Publications by authors named "Barbara Carpita"

37 Publications

Biochemical Correlates of Video Game Use: From Physiology to Pathology. A Narrative Review.

Life (Basel) 2021 Jul 30;11(8). Epub 2021 Jul 30.

Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.

In the last few decades, video game playing progressively became a widespread activity for many people, in childhood as well in adulthood. An increasing amount of literature has focused on pathological and non-pathological correlates of video game playing, with specific attention towards Internet Gaming Disorder (IGD). While many neurobiological studies in this field were based on neuroimaging, highlighting structural and functional brain changes among video game users, only a limited number of studies investigated the presence of biochemical correlates of video gaming. The present work aims to summarize and review the available literature about biochemical changes linked to video game use in IGD patients as well as non-pathological users, and the differences in between. Results may shed light on risks and benefits of video games, providing directions for further research on IGD treatment and, on other hand, on the potential role of video games in therapeutic or preventive protocols for specific conditions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/life11080775DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401252PMC
July 2021

The Microbiota/Microbiome and the Gut-Brain Axis: How Much Do They Matter in Psychiatry?

Life (Basel) 2021 Jul 28;11(8). Epub 2021 Jul 28.

Dipartimento di Biochimica e Biologia Molecolare, University of Siena, 53100 Siena, Italy.

The functioning of the central nervous system (CNS) is the result of the constant integration of bidirectional messages between the brain and peripheral organs, together with their connections with the environment. Despite the anatomical separation, gut microbiota, i.e., the microorganisms colonising the gastrointestinal tract, is highly related to the CNS through the so-called "gut-brain axis". The aim of this paper was to review and comment on the current literature on the role of the intestinal microbiota and the gut-brain axis in some common neuropsychiatric conditions. The recent literature indicates that the gut microbiota may affect brain functions through endocrine and metabolic pathways, antibody production and the enteric network while supporting its possible role in the onset and maintenance of several neuropsychiatric disorders, neurodevelopment and neurodegenerative disorders. Alterations in the gut microbiota composition were observed in mood disorders and autism spectrum disorders and, apparently to a lesser extent, even in obsessive-compulsive disorder (OCD) and related conditions, as well as in schizophrenia. Therefore, gut microbiota might represent an interesting field of research for a better understanding of the pathophysiology of common neuropsychiatric disorders and possibly as a target for the development of innovative treatments that some authors have already labelled "psychobiotics".
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/life11080760DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401073PMC
July 2021

The Microbiota/Microbiome and the Gut-Brain Axis: How Much Do They Matter in Psychiatry?

Life (Basel) 2021 Jul 28;11(8). Epub 2021 Jul 28.

Dipartimento di Biochimica e Biologia Molecolare, University of Siena, 53100 Siena, Italy.

The functioning of the central nervous system (CNS) is the result of the constant integration of bidirectional messages between the brain and peripheral organs, together with their connections with the environment. Despite the anatomical separation, gut microbiota, i.e., the microorganisms colonising the gastrointestinal tract, is highly related to the CNS through the so-called "gut-brain axis". The aim of this paper was to review and comment on the current literature on the role of the intestinal microbiota and the gut-brain axis in some common neuropsychiatric conditions. The recent literature indicates that the gut microbiota may affect brain functions through endocrine and metabolic pathways, antibody production and the enteric network while supporting its possible role in the onset and maintenance of several neuropsychiatric disorders, neurodevelopment and neurodegenerative disorders. Alterations in the gut microbiota composition were observed in mood disorders and autism spectrum disorders and, apparently to a lesser extent, even in obsessive-compulsive disorder (OCD) and related conditions, as well as in schizophrenia. Therefore, gut microbiota might represent an interesting field of research for a better understanding of the pathophysiology of common neuropsychiatric disorders and possibly as a target for the development of innovative treatments that some authors have already labelled "psychobiotics".
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/life11080760DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401073PMC
July 2021

Lifetime evolution of ADHD treatment.

J Neural Transm (Vienna) 2021 Jul 15;128(7):1085-1098. Epub 2021 May 15.

Department of Clinical and Experimental Medicine Section of Psychiatry, University of Pisa, Pisa, Italy.

Attention-deficit hyperactivity disorder (ADHD), has been traditionally considered a neurodevelopmental disorder affecting children and adolescents characterized by inattention, hyperactivity, disruptive behavior, and impulsivity. Although still debated, it is evident that ADHD is also present in adulthood, but this diagnosis is rarely carried out, mainly for the frequent comorbidity with other psychiatric and/or substance abuse disorders. Given the need to shed more light on the pharmacological treatment of ADHD, we performed a naturalistic review to review and comment on the available literature of ADHD treatment across the lifespan. Indeed, stimulants are endowed of a prompt efficacy and safety, whilst non-stimulants, although requiring some weeks to be fully effective, are useful when a substance abuse history is detected. In any case, the pharmacological management of ADHD appears to be still largely influenced by the individual experience of the clinicians. Further longitudinal studies with a careful and detailed characterization of participants across different phases of the lifespan are also required to provide relevant confirmations (or denials) regarding pharmacological treatments amongst the different age groups.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00702-021-02336-wDOI Listing
July 2021

Investigating the relationship between orthorexia nervosa and autistic traits in a university population.

