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BACKGROUND: Individuals with psychiatric disorders incur an increased risk of morbidity and mortality, with higher prevalence of cardio-metabolic risk factors s largely contributing to a significant reduction in life expectancy. OBJECTIVES: The aim of the present study was at evaluating the clinical effectiveness of an educational intervention targeting lifestyle habits in patients with mood and psychotic disorders. METHODS: Patients (n = 32) were randomly assigned to receive, in addition to the pharmacological treatment, either five sessions of group psychoeducation focused on healthy lifestyle or five sessions of a control group therapy. RESULTS: Both psychopathological severity (i.e. the brief psychiatric rating scale) and lifestyle quality (i.e. physical activity, sleep quality and adherence to the Mediterranean diet) improved significantly over time in patients who underwent specific psychoeducational sessions but not in the controls. CONCLUSIONS: These findings add to the accumulating evidence that educational interventions focused on lifestyle habits can ameliorate general and mental health in patients with psychiatric disorders and suggest that educational programs represent an effective non-pharmacological intervention to manage drug-induced cardiometabolic disturbances.
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Transtornos do Humor/psicologia , Transtornos do Humor/terapia , Psicoterapia de Grupo , Transtornos Psicóticos/psicologia , Transtornos Psicóticos/terapia , Feminino , Estilo de Vida Saudável , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
PURPOSE: To investigate the relationship between chronic cerebrospinal venous insufficiency (CCSVI) and cerebral hemodynamic parameters and to disclose any possible involvement in the pathophysiology of multiple sclerosis (MS). MATERIALS AND METHODS: The study was approved by the institutional review board, and written informed consent was obtained from all participants. The diagnosis of CCSVI was assigned by using specific color Doppler ultrasonographic criteria. Cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time were assessed with dynamic susceptibility contrast material-enhanced magnetic resonance imaging in normal-appearing white matter (NAWM) in 39 patients with MS. Of these, 25 had CCSVI and 14 did not. Twenty-six healthy control subjects were also evaluated, and of these, 14 had CCSVI and 12 did not. Two-way analysis of variance testing was used for statistical analysis, with Bonferroni correction for multiple comparisons. Correlation analysis was performed by calculating Spearman coefficients. RESULTS: Individuals with CCSVI showed cerebral hemodynamic anomalies, such as decreased CBF and CBV, as compared with individuals without CCSVI, without any delay in mean transit time. No significant interaction between MS and CCSVI was found for any hemodynamic parameters. Furthermore, no correlations were found between CBV and CBF values in NAWM or for severity of disability in patients with MS. The MS group showed prolonged mean transit time in the periventricular NAWM, as compared with the control group, and positive correlation was found between mean transit time values and disability scales in patients with MS. CONCLUSION: The data support a role of CCSVI in cerebral hemodynamic changes, such as a decrease of CBV and CBF, regardless of the presence of MS. CCSVI had no effect on neurologic function and disability progression in patients with MS.
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Circulação Cerebrovascular , Hemodinâmica/fisiologia , Imageamento por Ressonância Magnética/métodos , Esclerose Múltipla/fisiopatologia , Insuficiência Venosa/fisiopatologia , Adulto , Análise de Variância , Velocidade do Fluxo Sanguíneo , Volume Sanguíneo , Estudos de Casos e Controles , Meios de Contraste , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Ultrassonografia Doppler em CoresRESUMO
INTRODUCTION: The most important predictive factor for a successful outcome in Brief Psychotherapy is the motivation of patients to the treatment itself. Against the scarcity of literature on the subject, so far limited to offer standardized tools to assess motivation, applied mainly to education and work's areas, in spite of a possible application in psychotherapy, it was considered necessary to develop a questionnaire ad hoc. MATERIALS AND METHODS: It was therefore created a pattern of motivational diagnosis of the problem based on a sequence of questions and answers, which would make possible the classification of each case and then that could lead to the use of a specific method. It is the result of the attempt to create an orderly pattern and that it would be easy to use and then be analyzed. The questionnaire consists of twenty one questions and requires that the patient answers with a "yes" or a "no" to each applicant. It was administered to thirty patients who came from the psychiatric day hospital. The questionnaire was used as a "not standardized thread" in which, through groups of questions, are addressed some central cores: the spontaneous activity, motivation controlled from the outside, motivation directed to an activity that leads to results, motivation to and activity for a purpose, expectations of self-efficacy, the presence/absence of resistance and finally the area of the will. The purpose of this work is to show, bringing a contribution in agreement with the few studies on the subject, how motivation is a key parameter for predicting the effectiveness of a psychotherapy, in this case, Brief Psychotherapy. CONCLUSIONS: The study clearly shows how the motivation is the most important positive predictor in the preliminary assessment of a Brief Psychotherapy: results in treatment are most likely to be rapid and favorable if patients are motivated to change andif they are engaged with the therapist.
