Background:Indoleamine-2, 3-dioxygenase is responsible for tryptophan catabolism; IFN-β is a treatment for multiple sclerosis (MS) and it has been associated with depression. IDO activation might play a role in IFN-β induction of depressive symptoms. Depressive symptoms associated with MS illness and IFN-β treatment have been treated with pharmacological and non-pharmacological intervention.Aims:Evaluation of the kynurenine pathway, IDO activation and neurotoxic agents, serum BDNF in MS patients during IFN-β intervention.Methods:14 study subjects, aged 18-64 years with major depressive disorder and MS treated with IFN-β, before and after pharmacologic and non-pharmacologic intervention, and 34 age matched healthy controls were enrolled at the University of Rome "La Sapienza" and at the at the University of Antwerp. Depressed participants were randomized to sertraline-treatment or interpersonal psychodynamic psychotherapy.Results:There were significant improvements in both depression and anxiety symptoms with medication and psychotherapy groups, although the effect with sertraline was more robust. Sertraline treatment was associated with a decline in serotonin. In the psychotherapy group, a significant increase in 3-hydroxyanthranilic acid (HAA) was observed after 4 months treatment (p= .04) with a significant decrease in tryptophan levels at 6 weeks (p= .02) and a trend towards a significant decrease in BDNF after 6 wks (p=0.06), neither of which were seen in the medication condition.Discussion:The increase in HAA among the psychotherapy-treated patients raises the possibility of a neurodegenerative challenge for patients with multiple sclerosis during treatment with IFN-β which appeared to be prevented with pharmacological treatment.

OBJECTIVE:To evaluate the health-related quality of life in myotonic dystrophy type 1 and its relationships with clinical, genetic, neuropsychological and emotional factors.DESIGN:Case-control study of a continuous series of patients with myotonic dystrophy type 1.PATIENTS AND METHODS:Twenty patients, and 20 age-, sex- and education-matched healthy controls underwent the MOS 36-Item Short-Form Health Survey (SF-36), an extensive neuropsychological battery and emotional functioning tests.RESULTS:Patients' SF-36 mean scores were lower than those of controls in all dimensions. The neuropsychological study showed a significant impairment in visuospatial and verbal abstract reasoning (p=0.001), visuospatial memory (p=0.002) and attentive functions (p=0.03) in patients with myotonic dystrophy type 1. The emotional assessment showed significantly high scores in anxiety (p=0.002) and depression (p=0.001), which occurred in approximately 50% of patients. Both physical and mental SF-36 areas were inversely correlated with age, duration and grade of disease, depression and anxiety and positively correlated with attentive control. SF-36 areas were not correlated with cytosine thymine guanidine expansion.CONCLUSION:Health-related quality of life is severely impaired in myotonic dystrophy type 1 and it is negatively influenced by severity and duration of disease as well as by specific cognitive deficits and changes in emotional functioning. Therapeutic intervention in this field could contribute to ameliorate health-related quality of life in myotonic dystrophy type 1.

