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Biomedical subjects

C Maggini

Publications and source records attributed to C Maggini.

At least 19 recordsLinked to original sources
PubMed2006

Psychopathology factors in first-episode affective and non-affective psychotic disorders.

BACKGROUND: Since the onset, prevalence, and course of specific psychopathological features rarely have been analyzed simultaneously from the start of dissimilar psychotic illnesses, we compared symptom-clusters in first-episode DSM-IV affective and non-affective psychotic disorders. METHODS: Subjects (N=377) from the McLean-Harvard First Episode Project hospitalized for first-lifetime primary psychotic illnesses were followed prospectively for 2 years to verify stable DSM-IV diagnoses. We ascertained initial symptoms from baseline SCID and clinical assessments, applying AMDP and Bonn psychopathology schemes systematically to describe a broad range of features. Final consensus diagnoses were based on intake and follow-up SCID assessments, family interviews, and medical records. Factor-analytic methods defined first-episode symptom-clusters (Factors), and multiple-regression modeling related identified factors to initial DSM-IV diagnoses and to later categories (affective, non-affective, or schizoaffective disorders). RESULTS: Psychopathological features were accommodated by four factors: I represented mania with psychosis; II a mixed depressive-agitated state; III an excited-hallucinatory-delusional state; IV a disorganized-catatonic-autistic state. Each factor was associated with characteristic prodromal symptoms. Factors I and III associated with DSM-IV mania, II with major depression or bipolar mixed-state, III negatively with delusional disorder, IV with major depression and negatively with mania. Factors I and II predicted later affective diagnoses; absence of Factor I features predicted non-affective diagnoses, and no Factor predicted later schizoaffective diagnoses. CONCLUSION: The findings contribute to descriptive categorizations of psychopathology from onset of dissimilar psychotic illnesses. This approach was effective in identifying and subtyping affective psychotic disorders early in their clinical evolution, but non-affective and schizoaffective conditions appear to be more complex and unstable.

Adult↗
PubMed2006

Chlorpromazine, clozapine and olanzapine inhibit anionic amino acid transport in cultured human fibroblasts.

We report here that chlorpromazine, a first generation antipsychotic drug, inhibits anionic amino acid transport mediated by system X(-) (AG) (EAAT transporters) in cultured human fibroblasts. With 30 microM chlorpromazine, transport inhibition is detectable after 3 h of treatment, maximal after 48 h (>60%), and referable to a decrease in V(max). Chlorpromazine effect is not dependent upon changes of membrane potential and is selective for system X(-) (AG) since transport systems A and y(+) are not affected. Among antipsychotic drugs, the inhibitory effect of chlorpromazine is shared by two dibenzodiazepines, clozapine and olanzapine, while other compounds, such as risperidon, zuclopentixol, sertindol and haloperidol, are not effective. Transport inhibition by clozapine and olanzapine, but not by chlorpromazine, is reversible, suggesting that the mechanisms involved are distinct. These results indicate that a subset of antipsychotic drugs inhibits EAAT transporters in non-nervous tissues and prompt further investigation on possible alterations of glutamate transport in peripheral tissues of schizophrenic patients.

Amino Acid Transport Systems, Acidic↗
PubMed2006

Predictors of symptom resolution in panic disorder after one year of pharmacological treatment: a naturalistic study.

OBJECTIVE: In this naturalistic and prospective study, patients with panic disorder (PD) were treated for one year 1) to verify the rate of patients achieving the resolution of full-symptom attacks, limited-symptom attacks, anticipatory anxiety, phobic avoidance and depression; and 2) to identify the predictors of symptom resolution for each domain. METHOD: One hundred patients with PD, according to DSM-IV criteria, participated in the study. In all patients, a baseline and a follow-up with monthly evaluations of SCL-90, Ham-A, Ham-D and panic diaries were carried out over a one-year period. All patients were treated with paroxetine or citalopram. RESULTS: Seventy-one patients completed the study, whereas the remaining 29 dropped out. Among completers, remission of full- and limited-symptom panic attacks was observed in 76 % of patients, whereas complete remission (resolution of panic attacks, anticipatory anxiety, phobic anxiety, and depression) was achieved by only 46 % of patients. Predictors of absence of symptom remissions were obsessive-compulsive disorder (OCD) and recurrent major depression (MD) comorbidity (for panic attacks), pre-treatment severity of anxious symptoms (for anticipatory anxiety), phobic anxiety (for phobic avoidance), and depressive symptoms (for depression). CONCLUSION: This naturalistic study shows that the high comorbidity of OCD and MD and the greater pre-treatment severity of anxious, phobic and depressive symptoms reduced the likelihood of achieving complete remission of symptoms in PD patients who completed the protocol, even though they were adequately treated with SSRI medication.

