Safety evaluation of a multiallergen immunotherapy treatment in polyallergic patients. APOLO observational study

Aim: Assessment of safety, tolerability and changes in global clinical impression with an multiallergen immunotherapy treatment without dilutional effect in polyallergic patients. Patients & methods: This observational prospective study included patients with allergic rhinitis-rhinoconjunctivitis with or without asthma between 5 and 60 years old receiving immunotherapy treatment with a mixture of two allergenic sources. All adverse events were recorded. Global clinical impression, tolerability subjective assessment and satisfaction were also assessed. Results: 130 patients were analyzed. Nine clinically relevant local adverse reactions were reported in six patients (4.6%). Six systemic reactions (grades 0–I) occurred in four patients (3.1%). Patients improved significantly in their global clinical impression. Good tolerability subjective assessment and satisfaction values were also observed. Conclusion: This multiallergen immunotherapy treatment without dilutional effect can be considered as a potential therapeutic alternative for polyallergic patients suffering from allergic rhinitis.

Neurocognitive predictors of functional outcome in patients with bipolar disorder

IntroductionNeurocognitive deficits are known as a core feature in bipolar disorder (BPD). Persisting neurocognitive impairment is associated with low self-reported quality of life and low psychosocial functioning. Current findings indicate the importance of adjunctive psychosocial interventions in the treatment of BPD patients to enhance symptomatic and functional outcome.ObjectivesTo assess whether functional outcome in patients with BPD is affected by cognitive psychoeducational therapy, clinical parameters and cognitive impairment.AimsTo identify potential predictors of functional outcome, global clinical impression and early recurrence in patients with BPD.MethodsUsing a neurocognitive test battery 43 patients with BPD in euthymic state were compared to 40 healthy controls. Patients were assigned to two treatment Conditions cognitive psychoeducational therapy over 14 weeks (n = 19, 12 female, age) and treatment-as-usual (n = 24, 14 female). Predictors for functional disability, global clinical impression and early recurrence including clinical and cognitive variables as well as treatment conditions were examined using logistic regression.ResultsCompared to healthy controls patients with BPD showed lower performance in executive function (p < 0.01) and sustained attention (p < 0.001). Cognitive psychoeducation (p < 0.05) and subthreshold depressive symptoms (p < 0.05) were predictors for occupational functioning. Age (p < 0.05), delayed verbal memory (p < 0.05) and word fluency (p < 0.05) predicted global clinical impression. Recurrence in the follow-up period of 12 months was predicted by delayed verbal memory (p < 0.05).ConclusionsPatients with BPD seem to benefit from cognitive psychoeducational training mainly in areas of working life. The extent of cognitive impairment appears to impact clinical outcome and recurrence rate.

Insight in obsessive–compulsive disorder: a study of an Italian sample

SummaryInsight is a complex phenomenon that can be interpreted according to a dimensional model. Given the controversial data of insight in obsessive–compulsive disorder (OCD), our study aimed to investigate insight in an Italian sample of patients with OCD by means of the specific item on the Yale–Brown obsessive–compulsive scale (Y-BOCS) and to explore the possible correlations between it and clinical features. One hundred and seventeen out-patients with a DSM-IV diagnosis of OCD and different comorbid psychiatric disorders were included in the study and assessed by means of the Y-BOCS, Hamilton rating scale for depression (HRSD) and the global clinical impression. The results showed that almost 50% of the patients had an excellent level of insight and 15% had a little or no insight. No correlation between levels of insight and clinical features was observed, except for a negative trend with the presence of somatic obsessions. In addition, a trend towards a lower level of insight was observed in those bipolar patients with a positive history of repeated manic or hypomanic episodes. Further studies seem to be necessary in order to establish whether or not OCD patients with poor insight represent a distinct sub-group of patients.

Essai Clinique De La Mesoridazine (TPS-23) Chez Des Patients Psychotiques

Mesoridazine (TPS-23), a derivative of thioridazine, has been tried on twenty male psychotic patients with doses varying from 125 to 600 mg per day for a period of about two months. Modified BPRS and global clinical impression were our basis for evaluation of results. The improvement consisted mainly in a reduction of anxiety and symptoms related to it, particularly affective participation to delusions, also better attitude of the patient to his interviewers and other patients, considering that the most distinct symptoms of schizophrenic dissociation were not affected. Secondary effects were frequent, but moderate; frequency of extra-pyramidal effects impressed us, contrarily to most preceding researches. N.B.—Among twenty patients treated, ten had been receiving a neuroleptic medication for ten years without noticeable improvement.