Manuela Crucitti

The RS685012 Polymorphism of ACCN2, the Human Ortholog of Murine Acid-Sensing Ion Channel (ASIC1) Gene, is Highly Represented in Patients with Panic Disorder

Panic disorder (PD) is a disabling anxiety disorder that is characterized by unexpected, recurrent panic attacks, associated with fear of dying and worrying about possible future attacks or other behavioral changes as a consequence of the attacks. The acid-sensing ion channels (ASICs) are a family of proton-sensing channels expressed throughout the nervous system. Their activity is linked to a variety of behaviors including fear, anxiety, pain, depression, learning, and memory. The human analog of ASIC1a is the amiloride-sensitive cation channel 2 (ACCN2). Adenosine A2A receptors are suggested to play an important role in different brain circuits and pathways involved in anxiety reactions. In this work we aimed to evaluate the distribution of ACCN2 rs685012 and ADORA2A rs2298383 polymorphisms in PD patients compared with healthy subjects. We found no association between ADORA2A polymorphism and PD. Instead, the C mutated allele for ACCN2 rs685012 polymorphism was significantly more frequent in patients than in controls. On the contrary, the TT homozygous wild-type genotype and also the ACCN2 TT/ADORA2A CT diplotype were significantly more represented in controls. These results are suggestive for a role of ACCN2 rs685012 polymorphism in PD development in Caucasian people.

Abnormal illness behavior and Internet addiction severity: The role of disease conviction, irritability, and alexithymia

Background and aims While the association between health anxiety and maladaptive Internet use is a well-established finding, no studies have been performed to examine the possible effect of abnormal illness behavior (AIB). AIB is a maladaptive manner of experiencing, evaluating, or acting in response to health and illness that is disproportionate to evident pathology. The aim of this study was to investigate the association between AIB and Internet addiction (IA) severity in a sample of Italian University students. The possible effect of alexithymia, anxiety, and depression was also taken into account. Methods Participants were 115 men and 163 women (mean age = 23.62 ± 4.38 years); AIB was measured via the Illness Behavior Questionnaire (IBQ), and IA severity by the Internet Addiction Test (IAT). Results The most powerful IBQ factor predicting IA severity scores was disease conviction. Irritability was the only emotional IBQ factor associated with IA severity. Nevertheless, disease conviction and alexithymia remained the only significant predictors of IAT scores when hierarchical regression analysis was executed. Discussion and conclusions Our results support previous findings showing that those characterized by health anxiety are more prone to an excessive and maladaptive use of Internet. Moreover, this study showed that irritability was the only emotional aspect of AIB predicting IA severity. This finding is consistent with the cognitive model of hypochondria, which states that cognitive factors (dysfunctional beliefs and assumptions) play a major role in the explanation of this psychopathological condition.

Metabolic outcomes of bergamot polyphenolic fraction administration in patients treated with second-generation antipsychotics: a pilot study

Second-generation antipsychotics (SGAs) are notoriously associated with a marked increase in body weight and with a wide range of metabolic adverse effects, and their chronic use is related with an increased risk for the development of metabolic syndrome (MS). Different adjunctive treatments have been proposed to reduce SGAs-induced weight gain and/or metabolic abnormalities with inconsistent or too limited evidence to support their regular clinical use, thus suggesting the need to find new possible treatments. Bergamot polyphenolic fraction (BPF) has been proven effective in patients with MS, as demonstrated by a concomitant improvement in lipemic and glycemic profiles. The present study was aimed to explore the efficacy and safety of BPF treatment on metabolic parameters in a sample of subjects receiving atypical antipsychotics. Fifteen outpatients treated with SGAs assumed BPF at the oral daily dose of 1000 mg/day for 30 days. Fasting levels of glucose, glycated hemoglobin, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides were determined. BPF administration resulted in a statistically significant reduction of body weight (P=.004) and in a trend for body mass index decrease (P=.005). No significant differences in other and metabolic parameters were observed. Our findings suggest that BPF, at the daily dose of 1000 mg for 30 days, could be an effective and safe agent to prevent weight gain associated with atypical antipsychotic use. However, further clinical trials with adequately powered and well-designed methodology are needed to better explore the BPF effectiveness on the SGAs-induced weight gain and metabolic side effects.

