Biomedical subjects

Filippo Bogetto

Publications and source records attributed to Filippo Bogetto.

At least 19 recordsLinked to original sources

PubMed2006

Neuropsychological correlates of reality distortion in schizophrenic patients.

The present study aims at exploring the relationship between content-related aspects of delusions and hallucinations in schizophrenia and the basic domains of cognition, controlling for the other clinical and demographic variables that could produce bias in the interpretation of the results. Seventy stable schizophrenic patients were evaluated through psychiatric assessment and a neuropsychological battery including tests on attention, memory, perceptual-motor speed and executive functions. We found that the severity of negative symptoms was strongly correlated with poor performance in almost all domains of cognitive functions, while only the attentional deficit was correlated with positive symptoms. The relationships between different cognitive domains and specific types of delusions and hallucinations showed that thought insertion, guilt, grandiose, religious and somatic delusions were associated with impairment in different cognitive functions (verbal and visual memory, attention and executive functions). Voices arguing and tactile hallucinations were correlated to delay-recall memory function. Our results suggest that no specific cognitive pattern is associated with typical-content delusions and hallucinations. On the basis of our findings, cognitive impairments associated with delusions and hallucinations, as measured by our battery, seem not to play a central role in the genesis and the maintenance of these symptoms, suggesting a more complex model of pathogenesis.

Adult↗

PubMed2006

Valproate or olanzapine add-on to lithium: an 8-week, randomized, open-label study in Italian patients with a manic relapse.

BACKGROUND: Breakthrough manic episodes are the rule in bipolar disorders; valproate and olanzapine are considered first-line treatments for manic episodes, nevertheless the two drugs have only been compared in monotherapy studies. In our study we compared the efficacy and safety of valproate and olanzapine added to lithium in the treatment of patients experiencing breakthrough manic episodes while on lithium monotherapy. METHODS: Patients with bipolar I or II disorder (SCID-I), in treatment with lithium since at least one year, experiencing a manic or hypomanic relapse were randomly assigned to an open-label add-on therapy with valproate (500-1500 mg/day) or olanzapine (7.5-15.0 mg/day) for 8 weeks. The primary efficacy measure was the Young Mania Rating Scale (YMRS) total. RESULTS: Twenty-one patients were randomized to receive the add-on therapy with valproate (n=9) or olanzapine (n=12). Both groups showed a significant baseline to endpoint reduction in YMRS total and Clinical Global Impressions-Severity (CGI-S) scores (p<0.001). At endpoint, the mean reduction of YMRS total or CGI-S scores, as well as response or remission rates, was not significantly different between the groups. However, compared with patients in the valproate add-on group, patients treated with olanzapine add-on showed significantly greater reductions in the YMRS total and CGI-S mean scores at weeks 1 through 4 (p<0.05). The rate and profile of adverse events were numerically similar in the two groups. LIMITATIONS: Open-label design and limited sample size. CONCLUSION: Both add-on therapies were efficacious in treating patients with manic or hypomanic relapse, however the olanzapine group showed an earlier response to treatment. These findings can help clinicians in understanding the value of adding other treatments to lithium in patients experiencing a manic or hypomanic relapse.

Adult↗

PubMed2006

Dysmorphic concern symptoms and personality disorders: a clinical investigation in patients seeking cosmetic surgery.

Body dysmorphic disorder (BDD) is a somatoform disorder characterized by an excessive concern with an imagined or slight defect in appearance. BDD has been particularly studied in cosmetic surgery settings. The object of the present study is to investigate the relationship between personality disorders and dysmorphic symptoms in a group of 66 patients seeking cosmetic surgery. Assessment instruments included the following: a semistructured interview for demographic and clinical characteristics; the Structured Clinical Interview for DSM-IV, the Hamilton Depression and Anxiety Rating Scales, and the Body Dysmorphic Disorder Yale - Brown Obsessive--Compulsive Scale (BDD - YBOCS). A multiple regression analysis was performed using the BDD - YBOCS score as a continuous dependent variable. The severity of dysmorphic symptoms (BDD - YBOCS score) was significantly related to two factors: the number of diagnostic criteria for schizotypal and paranoid personality disorders. The results suggest that the presence of a psychopathological reaction to imagined defects in appearance in subjects pursuing a surgical correction is associated with the severity of schizotypal and paranoid personality disorders. Preoperative assessment could help to define the clinical profile of patients in cosmetic surgery settings.

Adult↗

PubMed2006

Managing the aggressive and violent patient in the psychiatric emergency.

