Kleptomania: clinical features and comorbidity in an Italian sample.

Kleptomania, listed in DSM-IV as an impulse control disorder not elsewhere classified, is a psychiatric condition still poorly understood and subject of only a few systematic studies. The aim of this research was, therefore, to evaluate the clinical features and comorbidity of Italian patients with a DSM-IV diagnosis of kleptomania. Twenty outpatients with a lifetime diagnosis of kleptomania by DSM-IV criteria, were included in the study and underwent a specially designed semistructured interview and the Family History Research Diagnostic Criteria. The majority of patients reported an early and abrupt onset and an episodic course of the disorder, with no gender preponderance. Lifetime comorbidity for other axis I disorders was high, in particular for mood, anxiety, and impulse control disorders. Family history also showed a high prevalence of psychiatric disorders. Our study indicates clear connections between kleptomania and different psychiatric disorders, the exact nature of which has yet to be clarified.     

Psychopathology in adopted and nonadopted children: a clinical sample.

The relationships of adoptive status to presenting psychopathology and to demographic and psychosocial variables were examined in a large sample of children and adolescents who attended psychiatric outpatient services over a 14-year period. Adopted boys and girls were both at increased risk of disruptive behavior, including conduct disorders and ADHD. Age at time of adoption was not related to psychopathology.     

The temporomandibular joint: clinical and surgical aspects

Advances in imaging techniques have greatly enhanced the ability to visualize the internal anatomy of the temporomandibular joint and have increased understanding of the etiology of many temporomandibular disorders. When used together with careful history and physical examination, this knowledge can contribute to better treatment outcomes.     

Mini mental Parkinson test: standardization and normative data on an Italian sample

The mini mental Parkinson (MMP) is a test built to overcome the limits of the mini mental state examination (MMSE) in the short-time screening of cognitive disorders in individuals with Parkinson’s disease (PD). In fact, in this scale, items tapping executive functioning are included to better capture PD-related cognitive changes. Some data sustain the sensitivity and validity of the MMP in the short neuropsychological screening of these individuals. Here, we report normative data on the MMP we collected on a sample of 307 Italian healthy subjects ranging from 40 to 91 years. The results document a detrimental effect of age and an ameliorative effect of education on the MMP total performance score. We provide for correction grids for age and literacy that derive from results of the regression analyses. Moreover, we also computed equivalent scores in order to allow a direct and fast comparison between the performance on the MMP and on other psychometric measures that can be administered to the subjects.     

Heterogeneous distribution of amyotrophic lateral sclerosis patients with SOD-1 gene mutations: preliminary data on an Italian survey

We report the absence of superoxide dismutase (SOD-1) gene mutations in 30 patients with amyotrophic lateral sclerosis (ALS) including individuals with a confirmed family history of ALS (familial ALS/FALS), ALS with an unclear family history (UFALS) and sporadic ALS (SALS). Single strand conformation polymorphism (SSCP) and sequence analysis of the 5 SOD-1 gene exons were undertaken to improve the accuracy of the mutation detection. Our preliminary data appear to diverge from the results of studies by other groups using different populations. We discuss the possible reasons for this disparity and the apparent heterogeneous distribution of ALS with SOD-1 gene mutations among different ethnic groups.     

Psychopathology and personality features in orthopedic patients with boxer's fractures

A boxer's fracture (BF) is the most common type of metacarpal fracture and is usually an intentional injury. This study aims to investigate the severity of depressive and anxiety symptoms and evaluate the personality features of patients with BF in comparison with patients with fractures other than boxer's fractures [other fractures (OFs)] and a group of healthy controls (C). The study group was comprised of 14 patients who were diagnosed to have BF, 13 patients who were assessed due to OF and 11 C. Patients and controls were assessed with Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-2) was used to screen axis II, personality disorders' symptoms. The results showed that patients with BF had more anxiety as a trait and had higher mean scores for self-defeating, borderline and antisocial personality disorders than both the group of OF and C. Additionally, BF group had higher scores on the anger and cynicism subscales of MMPI-2. These results suggest that maladaptive personality traits and anxiety symptoms are common in patients with BF. Psychiatric assessment of patients who apply to orthopedy clinics with BF should be a part of their treatment plan.     

