Papers by Stefano Pallanti
International Clinical Psychopharmacology, 2020
In this position statement, developed by The International College of Obsessive-Compulsive Spectr... more In this position statement, developed by The International College of Obsessive-Compulsive Spectrum Disorders, a group of international experts responds to recent developments in the evidence-based management of obsessive-compulsive disorder (OCD). The article presents those selected therapeutic advances judged to be of utmost relevance to the treatment of OCD, based on new and emerging evidence from clinical and translational science. Areas covered include refinement in the methods of clinical assessment, the importance of early intervention based on new staging models and the need to provide sustained well-being involving effective relapse prevention. The relative benefits of psychological, pharmacological and somatic treatments are reviewed and novel treatment strategies for difficult to treat OCD, including neurostimulation, as well as new areas for research such as problematic internet use, novel digital interventions, immunological therapies, pharmacogenetics and novel forms o...
CNS spectrums, May 27, 2019
Introduction: Bipolar Disorder (BD) and Obsessive Compulsive Disorder (OCD) are prevalent, comorb... more Introduction: Bipolar Disorder (BD) and Obsessive Compulsive Disorder (OCD) are prevalent, comorbid and disabling conditions, often characterized by early onset and chronic course. When comorbid, OCD and BD can determine a more pernicious course of illness, posing therapeutic challenges for clinicians. Available reports on prevalence and clinical characteristics of comorbidity between BD and OCD showed mixed results, likely depending on the primary diagnosis of analyzed samples. Methods: We assessed prevalence and clinical characteristics of BD comorbidity in a large International sample of patients with primary OCD (n=401), through the International College of Obsessive Compulsive Spectrum Disorders (ICOCS) snapshot database, by comparing OCD subjects with vs without BD comorbidity. Results: Amongst primary OCD patients, 6.2% showed comorbidity with BD. OCD patients with vs without BD comorbidity more frequently had a previous hospitalization (p<.001) and current augmentation therapies (p<.001). They also showed greater severity of OCD (p<.001), as measured by the Y-BOCS. Conclusion: These findings from a large International sample indicate that approximately 1 out of 16 patients with primary OCD may additionally have BD comorbidity along with other specific clinical characteristics, including more frequent previous hospitalizations, more complex therapeutic regimens and a greater severity of OCD. Prospective international studies are needed to confirm our findings.
F1000 - Post-publication peer review of the biomedical literature, 2008
F1000 - Post-publication peer review of the biomedical literature, 2008
Future Neurology, 2020
In schizophrenia, dopaminergic hyperactivity in the mesolimbic regions, or possibly even selectiv... more In schizophrenia, dopaminergic hyperactivity in the mesolimbic regions, or possibly even selectively so in the dorsal striatum, seems to cause the emergence of psychotic symptoms, whereas dopaminergic hypoactivity in cortical regions underlies the negative symptoms and cognitive deficits. Managing the negative symptoms is a major current challenge in the treatment of schizophrenia with a dearth of novel modalities to address this clinical issue. Cariprazine is a novel second-generation antipsychotic that specifically targets the D3 receptor mainly associated to negative symptoms. The review summarizes the main issues regarding negative symptom management and the role of cariprazine treatment.
Le malattie rare del sistema immunitario, 2013
F1000 - Post-publication peer review of the biomedical literature, 2008
Schizophrenia Research, 2010
pattern than controls. Whereas, in the link 1 the results obtained were similar to the showed by ... more pattern than controls. Whereas, in the link 1 the results obtained were similar to the showed by Hooker et al. (2000). The fact that the link 2 was preserved in schizophrenic suggests that could be efficacy the counterfactual therapy designed to increase or dramatize CFT oriented toward everyday social interactions. Regular practice with such CFT might produce improvement in social functioning.
European Psychiatry, 2009
Aims:To assess the impact of insomnia on quality of life (QoL) and functioning in patients with g... more Aims:To assess the impact of insomnia on quality of life (QoL) and functioning in patients with generalized anxiety disorder (GAD), and evaluate the efficacy of pregabalin and venlafaxine-XR in improving sleep and QoL.Methods:A double-blind trial in adults who met DSM-IV criteria for GAD, with a HAM-A total score ≥20,randomized to 8-weeks of flexible-dose treatment with pregabalin (300-600 mg/d, N=121), venlafaxine-XR (75-225 mg/d, N=125), or placebo (N=128).Results:At baseline, 64% of all subjects had insomnia (according to the Medical Outcomes Study Sleep scale [MOS]-Sleep Problems Index [SPI] criteria).While HAM-A total scores (minus the insomnia item) were similar for patients with and without baseline insomnia (25.7 vs. 25.0) those with reported significantly more impairment on the Quality of Life, Enjoyment, and Satisfaction Questionnaire (Q-LES-Q; 45.4 vs. 53.6; p< 0.0001) and Sheehan Disability Scale (SDS; 17.5 vs.14.3; p< 0.0001) than those without. At endpoint, there...
