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Are there any differences in clinical and biochemical variables between bipolar patients with or without lifetime psychotic symptoms?
- C. M. Esposito, A. Ceresa, M. Di Paolo, T. Surace, L. Moioli, F. Legnani, G. Nosari, V. Ciappolino, A. M. Auxilia, M. Cappellazzi, I. Tagliabue, L. Cirella, E. Capuzzi, A. Caldiroli, A. Dekanalis, M. Clerici, M. Buoli
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S505-S506
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Introduction
Bipolar Disorder (BD) is a frequent psychiatric disorder, which can be associated with high disability. Psychotic symptoms occur in more than half of bipolar patients and are associated with an unfavorable course of the disorder (Chakrabarti et al. World J Psychiatry 2022; 12(9) 1204-1232).
ObjectivesThe aim of this study is therefore to identify clinical and biological markers able to discriminate between BD patients with (BD-PS) and without lifetime psychotic symptoms (BD-NPS) to facilitate early diagnosis and to implement a target clinical management of these patients.
MethodsWe recruited 665 patients consecutively hospitalized for BD at Fondazione IRCCS Policlinico (Milan) and at San Gerardo Hospital (Monza). Data were obtained through a screening of the clinical charts and blood analyses conducted during the hospitalization. Patients were assessed by psychometric scales. The two groups (BD-PS and BD-NPS) were compared by t tests for quantitative variables and χ2 tests for qualitative ones. Variables that resulted to be significant in univariate analyses were inserted in binary logistic models with the presence of psychotic symptoms as dependent variable.
ResultsAmong the total sample, 64.5% of patients were affected by BD-PS while 35.5% by BD-NPS. The final binary logistic regression model showed that, compared to patients with BD-NPS, those with BD-PS had a longer duration of hospitalization (p=0.007) and were more frequently hospitalized for a manic episode (p=0.001). In addition, subjects with BD-PS had a lower score on the current Global Assessment of Functioning (GAF) (t = 3.157; p = 0.002) and were more frequently males (χ² = 4.061; p = 0.044; OR = 1.399). With regard to biological variables, patients with BD-PS, compared to the counterpart, had a higher Neutrophile to Lymphocyte Ratio (NLR) (t = 2.776; p = 0.006), lower levels of Gamma-Glutamyl Transferase (γGT) (t = 2.249; p = 0.026), higher total bilirubin (t = 2.348; p = 0.019) and creatine phosphokinase (CPK) (t=2.807; p = 0.005), lower total cholesterol (t = 2.369; p = 0.018) and triglycerides (t = 2.554; p = 0.013).
ConclusionsOur data appear to be in line with the literature, especially with respect to the occurrence of psychotic symptoms mainly in manic episodes and their association with greater clinical severity, longer hospitalization and worse outcome (Altamura et al. Aust N Z J Psychiatry 2019; 53(8) 772-781). From a biological point of view, it seems important to emphasize that patients with lifetime psychotic symptoms presented a higher NLR, revealing more prominent low-grade inflammation in these patients than the counterpart. These data confirm the possibility of using NLR as biomarker of severity in bipolar patients, as proposed previously by other authors (Kulacaoglu et al. Nord J Psychiatry 2022). Future multi-center study have to confirm the results of the present study.
Disclosure of InterestNone Declared
Clinical and biochemical parameters associated with substance-induced psychotic disorder: which differences between alcohol, cannabis and psychostimulants
- G. Nosari, A. Ceresa, M. Di Paolo, C. M. Esposito, V. Ciappolino, A. Calabrese, F. Legnani, A. M. Auxilia, M. Capellazzi, I. Tagliabue, L. Cirella, E. Capuzzi, A. Caldiroli, A. Dakanalis, M. Clerici, M. Buoli
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S514-S515
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Introduction
According to DSM V, substance-induced psychotic disorder is a mental health condition in which the onset of psychotic symptoms can be traced to the use of a psychotropic substance. The pathogenesis of this disease is still poorly understood; current literature traces its causes back to genetic predisposition and early traumatic events (i.e. child abuse).
ObjectivesThe present study aims to identify specific clinical features and biochemical markers which could be addressed as predictors for the long-term prognosis of this disease. Moreover, we aim to identify specific correlations between the clinical phenotype and the underlying substance abuse, in order to allow the early start of a tailored treatment.
MethodsBetween 2020 and 2022 we recruited 218 patients referring to the Policlinico Hospital in Milan and the San Gerardo Hospital in Monza, Italy. All the patients were diagnosed with substance induced psychotic disorder: 31 reported alcohol abuse (14,2%), 71 psichostimulants (32,6%), 116 cannabis, (53,2%). For each patients, we collected demographic data, medical records and a comprehensive psychometric assessment (GAF, PANSS, BPRS, Modified Sad Person Scale-MOAS). Furthermore, we collected a blood sample for dosing Na+, K+, Na+/K+, hemogram with formula and platelets, glucose , urea, creatinine, uric acid, transaminases, γGT, bilirubin, plasma proteins, albumin, LDH, CPK, PCHE, cholesterol, HDL, LDL, Tg, TSH.
ResultsChi squared test (χ²) has been used to compare qualitative variables between the 3 subgrous (alcohol-, psychostimulants- and cannabis-induced psychotic syndromes) (fig.1). One way ANOVA test has been used to compare quantitative variables between the same 3 subgroups (fig.2). After removing one of the subgropus (alcohol-induced psychotic symptoms), the same analysis have been repeated. Significant variables have been included in a binary logistic regression model in order to confirm their validity as predictors for cannabis- and psychostimulants-induced psychotic disorders (fig 3). Finally we performed Omnibus test and Hosmer-Lemeshow test in order to verify the validity of these regression models.
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ConclusionsFor each considered subgroups, we indentified the following features. Alcohol induced psychotic syndrome: higher age of onset and age of hospital admission, higher cholesterol and hurea levels, , high comorbidity with medical conditions anxiety/depression, low social functioning, higher suicidal risk;, higher hospitalization rate. Cannabis induced psychotic syndrome: higher hemoglobin and albumin levels, more severe psychiatric symtoms (BPRS), higher smoking rates. Psychostimulants induced psychotic syndrome: higher multi-drug abuse risk. We could assume that according to this consideration the treatment protocols for each of these subgroups should be tailored according to their specific features.
Disclosure of InterestNone Declared
Unconventional calibration strategies for micromanipulation work-cells
- G. Fontana, S. Ruggeri, G. Legnani, I. Fassi
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This paper presents and compares a set of calibration strategies useful to calibrate vision-based robotised work-cells for micromanipulation and microassembly. To grasp and release microparts precisely, robot calibration, camera calibration and robot-camera registration are needed. Conventional calibration methods are very onerous at the microscale, therefore, two alternative unconventional procedures, called virtual grid calibration and hybrid calibration, are developed for work-cells with high-performance robots, minimising necessary instrumentation. Moreover, an effective calibration of the robot end-effector is designed to compensate for misalignment and orientation errors with respect to the vertical rotational axis. This paper describes the calibration methods and their implementation, the results and the improvements achieved. A detailed comparison between the hybrid and the virtual grid calibrations is provided, demonstrating the higher performance of the latter strategy.