The aims of this study were to identify the frequency of the risk factors for postpartum depression (PPD) listed in the Postpartum Depression Predictors Inventory-Revised (PDPI-R) during pregnancy and 1 month after delivery and to determine the predictive validity of the PDPI-R. The study used a prospective cohort design. Women completed the PDPI-R at the 3rd and the 8th months of pregnancy and at the 1st month after childbirth. Women were prospectively followed across three different time points during the postpartum using Structured Clinical Interview for DSM-IV Disorders to determine the presence of major or minor depression. The prenatal version of the PDPI-R administered at two different time points during pregnancy predicted accurately 72.6% and 78.2% of PPD and the full version administered at the 1st month after delivery predicted 83.4% of PPD. The cutoffs identified were 3.5 for the prenatal version and 5.5 for the full version. The PDPI-R is a useful and a valid screening tool for PPD.

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Background: An increased risk of manic episodes has been reported in patients with neurodegenerative disorders, but the clinical features of bipolar disorder (BD) in different subtypes of dementia have not been thoroughly investigated. Objectives: The main aim of this study is systematically review clinical and therapeutic evidence about manic syndromes in patients with Alzheimer’s disease (AD), vascular dementia (VD), and frontotemporal dementia (FTD). Since manic-mixed episodes have been associated with negative outcomes in patients with dementia and often require medical intervention, we also critically summarized selected studies with relevance for the treatment of mania in patients with cognitive decline. Methods: A systematic review of the literature was conducted according to PRISMA guidelines. PubMed, Scopus and Web of Science databases were searched up to February 2022. Sixty-one articles on patients with AD, VaD or FTD and BD or (hypo)mania have been included. Results: Manic symptoms seem to be associated with disease progression in AD, have a greatly variable temporal relationship with cognitive decline in VaD, and frequently coincides with or precedes cognitive impairment in FTD. Overall, mood stabilizers and electroconvulsive therapy may be the most effective treatments, while the benefits of short-term treatment with antipsychotic agents must be balanced with the associated risks. Importantly, low-dose lithium salts may exert a neuroprotective activity in patients with AD. Conclusion: Prevalence, clinical features and treatment response to pharmacotherapy of manic syndromes in patients with dementia may be differentially affected by the nature of the underlying neurodegenerative conditions.

Introduction: After the recognition of the efficacy of cod–liver oil in rickets at the end of the eighteenth century, and the isolation and synthesis of the liposoluble vitamin D in 1931, its mode of actions and functions were deepened. Biochemical studies permitted to identify five forms of vitamin D, called D1, D2, D3, D4 and D5 differing in ultrastructural conformation and origin, with vitamin D2 (ergocalciferol) and D3 (cholecalciferol) representing the active forms. In the last decades especially, a constantly increasing bulk of data highlighted how vitamin D could regulate several activities and processes. Aims: The aim of the present papers is at reviewing and commenting on literature on vitamin D, with a focus on its possible role in the pathophysiology of neuropsychiatric disorders. Discussion: Available literature indicates that vitamin D regulates a variety of processes in humans and in the central nervous system. Vitamin D deficiency is associated with enhanced pro-inflammatory state, increased formation of Aβ oligomers that might contribute to the cognitive decline typical of the elderly age and, perhaps, dementias. More in general, vitamin D is supposed to play a crucial role in neuro-inflammation processes that are currently hypothesized to be involved in the pathophysiology of different psychiatric disorders, such as major depression, bipolar disorders, obsessive–compulsive disorders and psychosis. Conclusions: It is conceivable that vitamin D supplementation might pave the way towards “natural” treatments of a broad range of neuropsychiatric disorders, or at least be useful to boost pharmacological response in resistant cases.

The aim of this study was to compare treatment adherence and tolerability of different lithium formulations in 70 bipolar patients receiving lithium therapy for the first time. During the 1-year follow-up, information was collected regarding patient's clinical course, therapeutic adherence, side effects of the treatment and serum levels of lithium, creatinine and thyroid-stimulating hormone. At baseline, 30 patients (43%) were on prolonged-release lithium formulations and 40 (57%) on immediate-release formulations. At the final evaluation, 37 patients (53%) were considered lost to follow-up. Both prolongedand immediate-release patients showed significant improvement in the Functioning Assessment Short Test and in the Clinical Global Impressions for Bipolar Disorder scores during the follow-up. At the first follow-up visit, the mean plasma lithium level of prolonged-release patients was higher than immediate-release patients (0.61 vs. 0.47, respectively; P = 0.063), as well as the therapeutic adherence (85 vs. 64%, respectively; P = 0.089). Fine tremor and gastrointestinal symptoms were more frequent in immediate-release patients than in prolonged-release patients at each follow-up visit, with the sole exception of gastrointestinal symptoms at the last evaluation. Prolonged-release lithium therapy could provide potential advantages over immediate-release formulations. Future naturalistic studies and clinical trials with a longer follow-up duration are needed.

Zolpidem is a non-benzodiazepine agent used for short-term treatment of insomnia. Several cases of dependence and withdrawal from zolpidem are reported in the literature. Furthermore, involuntary movements after prolonged zolpidem misuse have been described. In this case report, a 69-year-old Italian woman with no history of diagnosed psychiatric or neurologic diseases developed uncontrolled movements and a depressive-anxious syndrome after twelve-year zolpidem misuse. The underlying mechanisms of involuntary movements occurring after long-term zolpidem intake are unknown; yet, we suggest that zolpidem might induce an increase in dopamine release through inhibition of gamma-aminobutyric acid neurons tonically suppressing dopamine cells. Future studies on the occurrence of persistent disorders after long-term benzodiazepine or Z-drug abuse are needed and clinicians should pay attention to the risk of tardive syndromes related to zolpidem misuse, especially in the case of long-term intake of over-therapeutic dosages.

Background and Aims:After the development of the Postpartum Depression Predictors Inventory-Revised (PDPI-R) only one study was conducted to determine the predictive validity of the Prenatal and Full Versions of the instrument. However this study did not succeed in identifying the cut-off for the Full Version.We aimed to determine the predictive validity of the PDPI-R as a screening instrument for post-partum depression (PPD).Methods:Women completed the PDPI-R at the 3rd month of pregnancy and at the 1st month after childbirth. PPD symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) at multiple time points during pregnancy and during the post-partum. When the EPDS score was ≥13, a Structured Clinical Interview for DSM-IV Disorders was conducted to determine whether criteria for depression were met.Results:The Prenatal and Full Versions of the PDPI-R predicted accurately 80.3% and 88.2% of PPD. The Prenatal PDPI-R yielded a sensitivity of .72 and a specificity of .74 at a cut-off score of 4.5, while the Full version yielded a sensitivity of .83 and a specificity ConclusionsThe PDPI-R is a useful and valid screener for PPD.

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