Adult↗
PubMed2006

The effect of temperament and character on response to selective serotonin reuptake inhibitors in panic disorder.

OBJECTIVE: In this prospective study, temperament and character were evaluated in patients with panic disorder (PD), before 1 year of medication therapy, to verify whether these factors influenced the outcome of treatment. METHOD: Seventy-one PD patients were evaluated with the SCID-IV, the Temperament and Character Inventory (TCI), the SCL-90, the Ham-A and the Ham-D. Patients were treated with pharmacotherapy and were evaluated monthly over 1 year. RESULTS: Before treatment, non-remitted patients showed higher levels of harm avoidance (HA) and lower levels of persistence (P), self-directedness (SD) and cooperativeness (C), whereas remitted patients showed only higher levels of HA. After controlling the effect of the confounding variables, the likelihood to achieve remission was positively related to SD score (OR = 1.12; P = 0.002), particularly 'self-acceptance' SD dimension (OR = 1.30; P = 0.02). CONCLUSIONS: Our data suggest that in PD: i) the evaluation of personality, using the Cloninger's model, confirms the presence of personality pathology as one predictor of non-response to treatment; ii) in patients with low SD a combination of medication and cognitive-behaviour therapy should be the most effective treatment.

Adult↗
PubMed2004

Anxiety and depressive disorders in an emergency department ward of a general hospital: a control study.

OBJECTIVE: In this study anxiety and depressive disorders were evaluated in patients admitted to an emergency department (ED) or to a medical department (MD). METHODS: The General Health Questionnaire-30 (GHQ-30) was administered to screen all patients (n = 719) consecutively admitted to an ED (n = 556) and to MD (n = 163) in a 120 day period. All GHQ-30 positive (score>4) underwent the Mini International Neuropsychiatric Interview, a structured interview to diagnose mental disorders according to DSM-IV criteria. RESULTS: Subjects positive to GHQ-30 were 264 (47%) in ED and 88 (54%) in MD. A mental disorder was diagnosed in 233 ED patients (42%) and in 77 MD patients (47%) (p = 0.70). The most frequent disorders were anxiety disorders in ED patients (18.1%) and depressive disorders in MD patients (21%) (p = 0.04). CONCLUSIONS: Anxious patients more frequently seek attention at ED, whereas patients with depressive disorders are more often observed in medical units. The improvement of quality of care, the waste of healthcare resources through unnecessary medical care, and the well known efficacy of appropriate treatments in patients with anxiety and depressive disorders make the diagnosis of these patients particularly important.

Adult↗
PubMed2001

Psychopathology, personality, and marital relationship in patients undergoing in vitro fertilization procedures.

OBJECTIVE: To compare the psychopathology, personality features, and marital relationships of women undergoing in vitro fertilization (IVF) with those of control patients, and to compare IVF inductees with program veterans. DESIGN: Cross-sectional clinical study. SETTING: A university hospital. PATIENT(S): One hundred and one women undergoing IVF treatment. INTERVENTION(S): Psychometric tests were administered at first visit (baseline) of index treatment cycle. MAIN OUTCOME MEASURE(S): Achievement of pregnancy. RESULT(S): Women undergoing IVF show higher levels of anxiety and emotional tension than do controls. Although the infertile women showed no abnormal personality dimensions, the IVF group did have a particular psychological profile and a different marital relationship pattern when compared with the control participants. Between IVF veterans and inductees, there are significant differences with respect to psychopathology, psychological dimensions, and couple dynamics. The achievement of pregnancy is not associated with any special psychopathological, personality, or marital characteristics among the IVF women. CONCLUSION(S): The most crucial period in IVF procedures may immediately follow the end of the first cycle because of the high risk of patients dropping out of the program. To determine the most effective supporting therapies for women undergoing fertilization procedures it could be useful to consider the psychological and relational differences between veterans and inductees.

