Biomedical subjects
Publications and source records attributed to A Meluzzi.
In this report role, possibilities and limits of psychiatry have been taken into account. Starting from a historical analysis, the Authors advance some hypotheses. Psychiatry could possible play a mediation role between sociology and biology, providing every patients with a specific therapy.
Subjective estimation of time varies according to age, to physical state and to the activity we are occupied with. The relationship between time and major depression can be considered from two different point of view. From a clinical-psychological point of view normal subjects with major depression estimate time intervals differently. Future, past and present change their meaning in major depression. These alterations cause important consequences in the cognitive structure of subjects with major depression and therefore influence depressive symptoms. On the other hand also the "biological time" is altered in major depression. Subjects with major depression suffer from many chronobiological alterations. The relationship between these two aspects are considered in the present report.
Recently a lot of studies have pointed to the relationships between the major homeostatic systems of the human body: the neuroendocrine system and the immune system. There is considerable evidence that they make up a psychoneuroendocrine immunologic network. In the present review the most interesting data concerning the relationships between the neuroendocrine system and the immune system are taken into account.
In this paper the Authors report on the immunologic alterations in two psychiatric disease: schizophrenia and infantile autism. While a lot of researches have been concluded on the immunologic alterations in schizophrenia, only a few data on infantile autism are available. Based on data from international literature the Authors advance some hypotheses on the role possibly played by the immune system in the pathogenesis of schizophrenia and infantile autism.
The paper stresses the importance of the dexamethasone suppression test in the diagnosis of severe depression (major psychiatric disorders). For some decades researchers have been aware of the importance of the hypothalamus-pituitary-adrenal gland axis in the physiological response to stress, and likewise the importance of possible correlations between emotional and biological factors in psychiatric disorders. Several studies have sustained that in major psychiatric disorders, and in particular in depression, not only is there a hypersecretion of cortisol, but also a resistance to the suppression of cortisol secretion which normally follows the injection of an exogenous steroid, for example dexamethasone. This laboratory test is therefore of value both for diagnostic purposes and for identifying severe depression from other morbid conditions; it may also be usefully employed for prognostic and therapeutic purposes.
On the basis of literature data relative to the alteration of beta-endorphin tone in obese subjects, we conducted a clinical trial employing Naltrexone (a receptorial antagonist of endogen opioids) in order to evaluate its efficacy in increasing the compliance of these subjects on dietary treatment. The drug dosage was 50 mg/daily (100 mg/die). The clinical study was carried out following the double-blind crossover method for a period of 4 months in a group of 17 obese subjects who also underwent to psychodiagnostic interviews. Significant weight reduction was observed in the 9 patients who carried out the treatment by assuming Naltrexone (kg 4.00 +/- 3.97) rather than with placebo (kg 0.96 +/- 4.95). The drug was subjectively well tolerated and it did not alter the endocrine, metabolic, psychometric, and cardiovascular monitored parameters. The insulin secretion during OGTT did not show significant alterations. Our data emphasize the Naltrexone efficacy in improving the compliance of the obese subjects during dietary treatment.
Several reported cases point out significant alterations in the psychologic profile of obese subjects and the utility of a psychotherapeutic support to the dietetic or pharmacological therapy. Each patient underwent a psychodiagnostic interview and the following rating-scales were applied: QPF (Psychophysiological Test); STAI X-1 and X-2 (State and Trait Anxiety Inventory); Hamilton-D (Depression); ZUNG (Self-administered Depression Test); TSR (Reaction Schemes Test). We observed an increase in the answer of the blocked projection (in the 40% of subjects), of negation (26.6%), of guilt (13.3%), a decrease in the projection answer (33.3%), high scores of QPF (21%). The STAI, the Hamilton, and the Zung were altered in the 10% of the examined subjects. Our data emphasize the importance of an individual psychotherapeutic support in a subgroup of obese subjects.
The presence of depressive symptomatology in alcoholics has frequently been encountered in clinical practice, but the relationship running between the two pathologies remains a subject for discussion. The methodological difficulty of this evaluation is seen in a major discordance of reported data. Against this background, a group of subjects hospitalized in a neuropsychiatric environment has been assessed for incidence of alcoholic and depressive pathologies and their possible correlations. Of 428 hospitalizations for alcoholism, 350 (82%) presented a depressive pathology. These patients were distinguished by DSM III into three groups [a) adaptation disturbance with depressed mood; b) dysthymic disturbance; c) atypical depression]. Within these groups, the incidence of prior stress-inducing psychosocial events was assessed according to the criterion of growing seriousness of DSM III. The results after statistical processing are discussed and compared with reported data.
Numerous observations have evidenced the high prevalence of psychosomatic disturbances in the third age, so much so that this type of pathology is second in order of frequency in the elderly. In the light of these data a study has been carried out on functional disturbances in the third age related to certain psychological and sociobiological variables. The purpose of the research was to assess the effective influence of these "extrinsic" variables in the psychosomatic disturbance observed through the psychophysiological test carried out in the different groups examined. The results of the study are discussed and some keys for interpreting the data observed are put forward.
The paper describes how the Balint method may be used in a variety of contexts and for different purposes. The analysis of two experiments, one in Ascona (an intensive seminar) and one in Turin (permanent training courses) revealed certain characteristic aspects of both, in which the same traditional Balint technique was always used. The data emerging from the various aspects covered, from forms of group participation to structuring, from aims to assessment made it possible to examine the two experiences as models for the application of the method. And it was found that despite their different contexts both experiences provided the psychological training that is, in fact, training in interpersonal relationships.
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