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Depression: HELP
Articles by Michele Fornaro
Based on 42 articles published since 2008
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Between 2008 and 2019, M. Fornaro wrote the following 42 articles about Depression.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Editorial Inflammatory markers and suicidal attempts in depressed patients: A review. 2016

Marini, Stefano / Vellante, Federica / Matarazzo, Ilaria / De Berardis, Domenico / Serroni, Nicola / Gianfelice, Daniela / Olivieri, Luigi / Di Renzo, Fulvia / Di Marco, Anna / Fornaro, Michele / Orsolini, Laura / Valchera, Alessandro / Iasevoli, Felice / Mazza, Monica / Perna, Giampaolo / Martinotti, Giovanni / Di Giannantonio, Massimo. ·Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy sfnmarini@gmail.com. · Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy. · NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4 Teramo, Italy. · Department of "Scienze della Formazione", University of Catania, Italy. · United Hospitals, Academic Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy. · School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts, UK. · Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy. · Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy. · Department of Health Science, University of L'Aquila, L'Aquila, Italy. · Hermanas Hospitalarias, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, Como, Italy. · Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, Florida, USA. · Department of Psychiatry and Neuropsychology, University of Maastricht, The Netherlands. ·Int J Immunopathol Pharmacol · Pubmed #26729403.

ABSTRACT: Major depressive disorder is a chronic and invalidating psychiatric illness and is associated with a greater risk of suicidal behaviors. In recent decades many data have supported a biological link between depressive states and inflammation. Pro-inflammatory cytokines have been found to rise, first of all TNF-α and IL-6. Suicidal behaviors have been consistently associated with increased levels of IL-6 and decreased levels of IL-2. The aim of this review is to investigate the relationship between inflammatory markers in depressed patients with or without suicidal attempts compared to healthy controls.

2 Review The emergence of loss of efficacy during antidepressant drug treatment for major depressive disorder: An integrative review of evidence, mechanisms, and clinical implications. 2019

Fornaro, Michele / Anastasia, Annalisa / Novello, Stefano / Fusco, Andrea / Pariano, Riccardo / De Berardis, Domenico / Solmi, Marco / Veronese, Nicola / Stubbs, Brendon / Vieta, Eduard / Berk, Michael / de Bartolomeis, Andrea / Carvalho, André F. ·Neuroscience, Reproductive Science and Odontostomatology Unit, Section of Psychiatry School of Medicine Federico II, Naples, Italy. Electronic address: Dott.Fornaro@gmail.com. · Casa di Cura Alma Mater S.p.A. "Villa Camaldoli", Naples, Italy. Electronic address: Anastasia.Annalisa@gmail.com. · Neuroscience, Reproductive Science and Odontostomatology Unit, Section of Psychiatry School of Medicine Federico II, Naples, Italy. Electronic address: stefano.novello1@gmail.com. · Neuroscience, Reproductive Science and Odontostomatology Unit, Section of Psychiatry School of Medicine Federico II, Naples, Italy. Electronic address: andreafusco1990@gmail.com. · Neuroscience, Reproductive Science and Odontostomatology Unit, Section of Psychiatry School of Medicine Federico II, Naples, Italy. Electronic address: riccardopariano123@gmail.com. · National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", Teramo, Italy. Electronic address: dodebera@aliceposta.it. · University of Padua, Neuroscience Department, Psychiatry Unit, Padua, Italy; Padova Neuroscience Center, University of Padua, Italy. Electronic address: marco.solmi83@gmail.com. · National Research Council, Ageing Branch, Padua, Italy. Electronic address: ilmannato@gmail.com. · Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK; Health Service and Population Research Department and the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK. Electronic address: brendon.stubbs@kcl.ac.uk. · Psychiatry and Psychology Department of the Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel St, 08036, Barcelona, Catalonia, Spain. Electronic address: EVIETA@clinic.cat. · Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, VIC, Australia; Centre for Youth Mental Health, Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia; The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia. Electronic address: mikebe@barwonhealth.org.au. · Neuroscience, Reproductive Science and Odontostomatology Unit, Section of Psychiatry School of Medicine Federico II, Naples, Italy. Electronic address: adebarto@unina.it. · Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada. Electronic address: andre.carvalho@camh.ca. ·Pharmacol Res · Pubmed #30385364.

ABSTRACT: The re-emergence (i.e. 'breakthrough') of depressive symptoms despite maintenance treatment of depression with antidepressant drugs is a complex clinical phenomenon referred to as tolerance. Herein we critically appraise evidence from both pre-clinical and clinical studies, focusing on putative mechanisms as well as clinical correlates and implications of the emergence tolerance during antidepressant treatment for major depressive disorder (MDD). It is firstly unclear to what extent this phenotype reflects a pharmacological effect of an antidepressant, is driven by non-adherence, is a marker of latent bipolarity or another comorbidity, a marker of neuroprogression of the underlying disorder or the intrusion of the impact of psychosocial variables into the clinical course. The operational definitions of tolerance and its related phenomena have also been largely inconsistent. Several protective clinical indicators have been proposed, including a rapid-cycling course and comorbid chronic anxiety, whilst poor treatment adherence, proneness to emotional blunting and sub-threshold bipolarity have been identified as possible correlates of tolerance to antidepressant treatment in MDD. Putative neurobiological underpinnings include adaptations in the hypothalamic-pituitary-adrenal (HPA) axis and the serotonergic system. Due to the clinical and diagnostic challenges imposed by the emergence of tolerance to antidepressants, there is an urgent need for upcoming international guidelines to reach a consensus on operational definitions for this complex clinical phenomenon, thus enabling a more precise appreciation of the incidence and correlates of tolerance to antidepressants. Taken together, the present review underscores the need to cautiously weight benefits and risks prior to considering long-term antidepressant treatment for patients with MDD as tolerance may emerge in a subset of patients.

3 Review Differentiating between bipolar and unipolar depression in functional and structural MRI studies. 2019

Han, Kyu-Man / De Berardis, Domenico / Fornaro, Michele / Kim, Yong-Ku. ·Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea. · Department of Mental Health Psychiatric Service, Diagnosis and Treatment Hospital "G. Mazzini," ASL 4, NHS, Teramo, Italy. · Head and Neck Department, Section of Psychiatry, University School of Medicine "Federico II", Naples, Italy. · Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address: yongku@korea.ac.kr. ·Prog Neuropsychopharmacol Biol Psychiatry · Pubmed #29601896.

ABSTRACT: Distinguishing depression in bipolar disorder (BD) from unipolar depression (UD) solely based on clinical clues is difficult, which has led to the exploration of promising neural markers in neuroimaging measures for discriminating between BD depression and UD. In this article, we review structural and functional magnetic resonance imaging (MRI) studies that directly compare UD and BD depression based on neuroimaging modalities including functional MRI studies on regional brain activation or functional connectivity, structural MRI on gray or white matter morphology, and pattern classification analyses using a machine learning approach. Numerous studies have reported distinct functional and structural alterations in emotion- or reward-processing neural circuits between BD depression and UD. Different activation patterns in neural networks including the amygdala, anterior cingulate cortex (ACC), prefrontal cortex (PFC), and striatum during emotion-, reward-, or cognition-related tasks have been reported between BD and UD. A stronger functional connectivity pattern in BD was pronounced in default mode and in frontoparietal networks and brain regions including the PFC, ACC, parietal and temporal regions, and thalamus compared to UD. Gray matter volume differences in the ACC, hippocampus, amygdala, and dorsolateral prefrontal cortex (DLPFC) have been reported between BD and UD, along with a thinner DLPFC in BD compared to UD. BD showed reduced integrity in the anterior part of the corpus callosum and posterior cingulum compared to UD. Several studies performed pattern classification analysis using structural and functional MRI data to distinguish between UD and BD depression using a supervised machine learning approach, which yielded a moderate level of accuracy in classification.

