Clinical Neuropsychiatry最新文献

{"title":"Does Dysregulation Of The Indirect Pathway Contribute To The Pathophysiology Of Catatonia Through Neurotransmitter Imbalance?","authors":"Pegah Seif","doi":"10.36131/cnfioritieditore20250306","DOIUrl":"10.36131/cnfioritieditore20250306","url":null,"abstract":"<p><strong>Objective: </strong>Catatonia is a complex neuropsychiatric syndrome characterized by motor, cognitive, and emotional disturbances, affecting approximately 7-38% of psychiatric inpatients. Despite its prevalence, it is frequently underrecognized in clinical practice. The objective of this narrative review is to explore the hypothesis that dysfunction of the basal ganglia's indirect pathway-mediated by neurotransmitter imbalances-plays a central role in the pathophysiology of catatonia.</p><p><strong>Method: </strong>This narrative review synthesized clinical, neuroimaging, and preclinical studies identified through PubMed, Embase, and PsycINFO (1980-April 2025) using terms related to catatonia, basal ganglia pathways, and neurotransmitters. Studies on GABA, dopamine, glutamate, serotonin, and acetylcholine in catatonia or indirect pathway function were included. Findings were conceptually integrated to link neurotransmitter dysregulation with catatonic features, considering age-related effects and circuit models.</p><p><strong>Results: </strong>Evidence indicates that impaired inhibitory control within the indirect pathway is a core mechanism underlying catatonia. Key findings include reduced GABAergic tone, dopamine D2 receptor dysfunction, glutamatergic hyperactivity, and altered serotonergic and cholinergic modulation. These disruptions collectively contribute to clinical features such as stupor, rigidity, and stereotypies. While benzodiazepines, which enhance GABA-A receptor activity, remain the first-line treatment, preliminary evidence suggests that NMDA antagonists, dopamine agonists, and serotonergic/cholinergic modulators may also offer therapeutic benefits, though these are not yet widely implemented.</p><p><strong>Conclusions: </strong>By integrating neurocircuit-based models with observed clinical phenomena, this review proposes a unifying framework to understand the neural basis of catatonia. Clarifying the role of indirect pathway dysfunction could support the development of targeted, mechanism-based interventions, ultimately improving recognition and treatment outcomes for this often-debilitating syndrome.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 3","pages":"229-242"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Too Good to be True\": An Explorative Study of Photo Manipulation, Body Image Dissatisfaction and Critical Thinking.","authors":"Amelia Rizzo, Martina Barbera, Fuat Aydoğdu, Müge Akbağ","doi":"10.36131/cnfioritieditore20250307","DOIUrl":"10.36131/cnfioritieditore20250307","url":null,"abstract":"<p><strong>Objective: </strong>Several studies have demonstrated an increase in body dissatisfaction following the use of photo filters; however, the role of intervening factors such as critical thinking has often been overlooked. The aim of this research was to investigate the relationships between photographic manipulation, body dissatisfaction, and critical thinking, taking into account the mediating role of critical thinking.</p><p><strong>Method: </strong>A convenience sample of 500 Italian-speaking subjects (44% male; 56% female) aged between 18 and 60 years (Mage = 25.7; SD = 17.8) participated at the study. The instruments used were: (1) the Revised Photo Manipulation Scale; (2) the Body Uneasiness Test; (3) the Fake Subscale of the Critical Processing of Beauty Images Scale; (4) a specifically constructed task for recognizing photographic manipulation (5) three control questions.</p><p><strong>Results: </strong>The results obtained show a positive relationship between the use of photo manipulation and body image dissatisfaction. Critical thinking has a partial mediating role in the relationship between body image dissatisfaction and photo manipulation.</p><p><strong>Conclusions: </strong>To delve deeper into the findings, the participants' ability to correctly classify natural and filtered photos have been described. Clinical and research implications are discussed.