Partial syndromes in eating disorders: a prevalence study on a sample of Italian adolescents.

OBJECTIVE: Exploring the spectrum of eating disorders (ED) and its sociodemographic correlates in a population of adolescents. METHOD: The sample included 788 adolescent students (384 females and 404 males, 12-14 years old) from Verona, Northern Italy. A two-stage sampling procedure was adopted. Eating Disorder Inventory-2 (EDI-2), Body Image Satisfaction Questionnaire (BISQ) and a socio-demographic questionnaire were applied to the sample in the first stage. The sample was then partitioned in two strata, "below-cutoff" and "above-cutoff", using the threshold DT > or = 14 for the Drive for Thinness (DT) subscale. A second sample of 59+58 subjects was selected from the two strata. The structural interview of the second stage consisted of the Structured Clinical Interview for DSM-IV Axis I Disorders and the Symptom Checklist of EDI-2. RESULTS: Partial syndromes of ED were diagnosed in 9.4% of the interviewed sample with a sex ratio F/M=6. The following factors resulted to be related to partial syndrome of ED: dieting to be thin, body mass index, mother's occupation and being a menstruating girl. CONCLUSION: This study represents one of the few prevalence and association studies about ED in young Italian adolescents. It evidences that partial syndromes of ED, in particular the partial syndrome of binge eating disorder, are the most frequent syndromes in early adolescence. Some social and parental factors resulted to be significantly related to these syndromes.

Social support, adversities and emotional distress in an Italian community sample.

The association of social support with emotional distress in relation to adversities such as social problems, physical health and undesirable life events was assessed in an Italian community sample of 222 men and 224 women. Univariate comparisons and logistic regression analyses showed that neither the quality of a confiding core relationship nor social support from kin confidants was related to adversities. In women only, social support from friend confidants exerted a statistically significant independent main effect together with social problems and undesirable life events in producing a greater probability of emotional distress. The implications of these findings are discussed considering the socio-cultural characteristics of Italian families and individual coping strategies.

[Pseudodementia. A critical review of the literature]. / La "pseudodemenza". Una rassegna critica della letteratura.

A review is made of the concept of "pseudodementia" through the main studies of the literature on clinical series. These can be divided in homogeneous and heterogeneous diagnostic series. Some of the main methodological flows of the research on the subject are pointed out and the difficult problem of differential diagnosis between depressive pseudodementia and recent onset organic dementia is discussed.

Anxiety and EEG alpha activity in neurotic patients.

The literature is reviewed on EEG alpha activity in different psychological states, i.e., morbid anxiety, attention and mental relaxation. In the present study, 20 male neurotic inpatients suffering from chronic moderate anxiety were assessed with respect to anxiety level and EEG alpha activity (frequency and per cent time) and fast activity. No significant EEG asymmetry was found. The average alpha per cent time was very low, most of the patients being low-alpha subjects. Anxiety and alpha index were significantly correlated. The patients were then treated with either 80 mg per day of temazepam or placebo for 2 weeks (double-blind). Significant effects were detected in the anxiety state, the drug group showing more improvement, but not in the EEG profile. The measures were expressed at this stage as change scores from the pre-treatment values and correlations between them were computed. The only correlation of significance was a negative correlation between anxiety level and alpha index found after 1 week in the drug group.

Anxiety and depression in 100 female geriatric inpatients. A psychopathological study.

50 anxious and 50 depressed female geriatric inpatients aged 70 and above were assessed with a semistructured interview focusing on the patient's experience of her illness and hospital admission and on the doctor-patient relationship. Each interview was completed by psychodynamic evaluations and a clinical assessment. The psychopathological findings suggested the distinction of four groups of patients characterized by different psychological reaction profiles: patients with anxiety reaction only, anxious patients with some depressive reactions, depressive-dependent and depressive-resigned patients. These profiles were related to age: anxiety was more frequent among the younger patients while severe depression (resigned depression) prevailed among the oldest age-group (80 years and above). Sociological, psychological and psychotherapeutic implications are discussed.

