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Aim: The study aims at evaluating the resocializing effects of music therapy as add-on therapy in the course of integrated, pharmacological and psychological, treatment., Methods: During a six months period, 24 patients belonging to a psychiatric Day Hospital were recruited and divided into 2 groups. An accurate music anamnesis was collected for each patient. Group 1 (n=11) received as add-on therapy 14 improvisational music therapy sessions on a weekly basis, while group 2 (n=13) received 7 improvisational music therapy sessions alternated with 7 listening music therapy sessions, on a weekly basis. The response to music therapy was evaluated at the beginning and at the end of the add-on therapeutic process through a music therapy observation form consisting of 9 variables., Results: In both groups there was a good response from patients affected by mood disorders as well as obsessive-compulsive disorder, while schizophrenic patients response was either absent or reduced. The improvement of the variable interaction between the components, sharing of the instrument, facial expressions and tension was significantly higher in the group that received as add-on therapy both improvisational music therapy and listening music therapy., Discussion and Conclusions: The findings suggest a significant role of the improvisational music therapy in gaining a re-socializing effect within a therapeutic group. The effectiveness turns out to be greater if the improvisation is combined with a listening therapy, aimed at educating the patient to a greater openness to the expressive aspect of sound. The active-passive music therapy association could then bring a valuable contribution as an add-on rehabilitative treatment.

Background: Individuals with psychiatric disorders incur an increased risk of morbidity and mortality, with higher prevalence of cardio-metabolic risk factors s largely contributing to a significant reduction in life expectancy., Objectives: The aim of the present study was at evaluating the clinical effectiveness of an educational intervention targeting lifestyle habits in patients with mood and psychotic disorders., Methods: Patients (n = 32) were randomly assigned to receive, in addition to the pharmacological treatment, either five sessions of group psychoeducation focused on healthy lifestyle or five sessions of a control group therapy., Results: Both psychopathological severity (i.e. the brief psychiatric rating scale) and lifestyle quality (i.e. physical activity, sleep quality and adherence to the Mediterranean diet) improved significantly over time in patients who underwent specific psychoeducational sessions but not in the controls., Conclusions: These findings add to the accumulating evidence that educational interventions focused on lifestyle habits can ameliorate general and mental health in patients with psychiatric disorders and suggest that educational programs represent an effective non-pharmacological intervention to manage drug-induced cardiometabolic disturbances.

Osteoporosis and depression are two chronic diseases that affect large population groups with great impact on morbidity, mortality and quality of life. Existing studies of the relationship between depression and osteoporosis have been heterogeneous in their design and use of diagnostic instruments for depression, which might have contributed to the different results on the comorbidity of these two conditions. Moreover, the direction of the causative link is still controversial and the etiology remains unclear. Definitely, limited data suggest that osteoporosis may enhance depressive symptoms, while far more studies have shown that depression adversely affects bone density and increases fracture risk. Thus the correlation of these diseases is still under research. This review comments on a plausible causative relationship and underlying mechanisms that might elucidate the link between two very common diseases. We describe the possible impact of osteoporosis on moods and the effect of depression on bone health. In particular, we focus on the role of the hypothalamic-pituitary-adrenocortical and sympathoadrenal axes, of the parathyroid hormone and cytokines. We also describe the effect of the antidepressant drugs as well as lifestyles that may explain this effect.

Caffeine is considered the world's most popular psychoactive substance. Its actions on the central nervous system, mainly mediated by antagonism of adenosine receptors and subsequent modulation of dopaminergic activity, would be particularly sought by depressed patients, as an attempt of self-medication. However, published data suggested that coffee consumption may worsen psychopathological conditions in mood disorders. Thus, we reviewed available evidence in the literature that investigated the effects of coffee consumption on clinical development of underlying psychopathology. Literature research was done by typing on Medline/PubMed and PsychINFO the key words "coffee AND major depression", "coffee AND dysthymia". The research was limited to English language publications and to studies conducted exclusively on humans. Although literature data are conflicting, extensive follow-up studies indicate a significant caffeine effect on risk reduction of developing clinical depression symptoms. Clinical worsening was observed mainly in cases of postpartum depression and comorbid panic disorder. Taking in account the study limitations, we observed a biphasic profile in caffeine psychostimulant effect: low to moderate doses may correlate with a reduction in depressive risk in healthy subjects and an improvement of many clinical symptoms (attention, arousal, psychomotor performance) in depressed patients, whereas the assumption of high doses may result in thymic dysregulation, favor mixed affective states and worsen circadian profiles and anxiety symptoms.