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Hospital Dia/estatística & dados numéricos , Hospitais Psiquiátricos/estatística & dados numéricos , Transtornos Mentais/terapia , Motivação , Psicoterapia Breve , Inquéritos e Questionários , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente/estatística & dados numéricos , Psicoterapia Breve/métodos , Cidade de Roma/epidemiologia , Resultado do TratamentoRESUMO
INTRODUCTION: Internet Addiction Disorder (IAD) is an emerging psychiatric disorder, assimilable to impulse control problems and related to maladaptive use of new networks and social and virtual technologies. AIM: Our study aims to analyze the presence of IAD among adolescents and to study the correlation with social interaction anxiousness. We investigated also the possibility that the Social Network (SN) represent a source of risk for the development of IAD. MATERIALS AND METHODS: The test group was composed of 250 subjects, aged between 14 and 18 years. They were administered: Young's IAT; IAS (Interaction Anxiousness Scale), AAS (Audience Anxiousness Scale) and SISST (Social Interaction Self-Statement Test) to analyze the dimension of social interaction anxiousness. RESULTS: We found a rate of 2% of the IAD. The SN are the most common use of the Net in our sample, but not the most clicked sites by subjects with IAD. It should be noted, finally, a correlation between social interaction anxiety and IAD, but not a significant difference in scores of social anxiousness scales based on the SN use/non-use. CONCLUSIONS: The use of SN intended as single variable doesn't correlate with increased risk for IAD, or for increased social interaction anxiousness. However, if associated with prolonged use of the net for 5-6 hours or more, or concomitant use of chat rooms and/or net gambling, we find a more significant risk of psychopathology. The data presented require further investigations, in order to guide new pathogenetic models and appropriate intervention strategies.
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Ansiedade , Comportamento Aditivo/diagnóstico , Comportamento Aditivo/psicologia , Internet , Relações Interpessoais , Adolescente , Análise de Variância , Ansiedade/epidemiologia , Comportamento Aditivo/epidemiologia , Redes de Comunicação de Computadores/estatística & dados numéricos , Feminino , Humanos , Incidência , Internet/estatística & dados numéricos , Itália/epidemiologia , Masculino , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Instituições Acadêmicas , Distribuição por Sexo , Estatísticas não Paramétricas , Estudantes/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
UNLABELLED: The assessment of defense mechanisms in psychotherapy is currently one of the most used ways to evaluate the effectiveness of psychotherapy. In literature there are few reports on defense mechanisms changes by short-term treatments. AIM: To determine whether the defense mechanisms are changed after twelve sessions of short-term psychotherapy related to psychopathological symptoms, severity and overall functioning. METHODS: Twenty patients (12 F and 8 M; age 38.4) affected by anxiety and mood disorders were recruited to the study between November 2008 and July 2009 and were assessed with the Defense Style Questionnaire-88 (DSQ-88), scale Symptom Checklist-90-Revised (SCL-90-R), scale Clinical Global Impression (CGI) and scale Valutazione Globale del Funzionamento (VGF) at the beginning and after short-term psychotherapy. Half the sample also assumed drugs. The treatment was supportive-expressive psychotherapy of Luborsky, a short focal dynamic therapy, characterized by the integration of supportive and expressive techniques. RESULTS: Both patients showed a significant decrease in immature defenses and a significant-increase in mature defenses (p < 0.01). Mature defenses were significantly correlated with severity (r = -0632; p = 0.003) and overall functioning (r = 0529; p = 0.01). DISCUSSION: Immature and mature defenses seem to be a useful outcome measure in short-term psychotherapy as well as severity and overall functioning and the combined treatment may be most effective in reducing immature defenses.