4 Review Eradicating Suicide at Its Roots: Preclinical Bases and Clinical Evidence of the Efficacy of Ketamine in the Treatment of Suicidal Behaviors. 2018

De Berardis, Domenico / Fornaro, Michele / Valchera, Alessandro / Cavuto, Marilde / Perna, Giampaolo / Di Nicola, Marco / Serafini, Gianluca / Carano, Alessandro / Pompili, Maurizio / Vellante, Federica / Orsolini, Laura / Fiengo, Annastasia / Ventriglio, Antonio / Yong-Ku, Kim / Martinotti, Giovanni / Di Giannantonio, Massimo / Tomasetti, Carmine. ·National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, "G. Mazzini" Hospital, p.zza Italia 1, 64100 Teramo, Italy. domenico.deberardis@aslteramo.it. · Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University "G. D'Annunzio", 66100 Chieti, Italy. domenico.deberardis@aslteramo.it. · Polyedra Research Group, 64100 Teramo, Italy. dott.fornaro@gmail.com. · Department of Neuroscience, Reproductive Science and Odontostomatology, School of Medicine 'Federico II' Naples, 80121 Naples, Italy. dott.fornaro@gmail.com. · Polyedra Research Group, 64100 Teramo, Italy. a.valchera@ospedaliere.it. · Villa S. Giuseppe Hospital, Hermanas Hospitalarias, 63100 Ascoli Piceno, Italy. a.valchera@ospedaliere.it. · Department of Theory, Analysis and Composition, Music Conservatory "L. Canepa", 07100 Sassari, Italy. marilde_cavuto@virgilio.it. · Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, 22032 Como, Italy. pernagp@gmail.com. · Department of Psychiatry and Neuropsychology, University of Maastricht, 6221 Maastricht, The Netherlands. pernagp@gmail.com. · Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, Coral Gables, FL 33114, USA. pernagp@gmail.com. · Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, 00118 Rome, Italy. marcodinicola.md@gmail.com. · Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy. gianluca.serafini@uniroma1.it. · NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "Madonna Del Soccorso", A.S.U.R. 12, 63074 San Benedetto del Tronto, Italy. alessandro.carano@gmail.com. · Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, 00118 Rome, Italy. maurizio.pompili@uniroma1.it. · Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University "G. D'Annunzio", 66100 Chieti, Italy. federica.vellante@gmail.com. · Polyedra Research Group, 64100 Teramo, Italy. laura.orsolini@hotmail.it. · Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, College Lane Campus, University of Hertfordshire, Hatfield SG141LZ, UK. laura.orsolini@hotmail.it. · Polyedra Research Group, 64100 Teramo, Italy. annastasia.fiengo@gmail.com. · NHS, Department of Mental Health ASUR Marche AV5, Mental Health Unit, 63100 Ascoli Piceno, Italy. annastasia.fiengo@gmail.com. · Department of Clinical and Experimental Medicine, University of Foggia, 71121 Foggia, Italy. a.ventriglio@libero.it. · Department of Psychiatry, Korea University College of Medicine, Seoul 08826, Korea. yongku@korea.edu. · Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University "G. D'Annunzio", 66100 Chieti, Italy. giovanni.martinotti@gmail.com. · Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University "G. D'Annunzio", 66100 Chieti, Italy. digiannantonio@unich.it. · Polyedra Research Group, 64100 Teramo, Italy. carmine.tomasetti@aslteramo.it. · Department of Neuroscience, Reproductive Science and Odontostomatology, School of Medicine 'Federico II' Naples, 80121 Naples, Italy. carmine.tomasetti@aslteramo.it. ·Int J Mol Sci · Pubmed #30249029.

ABSTRACT: Despite the continuous advancement in neurosciences as well as in the knowledge of human behaviors pathophysiology, currently suicide represents a puzzling challenge. The World Health Organization (WHO) has established that one million people die by suicide every year, with the impressive daily rate of a suicide every 40 s. The weightiest concern about suicidal behavior is how difficult it is for healthcare professionals to predict. However, recent evidence in genomic studies has pointed out the essential role that genetics could play in influencing person's suicide risk. Combining genomic and clinical risk assessment approaches, some studies have identified a number of biomarkers for suicidal ideation, which are involved in neural connectivity, neural activity, mood, as well as in immune and inflammatory response, such as the mammalian target of rapamycin (mTOR) signaling. This interesting discovery provides the neurobiological bases for the use of drugs that impact these specific signaling pathways in the treatment of suicidality, such as ketamine. Ketamine, an

5 Review Pharmacological management of depression in patients with multiple sclerosis. 2018

Carta, Mauro Giovanni / Paribello, Pasquale / Anastasia, Annalisa / De Berardis, Domenico / Nardi, Antonio Egidio / Fornaro, Michele. ·a Department of Health Sciences and Public Health , University of Cagliari , Cagliari , Italy. · b Villa Camaldoli Alma Mater SpA , Naples , Italy. · c National Health Care System , Mazzini Hospital , Teramo , Italy. · d Medical School - Institute of Psychiatry , Federal University of Rio de Janeiro National Academy of Medicine , Rio de Janeiro , Brazil. · e Neuroscience, Reproductive Science and Odontostolmatology , Federico II University of Naples , Naples , Italy. ·Expert Opin Pharmacother · Pubmed #30207800.

ABSTRACT: INTRODUCTION: The pharmacotherapeutic management of depression in patients with multiple sclerosis (MS) is a matter of debate that cannot be decided from the evidence available in the current literature. Therefore, its management essentially relies on the clinical experience of the prescribing clinician rather than on evidence-based approaches. AREAS COVERED: This review provides a clinically oriented critical perspective on the connection between MS and major depressive disorder (MDD) or depression associated with bipolar disorder (BD), focusing on its optimal pharmacotherapy. Both clinical and pharmacological considerations are accounted in order to promote rational pharmacotherapy, both in terms of efficacy and tolerability. EXPERT OPINION: Despite its clinical burden and relatively frequent occurrence, the interplay of MS and depression still requires further controlled trials to better clarify the appropriate pharmacotherapy across varying 'diseases categories' of MS itself, as well as discriminating between depressive symptoms that do not necessarily reach the threshold of either MDD or BD. Additional insight into new mood-tolerated neurological pharmacotherapy for MS is likewise warranted toward a more effective, immune- and patient-tailored pharmacotherapy, while promoting innovation in drug design, with the ultimate goal of enhancing the overall quality life of the affected individual, his/her caregivers, and to reduce the associated economic and social burden.

6 Review Current and Future Perspectives on the Major Depressive Disorder: Focus on the New Multimodal Antidepressant Vortioxetine. 2017

Orsolini, Laura / Tomasetti, Carmine / Valchera, Alessandro / Iasevoli, Felice / Buonaguro, Elisabetta Filomena / Fornaro, Michele / Fiengo, Annastasia L C / Martinotti, Giovanni / Vellante, Federica / Matarazzo, Ilaria / Vecchiotti, Roberta / Perna, Giampaolo / Di Nicola, Marco / Carano, Alessandro / Di Bartolomeis, Andrea / De Giannantonio, Massimo / De Berardis, Domenico. ·National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, "G. Mazzini" Hospital, p.zza Italia 1, 64100 Teramo,. Italy. ·CNS Neurol Disord Drug Targets · Pubmed #27781949.

ABSTRACT: BACKGROUND: Vortioxetine (VRX) is a multimodal antidepressant that acts as serotonin (5HT) transporter inhibitor as well as 5HT3A and 5HT7 receptors antagonist, 5HT1A and 5HT1B receptors partial agonist. It was recently approved in the US and the EU for the treatment of adult patients with Major Depressive Disorder (MDD). OBJECTIVE: The present article aims at systematically reviewing findings of the published and unpublished research on the pharmacological properties, efficacy, safety and tolerability of oral VRX in the treatment of MDD. METHOD: A systematic review, in accordance with the Cochrane Collaboration and the PRISMA guidelines, was conducted searching the electronic databases MEDLINE, by combining the following keyterms: ((vortioxetine OR LU AA21004 OR brintellix) AND (antidepressant OR depression OR major depressive disorder), without language/time restrictions. Further studies were retrieved from reference listing of relevant articles or manual search. Preclinical and clinical studies (RCT and open label trials) were here retrieved. RESULTS: Several placebo-controlled and active-treatment studies demonstrated the antidepressant efficacy and tolerability of VRX in adult patients affected with MDD. In addition, VRX seems to own procognitive activity. VRX seems generally well tolerated, without significant cardiovascular or weight gain effects. The most common adverse events reported included nausea, vomiting, hyperhidrosis, headache, dizziness, somnolence, diarrhoea and dry mouth. CONCLUSION: Overall, placebo controlled and active treatment trials support that VRX is effective and well tolerated in MDD. Its combined serotonin reuptake inhibition with agonism, partial agonism and antagonism of a number of receptors might provide a broader spectrum of antidepressant activity than currently available agents.

7 Review The Novel Antipsychotic Cariprazine (RGH-188): State-of-the-Art in the Treatment of Psychiatric Disorders. 2016

De Berardis, Domenico / Orsolini, Laura / Iasevoli, Felice / Prinzivalli, Emiliano / de Bartolomeis, Andrea / Serroni, Nicola / Mazza, Monica / Valchera, Alessandro / Fornaro, Michele / Vecchiotti, Roberta / Carano, Alessandro / Sepede, Gianna / Vellante, Federica / Matarazzo, Ilaria / Pompili, Maurizio / Perna, Giampaolo / Conti, Chiara / Segura-García, Cristina / Martinotti, Giovanni / Di Giannantonio, Massimo. ·National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, "G. Mazzini" Hospital, p.zza Italia 1, 64100 Teramo, Italy. dodebera@alice.it. ·Curr Pharm Des · Pubmed #27396597.