Throughout history most societies have assumed a link between mental disorders and violence. Although the majority of users of mental health services are not violent, it is clear that a small yet significant minority are violent in inpatient settings and in the community. The assessment of a violent patient may be very difficult due to the lack of a full medical and psychiatric history and the non-cooperativeness of the patient. Thus a full assessment is important for the early decisions that the clinician has to take in a very quick and effective way. The primary task and the short term outcome in a behavioral emergency is to act as soon as possible to stop the violence from escalating and to find the quickest way to keep the patient's agitation and violence under control with the maximum of safety for everybody and using the less severe effective intervention. The pharmacological treatment of acute, persisting and repetitive aggression is a serious problem for other patients and staff members. Currently, there is no medication approved by the Food and Drug Administration (FDA) for the treatment of aggression. Based on rather limited evidence, a wide variety of medications for the pharmacological treatment of acute aggression has been recommended: typical and atypical antipsychotics and benzodiazepines.

Aggression↗

PubMed2006

Axis I and II comorbidities in subjects with and without nocturnal panic.

Our purpose in this study was to compare the prevalence and pattern of Axis I and II comorbidities between patients with and without nocturnal panic (NP) attacks. One hundred and sixteen subjects with panic disorder (PD; according to DSM-IV criteria) were included: We assessed Axis I and II comorbidities using the Structured Clinical Interview for DSM-IV Axis I and II disorders, respectively. Of the sample, 27.6% of subjects had recurrent nocturnal panic attacks (NP group). Subjects with NP did not differ from those without in any sociodemographic or clinical characteristics. In the sample (94 subjects), 81% had at least one lifetime comorbid Axis I disorder, without significant differences between subjects with and without nocturnal panic even when considering comorbidity rates for single disorders; a trend toward significance was found for anorexia nervosa and somatization disorder, which both were more frequent among subjects with NP. Concerning Axis II disorders, 49.1% of the sample (57 subjects) met the criteria for at least one personality disorder, without significant differences between patients with and without NP. No significant differences were detected in comorbidity rates for any single Axis II personality disorder. Personality might play a relevant role in influencing treatment approaches to PD, but it does not appear to be a differential focus of concern in patients with compared to those without NP.

Adult↗

PubMed2006

Combined treatment of major depression in patients with borderline personality disorder: a comparison with pharmacotherapy.

OBJECTIVE: Combined treatment with psychotherapy and antidepressants is more effective than monotherapies. Recent data show that combined therapy has better results in patients with depression and Axis II codiagnosis. The aim of this study was to compare combined treatment using interpersonal psychotherapy (IPT) with pharmacotherapy alone in patients with depression and borderline personality disorder (BPD). METHODS: There were 39 consecutive outpatients diagnosed with BPD who presented with a major depressive episode enrolled in this study. They were randomly assigned to 1 of 2 treatment groups: fluoxetine 20 mg to 40 mg daily or fluoxetine 20 mg to 40 mg daily plus IPT 1 session weekly. Owing to noncompliance, 7 patients dropped out. We assessed the 32 patients who completed the 24 weeks of treatment at baseline, Week 12, and Week 24, using a semistructured interview for clinical characteristics, the Clinical Global Impression Scale (CGI), the Hamilton Depression Rating Scale (HDRS), and the Hamilton Anxiety Rating Scale (HARS), and 2 self-report questionnaires, that is, the Satisfaction Profile (SAT-P) for quality of life and the 64-item Inventory for Interpersonal Problems (IIP-64). We performed statistical analysis, using univariate general linear models with 2 factors: duration and type of treatment. RESULTS: Changes in remission rates, CGI, and HARS score did not differ between treatments. According to changes in the HDRS scores; changes in psychological functioning and social functioning scores on the SAT-P; and changes in vindictive or self-centred, cold or distant, intrusive or needy, and socially inhibited scores on the IIP-64, combined therapy was superior to fluoxetine alone. CONCLUSIONS: Combined therapy with IPT is more effective than antidepressant therapy alone, both in treating symptoms of major depression and in improving dimensions of quality of life and interpersonal functioning.

Adult↗

PubMed2006

Efficacy and tolerability of quetiapine in the treatment of borderline personality disorder: A pilot study.