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Mecanismos de Defesa , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Psicoterapia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Adulto JovemRESUMO
In the general reflection inherent categorical and dimensional diagnosis and the opportunity to put neurotic and psychotic personality in the various chapters of the discipline, a never-ending discussion on the similarities and differences between clinical pictures classified in separate entries (think of the comings and goings from one cluster to another between schizoid and avoidant personality disorder). Other cogent discussion focused on the nosographical criteria, targeted to a modified classification that takes into account dimensional rather than descriptive criteria. About personality disorders think of the debate on their degree of severity, as assessed by criteria such dissimilar from various authors, as to be very different in this sense a ranking according to the variables considered (eg, classifications by Kernberg and Millon). As an established tradition that a contribution to psychological studies derives also from the literary and artistic forms in general, we propose, through the interpretation of literary cases, the dimensional affinity between schizoid and narcissistic disorders. The dimensions taken into account are those of affectivity and intersubjectivity, impaired in both disorders.
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Transtorno da Personalidade Esquizoide/história , Argélia , Áustria , Dinamarca , França , História do Século XIX , História do Século XX , Humanos , Irlanda , Medicina na Literatura , Transtornos da Personalidade/história , Polônia , Federação Russa , Transtorno da Personalidade Esquizoide/diagnóstico , Transtorno da Personalidade Esquizoide/psicologia , Reino UnidoRESUMO
INTRODUCTION: Individuals with euthymic Bipolar Disorder (BD) can experience deteriorated cognitive functioning, with such deterioration being associated with functional impairment. Cognitive remediation (CR) is considered an effective add-on intervention for neuropsychological impairments, but relatively few CR controlled studies have been performed on BD. In the present study the efficacy of a CR intervention designed for the improvement of cognition and functioning in patients with euthymic BD was tested. METHODS: Patients (n = 54) with euthymic BD were assigned to receive active (n = 27) or control (n = 27) intervention. The active intervention (i.e. the Cognitive Remediation in Integrated Treatment - CRIIT - protocol) was made of 20 individual sessions focused on the treatment of attention, memory and executive functioning through the COGPACK software; each session was integrated with psychoeducation and rehabilitation interventions implemented through a metacognitive approach aimed at ameliorating personal agency. RESULTS: A significant (p ≤ 0.015) time x group interaction at repeated measures MANOVA was observed on Rey Auditory Verbal Learning Test, Rey Complex Figure Test, Wisconsin Card Sorting Test, Trail Making Test, Visual Search, Life Skills Profile, and Barratt Impulsiveness Scale. LIMITATIONS: A single-blind approach was used. DISCUSSION: The results showed that patients undergoing active intervention improved in domains related to executive functions, attention, memory, functioning and impulsivity more significantly than patients undergoing control interventions. This study adds to the evidence that CR improves neurocognition in BD, and suggests that CRIIT protocol represents an add-on intervention of potential relevance to increase cognition and functioning in BD euthymic patients.
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Transtorno Bipolar , Remediação Cognitiva , Transtorno Bipolar/complicações , Transtorno Bipolar/terapia , Transtorno Ciclotímico , Humanos , Testes Neuropsicológicos , Método Simples-CegoRESUMO
In recent years, many cases have been published about the appearance of a specific syndrome after the suspension or the sharp reduction in dose of antidepressants. Most of the reports and records relating to the very short half-life SSRI paroxetina. The following work intended to investigate the syndrome, its impact and its correlation with some parameters: age, sex, diagnosis, time of taking and antidepressant drug, therapeutic compliance, suspension and symptoms. The study, lasting approximately 6 months, was conducted with 148 outpatient, all treated with paroxetine.This paper highlights how the discontinuation syndrome is rare in individuals who received antidepressant treatment for short periods, and how it is, rather, much more common in cases of depression NAS, followed by panic attacks, compared with case of major depression. A positive correlation seems to be also with sex (having observed that go more frequently to meet withdrawal symptoms subjects male), and with age, patients being young adults between 35 and 55 years. The symptoms reported were very similar among all patients: headache, dizziness, abdominal pain and perineal, elevated pressure, anxiety, depersonalization and derealization, nightmares. Interestingly, the total absence of symptoms related to the original diagnosis of the disorder. Going to investigate the causal event for the emergence of the discontinuation syndrome, it was possible to divide the cases examined in three categories: independent suspension without medical opinion, suspension accelerated (both conditions due to outpatients) and finally patients that, although they had followed all the guidelines for suspension of the drug, had gone to meet equally symptoms. The syndrome can be prevented reducing very gradually the antidepressant dosage, while if there are symptoms it is indicated to reintroduce the drug and then scale or replance it with a different molecule.