Journal of Neural Transmission, 2011
Abstract Recently, neuropathological studies have shown an important motor cortex involvement in ... more Abstract Recently, neuropathological studies have shown an important motor cortex involvement in Alzhei-mer&amp;amp;amp;amp;amp;#x27;s disease (AD), even in its early stages, despite the lack of clinically evident motor deficit. Transcranial mag-netic stimulation (TMS) studies have demonstrated that cortical ...
CNS Spectrums, 2016
Obsessive-compulsive disorder (OCD) has been recognized as mainly characterized by compulsivity r... more Obsessive-compulsive disorder (OCD) has been recognized as mainly characterized by compulsivity rather than anxiety and, therefore, was removed from the anxiety disorders chapter and given its own in both the American Psychiatric Association (APA)Diagnostic and Statistical Manual of Mental Disorders(DSM-5) and the Beta Draft Version of the 11th revision of the World Health Organization (WHO)International Classification of Diseases(ICD-11). This revised clustering is based on increasing evidence of common affected neurocircuits between disorders, differently from previous classification systems based on interrater agreement. In this article, we focus on the classification of obsessive-compulsive and related disorders (OCRDs), examining the differences in approach adopted by these 2 nosological systems, with particular attention to the proposed changes in the forthcoming ICD-11. At this stage, notable differences in the ICD classification are emerging from the previous revision, appar...
Objective The aim of this study was to examine the importance of psychiatric emergency (PE) educa... more Objective The aim of this study was to examine the importance of psychiatric emergency (PE) education provided to physicians, for their emergency training, the workload and the emotional load of PE compared to the other kind of emergencies, as well as to assess individual PE knowledge, the interest in PE education, and the topics of major interest in PE training. Using clinical vignettes with a brief multiple choice test we have also tested the diagnostic ability, the management and drug treatment competence for PE.
Frontiers in Psychiatry
Gambling Disorder (GD) has been recently re-classified in the DSM-5 under the “substance-related ... more Gambling Disorder (GD) has been recently re-classified in the DSM-5 under the “substance-related and addictive disorders,” in light of its genetic, endophenotypic, and phenotypic resemblances to substance dependence. Diminished control is a core defining concept of psychoactive substance dependence or addiction and has given rise to the concept of “behavioral” addictions, which are syndromes analogous to substance addiction, but with a behavioral focus other than ingestion of a psychoactive substance. The main symptom clusters are represented by loss of control, craving/withdrawal, and neglect of other areas of life, whereas in a Research Domain Criteria (RDoC) perspective, GD patients exhibit deficits in the domain of “Positive valence systems,” particularly in the “Approach motivation” and “Reward learning” constructs, as well as in the “Cognitive systems,” primarily in the “Cognitive control” construct. In the Addictions Neuroclinical Assessment (ANA), three relevant domains for ...
Psychiatric Annals
... It would clearly be valuable to improve understanding of determinants of response and separat... more ... It would clearly be valuable to improve understanding of determinants of response and separate patients into more homogeneous groups, to predict response to pharmacotherapy and de-velop more treatment ... 2. Greist JH, Jefferson JW, Kobak KA, Katzel-nick DJ, Serlin RC. ...