CNS Spectr 2021 Apr 19:1-8. Epub 2021 Apr 19.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Background: Orthorexia nervosa (ON) is an emerging condition featuring restrictive eating behaviors on the basis of subjective beliefs about food healthiness. Many authors have stressed the similarities between ON and anorexia nervosa (AN) in both cognitive and behavioral patterns. Despite that, while the link between AN and female autism presentations is well known in the literature, no study has yet investigated the relationship between ON and autism spectrum. This work aims to investigate the relationship between ON and autistic traits in a university population.

Methods: An e-mail invitation was sent to all the students and University workers of University of Pisa. Subjects were asked to fulfill the ORTO-15 and the Adult Autism Subthreshold spectrum (AdAS spectrum) questionnaires.

Results: A total of 2426 subjects joined the survey: 623 subjects (26.3%) reported a score associated with significant orthorexic symptoms according to ORTO-15 (ON group), while 1789 subjects (73.7%) did not report ON symptomatology and were considered as healthy controls (HC). The ON group scored significantly higher on almost all AdAS spectrum domains. Moreover, being female and scoring higher on AdAS spectrum were statistically predictive factors for the presence of ON symptomatology. Among AdAS spectrum domains, higher scores on AdAS spectrum inflexibility and adherence to routine and restricted interests and rumination domains, as well as lower scores on verbal communication domain, were statistically predictive of orthorexic symptoms.

Conclusions: Our findings highlight an overlap between ON and autism spectrum psychopathology. Further studies are needed to clarify the relationship between restrictive eating disorders and female autism phenotypes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S1092852921000420DOI Listing
April 2021

Autism spectrum in patients with schizophrenia: correlations with real-life functioning, resilience, and coping styles.

CNS Spectr 2021 Apr 12:1-11. Epub 2021 Apr 12.

Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy.

Background: Previous researches highlighted among patients with schizophrenia spectrum disorders (SSD) a significant presence of autistic traits, which seem to influence clinical and functional outcomes. The aim of this study was to further deepen the investigation, evaluating how patients with SSD with or without autistic traits may differ with respect to levels of functioning, self-esteem, resilience, and coping profiles.

Methods: As part of the add-on autism spectrum study of the Italian Network for Research on Psychoses, 164 outpatients with schizophrenia (SCZ) were recruited at eight Italian University psychiatric clinics. Subjects were grouped depending on the presence of significant autistic traits according to the Adult Autism Subthreshold Spectrum (AdAS Spectrum) instrument ("AT group" vs "No AT group"). Other instruments employed were: Autism Spectrum Quotient (AQ), Specific Levels of Functioning (SLOF), Self-Esteem Rating scale (SERS), Resilience Scale for Adults (RSA), and brief-COPE.

Results: The "AT group" reported significantly higher scores than the "No AT group" on SLOF activities of community living but significantly lower scores on work skills subscale. The same group scored significantly lower also on SERS total score and RSA perception of the self subscale. Higher scores were reported on COPE self-blame, use of emotional support and humor domains in the AT group. Several correlations were found between specific dimensions of the instruments.

Conclusion: Our findings suggest the presence of specific patterns of functioning, resilience, and coping abilities among SSD patients with autistic traits.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S1092852921000353DOI Listing
April 2021

Defining the Optimal Threshold Scores for Adult Autism Subthreshold Spectrum (AdAS Spectrum) in Clinical and General Population.

Clin Pract Epidemiol Ment Health 2020 31;16:204-211. Epub 2020 Dec 31.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Background: The Adult Autism Subthreshold Spectrum (AdAS Spectrum) is a recently developed instrument tailored to assess the broad range of full-threshold as well as sub-threshold manifestations related to the autism spectrum. Although it has proved to be a valuable instrument for quantitative assessment of autistic symptoms, the AdAS Spectrum still lacks validated diagnostic thresholds.

Objective: The aim of this study was to define the best cut-off scores of the AdAS Spectrum for determining the presence of subthreshold autistic traits as well as a clinically significant autism spectrum disorder (ASD).

Methods: Our sample was composed of 39 patients with full-blown ASD, 73 subjects with autistic traits, and 150 healthy controls. Subjects were evaluated by trained psychiatrists, who performed a clinical diagnosis according to DSM-5 and then assessed with the AdAS Spectrum and the Autism Spectrum Quotient.

Results: Our results showed that the most discriminant cut-off scores were 70 for identifying subjects with full-blown ASD, and 43 for determining the presence of significant autistic traits.

Conclusion: The threshold values proposed here showed satisfying levels of specificity and sensibility, as well as a good agreement with the diagnosis according to DSM-5 criteria, confirming the validity of the AdAS Spectrum as a psychometric tool for measuring ASD-related conditions in the clinical and general population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2174/1745017902016010204DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931149PMC
December 2020

Eating disorders and autism spectrum: links and risks.