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Paroxetina/administração & dosagem , Paroxetina/efeitos adversos , Inibidores Seletivos de Recaptação de Serotonina/administração & dosagem , Inibidores Seletivos de Recaptação de Serotonina/efeitos adversos , Síndrome de Abstinência a Substâncias/diagnóstico , Síndrome de Abstinência a Substâncias/epidemiologia , Adulto , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Síndrome de Abstinência a Substâncias/etiologiaRESUMO
INTRODUCTION: After the advent of SSRI, antidepressants in low doses and in combination with neuroleptic treatment entered into use in clinical practice. The indication is the depression that may overlap with schizophrenic disorder. AIM: Our work, based on "serotonin dimension" of schizophrenic disorder and accepting the neuropharmacological paradox that is cotherapy antipsicotic drug/SSRI, has investigated two different combinations of integrated treatment: olanzapine+paroxetine and olanzapine+fluvoxamine. MATERIALS AND METHODS: The study sample consists of 50 patients with schizophrenia, all young adults aged up to 36 years. The therapeutic groups were structured as a term of one year, with scales by SANS and PANSS at time 0, 1 months, 6 months and 12 months. RESULTS; The clinical evidence has shown good parameters of efficacy, safety and tolerability of the drug SSRI in combination with neuroleptics. There was a reduction in negative symptoms, as evidenced by the decrease in scoring in the PANSS and SANS scales. This is especially valid for the molecule fluvoxamine. CONCLUSIONS: While the molecule paroxetine seems partly slatentize cognitive deficits (expression of residual psychotic negative component), fluvoxamine has proven effective in improving the negative symptoms and has shown, moreover, not to increase the positive symptoms of the disease.
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Benzodiazepinas/uso terapêutico , Fluvoxamina/uso terapêutico , Paroxetina/uso terapêutico , Esquizofrenia/diagnóstico , Esquizofrenia/tratamento farmacológico , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Adulto , Quimioterapia Combinada , Humanos , OlanzapinaRESUMO
AIM: The study aims at evaluating the resocializing effects of music therapy as add-on therapy in the course of integrated, pharmacological and psychological, treatment. METHODS: During a six months period, 24 patients belonging to a psychiatric Day Hospital were recruited and divided into 2 groups. An accurate music anamnesis was collected for each patient. Group 1 (n=11) received as add-on therapy 14 improvisational music therapy sessions on a weekly basis, while group 2 (n=13) received 7 improvisational music therapy sessions alternated with 7 listening music therapy sessions, on a weekly basis. The response to music therapy was evaluated at the beginning and at the end of the add-on therapeutic process through a music therapy observation form consisting of 9 variables. RESULTS: In both groups there was a good response from patients affected by mood disorders as well as obsessive-compulsive disorder, while schizophrenic patients response was either absent or reduced. The improvement of the variable interaction between the components, sharing of the instrument, facial expressions and tension was significantly higher in the group that received as add-on therapy both improvisational music therapy and listening music therapy. DISCUSSION AND CONCLUSIONS: The findings suggest a significant role of the improvisational music therapy in gaining a re-socializing effect within a therapeutic group. The effectiveness turns out to be greater if the improvisation is combined with a listening therapy, aimed at educating the patient to a greater openness to the expressive aspect of sound. The active-passive music therapy association could then bring a valuable contribution as an add-on rehabilitative treatment.
