G. Di Iorio

Agomelatine versus venlafaxine XR in the treatment of anhedonia in major depressive disorder: a pilot study

Abstract The primary aim of the present study was to compare the effects of agomelatine (AGO) and venlafaxine XR (VLX) on anhedonia in patients with major depressive disorder. Secondary end points were to test its antidepressant and anxiolytic efficacy. Sixty patients were enrolled and randomly assigned to two different treatments: AGO (25-50 mg/d; n = 30 subjects) or VLX (75-150 mg/d, n = 30 subjects). Psychopathological assessment was performed at baseline and after 8 weeks of treatment with the Snaith Hamilton Rating Scale (SHAPS), the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, and the Clinical Global Impression for anhedonia, depression, anxiety, and global improvement, respectively. Both groups showed a significant reduction in time for the SHAPS, the Hamilton Depression Rating Scale, and the Hamilton Anxiety Rating Scale. A significant between-group difference was observed for SHAPS scores: patients treated with AGO showed a more relevant reduction compared with that in VLX-treated patients. Moreover, only patients treated with AGO showed a statistically significant improvement in Clinical Global Impression scores. In this study, AGO showed significantly greater efficacy on anhedonia and similar antidepressant efficacy to the serotonin-norepinephrine reuptake inhibitor VLX in patients with major depressive disorder during an 8-week treatment period. Anhedonia has been considered a potential trait marker related to vulnerability for depression. Therefore, the efficacy of AGO on this dimension holds particular importance in the treatment of patients with anhedonic features.

Prevalence of Orthorexia Nervosa in a Population of Young Italian Adults

Introduction Orthorexia nervosa (ON) is an alleged eating disorder in which the person is excessively preoccupied with healthy food. First described by Bratman in 1997, ON entails a fixation on healthy food or a health food dependence. The term orthorexia nervosa arises from the Greek words orthos (=accurate) and orexis (=hunger) meaning obsession with healthy food and proper nutrition. Fears and worries about health, eating, and the quality of food are significant. Objectives We investigated the prevalence of ON in a a population of young Italian adults by using a validated questionnaire (ORTO-15). Aims We aimed to assess the prevalence of ON in a large sample of general population and to identify some possible specific correlation such as gender and Body Mass Index (BMI). Methods 1453 adult subjects from the general population were administered the ORTO-15 test and investigated for gender, age and BMI. Statistical analyses were performed referring to diagnostic threshold (40). Results Orthorexia had a 10,9% prevalence in our sample, with a female prevalence statistically significant (female vs male= 72,8% vs 27,2%). Moreover, age and Body Mass Index did not seem to be significant factors. Conclusions ON is not currently considered as a full-fledged and discrete mental disorder. Again, the definition and diagnostic criteria of ON remain unclear. Further studies are needed to clarify appropriate diagnostic methods and the place of ON among psychopathological categories. This should be accompanied by a vigorous research effort aimed at understanding the core nature of this condition.

Traumatic experiences affect negative emotion processing in bipolar disorder

Introduction Patients affected by bipolar disorder type I (BD-I) show a significant emotional impairment during both acute and euthymic phases of the illness, but the influence of negative life experiences is not yet fully understood. Objectives Aim of the present study was to investigate the role of previous traumatic events on negative emotion processing in euthymic BD-I patients. Methods Eighteen euthymic BD-I patients, 7 reporting past traumatic events (T-BD-I), but free of post-traumatic stress disorder (PTSD) symptoms at the moment of the evaluation and 11 never exposed to traumas (NT-BD-I), were compared to 24 not traumatized controls (NC). All participants performed a IAPS-based emotional task: they were required to identify vegetable items (targets) among neutral or negative pictures. Accuracy (percentage of correct responses) and mean reaction times (RT) were recorded. Results T-BD-I performed similarly to NC and significantly better than NT-BD-I in terms of accuracy ( Fig. 1 ). No significant between-group effects were observed for mean RT. Conclusions A previous history of traumatic events, without current PTSD symptoms, may significantly impact the negative emotion processing in euthymic BD-I. Interestingly, traumatized patients showed a better accuracy when processing both neutral and negative images, thus suggesting that paying more attention to external stimuli may be a successful compensatory mechanism to cope with potential environmental threats.

Manic Symptoms Associated with Stimulant and Cannabis Misuse: a Case Report

We report a clinical case of a patient with a manic episode after taking methylphenidate (up to 120mgr per day) and cannabis in order to improve performance during exam period. He was hospitalized for disorganized behaviour, increased aggresion, delusions, grandiosity. He was affected by attention deficit and hyperactivity during childhood and recent episods of subthreshold depression. The therapy consisted of benzodiazepine and hydratation. In conclusion clinicians shuould ha ve caution in prescribing neurostimulant in vulnerable subjects.

P.8.b.015 Mood stabilizers in the treatment of impulsive behavioral dyscontrol in borderline personality disorder: a systematic review

reduction of BMI (p< 0.05) was measured between t0 and t1, however body weight remained static over the 6-week period. The power of the test was, however, quite low (14.2%). Conclusions: Our results suggest that magnesium citrate supply is useful in promoting adherence to a hypocaloric diet, in terms of reduction in BMI, in overweight and obese middle-aged women. In particular, this effect seems to be mediated by a major capacity to impose a voluntary control on disordered alimentary habits in response to hedonic signals derived from highly palatable foods typical of today’s diet.

