1,721,012 research outputs found
Occurrence of Terrifying Nightmares after Few Days of Mirtazapine Use in Elderly Patients
No full textIntroduction. Sleep disturbance and insomnia are some of the most frequent complaints in patients suffering from depression. Some common antidepressant with excitatory effects may worsen sleep qualities, whereas others (like mirtazapine), thanks to their antihistaminergic action, are associated with sedative properties and can quickly improve sleep quality. In the case of mirtazapine, even if its mechanisms of action on sleep remain controversial, beneficial changes in sleep pattern may be observable since the first dose and are associated with a faster onset of the antidepressive action. Case Presentation. Despite these documented beneficial effects, we reported five cases of elderly patients (age ranging from 69 to 79) with various diagnoses and comorbidities (severe or recurrent depression, general anxiety disorder, borderline personality disorder, and Parkinson's disease) assessed during clinical daily routine for whom the use of mirtazapine was linked to the onset of nightmares so impressive and dramatic that made it necessary to interrupt the treatment. Discussion. This peculiar side effect is still scarcely documented, and the literature on this topic remains conflicting; however, considering that the cases were collected in a short range of time, the exacerbation of nightmares caused by mirtazapine may be more frequent than previously believed. Furthermore, some common features shared by all the cases reported have been highlighted such as the onset of the nightmares being chronologically associated with the initiation of the therapy with mirtazapine, the disappearance with the interruption, the similar age range of all, and the occurrence of the episodes described during fall season
Eating disorders and autism spectrum: links and risks
No full textIn the last decades, increasing attention has been provided to socio-cultural and 27 neurobiological factors involved in the psychopathology of Feeding and eating 28 disorders (FED), encouraging a multifactorial approach. In this framework, several 29 authors stressed an association between FED and other kinds of psychiatric disorders 30 from both a psychopathological and a neurobiological point of view. In particular, many 31 promising contributions are focusing on the possible link between FED and autism 32 spectrum disorder (ASD). Growing interest about this association rose from the 33 frequently reported evidence of ASD-like traits amongst FED patients and abnormal 34 eating behaviors amongst patients with ASD. This narrative review overview aims to 35 summarize the most relevant findings about the overlap between different kinds of FED 36 and the autism spectrum, taking into account the most recent hypotheses about the 37 psychopathology of both these conditions. While most of the studies focused on 38 Anorexia Nervosa, both ASD and autistic traits seem to be detectable also in other kinds 39 of FED. In addition, the recently increased interest towards a dimensional approach to 40 psychopathology led to progressively broadening the concept of ASD, focusing on its 41 subthreshold and gender-specific manifestations and on its link with other psychiatric 42 conditions, including FED. Globally the studies summarized here provide further 43 support to theoretical models featuring a neurodevelopmental approach for mental 44 disorders. In particular, FED have been conceptualized as a possible psychopathological 45 trajectory of a neurodevelopmental alteration, towards which female gender would act 46 as one of many predisposing factors
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Eating disorders and autism spectrum: Links and risks
No full textIn the last decades, increasing attention has been provided to socio-cultural and 27 neurobiological factors involved in the psychopathology of Feeding and eating 28 disorders (FED), encouraging a multifactorial approach. In this framework, several 29 authors stressed an association between FED and other kinds of psychiatric disorders 30 from both a psychopathological and a neurobiological point of view. In particular, many 31 promising contributions are focusing on the possible link between FED and autism 32 spectrum disorder (ASD). Growing interest about this association rose from the 33 frequently reported evidence of ASD-like traits amongst FED patients and abnormal 34 eating behaviors amongst patients with ASD. This narrative review overview aims to 35 summarize the most relevant findings about the overlap between different kinds of FED 36 and the autism spectrum, taking into account the most recent hypotheses about the 37 psychopathology of both these conditions. While most of the studies focused on 38 Anorexia Nervosa, both ASD and autistic traits seem to be detectable also in other kinds 39 of FED. In addition, the recently increased interest towards a dimensional approach to 40 psychopathology led to progressively broadening the concept of ASD, focusing on its 41 subthreshold and gender-specific manifestations and on its link with other psychiatric 42 conditions, including FED. Globally the studies summarized here provide further 43 support to theoretical models featuring a neurodevelopmental approach for mental 44 disorders. In particular, FED have been conceptualized as a possible psychopathological 45 trajectory of a neurodevelopmental alteration, towards which female gender would act 46 as one of many predisposing factors
Autism Spectrum Disorder in a Patient with Bipolar Disorder and Its Relationship with Catatonia Spectrum: A Case Study