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Transtornos Mentais/terapia , Musicoterapia , Terapia Combinada , Hospital Dia , Feminino , Hospitais Psiquiátricos , Humanos , Masculino , Pessoa de Meia-Idade , Reabilitação Psiquiátrica , Socialização , Resultado do TratamentoRESUMO
INTRODUCTION: Patients with bipolar disorder show a high relapse rate generally related to their poor adherence to the prescribed medications and to their high stress vulnerability, linked to genetic, neuroendocrine and cognitive factors. AIMS: The first aim of this study was to verify if for a group of pharmacologically stabilized bipolar patients, the attendance to a Group Psychoeducation program according to the Barcelona model would result in an improvement of their stress resilience, as measurable by evaluating their morning cortisol secretory profile. The second aim of the study has been to verify if these effects would maintain stable over time, organizing follow-up evaluations, after one year and after two years form the end of the group psychoeducation program. MATERIALS AND METHODS: 96 patients who had been euthymic for at least 6 months and were under stabilized pharmacologic maintenance treatment, were randomized in two groups: pharmacological treatment as usual (TAU) or pharmacological treatment plus group Psychoeducation (PE). Patients in both groups underwent a psychological assessment (HAMD, YMRS e ARMS), and to a functional assessment of the HPA axis activity, obtained evaluating cortisol levels from salivary samples collected in 5 different moments of the day: at baseline, at the end of the group psychoeducation program, and after 1 year and 2 years from the end of the last PE session. RESULTS: At the end of the study, both groups (PE and TAU) did not show any significant intergroup difference with regard to all the clinical variables and the patients' adherence to the prescribed medications. On the contrary, significative intergroup differences were observed with regard to morning cortisol secretory profile, that was found normalized at the endpoint only among patients of the PE group, but not among those of the TAU group. This normalization of the morning cortisol secretory profile observed among patients of the PE group, proved to maintain stably overtime, since it was observed also in the two follow-up assessments, organized after 1 year and after 2 year from the end the treatment. DISCUSSION: Data collected in this study may indicate that the efficacy of the psychoeducation programs for bipolar patients may activate an improvement of the functional activation of the HPA axis, and so obtaining a reduction of their stress vulnerability.
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Transtorno Bipolar/complicações , Transtorno Bipolar/terapia , Psicoterapia de Grupo , Estresse Psicológico/complicações , Adulto , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/psicologia , Feminino , Humanos , Hidrocortisona/análise , Masculino , Pessoa de Meia-Idade , Sistemas Neurossecretores , Cooperação do Paciente , Educação de Pacientes como Assunto , Saliva/químicaRESUMO
Tendon reflexes have been often used in studies of the human nervous system in health and disease. They have been investigated either in response to single tendon taps or to long duration vibrations. Tendon reflexes are described here in response to a high frequency vibration burst (3 cycles of a 100 Hz sine wave) applied to the Achilles tendon of standing subjects, either in quiet stance or during a forward leaning posture. The electromyogram from the soleus muscle usually showed three components separated by 10 ms which were interpreted as being three reflexes, each reflex induced by each of the three cycles in a burst. This result indicates that soleus tendon reflexes can respond in fast succession in a phasic manner when a brief high frequency vibration is applied to the Achilles tendon. This occurs in spite of possible depression of the Ia to motoneuron synapses and the long after hyperpolarization of the motoneurons. An interpretation of the results is that motoneurons from different subsets of the motoneuron pool respond to different cycles of the sinusoidal vibratory burst.
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Tendão do Calcâneo/fisiologia , Reflexo H/fisiologia , Músculo Esquelético/fisiologia , Reflexo de Estiramento/fisiologia , Adulto , Vias Aferentes/fisiologia , Estimulação Elétrica/métodos , Eletromiografia/métodos , Humanos , Neurônios Motores/fisiologia , Músculo Esquelético/inervação , Postura/fisiologia , VibraçãoRESUMO
This study examined associations between specific elements of therapeutic relationships and short-term psychodynamic psychotherapy (STPP) outcomes. Notably, we focused on therapists' subjective experiences during their first clinical interaction with patients, countertransference patterns and therapeutic alliance evaluated early in treatment, in relation to patient symptom changes at the end of STPP. Twenty clinicians completed the Comprehensive Psychopathological Rating Scale to evaluate patients' (N=32) symptom severity at the beginning and end of STPP. They also completed the Assessment of Clinicians' Subjective Experience (ACSE) to assess their subjective experiences of their patients at the first clinical interview and the Therapist Response Questionnaire (TRQ) and Working Alliance Inventory to evaluate their countertransference reactions and therapeutic alliance at the sixth therapy session. The findings showed that the TRQ and ACSE scales correlated in a coherent way, with the exception of the TRQ helpless/inadequate pattern and ACSE impotence. Strong and more negative TRQ countertransference patterns and ACSE dimensions were significantly associated with lower quality of the therapeutic alliance. Finally, better STPP outcomes were positively associated with a good therapeutic alliance and negatively correlated with greater difficulty in attunement at the beginning of clinical assessment and therapists' stronger responses of helplessness, frustration, and disengagement during therapy. These results confirm the precious value of the clinical relationship, which represents a useful source of information for therapists when planning therapeutic interventions.
