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Biomedical subjects

Antonella Azzoni

Publications and source records attributed to Antonella Azzoni.

12 recordsLinked to original sources
PubMed2006

Characteristics of HCV positive patients in an Italian urban psychiatric unit.

OBJECTIVES: 1) to assess the prevalence of hepatitis C virus (HCV) infection in a population of acute psychiatric in-patients; 2) to find out relationships between HCV comorbidity and clinical features of psychiatric patients. METHODS: Prospective observational study in a 6-year period. RESULTS: 2396 cases (1492 patients) were admitted in the considered period. Forty-two patients (2.8%) were affected by HCV infection. HCV infection was more frequent in patients with less years of education, lower social class, lower last year best Global Assessment of Functioning score, more hostile or violent behavior in hospital, with a lifetime history of previous suicide attempt, and with substance-related disorders. CONCLUSION: HCV infection in psychiatric patients constitutes a major threat to the health of psychiatric patients and is related with unfavorable social background, worse global functioning, hostile or violent behavior, substance-related disorders. It appears also to be a significant risk of suicidal behavior.

Journal Article↗
PubMed2005

Hostility and violence of acute psychiatric inpatients.

OBJECTIVE: The aim of the present study was to find out the extent of hostility and violence and the factors that are associated with such hostility and violence in a psychiatric intensive care unit. METHODS: Retrospective analysis of data prospectively collected in a 6-year period. RESULTS: No hostility was observed in 56.1%, hostility in 40.9%, and violence in 3.0% of the admitted cases. Seclusion was never used. Six cases (2.5 per thousand) required physical restraint. Risk factors associated with violence were younger age, suicidal risk, and diagnosis of schizophrenia. Risk factors associated with hostile and violent behavior were younger age at the onset of the disorder, being single, having no children, lower GAF scores, higher BPRS hostility, SAPS, and CGI scores, lower BPRS anxiety-depression score, higher doses of psychoactive drugs, more frequent use of neuroleptics, diagnosis of mania, personality disorder, substance and alcohol related disorders, no diagnosis of depression. CONCLUSION: The study confirms the low rate of violence among Italian psychiatric in-patients, the major relevance of clinical rather than socio-demographic factors in respect of aggressive behavior, the possibility of a no seclusion-no physical restraint policy, not associated either with higher rates of hostility or violence or with more severe drug side effects.

Journal Article↗
PubMed2004

Suicide attempts: differences between unipolar and bipolar patients and among groups with different lethality risk.

BACKGROUND: The present naturalistic study aimed to distinguish between suicide attempts (SAs) of bipolar and unipolar patients, and among SAs characterized by different lethality risk. METHODS: The records of 2395 consecutive admissions to our psychiatric intensive care unit (PICU) were assessed for presence of suicide attempt (SA). Cases of SA were rated for symptom severity with the brief psychiatric rating scale (BPRS), the scale for the assessment of positive symptoms (SAPS), the scale for the assessment of negative symptoms (SANS), the mini mental state examination (MMSE), the global assessment of functioning scale (GAF) and the clinical global impression (CGI). An original questionnaire was administered to explore clinical aspects related with suicidal behavior. RESULTS: Among 2395 admissions, 80 (3.3%) had attempted suicide. Fifty-three cases (66.2%) suffered from a mood episode, including 22 (27.5%) with unipolar depression and 31 (38.7%) with bipolar depression (types I and II combined) or mixed state, while 27 (33.8%) cases received other diagnoses. Forty-eight (60%) cases had attempted suicide prior to the index episode. Ten cases (12.5%) had a relative who attempted or committed suicide. Thirty-nine cases (48.7%) described their SA as impulsive. Twenty cases (25.0%) reported alcohol ingestion before SA. In comparison with women, men used more violent methods. Cases characterized by a non-lethal risk SA had higher BPRS psychotic cluster and SAPS scores than cases with either low or high lethal risk SA. Bipolar cases were over-represented in the high lethality risk group. BPRS anxiety-depressive cluster score was higher in unipolar than in bipolar cases. LIMITATIONS: The sample may not be representative of all patients with SA. The questionnaire has not been standardized for use in psychiatric populations. CONCLUSIONS: The higher proportion of high lethal risk SA in bipolar cases suggests that the risk of completed suicide is higher in bipolar disorder than in unipolar depression. The risk of lethality in SA was not associated with the intensity of symptoms of anxiety and depression.

Adult↗
PubMed2004

Clinical management of obsessive-compulsive-bipolar comorbidity: a case series.

OBJECTIVE: To assess the clinical characteristics and the optimal treatment of obsessive compulsive symptoms in patients with familial background, current or past symptoms consistent with a bipolar spectrum diagnosis. METHODS: Longitudinal clinical observation of seven cases with obsessive-compulsive-bipolar comorbidity. RESULTS: In the cases presented that met the DSM-IV-TR criteria for obsessive compulsive disorder (OCD), the concurrent symptoms and the clinical course pointed to a different principal diagnosis and suggested therapeutic strategies different from those currently recommended in OCD. Clear-cut onset of symptoms, high prevalence of mood disorders in relatives, revaluation of their history, switch into mania induced by antidepressants, and clinical follow-up suggested a hierarchical priority of bipolar diagnosis. CONCLUSIONS: The presence of the aforementioned atypical symptoms should alert the physician about the possibility of bipolar comorbidity in OCD patients. If the suspicion is confirmed, bipolar diagnosis should have priority, at least from a therapeutic point of view. The first choice in treatment should be with mood stabilizers or second generation antipsychotics. Mood stabilization should be achieved as a first objective.