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 3","pages":"243-252"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Characteristics, Services And Outcome Indicators Of Global Functioning In Adults With Autism Spectrum Disorders: Insights From A Group Of 503 Patients.","authors":"Nobile Emanuela, Cicinelli Giovanni, De Bartolo Elisa, Brambilla Romeo, Brighenti Stefania, Keller Roberto","doi":"10.36131/cnfioritieditore20250303","DOIUrl":"10.36131/cnfioritieditore20250303","url":null,"abstract":"<p><strong>Objective: </strong>Autism Spectrum Disorders are neurodevelopmental disorders characterized by persistent communication and social interaction challenges, restricted and repetitive behaviours and interests. The severity of ASD symptoms varies widely, influencing an individual's functioning throughout their lifespan. Various external contextual factors can further modulate these symptoms and their impact on overall functioning. The primary purpose of this study is to investigate global functioning as well as the types of services, interventions and therapies that subjects with ASD in adulthood have experienced throughout their lives. Additionally, we collected data to analyze and identify factors that impact outcomes for subjects with ASD.</p><p><strong>Method: </strong>A total of 503 subjects with ASD in adulthood, along with their families and clinicians, were interviewed to collect comprehensive data on demographic, clinical, and functional variables. Data were analyzed using regression models to identify factors independently associated with global functioning, measured through the Global Assessment of Functioning (GAF) scale.</p><p><strong>Results: </strong>We identified internal and external factors that significantly impacted the global functioning of ASD people.The analysis identified multiple factors significantly affecting global functioning, including levels of communication, psychiatric comorbidities, social relationships, use of interventions, and living and employment status. The study highlights the critical role of both individual and contextual elements in shaping outcomes.</p><p><strong>Conclusions: </strong>Our study represents an exploratory investigation of outcomes for ASD adults. It underscores the importance of personalized and targeted interventions to improve the quality of life and overall functioning of subjects with ASD in adulthood. The findings advocate for further research to address gaps in understanding and to design interventions tailored to diverse needs.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 3","pages":"196-206"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Comorbidities in Alzheimer's Disease: An Autopsy Confirmed Study with a Focus on Sex-Differences?","authors":"Antonina Luca, Maria Luca, Raffaele Ferri, Marco Barbanti, Roberta Malaguarnera, Basilio Pecorino, Paolo Scollo, Alessandro Serretti","doi":"10.36131/cnfioritieditore20250304","DOIUrl":"10.36131/cnfioritieditore20250304","url":null,"abstract":"<p><strong>Objective: </strong>Systemic comorbidities are common in Alzheimer's disease (AD) and may influence disease progression, severity, and management. Aim of the study was to assess the prevalence of comorbid medical conditions in a large cohort of AD patients, focusing on sex differences.</p><p><strong>Method: </strong>AD patients from the NIMH Alzheimer Disease Genetics Initiative were enrolled. Data on multimorbidity, demographics, disease characteristics, and clinical assessments were collected from interviews, medical records, and examinations. Univariate and multivariate logistic regression models were performed to identify possible associations between comorbidities and sex. Subgroup analysis was performed for patients with autopsy-confirmed AD.</p><p><strong>Results: </strong>Four hundred and twenty-four AD patients (295 women; mean age: 78.4±8.3 years) were included. Men had a higher prevalence of heart disease, diabetes, chronic obstructive pulmonary disease and smoking, whereas thyroid disease, hypertension and depression were more common in women (all p<0.05). Except for hypertension, all associations found in the univariate analysis were confirmed in the multivariate analysis after adjustment for age. Subgroup analysis of autopsy-confirmed cases confirmed these findings.</p><p><strong>Conclusions: </strong>Our findings support the importance of considering sex-specific comorbidities in AD for precision medicine and emphasize the need for comprehensive assessment of comorbidities to improve clinical outcomes, treatment strategies and health equity.nt.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 3","pages":"207-214"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observing the Influence of Shame and Guilt in Inflammatory Bowel Disease: A Systematic Review.","authors":"Marco Cannavò, Rocco Spagnuolo, Janine Gullo, Nadia Barberis","doi":"10.36131/cnfioritieditore20250302","DOIUrl":"10.36131/cnfioritieditore20250302","url":null,"abstract":"<p><strong>Objective: </strong>Inflammatory Bowel Disease (IBD) is a gastrointestinal condition that significantly impacts individuals' psychosocial functioning. Accumulating evidence from psychosomatic research shows how self-conscious emotions may influence various levels of adaptation to the condition. The current systematic review aims to encompass studies that have already assessed the role of Shame and Guilt in individuals with IBD.