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Biomedical subjects

S Fiume

Publications and source records attributed to S Fiume.

15 recordsLinked to original sources

Mechanism of action of ECT in major depressive disorders: a neuroendocrine interpretation.

Electroconvulsive therapy (ECT) is often efficacious in severe depression, and it is occasionally used in the treatment of schizophrenia. The mechanism of action of ECT is still poorly understood. We evaluated thyroid-stimulating hormone (TSH) and prolactin responses to thyrotropin-releasing hormone (TRH) after a first ECT and at the end of a series of seven ECTs in eight unipolar depressed patients with blunted basal TSH/TRH response, eight unipolar depressed patients with normal TSH/TRH response, and eight schizophrenic patients. The hormone patterns obtained after the first ECT showed an increase in prolactin and a decrease in TSH in all groups of patients, suggesting a nonspecific response. At the end of the therapeutic course, TSH responses increased in both groups of depressed patients, and the elevation was more relevant in depressed patients with normal TSH/TRH. Our data suggest that the mechanism of action of ECT becomes more specific when it is performed chronically and differs according to the organic substrate underlying different mental disorders. Moreover, an aminergic activation in the two groups of depressed patients seems to take place.

Adult

[Psychiatry and environment].

After having underlined the increasingly negative influence of environmental changes on human life, the paper focuses o their influence on the psyche which is subjected to a continual series of traumas caused by the abnormal rhythm of modern life and the lack of human solidarity and ideals. Because of their fragility, the greatest victims of this situation are the young, the old and women and the pay the greatest price by resorting to drugs, alcoholism, prostitution or new forms of reactive psychosis. This underlined the necessity for continual and intense preventive action.

Ecology

[Revival of convulsive therapy].

After a brief review of the history of convulsive therapy, the paper criticises the denigratory campaign which was directed against this form of therapy for many years in Italy and later abroad. It stresses that convulsive therapy is now used worldwide, in spite of a few justifiable restrictions, for these indications and that the risks involved in the therapy itself, which are minimum, have been reduced. The Authors complain that this revival, which is now spreading internationally, has been hardly felt in Italy, especially in university circles.

Convulsive Therapy

[Culture and alcoholism].

The paper examines the varying importance which has been attributed to alcohol in different periods and emphasis that today cultural attitudes towards alcohol and alcoholics are becoming increasingly ambiguous: there is growing difference towards teetotallers and substantial permissiveness towards drinkers. This incongruous attitude even goes so far as to romanticise the death of several artists from alcoholism.

Alcohol Drinking

[Fears of the contemporary age].

In this last century the contrast between man and environment has been exasperated by the disappointments that technical innovations have created in mankind. Such contrast has been exasperated as well by the continuing information, often trivial, that has engendered fears about loneliness, old age, ecological crimes and an ever-growing demand for psychotrope drugs. The problem is so serious that no solution is in sight.

Environment

[Human significance of mental diseases].

It is pointed out that for the understanding and humanization of mental disease, a series of measures of mental hygiene should be established so as to keep the patient away from the constant coming and going of frustrating situations which, while they should not be considered as decisive factors, at times take on the role of factors triggering the disease.

Anthropology

[Euthanasia and psychotherapy].

The therapeutical lengthening of many illnesses has made the closeness of psychiatrists and patients more and more necessary. This Author recommends a special training of the thanatological psychiatrists, whose task is very difficult: it can be made easier by treating patients in special institutions, where, acquainted with their mental condition, they may benefit by visiting relatives and a new, friendly relationship with the staff psychiatrists.

Euthanasia

[Orientations and prospects in psychiatry].

It is pointed out that despite the promising light cast by biological psychiatry, the discipline remains totally in the dark about the aetiology of mental illness. It is also shown that recent statements by certain psychoanalysts are both factitious and illogical, hampering the progress of psychiatry that, today more than ever before, needs the cooperation of every school from the biological to the social, the psychodynamic and, above all the organic.

Humans

[Euthanasia].

After examining the question of euthanasia from various viewpoints, the paper concludes that the socioeconomic factor is one of the most significant. It also shows that the greatest responsibility falls on the physician who has no decalogue or rulebook to guide him apart from his own conscience.

Euthanasia