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Biomedical subjects

G A Fava

Publications and source records attributed to G A Fava.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Psychological reactions to fetoscopy: a controlled study.

Twenty woman at risk of carrying a fetus with homozygous beta-thalassemia who underwent fetoscopy and a matched control group of pregnant women were administered the Symptom Questionnaire to evaluate changes in distress. Women who were offered fetoscopy had significantly more anxiety, depression, somatic symptoms and hostility than the control group. Psychological distress significantly decreased after the results of fetoscopy were communicated to the patient, and the decrease was similar in normal control women. Five other patients had a diagnosis of homozygous beta-thalassaemia and their pregnancies were terminated. Their psychological distress increased when they learned the outcome of fetoscopy, but decreased again after termination. Psychological reactions to fetoscopy and amniocentesis appear to be similar, yet women who undergo fetoscopy suffer from more psychological distress.

Anxiety↗
PubMedDate not supplied

Hypochondriacal fears and beliefs in DSM-III melancholia. Changes with amitriptyline.

The authors administered the Illness Attitude Scales, which identify hypochondriacal patients, to 20 nonpsychotic inpatients with DSM-III diagnosis of melancholia before and after 4 weeks of treatment with amitriptyline, and to a matched group of normals. Before treatment characteristic hypochondriacal responses occurred in over one-third of melancholics whereas after treatment the number was the same as in normals. The findings are in accord with the clinical observation that melancholia is one of the causes of hypochondriacal fears and beliefs and these tend to remit with recovery from depression.

Adult↗
PubMedDate not supplied

Rating depression in normals and depressives: observer versus self-rating scales.

Different methods of assessing depression and anxiety were tested in 20 patients suffering from a major depressive disorder with melancholia and 20 matched control subjects. Depressives were assessed before and after treatment with amitriptyline and normals were retested at the same interval. The scales used were: Paykel's Clinical Interview for Depression--which is an expanded version of the Hamilton Depression Rating Scale; the Brief Depression Rating Scale; and Symptom Questionnaire (SQ). All scales discriminated sensitively between patients and normals and the scores changed substantially with treatment. Except for the well-being subscales of the SQ, the scales showed an adequate test-retest reliability in normals. Although all scales were suitable for the measurement of depression, they differed in psychometric properties. For example, the Depression subscale of the SQ showed an unusually high test-retest reliability in normals, whereas the Contentment subscale was unreliable. Yet, the latter has been found to be highly sensitive in detecting differences between the effects of psychotropic drugs and placebo in drug trials, so it appears to measure sensitively a fleeting mood. The combined use of all three scales in patients with affective disorders yields information that might not be revealed if only one scale is used.

Adult↗
PubMedDate not supplied

Hypochondriacal fears and beliefs in agoraphobia.

In order to evaluate hypochondriacal fears and beliefs in agoraphobia, the authors administered the self-rated Illness Attitude Scales to 18 agoraphobic patients. The patients reported hypochondriacal concerns similar to those of patients with hypochondriasis. After agoraphobia had been treated with exposure therapy in ten patients, hypochondriacal concerns did not differ significantly from those of normals. The findings suggest that hypochondriacal concerns are substantial in agoraphobia and that these wane when anxiety decreases.

Adult↗
PubMedDate not supplied

Mechanisms of change of panic attacks with exposure treatment of agoraphobia.

In vivo exposure homework was applied to a consecutive series of 30 outpatients suffering from DSM-IIIR panic disorder with agoraphobia. Assessment of the characteristics of panic attacks (the prodromal phase immediately preceding the attack, acute peak anxiety, and the residual phase immediately afterwards) was done by an independent rater before treatment, after six sessions and at the end of therapy (12 sessions). Twenty-five of the 30 patients completed treatment. All of them still reported panic attacks after six sessions, even though the characteristics of panic partially improved. At the end of therapy, panic attacks disappeared in 21 of the 25 patients (84%) and these gains were maintained to 1 year follow-up thereafter by the majority (81%) of subjects.

Adult↗
PubMedDate not supplied

Affective disorders and endocrine disease. New insights from psychosomatic studies.

This is a review of psychosomatic interactions between affective disorders (depressive and anxiety disturbances, irritable mood) and endocrine disease. Particular reference is made to stressful life events in the pathogenesis of endocrine disease, psychopathology of hormonal disturbances, and pathophysiology of hypothalamic-pituitary-adrenal axis function in depression and Cushing's disease. These psychosomatic interactions may lead to appraisal of common etiological mechanisms in endocrine and psychiatric disorders, of the value of retaining the category of organic affective syndromes in psychiatric classification, and of the need for research on quality-of-life measures in endocrine disease. The establishment of "psychoendocrine units," where both endocrinologists and psychiatrists should work, is advocated. Such psychoendocrine units may serve and benefit clinical populations who currently defy traditional medical subdivisions.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

[Monitoring the impact on international literature of scientific production of Italian researchers, in the disciplines of "psychiatry" and "psychology." The period of 1995-1999 compared with the period of 1985-1989].

AIM: The aim of this paper is to present the results of a citation analysis concerned with the impact on the international literature of Italian researchers in psychiatry and psychology and of sub-fields, within these two disciplines, in 1995-1999 compared to 1985-1989. METHOD: We used a database prepared by the Institute for Scientific Information (ISI) that included all papers, with at least one Italian author, working in Italy, which appeared in two periods (1995-1999 and 1985-1989) in psychiatric or psychological journals listed in Current Contents. A citation analysis concerning the following years, up to 1999, was performed. RESULTS: In 1995-1999 the most cited researchers were those involved in clinical psychology, psychiatry and psychopharmacology research. Neuropsychology, which dominated the period 1985-1989, underwent a clear-cut decline. CONCLUSIONS: Citation analysis, concerning relatively short periods of time (five years), appears to be a very helpful tool for monitoring the development of scientific research in specific disciplines and the trend of the scientific production of researchers.