Journal of the European Academy of Dermatology and VenereologyVolume 20, Issue 8 p. 1000-1001 Alopecia areata with comorbid depression: early resolution with combined paroxetine–triamcinolone treatment A Ricciardi, Corresponding Author A Ricciardi Department of Psychiatry, *Corresponding author, Dipartimento di psichiatria, Università di Roma 'La Sapienza', II Facoltà di Medicina, Ospedale Sant'Andrea, Via di Grottarossa 1035-39, Rome, Italy, tel. +39 0633775675; fax +39 0633775342; E-mail: [email protected]Search for more papers by this authorA Ruberto, A Ruberto Department of Psychiatry,Search for more papers by this authorMJ García-Hernández, MJ García-Hernández Department of Dermatology and Venereology, Virgen Macarena Hospital, School of Medicine, University of Seville, Spain andSearch for more papers by this authorGD Kotzalidis, GD Kotzalidis Department of Psychiatry,Search for more papers by this authorM Trevisi, M Trevisi Department of Psychiatry,Search for more papers by this authorS Persechino, S Persechino Department of Dermatology, Plastic and Reconstructive Surgery, Sant'Andrea Hospital, 'La Sapienza' University, Rome, Italy,Search for more papers by this authorR Tatarelli, R Tatarelli Department of Psychiatry,Search for more papers by this authorS Ruiz-Doblado, S Ruiz-Doblado Consultation-Liaison Psychiatric Unit, Osuna Hospital, Seville, Spain.Search for more papers by this author A Ricciardi, Corresponding Author A Ricciardi Department of Psychiatry, *Corresponding author, Dipartimento di psichiatria, Università di Roma 'La Sapienza', II Facoltà di Medicina, Ospedale Sant'Andrea, Via di Grottarossa 1035-39, Rome, Italy, tel. +39 0633775675; fax +39 0633775342; E-mail: [email protected]Search for more papers by this authorA Ruberto, A Ruberto Department of Psychiatry,Search for more papers by this authorMJ García-Hernández, MJ García-Hernández Department of Dermatology and Venereology, Virgen Macarena Hospital, School of Medicine, University of Seville, Spain andSearch for more papers by this authorGD Kotzalidis, GD Kotzalidis Department of Psychiatry,Search for more papers by this authorM Trevisi, M Trevisi Department of Psychiatry,Search for more papers by this authorS Persechino, S Persechino Department of Dermatology, Plastic and Reconstructive Surgery, Sant'Andrea Hospital, 'La Sapienza' University, Rome, Italy,Search for more papers by this authorR Tatarelli, R Tatarelli Department of Psychiatry,Search for more papers by this authorS Ruiz-Doblado, S Ruiz-Doblado Consultation-Liaison Psychiatric Unit, Osuna Hospital, Seville, Spain.Search for more papers by this author First published: 05 May 2006 https://doi.org/10.1111/j.1468-3083.2006.01592.xCitations: 3Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume20, Issue8September 2006Pages 1000-1001 RelatedInformation

Objective: Attitudes and feelings toward the body may be a source of pleasure and well-being; on the other hand bodily dissatisfaction may lead to suffering, depression and even to suicide. Methods: The study population consisted of 500 university students (190 males, 310 females); mean age of participants was 21.62 (SD=2.70). Participants were assessed by means of the Body Uneasiness Test (BUT), the Reason for Living Inventory (RFL), Zung Self Depression Scale (SDS). Results: Data underline a linear relationship between uneasiness linked to body image and suicide risk. Such evidence suggests that only a serious disorder of the body image may be linked to an increased suicide risk. In our sample the increased suicide risk was due to primary depressive disorders or depression caused by the body uneasiness, which in turn is worsened by depression. Our results show significant gender differences for the body image and a moderate relationship between body uneasiness and depression. Conclusion: Body uneasiness is a source of great distress among non-clinical young individuals, causing depression and even increase of suicide risk.

Objective: To review the literature on suicide of inpatients with schizophrenia, to identify suicide risk factors as well as typical patterns of behavior and to suggest a rationale and strategies for future interventions. Method: A computerized MedLine, Excerpta Medica and PsycLit search supplemented by an examination of cross-references and reviews. Results: Up to half the suicides among patients with schizophrenia occur during inpatient admission. Inpatient suicides were found among those of a young age group who were predominantly single, childless and socially isolated. The vast majority experienced an illness characterized by long duration and prolonged psychiatric hospitalizations or multiple admissions and discharges. Up to 50% of the suicides occurred in the first few weeks and months following discharge from the hospital. The paranoid subtype of schizophrenia, where positive symptoms prevail and negative symptoms are few, is associated with a suicide risk that is three times greater than that associated with nonparanoid subtypes and eight times greater than the risk associated with the deficit subtype. Conclusions: Treatment of suicide is a major problem among inpatients with schizophrenia. Evidence suggests that suicide is generally carried-out by patients who have been recently discharged or by those who manage to get away from the hospital. Strategies aimed at preventing this phenomenon have been introduced to the medical personnel, but suicide in these patients does not seem to have been reduced. We emphasize the need to establish guidelines for the prevention of suicide in hospitalized patients with schizophrenia.

Objective: Depression in people related to delivering women is documented in their mates, but only anecdotal in other family members. We describe a case of depression in a woman who had previously experienced postpartum depression after the birth of her nephew.Method: A clinical description of the case.Results: A 53‐year‐old woman, hysterectomized at age 47 years, was admitted for attempted suicide. She developed major depressive episode 1 month after her daughter had delivered a son. She had a past history of two postpartum depressive episodes clinically identical to the current episode. The episode resolved after 5 weeks. At 1‐year follow‐up, the patient is still asymptomatic.Conclusion: Psychological and cultural factors were at play in this case more than hormonal and biopsychosocial ones.

