San Giovanni al Natisone, Italy
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Parisi P.,University of Rome La Sapienza | Moavero R.,Psychiatric Unit | Verrotti A.,University of Chieti Pescara | Curatolo P.,Psychiatric Unit
Brain and Development | Year: 2010

Attention deficit hyperactivity disorder (ADHD) is more frequent in children with epilepsy than in general pediatric population. Several factors may contribute to this comorbidity, including the underlying brain pathology, the chronic effects of seizures and of the epileptiform EEG discharges, and the effects of antiepileptic drugs. Symptoms of ADHD are more common in some specific types of epilepsies, such as frontal lobe epilepsy, childhood absence epilepsy and Rolandic epilepsy, and may antedate seizure onset in a significant proportion of cases. In epileptic children with symptoms of ADHD, treatment might become a challenge for child neurologists, who are forced to prescribe drugs combinations, to improve the long-term cognitive and behavioral prognosis. Treatment with psychotropic drugs can be initiated safely in most children with epilepsy and ADHD symptoms. © 2009 Elsevier B.V. All rights reserved.


Minelli A.,Genetic Unit | Zanardini R.,Neuropsychopharmacology Unit | Bonvicini C.,Genetic Unit | Sartori R.,University of Verona | And 4 more authors.
European Archives of Psychiatry and Clinical Neuroscience | Year: 2011

Consisting evidence in animal models has suggested that alterations in brain-derived neurotrophic factor (BDNF) brain expression and release are involved in the pathogenesis of mental illnesses, such as, mood, anxiety, and eating disorders. This hypothesis is supported by data emerging from biochemical studies on serum BDNF levels and genetic studies on the functional polymorphism Val66Met in the BDNF gene in patients and control subjects. Anxiety-related personality traits are associated with several mental disorders. However, they are also measurable in non-affected subjects and, so, may represent a useful "endophenotype" to study the biological correlation of the vulnerability factors in the general population. In this study, we analyzed putative correlations in subjects unaffected by mental disorders between personality traits, serum BDNF levels (N = 107), and the BDNF Val66Met genotype (N = 217). Furthermore, we tested the possible interactions between these variables. A significant correlation has been observed between high scores of harm avoidance (HA) measured by the temperament and character inventory (TCI), and low BDNF serum concentration (r = -0.253, P = 0.009). In addition, an association has been evidenced between low BDNF levels in serum and the BDNF Val/Val genotype (P = 0.021). By analyzing putative concomitant effects of different variables on HA scores in a regression model, we observed a significant correlation only with BDNF serum concentrations (P = 0.022). The study results suggest that a decrease in serum BDNF concentrations may represent a biochemical marker associated with anxiety personality traits also retrievable in the general population. © 2011 Springer-Verlag.


Minelli A.,University of Brescia | Maffioletti E.,University of Brescia | Cloninger C.R.,University of Washington | Magri C.,University of Brescia | And 8 more authors.
Depression and Anxiety | Year: 2013

Background Anxiety disorders exhibit remarkably high rates of comorbidity with major depressive disorder (MDD). Mood and anxiety disorders are considered stress-related diseases. Genetic variations in the co-chaperone FK506-binding protein 51, FKBP5, which modulates the function of glucocorticoid receptors, have been associated with an increased risk for the development of posttraumatic stress disorder, but data regarding its role in MDD are controversial. The aims of this study were to clarify the role of the FKBP5 gene in depression and anxiety disorders through a case-control study and an association study with personality traits using the Temperament and Character Inventory (TCI) in healthy subjects. Methods Six hundred fifty-seven MDD patients, with or without an anxiety disorder in comorbidity, and 462 healthy volunteers were enrolled in the study. Two hundred fifty-six controls agreed to fill out the TCI. Results The results showed that the T allele of rs1360780 was more frequent among the patients affected by MDD with a comorbidity of anxiety disorders, compared to those without (P <.001). Among the controls, we found that the T allele more often exhibited personality traits associated with an increased vulnerability to anxiety. Conclusions These results support the hypothesis that allelic variants of FKBP5 are a risk factor for anxiety disorders. The identification of genetic variants involved in anxiety may have implications for the optimization of therapeutic interventions. © 2013 Wiley Periodicals, Inc.