Adult↗
PubMed2001

The Parma High School Epidemiological Survey: obsessive-compulsive symptoms.

OBJECTIVE: This study was undertaken to assess the prevalence of obsessive-compulsive symptoms in a population of Italian adolescents. METHOD: A sample of 2877 high-school students, 1463 males (51%) and 1414 females (49%), aged 16-21 years were assessed with the Leyton Obsessional Inventory--Child Version (LOI-CV). Two groups of subjects were defined as 'positive' on the screen: the high interference (HI) (i.e. all subjects who scored 25 or more in the interference score), and the supernormals (Sn). RESULTS: Females scored higher than males both on yes and interference scores. One hundred and nineteen (4.1%) and 87 (3.0%) constitute, respectively, the HI and the Sn groups. The most interfering symptoms were obsessions linked to dirt phobia, rumination and nail biting. CONCLUSION: The prevalence estimates of OCD symptoms confirmed the recent data of the literature that adolescent OCD symptoms are more frequent than was believed previously. Females showed more symptoms and more interference on personal functioning than males.

Activities of Daily Living↗
PubMed2001

The use of an emergency ward by patients with depressive or anxiety disorders: a one year follow-up study.

OBJECTIVE: The present study examined patients during the year after the index hospitalization in an Emergency Ward (ED) to determine whether patients with depressive or anxiety disorders have a higher rate of readmission than patients without these conditions. METHOD: For this purpose, 165 subjects (85 diagnosed with DSM-IV depressive or anxiety disorders and 80 controls) were evaluated with the Hospital Anxiety and Depression Scale (HADS) and with the Duke Severity of Illness Scale both during the index hospitalization and one year later. Hospitalizations during the follow-up period were determined using the hospital database. RESULTS: During the follow-up period, depressed and anxious patients were more frequently rehospitalized in ED wards than controls (p = 0.006), after controlling for the effect of medical illnesses severity, marital status, living arrangement, and employment status. No difference was found regarding the admissions to wards different from ED. CONCLUSIONS: Patients with depressive or anxiety disorders use the ED ward more frequently than controls for the diagnosis and treatment of somatic symptoms.

Adolescent↗
PubMed2000

Are alexithymia, depression, and anxiety distinct constructs in affective disorders?

OBJECTIVE: the present study was undertaken to gain a better insight into the relationship between alexithymia, anxiety, and depression. Two hypotheses were tested: (1) whether a depressive or anxiety disorder is associated with an elevation of one or more dimensions of alexithymia; and (2) whether alexithymia is an independent construct from depression and anxiety in patients with depressive or anxiety disorders. METHOD: a total of 113 patients with depressive or anxiety disorders (DSM-IV) and 113 control subjects completed the 20-item version of the Toronto alexithymia scale (TAS-20) and the hospital anxiety and depression scale (HADS). RESULTS: the TAS-20 total score was higher in depressed and anxious patients than in controls. This finding mainly depended on an increased score for "difficulty identifying feelings"(DIF), and (only in depressed patients) on an increased score for "difficulty communicating feelings" (DCF). The factor analysis of the TAS-20 and HADS items showed that depression is a construct different from alexithymia, whereas some overlap exists between anxiety and DIF dimension. CONCLUSION: our results suggest that in depressive and anxiety disorders, alexithymia and depression are separate constructs that may be closely related; in contrast, there are some overlaps between the DIF dimension and anxiety.

Adolescent↗
PubMed1998

Is anxious-agitated major depression responsive to fluoxetine? A double-blind comparison with amitriptyline.