ABSTRACT: Cariprazine (RGH-188) is a novel antipsychotic drug that exerts partial agonism of dopamine D2/D3 receptors with preferential binding to D3 receptor, antagonism of 5HT2B receptors and partial agonism of 5HT1A. Currently, cariprazine is in late-stage clinical development (phase III clinical trials) in patients with schizophrenia (S) and in patients with bipolar disorder (BD), as well as an adjunctive treatment in patients with Major Depressive Disorder (MDD) and drug-resistant MDD. Cariprazine has completed phase III trials for the acute treatment of schizophrenia and bipolar mania, phase II trials for the bipolar depression and MDD whilst it is undergoing phase III trials as an adjunct to antidepressants. The present review aims at proving a comprehensive summary of the current evidence on the safety, tolerability and efficacy of cariprazine in the treatment of schizophrenia, BD (manic/mixed/ depressive episode) and MDD. A systematic search was conducted on PubMed/Medline/ Scopus and the database on Clinical Trials from inception until April 2015 by typing a set of specified keywords. Available evidence seems to support cariprazine efficacy in the treatment of cognitive and negative symptoms of schizophrenia. Preliminary findings suggest its antimanic activity whilst it is still under investigation its efficacy in the treatment of bipolar depression and MDD. Furthermore, the available data seems not to allow judgements about its antipsychotic potential in comparison with currently prescribed antipsychotics. Further studies should be carried out to better investigate its pharmacodynamic and clinical potential, particularly as alternative to current antipsychotic drugs.

8 Review New advances in the treatment of generalized anxiety disorder: the multimodal antidepressant vortioxetine. 2016

Orsolini, Laura / Tomasetti, Carmine / Valchera, Alessandro / Iasevoli, Felice / Buonaguro, Elisabetta Filomena / Vellante, Federica / Fornaro, Michele / Fiengo, Annastasia / Mazza, Monica / Vecchiotti, Roberta / Perna, Giampaolo / de Bartolomeis, Andrea / Martinotti, Giovanni / Di Giannantonio, Massimo / De Berardis, Domenico. ·a School of Life and Medical Sciences , University of Hertfordshire , Hatfield , UK. · b Villa San Giuseppe Hospital , Hermanas Hospitalarias , Ascoli Piceno , Italy. · c Polyedra Research Group , Teramo , Italy. · d Department of Psychiatry and Neuropsychology , University of Maastricht , Maastricht , The Netherlands. · e NHS, Department of Mental Health ASL Teramo, Psychiatric Service of Diagnosis and Treatment , Hospital 'Maria SS dello Splendore' , Giulianova , Italy. · f Laboratory of Molecular and Translational Psychiatry, Department of Neuroscience, Reproductive and Odontostomatogical Sciences , University of Naples 'Federico II' , Napoli , Italy. · g NHS, Department of Mental Health ASL Teramo, Psychiatric Service of Diagnosis and Treatment , Hospital 'G. Mazzini' , Teramo , Italy. · h Department of Neuroscience and Imaging , University 'G. d'Annunzio' , Chieti , Italy. · i New York Psychiatric Institute , Columbia University , New York , NY , USA. · j Department of Life, Health and Environmental Sciences , University of L'Aquila , L'Aquila , Italy. · k Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences , Villa San Benedetto Menni , Albese con Cassano , Como , Italy. · l Department of Psychiatry and Behavioral Sciences , Leonard Miller School of Medicine, University of Miami , Coral Gables , Florida , USA. ·Expert Rev Neurother · Pubmed #27050932.

ABSTRACT: Generalized Anxiety Disorder (GAD) is a persistent condition characterized by chronic anxiety, exaggerated worry and tension, mainly comorbid with Major Depressive Disorder (MDD). Currently, selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are recommended as first-line treatment of GAD. However, some patients may not respond to the treatment or discontinue due to adverse effects. Vortioxetine (VRX) is a multimodal antidepressant with a unique mechanism of action, by acting as 5-HT3A, 5-HT1D and 5-HT7 receptor antagonist, partial agonist at the 5-HT1A and 5-HT1B receptors and inhibitor at the 5-HT transporter. Preliminary clinical trials showed contrasting findings in terms of improvement of the anxiety symptomatology and/or cognitive impairment. Here, we aim to systematically review the evidence currently available on the efficacy, safety and tolerability of VRX in the treatment of GAD. The generalizability of results on the efficacy of VRX in patients with anxiety symptomatology and GAD is limited due to few and contrasting RCTs so far available. Only two studies, of which one prevention relapse trial, reported a significant improvement in anxiety symptomatology compared to three with negative findings.

9 Review The prevalence and predictors of obstructive sleep apnea in major depressive disorder, bipolar disorder and schizophrenia: A systematic review and meta-analysis. 2016

Stubbs, Brendon / Vancampfort, Davy / Veronese, Nicola / Solmi, Marco / Gaughran, Fiona / Manu, Peter / Rosenbaum, Simon / De Hert, Marc / Fornaro, Michele. ·Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London Box SE5 8AF, United Kingdom; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom. · KU Leuven Department of Rehabilitation Sciences, Tervuursevest 101, B-3001 Leuven, Belgium; University Psychiatric Centre KU Leuven, Kortenberg, KU Leuven Department of Neurosciences, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium. · Department of Medicine, DIMED, University of Padua, Via Gi ustiani, 2, 35128 Padova, Italy. · Department of Neurosciences, University of Padua, Via Giustiniani, 5, 35128 Padova, Italy; Local Health Unit ULSS 17, Mental Health Department, Monselice, Padova, Italy. · National Psychosis Service, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom. · Zucker Hillside Hospital, North Shore - LIJ Health System, 75-59 263rd Street, Glen Oaks, NY 11004, USA. · Musculoskeletal Division, The George Institute for Global Health and School of Public Health, University of Sydney, Sydney, Australia; School of Psychiatry, University of New South Wales, Sydney, Australia. · KU Leuven - University of Leuven, Department of Neurosciences, B-3000 Leuven, Belgium. · New York Psychiatric Institute, Columbia University, NYC, USA. ·J Affect Disord · Pubmed #26999550.

ABSTRACT: BACKGROUND: Obstructive sleep apnea (OSA) is a health hazard since it is associated with neurocognitive dysfunction and cardio-metabolic diseases. The prevalence of OSA among people with serious mental illness (SMI) is unclear. METHOD: We searched major electronic databases from inception till 06/2015. Articles were included that reported the prevalence of OSA determined by polysomnography (PSG) or an apnea-hypopnea index (AHI) >5 events/hr, in people with major depressive disorder (MDD), bipolar disorder (BD) or schizophrenia. A random effects meta-analysis calculating the pooled prevalence of OSA and meta-regression of potential moderators were performed. RESULTS: Twelve articles were included representing 570,121 participants with SMI (mean age=38.3 years (SD=7.5)), 45.8% male (range=32-80.4) and mean body mass index (BMI) 25.9 (SD=3.7). The prevalence of OSA in SMI in clinical studies was 25.7% (95% CI 13.9 to 42.4%, n=1,535). Higher frequencies of OSA were seen in MDD (36.3%, 19.4-57.4%, n=525) than in BD (24.5%, 95% CI 10.6-47.1, n=681) and schizophrenia (15.4%, 95% CI 5.3-37.1%, n=329). The prevalence of OSA in 568,586 people with SMI from population cohort studies was 10.7% (95% CI 2.4-37.0%) and 19.8% (95% CI 2.5-70.0%) in 358,853 people with MDD. Increasing age (β=0.063, 95% CI 0.0005-0.126, p=0.04, N=10) and BMI predicted increased prevalence of OSA (β=0.1642, 95% CI 0.004-0.3701, p=0.04, N=9). CONCLUSION: People with SMI (particularly MDD) have a high prevalence of OSA. Screening for and interventions to manage OSA in SMI including those focused on reducing BMI are warranted.

10 Review A comparative meta-analysis of TEMPS scores across mood disorder patients, their first-degree relatives, healthy controls, and other psychiatric disorders. 2016

Solmi, Marco / Zaninotto, Leonardo / Toffanin, Tommaso / Veronese, Nicola / Lin, Kangguang / Stubbs, Brendon / Fornaro, Michele / Correll, Christoph U. ·Department of Neuroscience, University of Padova, Padova, Italy; Mental Health Department, Local Health Unit ULSS 17, Monselice, Padova, Italy. Electronic address: marco.solmi83@gmail.com. · Department of Biomedical and Neuro-Motor Sciences, University of Bologna, Bologna, Italy. · Local Health Unit ULSS 7, Conegliano, Italy. · Department of Medicine - DIMED, Geriatrics Section, University of Padova, Italy. · Department of Affective Disorder, Guangzhou Brain Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. · Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, Box SE5 8 AF London, United Kingdom. · New York State Psychiatric Institute, Columbia University, NY, USA. · The Zucker Hillside Hospital, Psychiatry Research, North Shore, Glen Oaks, NY, USA; Hofsra North Shore LIJ School of Medicine, Hampstead, NY, USA. ·J Affect Disord · Pubmed #26897455.