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Cinema has been extensively used in psychiatric care. In the present article the cinema-based interventions implemented at the Day Hospital of Sapienza University of Rome - Policlinico Umberto I Hospital with various modalities and aims (e.g. rehabilitation, group therapies, projective evaluations, psychoeducation) will be discussed.
Assuntos
Transtornos Mentais/terapia , Filmes Cinematográficos , Psicoterapia/métodos , Hospital Dia , Humanos , Psicoterapia de Grupo , Cidade de RomaRESUMO
OBJECTIVE: Individuals with bipolar disorder (BD) experience difficulties in cognitive and emotional regulation in different phases of illness. In the present study, we aimed at exploring differences on hot and cool executive functioning (EF) between BD patients in euthymia (BDe) and mania (BDm), and associations of hot and cool EF with emotion regulation strategies. METHODS: Thirty-seven BD patients (among which 18 with a current manic episode and 19 in euthymia) and 15 healthy controls completed a battery of tests assessing hot and cool EF and emotion regulation strategies. RESULTS: Between group comparisons showed that in all the explored hot dimensions BDm subjects had significantly worse performances than BDe subjects, while in all the explored cool dimensions BDm subjects had significantly worse performances than HC subjects, with BDe patients having an intermediate profile. Results from bivariate correlations among BDe subjects (but not among BDm subjects) showed significant positive correlations (i) between elements of hot EF and elements of cool EF, and (ii) between cognitive reappraisal emotional regulation strategy and planning (i.e., a measure of cool EF), as well as a significant negative correlation between expressive suppression emotional regulation strategy and emotional intelligence. CONCLUSIONS: The results confirm previous findings on a role of impaired EF in BD, and suggest (i) that hot EF is more closely related to mood (i.e., state-dependant) than cool EF, and (ii) that BD patients can more effectively use emotion regulation strategies in association with EF during euthymia than during mania.
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Transtorno Bipolar/psicologia , Emoções , Função Executiva , Adulto , Feminino , Humanos , MasculinoRESUMO
The present article intends to go over the history of the Psychiatric Clinic of the Sapienza University of Rome, starting from the beginning of the teaching of Psychiatry at Santa Maria della Pietà mental hospital, back in 1871, to the eventual founding, at the University "La Sapienza" and the Umberto I general hospital, of the Institute of Psychiatric Clinic and next of the Nervous and Mental Diseases' Clinic with the enclosed specialization school in Psychiatry. A detailed overview is supplied on the characters of the eminent scientists who have succeeded over time at the head of the Clinic and on the description of its different organization, conceived by each of them because of their educational and cultural roots. In this humus is born, in 1966, the journal Rivista di Psichiatria, still alive. To follow, a brief description of what the academic Psychiatry of the Umberto I nowadays represents, and indeed point of contact of different psychiatric thinking roots, with an organic, pharmacological, phenomenological, and psychotherapeutic orientation, this latter in the psychodynamic, cognitive-behavioral, and family-related approaches.
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Hospitais Psiquiátricos/história , Transtornos Mentais/história , Psiquiatria/história , Universidades/história , Instituições de Assistência Ambulatorial/história , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Cidade de RomaRESUMO
Background. There is a gender disparity in the incidence, prevalence, and progression of renal disease. The object of this paper is to evaluate the presence and type of renal lesion in normogonadic and hypogonadic male rats in a mild hyperuricemia induced condition and exposed to a high-fructose diet. Methods. 56 adult male Wistar rats were used. Animals were divided into two groups, one normogonadic (NGN) and one hypogonadic (HGN), and each group was divided into four subgroups in accordance with the treatment: control with only water (C), fructose (F), oxonic acid (OA), and fructose + oxonic acid (FOA). Renal changes were evaluated by measuring glomerulosclerosis, fibrosis, and arteriolar media/lumen (M/L) ratio. Results. The OA and FOA groups presented significantly hypertension (p < 0.001). The OA group significantly increased (p < 0.05) the percentage of glomerulosclerosis as well as the FOA group (p < 0.001). When comparing NGN versus HGN, we observed a trend to a lower glomerulosclerosis in the latter. A higher arteriolar M/L ratio was observed in the OA (p < 0.05) and FOA (p < 0.001). Conclusion. Hyperuricemia conditions and a high-fructose diet favor blood pressure increase together with changes in the arteriolar media/lumen ratio and renal glomerular damage. These changes were more apparent in normogonadic animals.
