The Italian version of the Body Cathexis Scale.

AIMS: Various questionnaire measures have been developed to study body attitude and affect. The Body Cathexis Scale (BCS) was the first psychometric instrument devised to measure body dissatisfaction. In this study we report the validation of the Italian version of the BCS. Reliability and validity studies were conducted on 86 female subjects with eating disorders and 404 general population subjects. RESULTS: Factor analysis yielded three factors called "Bust", "Weight-related Body Shape and Functions" and "Physical Functionality". Internal consistency was 0.90 (Cronbach's alpha). Test-retest reliability was 0.81. Criterion and concurrent validity are considered and norms as percentiles are reported for age classes.

Levosulpiride in somatoform disorders: A double-blind, placebo-controlled cross-over study.

Reliable data on the psychopharmacotherapy of somatoform disorders (SDs) are scanty because of patients' poor psychopathological awareness and compliance, the need for combination treatment, and the lack of suitable instruments for clinical diagnosis and assessment. The aim of the present study was to investigate the efficacy and tolerability of low doses of levosulpiride in the treatment of SDs. Seventy-four patients with SDs diagnosed according to ICD-10 and DSM-IIIR criteria by means of the Comprehensive International Schedule for Somatoform Disorders-Somatoform Disorders Schedule (CISSD-SDS) were treated for 4 weeks either with levosulpiride (50 mg b.i.d.) or placebo, under double-blind, cross-over conditions. The clinical evaluation was performed using CISSD-SDS. Side-effects were evaluated using the Simpson and Angus Extrapyramidal Side Effects Scale (EPSE) and specific check-lists for anticholinergic and endocrine side effects. Levosulpiride significantly reduced the number of SD symptoms compared to placebo ( P =0.007) after 4 weeks of treatment. Eighty per cent of positive responses were observed during treatment with levosulpiride in the placebo-levosulpiride sequence; on the other hand, only 44% of positive responses were found during treatment with active compound in the levosulpiride-placebo sequence ( P <0.002). Levosulpiride also determined a more evident reduction of the total number of SD symptoms compared to placebo ( P <0.001). There were no differences in endocrine and anticholinergic side effects between levosulpiride and placebo. In the levosulpiride group, a higher percentage of patients (13.4 vs. 2.8%; P =0.029) showed signs of extrapyramidal system involvement compared to placebo. Levosulpiride appears to be a well-tolerated and effective drug for the treatment for SDs.

Reversal of bone marrow hypoplasia in anorexia nervosa: case report.

BACKGROUND: Bone marrow hypoplasia seems to be uncommon in anorexia nervosa. This marrow abnormality is rapidly reversible with intensive nutritional rehabilitation. The patient described in this case report had anorexia nervosa. METHOD: She presented with complete serous atrophy of the bone marrow associated with pancytopenia. RESULTS: She was cured with recombinant human erythropoietin administered subcutaneously. After 25, days, the hematological situation was normalized. DISCUSSION: The possible advantage and practical implications of the administration of erythropoietin are discussed.

[Effects of shift work on the quality of sleep and psychological health based on a sample of professional nurses]. / Effetti dei turni lavorativi sulla qualità del sonno e sulla salute psicologica in un campione di infermieri professionali.