C-reactive protein level and its relationship with suicide risk and alexithymia among newly diagnosed, drug-naïve patients with non-affective psychosis

The aim of the present study was to evaluate C-Reactive Protein (CRP) levels in newly diagnosed drug-naïve patients with non-affective psychosis, testing the hypotheses that in such patients serum CRP levels would be higher than in healthy controls and related to more severe psychopathology, suicide risk and alexithymia. CRP levels of 30 adult patients and 30 sex- and age-matched healthy controls were evaluated. Patients were tested with the Scale of Suicide Ideation (SSI), the Toronto Alexithymia Scale (TAS-20), the Scale for the Assessment of Positive and Negative Symptoms (SAPS and SANS) and the Calgary Depression Scale for Schizophrenia (CDSS). Higher suicide risk patients showed higher CRP levels than lower suicide risk patients and healthy controls. Moreover, such patients showed higher SAPS, SANS and CDSS scores than lower suicide risk patients. In linear regression model, CRP was significantly associated with higher SSI and TAS-20 scores. The results of the present study support the notion that CRP, suicide risk and alexithymia are strictly linked in newly diagnosed, drug-naïve patients with non-affective psychosis, independently of depressive symptoms or general psychopathology. Limitations are discussed.

P-476 - Impaired working memory resources in euthymic patients affected by recurrent unipolar depression

Introduction Working memory deficits have yet been reported in Schizophrenia and Bipolar Disorder and suggested to be trait markers of those disorders. A few data are reported for Recurrent Unipolar Depression. Objectives and aims Aim of the present study was to evaluate working memory resources in a group of euthymic unipolar subjects. Methods Fifteen outpatients (13 females) affected by Recurrent Unipolar Major Depression, were recruited by the Department of Mental Health of Ortona (Chieti), Italy, and compared to 15 age and gender matched healthy comparisons in terms of Working Memory resources. Inclusion criteria were: a DSM IV diagnosis of Recurrent Major Depression and a condition of euthymia, defined as a Hamilton Depression Scale (HAM-D) score Results Patients showed a significant lower performance, with respect to normal comparisons, limited to the highest level of difficulty working memory task (graph.1). Conclusions In our group of unipolar subjects, working memory resources seemed to be reduced during euthymic periods, thus significantly affecting quality of life and social functioning. Download full-size image

P03-195 - Alexithymia and suicide risk among patients with schizophrenia: A cross-sectional study

Objectives The aim of the present study was to evaluate the prevalence of alexithymia and its relationships with psychopathological features and suicide risk in a sample of adult patients with a DSM-IV diagnosis of paranoid schizophrenia. Method A mixed male-female sample of 60 subjects (30 males and 30 females) was evaluetd with the following rating scales: Toronto Alexithymia Scale (TAS-20), Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS), Calgary Depression Scale for Schizophrenia (CDSS), Scale for Suicidal Ideation (SSI), State-Trait Anxiety Inventory (STAI). RESULTS. 22 subjects (36.7%) were categorized as alexithymic (TAS-20 scores ≥ 61). Alexithymics showed more severe negative and depressive symptoms and increased suicide risk than nonalexithymics. However, the results of a linear regression with SSI score as dependent variable showed that Difficulty in Identifying and Describing Feelings dimensions of TAS-20 and higher CDSS scores were significantly associated with higher scores on the Scale for Suicide Ideation. Conclusions: The presence of alexithymia in schizophrenia may be related to higher risk of suicide ideation and more severe depressive symptoms, independently by the severity of positive and negative symptoms. However, results are preliminary and limitations must be considered.

P01-195 - Alexithymia, somatic complaints and depressive symptoms in a sample of italian adolescents: preliminary results of a one-year longitudinal study

Objective To evaluate relationships between alexithymia, somatic complaints and depressive symptoms in a non-clinical sample of school-aged Italian adolescents. Methods A mixed male-female sample of 168 school-aged adolescents with a mean age of 15.8 years was investigated with self-reported rating scales. Scales were: Toronto Alexithymia Scale (TAS-20), Beck Depression Inventory (BDI), Symptom Checklist 90 - Somatization Subscale (SCL-90-SOM), State-Trait Anxiety Inventory (STAI), Rosemberg Self Esteem Scale (RSES). Subjects were evaluated at three times: at the beginning (T0), at the middle (T1) and at the end (T2) of the scholastic year. Results 30 subjects (17.9%) were categorized as alexithymics and, overall, showed greater psychological distress than non-alexithymics. Alexithymia levels remained stable during the time as well as the number of alexithymics. Alexithymics were more suitable to develop more severe depressive symptoms. Results of a linear regression supported the notion that depressive symptoms at endpoint were significantly associated with female sex, DIF subscale of TAS-20 and higher SCL-90-SOM scores. Conclusions Alexithymia, depressive symptoms and somatic complaints appeared to be highly correlated in adolescence.