The relationship between traumatic experiences and major depressive disorder provides relevant insight into the etiopathogenesis of major depression. The purpose of the current paper is to provide a narrative review on the role of both early-life trauma and recent stressful life events in the onset and maintenance of major depression. We searched for studies using PubMed, PsycLIT, PsycINFO and EBSCOhost electronic databases. The review of the studies suggests that most episodes of major depression are preceded by some stressful life events, mostly involving interpersonal loss. The central role of childhood adversity (parental death, divorce and marital discord, parental mental illness and substance abuse, exposure to family violence, neglect, and sexual and physical abuse) has also been extensively investigated. Evidence in current literature supports the notion that the impact of childhood traumatic experiences is more enduring and profound and leads to cumulative effects of stressful or traumatic events later in life. Furthermore, recent research has explored possible mediators of the trauma-depression relationship focusing on the identification of factors associated with resilient responses to traumatic stressors. Genetic influences, neurobiological pathways and psychosocial determinants have been found to be primarily involved in mediating resilient phenotypes. La relazione esistente fra le esperienze traumatiche e il disturbo depressivo maggiore fornisce alcune considerazioni che possono aiutare a comprendere meglio l’eziopatogenesi della depressione maggiore. Lo scopo di questo articolo e di fornire una revisione narrativa del ruolo sia del trauma precoce che degli eventi di vita stressanti recenti sull’insorgenza e il mantenimento della depressione maggiore. Per la ricerca degli studi sono stati utilizzati database elettronici quali PubMed, PsycLIT, PsycINFO and EBSCOhost. La revisione della letteratura condotta suggerisce che gran parte degli episodi depressivi maggiori sono preceduti da eventi di vita stressanti, soprattutto la perdita di persone care. E stato ampiamente indagato anche il ruolo centrale che sembrano avere gli eventi di vita avversi del¬l’infanzia come la morte dei genitori, il conflitto o il divorzio dei genitori, la malattia mentale o l’abuso di sostanze dei genitori, l’esposizione alla violenza familiare, l’abbandono o la violenza sessuale o fisica. Le evidenze nella letteratura corrente supportano l’idea che l’esito delle esperienze traumatiche dell’infanzia sia piu duraturo e profondo e conduca a degli effetti cumulativi con gli eventi di vita stressanti o traumatici successivi. Inoltre alcune ricerche recenti hanno esplorato possibili mediatori della relazione tra trauma e depressione focalizzandosi sull’i¬den¬tifi¬cazione di fattori associati a risposte resilienti a stressors traumatici. Le influenze genetiche, le vie neurobiologiche e le caratteristiche psicosociali sembrerebbero primariamente coinvolte nella costituzione di fenotipi resilienti.

The aim of this study is to evaluate biological factors associated with recent suicidal attempts in a naturalistic sample. A total of 439 patients suffering from major depression disorder (MDD), bipolar disorder (BD) and psychotic disorders (schizophrenia, schizoaffective disorder and psychosis not otherwise specified), who were consecutively assessed in the Emergency Department of an Italian Hospital (January 2008-December 2009), were included. In the whole sample, suicide attempters and non-attempters differed with regard to free triiodothyronine (FT3) and prolactin values only. A univariate general linear model indicated significant effects of sex (F(1;379)=9.29; P=0.002), suicidal status (F(1;379)=4.49; P=0.04) and the interaction between sex and suicidal status (F(1;379)=5.17; P=0.02) on prolactin levels. A multinomial logistic regression model indicated that suicidal attempters were 2.27 times (odds ratio (OR)=0.44; 95% confidence interval (95%CI): 0.23/0.82; P=0.01) less likely to have higher FT3 values than non-attempters; while prolactin values failed to reach statistical significance (OR=0.99; 95%CI: 0.98/1.00; P=0.051). Both prolactin and thyroid hormones may be involved in a complex compensatory mechanism to correct reduced central serotonin activity. Further studies may help in understanding how these findings can be used by clinicians in assessing suicide risk.

