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Biomedical subjects

M Casacchia

Publications and source records attributed to M Casacchia.

At least 19 recordsLinked to original sources

Reliability of an Italian standardized and expanded Brief Psychiatric Rating Scale (BPRS 4.0) in raters with high vs. low clinical experience.

OBJECTIVE: The aims of this study were (i) to assess the inter-rater reliability of the latest Italian expanded 24-item version of the Brief Psychiatric Rating Scale, BPRS version 4.0 and (ii) to assess the feasibility of obtaining reliable BPRS 4.0 ratings by reliability training of clinically less experienced trainees (medical and rehabilitation students). METHOD: A videotape-training procedure was used, and the inter-rater agreement scores of three different groups of raters, namely psychiatrists and psychologists (n=28), psychosocial rehabilitation students (n=27) and medical students (n=54) were calculated and compared. RESULTS: The results indicated that both experienced raters (psychiatrists and psychologists) and inexperienced raters (medical and psychosocial rehabilitation students) were able to achieve high levels of inter-rater reliability. CONCLUSION: Our results are of particular interest in view of the increasing need to draw upon professionals, other than psychiatrists and psychologists, for cost-effective and standardized evaluation of rehabilitation interventions.

Adult

The Italian version of the Family Assessment Device.

The aim of the study was to evaluate in a heterogeneous. Italian sample (n = 340) the psychometric properties of the Italian version of the Family Assessment Device (FAD), a 60-item questionnaire assessing family functioning. The questionnaire was administered to psychiatric (n = 116), medical (n = 114) and non-clinical samples (n = 110). In a sample of 30 non-clinical subjects the temporal stability of the FAD was investigated. The results showed a good temporal stability for Problem Solving, General Functioning. Communication, and Affective Responsiveness scales, and a good internal reliability of the scale. Factor analysis of the Italian version provided discrepancies with the hypothesized structure of the instrument, leading to the identification of seven slightly different dimensions. The proposed seven-factor model of the instrument did not provide a good fit to our data. The results of our study suggest the need for a major improvement in the adaptation of the FAD in the Italian setting.

Adult

Association between striatal reduction and poor Wisconsin card sorting test performance in patients with schizophrenia.

Several findings support the hypothesis that the striatum is implicated in executive functions and in the modulation of goal-directed behavior, and could play a key role in the pathophysiology and in the production of symptoms and signs in schizophrenia. We have studied the relationship between the objective measures of the striatal structures, as evaluated by magnetic resonance imaging (MRI), and the Wisconsin Card Sorting Test (WCST) performance in a schizophrenic sample. Thirty-five schizophrenic patients underwent MRI scans of striatal structure and neuropsychological evaluation of executive functions by WCST. Poor WCST performers had a reduction of the left caudate nucleus and putamen, and right total striatum when compared to 24 healthy controls. Significant correlation coefficients were also observed between neuropsychological indexes and left striatal measures. The findings suggest the existence of a relationship between abnormalities of striatal structure and abnormal executive-type or organizational cognitive functions.

Adult

No deficit in Wisconsin Card Sorting Test performance of schizophrenic patients' first-degree relatives.

The Wisconsin Card Sorting Test (WCST) was administered to 92 schizophrenic patients, 25 first-degree relatives and 60 normal subjects in order to investigate whether this task could be considered a trait marker of vulnerability to schizophrenia. The schizophrenic patients performed significantly worse than either their relatives or normal subjects, but unaffected relatives did not differ from controls. Our results suggest that WCST performance is more likely a feature inherent to the disease process rather than an index of the genetic susceptibility to the illness.

Adult

Wisconsin card sorting test and Stroop test performance in schizophrenia: a shared construct.

The Wisconsin card sorting test (WCST) and Stroop test were administered to 25 schizophrenic patients in order to better identify and understand more specific processing mechanisms involved in executive dysfunctions and to investigate their hypothetical involvement in symptom formation. Data show that for as much as the two tests employed measured executive functions in terms of mental control and cognitive flexibility, our findings seemed to indicate shared or interconnected mechanisms. No correlations were seen between the psychopathological evaluation and any of the neuropsychological indexes. The use of the Stroop task could provide a more readily cognitive analysis in terms of specific processing mechanisms, at the basis of WCST impairment in schizophrenia.

