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Biomedical subjects

M Tansella

Publications and source records attributed to M Tansella.

At least 91 records · Page 5Linked to original sources
PubMed1986

South Verona's psychiatric service: an integrated system of community care.

Italy's mental health law of 1978 mandated the closing of state mental hospitals to new and former patients and the creation of comprehensive community-based service systems. The authors describe the organization, facilities and services, and treatment principles of one system created in accordance with the law--the South Verona Community Psychiatric Service, which serves a population of 75,000. Case register data for South Verona for the years 1978 to 1984 reflect the changes mandated by the law. They also indicate that despite an increase in admissions to the psychiatric ward in the general hospital following the closing of the state hospital, there was a substantial overall decrease in the number of hospital beds occupied per day by South Verona residents after passage of the law, and that a substantial proportion of patients with functional psychosis were able to be treated as outpatients.

Adolescent↗
PubMed1986

Hospital and community based psychiatry: a comparative study between a Danish and an Italian psychiatric service.

A Danish (Aarhus) institution-based and an Italian (South-Verona) community-based psychiatric service are compared. The incidence rates are 20/10,000 inhabitants in both areas with more psychotics and fewer neurotics in Aarhus. The admission rate as well as the one year rate of persons in in-patient care are about three times higher in Aarhus. Referrals to day and out-patient care, including home visits, are used 1.5-3.5 times as often in South-Verona, whereas the rates of persons in each of the three types of care are of similar size in the two centres. Geronto-psychiatric disorders are to a greater extent treated within the field of psychiatry in Aarhus. Compulsory admission rates are higher in Aarhus (3.7/10,000 inhabitants) than in South-Verona (1.3/10,000). Admission rates to private hospitals are 9.4/10,000 inhabitants in South-Verona against 3.0/10,000 in Aarhus.

Adolescent↗
PubMed1985

Self-reported use of psychotropic drugs and alcohol abuse in South-Verona.

The data for this cross-sectional survey were obtained from a stratified probability sample of 510 residents in South-Verona during the period May-June 1980. The two-week prevalence of psychotropic drug consumption was found to be 13%. The prevalence was higher in women (18%) than in men (9%). The most commonly consumed category of psychotropic drugs were the benzodiazepines, which accounted for 70% of all the psychotropic drugs consumed by women and 85% of those consumed by men. Using a logistic analysis, a strong association between drug consumption and minor psychiatric morbidity, as indicated by the GHQ scores, was found for both sexes, a finding not significantly different from that found in the West London study by Murray et al. (1981). Alcohol abuse in men was less prevalent in the youngest age-group. Thirty-three (19%) of the male GHQ low scorers were alcohol abusers, compared with 12 (40%) of the high scorers. No significant association was found between psychotropic drug consumption and alcohol abuse in men.

Adolescent↗
PubMed1985

Validation of the Italian version of the GHQ in a general practice setting.

The 30-item General Health Questionnaire (GHQ) and the Clinical Interview Schedule (CIS) were administered to 120 consecutive attenders at a general practice in Northern Italy run by a doctor who had a formal psychiatric training. The Italian versions of both the GHQ and the CIS were found to be feasible instruments for general practice studies in Italy. GHQ misclassification rates, sensitivity and specificity values are presented for different cut-off scores, a total score of 5 or more being the best discriminator between 'cases' and 'non-cases'. The prevalence of confirmed cases in this sample was 47.5%, a rate higher than those reported so far in developed and developing countries.

Adolescent↗
PubMed1985

Bringing into action the psychiatric reform in South-Verona. A five year experience.