Adult↗
PubMed2003

Comparison of three antipsychotics in the emergency psychiatric setting.

In the present naturalistic study, the effectiveness and safety of quetiapine, risperidone and olanzapine were compared in the treatment of non selected acutely psychotic patients. It was observed that the rate of antipsychotic switch because of a lack of efficacy or side effects was higher in the quetiapine treated cases in comparison with the risperidone or olanzapine treated cases. The proportion of cases concomitantly treated with typical neuroleptics was significantly higher in the quetiapine group compared with the other two groups. In the outcome of non crossover cases, there were more improvements in the risperidone and olanzapine groups than in the quetiapine group. The results of this study suggest that quetiapine is not as efficacious as risperidone or olanzapine in the emergency psychiatric setting. Due to the methodological limitations of the study, these results must be considered preliminary and need confirmation.

Acute Disease↗
PubMed2003

Sexual behavior and sexual problems among patients with severe chronic psychoses.

The aim of the present study was to investigate sexual behavior in population of psychiatric patients affected by schizophrenia, schizoaffective disorder or bipolar disorder by means of an ad hoc questionnaire designed to explore the three phases of the sexual response: desire (or interest), arousal, and performance. The study assessed patients' attitude toward sexuality, several aspects of their sexual behavior, including patients' awareness of the risk of sexually transmitted diseases (STD), contraceptive strategy preferred by patients, and sexual effects of psychotropic medication. Patients reported a high frequency of sexual dysfunction, in particular, hyposexuality. Schizophrenia diagnosis and female gender were associated with lower levels of sexual performance. The impact of psychotropic drugs on patients' sexuality was significant, with both positive and negative effects. Although 65.8% of patients reported to be concerned about the risk of contracting infections during sexual intercourse, most of them engaged in sexual behavior at high risk for acquisition and transmission of STD. Patients' compliance with contraceptive measures was poor.

Adult↗
PubMed2003

Oxcarbazepine vs. valproate in the treatment of mood and schizoaffective disorders.

To compare the efficacy of oxcarbazepine (OXC) and valproate (VPA) in the treatment of mood and schizoaffective disorders, we retrospectively analysed data regarding 27 in-patients with mood or schizoaffective diagnosis treated with OXC (and other psychoactive drugs except VPA) and 27 matched in-patients treated with VPA (and other psychoactive drugs except OXC), in a psychiatric intensive care unit of a general hospital. In the evaluation of the outcome, we considered the length of hospitalization, the changes in the scores of BPRS, SAPS, SANS, MMSE, CGI, GAF, UPDRS, BAS, and Morrison's scale. The assessment of global psychopathology and functioning, of positive and mood symptoms suggested similar efficacy of OXC and VPA. Unexpectedly, OXC appeared more efficacious in the treatment of negative symptoms.

Adult↗
PubMed2002

Diabetes is not a risk factor for tardive dyskinesia: a retrospective observational study.

The aim of this observational study was to compare the prevalence of tardive dyskinesia (TD) in diabetic and non diabetic patients. We compared 34 diabetic patients with 34 non diabetic controls, matched by sex, age and time of admission, who had received a complete neuropsychiatric evaluation and who had been exposed to antidopaminergic treatment for at least 3 months. Among them, 8 of 24 diabetic (33.3%) and 6 of 15 (40.0%) non diabetic patients presented TD. The prevalence of TD in the diabetic group is numerically lower than in the controls but the difference is not statistically significant (chi(2) = 0.006; fd = 1; p = 0.937). These results suggest that diabetes is unlikely to play a major role in the pathogenesis of TD.

Antipsychotic Agents↗
PubMed1999

Three cases of improvement of tardive dyskinesia following olanzapine treatment.

To date, clozapine is the only antipsychotic agent that has established itself as having minimal, if any, risk of tardive dyskinesia (TDk). In patients with TDk, clozapine permits the dyskinesia to disappear in approx. 50% of cases, particularly those with dystonic features, i.e. tardive dystonia (TDt) (Gardos, 1999). Unfortunately, clozapine is not always efficacious. Furthermore, some patients cannot be treated with clozapine because of its side-effects. Olanzapine is a serotonin-dopamine-receptor antagonist, which has an affinity for neuroreceptors similar to that of clozapine. Pooled tolerability data from controlled trials show that the overall incidence of TDk in patients treated with olanzapine is significantly lower than in patients treated with haloperidol (Tollefson et al., 1997). Here, we report three cases of patients affected by tardive disorders who dramatically improved after olanzapine treatment.

Journal Article↗