CNS Spectr 2020 Nov 9:1-9. Epub 2020 Nov 9.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

In the last decades, increasing attention has been provided to socio-cultural and neurobiological factors involved in the psychopathology of feeding and eating disorders (FED), encouraging a multifactorial approach. In this framework, several authors stressed an association between FED and other kinds of psychiatric disorders from both a psychopathological and a neurobiological point of view. In particular, many promising contributions are focusing on the possible link between FED and autism spectrum disorder (ASD). Growing interest about this association rose from the frequently reported evidence of ASD-like traits amongst FED patients and abnormal eating behaviors amongst patients with ASD. This narrative review overview aims to summarize the most relevant findings about the overlap between different kinds of FED and the autism spectrum, taking into account the most recent hypotheses about the psychopathology of both these conditions. While most of the studies focused on anorexia nervosa, both ASD and autistic traits seem to be detectable also in other kinds of FED. In addition, the recently increased interest toward a dimensional approach to psychopathology led to progressively broadening the concept of ASD, focusing on its subthreshold and gender-specific manifestations and on its link with other psychiatric conditions, including FED. Globally the studies summarized here provide further support to theoretical models featuring a neurodevelopmental approach for mental disorders. In particular, FED have been conceptualized as a possible psychopathological trajectory of a neurodevelopmental alteration, toward which female gender would act as one of many predisposing factors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S1092852920002011DOI Listing
November 2020

Lithium Use During Pregnancy in a Patient With Bipolar Disorder and Multiple Sclerosis.

Clin Neuropharmacol 2020 Sep/Oct;43(5):158-161

Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italy.

Although lithium is widely used as a first-line treatment for mood disorders, its mood-stabilizing effects remain not fully understood. A growing body of data are stressing that lithium seems to show broader properties, including neuroprotective effects. Lithium's ability to inhibit glycogen synthase kinase 3β, an enzyme that participates in the phosphorylation of τ, a microtubule-associated protein, stimulated interest in its possible therapeutic role in Alzheimer disease and other neurodegenerative disorders. Preliminary data also support exploration of lithium's potential therapeutic role in multiple sclerosis, an autoimmune disorder that is associated with co-occurring mood disorders. Lithium is associated with teratogenic risks to the developing fetus; however, recently revised downward estimates of its teratogenic risk of causing fetal cardiac malformation suggest that its potential therapeutic benefit to both mothers with bipolar disorder and their offspring should be considered in at least some cases. A 43-year-old woman previously diagnosed with bipolar disorder and MS was treated with lithium and thyroid hormone supplementation as her sole medications during her pregnancy. The patient remained euthymic throughout her pregnancy and over the course of her 5-year follow-up evaluations on this medication regimen. In addition to her stable mood, there has been no symptomatic progression or relapse of her MS, and her daughter continues to develop normally.The case supports consideration of balancing lithium's mood-stabilizing benefit with its known teratogenic risk during pregnancy. The case also supports exploration of possible additional benefit in the context of MS co-occurring with bipolar disorder.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/WNF.0000000000000407DOI Listing
July 2021

The complex interactions among serotonin, insulin, leptin, and glycolipid metabolic parameters in human obesity.

CNS Spectr 2020 Sep 14:1-10. Epub 2020 Sep 14.

Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy.

Objective: To provide evidence to the link between serotonin (5-HT), energy metabolism, and the human obese phenotype, the present study investigated the binding and function of the platelet 5-HT transporter (SERT), in relation to circulating insulin, leptin, and glycolipid metabolic parameters.

Methods: Seventy-four drug-free subjects were recruited on the basis of divergent body mass index (BMIs) (16.5-54.8 Kg/m2). All subjects were tested for their blood glycolipid profile together with platelet [3H]-paroxetine ([3H]-Par) binding and [3H]-5-HT reuptake measurements from April 1st to June 30th, 2019.

Results: The [3H]-Par Bmax (fmol/mg proteins) was progressively reduced with increasing BMIs (P < .001), without changes in affinity. Moreover, Bmax was negatively correlated with BMI, waist/hip circumferences (W/HC), triglycerides (TD), glucose, insulin, and leptin, while positively with high-density lipoprotein (HDL) cholesterol (P < .01). The reduction of 5-HT uptake rate (Vmax, pmol/min/109 platelets) among BMI groups was not statistically significant, but Vmax negatively correlated with leptin and uptake affinity values (P < .05). Besides, [3H]-Par affinity values positively correlated with glycemia and TD, while [3H]-5-HT reuptake affinity with glycemia only (P < .05). Finally, these correlations were specific of obese subjects, while, from multiple linear-regression analysis conducted on all subjects, insulin (P = .006) resulting negatively related to Bmax independently from BMI.

Conclusions: Present findings suggest the presence of a possible alteration of insulin/5-HT/leptin axis in obesity, differentially impinging the density, function, and/or affinity of the platelet SERT, as a result of complex appetite/reward-related interactions between the brain, gut, pancreatic islets, and adipose tissue. Furthermore, they support the foremost cooperation of peptides and 5-HT in maintaining energy homeostasis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S1092852920001820DOI Listing
September 2020

Complicated Grief: What to Expect After the Coronavirus Pandemic.