UNLABELLED: Impact of shiftwork on sleep and psychological health. OBJECTIVE: The purpose of the present study was to evaluate the impact of a rapid shiftwork system on sleep parameters and on psychopathological status among a sample of nurses. We hypothesize that in this type of shiftwork system, the rapid and continuous rotation of shifts doesn't lead to a lasting alteration of circadian rhythm but to a transitory increase of psychological disturbances after the night shift. METHODS: The population studied was the permanently employed staff of a public hospital in Modena. We recruited fifty-five workers. Participation was entirely voluntary. Every subject was given a self-administered questionnaire divided into three sections. Section I consisting in a base-line evaluation (sociodemographic data, use of psychotropic substances, General Health Questionnaire and Maslash Burnout Inventory). Sections II and III providing an evaluation of sleep and psychopathological parameters (Sleep Diary and Symptom Questionnaire) in two different moments during the shiftwork: respectively after the night following the night shift (corresponding to the end of the shift cycle), and after the night following the last day off (corresponding to the beginning of a new shift cycle). RESULTS: There were no significative differences in sleep parameters between the two moments of assessment. Regarding psychopathological features we found a reduction of SQ-Somatization (P = 0.002), SQ-Anxiety (p = 0.006) and SQ-Hostility (p = 0.075) subscale score at the end of the shift cycle. CONCLUSIONS: We confirm this type of shiftwork as not causing alterations of sleep parameters. We explain the improvement in psychopathological symptoms noted at the end of the shift cycle with the favourable psychological attitude of workers in the perspective of time off. The present data suggest that the psychological attitude of workers may play an important role in the clinical expression of psychopathological features.

Body image in secondary amenorrhea.

Body image and personality traits are described in women suffering from secondary amenorrhea. Data gathered, in 21 consecutive female patients, from the Minnesota Multiphasic Personality Inventory (MMPI), Body Cathexis Scale, Image Marking Method and Distorting Television Image Method, were examined and compared with those collected in a control group. No significant differences were found in terms of body perception and body dissatisfaction. The evaluation of MMPI profiles, on the contrary, suggested differences between amenorrheic subjects and controls for what concerned personality traits, these last being significantly, but differently, related to body dissatisfaction and wish for thinness in both groups.

Rapidity of onset of the antidepressant effect of parenteral S-adenosyl-L-methionine.

A possible method of reducing the delay in antidepressant response is to use S-adenosyl-L-methionine (SAMe), a naturally occurring compound that appears to have a rapid onset of effect in the treatment of depression. In this open, multicenter study, 195 patients were given 400 mg of SAMe, administered parenterally, for 15 days. Depressive symptoms remitted after both 7 and 15 days of treatment with SAMe, and no serious adverse events were reported. Further studies with a double-blind design are needed to confirm this preliminary indication that SAMe is a relatively safe and fast-acting antidepressant.

Body size perception and dissatisfaction in female subjects of different ages.

The relationships between age and both body size estimation and body dissatisfaction were assessed by Distorting Television Image Method (DTIM) and Body Cathexis Scale (BCS) in a sample of 96 female subjects of ages ranging from 7 to 65 years. We found that there were no significant body distortion differences between different age ranges, although the most accurate perception seemed to occur during adolescence. As far as DTIM assessment of body dissatisfaction was concerned, adolescents showed no significantly greater aesthetic preoccupation than subjects of other age groups. On the other hand, using BCS, body dissatisfaction appeared to increase proportionally with age. The low, although significant, correlations between these two techniques of measuring body dissatisfaction suggest that, in addition to evaluating aesthetic features, BCS also assesses the degree of satisfaction with functional body aspects which are exposed to unavoidable decline with ageing.

An open trial of methyltetrahydrofolate in elderly depressed patients.

5-methyltetrahydrofolate (MTHF) is a naturally occurring substance involved in the synthesis of s-adenosyl-l-methionine (SAMe), a major source of methyl groups in the brain. To assess the efficacy of a gastro-resistant, oral preparation of MTHF, 20 elderly patients with a DSM-III-R diagnosis of depressive disorder and a HAM-D-21 score > or = 18 underwent 6-weeks of open-label treatment with 50 mg per day of oral MTHF. Of these 20 patients, 16 completed at least 4 weeks of treatment and showed a markedly significant improvement in their depressive symptoms at endpoint, with 81% of them being considered responders. There were no clinically relevant changes in the routine laboratory tests during the study, and no adverse events considered to be definitely drug-related were reported.

Childhood's enuresis in the history of women with hyperprolactinemic amenorrhea.

