[Treatment of obsessive-compulsive disorder: drugs, psychotherapy or combined treatments?].

Serotonin reuptake inhibitors (SRIs) and cognitive-behavioral psychotherapy (CBT) are first-line treatments for obsessive-compulsive disorder (OCD). However, little is known concerning whether combining both treatments ab initio is more effective than either monotherapy alone. A review of the available literature, which is poor, shows that combining ab initio CBT and SRI has not been found to be clearly superior of either therapy alone, except for patients with severe depression (who could be treated effectively with pharmacotherapy alone) and for children and adolescents.

Effects of maintenance lithium treatment on serum parathyroid hormone and calcium levels: a retrospective longitudinal naturalistic study.

Objective: The aim of this retrospective longitudinal naturalistic study was to evaluate the effects of maintenance lithium treatment on parathyroid hormone (PTH) and calcium levels.

Methods: A retrospective longitudinal naturalistic study design was used. Data were collected from the database of a tertiary psychiatric center covering the years 2010-2014.

Vagus nerve stimulation for treatment-resistant mood disorders: a long-term naturalistic study.

Background: Limited therapeutic options are available for patients with treatment-refractory major depression who do not respond to routinely available therapies. Vagus nerve stimulation showed adjunctive antidepressant effect in chronic treatment resistant depression, even though available studies rarely exceed 2-year follow up. We report a naturalistic 5-year follow up of five patients who received VNS implant for resistant depression (3 patients with major depressive disorder and 2 with bipolar disorder).

Combined treatment of borderline personality disorder with interpersonal psychotherapy and pharmacotherapy: predictors of response.

Borderline personality disorder (BPD) is characterized by affective instability, impulsive behaviors, and disturbed interpersonal relationships. A previous study of our group found that combined therapy with interpersonal psychotherapy adapted to BPD (IPT-BPD) and fluoxetine was superior to single pharmacotherapy in BPD patients. The aim of the present study was to examine what clinical factors predicted response to combined therapy in patients evaluated in the previous efficacy study.

Increased uric acid levels in bipolar disorder subjects during different phases of illness.

Background: Recent evidence indicates the possible involvement of adenosine and the purinergic system in the pathophysiology of bipolar disorder (BD). The aim of this study is to compare serum uric acid (UA) levels in a large group of BD patients (in mania, depression and euthymia) vs. a control group of patients with different psychiatric disorders.

[Interpersonal psychotherapy: a model of intervention for borderline personality disorder].

Interpersonal psychotherapy (IPT) was proposed in 1984 by Klerman and colleagues. It is a time-limited psychotherapy (12-16 sessions), diagnosis-focused, based on a medical model. Psychiatric symptoms develop in an interpersonal context.

Negative symptoms and everyday functioning in schizophrenia: a cross-sectional study in a real world-setting.

Negative symptoms have been suggested to have a greater impact on real-world functioning in schizophrenia than other symptoms. We aimed to examine the relationship of specific negative symptoms components ("expressive deficits" - DE - which include alogia and blunted affect, and "avolition" - AA - which includes amotivation, anhedonia, and asociality), with separate domains of real-world outcomes (the Personal and Social Performance Scale - PSP - and selected items of the Heinrichs Quality of Life Scale - QLS - that did not overlap with negative symptoms) and two functional milestones (recent employment and marriage). Regression analyses were performed to identify the determinants of QLS and PSP scores and of the two milestones, in 92 consecutive outpatients with stable schizophrenia.

[Lithium treatment and potential long-term side effects: a systematic review of the literature].

Introduction And Aim: Lithium is recommended by all treatment guidelines for bipolar disorder (BD) as a first-line maintenance treatment. However, the potential side effects and risks associated with long-term lithium use may at times make the implementation of these recommendations in daily practice challenging. The aim of the study is to review available literature on potential long-term side effects of lithium.

Recurrence rates of bipolar disorder during the postpartum period: a study on 276 medication-free Italian women.

The postpartum period is considered a time of heightened vulnerability to bipolar disorder. The primary goal of this study was to examine the frequency and the polarity of postpartum episodes in a clinical sample of women with bipolar disorder who were medication-free during their pregnancies. In addition, we sought to examine whether there are differences in terms of clinical features of bipolar disorder between women with and without postpartum episodes.

Efficacy of omega-3 fatty acids in the treatment of borderline personality disorder: a study of the association with valproic acid.

Omega-3 fatty acids have received increasing interest due to their effects in stabilizing plasmatic membranes and regulating cell signaling. The efficacy of omega-3 fatty acids in psychiatric disorders, in particular mood disorders, has been studied. There have been two trials on eicosapentanoic acid (EPA) and docosahexanoic acid (DHA) in the treatment of borderline personality disorder (BPD).

Lithium-associated hyperparathyroidism and hypercalcaemia: a case-control cross-sectional study.

Background: Lithium is recommended as a first-line treatment for Bipolar Disorder (BD). Thyroid and renal alterations are well known lithium side-effects, while effects on parathyroids are less studied. The aim of this case-control cross-sectional study is to compare parathyroid hormone (PTH) and calcium levels in lithium-exposed bipolar patients and in subjects who had never been exposed to lithium.

[Brain stimulation therapies for treatment-resistant depression].

