Davide Broglia

Low-grade endotoxemia in patients with severe autism

The objective of this study was to examine whether levels of endotoxin and other markers of immuno-inflammatory activation are altered in adult patients with severe autism. We determined circulating serum endotoxin levels, its soluble receptor (sCD14), and markers of immuno-inflammatory activation (IL-1beta, IL-6, and IL-10) in 22 adult patients with severe autism and 28 age- and gender-matched healthy controls. Compared with healthy subjects, serum levels of endotoxin were significantly higher in autistic patients and inversely and independently correlated with Socialization scores on the Vineland Adaptive Behavior Scales (VABS) and ADI-R Domain A score (social). Whether increased endotoxin may contribute to the pathophysiology of inflammation and impaired reciprocal social interaction in autism should be further explored in future studies.

Effectiveness of a Single Education and Counseling Intervention in Reducing Anxiety in Women Undergoing Hysterosalpingography: A Randomized Controlled Trial

Hysterosalpingography (HSG) is generally considered a stressful and painful procedure; we aimed to evaluate whether a single education and counseling intervention could reduce womens distress and pain after undergoing HSG for infertility. Patients were randomized into control group (n = 108) and intervention group (n = 109). All patients filled the following questionnaires before and after HSG: Zung self-rating anxiety scale (Z-SAS), Zung self-rating depression scale (Z-SDS), and an ad hoc questionnaire designed to evaluate HSG procedure knowledge. Pain was scored using a visual analog scale. The intervention consisted in a 45-minute individualised session 48 h before HSG. We observed a reduction of anxiety and depression scores in the intervention arm compared to the control group. After controlling for potential confounding variables, intervention was an independent predictor of the difference of Z-SAS score before and after HSG. This is the first randomised controlled trial to assess the potential effectiveness of a single education and counseling intervention to lower anxiety in a diagnostic setting.

La terapia elettroconvulsiva: revisione critica del suo utilizzo in Italia

In this work we try to delineate the knowledge about the Electroconvulsive Therapy, trying to show the use of this therapy in Italy, describing the medical structure in which it’s used and the number of treatment did in these hospitals. So, we try to found the clinics in which the ETC is present and we analized the number of patients treat with this therapy: in our country this technique is presents in 14 hospitals, 5 pubblics and 7 linking to SSN. We compare also the Italian situation with the use in the foreign country.

Repetitive TMS on left cerebellum affects impulsivity in borderline personality disorder: A pilot study

The borderline personality disorder (BPD) is characterized by a severe pattern of instability in emotional regulation, interpersonal relationships, identity and impulse control. These functions are related to the prefrontal cortex (PFC), and since PFC shows a rich anatomical connectivity with the cerebellum, the functionality of the cerebellar-PFC axis may impact on BPD. In this study, we investigated the potential involvement of cerebello-thalamo-cortical connections in impulsive reactions through a pre/post stimulation design. BPD patients (n = 8) and healthy controls (HC; n = 9) performed an Affective Go/No-Go task (AGN) assessing information processing biases for positive and negative stimuli before and after repetitive transcranial magnetic stimulation (rTMS; 1 Hz/10 min, 80% resting motor threshold (RMT) over the left lateral cerebellum. The AGN task consisted of four blocks requiring associative capacities of increasing complexity. BPD patients performed significantly worse than the HC, especially when cognitive demands were high (third and fourth block), but their performance approached that of HC after rTMS (rTMS was almost ineffective in HC). The more evident effect of rTMS in complex associative tasks might have occurred since the cerebellum is deeply involved in integration and coordination of different stimuli. We hypothesize that in BPD patients, cerebello-thalamo-cortical communication is altered, resulting in emotional dysregulation and disturbed impulse control. The rTMS over the left cerebellum might have interfered with existing functional connections exerting a facilitating effect on PFC control.

The Recovery Orientation of a Farm Community for Severe Autism — Data from the DREEM-IT (Developing Recovery Enhancing Environment Measures — Italian Version)

Recent years have witnessed an increasing interest in the concept of ‘recovery’ in the field of mental health and psychiatry. Anthony (1993) described personal recovery as occurring in the presence of ongoing symptoms but involving ‘a way of living a satisfying, hopeful and contributing life even with limitations caused by illness’ (Anthony, 1993). Recovery from mental illnesses has been conceptualized to involve not only remission of symptoms and achievement of psychosocial milestones but also subjective changes in how persons appraise their lives and the extent to which they experience themselves as meaningful agents in the world (Jacobson & Greenley, 2001). Diverse forms of recovery are possible. In people with optimal outcome, recovery may produce important remission and changes, including the exit from mental health services for a long time period or, sometimes, permanently (Emsley et al, 2011). For other patients, it may mean continuing to receive medical, personal or social support, enabling people to get on with their lives (Emsley et al, 2011). However, in all conditions, the role played by the service in promoting, maintaining and restoring an adequate level of recovery for each patients is pivotal.

Autismo ed epilessia nell’adulto: analisi della letteratura

Several studies in literature have pointed out a close relationship between autism and epilepsy, with reported rates of epilepsy in autism varying as result of sample characteristics: age, female gender, intellectual disability and association with other neurological diseases affected this rates. From a literature review, epilepsy appears to be a negative prognostic factor for the outcome of autism in adulthood since autistic adults with epilepsy have more severe cognitive impairment than adults with autism and no epilepsy. Individuals affected have poor social functioning ability, few live independently or are capable of employment, requiring more support throughout their lifetime, both qualitatively and quantitatively.

Aspetti psichiatrici dell’infertilità: analisi della letteratura

L’infertilita, condizione patologica molto frequente nella popolazione occidentale, e il suo trattamento rappre-sentano un importante evento stressante e traumatico nell’esistenza di una donna determinando un peggioramento della sua qualita di vita. Il percorso di diagnosi e di cura risulta inoltre particolarmente lungo e faticoso, gli esami a cui le donne vengono sottoposte sono numerosi e le tecniche di PMA usate per il suo tratta-mento spesso risultano invasive e caratterizzate da numerosi fallimenti. Abbiamo analizzato la letteratura rela-tiva agli aspetti psichiatrici dell’infertilita e di uno degli esami eseguiti di routine per un completo inquadramento di tale condizione, l’isterosalpingografia. Da quest’analisi e emerso che l’isterosalpingografia e un esame accompagnato da un’importante componente emotiva e che l’infertilita e una condizione patologica che provoca una vera e propria crisi esistenziale e che risulta spesso associata ad ansia e depressione. Risulta dunque fondamentale che il medico, nell’ambito di una completa presa in carico di una donna con problemi di infertilita che si deve sottoporre ad isterosalpingografia, tenga in considerazione quest’importante aspetto e-motivo.