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Biomedical subjects

M Ferreri

Publications and source records attributed to M Ferreri.

At least 19 recordsLinked to original sources
PubMed2001

Benefits from mianserin augmentation of fluoxetine in patients with major depression non-responders to fluoxetine alone.

OBJECTIVE: To assess, in depressed patients, the clinical benefit of mianserin augmentation of fluoxetine or the the benefit of switching treatment from fluoxetine to mianserin. METHOD: In a 6-week double-blind study we compared the therapeutic efficiency and tolerance of mianserin 60 mg/day (N = 34), mianserin 60 mg/day plus fluoxetine 20 mg/day (N = 32) and continuing fluoxetine 20 mg/day (N = 38) in patients with major depression who did not respond to previous fluoxetine treatment. RESULTS: Intent-to-treat analysis showed that at week 6 the decrease in the Hamilton Depression rating scale score was significantly (P < or = 0.03) greater in the mianserin plus fluoxetine group when compared to the fluoxetine group (effect size 0.665). Switching from fluoxetine to mianserin gave intermediate results. Mianserin augmentation of fluoxetine was well tolerated. CONCLUSION: Mianserin augmentation of fluoxetine in patients non-responders to fluoxetine 20 mg/day increases response to treatment and is well tolerated.

Adult↗
PubMed2001

[The STF Project: Female Tumor Screening].

A pilot study has been carried out to evaluate women's compliance to a screening program for cervical cancer. The study, initiated in 1994, was performed in conjunction with the ACRO project of the CNR by the Italian National Health Institute, in collaboration with La Sapienza University of Rome and the National Institute for Cancer Research in Genoa. A preliminary telephone survey was carried out on a sample of 400 women (200 in Rome and 200 in Genoa) to assess, among other factors, their attitude towards the screening program. Afterwards, an ad hoc advertising campaign was launched and 21,827 women, randomly chosen from the register office's lists, were sent a personal invitation to participate in the screening. Most women showed interest in attending the screening program at the interview, but the percentages of participation were low (25.7% in Genoa and 27.3% in Rome). On the other hand, a high percentage of women who participated in the screening had already had a Pap test in the previous three years (Genoa, 73%; Rome, 76%). The recruiting techniques that were used in this study, and that are commonly used, do not seem to reach the core of the target population for cervical screening, i.e. women who have never had a Pap test or who had a Pap test more than 5 years earlier. New methods of recruiting aimed at categories at risk and based more on direct contacts need to be developed.

Adult↗
PubMed2000

What is the schizophrenic patients' level of information about their disease and their treatment?

Improved compliance with antipsychotic medication is a major issue in schizophrenic management. For this purpose educational programs have been used, but up to now, little or no information has been gathered or published in France concerning schizophrenic patients' opinion on information they have about their disease and their treatment. Thus we conducted a survey in concert with 78 psychiatrists from the French psychiatric health service. From this cross sectional survey we assessed 336 outpatients (male: 72%; mean age: 36 +/- 10.4 years) with schizophrenia according to the DSM IV (paranoid sub type: 57%, disorganized: 12%, catatonic: 1%, undifferentiated: 12%, residual: 18%). The mean duration of the illness was 11.6 years (sd: 8.5) and the mean duration of the follow up with the same psychiatrist was 5.4 years (sd: 5.1). Patients completed a questionnaire which assessed their level of information on mental illness and treatment. The diagnosis of schizophrenia has been told to their patients by 39% of the psychiatrists, and treatment has been explained to the patients by 96% of the practitioners. Results indicate less than half of the patients (45%) felt ill, only 46% thought they knew their illness well or very well (nevertheless only 31% of them named spontaneously the diagnosis of schizophrenia or psychosis), and 61% considered that they had been given sufficient information. Most of the patients (79%) were persuaded that their treatment was useful, and 75% of patients were completely satisfied with their treatment. Surprisingly 92% reported taking their medication regularly. Most patients think that a high level of information about their illness (74%) and treatment (79%) help them to cope better with their schizophrenia. Analysis performed according to patients characteristics indicated that paranoid patients felt more ill (p = 0.035) than others, thought to know less about their illness (p = 0.0065), and were less satisfied with their treatment (p = 0.04) and their level of information (p = 0.03). Patients with a duration of their illness longer than 10 years were more convinced of the utility of their treatment (p = 0.02) and had debated more on the choice of their treatment with their psychiatrist (p = 0.047). Patients older than 35 years were more satisfied with their information (p = 0.002). More patients with atypical antipsychotics accepted to take their treatment on a regular basis (p = 0.035) compared to patients under classical neuroleptics. This survey underlines that mental health consumers' opinions can be obtained even in the field of schizophrenia, and argues in favour of further such investigations. It also highlights the need for educational programs on schizophrenia and antipsychotic medications.