Introduction: Internet Addiction Disorder (IAD) is an emerging psychiatric disorder, assimilable to impulse control problems and related to maladaptive use of new networks and social and virtual technologies., Aim: Our study aims to analyze the presence of IAD among adolescents and to study the correlation with social interaction anxiousness. We investigated also the possibility that the Social Network (SN) represent a source of risk for the development of IAD., Materials and Methods: The test group was composed of 250 subjects, aged between 14 and 18 years. They were administered: Young's IAT; IAS (Interaction Anxiousness Scale), AAS (Audience Anxiousness Scale) and SISST (Social Interaction Self-Statement Test) to analyze the dimension of social interaction anxiousness., Results: We found a rate of 2% of the IAD. The SN are the most common use of the Net in our sample, but not the most clicked sites by subjects with IAD. It should be noted, finally, a correlation between social interaction anxiety and IAD, but not a significant difference in scores of social anxiousness scales based on the SN use/non-use., Conclusions: The use of SN intended as single variable doesn't correlate with increased risk for IAD, or for increased social interaction anxiousness. However, if associated with prolonged use of the net for 5-6 hours or more, or concomitant use of chat rooms and/or net gambling, we find a more significant risk of psychopathology. The data presented require further investigations, in order to guide new pathogenetic models and appropriate intervention strategies.

Introduction: The most important predictive factor for a successful outcome in Brief Psychotherapy is the motivation of patients to the treatment itself. Against the scarcity of literature on the subject, so far limited to offer standardized tools to assess motivation, applied mainly to education and work's areas, in spite of a possible application in psychotherapy, it was considered necessary to develop a questionnaire ad hoc., Materials and Methods: It was therefore created a pattern of motivational diagnosis of the problem based on a sequence of questions and answers, which would make possible the classification of each case and then that could lead to the use of a specific method. It is the result of the attempt to create an orderly pattern and that it would be easy to use and then be analyzed. The questionnaire consists of twenty one questions and requires that the patient answers with a "yes" or a "no" to each applicant. It was administered to thirty patients who came from the psychiatric day hospital. The questionnaire was used as a "not standardized thread" in which, through groups of questions, are addressed some central cores: the spontaneous activity, motivation controlled from the outside, motivation directed to an activity that leads to results, motivation to and activity for a purpose, expectations of self-efficacy, the presence/absence of resistance and finally the area of the will. The purpose of this work is to show, bringing a contribution in agreement with the few studies on the subject, how motivation is a key parameter for predicting the effectiveness of a psychotherapy, in this case, Brief Psychotherapy., Conclusions: The study clearly shows how the motivation is the most important positive predictor in the preliminary assessment of a Brief Psychotherapy: results in treatment are most likely to be rapid and favorable if patients are motivated to change andif they are engaged with the therapist.

Introduction: After the advent of SSRI, antidepressants in low doses and in combination with neuroleptic treatment entered into use in clinical practice. The indication is the depression that may overlap with schizophrenic disorder., Aim: Our work, based on "serotonin dimension" of schizophrenic disorder and accepting the neuropharmacological paradox that is cotherapy antipsicotic drug/SSRI, has investigated two different combinations of integrated treatment: olanzapine+paroxetine and olanzapine+fluvoxamine., Materials and Methods: The study sample consists of 50 patients with schizophrenia, all young adults aged up to 36 years. The therapeutic groups were structured as a term of one year, with scales by SANS and PANSS at time 0, 1 months, 6 months and 12 months. RESULTS; The clinical evidence has shown good parameters of efficacy, safety and tolerability of the drug SSRI in combination with neuroleptics. There was a reduction in negative symptoms, as evidenced by the decrease in scoring in the PANSS and SANS scales. This is especially valid for the molecule fluvoxamine., Conclusions: While the molecule paroxetine seems partly slatentize cognitive deficits (expression of residual psychotic negative component), fluvoxamine has proven effective in improving the negative symptoms and has shown, moreover, not to increase the positive symptoms of the disease.

The purpose of the study is to investigate the action of one antipsychotic molecule of recent introduction on the market. Paliperidone, in this occasion used in the formulation extended-release tablets, is an oral antipsychotic who takes advantage of the OROS system. Studies about are up to now focused on the effectiveness of paliperidone ER in the acute phase of the schizophrenia. In our job we have, instead, intention to show one possible application in a case of a chronic patient with undifferentiated schizophrenia resistant to the other antipsychotic treatments. Moreover 3TRE scale has been associated to establish the effects of the new therapy. The entrance prescription has been with paliperidone ER in a dosage of 6mg once a day. Clinical effects of paliperidone ER 6 mg became obvious and meaningful, online with other jobs, already in the first days of treatment. But the improvement of the partials and totals scale's scores have been had mainly with the dosage to 12 mg, that the patient has assumed autonomously unknown to the care provider.