News Article | October 28, 2016
Site: www.prweb.com

Pine Grove Behavioral Health & Addiction Services, one of the nation’s most comprehensive treatment campuses is partnering with the University of Mississippi Medical Center’s Psychiatry Program, to provide the department’s fourth year residents with Addiction Medicine training. The program launched in September of 2016 and the month long training rotation gives residents the opportunity to enhance their ability to assess and treat patients with addictions. Dr. Chaz Richardson of Hattiesburg, who is familiar with Pine Grove’s reputation as a leader in the behavioral health care and addiction field, is the first of six residents to participate in the partnership this year. He said, “I plan to take in as much as possible.” After completing his residency training, Dr. Richardson wants to practice in Mississippi where there is a disparity between the numbers of practicing Psychiatrists compared to the patient population in need of mental health care. It’s a sentiment echoed by Debbie Sanford, Forrest General Hospital’s Chief Behavioral Health & Addiction Services Officer. Sanford said, “Pine Grove recognizes that within Mississippi and nationally there is a severe shortage of Psychiatrists, and we are committed to provide addiction medicine training to prepare the next generation of Psychiatrists and help close this gap, while ensuring patients receive the highest quality behavioral health care.” During their Pine Grove rotation, residents will receive training at the organization’s Next Step program, which treats men with chemical addictions; the Women’s Center, where women with substance use issues and co-occurring eating disorders are treated; Legacy, one of a few programs nationally that treats adults age 55 plus with chemical dependency, and Pine Grove’s Family Program. The Family Program is part of the treatment curriculum for patients receiving residential care at Pine Grove. Additionally, the program includes a rotation with Pine Grove’s Intensive Outpatient Program for adults with drug and alcohol issues, along with the Professional Enhancement Program for individuals with behavioral problems, interpersonal difficulties and addiction disorders. Pine Grove Behavioral Health & Addiction Services is an extension of Forrest General Hospital, located in Hattiesburg, Mississippi. Pine Grove’s world renowned programs treat gender specific chemical addiction including a specialized track for co-occurring eating disorders. Additionally, Pine Grove offers a substance abuse healing program for adults age 55 and over. Other Pine Grove specialty programs include a dedicated professional’s treatment curriculum and a comprehensive evaluation center. Pine Grove also features a gender focused program for patients with sexual addiction. Inpatient Services including an Adult Psychiatric Unit, along with a Child and Adolescent Psychiatric Unit, and Outpatient Services are other components. Pine Grove was established in 1984 and has provided nationally and internationally recognized health care for over 30 years.


Isserles M.,Hebrew University of Jerusalem | Shalev A.Y.,Hebrew University of Jerusalem | Roth Y.,Ben - Gurion University of the Negev | Peri T.,Bar - Ilan University | And 3 more authors.
Brain Stimulation | Year: 2013

Background: Post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder induced by traumatic experiences. To date, psychotherapy and drug treatment achieve only partial success, indicating need for further development of treatment strategies. Recent research has found that impaired acquired fear extinction capability serves as an important factor at the pathogenesis of the disorder. Medial prefrontal cortex (mPFC) hypo-activity has been implicated in this extinction impairment, providing insight as to why some trauma exposed individuals will develop PTSD. Objective: To test whether fear extinction can be facilitated and therapeutic effect achieved by repeated mPFC deep transcranial magnetic stimulation (DTMS) of PTSD patients resistant to standard treatment. Methods: In a double-blind study, 30 PTSD patients were enrolled and randomly assigned into 3 treatment groups: A) DTMS after brief exposure to the traumatic event with the script-driven imagery procedure; B) DTMS after brief exposure to a non-traumatic event; C) sham stimulation after brief exposure to the traumatic event. Results: Significant improvement was demonstrated in the intrusive component of the CAPS scale in patients administered DTMS after exposure to the traumatic event script, while patients in the control groups showed no significant improvement. Similar trend was demonstrated in the Total-CAPS score as in the other rating scales. A significant reduction in the HR response to the traumatic script was evident in group A, further supporting the above results. Conclusions: Combining brief script-driven exposure with DTMS can induce therapeutic effects in PTSD patients. A wide multi-center study is suggested to substantiate these findings. Trial registration: ClinicalTrials.gov identifier: NCT00517400. © 2013 Elsevier Inc. All rights reserved.


Schlaepfer T.E.,Universitatsklinikums Bonn | Agren H.,Gothenburg University | Monteleone P.,University of Naples | Gasto C.,University of Barcelona | And 4 more authors.
Journal of Psychopharmacology | Year: 2012

Treatment-resistant depression (TRD) presents many challenges for both patients and physicians. This review aims to evaluate the current status of the field of TRD and reflects the main findings of a consensus meeting held in September 2009. Literature searches were also conducted using PubMed and EMBASE. Abstracts of the retrieved articles were reviewed independently by the authors for inclusion. Evaluation of the clinical evidence in TRD is complicated by the absence of a validated definition, and there is a need to move away from traditional definitions of remission based on severity of symptoms to one that includes normalisation of functioning. One potential way of improving treatment of TRD is through the use of predictive biomarkers and clinical variables. The advent of new treatments may also help by focusing on neurotransmitters other than serotonin. Strategies such as the switching of antidepressants, use of combination therapy with lithium, atypical antipsychotics and other pharmacological agents can improve outcomes, and techniques such as deep brain stimulation and vagus nerve stimulation have shown promising early results. Despite consistent advances in the pharmacotherapy of mood disorders in the last decade, high rates of TRD are still a challenging aspect of overall management. © The Author(s) 2012.


