Mood profiling has a long history in the field of sport and exercise. Several novel mood profile clusters were identified and described in the literature recently (Parsons-Smith et al., 2017). In the present study, we investigated whether the same clusters were evident in an Italian-language, sport and exercise context. The Italian Mood Scale (ITAMS; Quartiroli et al., 2017) was administered to 950 Italian-speaking sport participants (659 females, 284 males, 7 unspecified; age range = 16-63 year, M = 25.03, SD = 7.62) and seeded k-means clustering methodology applied to the responses. Six distinct mood profiles were identified, termed the iceberg, inverse iceberg, inverse Everest, shark fin, surface, and submerged profiles, which closely resembled those reported among English-speaking participants (Parsons-Smith et al., 2017). Significant differences were found in the distribution of specific mood profiles across gender and age groups. Findings supported the cross-cultural generalizability of the six mood profiles and offer new research avenues into their antecedents, correlates and behavioral consequences in Italian-language contexts.
This international guideline proposes improving clozapine package inserts worldwide by using ancestry-based dosing and titration. Adverse drug reaction (ADR) databases suggest that clozapine is the third most toxic drug in the United States (US), and it produces four times higher worldwide pneumonia mortality than that by agranulocytosis or myocarditis. For trough steady-state clozapine serum concentrations, the therapeutic reference range is narrow, from 350 to 600 ng/mL with the potential for toxicity and ADRs as concentrations increase. Clozapine is mainly metabolized by CYP1A2 (female non-smokers, the lowest dose; male smokers, the highest dose). Poor metabolizer status through phenotypic conversion is associated with co-prescription of inhibitors (including oral contraceptives and valproate), obesity, or inflammation with C-reactive protein (CRP) elevations. The Asian population (Pakistan to Japan) or the Americas' original inhabitants have lower CYP1A2 activity and require lower clozapine doses to reach concentrations of 350 ng/mL. In the US, daily doses of 300-600 mg/day are recommended. Slow personalized titration may prevent early ADRs (including syncope, myocarditis, and pneumonia). This guideline defines six personalized titration schedules for inpatients: 1) ancestry from Asia or the original people from the Americas with lower metabolism (obesity or valproate) needing minimum therapeutic dosages of 75-150 mg/day, 2) ancestry from Asia or the original people from the Americas with average metabolism needing 175-300 mg/day, 3) European/Western Asian ancestry with lower metabolism (obesity or valproate) needing 100-200 mg/day, 4) European/Western Asian ancestry with average metabolism needing 250-400 mg/day, 5) in the US with ancestries other than from Asia or the original people from the Americas with lower clozapine metabolism (obesity or valproate) needing 150-300 mg/day, and 6) in the US with ancestries other than from Asia or the original people from the Americas with average clozapine metabolism needing 300-600 mg/day. Baseline and weekly CRP monitoring for at least four weeks is required to identify any inflammation, including inflammation secondary to clozapine rapid titration.