Treatment-resistant depression (TRD) is a major public health problem, affecting patients, their close relatives, and the society as a whole. Despite recent developments in psychopharmacotherapy, more than 50% of depressed patients fail to reach complete remission even when adequately treated. Neurostimulation therapies are an open field in research for the treatment of TRD, involving the delivery of physical interventions either through electric current or a magnetic field to target selective or generalized brain regions.

Insight in stable schizophrenia: relations with psychopathology and cognition.

Objective: This study evaluated the relationship among insight, sociodemographic and clinical variables, symptoms and cognitive functions in a population of outpatients with stable schizophrenia, in order to identify possible contributing factors to awareness.

Method: Two-hundred and seventy-six consecutive outpatients with stable schizophrenia were enrolled in a cross-sectional study. All subjects were assessed by psychiatric scales and interview, and a wide neuropsychological battery.

Metabolic syndrome and obsessive-compulsive disorder: a naturalistic Italian study.

Objective: The increased risk for metabolic syndrome (MetS) in individuals with schizophrenia and bipolar disorder has been documented. No study examined MetS in patients with obsessive-compulsive disorder (OCD), despite the fact that a great proportion of them are treated with antipsychotic addition. The aim of our study was to investigate the prevalence and the sociodemographic and clinical correlates of MetS in an Italian sample of patients with OCD.

[Combined treatments in obsessive-compulsive disorder: current knowledge and future prospects].

Aim: Serotonin reuptake inhibitors (SRIs) and/or cognitive-behavioral psychotherapy (CBT) are first-line treatments for obsessive-compulsive disorder (OCD). The study discuss whether: a) combining both treatments ab initio is more effective than either monotherapy alone; and b) a sequential treatment is effective both in responder and non responder patients.

Methods: Have been carried out a search on Medline/PubMed database, selecting clinical randomized controlled studies in English.

Prosody recognition and audiovisual emotion matching in schizophrenia: the contribution of cognition and psychopathology.

This study aimed to evaluate the ability to decode emotion in the auditory and audiovisual modality in a group of patients with schizophrenia, and to explore the role of cognition and psychopathology in affecting these emotion recognition abilities. Ninety-four outpatients in a stable phase and 51 healthy subjects were recruited. Patients were assessed through a psychiatric evaluation and a wide neuropsychological battery.

Rethinking the role of long-acting atypical antipsychotics in the community setting.

Schizophrenia is a relapsing and evolving condition, which requires treatment continuity. Increasing evidence shows that antipsychotic discontinuation is associated with relapse in most patients, and that early interventions have a positive impact on long-term outcomes. Poor adherence to antipsychotics is a major factor in the treatment of schizophrenia and a relevant risk factor for relapse.

[OCD during pregnancy and post partum].

Aim: Obsessive-compulsive disorder (OCD) can occur with specific characteristics during the pregnancy/postpartum period. The presence of OCD in a such delicate period in a woman's life can lead to severe suffering of the patient herself, of her relatives and the newborn. The purpose of this article is to offer a comprehensive review of scientific literature concerning the relationship between OCD and pregnancy/post partum.

Stressful life events and obsessive-compulsive disorder: clinical features and symptom dimensions.

The potential role of stressful life events (SLEs) in the genesis of obsessive-compulsive disorder (OCD) has been suggested by several authors, but whether the number or the severity or the type of SLEs preceding the onset of OCD has a triggering effect is unclear. Further, sociodemographic and clinical features of OCD preceded by SLEs, and the relationship between type of SLEs and type of obsessive-compulsive symptomatology remain mainly unexplored. The aims of this study were to compare the clinical features of OCD with and without SLEs preceding it and to examine the relationship between type of SLEs and OCD symptom dimensions.

Metabolic syndrome in Italian patients with bipolar disorder: a 2-year follow-up study.

Background: Metabolic syndrome (MetS) is highly prevalent in patients with bipolar disorder (BD). Few prospective studies have demonstrated an increase of MetS prevalence over time in patients with BD, but no study has tried to unveil the characteristics of patients with BD eventually developing the MetS. In our study we assessed the prevalence of MetS and its criteria over a period of 2-years; then, we identified the baseline clinical features of patients who developed the MetS during the follow-up with the intent to identify potential predictors for developing the MetS.

Paliperidone ER in the Treatment of Borderline Personality Disorder: A Pilot Study of Efficacy and Tolerability.

Antipsychotics are recommended for the treatment of impulsive dyscontrol and cognitive perceptual symptoms of borderline personality disorder (BPD). Three reports supported the efficacy of oral risperidone on BPD psychopathology. Paliperidone ER is the metabolite of risperidone with a similar mechanism of action, and its osmotic release reduces plasmatic fluctuations and antidopaminergic effects.

[Lithium and anticonvulsants in the treatment of mania and in the prophylaxis of recurrences].

Introduction: A mood stabilizer is an agent effective in treating both poles of the illness and at the same time being able to prevent both manic and depressive episodes in bipolar disorder. According to a broader definition, a mood stabilizer should be effective in decreasing the frequency or severity of any type of episode in bipolar disorder, without worsening the frequency or severity of episodes of opposite polarity. According to this, anticonvulsants and atypical antipsychotics can be considered as mood stabilizers.