Adult

Risperidone, negative symptoms and cognitive deficit in schizophrenia: an open study.

The aim of this study was to evaluate the effects of a new antipsychotic compound on negative symptoms and cognitive deficit in schizophrenia. Psychiatric symptoms and cognition were assessed in 25 patients with schizophrenia, at baseline and after they had taken risperidone for 4 weeks. The Positive and Negative Symptoms Scale (PANSS), the Wisconsin Card Sorting Test (WCST) and two WAIS sub-tests were used to assess the patients. After the study period, both negative and positive symptoms and also measures of cognitive performance improved significantly. The WCST results correlated with negative symptom scores before and after treatment. This suggests that negative symptoms and cognitive deficit have a common underlying substrate which is the target of the risperidone treatment. Our data show that risperidone may have a substantial effect on complex cognitive functions in schizophrenia, and they suggest that certain cognitive deficits are relatively dependent on the negative symptoms of this disorder.

Adult

Schizophreniform disorder: a 1-year follow-up study.

The study reports the preliminary data from a small 12-patient sample assessed at the time of their first psychotic episode and diagnosed as having a schizophreniform disorder. After a 1-year follow-up period all the patients were newly evaluated on clinical and global functioning variables, using clinical diagnosis as an outcome measure. A diagnostic stability in the schizophrenic spectrum was found.

Adult

High resolution cytogenetic study in schizophrenia.

A high resolution cytogenetic study was performed on forty unrelated schizophrenic patients defined by DSM-III-R criteria. We have not included cases with mental retardation, severe dysmorphic features or other characteristic symptoms of chromosomal syndromes in our analysis. No recognizable chromosomal abnormality was found.

Adult

Assessment of the efficacy of buspirone in patients affected by generalized anxiety disorder, shifting to buspirone from prior treatment with lorazepam: a placebo-controlled, double-blind study.

Forty-four patients with DSM-III-R generalized anxiety disorder participated in this double-blind, randomized study. Patients were on a benzodiazepine before the study and were stabilized on 3 to 5 mg/day lorazepam for 5 weeks (weeks 0 to 5). Thereafter, they were randomized to 15 mg/day buspirone or placebo for the following 6 weeks (weeks 6 to 11). During the first 2 weeks of double-blind, randomized treatment (weeks 6 to 7), lorazepam was tapered off. During weeks 12 to 13, patients received single-blind placebo. Assessment included the Hamilton Rating Scale for Anxiety, the State-Trait Anxiety Inventory, the Zung and Eddy Self-Rating Scale of Anxiety Symptoms, the Hamilton Rating Scale for Depression, and the Rome Depression Inventory, completed at weeks 0, 5, 6, 7, 8, 9, 11, and 13. Side effects were assessed through the Dosage Treatment Emergent Symptoms at the same times. The benzodiazepine-withdrawal syndrome was evaluated through a 27-symptom checklist (Clinical-Rated Benzodiazepine Withdrawal Symptom Schedule) at weeks 0, 5, 6, 7, 11, and 13. The results showed that buspirone was more effective than placebo and comparable to lorazepam. Buspirone-treated patients showed no rebound anxiety or benzodiazepine-withdrawal syndrome compared with placebo. Buspirone caused fewer side effects than lorazepam and was not different from placebo in this respect. Finally, buspirone maintained its anxiolytic effect for at least 2 weeks after the discontinuation of treatment.

Adult

Sensorimotor gating and habituation evoked by electro-cutaneous stimulation in schizophrenia.

The present study has been performed in order to evaluate two relevant phenomena related to startle reflex (SR) evoked by electro-cutaneous stimulation in schizophrenic patients: 1) the effect of different interstimulus intervals on R1, R2 magnitude and on R2 latency in schizophrenia in order to verify if the gating effect influences all blink reflex (BR) parameters and 2) to replicate and extend our previous data on SR habituation. Our data have confirmed the existence of an impairment of habituation and an abnormal facilitatory effect of R1 component of BR in schizophrenics compared to healthy controls. The present study provides further evidence of specific defective mechanisms of information processing in schizophrenia. The methodology used for SR paradigm appears to be founded on a sound research basis and represents an advantageous paradigm for assessing attentional variables of information processing in mental disorders.

