Evaluation of secondary school teachers' knowledge about psychosis: a contribution to early detection

Aims: We sought to evaluate secondary school teachers’ knowledge about psychosis and their level of interest in this topic given the key role they may be able to play in the early detection of psychosis. Methods: A questionnaire survey of 268 secondary school teachers from eight secondary schools within the Azienda Sanitaria Locale Rome/E and Rome/A catchment areas (two of the five city health districts) in Rome. Teachers were asked to complete the Italian version Esperienza e Conoscenza delle Difficoltò Sociali ed Emotive dei Giovani of the Knowledge and Experience of Social Emotional Difficulties among Young people self‐report questionnaire that investigates the diagnosis, age of onset, aetiology, prognosis and treatment of psychosis. They were also asked about their experience with pupils with possible psychosis. Results: Most of teachers were able to recognize psychotic symptoms from a case vignette. Approximately 25% of the teachers had experienced a pupil with possible symptoms of psychosis. However, teachers displayed little awareness of psychiatric community services available for young people. Conclusions: Our study shows that teachers may play an important role in early detection and psychosis prevention strategies. The teachers also displayed a keen interest in gaining a deeper knowledge of early psychotic signs and in cooperating closely with a mental health specialist to obtain guidance and support when faced with serious mentally ill pupils.     

Stabbing headache in patients with autoimmune disorders

Stabbing headache is a relatively rare type of chronic “primary” headache with distinctive features with respect to more common forms of paroxysmal headache, such as cluster headache and trigeminal neuralgia. Drug treatment is empirical because of the lack of knowledge on the pathophysiology of stabbing headache. We examined 26 patients recruited over 10 years, who met the diagnostic criteria for stabbing headache. Interestingly, more than half of these patients had autoimmune disorders, including multiple sclerosis, Sjögren's disease, Systemic Lupus Erythematosus, Behçet's disease, autoimmune vasculitis, and antiphospholipid antibody syndrome. We speculate that stabbing headache may develop as a result of neuroinflammation and, at least in some cases, may be an epiphenomenon of focal demyelinating lesions of the upper or lower brain stem.     

Posterior resection for childhood lesional epilepsy: neuropsychological evolution

The aim of this study was to provide information on the neuropsychological evolution of children with symptomatic epilepsy who have undergone surgical resection of posterior (occipitoparietal) lesions. Twelve children with epilepsy with parietal and/or occipital lesions were enrolled in the study and followed after surgical resection: full clinical and epileptic examinations were performed before and after surgery, as was a neuropsychological study of both general and specific cognitive abilities. Epilepsy evolution was generally good (Engel classification IA in nine cases) with persistent selective neurological impairments (eye field defects, sensory unilateral spatial neglect) in some cases, consistent with the lesion site. Neuropsychological defects before surgery in the absence of refractory epilepsy were minimal with a normal global cognitive competence; yet, the relatively low performance scores with some impairment of specific cognitive skills were strictly correlated with defects in visual perceptive skills in both right- and left-sided lesions. Surgery seems to have improved performance abilities, whereas other abnormal specific skills did not change with the exception of working memory that in some cases was defective before surgery and normalized after lesion removal. Our study in this particular cohort of children with epileptogenic occipitoparietal lesions thus confirmed a trend toward a benign epileptic and neurodevelopmental outcome after surgical resection of the lesion.     

A meta-analysis of the cross-cultural psychometric properties of the Social Phobia and Anxiety Inventory for Children (SPAI-C)

Several studies have found that the Social Phobia and Anxiety Inventory for Children (SPAI-C), an empirically derived self-report instrument to assess DSM-IV social phobia in childhood and adolescence, has good psychometric properties. While these findings were replicated across different cultures, the overall strength of the psychometric properties of the SPAI-C remains unknown. We assessed the validity of the SPAI-C by meta-analytic techniques across studies collected from PubMed, PsycInfo and Eric databases, conducted in different countries, among subjects of different age, and sex. A total of 21 articles were retained, predominantly from Europe and North America. We found that the psychometric properties based on Cronbach alpha, mean score differences between sexes, and construct validity, were robust for the SPAI-C scale. Girls scored significantly higher than boys, and geographical differences played a moderating effect on sex-related score differences. These results further support the SPAI-C as an instrument to identify Social Phobia in youth.     

Estrogen receptors and type 1 metabotropic glutamate receptors are interdependent in protecting cortical neurons against β-amyloid toxicity

We examined the interaction between estrogen receptors (ERs) and type 1 metabotropic glutamate receptors (mGlu1 receptors) in mechanisms of neurodegeneration/neuroprotection using mixed cultures of cortical cells challenged with β-amyloid peptide. Both receptors were present in neurons, whereas only ERα but not mGlu1 receptors were found in astrocytes. Addition of 17β-estradiol (17βE2) protected cultured neurons against amyloid toxicity, and its action was mimicked by the selective ERα agonist, 1,3,5-tris(4-hydroxyphenyl)-4-propyl-1H-pyrazole (PPT) as well as by a cell-impermeable bovine serum albumin conjugate of 17βE2. The selective ERβ agonist, diarylpropionitrile (DPN), was only slightly neuroprotective. The mGlu1/5 receptor agonist, 3,5-dihydroxyphenylglycine (DHPG), was also neuroprotective against amyloid toxicity, and its action was abolished by the mGlu1 receptor antagonist, (3,4-dihydro-2H-pyrano[2,3-b]quinolin-7-yl)-(cis-4-methoxycyclohexyl)-methanone (JNJ 16259685). Neuroprotection by 17βΕ2 or PPT (but not DPN) and DHPG was less than additive, suggesting that ERα and mGlu1 receptors activate the same pathway of cell survival. More important, neuroprotection by 17βΕ2 was abolished not only by the ER antagonist fulvestrant (ICI 182,780) but also by JNJ 16259685, and neuroprotection by DHPG was abolished by ICI 182,780. ERα and mGlu1 receptors were also interdependent in activating the phosphatidylinositol-3-kinase pathway, and pharmacological blockade of this pathway abolished neuroprotection by 17βE2, DHPG, or their combination. These data provide the first evidence that ERα and mGlu1 receptors critically interact in promoting neuroprotection, information that should be taken into account when the impact of estrogen on neurodegeneration associated with central nervous system disorders is examined.     

A Genetically Informed Study of the Covariation Between the CBCL/6-18 DSM-Oriented Problem Scales and the Competence Scales

In 398 twin pairs belonging to the population-based Italian Registry, we investigated by the monozygotic twin intrapair differences model and bivariate designs whether the phenotypic correlations between CBCL/6–18 problem behaviours and competencies could better be accounted for by direct, causal effects, or by the presence of latent etiological factors, acting simultaneously as elements of risk/protection for psychopathology and competencies. All zero-order correlations between six CBCL DSM-oriented scales (DOS) and three competence scales (CS) were negative and small-to-moderate. After implementing multiple regressions we found robust enough prediction only for ADH DOS on school CS, and for anxiety DOS on social CS. Results from the intrapair differences model indicated shared elements of liability, rather than direct causation, as more likely explanations for the negative phenotypic correlations between these emotional/behavioural problem and competencies scores. Bivariate analyses indicated shared genetic factors that influence simultaneously the emotional/behavioural problems and the competencies domains as the best explanations for the phenotypic covariations between DOS and CS.