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Biomedical subjects

L Bellodi

Publications and source records attributed to L Bellodi.

At least 73 records · Page 4Linked to original sources

Plasma tryptophan levels and tryptophan/neutral amino acid ratios in obsessive-compulsive patients with and without depression.

We have studied fasting plasma tryptophan (TRP) levels and tryptophan/large neutral amino acid (TRP/LNAA) ratios in 12 patients with obsessive-compulsive disorder (OCD) and 12 patients with OCD and a coexisting current diagnosis of major depressive disorder (OCD-MDD). Assessments were made at baseline and after 6 weeks of treatment with fluvoxamine. OCD-MDD patients had significantly lower baseline TRP levels and TRP/LNAA ratios than OCD patients. After 6 weeks of fluvoxamine treatment, OCD-MDD patients had significant increases in plasma TRP and TRP/LNAA ratio, whereas OCD patients had non-significant decreases. Our data suggest that a major depressive syndrome could be a state variable affecting the changes in plasma TRP and TRP/LNAA ratio in OCD patients.

Adult↗

Panic attacks: a twin study.

The role of genetic factors in panic disorder (PD) and sporadic panic attacks (SPAs) was investigated. A total of 120 twins recruited from the general population were interviewed for the presence of anxiety disorders and SPAs. A significantly higher concordance among MZ than DZ twins was found for PD (73% vs. 0%) but not for SPAs (57% vs. 43%). These results confirm a significant role of genetic factors in PD but suggest that genetic factors might not be crucial for the development of SPAs.

Adult↗

Predictive value of obsessive-compulsive personality disorder in antiobsessional pharmacological treatment.

Previous reports have stressed the implication of Personality Disorders as predictors of a poorer treatment outcome in Obsessive-Compulsive Disorder (OCD). The aim of this study was to see whether or not Obsessive-Compulsive Personality Disorder in Obsessive-Compulsive Disorder may be predictive for a poorer outcome to antiobsessive pro-serotonergic pharmacological treatment. For this purpose, 30 OCD patients were divided into two groups according to the presence or absence of Obsessive-Compulsive Personality Disorder. Ten-week standardized treatments with oral SRI drugs were given to look for different outcomes between the two groups in Obsessive-Compulsive symptom severity. At the end of the study we found that the presence of Obsessive-Compulsive Personality Disorder, along with the total number of Personality Disorders, did predict poorer response to pharmacological treatment in OCD.

Adult↗

The structure of DSM-III-R schizotypal personality disorder diagnosed by direct interviews.

Confirmatory factor analysis techniques were applied to test how competing models (unifactorial, bifactorial, and trifactorial) could be used to explain the structure of schizotypal disorder as defined in DSM-III-R and DSM-IV. Subjects were 538 nonpsychotic psychiatric outpatients and a replication sample of 225 nonpsychiatric patients and control subjects, interviewed by clinicians using the Structured Interview for DSM-III-R Personality Disorders. The study found that the best-fit solution encompassed three factors: cognitive-perceptual, interpersonal, and oddness. Future studies may benefit from considering schizotypal personality disorder as composed of three factors that may indicate the existence of three underlying (dys)functional systems.

Adult↗

Long-term pharmacotherapy of obsessive-compulsive disorder: a double-blind controlled study.

The aim of this study was to investigate whether obsessive-compulsive patients previously treated successfully with clomipramine or fluvoxamine could tolerate reduction of the daily dosage without worsening of the clinical condition. Thirty informed obsessive-compulsive patients, given a diagnosis according to DSM-III-R criteria, were recruited consecutively into the study. Patients were blindly assigned to one of the groups of treatment with different rates of reduction of the previously effective daily drug dosage: group 1 (control group, no reduction), group 2 (reduction of 33-40%), and group 3 (reduction of 60-66%). The entire study lasted 102 days. From baseline to the end of the study, the clinical condition was evaluated by the administration of standardized tests (Yale-Brown Obsessive-Compulsive Scale, Hamilton Rating Scale for Depression, Clinical Global Impression [CGI] scale), and blood samples were collected for plasma drug level determinations. The criterion for discontinuation of the study was the worsening of obsessive-compulsive symptoms, arbitrarily defined by an increase of > 5% from the baseline total Yale-Brown Obsessive-Compulsive Scale score, as measured in two successive assessments, and a worsening of global clinical condition as measured by the CGI scale. The main result of the study was borne out from the survival analysis. There were no significant differences in the cumulative proportion of patients from each group of treatment who did not worsen during the 102 days of observation. This preliminary result, which needs to be confirmed in larger samples, suggests that long-term maintenance therapy for obsessive-compulsive disorder might be provided with lower dosages of the antiobsessional drug, with clear advantages for tolerability and compliance.

Adult↗

Pharmacologic effect of imipramine, paroxetine, and sertraline on 35% carbon dioxide hypersensitivity in panic patients: a double-blind, random, placebo-controlled study.

