Paolo Giuseppe Orsi

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.

Serum levels of vascular endothelial growth factor and its receptors in patients with severe autism

OBJECTIVE To study vascular endothelial growth factor (VEGF) and its soluble receptors sVEGFR-1 and -2 in autism. DESIGN AND METHODS We measured serum levels of angiogenic molecules in 22 patients with severe autism and 28 controls. RESULTS Patients and controls had similar sVEGFR-2 levels, but VEGF levels were lower and sVEGFR-1 higher in patients with autism. CONCLUSION The imbalance between VEGF and its receptor sVEGFR-1 may be involved in the pathophysiology of autism.

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.

P02-179 Using the DREEM-Italian version to evaluate the recovery-orientation of Pavia rehabilitative services

We assessed the recovery-orientation of the Pavia Rehabilitation Services using an Italian Version of the DREEM (Developing Recovery Enhancing Environment Measure). A preliminary Italian Version of the DREEM was translated by the first author (MB) and a back-translation was carried out by a trained translator (MT). A third member of the research team (JS) resolved disagreements between the two versions by discussion and consensus with MB and MT. The final version was administered to the patients of the rehabilitation services of Pavia. 15 patients out of a possible 21 (71.4%) participated in the first interview. Demographic information including gender (53% male, 47% female), age range (26-35 years: 27%, 36-45 years: 33%, 46-55 years: 27%, 56-65 years: 6%, 66 years and over: 7%), ethnicity (Italian: 100%) was collected. 20% had been using mental health services for between 5 and 10 years, and 80% for more than 10 years. The section “elements of recovery and recovery enhancing services” scored 1.2 for “importance ratings for recovery elements” and 2.4 for “staff performance”, with a performance gap of 1.2. Mean scores for “organizational climate” and “recovery markers” were 2.3 in both sections. The mean score of 1.2 on the importance ratings shows that patients have a good understanding of recovery elements. The other scores reveal a fairly good recovery orientation of the service, but with a wide margin for improvements as indicated by the performance gap. The Italian version of the DREEM is useful; the results can promote reflections, discussion and learning within the staff.