The advent of the Internet is among the most significant changes in recent decades and has greatly affected the entire range of human experience. However, it has, in turn, led to the emergence of psychopathological features of addiction linked to its use. Literature on the clinical management of the distress related to Internet use systematically measures up to an evolving nosography, with ambiguous definitions of the phenomenon and a diversity of diagnostic, prognostic, and therapeutic criteria. To date, case studies on ‘‘Internet addiction’’ treatment are rather limited, and no standard clinical treatment protocols exist. With regard to pharmacological treatment options, empirical or anecdotal assessments are mostly referred to. The aim of this article was to review current literature on Internet addiction treatment and assess the extent to which specific pharmacological interventions alleviate these patients’ symptomatic burden, to propose a rationale that may guide the therapeutic approach. To this end, we also explored pharmacological interventions that target patterns of comorbidity and underlying psychopathological dimensions shared with other behavioral or substance addictions.

In an attempt to establish whether, in patients with major depression, dopaminergic receptors are involved in the release of growth hormone (GH) induced by thyrotropin releasing hormone (TRH), eleven subjects were tested with TRH (200 micrograms in an i.v. bolus) with or without concomitant treatment with domperidone (10 mg in an i.v. bolus 10 min before TRH), an antidopaminergic agent which does not readily cross the blood-brain barrier. In 7 out of the 11 patients, TRH strikingly increased GH levels (responders) (the mean peak level was 9 times higher than basal value), whereas it was without effect in the remaining 4 patients (non-responders). When the responders were treated with domperidone before TRH injection, TRH-induced GH increase was still present, but it was significantly lower (the mean peak level was 5.3 times higher than basal value) than in the TRH test (p less than 0.02). These data suggest that the paradoxical response of GH or TRH in patients with major depression involves a dopaminergic mechanism active at sites situated outside the blood-brain barrier.

The authors analyse data from a case series of 1500 attempted suicides, gathered by the University of Parma, Institute of Psychiatry. The attempted suicides were studied according to sex, age, class, place where the subject was born and where the attempt took place, marital status, family background, level of education, financial position, occupation, as well as the method of the attempted suicide and the mental condition of the patient when under observation. The main points to emerge were the similarities between these data and those of the literature, as well as the psychological features and social background of these patients. Our study also confirms the results of a previous research on 500 attempted suicides, here included: the obtained out of the last 1.000 cases confirms those out of previous 500.

In this work the authors studied the effects of lithium on memory and reaction times in 7 manic-depressive patients receiving long-term therapy. The results suggest lithium treatment does not change these intellectual functions to any significant extent, comparing the trials of the experimental sessions during the therapy and after two weeks off lithium. Our data mostly agree with the studies of other Authors who used similar experimental methods.

The difficulties in correct differential diagnosis between depression and early pre-senile dementia syndromes are pointed-out by the AA. They underline that, on the ground of literature reports and clinical experience, the instrumental methods (electroencephalography, cerebral blood flow examination, pneumoencephalography, evoked cerebral responses, etc...) appear of little use in differential diagnosis, if separately considered. A particular attention is called on psychometric tests, in order to worn the non-specialist against any too over-simplified and mechanistic acceptance of test results.

In this work we have again examined a sample of 500 attempted suicides which took place in Parma between September 1971 and January 1976. We have made a distinction between the various types--those who tried only once and those who repeated their attempts, and have also taken into consideration other factors--sex, marital status, family background, level of education, financial position, as well as the method of the attempted suicide and the mental condition of the patient when under observation. The main points to emerge were: a) there was a much higher rate of mental illness among the patients who had repeated their attempts, (66,6%), in comparison to those who had tried only once (19,5%). b) while there was already a high proprotion of females who made one attempt (74%), the rate rose even higher so with those who repeated their attempts (88,8%).

18 subjects, affected by manic-depressive psychosis, have been studied during lithium therapy, in order to control EEG. changes in relation to erythrocyte lithium concentration. According to data obtained, significant relation subsistes between EEG. changes and erythrocyte lithium concentration.

The clinical features, etiology and treatment of tardive dyskinesia, a neurological syndrome observed during or after withdrawal of long term neuroleptic therapy, are discussed in reference to the literature records and to the contributions drawn out from 16 new cases.