Front Psychiatry 2020 26;11:489. Epub 2020 May 26.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

The COVID-19 pandemic is one of the worst public health crises in a century, with an expected amount of deaths of several million worldwide and an even bigger number of bereaved people left behind. Although the consequences of this crisis are still unknown, a significant number of bereaved people will arguably develop Complicated Grief (CG) in the aftermath of this emergency. If the current pandemic is unprecedented, the grief following the coronavirus outbreak is likely to share features with grief related to natural disasters and after Intensive Care Unit (ICU) treatment. The aim of this paper is to review the most prominent literature on CG after natural disasters, as well as after diseases requiring ICU treatment. This body of evidence may be useful for helping bereaved people during the acute phase of the COVID-19 pandemic and for drawing clinical attention to people at risk for CG.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpsyt.2020.00489DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264152PMC
May 2020

State-of-the-Art: Inflammatory and Metabolic Markers in Mood Disorders.

Life (Basel) 2020 Jun 6;10(6). Epub 2020 Jun 6.

Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, 56100 Pisa, Italy.

Mounting evidence highlights the involvement of inflammatory/immune systems and their relationships with neurotransmitters and different metabolic processes in mood disorders. Nevertheless, there is a general agreement that available findings are still inconclusive. Therefore, further investigations are required, aimed at deepening the role of possible alterations of biomarkers in the pathophysiology of mood disorders that might lead to more focused and tailored treatments. The present study is a comprehensive review on these topics that seem to represent intriguing avenues for the development of real innovative therapeutic strategies of mood disorders.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/life10060082DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345093PMC
June 2020

Inflammatory and metabolic markers in patients with mood disorders.

World J Biol Psychiatry 2021 03 18;22(3):228-235. Epub 2020 Jun 18.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Objectives: An increasing bulk of data underlined that mood disorders show alterations that are not confined to the brain, but involve several other systems. The aim of this retrospective study was to explore metabolic/inflammatory profiles, blood pressure, and BMI in patients affected by bipolar disorders (BDs) to better understand the role of peripheral biomarkers in mood disorders.

Methods: Different metabolic/inflammatory parameters and clinical characteristics were evaluated in 97 BD inpatients from Sicily, a southern Italian region, and compared with normative values from the same area.

Results: No difference was detected between the assessed parameters and the normative values, or between treated and untreated patients. Interestingly, the mean acid uric levels were at the lowest extreme of the normative values, with men showing higher concentrations than women.

Conclusions: No metabolic nor inflammatory alterations emerged in BD patients, even if when obese. A possible explanation might be due to their geographical origin, with culinary traditions based on the Mediterranean diet. Therefore, it would be interesting to ascertain whether such a diet might improve the metabolic impairment often associated with mood disorders. Again, the routine assessment of different clinical/chemistry parameters might be helpful to improve the diagnostic stratification and the personalised treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/15622975.2020.1775891DOI Listing
March 2021

Camouflaging: psychopathological meanings and clinical relevance in autism spectrum conditions.

CNS Spectr 2020 May 26:1-3. Epub 2020 May 26.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

In the last decade, increasing literature focused on camouflaging as a strategy adopted to cope with social environment by patients with autism spectrum disorder (ASD). A better understanding of this phenomenon may shed more light on cognitive mechanisms and coping strategies of patients in the autism continuum, eventually leading to reconsider some previous "dogmas" in this field, such as the gender discrepancy in ASD diagnosis. Moreover, shared features can be observed in the camouflaging strategies adopted among the general population, among patients of the autism spectrum, and among patients with different kinds of psychiatric disorders, further challenging our perspectives. Camouflaging behaviors might be considered as a transdiagnostic element, closely associated with the continuous distribution of the autism spectrum among the general and the clinical population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S1092852920001467DOI Listing
May 2020

Plasma redox and inflammatory patterns during major depressive episodes: a cross-sectional investigation in elderly patients with mood disorders.

CNS Spectr 2021 08 19;26(4):416-426. Epub 2020 May 19.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Background: While both depression and aging have been associated with oxidative stress and impaired immune response, little is known about redox patterns in elderly depressed subjects. This study investigates the relationship between redox/inflammatory patterns and depression in a sample of elderly adults.

Methods: The plasma levels of the advanced products of protein oxidation (AOPP), catalase (CAT), ferric reducing antioxidant power (FRAP), glutathione transferase (GST), interleukin 6 (IL-6), superoxide dismutase (SOD), total thiols (TT), and uric acid (UA) were evaluated in 30 patients with mood disorders with a current depressive episode (depressed patients, DP) as well as in 30 healthy controls (HC) aged 65 years and over. Subjects were assessed with the Hamilton Depression Rating Scale (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A), the Geriatric Depression Rating Scale (GDS), the Scale for Suicide Ideation (SSI), the Reason for Living Inventory (RFL), the Activities of Daily Living (ADL), and the Instrumental Activity of Daily Living (IADL).

Results: DP showed higher levels than HC of AOPP and IL-6, while displaying lower levels of FRAP, TT, and CAT. In the DP group, specific correlations were found among biochemical parameters. SOD, FRAP, UA, and TT levels were also significantly related to psychometric scale scores.