Get PDFAccording to several studies, the prevalence of Autism Spectrum Disorder (ASD) ranges from 2.4 to 9.9 percent among adult mental inpatients. However, subjects with forms of ASD that fit in the high functioning spectrum may remain undiagnosed during childhood and adolescence without reaching clinical attention until they develop in adult life other psychiatric disorders, often characterized by treatment resistance and poor outcomes. The aim of this case report was to evaluate the role of an undiagnosed ASD in the mental illness trajectory and discuss the diagnostic and therapeutic implications. We reported a case of a young man with an undiagnosed ASD that came to clinical attention only after the development of a severe manic episode with mixed and psychotic features and with catatonia in adulthood, despite meeting DSM-5-TR (APA, 2022) diagnostic criteria for ASD since early childhood. This case confirms the need of a timely identification of ASD in order to prevent the development of a mental illness trajectory and to improve the prognosis and the outcome. Moreover, on the heuristic level, this case seems to support the presence of a continuum between ASD and catatonia. In this framework, the use of a questionnaire based on a spectrum model, such as the AdAS Spectrum, could be useful in early diagnosis of ASD without intellectual or language impairment as well as in early detection of subthreshold conditions (broad autism spectrum phenotype or autistic traits), which represents a vulnerability factor for the development of various mental disorders
Rumination and altered reactivity to sensory input as vulnerability factors for developing post-traumatic stress symptoms among adults with autistic traits
No full textObjective. Recent literature has suggested that individuals with autism spectrum disorder (ASD) or autistic traits (ATs) would be more likely to encounter traumatic events in their lifetime and to develop post-traumatic stress disorder (PTSD). However, the nature of this relationship has not yet been fully elucidated. The aims of this study were to evaluate the relationship between AT and PTSD and to investigate which specific autistic dimension was more associated with trauma and stress-related symptoms. Methods. A total of 68 subjects with ASD and 64 healthy controls (HCs) were assessed with the Adult Autism Subthreshold Spectrum (AdAS Spectrum) and the Trauma and Loss Spectrum (TALS) questionnaires. Statistical analyses included Mann–Whitney U test, chi-square test, calculation of Spearman’s coefficients, and logistic regression analysis. Results. Patients with significant AT reported a 30% rate of PTSD and higher TALS total and domain scores than HCs, among whom no PTSD was found instead. Significant positive correlations were reported between AdAS Spectrum and TALS-SR scores in the whole sample. AdAS Spectrum total scores were statistically predictive of the presence of PTSD. High scores at AdAS Spectrum Inflexibility and adherence to routine and Restrictive interest and rumination domains were identified as positive predictors of a probable PTSD. Conclusion. Compared to HCs, subjects with significant AT are more likely to present symptoms of PTSD. In particular, AT related to ruminative thinking, narrow interests, and sensorial reactivity would seem to predict the presence of post-traumatic stress symptomatology
Complicated Grief: What to Expect After the Coronavirus Pandemic
Get PDFThe 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
Measuring Social Camouflaging in Individuals with High Functioning Autism: A Literature Review
Get PDFIn the recent years, growing attention has been paid to the use of camouflaging strategies by adult populations suffering from autism spectrum disorder (ASD) with milder manifestations and without intellectual impairment, which may lead to a delay in diagnosis or even a misdiagnosis. In fact, high-functioning ASD individuals were reported to be more aware of their communication difficulties and were more likely make considerable efforts to adjust their behavior to conventional rules of non-autistic individuals, learning to imitate other non-ASD individuals. Moreover, females reported a higher frequency of camouflaging strategies, suggesting a role of camouflaging in the gender gap of the ASD diagnosis. Although camouflaging strategies can sometimes grant a better level of adjustment, even resulting in a hyper-adaptive behavior, they are also often correlated with negative mental health consequences due to the long-term stress associated with continuous attempts to adapt in day-to-day life. In this framework, the aim of the present work was to review the available studies that assessed the presence and correlates of camouflaging strategies in individuals with ASD. Although the literature available on the topic is still scarce, some interesting correlations between camouflaging and anxious and depressive symptoms, as well as suicidality, were highlighted. In particular, the controversial and sometime opposite thoughts and results about camouflaging may be clarified and integrated in light of a dimensional approach to psychopathology
Ptsd and burnout are related to lifetime mood spectrum in emergency healthcare operator
No full textBackground: PTSD and burnout are frequent conditions among emergency healthcare personnel because exposed to repeated traumatic working experiences. Increasing evidence suggests high comorbidity between PTSD and mood symptoms, particularly depression, although the real nature of this relationship still remains unclear. The purpose of this study was to investigate the relationship between PTSD, burnout and lifetime mood spectrum, assessed by a specific scale, among health-care professionals of a major University Hospital in Italy. Methods: N=110 Emergency Unit workers of the Azienda Ospedaliero-Universitaria Pisana (Pisa, Italy) were assessed by the TALS-SR, MOODS-SR lifetime version and the ProQOL R-IV. Results: Approximately 60% of participants met at least one PTSD symptom criterion (criterion B, 63.4%; criterion C, 40.2%; criterion D 29.3%; criterion E, 26.8%), according to DSM-5 diagnosis. Almost sixteen percent of the sample reported a full symptomatic DSM-5 PTSD (work-related) diagnosis, and these showed significantly higher scores in all MOODS-SR depressive domains, as well as in the rhythmicity domain, compared with workers without PTSD. Further, mood-depressive and cognition-depressive MOODS-SR domains resulted to be predictive for PTSD. Significant correlations emerged between either PTSD diagnosis and criteria or ProQOL subscales and all the MOOD-SR domains. Conclusion: A significant association emerged among PTSD, burnout and lifetime MOOD Spectrum, particularly the depressive component, in emergency health care operators, suggesting this population should be considered at-risk and undergo regular screenings for depression and PTSD
- …
