Stefano Caracciolo

Serum cholesterol concentrations in parasuicide.

OBJECTIVE —To evaluate whether people who have committed parasuicide have low serum cholesterol concentrations. DESIGN —Results of blood tests in subjects admitted to hospital for parasuicide compared with those of a control group of non-suicidal subjects; comparison in subgroup of parasuicide subjects of two sets of blood test results (one set from admission for parasuicide and the other from admission for some other illness). SETTING —General hospital, Ferrara, Italy. SUBJECTS —331parasuicide subjects aged 44 (SD 21) years (109 with two sets of blood test results) and 331 controls. MAIN OUTCOME MEASURES —Serum cholesterol concentrations and possible association with parasuicide, considering sex, violence of method of parasuicide, and underlying psychiatric disorder. RESULTS —Lower serum cholesterol concentrations (4.96 (SD 1.16) mmol/l) were found in the parasuicide subjects than in the controls (5.43 (1.30); P < 0.001), regardless of sex and degree of violence of parasuicide method. Both men and women with two sets of blood test results had lower cholesterol concentrations after parasuicide. Linear regression analysis showed that the difference in cholesterol concentrations was significantly related to the length of time between the taking of the two sets of blood samples. CONCLUSION —The study showed low cholesterol concentrations after parasuicide. This finding agrees with previous studies, which suggest an association between low cholesterol concentration and suicide. Key messages Trials of cholesterol lowering have shown an increased mortality from violent deaths and suicide No studies of cholesterol concentrations in parasuicide subjects are available This study shows lower cholesterol concentrations in parasuicide subjects than in controls The association between low cholesterol concentration and parasuicide, however, does not allow definite conclusions to be drawn Further prospective trials are needed to focus on the possible effects of abrupt variation in cholesterol concentration on behaviour

Procreative sex in infertile couples: the decay of pleasure?

BackgroundInfertility represents a major challenge to the emotional balance and sexual life of couples, with long-lasting and gender-specific effects. The objective of this study is to explore personality features of infertile patients and detect possible sexual disorders in couples undergoing infertility treatment.Materials and methodsIn this prospective study 60 infertile couples and 52 fertile control couples were asked to complete standardized and validated questionnaires: the Adjective Check List (ACL) to enquire about personality features and the Female Sexual Function Index (FSFI) or the International Index of Erectile Function (IIEF) to assess sexual functioning of female and male partners. The study population was divided into 3 groups: Group A (N = 30, recently diagnosed infertile couples) Group B (N = 30, infertile couples already undergoing Intrauterine Insemination) and Group C (N = 52, fertile control group).ResultsInfertile patients did not display any distinguishing personality features. Regarding sexual function, men of all the three groups scored higher in both questionnaires (sexual satisfaction, desire and orgasm) than their female partners. Comparing results between groups, Group A male partners obtained lower scores in all the subscales. Women belonging to Group A and Group B showed an impairment of sexual arousal, satisfaction, lubrification and orgasm when compared to fertile controls.ConclusionsEven if at the very first stages of infertility treatment no personality disturbances can be detected, the couples’ sexual life is already impaired with different sexual disorders according to gender.

The association of low serum cholesterol with depression and suicidal behaviours: new hypotheses for the missing link

Several observational studies indicate that reduction of serum cholesterol levels is related to an increase in violent deaths and suicide but the nature of this possible relationship remains unclear. Many confounding factors, e.g. poor health, depression and loss of appetite may play a role in the apparent relationship between serum cholesterol levels and suicide. Two separate phenomena should be considered: lowering total cholesterol and low total cholesterol. This review considers the evidence from epidemiological studies on serum cholesterol lowering and psychiatric disturbances. The available evidence does not seem to substantiate the view that large-scale intervention to reduce cholesterol concentrations could lead to more violent and aggressive behaviour, and generally greater unhappiness. In recent trials using statin treatment, there were slightly fewer deaths from accidents and suicide in the treated group compared with the placebo group. We believe that clinicians should not be deterred from prescribing cholesterol-lowering drugs, to reduce the risk of death from coronary heart disease, when they are indicated.

The time for suicide.

To evaluate whether a time pattern exists in the occurrence of suicide, 223 cases observed in Ferrara, Italy, over a 10-year period were considered. The determination of the hour of suicide was precise in 99 cases, presumptive (within a range of 1 hour) in 53, while for another 44 cases it was possible to define a probable time of suicide, grouping into four 6-hour periods (night, morning, afternoon, and evening). The remaining 27 cases were excluded as it was impossible to determine the time reliably. The data were analysed both by means of chi 2 test for goodness-of-fit and by single cosinor. A specific pattern, characterized by a significant peak in the late morning -early afternoon hours was found for the entire sample and sex subgroups.

Circadian rhythm of parasuicide in relation to violence of method and concomitant mental disorder

Caracciolo S, Manfredini R, Gallerani M, Tugnoli S. Circadian rhythm of parasuicide in relation to violence of method and concomitant mental disorder.

Type A behavior pattern and mortality after recurrent myocardial infarction: preliminary results from a follow-up study of 5 years

The purpose of the current study is to examine the association between the type A Behavior Pattern (TABP) and recurrent myocardial infarction (RMI). Rosenmans Structured Interview was administered to a consecutive series of patients admitted to the hospital for myocardial infarction (n = 88). Incidence and mortality from RMI in relation to TABP categories were evaluated after a follow-up period of 5 years. The number of new episodes of myocardial infarction observed in the extreme categories was nearly the same but the number of subjects who dies was nearly twice as large in the B as in the A1 category (10.3% vs. 5.8%, chi 2 = 9.074, p less than 0.0283). No subject was observed to survive after RMI in the B group. In agreement with other recent studies, our preliminary results failed to confirm the association between TABP and RMI, but showed a protection from death for subjects displaying high TABP levels. This finding is discussed in terms of the possibility for type A subjects to cope better with the acute illness.

The orthodontist burnout

OBJECTIVE The aim of this study was to assess whether the Burnout Syndrome is clearly expressed in orthodontic practice and to identify its impact in both general dentistry and orthodontics. MATERIALS AND METHODS A questionnaire was administered to 366 operators in the dentistry-orthodontic field, hence a multi-factorial statistical analysis based on the multi-factorial method was carried out. Demographic data, the Maslach Burnout Inventory (MBI), divided into three subsets, Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA), and a specific questionnaire for orthodontists were analysed. RESULTS The analysis of the MBI showed that EE affects only 1/5 of the sample, DP significantly affects only 1/3 of the sample, while the RPA was reported to be low in 2/3 of the sample. General dentists were more affected from burnout as compared with orthodontists. The specific questionnaire highlighted that members of both categories had work-related stress, mostly due to management and financial issues related to the workplace. CONCLUSIONS The research suggested that Italian orthodontists were less prone to Burnout Syndrome compared to general dentists. As life-style has a major impact on the onset of the syndrome, preventive measures and solutions could be useful in order to prevent the symptoms of the Burnout Syndrome.

A response to Gadarowski's letter to the editor.

This discussion is meant to examine the issues raised by Gadarowski in a recent Letter to the Editor.This is a reply to http://www.hqlo.com/content/pdf/1477-7525-11-52.pdf.