</p><p><strong>Method: </strong>Academic databases were screened to collect studies that met the criteria coded by the authors. 15 studies met the inclusion criteria, and their quality was assessed. Data were categorized as follows: (1) general description of methodology and measures; (2) characteristics of the study samples; (3) shame and guilt in individuals with IBD.</p><p><strong>Results: </strong>Findings from the current systematic review emphasize that Shame and Guilt are prevalent among individuals suffering from IBD and that they may contribute to the development of maladaptive behavioral and cognitive patterns.</p><p><strong>Conclusions: </strong>Clinical interventions should assess the presence of these self-conscious emotions and target them to improve clinical efficacy.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 3","pages":"185-195"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Diagnostic Stability of Autism Before the Concept of Spectrum: An Italian Hub-Center Experience.","authors":"Valentina Iannuzzi, Virginia Giuberti, Debora Formisano, Michele Poletti","doi":"10.36131/cnfioritieditore20250202","DOIUrl":"10.36131/cnfioritieditore20250202","url":null,"abstract":"<p><strong>Objective: </strong>The diagnosis of autism is considered more longitudinally stable compared to other diagnoses for children and adolescents, although significant heterogeneity in longitudinal outcomes emerges between studies based on temporal intervals and diagnostic instruments. The introduction of the concept of Autism Spectrum Disorder (ASD) by DSM-5 may have impacted diagnostic stability. The current study aimed to investigate the longitudinal diagnostic stability of different diagnoses of autism according to the ICD-10 diagnostic system before the institutional move towards the utilization of a unique ASD diagnosis according to DSM-5.</p><p><strong>Method: </strong>A retrospective study based on medical records and the ELEA electronic database was performed on children attending the Autism Center of the Child and Adolescent Mental Health Service of the Azienda USL-IRCCS, Reggio Emilia, Italy, from January 1, 2005, to December 31, 2015. Diagnostic stability was evaluated according to the diagnosis at follow-up, which was set at 10 years from baseline or December 31, 2020.</p><p><strong>Results: </strong>A total of 380 children were included at baseline, and 341 were included at follow-up (with a mean temporal interval of 8.74 ± 2.7 years). Among them, 251 individuals maintained a diagnosis within the F84 spectrum, resulting in a diagnostic stability of 73.6%. Specifically, diagnostic stability was 79.8% for the F84.0 diagnosis and 68.2% for the F84.9 diagnosis.</p><p><strong>Conclusions: </strong>Before the adoption of DSM-5 diagnostic criteria for ASD, ICD-10 diagnoses related to autism were relatively stable in the long run, with an 8-year follow-up. The next step is to assess the longitudinal diagnostic stability of ASD after the adoption of DSM-5 criteria.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 2","pages":"121-124"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capgras Syndrome in Popular Media: A Cinematic Exploration in Kinds of Kindness (2024).","authors":"Francesco Brigo","doi":"10.36131/cnfioritieditore20250207","DOIUrl":"10.36131/cnfioritieditore20250207","url":null,"abstract":"","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 2","pages":"165-166"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metacognition and Personality Functioning Levels as Mediators Between Maladaptive Personality Traits and Risk of Gambling Problems in a Non-Clinical Sample.","authors":"Roberto Pedone","doi":"10.36131/cnfioritieditore20250205","DOIUrl":"10.36131/cnfioritieditore20250205","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the role of metacognition and personality functioning levels as mediators in the relationship between maladaptive personality traits and the risk of problematic gambling (PG) within a non-clinical adult sample.</p><p><strong>Method: </strong>A cross-sectional design was employed with 619 participants who completed self-report questionnaires assessing maladaptive personality traits, metacognitive abilities, personality functioning levels, and gambling-related behaviors. Instruments included the South Oaks Gambling Screen, the Assessment of DSM-IV Personality Disorders, the Metacognition Self-Assessment Scale, and the Levels of Personality Functioning Scale-Self Report. Data were analyzed using linear regression and serial mediation analyses.