Adult↗
PubMed1999

[Dysthymic disorders].

Long lasting, low intensity depressive episodes have been diversely integrated according to the classifications types or the psychodynamic points of view. The concept of anxious persistent lasting depression, neurotic depressive states, neurotic depression ... have been unified into the dysthymic disorder category of the DSM classification. This concept unification have been a topic of dispute considering that dysthymic disorder was a restrictive, heterogeneous an extensively comorbid diagnosis. Nevertheless the definition of this category offers the opportunity to place the notions of temperament, personality, adjustment disorder. Including dysthymic disorders as a category inside of the mood disorders classification suggests the interest of using an antidepressive medication in presence of chronic depressive states not included in the major depressive disorder category.

Adjustment Disorders↗
PubMed1998

Recent clinical trials of hydroxyzine in generalized anxiety disorder.

Numerous clinical trials in the 1960s and 1970s have attested to the anxiolytic efficacy of hydroxyzine and its beneficial effect on sleep, as well as in reducing stress and anxiety associated with coronary disease. Experience with hydroxyzine has also shown a lack of organ toxicity and an absence of dependency. Recent controlled clinical trials with hydroxyzine have confirmed its efficacy (at a fixed dose of 50 mg) in generalized anxiety disorder--superiority over placebo on all anxiety measures from the first week with early target symptoms which are grouped in a cognitive component of anxiety. Efficacy was maintained throughout the 4 weeks of treatment and after abrupt discontinuation. In another controlled trial vs. lorazepam, hydroxyzine demonstrated greater and more rapid cognitive improvement.

Anti-Anxiety Agents↗
PubMed1997

[Epidemiological approach of inhibition in general practice].

OBJECTIVE: To obtain preliminary data on the prevalence and characteristics of inhibition in an adult population consulting in general practice. PATIENTS AND METHODS: Eight hundred thirteen general practitioners, forming a representative distribution of general medicine clinics in France. Each evaluated, during a study period which did not exceed 2 days in 70% of the cases, 20 consecutive patients using a standard questionnaire, noting age, sex, motivation for consultation, presence of inhibition, inhibition score, and associated diseases (5 were possible). The physicians also scored 12 specific items (attitude, fatigue, feeling of being "blocked", concentration, memory, planning, indecision, inefficiency, creativity, sleep, appetite, sexuality) (0 = absent; 1 = discrete; 2 = moderate). The sum of the scores provided the global inhibition score (maximum = 24). RESULTS: Among the 15076 patients evaluated (M/F ratio 41.3/58.7; mean age 49.4 +/- 18 years; educational level: French aptitude certificate 44%) one or more of the inhibition items was the motivation for consultation in 23.9% and at least one item was scored in 80% of the cases. Fatigue was scored in more than half the patients. The percentage of patients considered to be inhibited (I) was 35.8% (M/F ratio 35.3/64.7; mean age 51.9 +/- 18 years). Compared with the non inhibited population (NI), the items most frequently associated with and most characteristic of inhibition were severe fatigue (I = 42.4% vs 8.7 NI), sleep disorders, difficulties in concentrating or memory, and a feeling of being "blocked". The symptom intensity score was 2.9 +/- 3.3, 10.9 +/- 5 and 15.9 +/- 4.7 in populations NI, I and PI (patients considered to be the most inhibited) respectively. This suggested that there is a correlation between a high score and presence of inhibition and its intensity. Anxiety was invariably described in all three subpopulations, but depression was the most discriminating factor (3.7, 33.9, and 67.2 for NI, I and PI respectively). CONCLUSION: These preliminary data show an unsuspected high frequency of inhibition in patients consulting in general practice. Inhibition was more frequently observed in women and in older patients inhibition showed a characteristic physical, intellectual and psychic symptomatology dominated by fatigue and increased in intensity when associated with a depressive syndrome.

