Search PubMed⌕ Search

Biomedical subjects

C Faravelli

Publications and source records attributed to C Faravelli.

At least 55 records · Page 3Linked to original sources
PubMed1983

Double-blind trial with oral versus intravenous clomipramine in primary depression.

Intravenous clomipramine and oral clomipramine at a daily dose of 2 mg/kg body weight were compared in a double-blind study of 40 inpatients with primary depressive illness. No significant differences between the two routes of clomipramine administration were found, either in response or in side effects. Steady state was not attained at the 4th week of treatment in 30% of patients. However, combined plasma levels of clomipramine (CI) plus desmethylclomipramine (DMCI) were similar in the two groups at all stages of treatment. The only significant pharmacokinetic difference that was found was in the ratio of DMCI to CI, which was higher among the patients who received the drug orally, but this did not correlate with clinical response. Conversely, Day 28 plasma concentrations of CI, DMCI, and the sum CI + DMCI were significantly related to clinical outcome in the patients treated orally. Among the patients who received the drug intravenously only CI was significantly associated with the percentage reduction of symptoms. By pooling the two groups, CI, DMCI, and their sum all bore relationships to clinical response significant at the 0.01 level.

Administration, Oral↗
PubMed1982

Stability of the diagnosis of primary affective disorder. A four-year follow-up study.

Most modern studies on depression use standardized diagnostic approaches, such as the St. Louis Criteria or the RDC. The main aim of these methods is to select reliable samples for research purposes. However, doubts have been raised as to whether the groups derived through these criteria are homogeneous. In order to investigate the stability of the diagnosis of Primary Affective Disorder (PAD), a group of 78 patients meeting the criteria for this disorder were followed for 4 years. During this period 19.2% of patients showed important psychopathological symptoms other than affective. No particular factor, apart from bipolar illness, was found to be significantly predictive of a stable diagnosis. However, the rate of diagnoses would have been greater by taking into account family history and premorbid personality of the patients. The authors conclude that other sources of information, beyond present symptoms, ought to be taken into account in order to reach more homogeneous groupings.

Adult↗
PubMed1979

Clinical response and tricyclic plasma levels during treatment with clomipramine.

Fifty depressed in-patients at two psychiatric units, one in Italy the other in England, were treated with clomipramine, either orally, or intravenously and orally. A comparison of clinical response with plasma levels of clomipramine and its metabolite, desmethylclomipramine, showed clear relationships especially in the case of desmethylclomipramine. In the intravenously-treated group this was linear, in the orally-treated group it was curvilinear. Plasma levels of desmethylclomipramine and administered clomipramine correlate highly. These findings, together with the fact that significant clinical improvement was observed in only 55% of the patients, suggest that titration of the administered dose to obtain more effective plasma levels of the metabolite might improve the clinical response to the drug in some patients.

Administration, Oral↗
PubMed1976

[The Rorschach test during chronic haemodialysis (author's transl)].

Twenty-eight patients undergoing chronic haemodialysis for renal failure and seven patients suffering from chronic uremia, but not on dialysis programs were submitted to the Rorschach test. The patients who were undergoing haemodialysis for less than one year showed higher signs of anxiety (shock and Hd responses); on the other hand patients undergoing the treatment for more than 5 years showed a generally worse quality response to the test. This bad performance was interpreted either as a sign of organic brain damage or as a worse cooperation in the test procedure.

Adult↗
PubMedDate not supplied

Assessment of depression: a comparison of rating scales.

Six depression rating scales (RS) (Beck Depression Inventory, BDI; Zung Self-Rating Scale, SDS; Visual Analogue Scale, VAS; Hamilton Depression Rating Scale, HRSD; Wechsler Depression Rating Scale; Bunney and Hamburg Rating Scale, BHRS) were administered to the same 100 depressed patients and compared as regards ease of use, reliability, distribution, and validity. Separate factor analyses carried out on the items of the single scales showed considerably different factorial structures, thus revealing that different concepts of depression are at the basis of the various scales. These differences suggest that comparison of results derived by the use of different scales must be regarded with caution.

Depressive Disorder↗
PubMedDate not supplied

5-year prospective, naturalistic follow-up study of panic disorder.

Ninety-nine patients with panic disorder (PD) not comorbid with other psychiatric disorders were evaluated for 5 years using a naturalistic prospective design. The probability of achieving full remission, albeit transitory, was 37.5%, whereas 72.8% of cases showed a consistent amelioration. However, among patients with an initial positive outcome, the probability of remaining well was 41.4% after 5 years. When the general course of the disorder during the follow-up period was considered, only 12.12% of the subjects had a complete and stable remission of symptoms, whereas 47.47% had a generally positive but not fully satisfactory amelioration either due to infrequent recurrences of the illness or to chronic continuation of symptoms at a mild level. On the other hand, 40.40% of the subjects reported an overall poor outcome because of the presence of a recurrent pattern of illness (11.11%) or because the periods of well-being did not represent more than 40% of the time being considered (29.29%). Among the predictors taken into consideration, only duration of illness before intake showed a strict relationship with long-term outcome, with patients having a lesser duration of illness at the moment of the index episode showing a significantly better outcome.

