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        The Burden of Agoraphobia in Worsening Quality of Life in a Community Survey in Italy

        Antonio Preti,Martina Piras,Giulia Cossu,Elisa Pintus,Mirra Pintus,Goce Kalcev,Federico Cabras,Maria Francesca Moro,Ferdinando Romano,Matteo Balestrieri,Filippo Caraci,Liliana Dell’Osso,Guido Di Scias 대한신경정신의학회 2021 PSYCHIATRY INVESTIGATION Vol.18 No.4

        Objective Current nosology redefined agoraphobia as an autonomous diagnosis distinct from panic disorder. We investigated the life-time prevalence of agoraphobia, its association with other mental disorders, and its impact on the health-related quality of life (HR-QoL). Methods Community survey in 2,338 randomly selected adult subjects. Participants were interviewed with the Advanced Neuropsy-chiatric Tools and Assessment Schedule (ANTAS), administered by clinicians. The diagnoses were based on the ICD-10 criteria. The Short-Form Health Survey (SF-12) was used to quantify HR-QoL. Results In the sample, 35 subjects met the criteria for agoraphobia (1.5%), with greater prevalence among women (2.0%) than men (0.9%): odds ratio (OR) 2.23; 95% CI: 1.0-5–2. Agoraphobia was more often seen among those with (n=26; 1.1%) than without (n=9; 0.4%) panic disorder: OR=8.3; 2.9–24.4. Co-morbidity with other mental disorders was substantial. The mean score of SF-12 in people with agoraphobia was 35.2±7.8, with similar levels of HR-QoL in people with (35.3±7.9) or without (34.8±7.3) panic disorder: ANOVA: F(1;33)=0.0; p=1.00. Conclusion One out of seventy people may suffer from agoraphobia in their lifetime. The attributable burden in terms of HR-QoL is substantial and comparable to the one observed for chronic mental disorders such as major depression, post-traumatic stress disorder, or obsessive-compulsive disorder. Psychiatry Investig 2021;18(4):277-283

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        Schizophrenia, Cancer and Obstetric Complications in an Evolutionary Perspective-An Empirically Based Hypothesis

        Antonio Preti,Daniel R. Wilson 대한신경정신의학회 2011 PSYCHIATRY INVESTIGATION Vol.8 No.2

        Objective Patients diagnosed with schizophrenia have reduced fecundity and premature mortality (both accidental and violent) with no obvious compensatory advantages among kin. The prevalence of the disorder is around 0.7/1%, higher than the expected prevalence of spontaneous mutations. Genes favoring schizophrenia may have been positively selected in the environment of evolutionary adaptation. Literature on potential adaptive genes is reviewed within an evolutionary framework. Methods Literature search on major scientific search engine (PubMed/Medline, Ovid/PsychInfo) on papers aimed at investigating potential pathways justifying a mutation-selection balanced model. Findings are presented with a narrative touch to favor readability and understanding. Results Reduced incidence of cancer in both patients diagnosed with schizophrenia and their siblings was reported worldwide. Such findings are notable given higher cancer risk factors in schizophrenia, i.e., smoking, alcohol abuse, obesity, poor diet, and poor adherence to therapy. Some genes involved in cancer proliferation might as well confer protective advantage in immune-surveillance, inflammation,vascular proliferation or apoptosis that otherwise will adversely affect early neurodevelopment. Conclusion Evidence that reduced risk of certain somatic diseases is associated with schizophrenia is quite significant to progress in the evolutionary epidemiological analysis of psychopathology.

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