In recent years, many cases have been published about the appearance of a specific syndrome after the suspension or the sharp reduction in dose of antidepressants. Most of the reports and records relating to the very short half-life SSRI paroxetina. The following work intended to investigate the syndrome, its impact and its correlation with some parameters: age, sex, diagnosis, time of taking and antidepressant drug, therapeutic compliance, suspension and symptoms. The study, lasting approximately 6 months, was conducted with 148 outpatient, all treated with paroxetine.This paper highlights how the discontinuation syndrome is rare in individuals who received antidepressant treatment for short periods, and how it is, rather, much more common in cases of depression NAS, followed by panic attacks, compared with case of major depression. A positive correlation seems to be also with sex (having observed that go more frequently to meet withdrawal symptoms subjects male), and with age, patients being young adults between 35 and 55 years. The symptoms reported were very similar among all patients: headache, dizziness, abdominal pain and perineal, elevated pressure, anxiety, depersonalization and derealization, nightmares. Interestingly, the total absence of symptoms related to the original diagnosis of the disorder. Going to investigate the causal event for the emergence of the discontinuation syndrome, it was possible to divide the cases examined in three categories: independent suspension without medical opinion, suspension accelerated (both conditions due to outpatients) and finally patients that, although they had followed all the guidelines for suspension of the drug, had gone to meet equally symptoms. The syndrome can be prevented reducing very gradually the antidepressant dosage, while if there are symptoms it is indicated to reintroduce the drug and then scale or replance it with a different molecule.

This study was performed to determine the correlation between psychiatric manifestations and several autoantibodies that might participate in the pathogenesis of psychiatric disorders in the course of systemic lupus erythematosus (SLE). Fifty-one unselected outpatients with SLE were enrolled. Psychiatric evaluation was performed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. The prevalence of antibodies against endothelial cells (AECA), cardiolipin, beta2 glycoprotein I, Ro, Ro52, La, glial fibrillary acidic protein, ribosomal P protein, dsDNA, and nucleosomes was assessed by experimental and commercial enzyme-linked immunosorbent assays. According to the cutoff value, AECA were present in 11 of 17 (64.7%) SLE patients with psychosis and mood disorders and in 10 of 34 (29.4%) patients without psychiatric manifestations other than anxiety (P = 0.03). Moreover, the AECA binding index was significantly higher in the first group (P = 0.03). Conversely, no significant correlation was found between the presence of the other autoantibodies studied and psychiatric involvement. The results of this study suggest a relationship between AECA and psychosis and mood disorders in SLE, supporting the hypothesis of a biological origin of these disturbances.

Our study was carried out to determine the prevalence of chronic fatigue syndrome (CFS) within a selected population of patients suffering from persistent fatigue. We studied subjects with recurrent or persistent fatigue lasting 6 months and fulfilling at least four minor Center for Disease Control (CDC) criteria for the diagnosis of CFS. Evaluation included both clinical examination and laboratory testing. All subjects filled out a questionnaire specifically designed to gain information about the length and severity of symptoms, and patients with a previously diagnosed illness associated with fatigue were excluded. The study was carried out at the Fatigue Clinic of an internal medicine unit (Clinica Medica I) of the University of Rome "La Sapienza". Sixty-three subjects, residents of the Lazio region (central Italy), completed the diagnostic assessment. Alternative diagnoses were established in 37 (59%) of the 63 patients. A diagnosis of CFS based on the CDC criteria was established in only 6 cases. In 2 subjects, CFS had appeared following infectious mononucleosis, and no definitive diagnosis could be formulated for 18 patients. In Italy, CFS seems to be an infrequent cause of severe and persistent fatigue in a selected population. Numerous morbid conditions may be responsible for a clinical picture closely resembling CFS. We recommend that patients suffering from fatigue be thoroughly evaluated.

The authors review the most recent literature on "dental phobia" which is responsible for discomfort and delays in prevention and treatment of odontoiatric disorders. Special attention is devoted to the multifactorial etiology and to diagnostic classification of these difficulties, as well as to the therapeutic possibilities available today.

The aim of the study was the investigation of the ability of L-acetylcarnitine (Acn; 1.5 g daily oral route for 1 month) to enhance some performances requiring a high level of attention and reflex velocity. The sample includes 17 healthy subjects, 8 males and 9 females, 22 to 27 years old; 10 of the subjects practice sports at agonistic level, while 7 have a sedentary life style. Reflexes have been measured, baseline and after 17 and 30 days of Acn administration, through a purposely constructed reflex-meter able to determine the latency (csec) of the reaction to an auditory stimulus. The ability as well as the time of learning was determined, before and after treatment, as the time and the number of errors to get out of the maze of a videogame (the test was also carried out by an untreated control group). Acn seems to induce an enhancement of reflex velocity, with complete annulment of the difference between the dominant and the opposite hand, as well as a significant reduction (3 to 4 times superior to controls) of both the errors and the time with the maze test.