ABSTRACT: BACKGROUND: The Temperament Evaluation Memphis, Pisa, Paris and San Diego Auto-questionnaire (TEMPS) is validated to assess temperament in clinical and non-clinical samples. Scores vary across bipolar disorder (BD), major depressive disorder (MDD), attention-deficit/hyperactivity disorder (ADHD), borderline personality disorder (BPD) and healthy controls (HCs), but a meta-analysis is missing. METHODS: Meta-analysis of studies comparing TEMPS scores in patients with mood disorders or their first-degree relatives to each other, or to a psychiatric control group or HCs. RESULTS: Twenty-six studies were meta-analyzed with patients with BD (n= 2025), MDD (n=1283), ADHD (n=56) and BPD (n=43), relatives of BD (n=436), and HCs (n=1757). Cyclothymic (p<0.001) and irritable TEMPS scores (p<0.001) were higher in BD than MDD (studies=12), and in MDD vs HCs (studies=8). Cyclothymic (p<0.001), irritable (p<0.001) and anxious (p=0.03) scores were higher in BD than their relatives, who, had higher scores than HCs. No significant differences emerged between ADHD and BD (studies=3); CONCLUSION: Affective temperaments are on a continuum, with increasing scores ranging from HCs through MDD to BD regarding cyclothymic and irritable temperament, from MDD through BD to HC regarding hyperthymic temperament, and from HC through BD relatives to BD regarding cyclothymic, irritable and anxious temperament. Depressive and anxious temperaments did not differ between BD and MDD, being nonetheless the lowest in HCs. BD did not differ from ADHD in any investigated TEMPS domain. LIMITATIONS: Different TEMPS versions, few studies comparing BD with ADHD or BPD, no correlation with other questionnaires.

11 Review Atypical Antipsychotics in the Treatment of Acute Bipolar Depression with Mixed Features: A Systematic Review and Exploratory Meta-Analysis of Placebo-Controlled Clinical Trials. 2016

Fornaro, Michele / Stubbs, Brendon / De Berardis, Domenico / Perna, Giampaolo / Valchera, Alessandro / Veronese, Nicola / Solmi, Marco / Ganança, Licínia. ·New York Psychiatric Institute, Columbia University, New York City, NY 10032, USA. dott.fornaro@gmail.com. · Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. brendon.stubbs@kcl.ac.uk. · Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK. brendon.stubbs@kcl.ac.uk. · National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital. Mazzini, ASL 4, Teramo 64100, Italy. dodebera@aliceposta.it. · Department of Clinical Neurosciences, Hermanas Hospitalarias-Villa San Benedetto Menni Hospital, FoRiPsi 22032, Italy. pernagp@gmail.com. · Hermanas Hospitalarias-Villa San Giuseppe, Ascoli Piceno 63100, Italy. a.valchera@ospedaliere.it. · Department of Medicine (DIMED), University of Padua, Padova 35121, Italy. ilmannato@gmail.com. · Department of Neurosciences, University of Padua, Padova 35121, Italy. marco.solmi83@gmail.com. · New York Psychiatric Institute, Columbia University, New York City, NY 10032, USA. lg2733@cumc.columbia.edu. · Departamento de Psiquiatria e Saúde Mental, Faculdade de Medicina, Universidade de Lisboa, Lisbon 1649-035, Portugal. lg2733@cumc.columbia.edu. ·Int J Mol Sci · Pubmed #26891297.

ABSTRACT: Evidence supporting the use of second generation antipsychotics (SGAs) in the treatment of acute depression with mixed features (MFs) associated with bipolar disorder (BD) is scarce and equivocal. Therefore, we conducted a systematic review and preliminary meta-analysis investigating SGAs in the treatment of acute BD depression with MFs. Two authors independently searched major electronic databases from 1990 until September 2015 for randomized (placebo-) controlled trials (RCTs) or open-label clinical trials investigating the efficacy of SGAs in the treatment of acute bipolar depression with MFs. A random-effect meta-analysis calculating the standardized mean difference (SMD) between SGA and placebo for the mean baseline to endpoint change in depression as well as manic symptoms score was computed based on 95% confidence intervals (CI). Six RCTs and one open-label placebo-controlled studies (including post-hoc reports) representing 1023 patients were included. Participants received either ziprasidone, olanzapine, lurasidone, quetiapine or asenapine for an average of 6.5 weeks across the included studies. Meta-analysis with Duval and Tweedie adjustment for publication bias demonstrated that SGA resulted in significant improvements of (hypo-)manic symptoms of bipolar mixed depression as assessed by the means of the total scores of the Young Mania Rating Scale (YMRS) (SMD -0.74, 95% CI -1.20 to -0.28, n SGA = 907, control = 652). Meta-analysis demonstrated that participants in receipt of SGA (n = 979) experienced a large improvement in the Montgomery-Åsberg Depression Rating Scale (MADRS) scores (SMD -1.08, 95% CI -1.35 to -0.81, p < 0.001) vs. placebo (n = 678). Publication and measurement biases and relative paucity of studies. Overall, SGAs appear to offer favorable improvements in MADRS and YMRS scores vs. placebo. Nevertheless, given the preliminary nature of the present report, additional original studies are required to allow more reliable and clinically definitive conclusions.

12 Review A comprehensive review on the efficacy of S-Adenosyl-L-methionine in Major Depressive Disorder. 2016

De Berardis, Domenico / Orsolini, Laura / Serroni, Nicola / Girinelli, Gabriella / Iasevoli, Felice / Tomasetti, Carmine / de Bartolomeis, Andrea / Mazza, Monica / Valchera, Alessandro / Fornaro, Michele / Perna, Giampaolo / Piersanti, Monica / Di Nicola, Marco / Cavuto, Marilde / Martinotti, Giovanni / Di Giannantonio, Massimo. ·National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, "G. Mazzini" Hospital, p.zza Italia 1, 64100 Teramo, Italy. dodebera@aliceposta.it. ·CNS Neurol Disord Drug Targets · Pubmed #26295824.

ABSTRACT: OBJECTIVE: To review the antidepressant efficacy of S-Adenosyl-L-Methionine (SAMe) both in monotherapy and/or in augmentation with antidepressants to better understand its potential role in the treatment of patients with Major Depressive Disorder (MDD) and Treatment-Resistant Depression (TRD). DATA SOURCES: A MEDLINE/PubMed search was carried out by using the following set of keywords: ((SAMe OR SAdenosyl- L-Methionine) AND (major depressive disorder OR depression)). Data Selection and Data Extraction: No language or time restrictions were placed on the electronic searches. Randomized controlled trials and open trials involving humans were here included and analyzed. The references of published articles identified in the initial search process were also examined for any additional studies appropriate for the review. DATA SYNTHESIS: SAMe is an important physiologic compound, playing a central role as precursor molecule in several biochemical reactions. Numerous studies have shown that SAMe may affect the regulation of various critical components of monoaminergic neurotransmission involved in the pathophysiology of MDD. Some findings have suggested its antidepressant efficacy in treating MDD. Several randomized controlled trials have supported that the antidepressant efficacy of SAMe in monotherapy is superior to placebo and tricyclic antidepressants. Recent findings have also demonstrated its efficacy in patients nonresponsive to selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. CONCLUSION: Overall, SAMe is a well-tolerated medication, which may offer considerable advantages as an alternative to antidepressant drugs or as an add-on therapy in the treatment of MDD and TRD. More large-scale controlled trials are needed to gain a better understanding of the relative efficacy of this drug.

13 Review Agomelatine beyond borders: current evidences of its efficacy in disorders other than major depression. 2015

De Berardis, Domenico / Fornaro, Michele / Serroni, Nicola / Campanella, Daniela / Rapini, Gabriella / Olivieri, Luigi / Srinivasan, Venkataramanujam / Iasevoli, Felice / Tomasetti, Carmine / De Bartolomeis, Andrea / Valchera, Alessandro / Perna, Giampaolo / Mazza, Monica / Di Nicola, Marco / Martinotti, Giovanni / Di Giannantonio, Massimo. ·National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, 64100 Teramo, Italy. dodebera@aliceposta.it. · Department of "Scienze della Formazione", University of Catania, 95121 Catania, Italy. dott.fornaro@gmail.com. · Department of Neuroscience and Imaging, University "G. D'Annunzio", 66013 Chieti, Italy. serroni.nicola@virgilio.it. · Department of Neuroscience and Imaging, University "G. D'Annunzio", 66013 Chieti, Italy. danicampa@virgilio.it. · Department of Neuroscience and Imaging, University "G. D'Annunzio", 66013 Chieti, Italy. gabriella.rapini@aslteramo.it. · National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, 64100 Teramo, Italy. luigi.olivieri@yahoo.it. · Sri Sathya Sai Medical Educational and Research Foundation, Medical Sciences Research Study Center, Prasanthi Nilayam, 40-Kovai Thirunagar Coimbatore-641014, 641014 Tamilnadu, India. · Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", 80131 Naples, Italy. felix_ias@hotmail.com. · Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", 80131 Naples, Italy. carmine.tomasetti@unina.it. · Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", 80131 Naples, Italy. adebarto@unina.it. · Hermanas Hospitalarias, FoRiPsi, Villa S. Giuseppe Hospital, 63100 Ascoli Piceno, Italy. alessandrovalchera@gmail.com. · Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, 22032 Como, Italy. pernagp@tin.it. · Department of Neuroscience and Imaging, University "G. D'Annunzio", 66013 Chieti, Italy. giovanni.martinotti@gmail.com. · Department of Neuroscience and Imaging, University "G. D'Annunzio", 66013 Chieti, Italy. digiannantonio@unich.it. ·Int J Mol Sci · Pubmed #25569089.