Epilepsy in chromosomal abnormalities: an Italian sample

Epilepsy is common in chromosomal abnormalities, but systematic studies are scanty. We describe an Italian sample of patients with chromosomopathies to establish epilepsy occurrence and clinical electroencephalographic (EEG) features. Forty-five patients with different types of chromosomal abnormalities were analyzed to examine different variables in patients with epilepsy (group 1) and without (group 2) and to compare the types of epilepsy in our cases with respect to a nonselected sample of Italian people with epilepsy. Epilepsy occurred in 51.1% (group 1) of cases and prevailed in autosomal abnormalities but without a statistical significance (P > .05). There was a prevalence of EEG paroxysmal abnormalities in group 1 (P < .0001); continuous spike-waves during sleep were observed in three cases. Profound mental retardation prevailed in group 1 (P < .001) and mild mental retardation in group 2 (P < .05). Generalized epilepsies prevailed significantly (P < .00001). A high-resolution karyotype should be undertaken in all patients with epilepsy presenting with mental retardation when an obvious etiology is not available.     

Mini-Mental State Examination (MMSE): sensitivity in an Italian sample of patients with dementia

The sensitivity of the Mini-Mental State Examination (MMSE) was assessed in a sample of patients with dementia of the Alzheimer type or vascular dementia. The MMSE identified the majority of pts with diffuse cognitive impairment but did not discriminate between the two types of dementia. It failed to detect mild deterioration or forms in which only some cognitive functions were impaired. The test is therefore not sufficient for distinguishing deteriorated from non deteriorated pts, although it is still useful in mass screening or for a quick assessment of deterioration in the course of clinical neurological examination.

---

Sommario Sono state valutate le prestazioni al Mini-Mental State Examination (MMSE) in un campione di soggetti affetti da demenza tipo Alzheimer o da demenza vascolare. Il MMSE individua la maggior parte dei pt. compromessi diffusamente sul piano cognitivo, senza peraltro discriminare fra i due tipi di demenza. Non vengono diagnosticati, invece, deterioramenti di lieve entità o in cui la compromissione è presente solo in alcune funzioni cognitive. Il test non è pertanto sufficiente per distinguere deteriorati da non deteriorati, benchè conservi un'utilità per indagini di massa o per una rapida valutazione del deterioramento durante l'esame neurologico clinico.

     

Body dysmorphic disorder and its associated psychological and psychopathological features in an Italian community sample

Objective: Body Dysmorphic Disorder (BDD) is a psychiatric condition characterized by preoccupation with perceived defects in physical appearance that are not observable or appear slight to others, along with low self-esteem, high perfectionism, and high comorbidity. Little is known about BDD prevalence and phenomenology in the Italian context, and no data are currently available on BDD prevalence using DSM-5 criteria in the Italian context. The aims of the current study were to explore the prevalence and the phenomenology of BDD and its associated psychological and psychopathological features such as self-esteem, perfectionistic traits, social anxiety, depressive, and obsessive–compulsive symptoms in a community sample.

Methods: Six hundred and fifteen community individuals completed a battery of self-report questionnaires.

Results: 10 (1.63%) individuals met DSM-5 diagnostic criteria for BDD; hair, nose and teeth were the most common areas of concern. Individuals with BDD reported also lower levels of self-esteem, more severe social anxiety symptomatology, general distress, depression and obsessive–compulsive features than people without BDD.

Conclusions: BDD is not a rare condition in the Italian context and it emerged to be associated with significant morbidity.     

Thrombophilic risk factors and unusual clinical features in three Italian CADASIL patients

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a genetically transmitted cerebrovascular disease. Typically, the first clinical manifestation is migraine and the full clinical spectrum of the disease with recurrent strokes of the subcortical type, cognitive, and mood disorders is seen during the fourth and fifth decades of life. Vascular risk factors are usually absent in CADASIL patients and the diagnosis of the disease is particularly suspected in young adults with cerebrovascular events of unknown cause, diffuse leukoencephalopathy on computed tomography or magnetic resonance imaging, and a history of cerebrovascular diseases or dementia in many family members. We describe three Italian CADASIL patients who presented to medical attention for cerebrovascular events occurred after the age of 55 and had, in addition to hypertension and hyperlipidemia, thrombophilic risk factors such as hyperhomocysteinemia, elevated levels of lipoprotein(a), and antiphospholipid antibodies. Symptoms possibly related to cortical involvement, such as dysphasia and visual field deficits, were reported by two of these patients. We conclude that a diagnosis of CADASIL should not be disregarded in patients with vascular risk factors and presenting with symptoms not immediately referable to subcortical damage at ages more advanced than commonly reported.     