Dear Editors, Depression and pregnancy—may selective serotonin reuptake inhibitors be associated to behavioural teratogenicity? Comment on “The obstetrician and depression during pregnancy” by Campagne DM [Eur J Obstet Gynecol Reprod Biol 116 (2) (2004) 125–30]European Journal of Obstetrics and Gynecology and Reproductive BiologyVol. 120Issue 1PreviewDear Editors, Full-Text PDF Response to Dr. Maurizio Pompili's comment as to the suicide risk during pregnancyEuropean Journal of Obstetrics and Gynecology and Reproductive BiologyVol. 120Issue 1PreviewDr. Pompili cites some older investigations that minimize the risk of suicide during pregnancy on the assumption that pregnancy itself, as a rule, reduces that risk. He wisely adds that this information should be considered with caution and that it does not apply to psychiatric populations. Full-Text PDF

Suicide is the first cause of premature death in patients with schizophrenia. Numerous studies have identified risk factors for suicide among these patients. This study reviews available literature focusing on awareness of illness in patients with schizophrenia. Insight, or awareness of illness, has been considered a risk factor for suicide in schizophrenic patients. In assessing insight, many issues have to be taken into account, because a high degree of insight is not desirable in some conditions.

The antidepressant mirtazapine enhances both noradrenergic and serotonergic transmission by blocking α2-adrenergic presynaptic auto- and heteroreceptors, respectively. We here report on three patients with mood disorders with psychotic features (two cases with depressive and one with bipolar disorder). Treatment with mirtazapine significantly improved not only their depression, but also their delusions. Depressive symptoms were only partially responsive and delusions unresponsive in all three patients to previous antidepressive and/or antipsychotic treatment, and only mirtazapine induced persistent improvement. These clinical cases suggest that mirtazapine can be a valid alternative for patients with depression with psychotic features and partial treatment-resistance.

A 25-year-old man with DSM-IV-TR Axis I social phobia and Axis II avoidant personality disorder and erectile dysfunction, presenting with depression, anxiety and insomnia, responded partially to extended release oral venlafaxine (75 mg/die for 6 weeks), but developed side effects and worsening symptoms when dose was increased to 150 mg/die; he responded to a combination of 75 mg/die venlafaxine and 4 mg/die reboxetine and improved on most of his symptoms.

Suicide is the primary cause of death among schizophrenic patients; follow-up studies suggested that 10-13% of schizophrenic patients die by suicide. Preventive measures based on early recognition or risk factors and the establishment of drug treatment protocols are no doubt of great help but have not resulted in a significant reduction or the number or suicides among these patients. Schizophrenia is a chronic disorder affecting all aspects of the individual's life. Prevention should therefore be addressed to various areas. This paper overviews studies dealing with major fields of interest in the prevention or suicide among patients with schizophrenia. The authors focus on the role of pharmacological treatment, psychosocial interventions and psychotherapy, the struggle against stigmatisation and the role of GPs. Prevention or suicide among inpatients with schizophrenia is also analysed. It is concluded that those integrated strategies already in use and the implementation of less known interventions should constitute a more effective prevention of self-inflicted deaths among these patients.

This paper provides an analysis to establish a practical guideline in the therapeutic management and subsequent monitoring of Munchausen Syndrome by Proxy (MSP) adapted to the Spanish social and legal context and based on scientific literature published before December 2008. An interdisciplinary team made up of various professionals involved in caring for the child will design a therapeutic strategy and monitoring at different levels. In the field of mental health there must be a triple therapeutic approach: the child as a victim, the agent as abuser and the family as a whole. In terms of social work, the socio-familiar situation should be evaluated using different resources at a health care level. It is important to plan the time to confront the family to obtain their necessary collaboration. The monitoring plan will be collective at the hospital level and the child's primary pediatrician, in the medical and educational fields in those of mental health and social work.A therapeutic strategy and monitoring by an interdisciplinary team at the medical, social and mental health level, is proposed as a useful tool in the management of MSP. In this way, in some cases the removal of child from the family nucleus can be avoided.