OBJECTIVE: Second-generation antipsychotics with a favorable tolerability profile have offered new treatment options for patients with borderline personality disorder. Sparse data are available on the use of quetia-pine in treating this disorder. The aim of the present study is to investigate efficacy and tolerability of quetia-pine in a group of patients with borderline personality disorder. METHOD: Fourteen consecutive outpatients with a DSM-IV diagnosis of borderline personality disorder were treated for 12 weeks with open-label quetiapine at the dose of 200-400 mg/day. Patients were assessed at baseline, week 4, and week 12 with the Clinical Global Impressions (CGI) severity item, the Brief Psychiatric Rating Scale (BPRS), the Hamilton Rating Scale for Depression (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A), the Social and Occupational Functioning Assessment Scale (SOFAS), the Borderline Personality Disorder Severity Index (BPDSI), and the Barratt Impulsiveness Scale-version 11 (BIS-11). Adverse effects were evaluated using the Dosage Record and Treatment Emergent Symptom Scale. Statistical analysis was performed with the ANOVA for repeated measures. Significant p values were < or = .05. RESULTS: Eleven patients completed the study. Three patients (21.4%) dropped out due to excessive somnolence or noncompliance. The mean +/- SD dose of quetia-pine was 309.09 +/- 83.12 mg/day. A significant change was found for the scores of the following scales: CGI severity item, BPRS, HAM-A, SOFAS, BPDSI total score, BPDSI items "impulsivity" and "outbursts of anger," and BIS-11. Common adverse effects were mild-to-moderate somnolence, dry mouth, and dizziness. CONCLUSION: Initial data suggest that quetiapine is efficacious and well tolerated in treating patients who have borderline personality disorder, particularly when impulsiveness/aggressiveness-related symptoms are prominent. At the moment, no reliable comparison is available in the literature. Double-blind controlled trials are needed to verify these findings.

Adult↗

PubMed2005

Clinical picture of obsessive-compulsive disorder with poor insight: a regression model.

DSM-IV included a type of obsessive-compulsive disorder (OCD) with poor insight in the official classification. The present study was performed using a continuous measure of the level of insight to analyze the association between this variable and characteristics of the disorder. Seventy-four consecutive OCD outpatients (DSM-IV criteria) were assessed using: a semistructured interview for sociodemographic and clinical features, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the National Institute of Mental Health Obsessive-Compulsive Scale (NIMH-OCS), the Hamilton Depression and Anxiety Rating Scales (HDRS, HARS), and the Overvalued Ideas Scale (OVIS) as a continuous measure of the level of insight. Stepwise multiple regression analysis revealed that demographic and clinical factors were related to the OVIS score. The following four factors were found to be significantly related to the OVIS score: the Y-BOCS score for compulsions, OCD chronic course, and family history of OCD were positively related, while obsessive-compulsive personality disorder was negatively related. These results suggest that poor insight identifies a group of OCD patients with distinct clinical characteristics.

Adult↗

PubMed2005

Nocturnal panic and recent life events.

Recent research has hypothesized an association between traumatic events and nocturnal panic (NP). The purpose of this study was to investigate whether the onset of nocturnal panic attacks is associated with a higher frequency of and/or greater severity of stressful or traumatic life events than that of patients with panic disorders (PDs) who experience daytime panic attacks (DPs) while awake. A secondary aim was to investigate whether NP is associated with specific life events at the onset of the disorder. Our sample comprised 129 subjects with PD (DSM-IV). We investigated the number and types of stressful life events that occurred in the year prior to PD onset using a semistructured interview. Of the sample, 28.7% had recurrent nocturnal panic attacks (NP group). Subjects with and without recurrent NP did not differ on any sociodemographic or clinical characteristic. Neither the number nor type of life event distinguished those with or without NP. The subgroup of patients with PD with recurrent NP appears to represent a variant of PD with a possible increased vulnerability to conditions of diminished arousal as a trigger of panic attacks. However, the hypothesis that this vulnerability might be determined by life events that occur in the period preceding PD onset was not supported by the findings of this study.

Adult↗

PubMed2005

Randomized controlled trial comparing brief dynamic and supportive therapy with waiting list condition in minor depressive disorders.

BACKGROUND: Although many evidences suggest the presence of specific therapeutic factors in brief dynamic therapy (BDT), few studies have investigated its efficacy in the treatment of depressive disorders in comparison to other psychotherapies. The aim of this study was to determine whether BDT is more effective than brief supportive psychotherapy (BSP) and waiting list condition in the treatment of minor depressive disorders. METHOD: Thirty patients with primary DSM-IV dysthymic disorder, depressive disorder not otherwise specified or adjustment disorder with depressed mood completed a randomized controlled trial with three treatment groups (BDT, BSP, waiting list condition). A 6-month follow-up was performed for patients treated with both psychotherapeutic approaches. Other psychiatric treatments were not permitted throughout the treatment period and the 6-month follow-up. Symptoms were assessed at baseline, at the end of treatment, and after 6 months of follow-up. RESULTS: Patients treated with both psychotherapeutic approaches showed a significant improvement after treatment in comparison to non-treated controls, but BDT was more effective at follow-up evaluation. CONCLUSIONS: BDT is a promising treatment for minor depressive disorders. This study also suggests that BDT is more effective than supportive psychotherapy in improving the long-term outcome of depressive disorders.