Epidemiologia e Psichiatria Sociale
Nell'ultimo decennio la qualita della vita ha acquisito una sempre maggiore rilevanza come mi... more Nell'ultimo decennio la qualita della vita ha acquisito una sempre maggiore rilevanza come misura di esito sociale e clinico (Katschnig, 1997) dei disturbi mentali. Vi e un ampio consenso sul fatto che il costrutto della qualita della vita è multidimensionale e comprende la percezione che il paziente ha delle relazioni sociali, della propria salute fisica, della capacità di svolgere le attivita quotidiane domestiche e lavorative e del proprio benessere in generale (Patrick & Erickson, 1988). Mentre le misure di funzionamento si propongono di quantificare la compromissione in modo oggettivo, le misure della qualita della vita valutano la capacita del soggetto di trarre soddisfazione e piacere da varie attivita e richiedono una valutazione soggettiva. La definizione di qualita della vita del Quality of Life Group dell'Organizzazione
European Radiology
To assess patients&amp;amp;#39; experience of bowel preparation and procedure for screening C... more To assess patients&amp;amp;#39; experience of bowel preparation and procedure for screening CT colonography with reduced (r-CTC) and full cathartic preparation (f-CTC) that showed similar detection rate for advanced neoplasia in a randomised trial. Six hundred seventy-four subjects undergoing r-CTC and 612 undergoing f-CTC in the SAVE trial were asked to complete two pre-examination questionnaires-(1) Life Orientation Test - Revised (LOT-R) assessing optimism and (2) bowel preparation questionnaire-and a post-examination questionnaire evaluating overall experience of CTC screening test. Items were analysed with chi-square and t test separately and pooled. LOT-R was completed by 529 (78%) of r-CTC and by 462 (75%) of f-CTC participants and bowel preparation questionnaire by 531 (79%) subjects in the r-CTC group and by 465 (76%) in the f-CTC group. Post-examination questionnaire was completed by 525 (78%) subjects in the r-CTC group and by 453 (74%) in the f-CTC group. LOT-R average score was not different between r-CTC (14.27 ± 3.66) and f-CTC (14.54 ± 3.35) (p = 0.22). In bowel preparation questionnaire, 88% of r-CTC subjects reported no preparation-related symptoms as compared to 70% of f-CTC subjects (p &amp;amp;lt; 0.001). No interference of bowel preparation with daily activities was reported in 80% of subjects in the r-CTC group as compared to 53% of subjects in the f-CTC group (p &amp;amp;lt; 0.001). In post-examination questionnaire, average scores for discomfort of the procedure were not significantly different between r-CTC (3.53 ± 0.04) and f-CTC (3.59 ± 0.04) groups (p = 0.84). Reduced bowel preparation is better tolerated than full preparation for screening CT colonography. • Reduced bowel preparation is better tolerated than full preparation for screening CT colonography. • Procedure-related discomfort of screening CT colonography is not influenced by bowel preparation. • Males tolerate bowel preparation and CT colonography screening procedure better than females.
CNS Spectrums
True progress in understanding how experience arises from the brain has been relatively slow when... more True progress in understanding how experience arises from the brain has been relatively slow when viewed from a historical perspective. Recently, several technologies to study and stimulate the brain have been applied to this field of inquiry. Such progress was made only 2,500 years after the ancient Greek philosopher Parmenides first adopted a technical procedure involving the application of formal logic instruments to explore the perception of experiences. At the phenomenological level, consciousness has been referred to as “what vanishes every night when we fall into dreamless sleep and reappears when we wake up or when we dream. It is also all we are and all we have: lose consciousness and, as far as you are concerned, your own self, and the entire world dissolves into nothingness”. According to the integrated information theory, consciousness is integrated information. The term “consciousness” therefore has two key senses: wakefulness and awareness. Wakefulness is a state of co...
International journal of psychiatry in clinical practice, 2017
Obsessive-Compulsive Disorder (OCD) and Tic Disorder (TD) are highly disabling and often comorbid... more Obsessive-Compulsive Disorder (OCD) and Tic Disorder (TD) are highly disabling and often comorbid conditions. Of note, the DSM-5 acknowledged a new 'tic-related' specifier for OCD, which might be referred to as Obsessive-Compulsive Tic Disorder (OCTD), raising new interest toward a better clinical characterisation of affected patients. Available literature indicates that early onset, male gender, sensory phenomena and obsessions of symmetry, aggressiveness, hoarding, exactness and sounds as well as comorbidity with Attention Deficit Hyperactivity Disorder (ADHD) may be of more frequent observation in patients with OCTD. In order to share expertise in the field from different perspectives, a multidisciplinary panel of Italian clinicians, specifically involved in the clinical care of OCD and TD patients, participated into a consensus initiative, aimed to produce a shared document. As a result, after having examined the most relevant literature, authors sought to critically ide...
International journal of psychiatry in clinical practice, 2017
&#39;Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections... more &#39;Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections&#39; (PANDAS) identified a unique subgroup of patients with abrupt onset of obsessive compulsive disorder (OCD) symptoms clinically related to Streptococcus infection and accompanied by neuropsychological and motor symptoms. After almost 20 years, PANDAS has not been accepted as distinct disorder and new criteria for paediatric acute-onset neuropsychiatric syndrome (PANS) have been replaced it, highlighting the fact that several agents rather than only Streptococcus might be involved. Extensive review of the PANDAS/PANS literature was performed on PubMed. Although antibiotics have been reported to be effective for acute and prophylactic phases in several uncontrolled studies and non-steroidal anti-inflammatory drugs (NSAID) are used during exacerbations, clinical multicenter trials are still missing. Selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioural therapy (CBT) are still the first line of recommendation for acute onset OCD spectrum. Immunological therapies should be restricted to a few cases. While PANDAS has found no confirmation as a distinct syndrome, and it is not presented in DSM-5, patients with acute onset OCD spectrum, neurocognitive and motor symptoms should be evaluated for inflammatory, infective, immunological and metabolic abnormalities with a comprehensive diagnostic algorithm.
Uploads
Papers by Stefano Pallanti