Cattaneo A.,University of Brescia | Cattaneo A.,Genetics Unit | Sesta A.,University of Brescia | Sesta A.,Genetics Unit | And 5 more authors.
Neuropsychopharmacology | Year: 2010

Major depression is a disease characterized by an inability of neuronal systems to show appropriate adaptive plasticity especially under challenging conditions, such as stress. Conversely, pharmacological intervention may normalize such defects through the modulation of factors that might act in concert for the functional recovery of depressed patients, like the neuropeptide VGF, which has previously shown to possess antidepressant like activity. We analyzed VGF mRNA levels in the brain of rodents exposed to stress or treated with antidepressant drugs. In addition, we assessed VGF expression in leukocytes obtained from 25 drug-free depressed patients before and during antidepressant treatment. We found a persistent reduction of VGF expression after exposure to prenatal stress and an upregulation of its levels following chronic treatment with different antidepressant drugs. Moreover, VGF mRNA levels were significantly reduced in drug-free depressed patients, as compared with controls, and were modulated in response to effective antidepressant treatment. Our data provide further support to the role of VGF in mood disorders and suggest that VGF could be a more specific biomarker for treatment responsiveness. © 2010 Nature Publishing Group All rights reserved.


Cattaneo A.,Genetics Unit | Bocchio-Chiavetto L.,Neuropsychopharmacology Unit | Zanardini R.,Neuropsychopharmacology Unit | Milanesi E.,Genetics Unit | And 4 more authors.
International Journal of Neuropsychopharmacology | Year: 2010

Consistent data coming from biochemical studies have evidenced a brain-derived neurotrophic factor (BDNF) serum reduction in depressed patients compared to controls and a restoration following antidepressant treatment. However, to date, no study has evaluated whether BDNF synthesis in leukocytes could contribute to such modulation. Therefore, in this study, we analysed BDNF mRNA levels in leukocytes from 21 depressed patients prior to and during escitalopram treatment and from 23 control subjects showing that BDNF mRNA levels were decreased in drug-free depressed patients and that 12 wk escitalopram treatment was able to reverse this deficit. Interestingly, changes in BDNF mRNA levels paralleled BDNF serum increase during antidepressant treatment, and were correlated with symptoms improvement. Our results indicate that BDNF serum modulation observed in depressed patients is associated with BDNF synthesis alteration in leukocytes and suggest that these peripheral cells might play an active role in the mechanisms of action of antidepressants. Copyright © 2009 CINP.


Gudmundsdottir R.M.,Psychiatric Unit | Thome M.,University of Iceland
Journal of Psychiatric and Mental Health Nursing | Year: 2014

The aim of this study is to evaluate the effects of individual and group cognitive behavioural therapy (CBT) and of psychiatric rehabilitation (PR) on hopelessness for depressed patients in a rehabilitation setting. Three groups of patients who underwent PR were allocated to individual CBT combined with PR (n=43), group CBT combined with PR (n=52) or PR only (n=22). Hopelessness was assessed by the Beck Hopelessness Scale (BHS). The majority of the patients (68.4%) suffered from moderate to severe hopelessness before treatment (score≥9-20). Results showed that the pretest mean score on the BHS decreased from 11. 57 (SD=5.58) to 7.46 (SD=5.20) at posttest. The mean scores on the BHS decreased in all groups under nine. The combination of individual CBT and PR was significantly more effective in reducing hopelessness than group CBT with PR or PR only. Group CBT combined with PR was not significantly more effective than PR only. It is concluded that individual CBT combined with PR is more effective in alleviating hopelessness among depressed patients than group CBT with PR or PR only. CBT can be delivered by an interdisciplinary team including advanced psychiatric nurses. © 2014 John Wiley & Sons Ltd.


Dave S.,Psychiatric Unit | Dogra N.,University of Leicester | Leask S.J.,University of Nottingham
Psychiatrist | Year: 2010

Universities are the main provider of medical student education in the UK; however, its delivery, especially the clinical years but increasingly also the pre-clinical years, often takes place in National Health Service hospitals. Trusts are paid for this privilege through service increment for teaching (SIFT). Developments in clinical governance structures have meant that there is now increased scrutiny and transparency in the funding of clinical services. Lack of similarly robust educational governance structures has led to the risk of educational funds being used to deliver clinical services. This paper examines the current role of SIFT funding and the possible ways forward, using a case study.

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