Conclusion: Specific alterations of redox systems are detectable among elderly DP.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S1092852920001443DOI Listing
August 2021

Autistic Traits and Illness Trajectories.

Clin Pract Epidemiol Ment Health 2019 30;15:94-98. Epub 2019 Aug 30.

Department of Clinical and Experimental Medicine, University of Pisa, Italy.

In the framework of increasing attention towards autism-related conditions, a growing number of studies have recently investigated the prevalence and features of sub-threshold Autistic Traits (ATs) among adults. ATs span across the general population, being more pronounced in several clinical groups of patients affected by psychiatric disorders. Moreover, ATs seem to be associated with specific personality features in non-clinical population, implying both a higher vulnerability towards psychopathology and extraordinary talents in specific fields. In this framework, the DSM-5's Autism Spectrum Disorder (ASD) presentations may be considered as the tip of an iceberg that features several possible clinical and non-clinical phenotypes. Globally, the autism spectrum may be considered as a trans-nosographic dimension, which may not only represent the starting point for the development of different psychopathological trajectories but also underlie non-psychopathological personality traits. These different trajectories might be shaped by the specific localization and severity of the neurodevelopmental alteration and by its interaction with the environment and lifetime events. In this wider framework, autistic-like neurodevelopmental alterations may be considered as a general vulnerability factor for different kinds of psychiatric disorders, but also the neurobiological basis for the development of extraordinary abilities, eventually underlying the concept of geniality. Moreover, according to recent literature, we hypothesize that ATs may also be involved in the functioning of human mind, featuring the peculiar sense of "otherness" which can be found, with different grades of intensity, in every human being.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2174/1745017901915010094DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882132PMC
August 2019

The broad autism phenotype in real-life: clinical and functional correlates of autism spectrum symptoms and rumination among parents of patients with autism spectrum disorder.

CNS Spectr 2020 12 21;25(6):765-773. Epub 2019 Nov 21.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Objective: Increasing literature reported higher rates of psychiatric disorders in parents of children with autism spectrum disorder (ASD), as well as of autistic-like features in social and cognitive functioning. However, little attention has been paid to the association between autistic traits (AT) and global functioning in this population. The aim of the present work was to investigate clinical and functional correlates of AT among parents of ASD children, with a specific focus on ruminative thinking.

Methods: One hundred and twenty parents of ASD children were assessed by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the Adult Autism Subthreshold Spectrum (AdAS Spectrum), the Ruminative Response Scale (RRS), the Social and Occupational Functioning Assessment Scale (SOFAS).

Results: Subjects with at least 1 psychiatric disorder (39.2%) showed significantly higher AdAS Spectrum and RRS scores. Subjects with a history of school difficulties and with language development alterations scored significantly higher on specific AdAS Spectrum domains. A significant negative correlation was found between SOFAS and AdAS Spectrum scores, as well as between SOFAS and RRS scores. AdAS Spectrum nonverbal communication domain score was identified has a statistically predictive variable for the presence of psychiatric disorders and lower SOFAS scores. Finally, we found a significant indirect effect of AdAS total score on SOFAS score, which was fully mediated by RRS total score.

Conclusions: AT in parents of ASD children seem to be associated with a higher vulnerability toward psychopathology and with a lower global functioning. Ruminative thinking may play a role in the relationship between AT and functional outcome.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S1092852919001615DOI Listing
December 2020

Subthreshold autism spectrum in bipolar disorder: Prevalence and clinical correlates.

Psychiatry Res 2019 11 7;281:112605. Epub 2019 Oct 7.

Department of Clinical and Experimental Medicine, University of Pisa, Italy.

Background: While few previous studies highlighted a higher prevalence of autistic traits among adults with Bipolar Disorder (BD), little is known about their clinical significance in this population.

Method: 143 subjects with BD were enrolled at the adult psychiatric inpatient clinic of the University of Pisa. Assessments included the SCID-5, the MOODS-SR, the AQ and the AdAS Spectrum.

Results: 42.7% of the sample scored positively for significant levels of autistic traits. Subjects with high autistic traits showed a greater likelihood of a very early onset of BD, greater length of current in-hospital stay, significantly higher rates of anxiety disorders and lower rates of substance use disorders compared to patients with low autistic traits. They also show significantly greater depressive symptoms and suicidality across the lifetime. Suicidality was associated with the altered responsiveness to sensory input and inversely related to adherence to routine and inflexibility.

Conclusion: The study is a first exploration of the clinical significance of autistic traits among BD patients. Our results highlight the clinical significance of autistic traits in patients with BD, supporting the usefulness of a dimensional approach to the autism spectrum.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.psychres.2019.112605DOI Listing
November 2019

Measuring subthreshold autistic traits in the general population: Psychometric properties of the Adult Autism Subthreshold Spectrum (AdAS Spectrum) scale.