The Frontal Assessment Battery (FAB): normative data from an Italian sample and performances of patients with Alzheimer's disease and frontotemporal dementia

The Frontal Assessment Battery (FAB) is a short neuropsychological tool aiming to assess executive functions at the bedside. Two-hundred and thirty-six normal controls were administered the FAB and three other tasks assessing attentional and executive functions. The FAB was also administered to 28 patients suffering from mild Alzheimer's disease (AD, n. 15 subjects) or frontotemporal dementia (FTD, n. 13 subjects). The FAB showed good concurrent and discriminant validity and high internal consistency. Test-retest and inter-rater reliability were fairly good. A multiple regression analysis showed a significant positive effect of education and a negative effect of age. Cut-off values of non-parametric distribution were computed. A difference on FAB scores within dementia patients was observed, with subjects with FTD performing worse than patients suffering from AD.     

Psychopathology in amyotrophic lateral sclerosis: a preliminary study with 27 ALS patients.

Considering the few studies published on the psychopathology of ALS patients, we carried out a preliminary study evaluating depression, anxiety, emotional reactions and coping strategies in such patients. Twenty-seven ALS patients were included and evaluated using a semi-structured interview, after which they were asked to complete a questionnaire. The rater asessed the DSM-IV criteria for a major depressive episode, dysthymia and generalized anxiety, using the MADRS scale for depression, the Covi anxiety scale and the Depressive Mood scale. Subsequently, patients completed the Ways of Coping checklist. Patients were neither anxious nor depressed. Patients whose diagnosis was recent (less than six months) presented greater emotional deficit. Patients younger than 50 years of age used problem focused strategies more frequently. Those having received the diagnosis in the preceeding six months used emotion focused strategies significantly more often.The absence of characterized depression and anxiety confirmed results of the literature. The significance of this study is found in the observation of specific emotional reactions present in the first six months following diagnosis disclosure. The results show that it is useful to continue the affective evaluation of these patients and to undertake longitudinal studies starting at the time of diagnosis disclosure.     

颞肌筋膜瓣移植重建颞下颌关节盘19例

背景：颞肌筋膜瓣移植是颞下颌关节紊乱病不可缺少的的治疗方法,但如何选择合适的适应证及移植方式方能达到理想的治疗目的是目前临床正在探讨的热门课题。 目的：为对病变严重致不能保留的关节盘进行重建,报道应用带蒂颞肌筋膜瓣移植治疗颞下颌关节紊乱患者的方法和随访结果,对相关问题进行探讨。 设计、时间及地点：病例分析,于2005-12/2007-06山东省滨州医学院附属医院口腔颌面外科完成。 对象：选择14例(16侧)不可复性关节盘移位和5例(5侧)关节盘穿孔,共19例（21侧）颞下颌关节紊乱病患者进行手术治疗。 方法：19例（21侧）颞下颌关节紊乱病患者经耳颞部切口行关节盘切除并应用带蒂颞肌筋膜瓣移植重建。对所有患者移植前与移植后随访的临床资料进行比较,并分析MRI资料。 主要观察指标：随访观察带蒂颞肌筋膜瓣移植重建关节盘后患者张口度、咬合关系、颞部丰满度、关节区疼痛的数据化测定值、患者满意度等及MRI影像T1、T2加权像矢状位与冠状位移植物信号变化及连续性。 结果：19例患者随访时间平均17个月,患者症状显著改善。统计学比较发现患者主要临床症状移植前后差异有显著性意义（P < 0.01）;MRI检查可见关节间隙内移植物呈中等信号带状影像且边界较清晰,未见中断或呈片段状。 结论：带蒂颞肌筋膜瓣移植重建颞下颌关节盘能恢复关节功能、防止关节粘连,并且制备方便、无明显供区并发症,是一种可行方式。