Adolescent↗

PubMed2005

Major depression in patients with borderline personality disorder: a clinical investigation.

OBJECTIVE: Borderline personality disorder (BPD) is characterized by a high frequency of comorbidity with major depressive disorder (MDD). This study aimed to compare the clinical characteristics of 2 groups of patients with MDD: those with concomitant BPD and those with other concomitant personality disorders. METHODS: We assessed 119 outpatients, using a semistructured interview for demographic and clinical features, the Structured Clinical Interview for DSM-IV, Hamilton anxiety and depression scales, the Zung Self-Rating Depression Scale (ZSDS), the Social and Occupational Functioning Assessment Scale (SOFAS), the Sheehan Disability Scale, and the Revised Childhood Experiences Questionnaire. We performed a regression analysis, using the number of criteria for BPD as the dependent variable. RESULTS: Severity of BPD was positively related to the ZSDS score, to self-mutilating behaviours, and to the occurrence of mood disorders in first-degree relatives; it was negatively related to the SOFAS score and age at onset of MDD. CONCLUSIONS: Patients with comorbid MDD and BPD present differential characteristics that indicate a more serious and impairing condition with a stronger familial link with mood disorders than is shown by depression patients with other Axis II codiagnoses.

Adult↗

PubMed2005

Personality disorders in patients with burning mouth syndrome.

Burning Mouth Syndrome (BMS) presents high rates of comorbid Axis I disorders while no controlled studies have addressed the question of Axis II comorbidities. The aim of the present study was to examine DSM-IV (APA, 1994) Axis II comorbidity in BMS patients and to control for the specificity of this association. Seventy BMS patients were compared to a nonpsychiatric population sample and to patients with other Somatoform Disorders for the presence of personality disorders (assessed with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders [SCID-II; First, Gibbon, Spitzer, & Williams, 1997). Prevalence rates were compared using the Pearson's chi square test. At least one personality disorder (PD) was found in 85.7%, 24.3%, and 88.6% of subjects in the three groups, respectively. When examining PD subgroups, significant differences emerged even between the BMS and the somatoform disorder group, with BMS patients showing more Cluster A and fewer Cluster B PDs. Our results suggest that BMS is associated with a specific pattern of Axis II comorbidity.

Aged↗

PubMed2005

Citalopram versus sertraline in late-life nonmajor clinically significant depression: a 1-year follow-up clinical trial.

OBJECTIVE: The aim of this study was to compare over 1 year the effect of sertraline and citalopram on depressive symptoms and cognitive functions of nondemented elderly patients with minor depressive disorder and subsyndromal depressive symptomatology. METHOD: We recruited 138 consecutive non-demented outpatients of either sex, aged > or =65 years, who were classified as meeting research criteria for minor depressive disorder or sub-syndromal depressive symptomatology using the Structured Clinical Interview for DSM-IV. Subjects were assigned to receive citalopram 20 mg/day (66 patients) or sertraline 50 mg/day (72 patients) orally for 1 year. Patients were assessed at baseline and after 1, 2, 3, and 6 months and at 1 year by raters masked with regard to patients' treatment assignments. The Hamilton Rating Scale for Depression, the Geriatric Depression Scale, and the Global Assessment of Functioning were administered to assess the course of depressive symptoms and social functioning during the study. Cognitive measures included Trail Making Test-Parts A and B, Wechsler Memory Scale, Mini-Mental State Examination, and a verbal fluency test. Data were collected from March 2000 to March 2003. RESULTS: The overall completion rate was 72%. Both treatments induced a significant, sustained, and comparable improvement in depressive symptoms and in social functioning. Nearly half of the subjects in the 2 groups achieved remitter status at study endpoint. Significant within-group improvements also were observed in all cognitive measures. Both drugs were well tolerated during the whole study period. CONCLUSION: Our results suggest that sertraline and citalopram can improve depressive symptoms and cognitive functions of minor depressive disorder and subsyndromal depressive symptomatology in elderly nondemented patients.