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Osteoporosis and depression are two chronic diseases that affect large population groups with great impact on morbidity, mortality and quality of life. Existing studies of the relationship between depression and osteoporosis have been heterogeneous in their design and use of diagnostic instruments for depression, which might have contributed to the different results on the comorbidity of these two conditions. Moreover, the direction of the causative link is still controversial and the etiology remains unclear. Definitely, limited data suggest that osteoporosis may enhance depressive symptoms, while far more studies have shown that depression adversely affects bone density and increases fracture risk. Thus the correlation of these diseases is still under research. This review comments on a plausible causative relationship and underlying mechanisms that might elucidate the link between two very common diseases. We describe the possible impact of osteoporosis on moods and the effect of depression on bone health. In particular, we focus on the role of the hypothalamic-pituitary-adrenocortical and sympathoadrenal axes, of the parathyroid hormone and cytokines. We also describe the effect of the antidepressant drugs as well as lifestyles that may explain this effect.
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Transtorno Depressivo Maior/complicações , Estilo de Vida , Osteoporose/complicações , Qualidade de Vida , Distribuição por Idade , Densidade Óssea , Comorbidade , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/fisiopatologia , Fraturas Ósseas/fisiopatologia , Humanos , Sistema Hipotálamo-Hipofisário/fisiopatologia , Itália/epidemiologia , Osteoporose/epidemiologia , Osteoporose/imunologia , Osteoporose/fisiopatologia , Sistema Hipófise-Suprarrenal/fisiopatologia , Prevalência , Fatores de RiscoRESUMO
BACKGROUND: In spite of a large amount of observations made in Psychiatric Day-Hospital of Sapienza University of Rome relating to comorbidity between sexual and gynecological disorders and hysteria, we have attempted to quantify the incidence of this phenomenon in order to assess their significance. METHODS: A retrospective study was conducted on medical records of patients hospitalized at the Day-Hospital of the Policlinico Umberto I in Rome between 1989 and 2009. RESULTS: It seems to be confirmed the hypothesis of a high frequency of correlating these disorders, although the results lead to a number of critical reflections on its significance and the method adopted. CONCLUSIONS: This research needs larger and more accurate future investigations, cause the type of study was made without direct information.
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Doenças dos Genitais Femininos/epidemiologia , Transtornos Mentais/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/epidemiologia , Comorbidade , Transtorno Conversivo/epidemiologia , Hospital Dia/estatística & dados numéricos , Escolaridade , Feminino , História do Século XV , História do Século XIX , História Antiga , História Medieval , Humanos , Histeria/epidemiologia , Histeria/história , Ciclo Menstrual , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Ambulatório Hospitalar/estatística & dados numéricos , Estudos Retrospectivos , Cidade de Roma/epidemiologia , Transtornos Somatoformes/epidemiologia , Adulto JovemRESUMO
Caffeine is considered the world's most popular psychoactive substance. Its actions on the central nervous system, mainly mediated by antagonism of adenosine receptors and subsequent modulation of dopaminergic activity, would be particularly sought by depressed patients, as an attempt of self-medication. However, published data suggested that coffee consumption may worsen psychopathological conditions in mood disorders. Thus, we reviewed available evidence in the literature that investigated the effects of coffee consumption on clinical development of underlying psychopathology. Literature research was done by typing on Medline/PubMed and PsychINFO the key words "coffee AND major depression", "coffee AND dysthymia". The research was limited to English language publications and to studies conducted exclusively on humans. Although literature data are conflicting, extensive follow-up studies indicate a significant caffeine effect on risk reduction of developing clinical depression symptoms. Clinical worsening was observed mainly in cases of postpartum depression and comorbid panic disorder. Taking in account the study limitations, we observed a biphasic profile in caffeine psychostimulant effect: low to moderate doses may correlate with a reduction in depressive risk in healthy subjects and an improvement of many clinical symptoms (attention, arousal, psychomotor performance) in depressed patients, whereas the assumption of high doses may result in thymic dysregulation, favor mixed affective states and worsen circadian profiles and anxiety symptoms.