ABSTRACT: Agomelatine, a melatonergic antidepressant with a rapid onset of action, is one of the most recent drugs in the antidepressant category. Agomelatine's antidepressant actions are attributed to its sleep-promoting and chronobiotic actions mediated by MT1 and MT2 receptors present in the suprachiasmatic nucleus, as well as to its effects on the blockade of 5-HT2c receptors. Blockade of 5-HT2c receptors causes release of both noradrenaline and dopamine at the fronto-cortical dopaminergic and noradrenergic pathways. The combined actions of agomelatine on MT1/MT2 and 5-HT2c receptors facilitate the resynchronization of altered circadian rhythms and abnormal sleep patterns. Agomelatine appeared to be effective in treating major depression. Moreover, evidence exists that points out a possible efficacy of such drug in the treatment of bipolar depression, anxiety disorders, alcohol dependence, migraines etc. Thus, the aim of this narrative review was to elucidate current evidences on the role of agomelatine in disorders other than major depression.

14 Review Could the underestimation of bipolarity obstruct the search for novel antidepressant drugs? 2011

Fornaro, Michele / Aguglia, Eugenio / Dell'Osso, Liliana / Perugi, Giulio. ·University of Catania, Scienze della Formazione, via Teatro Greco 78, Catania, ZIP 94125, Italy. dott.fornaro@gmail.com ·Expert Opin Pharmacother · Pubmed #22098226.

ABSTRACT: INTRODUCTION: Despite the clinical and social relevance of depression, and the availability of numerous antidepressants and non-pharmacological interventions, response rates remain unsatisfactory and novel therapeutic targets are being explored. AREAS COVERED: This review starts with a brief overview of the evolution of the current antidepressant drug scenario and ends with a focus on the potential influence of the underestimation of bipolarity on the exploration of novel antidepressant drugs. EXPERT OPINION: The field of antidepressant drug development has suffered from a relative decline recently and, with the exception of agomelatine, innovative non-monoaminergic antidepressants have yet to be developed. The need for more effective compounds is evident. Clinicians and researchers should pay greater attention to the impact of bipolarity in depression. The ultimate goal of this review is not to discourage the use of antidepressants but rather to encourage judicious prescriptions, and also to solicit a better collaboration between clinicians and preclinical researchers so that more reliable diagnostic criteria can be adopted.

15 Article The relationship between the dietary inflammatory index (DII 2018

Shivappa, Nitin / Hébert, James R / Veronese, Nicola / Caruso, Maria Gabriella / Notarnicola, Maria / Maggi, Stefania / Stubbs, Brendon / Firth, Joseph / Fornaro, Michele / Solmi, Marco. ·Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Connecting Health Innovations LLC, Columbia, SC 29201 USA. · National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy; Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy; Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy. · Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy; Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy. · Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy. · National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy. · South London and Maudsley NHS Foundation Trust, London, UK; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK. · NICM Health Research Institute, University of Western Sydney, Sydney, Australia. · University of Naples Psychiatry Department, Naples, Italy. · Department of Neurosciences, Psychiatry Unit, University of Padova, Via Giustiniani, Padova 2 35128, Italy. Electronic address: marco.solmi83@gmail.com. ·J Affect Disord · Pubmed #29649709.

ABSTRACT: BACKGROUND: Diet is a common source of inflammation, and inflammation is associated with depression. We examined the association between the dietary inflammatory index (DII METHODS: This longitudinal study, with a follow-up of 8 years, included 3648 participants (1577 males, 2071 females; mean age: 60.6 years) with/at risk of knee osteoarthritis. DII RESULTS: In total, 837 individuals (310 men and 527 women) developed incident depressive symptoms over the course of 8 years. Participants in the most pro-inflammatory group (quartile 4) had approximately 24% higher risk of developing depressive symptoms compared to subjects with the most anti-inflammatory diet (HR: 1.24; 95% CI: 1.01-1.53; p = 0.04). CONCLUSION: These results suggest that a pro-inflammatory diet may be associated with higher incidence of depressive symptoms in a cohort of older Americans. Transitioning to a more anti-inflammatory diet may reduce depression risk.

16 Article Incidence, prevalence and clinical correlates of antidepressant-emergent mania in bipolar depression: a systematic review and meta-analysis. 2018

Fornaro, Michele / Anastasia, Annalisa / Novello, Stefano / Fusco, Andrea / Solmi, Marco / Monaco, Francesco / Veronese, Nicola / De Berardis, Domenico / de Bartolomeis, Andrea. ·Section of Psychiatry, Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University, Naples, Italy. · Neuroscience Department, University of Padua, Padua, Italy. · Azienda Ospedaliera di Padova, Padua Hospital, Psychiatry Unit, Padua, Italy. · Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neuroscience, University of Salerno, Salerno, Italy. · National Research Council, Aging Branch, Padua, Italy. · National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Teramo, Italy. ·Bipolar Disord · Pubmed #29441650.

ABSTRACT: BACKGROUND: Treatment-emergent mania (TEM) represents a common phenomenon inconsistently reported across primary studies, warranting further assessment. METHODS: A systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines were conducted. Major electronic databases were searched from inception to May 2017 to assess the incidence and prevalence rates and clinical features associated with manic switch among bipolar depressed patients receiving antidepressants, using meta-regression and subgroup analysis. RESULTS: Overall, 10 098 depressed patients with bipolar disorder (BD) across 51 studies/arms were included in the quantitative analysis. The cumulative incidence of cases (TEM CONCLUSIONS: Rates of TEM vary primarily depending on study setting, which is concordant with the high degree of heterogeneity of the included records. Forthcoming RCT studies should adopt consistent operational definitions of TEM and broaden the number of moderators, in order to contribute most effectively to the identification of clear-cut sub-phenotypes of BD and patient-tailored pharmacotherapy.

17 Article Aspirin and incident depressive symptoms: A longitudinal cohort study over 8 years. 2018

Veronese, Nicola / Koyanagi, Ai / Stubbs, Brendon / Solmi, Marco / Fornaro, Michele / Fernandes, Brisa S / Mueller, Christoph / Thompson, Trevor / Carvalho, André F / Maggi, Stefania. ·National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy. · Institute for clinical Research and Education in Medicine (IREM), Padova, Italy. · Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain. · South London and Maudsley NHS FoundationTrust, London, UK. · Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. · Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK. · Department of Neurosciences, University of Padova, Padova, Italy. · New York Psychiatric Institute, Columbia University, New York, NY, USA. · IMPACT Strategic Research Centre, School of Medicine, and Barwon Health, Deakin University, Geelong, Australia. · Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. · Faculty of Education and Health, University of Greenwich, London, UK. · Translational Psychiatry Research Group, Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceara, Fortaleza, Brazil. ·Int J Geriatr Psychiatry · Pubmed #28782132.

ABSTRACT: OBJECTIVE: Aspirin exhibits anti-atherosclerotic and anti-inflammatory properties-two potential risk factors for depression. The relationship between aspirin use and depression, however, remains unclear. We investigated whether the aspirin use is associated with a decreased incidence of depressive symptoms in a large North American cohort. METHODS: Data from the Osteoarthritis Initiative dataset, a multicenter, longitudinal study on community-dwelling adults was analyzed. Aspirin use was defined through self-report in the past 30 days and confirmed by a trained interviewer. Incident depressive symptoms were defined as a score of ≥16 in the 20-item Center for Epidemiologic Studies-Depression scale. RESULTS: A total of 137 participants (mean age 65 y, 55.5% female) were using aspirin at baseline. Compared with 4003 participants not taking aspirin, no differences in Center for Epidemiologic Studies-Depression at baseline were evident (P = .65). After a median follow-up time of 8 years, the incidence of depressive symptoms was similar in those taking aspirin at baseline (43; 95% CI, 3-60) and in aspirin nonusers (38; 95% CI, 36-41) per 1000 y; log-rank test = 0.63). Based on Cox's regression analysis adjusted for 11 potential confounders, aspirin use was not significantly associated with the development of depressive symptoms (hazard ratio = 1.12; 95% CI, 0.78-1.62; P = .54). Adjustment for propensity scores or the use of propensity score matching did not alter the results. CONCLUSION: Our study found that prescription of aspirin offered no significant protection against incident depressive symptoms. Whether aspirin is beneficial in a subgroup of depression with high levels of inflammation remains to be investigated in future studies.