Age Factors↗

PubMed2005

Oxcarbazepine in the treatment of borderline personality disorder: a pilot study.

BACKGROUND: According to available studies concerning treatment of patients with borderline personality disorder, mood stabilizers have been found effective in controlling core symptoms of borderline pathology, in particular impulsive behavior and mood instability. Oxcarbazepine, an anticonvulsant structurally related to carbamazepine, has been tested in psychiatric settings for treating patients with bipolar disorders, substance abuse, resistant psychosis, and schizoaffective disorder. The present article is a pilot study on the efficacy and tolerability of oxcarbazepine in the treatment of borderline personality disorder. METHOD: Seventeen outpatients diagnosed with DSM-IV-TR borderline personality disorder were included. Patients were administered oxcarbazepine, 1200 to 1500 mg/day supplied twice daily, and tested at baseline, week 4, and week 12 using the Clinical Global Impressions scale-Severity of Illness item (CGI-S), the Brief Psychiatric Rating Scale (BPRS), the Hamilton Rating Scales for Depression and Anxiety (HAM-D, HAM-A), the Social Occupational Functioning Assessment Scale, and the Borderline Personality Disorder Severity Index (BPDSI). Adverse effects were collected and serum sodium level was measured. Statistics were performed by using the analysis of variance for repeated measures. RESULTS: Four patients discontinued treatment in the first 4 weeks due to noncompliance. A statistically significant response to oxcarbazepine was observed according to CGI-S and BPRS mean score (p = .001), HAM-A mean score (p = .002), BPDSI total score (p = .0005), and 4 BPDSI items, including interpersonal relationships (p = .0005), impulsivity (p = .0005), affective instability (p = .0005), and outbursts of anger (p = .045). No cases of significant hyponatremia or severe adverse effects were reported. Mild to moderate adverse effects included sedation, dizziness, nausea, and headache. Seven patients reported no adverse effects. CONCLUSION: Oxcarbazepine was found an effective and well-tolerated treatment in the management of borderline personality disorder patients.

Adult↗

PubMed2005

Naturalistic, retrospective comparison between second-generation antipsychotics and depot neuroleptics in patients affected by schizophrenia.

OBJECTIVE: Data in the literature comparing second-generation antipsychotics (SGAs) and depot neuroleptics are scarce. The aim of this retrospective, naturalistic study is to examine the relative effectiveness of SGAs and depot neuroleptics in 2 matched groups of patients affected by schizophrenia. METHOD: Between July 2004 and September 2004, we collected data from 2 groups of 30 DSM-IV-TR schizophrenia outpatients, matched for a number of demographic and clinical characteristics, who received a 2-year treatment with depot neuroleptics or SGAs. Treatments were compared through the Clinical Global Impressions-Severity of Illness scale (CGI-S), performed on several symptom domains of schizophrenia. Other outcomes included 1-and 2-year readmission rates, the number of self-injuries during the treatment period, and anticholinergic drug prescription, considered as an index of extrapyramidal symptoms. RESULTS: Treatment with both drug classes produced broadly comparable clinical effects. Clinician-assessed effectiveness was similar for SGA and depot recipients, with significant decreases over baseline in all CGI-S symptom domain scores. The percentages of patients readmitted during the follow-up period were similar among drug groups. After 1 year, 6 SGA patients (20%) were readmitted compared with 7 depot patients (23%); after 2 years, 9 SGA patients (30%) were rehospitalized compared with 11 depot patients (37%). Also, no between-group differences were detected with respect to the number of self-injuries. Anticholinergic drug prescription was significantly less common in SGA patients compared with depot recipients (p = .0112). CONCLUSION: These findings confirm at least equal long-term effectiveness of depot neuroleptics and SGAs, but a possible advantage for SGAs in decreased use of anticholinergic drugs.

Adult↗

PubMed2004

Relationships of age at onset with clinical features and cognitive functions in a sample of schizophrenia patients.