Psychiatry Res 2019 11 23;281:112576. Epub 2019 Sep 23.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

The Adult Autism Subthreshold Spectrum (AdAS Spectrum) has been developed to assess the wide spectrum of autistic-like clinical and non-clinical features in adults. Nevertheless, its psychometric properties have been analyzed only with clinical individuals so far. This study was aimed at investigating the dimensionality, reliability and validity of the AdAS Spectrum on a non-clinical sample. Participants were 395 Spanish undergraduate students (60% males; mean age of 21.1 years, SD = 2.6), who completed the AdAS Spectrum, the Autism-Spectrum Quotient (AQ), and the Empathy Quotient (EQ). A confirmatory factor analysis supported the seven-factor structure of the questionnaire. Internal consistency was excellent for the total score and acceptable for five factors. Test-retest reliability over a 4-week period was good. Higher AdAS Spectrum scores significantly correlated with higher AQ and lower EQ scores, supporting the validity of the scale. Moreover, participants studying Science/Technology programs did significantly differ from students following Social/Humanities degree courses on all the AdAS Spectrum scores. Overall, findings support the psychometric properties of the AdAS in a non-clinical sample. Future research is needed to further examine the factorial structure and the internal consistency of the scale in larger samples of general population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.psychres.2019.112576DOI Listing
November 2019

Overlapping features between social anxiety and obsessive-compulsive spectrum in a clinical sample and in healthy controls: toward an integrative model.

CNS Spectr 2020 08 2;25(4):527-534. Epub 2019 Oct 2.

Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Italy.

Background: While the literature frequently highlighted an association between social anxiety disorder (SAD) and obsessive-compulsive disorder (OCD), few studies investigated the overlapping features of these conditions. The presented work evaluated the relationship between SAD and OCD spectrum in a clinical population and in healthy controls (HC).

Methods: Fifty-six patients with OCD, 51 with SAD, 43 with major depressive disorder (MDD), and 59 HC (N = 209) were assessed using the Mini International Neuropsychiatric Interview, the Social Phobia Spectrum (SCI-SHY), and the Obsessive-Compulsive Spectrum (SCI-OBS).

Results: SAD patients scored significantly higher than other groups on all SCI-SHY domains and total score; OCD patients scored significantly higher than HC. MDD patients scored significantly higher than HC on the SCI-SHY total, Behavioral inhibition, and Interpersonal sensitivity domains. OCD patients scored significantly higher than other groups on all SCI-OBS domains except Doubt, for which OCD and SAD scored equally high. SAD patients scored significantly higher than HC on the SCI-OBS total, Childhood/adolescence, Doubt, and Hypercontrol domains. MDD patients scored significantly higher than HC on the Hypercontrol domain. SCI-OBS and SCI-SHY were widely correlated among groups, although lower correlations were found among OCD patients. Stronger correlations were observed between SCI-SHY Interpersonal sensitivity and SCI-OBS Doubt, Obsessive-compulsive themes, and Hypercontrol; between SCI-SHY Specific anxieties/phobic features and SCI-OBS Obsessive-compulsive themes; and between SCI-SHY Behavioral inhibition and SCI-OBS Doubt, with slightly different patterns among groups.

Conclusion: OCD and SAD spectrums widely overlap in clinical samples and in the general population. Interpersonal sensitivity and obsessive doubts might represent a common cognitive core for these conditions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S109285291900138XDOI Listing
August 2020

Microbiota, Immune System and Autism Spectrum Disorders: An Integrative Model towards Novel Treatment Options.

Curr Med Chem 2020 ;27(31):5119-5136

Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Roma, 6756100 Pisa, Italy.

Background: Autism Spectrum Disorder (ASD) is a condition strongly associated with genetic predisposition and familial aggregation. Among ASD patients, different levels of symptoms severity are detectable, while the presence of intermediate autism phenotypes in close relatives of ASD probands is also known in literature. Recently, increasing attention has been paid to environmental factors that might play a role in modulating the relationship between genomic risk and development and severity of ASD. Within this framework, an increasing body of evidence has stressed a possible role of both gut microbiota and inflammation in the pathophysiology of neurodevelopment. The aim of this paper is to review findings about the link between microbiota dysbiosis, inflammation and ASD.

Methods: Articles ranging from 1990 to 2018 were identified on PUBMED and Google Scholar databases, with keyword combinations as: microbiota, immune system, inflammation, ASD, autism, broad autism phenotype, adult.

Results: Recent evidence suggests that microbiota alterations, immune system and neurodevelopment may be deeply intertwined, shaping each other during early life. However, results from both animal models and human samples are still heterogeneous, while few studies focused on adult patients and ASD intermediate phenotypes.

Conclusion: A better understanding of these pathways, within an integrative framework between central and peripheral systems, might not only shed more light on neural basis of ASD symptoms, clarifying brain pathophysiology, but it may also allow to develop new therapeutic strategies for these disorders, still poorly responsive to available treatments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2174/0929867326666190328151539DOI Listing
September 2020

Rumination, posttraumatic stress disorder, and mood symptoms in borderline personality disorder.