The organization of psychiatric care in Verona prior to the new Italian Mental Health Act, and the organization of the new South-Verona Community Psychiatric Service (CPS) implemented in 1978 after the approval of the new law, are described. Case-register data for the period 1979-1983 are also reported. To compare in-patient care provided in South-Verona after the Reform with that of the previous year, data on hospital admissions during 1977 were collected retrospectively. From 1977 to 1983 compulsory admissions have decreased by 67%, the average number of occupied beds per day and the average length of in-patient stay have decreased by 34%, while the total rates of admission have increased by 4%. The long-stay in-patient rate, which was already considerably low in 1977 (48/100,000), is still decreasing slightly and no "new" long-stay patients have accumulated in psychiatric institutions during the past three years. In South-Verona most of the patients are treated outside the hospital and the same staff is responsible for in- as well as for out-patient care (which includes domiciliary visits and day care), to ensure therapeutic continuity. Although it lacks some complementary facilities the South-Verona CPS in its five years of experience has been able to bring into action the psychiatric reform as indicated by the new Law.

Ambulatory Care↗
PubMed1984

Psychological performance of workers with blood-lead concentration below the current threshold limit value.

The effects of lead exposure on psychological test performance and subjective feelings of well-being were investigated in 40 exposed workers whose PbB levels had never exceeded 60 micrograms/100 ml and in 20 controls matched for sex, age and educational level. The exposed workers were divided into two groups of 20, with recent PbB levels in the range 45-60 micrograms/100 ml or below 35 micrograms/100 ml. The group of workers with the higher PbB levels showed significantly poorer performance and reported more physical symptoms than the other two groups. These differences were unrelated to sociodemographic and personality characteristics. A principal component analysis suggested that the poorer performance was mainly due to an impairment of general functioning and only to some extent to a deterioration in specific functions, such as verbal reasoning and abstraction. Higher lead concentrations were correlated with poorer performance and a higher number of physical complaints. These results indicate that in exposed workers the threshold for impaired performance lies below the blood-lead concentration of 60 micrograms/100 ml, which is the current threshold limit value (TLV).

Adult↗
PubMed1983

Psychological and physical complaints of subjects with low exposure to lead.

The relationship between lead uptake level and subjective psychological and physical symptoms was investigated in two groups of occupationally exposed workers with PbB levels between 45 and 60 micrograms/100 ml and below 35 micrograms/100 ml respectively. Findings were compared with those of a non-exposed control group. Psychological symptomatology as defined by the GHQ proved unsensitive to low levels of lead exposure, while physical symptomatology as defined by the SSQ, in particular neurological symptoms, showed a significant tendency towards an uptake response relationship. The minimum uptake level for neurological symptoms in this study was below 35 micrograms/100 ml.

Adult↗
PubMed1979

Psychological performance in anxious patients treated with diazepam.

1. After each week of a flexible dosage treatment with either diazepam, amylobarbitone or placebo anxious patients were assessed by a comprehensive battery of psychiatrist's ratings, subjective tests and psychological performance tasks to detect the clinical and psychological effects of the drugs. 2. Self rated anxiety and insomnia were improved significantly by diazepam, while amylobarbitone improved only the self rated insomnia. 3. An impairment of performance relative to placebo was detected on two performance tasks after the barbiturate and on six performance tasks after the benzodiazepine. 4. The patient's reported level of anxiety under each treatment condition was related to the performance on the five tasks showing drug effects, thus confirming the postulated inverted U-shape relationship between drive and performance.

Adult↗
PubMed1979

A comparison of the clinical and psychological effects of diazepam and amylobarbitone in anxious patients.

1. Twenty-four anxious inpatients were treated with diazepam, amylobarbitone sodium and placebo in flexible dosage for 1 week. They each received all three treatments according to a fully-balanced design, using double-blind procedures. 2. The clinical and the psychological effects of the drugs were assessed by the comprehensive battery of psychiatrist's ratings, subjective and psychological tests before treatment and at the end of each week of treatment. The tests included self-rating of anxiolytic and hypnotic effects, reaction-time, card sorting, coding and cancellation tasks, arithmetic and tappin. 3. Diazepam improved significantly subjective anxiety and insomnia, while amylobarbitone improved only the self-rated quality of sleep. Occasion effects were absent on clinical measures, indicating that the patients did not respond to non-specific temporal factors. Performance on motor tasks improved over time because of the expected practice effect, but an impairment relative to placebo was detected on two motor tests after the barbiturate and on four other tests with a cognitive component after the benzodiazepine.