18 Article Depression and pain: primary data and meta-analysis among 237 952 people across 47 low- and middle-income countries. 2017

Stubbs, B / Vancampfort, D / Veronese, N / Thompson, T / Fornaro, M / Schofield, P / Solmi, M / Mugisha, J / Carvalho, A F / Koyanagi, A. ·Physiotherapy Department,South London and Maudsley NHS Foundation Trust,Denmark Hill, London SE5 8AZ,UK. · KU Leuven,Department of Rehabilitation Sciences,Leuven,Belgium. · Geriatrics Division,Department of Medicine-DIMED,University of Padova,Padova,Italy. · Faculty of Education and Health,University of Greenwich,London,UK. · New York Psychiatric Institute,Columbia University,New York, NY,USA. · Faculty of Health,Social Care and Education,Anglia Ruskin University,Chelmsford,UK. · Institute of clinical Research and Education in Medicine (IREM),Padova,Italy. · Kyambogo University,Kampala,Uganda. · Department of Clinical Medicine and Translational Psychiatry Research Group,Faculty of Medicine,Federal University of Ceará,Fortaleza, CE,Brazil. · Research and Development Unit,Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Dr. Antoni Pujadas, 42,Sant Boi de Llobregat,Barcelona 08830,Spain. ·Psychol Med · Pubmed #28637534.

ABSTRACT: BACKGROUND: Depression and pain are leading causes of global disability. However, there is a paucity of multinational population data assessing the association between depression and pain, particularly among low- and middle-income countries (LMICs) where both are common. Therefore, we investigated this association across 47 LMICs. METHODS: Community-based data on 273 952 individuals from 47 LMICs were analysed. Multivariable logistic and linear regression analyses were performed to assess the association between the International Classification of Diseases, 10th Revision depression/depression subtypes (over the past 12 months) and pain in the previous 30 days based on self-reported data. Country-wide meta-analysis adjusting for age and sex was also conducted. RESULTS: The prevalence of severe pain was 8.0, 28.2, 20.2, and 34.0% for no depression, subsyndromal depression, brief depressive episode, and depressive episode, respectively. Logistic regression adjusted for socio-demographic variables, anxiety and chronic medical conditions (arthritis, diabetes, angina, asthma) demonstrated that compared with no depression, subsyndromal depression, brief depressive episode, and depressive episode were associated with a 2.16 [95% confidence interval (CI) 1.83-2.55], 1.45 (95% CI 1.22-1.73), and 2.11 (95% CI 1.87-2.39) increase in odds of severe pain, respectively. Similar results were obtained when a continuous pain scale was used as the outcome. Depression was significantly associated with severe pain in 44/47 countries with a pooled odds ratio of 3.93 (95% CI 3.54-4.37). CONCLUSION: Depression and severe pain are highly comorbid across LMICs, independent of anxiety and chronic medical conditions. Whether depression treatment or pain management in patients with comorbid pain and depression leads to better clinical outcome is an area for future research.

19 Article Frailty and incident depression in community-dwelling older people: results from the ELSA study. 2017

Veronese, Nicola / Solmi, Marco / Maggi, Stefania / Noale, Marianna / Sergi, Giuseppe / Manzato, Enzo / Prina, A Matthew / Fornaro, Michele / Carvalho, André F / Stubbs, Brendon. ·Department of Medicine DIMED, Geriatrics Division, University of Padua, Padua, Italy. · Institute of Clinical Research and Education in Medicine (IREM), Padua, Italy. · National Research Council, Neuroscience Institute, Padua, Italy. · Department of Neuroscience, University of Padua, Padua, Italy. · Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. · New York Psychiatric Institute, Columbia University, New York, NY, USA. · Translational Psychiatry Research Group, Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil. · Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK. · Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK. ·Int J Geriatr Psychiatry · Pubmed #28195361.

ABSTRACT: OBJECTIVE: Frailty and pre-frailty are two common conditions in the older people, but whether these conditions could predict depression is still limited to a few longitudinal studies. In this paper, we aimed to investigate whether frailty and pre-frailty are associated with an increased risk of depression in a prospective cohort of community-dwelling older people. METHODS: Four thousand seventy-seven community-dwelling men and women over 60 years without depression at baseline were included from the English Longitudinal Study of Ageing. Frailty status was defined according to modified Fried's criteria (weakness, weight loss, slow gait speed, low physical activity and exhaustion) and categorized as frailty (≥3 criteria), pre-frailty (1-2 criteria) or robustness (0 criterion). Depression was diagnosed as ≥4 out of 8 points of Center for Epidemiologic Studies Depression Scale, after 2 years of follow-up. RESULTS: Over a 2-year follow-up, 360 individuals developed depression. In a logistic regression analysis, adjusted for 18 potential baseline confounders, pre-frailty (odds ratio (OR) = 0.89; 95% confidence interval (CI), 0.54-1.46; p = 0.64) and frailty (OR = 1.22; 95% CI, 0.90-1.64; p = 0.21) did not predict the onset of depression at follow-up. Among the criteria included in the frailty definition, only slow gait speed (OR = 1.82; 95% CI, 1.00-3.32; p = 0.05) appeared to predict a higher risk of depression. CONCLUSIONS: Among older community dwellers, frailty and pre-frailty did not predict the onset of depression during 2 years of follow-up, when accounting for potential confounders, whilst slow gait speed considered alone may predict depression in the older people. Copyright © 2017 John Wiley & Sons, Ltd.

20 Article Effect of agomelatine treatment on C-reactive protein levels in patients with major depressive disorder: an exploratory study in "real-world," everyday clinical practice. 2017

De Berardis, Domenico / Fornaro, Michele / Orsolini, Laura / Iasevoli, Felice / Tomasetti, Carmine / de Bartolomeis, Andrea / Serroni, Nicola / De Lauretis, Ida / Girinelli, Gabriella / Mazza, Monica / Valchera, Alessandro / Carano, Alessandro / Vellante, Federica / Matarazzo, Ilaria / Perna, Giampaolo / Martinotti, Giovanni / Di Giannantonio, Massimo. ·1National Health Service,Department of Mental Health,Psychiatric Service of Diagnosis and Treatment,Hospital "G. Mazzini",Teramo,Italy. · 3New York Psychiatric Institute,Columbia University,New York,New York,USA. · 4Polyedra,Teramo,Italy. · 7Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics,Section of Psychiatry,Department of Neuroscience,University School of Medicine "Federico II",Naples,Italy. · 2Department of Neurosciences and Imaging,Chair of Psychiatry,University "G. D'Annunzio",Chieti,Italy. · 8Department of Health Science,University of L'Aquila, L'Aquila,Italy. · 9National Health Service,Department of Mental Health,Psychiatric Service of Diagnosis and Treatment,Hospital "Madonna Del Soccorso",San Benedetto del Tronto,Ascoli Piceno,Italy. · 10Hermanas Hospitalarias,FoRiPsi,Department of Clinical Neurosciences,Villa San Benedetto Menni,Albese con Cassano,Como,Italy. ·CNS Spectr · Pubmed #27702411.

ABSTRACT: OBJECTIVE: Agomelatine is a newer antidepressant but, to date, no studies have been carried out investigating its effects on C-reactive protein (CRP) levels in major depressive disorder (MDD) before and after treatment. The present study aimed (i) to investigate the effects of agomelatine treatment on CRP levels in a sample of patients with MDD and (ii) to investigate if CRP variations were correlated with clinical improvement in such patients. METHODS: 30 adult outpatients (12 males, 18 females) with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) diagnosis of MDD were recruited in "real-world," everyday clinical practice and treated with a flexible dose of agomelatine for 12 weeks. The Hamilton Rating Scale for Depression (HAM-D) and the Snaith-Hamilton Pleasure Scale (SHAPS) were used to evaluate depressive symptoms and anhedonia, respectively. Moreover, serum CRP was measured at baseline and after 12 weeks of treatment. RESULTS: Agomelatine was effective in the treatment of MDD, with a significant reduction in HAM-D and SHAPS scores from baseline to endpoint. CRP levels were reduced in the whole sample, with remitters showing a significant difference in CRP levels after 12 weeks of agomelatine. A multivariate stepwise linear regression analysis showed that higher CRP level variation was associated with higher baseline HAM-D scores, controlling for age, gender, smoking, BMI, and agomelatine dose. CONCLUSIONS: Agomelatine's antidepressant properties were associated with a reduction in circulating CRP levels in MDD patients who achieved remission after 12 weeks of treatment. Moreover, more prominent CRP level variation was associated with more severe depressive symptoms at baseline.