The effects of short treatment (7 days) with the tricyclic antidepressant imipramine and the two selective serotonin reuptake inhibitors paroxetine and sertraline on the reactivity to inhalation of 35% CO2/65% O2 were compared in 70 panic patients who had positive responses to 35% CO2 inhalations. A double-blind, random, placebo-controlled design was applied. Each patient was given the 35% CO2 challenge on days 0 (before starting the treatment), 3, and 7. In the placebo group, there were no significant changes in the reactivity to 35% CO2 in the three sessions whereas there were significant similar reductions of reactivity to 35% CO2 in all three drug-treated groups. These results confirm the good reproducibility of 35% CO2 reactivity and the negligible effects of placebo on reactivity to CO2 and suggest that short treatments with imipramine, paroxetine, and sertraline decrease reactivity to 35% CO2, possibly as an expression of their antipanic properties.

Adult↗

Modification of 35% carbon dioxide hypersensitivity across one week of treatment with clomipramine and fluvoxamine: a double-blind, randomized, placebo-controlled study.

The effects of short treatments (7 days) with clomipramine and fluvoxamine on the reactivity to inhalations of 35% CO2/65% O2 were compared in 39 panic patients who had positive responses to 35% CO2 inhalations. A double-blind, randomized, placebo-controlled design was applied. Each patient was given the 35% CO2 challenge on days 0 (before starting treatment), 3, and 7. Patients on placebo did not report any significant changes in their reactivity to 35% CO2 across the three sessions, whereas patients on clomipramine and fluvoxamine reported a significant attenuation of the reactivity on day 7. These results indicate that treatments with clomipramine and fluvoxamine decrease hypersensitivity to 35% CO2 after a few days, suggesting a relevant role of the modulation of CO2 sensitivity by the serotonergic system in antipanic properties of these compounds.

Adult↗

Efficacy of fluvoxamine, paroxetine, and citalopram in the treatment of obsessive-compulsive disorder: a single-blind study.

Obsessive-compulsive disorder (OCD) has been successfully treated with proserotonergic agents for some years. Clomipramine was the first drug used, but several clinical trials have been conducted more recently to assess the antiobsessional efficacy of selective serotonin reuptake inhibitors (SSRIs). The aim of this study was to compare the antiobsessional efficacy of three SSRIs, fluvoxamine, paroxetine, and citalopram. Thirty obsessive-compulsive patients without comorbid axis I diagnoses except for tic disorder as assessed by DSM-III-R criteria gave informed consent and were recruited consecutively; they underwent a 10-week randomized treatment with fluvoxamine, paroxetine, or citalopram. Ratings were performed under blind conditions every 2 weeks from baseline to the end of the study and by the Yale-Brown Obsessive-Compulsive Scale, the National Institute of Mental Health-Obsessive-Compulsive Scale, the Clinical Global Impressions Scale, and the Hamilton Rating Scale for Depression. Quantitative and qualitative analyses of the antiobsessional efficacy of the three drugs were completed with analysis of variance with repeated measures and survival analysis. The results showed no significant differences between the three treatments. The preliminary conclusions drawn from this study concern the interchangeable antiobsessional effects of different SSRIs, although further studies of "cross-response" to these drugs are needed.

Adult↗

Functional promoter polymorphism of the human serotonin transporter: lack of association with panic disorder.

To probe the hypothesis of a role for a functionally relevant 44 bp insertion/deletion of the serotonin transporter promoter in the aetiopathogenesis of panic disorder, we determined the allele frequency of the variant in two samples (combined n = 158) of panic disorder patients (DSMIII-R) and compared it with its allele frequency in two ethnically matched control samples (combined n = 169). The fact that no difference could be observed (x 2 analysis) argues against a major role for this serotonin transporter promoter polymorphism in the aetiopathogenesis of panic disorder.

Alleles↗

Tryptophan depletion in obsessive-compulsive patients.

Twelve patients with obsessive-compulsive disorder were studied after the administration of a mixture of amino acids devoid of tryptophan (TRP) or a mixture containing all the essential amino acids, in a double-blind, crossover design. The TRP-free mixture caused a marked depletion of plasma TRP. After TRP decrease, mean ratings of obsessions and compulsions, measured by Visual Analogue Scales (VAS) ratings, did not worsen. In contrast with other reports in literature, TRP depletion also failed to alter mood in our subjects.

Adult↗

EEG power modifications in obsessive-compulsive disorder during olfactory stimulation.

Temporal lobe electroencephalogram (EEG) activity was quantitatively analyzed in obsessive-compulsive disorder (OCD) when subjects are at rest and during a temporal lobe activating procedure, i.e., olfactory stimulation. At rest with eyes closed, delta-1 and alpha-2 power differences were evident in OCD patients as compared with normal controls. During olfactory stimulation, differences between patients and normal groups were detectable in the slower beta frequencies: Normal subjects showed a power increase, whereas OCD patients showed no modification or slight decrease. Our results support previous findings of temporal lobe EEG abnormalities in OCD patients with an abnormal pattern of response to a temporal lobe activating procedure.