Adult↗
PubMed1979

Predictive scales for parasuicide repetition. Further results.

A six-item predictive scale for parasuicide repetition was retested on a second sample of Italian parasuicides. All the patients firstever admitted after a deliberate self-harm to the psychiatric department of a general hospital during the period April 1973-March 1976 were interviewed and followed-up after an interval of 1 year. The scale showed the same predictive power found in the first sample (1970-73) and gave a range of probability of repetition within 1 year of 15% at a score of 0 up to 44.8% at the scores 3, 4, 5, and 6. Moreover it discriminated between repeaters and non-repeaters at a significant level. Only two items (diagnosis of sociopathy and change of domicile in the last year) of the five items which discriminated repeaters from non-repeaters in the first study were still significantly associated with repetition, while four additional items (previous in-patient psychiatric treatment; previous parasuicide resulting in hospital admission; unemployment; criminal record) appeared as new discriminating factors. In spite of these changes the rate of repetition remained constant over the years at around 26%.

Follow-Up Studies↗
PubMed1978

Plasma concentrations of diazepam, noradiazepam and amylobarbitone after short-term treatment of anxious patients.

Twenty-four anxious inpatients were treated with diazepam, amylobarbitone and placebo, each given in flexible dosage for one week, according to a fully-balanced design. Plasma concentrations of diazepam and of its metabolite nordiazepam and of amylobarbitone were determined after two, four and seven days of treatment. Clinical and psychological assessments were made after seven days of each treatment by means of psychiatrist rating scales, patient's self-rating and a comprehensive battery of performance measures. Diazepam and nordiazepam but not amylobarbitone were accumulating over the seven days of treatment. In patients on diazepam without previous amylobarbitone, nordiazepam accumulated more rapidly than diazepam over the week so that the ratio of diazepam to nordiazepam was 2.21 after two days but only 1.14 after seven days; those with previous amylobarbitone on the other hand always had nordiazepam concentrations higher than those of the administered drug and both were accumulating equally. Diazepam and nordiazepam were still detectable in most patients two weeks after the interruption of treatment. No correlations were found between drug concentrations and clinical and psychological effects.

Adult↗
PubMed1976

Obsessional scores and subjective general psychiatric complaints of patients with duodenal ulcer or ulcerative colitis.

The Leyton Obsessional Inventory (LOI), together with 46 questions taken from Sections M-R or the Cornell Medical Index, were administered to 30 inpatients suffering from duodenal ulcer and to 30 patients admitted for ulcerative colitis to test the hypothesis that the latter have more obsessional traits than the former. The results indicated that although the two groups did not differ much in their obsessive personality traits, the ulcerative colitis patients were significantly more worried and concerned about them. None of the socio-cultural factors measured, which are known from other studies to influence these obsessive scores, was associated with the differences found. An analysis of the individual LOI items between the two groups showed that the ulcerative colitis patients were more indecisive, and also more morose, more rigid and more punctual than the duodenal ulcer patients, i.e. traits traditionally associated with obsessional personality types. The two groups did not differ on the Cornell score.

Adolescent↗
PubMed1976

Cross-validation of a predictive scale for subsequent suicidal behaviour in an Italian sample.

A six-point prodictive scale for parasuicide repetition developed by Buglass and Horton (1974a) was tested on a group of patients admitted for parasuicide to a psychiatric ward of one of the city hospitals of Verona. The scale gave a range of probability of repetition within 12 months of 15 per cent at a score of o up to 45-5 per cent at the scores 3, 4, 5 and 6. Moreover the scale discriminated significantly between repeaters and non-repeaters. Items significantly associated with repetition in the Italian sample, which are not represented by the six-point scale were: previous parasuicide not admitted to hospital, violence received, alcohol taken at time of act, less than one year at the present address.

Alcohol Drinking↗