Acetyl-L-Carnitine Augmentation of Clozapine in Partial-Responder Schizophrenia: A 12-Week, Open-Label Uncontrolled Preliminary Study.

ObjectivesThis was the first 12-week, open-label, uncontrolled trial aimed at exploring the efficacy of acetyl-L-carnitine (ALC) add-on pharmacotherapy on clinical symptoms and cognitive functioning in 15 schizophrenia patients with suboptimal clinical response despite receiving clozapine (CLZ) monotherapy at the highest tolerated dosage. MethodsAfter clinical (Positive and Negative Symptoms Scale [PANSS]) and neuropsychological (Wisconsin Card Sorting Test, Stroop Color-Word Test, Verbal Fluency Test) assessments, patients received 1 g/d of ALC for 12 weeks. ResultsA final sample of 9 subjects completed the study. Acetyl-L-carnitine augmentation of CLZ significantly reduced only PANSS domains “positive” (P = 0.049); at end point, only 2 subjects (22.2% of the completers) reached a minimal improvement (25% reduction in PANSS total score). No significant differences emerged in cognitive performances at the end of the study; effect sizes were small in each explored cognitive dimension. ConclusionsThe findings provide preliminary evidence that ALC added to ongoing CLZ treatment appeared to be ineffective to improve symptoms in schizophrenia patients who have failed to respond sufficiently to CLZ. Further trials with adequately powered methodology are needed to identify which augmentation strategies are more effective in schizophrenia patients showing a suboptimal response to CLZ.

Low-Dose of Bergamot-Derived Polyphenolic Fraction (BPF) Did Not Improve Metabolic Parameters in Second Generation Antipsychotics-Treated Patients: Results from a 60-days Open-Label Study

Objectives: The nutraceutical approach to the management of metabolic syndrome (MetS) might be a promising strategy in the prevention of cardio-metabolic risk. Low-dose bergamot-derived polyphenolic fraction (BPF) has been proven effective in patients with MetS, as demonstrated by a concomitant improvement in lipemic and glycemic profiles. The present study was aimed to further explore, in a sample of subjects receiving second generation antipsychotics (SGAs), the effects on body weight and metabolic parameters of a low dose of BPF (500 mg/day) administered for 60 days. Methods: Twenty-eight outpatients treated with SGAs assumed BPF at single daily dose of 500 mg/day for 60 days. Body weight, BMI, fasting levels of glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglycerides were determined; moreover, Brief Psychiatric Rating Scale (BPRS) was administered. Results: Low-dose BPF administration did not change clinical and metabolic parameters, as well as clinical symptoms in the study sample. At the end of the trial, among completers (n = 24) only nine patients (37.5%) reached an LDL reduction >0 but <50%. Conclusions: Our results demonstrate that patients treated with SGAs may need higher BPF doses for obtaining the positive effects on body weight and metabolic parameters previously found in the general population at lower doses.

Red Yeast Rice (RYR) supplementation in patients treated with second-generation antipsychotics

OBJECTIVE Second-generation antipsychotics (SGAs) have a negative impact on metabolic syndrome (MetS) risk factors for their effects on body weight and on metabolic parameters. Statins are widely used in the treatment of dyslipidemia; less is known on the ability of statins to treat SGAs-induced dyslipidemia, and nutraceutical approaches may represent promising strategies in SGAs-treated patients. Red Yeast Rice (RYR), the fermented product of the Aspergillaceae mold Monascus purpureus (red yeast) grown on white rice, has been shown to have a cholesterol-lowering effect which can be ascribed to monacolin K, although other active compounds may play a role management of hyperlipidemia. The present study was aimed to explore the efficacy and safety of RYR treatment on clinical and metabolic parameters in a sample of subjects receiving SGAs. METHODS Fifteen outpatients treated with SGAs assumed RYR at the oral daily dose of 200 mg/day (total monacolin K = 11.88 mg) for 30 days. Fasting levels of triglycerides, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and glucose were determined. RESULTS RYR administration resulted in a statistically significant reduction of LDL (p = 0.029), corresponding to 11.0% decrease from baseline mean value. No significant differences in clinical and in other and metabolic parameters were observed. CONCLUSIONS Our findings suggest that RYR, at the daily dose of 200 mg for 30 days, could be a promising agent to prevent and/or treat SGAs-induced hyperlipidemia. However, future adequately-powered and well-designed studies with long-term follow-up should evaluate RYR effectiveness, as an alternative option to statins, on the SGAs-induced metabolic side effects.