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.

A community survey of psychotropic drug consumption in South Verona: prevalence and associated variables.

A cross-sectional community survey was undertaken to investigate the pattern of psychotropic drug consumption in 453 community residents of South Verona. Overall, 15.0% of the subjects were taking psychotropics (benzodiazepines 13.5%, antidepressants 2.2%, neuroleptics 1.1%). Prevalence was higher in females (20.0%), in those over 45 years (25%), in high General Health Questionnaire (GHQ) scorers (26.2%), and in subjects with physical ill-health (27.0%), with social problems (20.0%), with distressing events (22.0%) and with alcohol abuse (32.3%). Logistic regression analysis showed that age, sex, GHQ score, physical ill-health and life events were all significantly and independently associated with psychotropic drug consumption.

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.

Social factors associated with the use of psychotropic drugs: alcohol abuse and minor psychiatric morbidity in the community.

The association of socio-demographic factors and life events with psychotropic drug consumption, alcohol abuse and minor psychiatric morbidity was investigated in a representative community sample of 181 respondents. The statistical model used was a logistic multiple regression analysis. Psychotropic drug use was best predicted by family size and employment status; alcohol abuse by sex, family size and "exit" events; and minor psychiatric morbidity by sex, marital status and undesirable life events.

Life events, social problems and physical health status as predictors of emotional distress in men and women in a community setting.

The main aim of this study was to construct logistic models of emotional distress (defined as a GHQ-30 score of 6 or greater) in a community sample of 226 men and 225 women. The independent variables included were: sociodemographic characteristics, physical health status, social problems and undesirable life events. Univariate comparisons showed that in both sexes undesirable life events and social problems were associated with emotional distress; in men the presence of physical symptoms and widowed, separated or divorced status also showed such an association. Separate logistic regression models for men and women confirmed the importance of undesirable life events and social problems as predictors for emotional distress. In women there was also a significant interaction effect between the two variables on emotional distress. Sociodemographic characteristics and physical health status did not exert a statistically significant effect in these models.

Inter-observer and test-retest reliability of the Italian version of the Karolinska Psychodynamic Profile in two groups of psychiatric patients.

A total of 64 psychiatric patients were tested with the Italian version of the Karolinska Psychodynamic Profile in order to investigate interobserver and test-retest reliability. The mean inter-observer agreement coefficients (rho) ranged from 0.75 to 0.80 with less experienced psychiatrists, while the mean rho value was higher (0.96) with more experienced raters. Test-retest values were good, ranging from 0.53 to 0.93. Overall, reliability was comparable with that reported in the original Swedish study.

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.

Family factors associated with the use of psychotropic drugs, alcohol abuse, and minor psychiatric morbidity in the community.

The association of family health and family structure factors with psychotropic drug consumption, alcohol abuse, and minor psychiatric morbidity was investigated in a representative community sample of 151 respondents by means of a logistic multiple regression analysis. A General Health Questionnaire GHQ score of 5 or above was best predicted by undesirable events, sex, the number of generations, marital status, and the number of family members with a high GHQ score. Psychotropic drug consumption was best predicted by the number of family members with distress manifestations, while alcohol abuse in men was predicted best by events of the exit type.

N-desmethyldiazepam and amylobarbitone sodium as hypnotics in anxious patients. Plasma levels, clinical efficacy and residual effects.

Drug plasma levels of N-desmethyldiazepam (10 and 20 mg/day given at night) and amylobarbitone sodium (200 mg/day given at night) were determined in 45 patients after 1 and 7 days of treatment together with estimates of hypnotic and residual effects. No relationships were found between clinical rati ngs of hypnotic effect and drug plasma levels, while significant correlations were observed between some performance taska and drug plasma concentrations of amylobarbitone sodium, and of the higher dose of N-desmethyldiazepam.