21 Article Alexithymia, Suicide Ideation, C-Reactive Protein, and Serum Lipid Levels Among Outpatients with Generalized Anxiety Disorder. 2017

De Berardis, Domenico / Serroni, Nicola / Campanella, Daniela / Marini, Stefano / Rapini, Gabriella / Valchera, Alessandro / Iasevoli, Felice / Mazza, Monica / Fornaro, Michele / Perna, Giampaolo / Di Iorio, Giuseppe / Martinotti, Giovanni / Di Giannantonio, Massimo. · ·Arch Suicide Res · Pubmed #25856390.

ABSTRACT: The aim of the present study was to investigate the relationships between alexithymia, suicide ideation, C-Reactive Protein (CRP), and serum lipid levels in adult outpatients with a DSM-IV diagnosis of Generalized Anxiety Disorder (GAD). Seventy consecutive patients with GAD were recruited and evaluated. Measures were the Hamilton Anxiety Scale, the Toronto Alexithymia Scale (TAS-20), the Scale of Suicide Ideation (SSI), and the Montgomery Åsberg Depression Rating Scale (MADRS). All patients were assessed for: CRP, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceridaemia (TG), and very-low-density lipoprotein cholesterol (VLDL-C). TC/HDL-C and LDL-C/HDL-C ratios were also evaluated. Alexithymic patients showed higher scores on almost all rating scales and altered serum CRP and lipid levels vs. non-alexithymics. In the hierarchical regression model, the presence of higher MADRS scores together with higher scores at the Difficulty in Identifying Feelings dimension of TAS-20 were associated with higher rates of suicide ideation. Although alexithymic subjects with GAD may show a CRP and cholesterol dysregulation, this latter seems independent on increased suicide ideation, rather to Difficulty in Identifying Feelings, and subthreshold depressive symptoms. Study limitations and future research implications are discussed.

22 Article Cotard's Syndrome after breast surgery successfully treated with aripiprazole augmentation of escitalopram: a case report. 2015

De Berardis, Domenico / Brucchi, Maurizio / Serroni, Nicola / Rapini, Gabriella / Campanella, Daniela / Vellante, Federica / Valchera, Alessandro / Fornaro, Michele / Iasevoli, Felice / Mazza, Monica / Lucidi, Giuliana / Martinotti, Giovanni / di Giannantonio, Massimo. · ·Riv Psichiatr · Pubmed #25994620.

ABSTRACT: In 1880 the French neurologist Jules Cotard described a condition characterized by delusion of negation (nihilistic delusion) in a melancholia context. Recently, there has been a resurgence of interest in Cotard's syndrome (CS), but the nosographical figure of CS remains unclear. It isn't determined if it pertains to the delusional themes area or if it is related to the sense of immanent ruin in some depressive episodes. For these reasons CS has recently been supposed to be an intermediate form. Furthermore, since even less is known about secondary CS in subjects who had never suffered of psychiatric disorders, in the present case we report the development of a secondary CS in a female patient who underwent a lumpectomy for the removal of a benign fibroadenoma. The patient responded well to aripiprazole augmentation of escitalopram and totally remitted.

23 Article Factor structure and reliability of the Italian adaptation of the Hypomania Check List-32, second revision (HCL-32-R2). 2015

Fornaro, Michele / De Berardis, Domenico / Mazza, Monica / Pino, Mariachiara / Favaretto, Ettore / Bedani, Fulvio / Wieser, Christian / Indelicato, Luisa / Paternò, Vito Fabio / Lo Monaco, Francesca / Dugo, Febronia / Ventriglio, Antonio / Mungo, Sergio / Selle, Valerio / Valchera, Alessandro / Elassy, Mai / Martinotti, Giovanni / De Bartolomeis, Andrea / Iasevoli, Felice / Tomasetti, Carmine / Avvisati, Livia / Tartaglione, Sergio / Perna, Giampaolo / Cattaneo, Carlo Ignazio / Consoli, Giorgio / Romano, Anna / Del Debbio, Alessandro / Martino, Matteo / D' Angelo, Emanuela / De Pasquale, Concetta / Koshy, Ann Sarah / Angst, Jules. ·Department of Education Science, University of Catania, Catania, Italy; Polyedra Research Group, Italy. Electronic address: dott.fornaro@gmail.com. · Polyedra Research Group, Italy; National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy. Electronic address: dodebera@aliceposta.it. · Polyedra Research Group, Italy; Department of Life, Health and Environmental Sciences, University of L׳Aquila, L׳Aquila, Italy. Electronic address: monica.mazza@cc.univaq.it. · Department of Life, Health and Environmental Sciences, University of L׳Aquila, L׳Aquila, Italy. Electronic address: mariachiara.pino@graduate.univaq.it. · Department of Psychiatry of Bressanone (Brixen), Bolzano (Bozen), Italy. Electronic address: efavaretto@yahoo.com. · Department of Psychiatry of Bressanone (Brixen), Bolzano (Bozen), Italy. Electronic address: fulviobedani@icloud.com. · Department of Psychiatry of Bressanone (Brixen), Bolzano (Bozen), Italy. Electronic address: christian.wieser@sb-brixen.it. · Department of Education Science, University of Catania, Catania, Italy. Electronic address: luisa.indelicato@hotmail.it. · Centro siciliano per la cura di Depressione e Ansia (CESIDEA), Catania, Italy; Ospedale San Raffaele, Milano, Italy. Electronic address: info@cesidea.it. · Department of Education Science, University of Catania, Catania, Italy. Electronic address: francescalomonaco91@live.it. · Department of Education Science, University of Catania, Catania, Italy. Electronic address: brunelladugo@alice.it. · Section of Psychiatry, University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy. Electronic address: dr.ventriglio@gmail.com. · Department of Psychiatry, University of Genova, Genoa, Italy. Electronic address: sergiomungo@libero.it. · Clinica Viarnetto, Lugano, Switzerland. Electronic address: v.selle@clinicaviarnetto.ch. · Polyedra Research Group, Italy; Casa di Cura Villa San Giuseppe, Via dei Girasoli, n.6, 63100 Ascoli Piceno, Italy. Electronic address: alessandrovalchera@gmail.com. · Department of Psychiatry, Mansoura Faculty of Medicine, Mansoura City, Egypt. Electronic address: elassym@gmail.com. · Polyedra Research Group, Italy; Department of Neuroscience and Imaging, University "G. d׳Annunzio", Chieti, Italy. Electronic address: giovanni.martinotti@gmail.com. · Section of Psychiatry - Department of Neuroscience - University School of Naples "Federico II", Naples, Italy. Electronic address: adebarto@unina.it. · Polyedra Research Group, Italy; Section of Psychiatry - Department of Neuroscience - University School of Naples "Federico II", Naples, Italy. Electronic address: felix_ias@hotmail.com. · Polyedra Research Group, Italy; Section of Psychiatry - Department of Neuroscience - University School of Naples "Federico II", Naples, Italy; National Health Service, Department of Mental Health, Unit of Psychiatry, Isernia, Italy. Electronic address: carmine.tomasetti@gmail.com. · Section of Psychiatry - Department of Neuroscience - University School of Naples "Federico II", Naples, Italy. Electronic address: livia.avvisati@gmail.com. · National Health Service, Department of Mental Health, Unit of Psychiatry, Isernia, Italy. Electronic address: sergio.tartaglione@asrem.org. · Polyedra Research Group, Italy; Department of Clinical Neuroscience, San Benedetto Hospital, Hermanas Hospitalarias, Albese con Cassano, Como, Italy. Electronic address: pernagp@gmail.com. · National Health System, "ASL 13", Novara, Italy. Electronic address: dr.carloignaziocattaneo@gmail.com. · Department of Psychiatry, University of Pisa, Pisa, Italy. Electronic address: cogi77@gmail.com. · Department of Psychiatry, University of Pisa, Pisa, Italy. Electronic address: annaromano21@libero.it. · Department of Psychiatry, University of Pisa, Pisa, Italy. Electronic address: adeldebbio@gmail.com. · Department of Psychiatry, University of Genova, Genoa, Italy. Electronic address: matteomartino9@gmail.com. · Department of Psychiatry, University of Genova, Genoa, Italy. Electronic address: dangelo1980@hotmail.com. · Department of Education Science, University of Catania, Catania, Italy. Electronic address: depasqua@unict.it. · St. John׳s National Academy of Health Sciences, Bangalore, India. Electronic address: ann007sarah@gmail.com. · Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland. Electronic address: jules.angst@uzh.ch. ·J Affect Disord · Pubmed #25805403.