The rs237887 single nucleotide polymorphism in oxytocin receptor gene and the risk for mood disorders in Italian population: A case-control study

Primary objective and hypothesis: Oxytocin plays a key role as regulator of several prosocial behaviors, and its plasma and cerebrospinal fluid concentrations have been found to be reduced in psychiatric conditions involving alterations in social phenotypes. Interestingly, single nucleotide polymorphisms (SNPs) in oxytocin receptor (OXTR) gene sequence have been reported to be associated with autism, personality disorder, and depression. Recently, the SNP rs237887 has been reported to lie in a functional region of OXTR gene, required for transcriptional regulation of OXTR, and, as consequence, likely playing a role in oxytocin pathway dysregulation. We aimed to first investigate the potential role of OXTR rs237887 as genetic risk factor for mood disorders. Research design: We carried out a case-control study by evaluating the distribution of OXTR rs237887 in 87 patients with major depressive disorder (MDD), 128 with bipolar disorder (BD), and 140 healthy subjects, matched for age and gender. Genotyping was performed by Real-time PCR allelic discrimination. Outcomes and results: A higher frequency for OXTR rs237887 G mutated allele was found in MDD patients compared with BD patients and controls (0.48 vs 0.42 vs 0.42). Moreover, the frequency of GG mutated genotype was higher in MDD than in BD patients and controls (24% vs 17% vs 16%). Instead, similar genotype and allele frequencies were observed between BD cases and controls. However, the differences found were not statistically significant, likely due to the small sample size. Conclusions: These preliminary observations suggest to move the interest on OXTR rs237887 polymorphism towards MDD and, at the same time, replicate the present results in a larger sample size. Correspondence to: Daniela Caccamo, Department of Biomedical Sciences, Dental Sciences and Morpho-functional Imaging, Polyclinic Hospital University, Via C. Valeria 1, -98125 Messina, Italy, Tel: +39 0902213389, Fax: +390902213382, E-mail: dcaccamo@unime.it

A Rorschach investigation of Autism Spectrum Disorders in Adulthood

Autism is a pervasive developmental disorder characterized by deficits in the areas of communication, socialization and behavior. Current diagnostic criteria have been modified in a restrictive sense, thus the possibility that individuals with milder impairments may not reach the diagnostic threshold is concrete. Furthermore, heterogeneity in phenotypic expression and the high rate of comorbidity with other psychiatric disorders would make even more difficult the diagnostic classification in individuals with autism spectrum disorder (ASD). The present study was a Rorschach investigation aimed to identify specific psychopathological elements to properly orient the diagnosis of ASD in adulthood. Results have shown that the examined subjects were characterized by pragmatism, documented by the presence of details and little details, falls in formal thinking, thought inflexibility, lack of answers with human content, and the prevalence of particular phenomena (denial, perseveration). Data obtained in the study showed a specific pattern of psychopathological signs in adults with ASD, thus suggesting the importance of projective methods for a better understanding of the clinical features of avoidance behaviors and relationships.

THE RELATIONSHIP BETWEEN ANGER AND SEXUAL BEHAVIOR: A REVIEW OF THEORIES AND RESEARCH.

The aim of this paper is to explore the state of the art about the connection between anger and sexual behavior in eterosexual couples. After a description of anger in psychiatric and psychological literature, the Authors review the available studies about anger-sexuality relationship from theorethical, clinical and experimental point of view. They conclude that there is, till now, a significant confusion about the question. Therefore, Authors suggest a new approach to this problem, due to the possible relevance of the topic in clinical practice. Despite the complexity of this research area, there is a need of clarification regarding methodological trends and clinical perspectives. Authors suggest the relevance of such a research for the understanding of sexual behavior, sexual couples problems and the finding of treatment strategies for anger problems connected to sexual behavior.