Adult↗
PubMed1997

Efficacy of amineptine in the prevention of relapse in unipolar depression.

The clinical properties of amineptine, a mainly dopaminergic antidepressant, were assessed in a double-blind controlled study involving patients fulfilling Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria for unipolar depression. The aim was to determine how relapses could be prevented in this frequently recessing disorder. The study was a two-phase, 12-month, multicentre trial of patients suffering from major depression or dysthymia, diagnosed using DSM-III criteria and evaluated on the Montgomery-Asberg Depression Rating Scale and the Mood, Anxiety, Retardation, Danger scale. Phase I was an open-label 3-month period, with the patients being given 200 mg amineptine per day. The second, 9-month period was a placebo-controlled prophylactic phase. A total of 458 patients were initially included in the study. Of the 376 who completed phase I, 303 (66%) were responders; 284 entered the prophylactic study, randomly assigned to two groups. Of the 134 patients in the placebo group who completed phase II, 25 (18.7%) suffered a relapse, compared with nine out of the 136 (6.6%) in the amineptine group. After resolution of an acute episode of major depression or dysthymia, long-term antidepressant therapy with amineptine significantly reduced the relapse rate.

Adult↗
PubMed1996

Initial monoamine oxidase-A inhibition by moclobemide does not predict the therapeutic response in patients with major depression. A double blind, randomized study.

It is generally accepted that the clinical efficacy of monoamine oxidase inhibitors (MAOI) is related to inhibition of this enzyme. In order to evaluate the predictive ability of monoamine oxidase-A inhibition for therapeutic efficacy, the start of treatment effects of moclobemide, a selective, reversible monoamine oxidase-A inhibitor, on plasma concentrations of monoamines and monoamine metabolites were determined. The plasma levels of 3,4-dihydroxyphenylglycol (DHPG, deaminated metabolite of noradrenaline), 5-hydroxyindoleacetic acid (5-HIAA, deaminated metabolite of serotonin), 3,4-dihydroxyphenylacetic acid and homovanillic acid (DOPAC and HVA, deaminated metabolites of dopamine), L-dihydroxyphenylalanine (L-dopa) and noradrenaline were investigated and related to treatment outcome. This was a randomized double blind parallel group study in 47 patients with criteria of major depression according to DSM III R. Moclobemide 300 mg/day, 450 mg/day or 600 mg/day was administered continuously for 6 weeks. Plasma concentrations of monoamine metabolites and monoamines were determined just before treatment by moclobemide, 4 h after the first dose, 24 h after the first dose, before the first dose on day 7, and 4 h after the first dose, on day 7. Each moclobemide dose improved depression as measured by MADRS (Montgomery-Asberg Depression Rating scale) but there was no difference between the three doses. Moclobemide dose-dependently reduced plasma concentration of DHPG, L-dopa and HVA. No dose-dependent treatment effect was observed for plasma 5-HIAA, noradrenaline and DOPAC. The clinical outcome as defined by the final MADRS score was not related to any start of treatment changes in plasma monoamine metabolites reflecting inhibition of MAO-A. It is concluded that monoamine oxidase-A inhibition at the beginning of the treatment does not predict clinical outcome.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1996

Attitude of women towards early cancer detection and estimation of the compliance to a screening program for cervix and breast cancer.

Before the start of a feasibility study for cervical and breast cancer screening in two towns (Genoa and Rome) in Italy, a random sample (N = 349) of the target population was interviewed with the aim of evaluating (i) the degree of knowledge as to the purpose of the screening tests; (ii) the attitude towards early detection of these cancers; and (iii) the potential compliance to the program. Pap test: 48.7% of women were correctly informed about the object of the test; information was associated with the degree of education (p < 0.0001). Periodic Pap test was reported by 77.9% of women: the proportion was higher among younger (p = 0.013) and married women (p = 0.001). A 1-year interval between two tests was more frequently reported by younger women (p < 0.001). Estimated participation in the cervical cancer screening program was 63.3%. Increasing age (OR = 0.78; CI = 0.6-1.0), the married status (OR = 0.39; CI = 0.18-0.83) and lack of knowledge of the object of the test (OR = 0.47; CI = 0.25-0.87) hindered participation in the program. Mammography: 53.3% of women reported that it is a method used for early detection of breast cancer. Well-educated women were more likely to be correctly informed (p < 0.0001). Previous mammography was reported by 49.3% of women aged 50 to 69 years who never experienced breast cancer symptoms; married women more frequently reported having had the test (p = 0.02). Estimated participation in the breast cancer screening program was 59%. Women aged 60 years and over were less prone to participate (OR = 0.44; CI = 0.22-0.89). Increasing age was the most relevant barrier to participation in screening programs, and strong efforts should be made to involve older women, due to their greater chance of getting cancer.