BACKGROUND: A number of studies investigated the relationships of age at onset with clinical presentation and cognitive performance of schizophrenic patients. The aim of the present study was to assess demographic and clinical characteristics; psychopathologic, social functioning, and quality-of-life ratings; and neuropsychological measures in a sample of patients with stabilized schizophrenia and to identify which factors independently contributed to a multiple regression model with age at onset as the dependent variable. METHOD: Ninety-six consecutive outpatients with schizophrenia (DSM-IV-TR criteria) were included in the study. Assessment instruments were as follows: a semistructured interview, the Clinical Global Impressions scale, the Comprehensive Psychopathological Rating Scale, and the Positive and Negative Syndrome Scale (PANSS) for psycho-pathology of schizophrenia; the Calgary Depression Scale for Schizophrenia (CDSS) for depression; the Social and Occupational Functioning Assessment Scale and the Sheehan Disability Scale for social functioning; the Quality of Life Scale; and a neuro-psychological battery including the Wisconsin Card Sorting Test (WCST) and the Continuous Performance Test. Two models of multiple regression were tested: the first included clinical features and psychopathologic, social functioning, and quality-of-life scales; the second also considered neuro-psychological variables. Data were collected from October 2001 to November 2002. RESULTS: The first multiple regression showed that age at onset was significantly related to scores on the PANSS subscale for negative symptoms (p =.042) and the CDSS (p =.041); the second regression found a relation of age at onset with PANSS score for negative symptoms (p =.002) and 2 neuropsychological measures, number of preservative errors on the WCST and Continuous Performance Test reaction time (p =.0005 for both). CONCLUSION: Our data indicate that, when results of neuropsychological tests are considered, early age at onset of schizophrenia is associated with severity of negative symptoms and compromised cognitive measures of executive functioning and sustained attention.

Adult↗

PubMed2004

Weight gain during long-term treatment of obsessive-compulsive disorder: a prospective comparison between serotonin reuptake inhibitors.

BACKGROUND: The effect of extended anti-depressant treatment on weight has been poorly investigated. Also unknown is whether different compounds have differential effects. The aim of the present study was to assess changes in weight in obsessive-compulsive disorder (OCD) patients treated for 2.5 years with clomipramine or selective serotonin reuptake inhibitors. METHOD: 138 DSM-IV OCD patients who responded to 6-month acute treatment at the Mood and Anxiety Disorders Unit, Department of Neuroscience, University of Turin, Italy, were followed-up for 2 years while receiving open-label clomipramine, citalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline. Patients were consecutively recruited and followed from May 1998 to March 2003. The mean percentage change in weight was compared for each group, as was the proportion of patients who had a > or = 7% weight increase from baseline. RESULTS: At the end of the 2.5-year study period, patients had gained a mean of 2.5% of their body weight with respect to baseline (1.58 kg); 14.5% of the total sample experienced a significant (> or = 7%) weight increase. Within each but the fluoxetine treatment group, paired t tests showed a significant increase in weight from baseline to final visit. Analysis of variance showed a significant difference between treatment groups (p = .009), with clomipramine being associated with the highest weight increase and fluoxetine and sertraline with the lowest. A higher proportion of clomipramine-treated patients (34.8%) gained > or = 7% in weight as compared with sertraline and fluoxetine, which accounted for the lowest percentage of patients with a significant weight gain (4.5% and 8.7%, respectively), although this difference was not statistically significant. CONCLUSION: Risk of weight gain during extended serotonin reuptake inhibitor treatment for OCD differs depending on which compound is used. The differences among antiobsessive drugs may affect compliance with medication and health risks.

Adult↗

PubMed2003

Predictors of psychiatric disorders in liver transplantation candidates: logistic regression models.

This study has two goals. The first goal is to assess the prevalence of psychiatric disorders in orthotopic liver transplantation (OLT) candidates by means of standardized procedures because there has been little research concerning psychiatric problems of potential OLT candidates using standardized instruments. The second goal focuses on identifying predictors of these psychiatric disorders. One hundred sixty-five elective OLT candidates were assessed by our unit. Psychiatric diagnoses were based on the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Patients also were assessed using the Hamilton Depression Rating Scale (HDRS) and the Spielberger Anxiety Index, State and Trait forms (STAI-X1 and STAI-X2). Severity of cirrhosis was assessed by applying Child-Pugh score criteria. Chi-squared and general linear model analysis of variance were used to test the univariate association between patient characteristics and both clinical psychiatric diagnoses and severity of psychiatric diseases. Variables with P less than.10 in univariate analyses were included in multiple regression models. Forty-three percent of patients presented at least one psychiatric diagnosis. Child-Pugh score and previous psychiatric diagnoses were independent significant predictors of depressive disorders. Severity of psychiatric symptoms measured by psychometric scales (HDRS, STAI-X1, and STAI-X2) was associated with Child-Pugh score in the multiple regression model. Our data suggest a high rate of psychiatric disorders, particularly adjustment disorders, in our sample of OLT candidates. Severity of liver disease emerges as the most important variable in predicting severity of psychiatric disorders in these patients.

Adult↗