assumption of different drugs. The personal genome-based choice of pharmacological therapies allowed to avoid surgery-related adverse effects. Through genome-guided therapy selection, rapidly we set-up an efficacious psychotropic therapy. After a year the access to the PM Service, the patient showed an important improvement in both social impairment and quality of life, allowing her to get out, without a surgical mask.
Application of pharmacogenomic screening to patients undergoing composite therapies could be an effective tool to improve clinical outcomes and minimize side effects.
Programs of X-ray polarimetry in Italy arise from the convergence of a long experience of X-ray astronomy missions with an outstanding tradition in development of radiation detectors. The gas pixel detector in the focus of X-ray optics can perform angular-resolved polarimetry with a breakthrough improvement in sensitivity, even with a moderate collecting surface. POLARIX makes a large use of already existing items and, in particular, of the three telescopes from the JET-X program. It can extend the X-ray polarimetry from one positive detection only, to tens of sources, including a few brighter extragalactics: an ambitious pathfinder on a very limited budget. Phase A study of POLARIX, and of four other missions, was performed in 2008 and ASI should select two missions to fly. Another pathfinder is under study: two short telescopes, designed with modern tight packing techniques, mounted as piggy-back on the Chinese mission HXMT.
The national context
X-ray polarimetry has been a line of research at IASF for many years. A scattering polarimeter was proposed for the XMM mission, but was not selected. An IASF team joined the collaboration headed by R. Novick for the Stellar X-ray Polarimeter, aboard the Spectrum X-Gamma mission, contributing the detectors as the sensors for both scattering and diffraction stages. SXRP was completed but the whole mission was not. Considering the large area of the telescope, SXRP was close to the best achievable with conventional techniques.
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