Whether fluoxetine (FX) is effective in the treatment of anxious depression is still debated. In the present study, after one week of placebo (single blind), 142 outpatients affected by major depression with relevant anxiety and agitation were randomly assigned (double blind) to either FX (20 mg/day) (n. 67) or amitriptyline (AM) (daily dose: 115+/-39.2mg) (n.75) for a period of 10 weeks. Between groups, the mean score of Hamilton Rating Scale for Depression (HRSD) was significantly different only after 3 weeks of treatment (AM 14.7+/-5.7 vs FX 17.3+/-6.2 (p = 0.02), whereas at the end of the trial it was similar (AM 8.15+/-6.9; FX 8.96+/-6.6). At each visit, no significant difference between groups was found regarding the scores of the HRSD items "psychic anxiety", "somatic anxiety", "agitation". Furthermore, the FIX treatment did not increase the scores of the items "suicide", "psychic anxiety", "somatic anxiety", "agitation" and "insomnia". These findings suggest that patients affected by major depression with anxiety and/or agitation were effectively and safely treated with FX without increasing risks.

Adult↗
PubMed1997

Temperament and personality features in panic disorder with or without comorbid mood disorders.

Personality and temperament features, assessed with the Structured Interview for DSM-III-R Personality Disorders-Revised (SIDP-R) and the Tridimensional Personality Questionnaire (TPQ), respectively, were evaluated in 62 patients affected by panic disorder with (PD + MD) (n = 22) or without comorbid mood disorder (PD) (n = 40). A significant difference in the prevalence of personality disorders (PD + MD, 86% vs. PD, 62%; P < 0.05), particularly dependent (PD + DM, 50% vs. PD, 17%; P < 0.01) and borderline (PD + DM, 9% vs. PD, 0%; P = 0.05) personality disorders, was observed between the groups. Moreover, patients in the PD + MD group had higher scores for harm avoidance (PD + MD, 22.2 +/- 5.6 vs. PD, 26.9 +/- 5.1; P < 0.05) than patients in the PD group. The harm avoidance score in PD patients was significantly related to personality disorder and not to MD, suggesting that harm avoidance is not associated with greater severity of the illness. Our data confirm the hypothesis that subjects with higher harm avoidance scores have a greater probability of being affected by cluster C personality disorders and comorbid mood and anxiety disorders.

Adult↗
PubMed1997

The treatment of panic disorder in a clinical setting: a 12-month naturalistic study.

In the treatment of panic disorder double-blind controlled studies have demonstrated that imipramine (IMI) was effective at doses higher than 125 mg/day. However a high rate of dropouts because of side effects has been reported in these subjects. In clinical settings, the administration of benzodiazepines (BDZ) in combination with IMI has been proposed to reduce the frequency and severity of side effects. In this naturalistic study, 49 patients affected by panic disorder with agoraphobia (n = 36) or without agoraphobia (n = 13) were treated with IMI plus lorazepam (LRZ) and followed for 12 months. The mean effective doses were 63.5 +/- 35.5 mg/day for IMI and 2.4 +/- 1.3 mg/day for LRZ. During the follow-up period, panic attacks disappeared in 75.5% of patients and 69.5% of agoraphobics were free of phobic avoidance. The patients with comorbid mood disorders and longer duration of illness required higher doses of both drugs. The combined treatment of IMI and LRZ allowed the use of low doses of the drugs, reduced the frequency and severity of the side effects and improved patient compliance. In fact, only 1 patient (2%) dropped out because of the severity of side effects. Furthermore, the patients who tapered LRZ treatment did not show BDZ withdrawal syndrome.

Agoraphobia↗
PubMed1994

Homicide in Capgras' syndrome.

A case of Capgras' syndrome associated with homicidal behavior is reported. The psychodynamic implications are discussed. Capgras' syndrome could lie at the base of aggressive and homicidal acts directed towards family members during psychotic breakdown. Capgras' syndrome should always be evaluated in order to prevent violent acts, understand the psychologic characteristics of the patient and undertake the corresponding treatment.

Adult↗