Adult↗
PubMedDate not supplied

Number of symptoms, quantification, and qualification of depression.

Current classification systems (ICD-10 and DSM-IV) require a quantitative criterion for differentiating depressive states, suggesting a correlation between the number of symptoms, i.e., the pervasiveness of the syndrome, and the subtype of the illness. All the symptoms (within those contained in the diagnostic lists) are assumed to have comparable value. To investigate the relevance of the number and the type of symptoms reported by 196 patients suffering from depression, we compared the symptoms using independent indicators of severity such as the Clinical Global Index (CGI) and the social functioning subscale of the Global Assessment of Functioning (GAF). A second comparison using the same indicators was made between qualitatively distinct categories of DSM-IV and ICD-10 (i.e., melancholic v nonmelancholic, somatic v nonsomatic, and psychotic v nonpsychotic). There was evidence that increasing numbers of symptoms actually reflect higher levels of severity, but the categorizations that were mainly based on qualitative criteria (e.g., melancholia, somatic syndrome, etc.) usually attained better discrimination compared with those based on the number of symptoms. Moreover, certain symptoms (usually those indicated as endogenous) were more likely to be associated with greater severity and pervasiveness. Finally, the results clearly showed that different symptoms had different weight in establishing the gradient of severity.

Adult↗
PubMedDate not supplied

Cognitive-behavioural therapy for bulimia nervosa and binge eating disorder. A review.

Cognitive-behavioural therapy (CBT) programmes for bulimia nervosa (BN) have been considerably refined during the last 2 decades, and such a treatment is now extensively used. The present paper describes the treatment rationale and structure, and reviews the available evidence on its efficacy. Compared to any other psychological or pharmacological treatment for which controlled studies have been published, CBT is reported to be more effective (the majority of studies), or at least as effective. A CBT programme for binge eating disorder (BED) has been created by adapting that of BN, but it has been less extensively evaluated in field trials. Even here, however, no other treatment has proven to be of greater efficacy than CBT. Various methodological limitations reduce the possibility of generalizing these findings. Moreover, CBT was found to be completely satisfactory neither for BN nor for BED, with moderate effectiveness and some limits. However, at the present state of treatment, no other therapeutical procedure seems to be more effective, more specific or more promising. It is speculated therefore that CBT could be presently considered the first-choice remedy for these severely disabling disorders.

Bulimia↗
PubMedDate not supplied

Fluoxetine and fluvoxamine combined with individual cognitive-behaviour therapy in binge eating disorder: a one-year follow-up study.

BACKGROUND: : The treatment of binge eating disorder (BED) is still the object of debate. In the present study, the effectiveness of antidepressant drugs (fluoxetine - FLX - 60 mg/day, fluvoxamine - FLV -300 mg/day), cognitive-behavioural therapy (CBT) and combined treatments (CBT + FLX, CBT + FLV) has been evaluated in a randomized, clinical trial. Results at the end of the active treatment (in the 24th week) and 1-year follow-up outcomes have been evaluated. METHODS: One hundred eight (44 M, 64 F) BED patients were randomly assigned to either CBT, FLX (60 mg/day), FLV (300 mg/day), CBT + FLX or CBT + FLV, for 24 weeks. At the beginning (T0), at the end (T1) of treatment and after 1 year (T2), body mass index (BMI) and eating attitude and behaviours (by EDE 12.0D) were assessed. RESULTS: At T1, BMI and EDE scores were significantly reduced in CBT, CBT + FLX and CBT + FLV, but not in the FLX and FLV treatment groups. In the CBT + FLV group, a greater (p < 0.05) reduction of EDE total scores was observed, when compared to CBT + FLX or CBT treatment groups. At T2, BMI was significantly higher than at T1, but still significantly lower than at T0 in the CBT, CBT + FLX and CBT + FLV groups, while EDE scores remained unchanged from T1 in all treatment groups. CONCLUSIONS: CBT was more effective than FLX or FLV in the treatment of BED. The addition of FLX to CBT does not seem to provide any clear advantage, while the addition of FLV could enhance the effects of CBT on eating behaviours. Modifications of eating behaviours are maintained at the 1-year follow-up, although the lost weight was partly regained.

Adult↗
PubMedDate not supplied

A self-controlled, naturalistic study of selective serotonin reuptake inhibitors versus tricyclic antidepressants.