Hyperprolactinemia, or elevated levels of prolactin in blood, is a normal physiologic post-partum response in lactating women. Non-lactating women with hyperprolactinemia often present during the reproductive years since they may have amenorrhea, galactorrhea, or both. Hypersecretion of prolactin is most commonly due to pituitary adenomas. Women with hyperprolactinemic amenorrhea are often quite anxious, depressed and hostile. It has been hypothesized that these psychological symptoms might antecede the onset of hyperprolactinemia and that hyperprolactinemia may be associated with early developmental problems and may be psychogenic in origin. Twenty patients with hyperprolactinemic amenorrhea and twenty-one normoprolactinemic patients with amenorrhea had an interview covering psychiatric history in order to establish whether they had ever met DSM-III criteria for functional nocturnal enuresis at one time during their childhood. While seven out of twenty (35%) patients with hyperprolactinemic amenorrhea were found to have had functional enuresis during their childhood, only two out of twenty-one (9.5%) normoprolactinemic amenorrheic women reported having had functional enuresis. The difference between the two groups was statistically significant (chi-squared: 3.88; p less than 0.05). We postulate that early stress and developmental problems may present in children as psychological distress and functional enuresis and in women as psychological symptoms (e.g., anxiety and depression) and hyperprolactinemic amenorrhea.

Acute alkalosis, but not acute hypocalcemia, increases panic behavior in an animal model.

Non-pretrained, randomized adult rats were tested in a panic-inducing model of passive avoidance. Intravenous treatment with alkalinizing agents (sodium lactate 0.5 M, 0.5 ml/100 g b.wt., or NaHCO3, 0.5 mEq/100 g b.wt.), but not with a hypocalcemic dose of EDTA (75 mg/kg) 3 min before testing, significantly increased panic behavior. These data may support the hypothesis that panic attacks are due to alkalosis and not to lactate-induced hypocalcemia.

General hospital psychiatry in Italy: on the hospitalization of psychiatric patients and consultation-liaison psychiatry after Law 180, 1978.

The type of psychiatric assistance carried out in Italy before Basaglia's views gained ground--that is, before 1968, when his book L'Istituzione Negata was published--is first described. The "Democratic Psychiatry" movement he launched was the mainspring of Law 180 (1978), known to have led to the closing of asylums. This law has brought about moves to create new mental health community services covering wide areas, the setting up of special diagnosis and care sections in general hospitals responsible for compulsory admissions--and overcrowding in private clinics and University clinics within general hospitals. The role of the psychiatric ward (opposed by the supporters of "Democratic Psychiatry") and of consultation-liaison psychiatry within the ambit of the general hospital is then discussed in the light of our experience.

Prevention of child abuse and neglect through early diagnosis of serious disturbances in the mother-child relationship in Italy.

At the obstetrical clinic of Modena University and a family center of the same municipality during the first six months of 1980 a questionnaire based on "Risks of Child Abuse" by Kempe, Gray and others was administered to 33 expectant mothers during the third trimester of pregnancy, a few days after delivery, and a month and one-half after childbirth, for the purpose of examining the mother-child relationship. Two principal groups of "risk factors" which may lead to child abuse and neglect appeared: mothers with preceding personal and social experiences, and cases of medical intervention (e.g., prematurity, caesarean). Use of a questionnaire that permitted early diagnosis made possible help in establishing a good mother-child relationship in the first months of life. Such help can be given by the hospital and public centers both before and after birth.

[The child and his dentist]. / Il bambino e il suo dentista.

The complex symbology connected with dental pathology and the significance for the patient of his meeting with the professional figure of the dentist are considered. The results of an experiment in which a dentist, psychologist and neuropsychiatrist cooperated in order to throw light on the different psychological implications in the two basic periods of development age, pre-school and primary school, are reported. In both cases, examined on the basis of a standard questionnaire administered by the dentist, it emerged that an approach directed at affective and emotive components has the effect of minimizing the child-dentist relationship and thus aiding the dentist's work.