</p><p><strong>Results: </strong>The findings revealed that the risk of PG was positively associated with maladaptive personality traits, particularly Antisocial, Narcissistic, and Borderline traits, and negatively associated with metacognitive abilities and personality functioning levels. Serial mediation analyses demonstrated that metacognitive functions, especially Critical Distance and Self-Reflexivity, along with personality functioning levels, mediated the relationship between maladaptive personality traits and PG risk. Notably, in individuals with pronounced Cluster B traits, metacognition alone served as the primary mediator, while in those with Cluster C traits, the mediation effect involved both metacognitive abilities and personality functioning levels, indicating a dual mediation pathway. These findings highlight distinct mechanisms across personality profiles.</p><p><strong>Conclusions: </strong>The results underscore the critical role of metacognition and personality functioning in linking maladaptive personality traits to the risk of PG. Clinically, these findings suggest that interventions enhancing specific metacognitive abilities, such as perspective-taking and self-reflection, along with addressing impairments in personality functioning, could mitigate the risk of problematic gambling. These insights contribute to the development of tailored therapeutic strategies for preventing and managing gambling-related behaviors in at-risk populations.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 2","pages":"149-159"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Exploratory Structural Equation Modeling Approach for the Narcissistic Personality Inventory: Support for the NPI-13 Brief Version and Evidence Based on Relations to Other Variables.","authors":"Rossella Bottaro, Giuseppe Craparo, Palmira Faraci","doi":"10.36131/cnfioritieditore20250203","DOIUrl":"10.36131/cnfioritieditore20250203","url":null,"abstract":"<p><strong>Objective: </strong>The Narcissistic Personality Inventory (NPI) is the most commonly used psychometric instrument for assessing narcissistic traits in the general population. Despite its widespread adoption, various factorial structures have been proposed. The present study aimed to provide new evidence for the NPI factorial solution using the not-yet-explored Exploratory Structural Equation Modeling (ESEM) approach and to improve understanding of its relationship with other variables.<i>Method</i>:We administered the NPI along with measures of anxiety, depression, stress, self-esteem, and loneliness to 583 participants (50.8% male, M age = 30.96, SD = 12.12) in a survey online. We compared confirmatory factor analyses and ESEMs for both the long and brief versions.</p><p><strong>Results: </strong>The NPI-13 ESEM model was the optimal fitting model (ꭓ2=72.060, df = 42, CFI = 0.979, TLI = 0.961, RMSEA = .035 [.021-.049]) also for its bifactorial solution. Moreover, our findings supported the evidence based on relations to other variables for the NPI-13.</p><p><strong>Conclusions: </strong>In conclusion, our results argued the use of a multidimensional brief version of the NPI and supported the ESEM's advantages for explaining the factorial structure of complex psychological constructs.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 2","pages":"125-140"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive Short-Term Dynamic Psychotherapy for Functional Somatic Disorders: A Scoping Review.","authors":"Allan Abbass, Behnia Haghiri","doi":"10.36131/cnfioritieditore20250201","DOIUrl":"10.36131/cnfioritieditore20250201","url":null,"abstract":"<p><strong>Objective: </strong>Functional somatic disorders (FSD) are extremely common amongst neuropsychiatric and other specialty medicine referrals. Intensive Short-term Dynamic Psychotherapy (ISTDP) is an emotionally focused form of brief therapy that has been researched and developed specifically for the diagnostic assessment and treatment of FSD, amongst other conditions.</p><p><strong>Method: </strong>In this publication, we review the ISTDP theoretical underpinnings, the diagnostic assessment, treatment approach and evidence base.</p><p><strong>Results: </strong>There are now over 50 publications evaluating ISTDP and its effect and processes in FSD. It has been demonstrated efficacious for the spectrum of functional somatic disorders, including chronic pain, functional gastrointestinal disorders, and functional neurological disorders among others. It has further been found more effective than cognitive behavioral therapy in the treatment of chronic pain. Further there is evidence that it is cost-effective in treating these conditions.</p><p><strong>Conclusions: </strong>ISTDP is a broadly useful clinical tool in the assessment and treatment of FSD.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 2","pages":"111-120"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}