Adult

Three-dimensional in vivo planum temporale reconstruction.

We describe a new multistep technique for three-dimensional reconstruction and analysis of the in vivo planum temporale (PT) based on the manipulation of magnetic resonance raw data obtained with a special protocol. Measurements of left and right plana confirm previous neuroanatomical descriptions of a larger left planum temporale. This method can be easily adopted, allowing anatomically valid PT measurements.

Adult

Magnetic resonance imaging findings of amygdala-anterior hippocampus shrinkage in male patients with schizophrenia.

Recent magnetic resonance imaging (MRI) studies found abnormalities of medial temporal lobe and basal ganglia structures. We used an inversion recovery (IR) protocol with the assistance of the Talairach atlas to identify neuroanatomical regions of interest in 19 male schizophrenic patients and 14 matched control subjects. The patient group showed smaller amygdala-hippocampus volume as compared with normal control subjects. This finding was more pronounced for the left side, although no diagnosis X side interaction was present. Third ventricle volume was also enlarged in schizophrenic patients. Trends toward an overall reduction of basal ganglia (striatum and lenticular nucleus) and limbic structures and toward an increase in ventricle-brain ratio were also seen. The study confirms previous evidence of mesial temporal lobe shrinkage, more evident on the left side in a group of relapsing noninstitutionalized male schizophrenic patients.

Adult

Planum temporale asymmetry and thought disorder in schizophrenia.

Magnetic resonance imaging (MRI) was used to investigate the size and the asymmetry of the planum temporale (PT) in 22 schizophrenic patients and 23 strictly matched healthy volunteers. The degree of thought disorder was related to the reduction of the physiological PT asymmetry. When thought disordered patients were contrasted with non-thought disordered patients and healthy controls for a measure of PT laterality, those with thought disorder showed a statistically significant loss of PT laterality. This finding suggests that thought disordered schizophrenics may be characterized by an abnormal development of cerebral lateralization in a region crucial for language processing.

Adult

The efficacy and safety of tianeptine in the treatment of depressive disorder: results of a controlled double-blind multicentre study vs. amitriptyline.

Three hundred in- and outpatients suffering from depressive disorder, as diagnosed using DSM-III criteria were treated for 6 weeks under double-blind conditions in a multicenter controlled study of tianeptine vs. amitriptyline. Both groups presented steady improvement of depressive syndrome from day 7 up to the end of the treatment, as shown by all evaluation scales: HDRS, SAD, CGI. Furthermore, anxiety linked to the depressive syndrome decreased equally in both groups, as shown by the HARS measurements. In addition to the improvement of mood, the tianeptine-treated patients presented less somatic complaints and side effects when compared to the reference antidepressant. These results confirm previous findings that tianeptine is an effective antidepressant with a lower side effect profile than amitriptyline.

Adolescent

Information processing strategy to remediate Wisconsin Card Sorting Test performance in schizophrenia: a pilot study.

A modified procedure for administering the Wisconsin Card Sorting Test, focusing on a hypothesized deficit of organizational strategy in information processing, was used to administer the test to 20 schizophrenic patients. By using this procedure, 61.5% of the poor performers (eight of 13) were dramatically transformed into good performers without any task instruction or reinforcement. The results, albeit preliminary, support the hypothesis and the possibility of remediating the task performance of some schizophrenic patients.

Adult

Cerebellar vermal size in schizophrenia: a male effect.

Magnetic resonance (MR) was used to examine the cerebellar vermis in 23 patients with schizophrenia and 16 matched controls. MR midsagittal images were processed with computerized image analysis to control partial volume effects as precisely as possible. No between-group differences were found for vermal-to-cerebrum ratio. When gender differences were examined, male patients showed a lower vermal-to-brain ratio than their female counterparts, mainly because of a reduction of the lobules I-V.

Adult