Bibliometrics↗
PubMedDate not supplied

[The impact on the international literature of the scientific production of Italian researchers in the disciplines "psychiatry" and "psychology". A bibliometric evaluation].

OBJECTIVE: The aim of the study was to present the results of a citation analysis concerned with the impact of Italian researchers and institutions in psychiatry and psychology upon the international scientific community. METHOD: The analysis has been performed using a database of the Institute for Scientific Information (ISI): All scientific papers which were published between 1981 and 1998 in psychiatric and psychological journals included in the Science Citation Index (SCI) and the Social Sciences Citation Index (SSCI) were considered. The most cited Italian papers, authors and institutions are reported, as well the most frequently utilised journals. RESULTS: Publications concerned with neuropsychology, psychopharmacology and biological psychiatry were the most cited. This prevalence also affected the ranking of the most cited authors, even though, in this case, research groups in disciplines such as clinical psychology and epidemiological psychiatry appeared to be strong. The four most productive Italian Universities were characterized by the presence of both a School of Medicine and a School of Psychology. The Journal of Neurology, Neurosurgery and Psychiatry and Psychopharmacology were the most frequent vehicles of scientific communication. CONCLUSIONS: The results entail important implications for Italian research in psychology and psychiatry. On a general level, these analyses appear to be helpful for monitoring scientific production by granting agencies and for comparing different individual researchers. On a more specific level the analysis has identified the leading trends in research of Italian psychiatry and psychology.

Bibliometrics↗
PubMedDate not supplied

Psychosomatic medicine: emerging trends and perspectives.

Developments have occurred in all aspects of psychosomatic medicine. Among factors affecting individual vulnerability to all types of disease, the following have been highlighted by recent research: recent and early life events, chronic stress and allostatic load, personality, psychological well-being, health attitudes and behavior. As to the interaction between psychological and biological factors in the course and outcome of disease, the presence of psychiatric (DSM-IV) as well as subclinical (Diagnostic Criteria for Psychosomatic Research) symptoms, illness behavior and the impact on quality of life all need to be assessed. The prevention, treatment and rehabilitation of physical illness include the consideration for psychosomatic prevention, the treatment of psychiatric morbidity and abnormal illness behavior and the use of psychotropic drugs in the medically ill. In the past 60 years, psychosomatic medicine has addressed some fundamental questions, contributing to the growth of other related disciplines, such as psychoneuroendocrinology, psychoimmunology, consultation-liaison psychiatry, behavioral medicine, health psychology and quality of life research. Psychosomatic medicine may also provide a comprehensive frame of reference for several current issues of clinical medicine (the phenomenon of somatization, the increasing occurrence of mysterious symptoms, the demand for well-being and quality of life), including its new dialogue with mind-body and alternative medicine.

Complementary Therapies↗
PubMedDate not supplied

Assessing somatization in functional gastrointestinal disorders: integration of different criteria.

BACKGROUND: Psychiatric assessment of somatization (the tendency to experience and communicate psychological distress in the form of physical symptoms and to seek medical help for them) currently rests on DSM criteria. An alternative diagnostic and conceptual framework has been proposed by an international group of psychosomatic investigators. The aim of this study was to compare these new criteria (Diagnostic Criteria for Psychosomatic Research, DCPR) with DSM-IV in a population where a high prevalence of psychosocial problems is expected (functional gastrointestinal disorders, FGID). METHOD: One hundred and ninety consecutive patients with FGID in a tertiary care center were assessed according to DSM-IV and DCPR criteria. RESULTS: The number of the 12 DCPR diagnoses was almost double that of DSM diagnoses. Only 9% of the patients were not identified by DCPR criteria, whereas this occurred in 25% of patients using DSM criteria. While patients who were given a DSM diagnosis frequently had additional DCPR diagnoses, many patients with DCPR syndromes did not fulfill any DSM criteria. Four DCPR syndromes appared to be particularly frequent and accounted for almost three quarters of the total diagnoses (alexithymia, persistent somatization, functional symptoms secondary to a psychiatric disorder, demoralization). CONCLUSIONS: The joint use of DSM and DCPR criteria was found to improve the identification of psychological factors in FGID. The results may pave the way for changes in DSM classification of somatoform disorders.

Adult↗
PubMedDate not supplied

A clinical index for rating severity in Cushing's syndrome.

BACKGROUND: In assessing the clinical response to medical and/or surgical treatments in patients with established Cushing's syndrome, the need for an instrument that could measure the magnitude of changes in the most common symptoms was felt. We therefore tested the usefulness of a simple clinical index, the Cushing's syndrome severity index (CSI), based on clinimetric principles. Eight clinical features were selected. Each one was graded on an ordinal 3-point scale (0-2) with specification of anchor points based on severity. The total score ranged from 0 to 16. METHODS: Interrater agreement, construct validity and concurrent validity of the index were evaluated. Fourteen patients with Cushing's syndrome were evaluated independently by 2 endocrinologists before and after successful treatment. The CSI and two global scales of illness severity were administered. Urinary cortisol measurements were also performed. RESULTS: The intraclass correlation coefficient of the CSI was 0.95 before treatment and 0.87 after treatment. The CSI significantly discriminated (p<0.001) the effects of treatment and paralleled the changes in urinary cortisol. There were significant correlations between CSI and global scales of illness severity and change after treatment. CONCLUSION: The results indicate that the CSI is a valid and reliable clinimetric method to evaluate severity in Cushing's syndrome. It may provide a tool for better assessing the complex array of signs and symptoms in this condition. The index is suitable for descriptive studies, outcome investigations and treatment trials.

Adolescent↗