Neuropsychiatr Dis Treat 2019 13;15:1231-1238. Epub 2019 May 13.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

The interrelationship between mood disorders and borderline personality disorder (BPD) has been long debated in the literature. Increasing attention has also been paid to the relationship between posttraumatic stress disorder (PTSD) and BPD, as well as to the role of rumination in the development and severity of BPD. This study aims to evaluate the association of rumination, PTSD, and mood spectrum among patients with BPD with or without comorbid mood disorders. Fifty patients with BPD and 69 healthy controls were assessed with the Structured Clinical Interview for the 5, Mood Spectrum Self-Report (MOODS-SR), and Ruminative Response Scale (RRS). The BPD group was split into subjects with BPD+ mood disorder (MD) or BPD only) . PTSD-criteria fulfillment, MOODS, and RRS scores were significantly higher in both BPD subgroups than in controls, while BPD+MD patients scored significantly higher than the BPD-only group. RRS scores and PTSD-criteria fulfillment were significantly related to the presence of both BPD and BPD+MD, with no effect of MOODS-SR scores. Our findings confirm the presence of a relationship between BPD and the PTSD spectrum, highlighting also a possible role of rumination in BPD psychopathology. Rumination and PTSD symptoms seem to prevail in the effect of mood spectrum in predicting BPD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/NDT.S198616DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6526028PMC
May 2019

Rumination, posttraumatic stress disorder, and mood symptoms in borderline personality disorder.

Neuropsychiatr Dis Treat 2019 13;15:1231-1238. Epub 2019 May 13.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

The interrelationship between mood disorders and borderline personality disorder (BPD) has been long debated in the literature. Increasing attention has also been paid to the relationship between posttraumatic stress disorder (PTSD) and BPD, as well as to the role of rumination in the development and severity of BPD. This study aims to evaluate the association of rumination, PTSD, and mood spectrum among patients with BPD with or without comorbid mood disorders. Fifty patients with BPD and 69 healthy controls were assessed with the Structured Clinical Interview for the 5, Mood Spectrum Self-Report (MOODS-SR), and Ruminative Response Scale (RRS). The BPD group was split into subjects with BPD+ mood disorder (MD) or BPD only) . PTSD-criteria fulfillment, MOODS, and RRS scores were significantly higher in both BPD subgroups than in controls, while BPD+MD patients scored significantly higher than the BPD-only group. RRS scores and PTSD-criteria fulfillment were significantly related to the presence of both BPD and BPD+MD, with no effect of MOODS-SR scores. Our findings confirm the presence of a relationship between BPD and the PTSD spectrum, highlighting also a possible role of rumination in BPD psychopathology. Rumination and PTSD symptoms seem to prevail in the effect of mood spectrum in predicting BPD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/NDT.S198616DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6526028PMC
May 2019

Oxidative Stress, Maternal Diabetes, and Autism Spectrum Disorders.

Oxid Med Cell Longev 2018 5;2018:3717215. Epub 2018 Nov 5.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa 55100, Italy.

Autism spectrum disorders (ASD) are a group of early-onset neurodevelopmental conditions characterized by alterations in brain connectivity with cascading effects on neuropsychological functions. To date, in the framework of an increasing interest about environmental conditions which could interact with genetic factors in ASD pathogenesis, many authors have stressed that changes in the intrauterine environment at different stages of pregnancy, such as those linked to maternal metabolic pathologies, may lead to long-term conditions in the newborn. In particular, a growing number of epidemiological studies have highlighted the role of obesity and maternal diabetes as a risk factor for developing both somatic and psychiatric disorders in humans, including ASD. While literature still fails in identifying specific etiopathological mechanisms, a growing body of evidence is available about the presence of a relationship between maternal immune dysregulation, inflammation, oxidative stress, and the development of ASD in the offspring. In this framework, results from high-fat diet animal models about the role played by oxidative stress in shaping offspring neurodevelopment may help in clarifying the pathways through which maternal metabolic conditions are linked with ASD. The aim of this review is to provide an overview of literature about the effects of early life insults linked to oxidative stress which may be involved in ASD etiopathogenesis and how this relationship can be explained in biological terms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2018/3717215DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6247386PMC
January 2019

The mediating effect of trauma and stressor related symptoms and ruminations on the relationship between autistic traits and mood spectrum.

Psychiatry Res 2019 09 16;279:123-129. Epub 2018 Oct 16.

Department of Clinical and Experimental Medicine, University of Pisa, Italy.

An increasing number of studies highlighted significant correlations between autistic traits (AT) and mood spectrum symptoms. Moreover, recent data showed that individuals with high AT are likely to develop trauma and stressor-related disorders. This study aims to investigate the relationship between AT and mood symptoms among university students, focusing in particular on how AT interact with ruminations and trauma-related symptomatology in predicting mood symptoms. 178 students from three Italian Universities of excellence were assessed with The Structured Clinical Interview for DSM-5 (SCID-5), the Adult Autism Subthreshold Spectrum (AdAS Spectrum), the Ruminative Response Scale (RRS), the Trauma and Loss Spectrum (TALS) and the Moods Spectrum (MOODS). Considering the AdAS Spectrum total scores, 133 subjects (74.7%) were categorized as "low scorers" and 45 subjects (25.3%) as "high scorers". Students in the high scorer group showed significantly higher scores on RRS, TALS-SR and MOOD-SR total scores. Total and direct effects of AdAS Spectrum total score on MOODS-SR total score were both statistically significant. AdAS Spectrum total score also showed a significant indirect effect on MOODS-SR total score through TALS and RRS total scores. Results showed a significant relationship between AT and mood spectrum, which is partially mediated by ruminations and trauma/stressor-related symptomatology.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.psychres.2018.10.040DOI Listing
September 2019

Mothers and fathers of children with epilepsy: gender differences in post-traumatic stress symptoms and correlations with mood spectrum symptoms.