Adult↗

Familial risks and reproductive fitness in schizophrenia.

Recently published data from the Roscommon Family Study show that a parental diagnosis of schizotypal disorder (SPD) has a significant and specific impact on the risk for schizophrenia in siblings of index probands with schizophrenia spectrum disorders. The distribution patterns of risks for schizophrenia and SPD in parents were of opposite magnitude to those of patients' siblings and children. These patterns can be predicted from the diminished reproductive fitness of patients with schizophrenia if subjects with SPD belong in the schizophrenia spectrum but have no diminished fitness. We briefly review how the few available data about the distribution of risks for schizophrenia and SPD among relatives of probands with SPD and the data for their marital status, as a tentative index of reproductive fitness, may support this interpretation. There is some indirect evidence that, unlike what is usually reported for people with schizophrenia, reproductive fitness may not be diminished in SPD. This might partially account for the opposite patterns of distribution of risks for schizophrenia and SPD in families.

Adult↗

Family history of panic disorder and hypersensitivity to CO2 in patients with panic disorder.

OBJECTIVE: The authors investigated the relationships between hypersensitivity to CO2 and familial-genetic risk for panic disorder in patients with panic disorder. METHOD: Morbidity risks for panic disorder were calculated for families of 203 patients with panic disorder, each of whom was challenged with 35% CO2. RESULTS: Patients who reacted with a positive response to the 35% CO2 challenge showed a genetic risk for panic disorder (morbidity risk = 14.4%) that was significantly higher than that for patients who did not react (morbidity risk = 3.9%). CONCLUSIONS: These findings support the idea that hypersensitivity to CO2 might be associated with a subtype of panic disorder specifically related to a greater familial loading.

Adult↗

Obsessive compulsive disorder and mood disorders: a family study.

Obsessive compulsive disorder (OCD) often coexists with major depression (MD), with rates varying from 35 to 75%. The nature of the depressive symptomatology can be investigated by familial aggregation analysis, assuming that the disorder which occurs first is the one showing greater genetic liability and should have higher familial concentration. Therefore, the aim of our study was to assess the familial loading for OCD and mood disorders in the families of OCD patients with different chronology of onset for the mood disorder, to evaluate how the familial pattern of the diseases differs with different temporal sequences in which the two syndromes occur. A total of 172 OCD patients entered the study; 112 were pure OCD probands, 12 were unable to separate the onset of the two syndromes, 11 had prior mood disorder, and 37 of them had experienced their first depressive episodes after the onset of OCD. Information about the family history was collected by means of the Family History-Research Diagnostic Criteria (FH-RDC) and by directly interviewing at least 2 relatives per family. Morbidity risks for OCD indicate a familial concentration of the disorder in all groups, except the MD/OCD group. We found the highest rate of relatives affected by mood disorders in the families of patients with first onset of MD (28.8%), whereas in the other 3 groups MRs were much lower. These results suggest the affective nature of OCD patients who experienced first onset of MD. Thus, the chronology of onset seems to identify 2 different typologies of familial distribution.

Adult↗

Serum cholinesterase in obsessive-compulsive disorder.

Levels of serum cholinesterase (PsChe) were measured in 32 drug-free patients with obsessive-compulsive disorder (OCD) and 32 sex- and age-matched healthy normal volunteers. No significant differences between OCD patients and normal subjects were found in PsChe levels. A significant positive correlation between patients' PsChe levels and the severity of anxiety, as measured by the Hamilton Rating Scale for Anxiety, was found, in agreement with the hypothesis of a relationship between state anxiety and PsChe activity. In contrast to findings in other reports, PsChe levels significantly increased after 10 weeks of antiobsessional pharmacological treatment, underscoring the potential influence of drugs on PsChe activity.

Acetylcholinesterase↗

Effects of acute intravenous clomipramine on obsessive-compulsive symptoms and response to chronic treatment.

The aim of this study was to test the hypothesis that obsessive-compulsive symptoms are temporarily worsened by acute intravenous clomipramine, suggesting that there is a basal hypersensitivity of serotonin (5-HT) receptors in obsessive-compulsive (OC) patients. We also investigated the relationship of the effects of acute (intravenous) and chronic (oral) administration of clomipramine. Twenty-eight OC patients were recruited. The first part of the study included placebo and clomipramine infusions and monitoring of OC symptoms by 100 mm Visual Analogue self-rated scales (VAS). There was significant worsening of obsessions in the whole sample during clomipramine infusion. The second part included standardized 10-week oral treatments with clomipramine and evaluation of clinical efficacy. Among the 18 patients who completed the second part of the study, oral clomipramine significantly reduced OC symptoms, but OC patients who had become worse after clomipramine infusion showed higher Y-BOCS scores.

Administration, Oral↗