ABSTRACT: OBJECTIVE: To assess the psychometric properties of the Italian adaptation of the Hypomania-Check-List 32-item, second revision (HCL-32-R2) for the detection of bipolarity in major depressive disorder (MDD) treatment-seeking outpatients. METHODS: A back-to-back Italian adaption of the "Bipolar Disorders: Improving Diagnosis, Guidance, and Education" English module of the HCL-32-R2 was administered between March 2013 and October 2014 across twelve collaborating sites in Italy. Diagnostic and Statistical Manual Fourth edition (DSM-IV) diagnoses were made adopting the mini-international neuropsychiatric interview, using bipolar disorder (BD) patients as controls. RESULTS: In our sample (n=441, of whom, BD-I=68; BD-II=117; MDD=256), using a cut-off of 14 allowed the HCL-32-R2 to discriminate DSM-IV-defined MDD patients between "true unipolar" (HCL-32-R2(-)) and "sub-threshold bipolar depression" (HCL-32-R2(+)) with sensitivity=89% and specificity=79%. Area under the curve was .888; positive and negative predictive values were 75.34% and 90.99% respectively. Owing to clinical interpretability considerations and consistency with previous adaptations of the HCL-32, a two-factor solution (F1="hyperactive/elated" vs. F2="irritable/distractible/impulsive") was preferred using exploratory and confirmatory factor analyses, whereas items n.33 ("I gamble more") and n.34 ("I eat more") introduced in the R2 version of the scale slightly loaded onto F2 and F1 respectively. Cronbach׳s α=.88 for F1 and .71 for F2. LIMITATIONS: No cross-validation with any additional validated screening tool; treatment-seeking outpatient sample; recall bias; no systematic evaluation of eventual medical/psychiatric comorbidities, current/lifetime pharmacological history, neither record of severity of current MDE. CONCLUSIONS: Our results seem to indicate fair accuracy of HCL-32 as a screening instrument for BD, though replication studies are warranted.

24 Article Factor structure and reliability of the Arabic adaptation of the Hypomania Check List-32, second revision (HCL-32-R2). 2015

Fornaro, Michele / Elassy, Mai / Mounir, Mina / Abd-Elmoneim, Noran / Ashour, Hala / Hamed, Rania / Al-Shehri, Abdullah / Bedir, Samir / Rashed, Ibrahem / Amer, Noha / Mohammed, Talal A / De Berardis, Domenico / Mazza, Monica / Pino, Mariachiara / Koshy, Ann Sarah / De Pasquale, Concetta / Okasha, Tarek / Angst, Jules. ·Department of Education Science, University of Catania, Catania, Italy. Electronic address: dott.fornaro@gmail.com. · Department of Psychiatry, Mansoura University, Mansoura City, Egypt. Electronic address: elassym@gmail.com. · Department of Psychiatry, Mansoura University, Mansoura City, Egypt. Electronic address: marianne_123@hotmail.com. · Department of Psychiatry, Mansoura University, Mansoura City, Egypt. Electronic address: mohamed.samir33@yahoo.com. · Department of Psychiatry, Mansoura University, Mansoura City, Egypt. Electronic address: zeyadloay@yahoo.com. · Al-Azhar University, Cairo, Egypt. Electronic address: mohammed.ragab40@yahoo.com. · Abha general hospital, Abha, Saudi Arabia. Electronic address: al-shehri99@live.com. · Department of Psychiatry, Mansoura University, Mansoura City, Egypt. Electronic address: samirelsayed112@yahoo.com. · Department of Psychiatry, Mansoura University, Mansoura City, Egypt. Electronic address: Ibrahem.hamdey@yahoo.com. · Department of Psychiatry, Mansoura University, Mansoura City, Egypt. Electronic address: noha.amer87@gmail.com. · South Valley University, Qenna, Egypt. Electronic address: Tolaetela@hotmail.com. · National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy. Electronic address: dodebera@aliceposta.it. · Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy. Electronic address: monica.mazza@cc.univaq.it. · Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy. Electronic address: mariachiara.pino@graduate.univaq.it. · St. John's National Academy of Health Sciences, Bangalore, India. Electronic address: ann007sarah@gmail.com. · Department of Education Science, University of Catania, Catania, Italy. Electronic address: depasqua@unict.it. · Institute of Psychiatry, Ain Shams University, Cairo, Egypt. Electronic address: tokasha@internetegypt.com. · Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland. Electronic address: jules.angst@uzh.ch. ·Compr Psychiatry · Pubmed #25770763.

ABSTRACT: OBJECTIVE: To assess the psychometric properties of the Arabic adaptation of the Hypomania-Check-List 32-item, second revision (HCL-32-R2) for the detection of bipolarity in major depressive disorder (MDD) inpatients suffering a current major depressive episode (MDE). METHOD: The "Bipolar Disorders: Improving Diagnosis, Guidance, and Education" Arabic module of the HCL-32-R2 was administered to mother-tongue Arabic MDE inpatients between March 2013 and October 2014. Diagnostic and Statistical Manual Fourth edition (DSM-IV) diagnoses were made adopting the mini-international neuropsychiatric interview, using bipolar disorder (BD) patients as controls. RESULTS: In our sample (n=500, of whom, BD-I=329; BD-II=70; MDD=101), using a cut-off of 17 allowed the HCL-32-R2 to discriminate DSM-IV-defined MDD patients between "true unipolar" (HCL-32-R2(-)) and "sub-threshold bipolar depression" (HCL-32-R2(+)) with sensitivity=82% and specificity=77%. Area under the curve was .883; positive and negative predictive values were 93.44% and 73.23% respectively. Owing to clinical interpretability considerations and consistency with previous adaptations of the HCL-32, a two-factor solution (F1="hyperactive/elated" vs. F2="irritable/distractible/impulsive") was preferred using exploratory and confirmatory factors analyses. Item n.33 ("I gamble more") and n.34 ("I eat more") introduced in the R2 version of the HCL-32 loaded onto F1, though very slightly. Cronbach's alphas were F1=.86 and F2=.60. LIMITATIONS: No cross-validation with any additional validated screening tool. Inpatients only sample; recall bias; no systematic evaluation of eventual medical/psychiatric comorbidities, current/lifetime pharmacological history, or record of severity of current MDE. CONCLUSIONS: In our sample, the HCL-32 fairly discriminated between MDD and BD-I but not BD-II, therefore soliciting for replication studies for use in Arabic-speaking depressed inpatients.

25 Article Alexithymia, responsibility attitudes and suicide ideation among outpatients with obsessive-compulsive disorder: an exploratory study. 2015

De Berardis, Domenico / Serroni, Nicola / Campanella, Daniela / Rapini, Gabriella / Olivieri, Luigi / Feliziani, Barbara / Carano, Alessandro / Valchera, Alessandro / Iasevoli, Felice / Tomasetti, Carmine / Mazza, Monica / Fornaro, Michele / Perna, Giampaolo / Di Nicola, Marco / Martinotti, Giovanni / Di Giannantonio, Massimo. ·NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy; Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio" of Chieti, Chieti Scalo, Italy. Electronic address: dodebera@aliceposta.it. · NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy. · Department of Neurosciences and Imaging, Chair of Psychiatry, University "G. D'Annunzio" of Chieti, Chieti Scalo, Italy. · Hermanas Hospitalarias, FoRiPsi, Villa S. Giuseppe Hospital, Ascoli Piceno, Italy. · Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy. · Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy. · Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy. · Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, The Netherlands; Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, Como, Italy; Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, FL, USA. · Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, Rome, Italy. ·Compr Psychiatry · Pubmed #25591904.

ABSTRACT: AIMS: Obsessive-compulsive disorder (OCD) is psychiatric disorder with a significant suicide risk, and the presence of alexithymia may increase this risk. As several studies attribute an important role, in OCD, to responsibility, the aims of this study were to evaluate possible clinical differences between patients positive or not for alexithymia concerning disorder severity, responsibility attitudes and suicide ideation and investigate which variables were associated with increased suicide ideation. METHODS: 104 adult outpatients with OCD were recruited. Alexithymia was measured with Toronto Alexithymia Scale (TAS-20), attitude about responsibility was tested with Responsibility Attitude Scale (RAS), suicide ideation was assessed with Scale of Suicide Ideation (SSI) and depressive symptoms were evaluated with Montgomery Åsberg Depression Rating Scale (MADRS). Score of item #11 on the Y-BOCS was considered as a measure of insight. RESULTS: Patients positive for alexithymia showed higher responsibility attitudes and more severe suicide ideation. In a blockwise regression model, the presence of lower insight, higher RAS scores and difficulty in identifying feelings dimension of TAS-20 were associated with higher SSI scores. CONCLUSIONS: OCD patients with alexithymia may show higher disorder severity, lower insight and inflated responsibility, all related to suicide ideation, independently from depressive symptoms. Implications were discussed and study limitations considered and reported.

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