Neuropsychiatr Dis Treat 2018 25;14:1371-1379. Epub 2018 May 25.

Psychiatric Clinic.

Background: Post-traumatic stress disorder (PTSD) and post-traumatic stress spectrum have been recently applied to understand the impact of life-threatening disease or injury in one's child; nevertheless, scant data are available on a particular chronic illness such as epilepsy whose phenotypic expression is seizures, which are acute, sudden, and unpredictable manifestations. Subjects with bipolar disorders or with mood spectrum symptoms demonstrated to be more vulnerable to develop PTSD in the aftermath of a trauma.

Objectives: The main aim of this study was to evaluate post-traumatic symptoms among 134 parents of children with a diagnosis of epilepsy, followed at the outpatient neurologic unit of Department of Pediatrics in Santa Chiara Hospital in Pisa, as well as gender differences. The second aim of this study was to estimate the impact of lifetime mood spectrum on post-traumatic stress symptoms in the same study sample after fulfillment of the Trauma and Loss Spectrum-Self Report (TALS-SR) and the Mood Spectrum-Self Report (MOODS-SR) lifetime version.

Results: Results showed 10.4% and 37.3% of PTSD full and partial, respectively. Demographic characteristics and clinical features of the study sample did not show any impact on stress symptomatology. Mothers presented higher rates at all (DSM)-5 PTSD symptoms' clusters except avoidance. Nevertheless, noteworthy correlations between post-traumatic symptomatology and mood spectrum symptoms detected with the self-report tools, emerged only in the subgroup of the fathers.

Conclusion: These findings corroborate the need to provide assistance to caregivers of pediatric patients and confirm the hypothesis that lifetime mood spectrum may have an impact on reaction to traumas.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/NDT.S158249DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973431PMC
May 2018

Polysubstance and Behavioral Addictions in a Patient with Bipolar Disorder: Role of Lifetime Subthreshold Autism Spectrum.

Case Rep Psychiatry 2018 22;2018:1547975. Epub 2018 Feb 22.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

This case report draws attention to the potential relevance of undetected autism spectrum symptoms in a bipolar patient with high work functioning showing a peculiar addictive profile with impulsive and antisocial behaviors. A 23-year-old man with a diagnosis of Bipolar Disorder (BD) and Substance Use Disorder (SUD) was hospitalized at the Psychiatric Clinic of the University of Pisa for diuretics and -2 adrenergic agonist abuse in a remission phase of benzodiazepines and substance abuse. He reported a history of behavioral addictions in the framework of a global high work functioning with particular skills in computer science. When assessed for adult autism spectrum symptoms, despite not fulfilling a DSM-5 diagnosis of Autism Spectrum Disorder (ASD), he reported a score of 93/240 at the Ritvo Autism and Asperger Diagnostic Scale (RAADS-r) and of 88/160 at the Adult Autism Subthreshold Spectrum (AdAS Spectrum), both indicative of ASD. We argue the possible role of adult subthreshold autism spectrum features, generally disregarded in adult psychiatry, in the peculiar addictive profile developed by this patient with BD that may deserve appropriate treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2018/1547975DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842737PMC
February 2018

Management of psychiatric patients before deinstitutionalization: an inquiry into the years 1907-1913 in Pisa

Riv Psichiatr 2018 Mar-Apr;53(2):80-87

Department of Clinical and Experimental Medicine, University of Pisa.

Aim: Asylums comprises the main focus of historical research on early 20th century psychiatry. To assess the characteristic of asylum transfers in a clinical population, we analyzed newly found clinical records from University of Pisa Clinic for Mental and Nervous Illness. We focused on the early years of this structure’s activities considering all admissions from 24th April 1907 to 31st January 1913.

Methods: We collected demographic and clinical data from 1,068 patients performing Chi-Square Tests to study correlation between asylum transfer and diagnosis and gender difference; independent sample Student’s t-tests were also performed to compare mean Age, mean number of Days of Hospitalization and mean number of Subsequent Admissions to the Clinic observed in patients transferred to an asylum versus those who had been discharged. Multiple logistic regression model was employed to identify the best predictors of asylum transfers.

Results: Most patient were discharged, and only a third of the hospitalization led to asylum confinement. Our data outlines a peculiar discharge rationale, suggesting that the Clinic acted like a “sieve-institution” to prevent asylum overcrowding from treatable, non-chronic conditions.

Discussion: These data suggest that our historical view of psychiatric care is probably not complete, and that a different approach to source materials could provide new research paradigms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1708/2891.29156DOI Listing
November 2018
-->