Adult↗
PubMed1995

[Classification and psychiatric practice].

The DSM IV/CIM 10 classifications constitute an important effort to organize some aspects of psychiatric field. It represents a specific model--categorical, descriptive, discontinuous--aiming at identifying and classifying the mental disorders. The needs of daily psychiatric practice imply that the clinician should use new frames and models in which the dynamical, interactive, continuous component prevails.

Comorbidity↗
PubMed1993

Planning of a screening programme for cervical cancer in Liguria and evaluation of the attitude of the female population towards cancer detection.

In 1990 an investigation aimed at evaluating the possibility of organizing a regional screening programme for the early detection of cervical cancer was carried out in Liguria. Information on resources available for early detection of cervical cancer was obtained from 12 of 20 Public Health Units; a screening programme was feasible in 8 of them. The number of Pap tests examined was evaluated for 6 of 20 cytology laboratories. Only one laboratory examined more than 20,000 Pap tests in 1989 and, according to the international guidelines, can be a referring centre for screening. However, no information was available concerning inter- and intralaboratory quality control programmes. In the same period a population-based survey was carried out using a self-administered questionnaire in order to evaluate the attitudes of women towards cervical cancer prevention. A total of 1,454 of 4,197 women (35%) participated in the study. Younger, well educated women employed in non non-manual work were more likely to participate in the study. About 65% of the respondents had satisfactory practices with regards to the Pap test, suggesting a strong self-selection that probably resulted in a sample of women more health-conscious than the general population. In conclusion, our results suggest that major interventions should be carried out in the Public Health Units to direct resources to the needs of the population. In addition, new educational methods should be adopted to reach selected population groups to encourage them to have a Pap test performed on a regular basis.

Adult↗
PubMed1990

A double-blind multicentre comparison of remoxipride, at two dose levels, and haloperidol.

A total of 186 patients who met the DSM-III criteria for schizophrenia were admitted to a double-blind randomized multicentre trial in which the efficacy and safety of remoxipride at two dose levels was compared with those of haloperidol. Over a period of six weeks the patients received remoxipride 100-300 mg/day (n = 60), remoxipride 200-600 mg/day (n = 61), or haloperidol 10-30 mg/day (n = 64). There was no significant difference between the three treated groups with regard to the Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI) scores obtained. Remoxipride, at both dosage ranges used, thus had comparable therapeutic efficacy to that of haloperidol. In contrast, extrapyramidal symptoms occurred significantly more frequently in the group treated with haloperidol. Laboratory tests and cardiovascular investigations showed no specific drug effect in any of the treated patients. Remoxipride is thus effective in acute treatment of schizophrenia at both dosage levels and has an advantage over haloperidol in neurological acceptability.

Adolescent↗
PubMed1989

Fluoxetine versus amineptine in the treatment of outpatients with major depressive disorders.

Fluoxetine, a selective serotonin reuptake inhibitor, was compared to amineptine, a tricyclic antidepressant agent, in the treatment of 63 outpatients with major depressive disorders of mild or moderate severity. Patients were randomly assigned to 6 weeks of treatment with either fluoxetine or amineptine. Fluoxetine was found to have a more marked therapeutic effect than that of amineptine: better efficacy, fewer side-effects, and quicker and better improvement on the self evaluation scales.

Adult↗
PubMed1988

[Oropharyngeal form of the Lasthenie de Ferjol syndrome. Apropos of a case].

The Lasthenie de Ferjol Syndrome associates an iron-deficient anemia by blood auto-spoliation with mental disorders. In this paper, the authors present an oropharyngeal form of this disease. Based on this case review (and those reported in the literature), they remind us this syndrome's mains characteristics, underlying how exceptional and particular this clinical report is. At least they point out how to diagnose, manage, and treat patients with this strange illness.

Adult↗