OBJECTIVE: To compare the effectiveness of serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) for anxiety and mood disorders in a naturalistic setting. METHODS: 114 of 2,000 outpatients drawn from a private facility with a diagnosis of mood or anxiety disorder had two separate episodes during which they were treated once with a SSRI and once with a TCA. The drugs had to be in monotherapy and appropriate according to the recent guidelines. Key outcome measures included several rating scales, the results of which were combined into three measures of outcome: full response (no symptom), partial response (residual symptoms), poor response. RESULTS: TCAs produced a better response in 63 cases and SSRIs in 18 cases (p < 0.00001). When the outcome was dichotomized, TCAs were still superior (stricter criterion of full response: p = 0.0002; lower threshold: p < 0.0001). Considering depressive and anxiety disorders separately, TCAs remained superior in terms of efficacy (for depression: p < 0.0001; for anxiety: p = 0.026). Moreover, the second episode of illness showed a better outcome than the first (p = 0.0008). CONCLUSIONS: In those cases where two different antidepressants were prescribed over two different episodes of illness, TCAs were significantly more effective than SSRIs, regardless of the type of disorder and order of prescription.

Adult↗
PubMedDate not supplied

[Some problems of psychiatric care unit in a general hospital I: Concerning decision of admission to hospital (author's transl)].

Over a thousand patients a year request hospitalization at the Psychiatric Admission Unit of the Region General Hospital of Santa Maria Nuova in Florence. About five hundred are actually hospitalized, less than half. Decision to hospitalize depends on several factors: a) factors relating to the patient (the psychopathological picture, the severity of his condition, his family background etc.); b) factors relating to the doctor on duty (degree of experience, attitude toward the patients, theoretical view toward hospitalization etc.); c) practical and administrative factors (service situation, day of the week, time of the day etc.). On the other hand the doctor's attitude may be that of undertaking care of the patient's psychiatric needs or not. This behaviour is largely independent from the decision to hospitaliz or not. Hospitalization does not necessarily mean taking care of the patient from a psychiatric point of view (hospital seen as a parking place, for example) and, vice versa, treatment can be planned without hospitalizing the patient who asks for it. Thus, there are four possibilities in a Psychiatric Admission Unit: a) hospitalization and care of the patient; b) no hospitalization but care of the patient; c) hospitalization without care of the patient; d) no hospitalization and no care of the patient. These four situations discussed with appropriate examples. The emotional attitude of the psychiatrist in his relationship with the patients who request admission is viewed as the most important factor for a correct decision.

Humans↗
PubMedDate not supplied

[Headache in depressive syndromes: a clinical study (author's transl)].

The possibility of a close relationship between depression and headache has been investigated by many authors; and supported by clinical, biochemical and pharmacological findings. In the present study the features of headaches were investigated in a sample of 58 depressed inpatients, selected according to Feighner's diagnostic criteria. Head pain was found in over 50% of the depressed, with a greater incidence within the psychogenic group. On the other hand headache did not correlate with the nuclear symptoms of depression (depressed mood, guilt, retardation, inadequacy); it correlated with tension and somatic anxiety. The authors conclude that headache, as a symptom of depressive syndrome, must be considered only an accessory component of depression, but not a central feature of the syndrome.

Adolescent↗
PubMedDate not supplied

[Some problems of a psychiatric care unit in a general hospital. II: Compulsory health treatments (author's transl)].

The new italian law regulating psychiatric treatments (number 180/78) does away with hospitalization for mental diseases in Psychiatric Hospitals. When required, hospitalization occurs only in Psychiatric Care Units attached to General Hospitals. Compulsory Health Treatments (T.S.O from italian "Trattamenti Sanitari Obbligatori") may be enforced whenever the patient refuses to be hospitalized although he needs hospitalization for treatment and there are no alternatives to it. The Authors report on the first seven months of experience in a Psychiatric Care Unit of a General Hospital in Florence where T.S.O. had been made available. The characteristics, places of origin, profession of the 42 patients admitted for T.S.O. have been investigated. Organizational and emotional issues arising from the enforcement of the new regulations and involving the staff are examined; the main issue being the significance of not having participated in the decision for hospitalization although having the responsibility for the patient's staying in the hospital. All these seem to have made more difficult, at least at first, to achieve a thorough psychiatric treatment, whereas it is easier to resort to a mere drug treatment. Possible solutions to ease the situation are put forward.

Commitment of Persons with Psychiatric Disorders↗
PubMedDate not supplied

[Action mechanism of antidepressive drugs. Review of current knowledge].

Although more than twenty-five years of clinical use and several placebo-controlled studies have demonstrated the clinical effectiveness of anti-depressant drugs, the mechanism through which these drugs function and how they relate to the pathological mechanisms that underlie depressive disorders are still not clear. The present article briefly reviews the literature available on the subject. In chronological order, it examines studies on the clinical effectiveness of antidepressants, their effects on biogenic amine metabolism and on known receptor systems. The existence of possible specific receptor systems for tricyclic anti-depressants, their modifications during depressive illness, the effect of treatment with psychotropic drugs and the role which these systems may play in depression are then illustrated.

Animals↗