Bollettino della Società italiana di biologia sperimentale, Jan 30, 1979
In rat brain the tranylcypromine administration induces after two hours a 151% increase of seroto... more In rat brain the tranylcypromine administration induces after two hours a 151% increase of serotonin levels and a 50% fall of glycogen concentration. The activity of phosphorylase a and b and the glycolytic flow rate are unchanged.
While the worldwide prevalence of bipolar disorder is approxi-mately 2%, it increases to 6 % if t... more While the worldwide prevalence of bipolar disorder is approxi-mately 2%, it increases to 6 % if the broad bipolar spectrum subtypes are also considered. Among other psychiatric condi-tions, anxiety disorders are most frequently observed in bipolar patients. Anxiety can be a symptom of bipolar disorder, and was first recognized by Kraepelin in 1921 who described “anxious mania ” and also “excited depression”, which included a “great restlessness”. He specifically named anxiety as one of the com-ponents of this illness, but at present “anxiety ” is not generally considered as a symptom of bipolar disorder, but rather as a comorbid condition. However, comorbid anxiety disorders have a significant impact on clinical presentation and prognosis of bi-polar disorder in at least one-half of cases of bipolar disorder beyond the acute phase (in the euthymic phases). The aim of this study was to explore the correlation between anxiety and bi-polar disorder through a critical review of the rece...
Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale
The importance of certain psychological aspects during post-surgical rehabilitation of laringecto... more The importance of certain psychological aspects during post-surgical rehabilitation of laringectomized patients is being more and more emphasized in research on the subject. The aim of this study is to consider a group of 55 patients who had undergone a total laryngectomy 6 to 48 months previously. The patients studied spoke using an esophageal voice and were chosen from among a group of 400 operated in our Department. This investigation was carried out not only from an organic point of view but took into consideration the consequence of such an important disability in the personal psychological, social, domestic and relational sphere as well. The study was carried out through a partially guided interview whose aim was to obtain anamnestic information regarding psychological symptoms present at the moment of the interview, the amount of understanding of the patients and their relatives concerning the diagnosis and the signs of sinergy. The Zung scale for self-evaluation of depressio...
In a short communication addressed particularly to medical doctors, the Authors make a statement ... more In a short communication addressed particularly to medical doctors, the Authors make a statement about the concepts of psychoneurosis and psychosomatic disease, taking into consideration the hypothesis of a psychopharmacological treatment. The Authors consider the drug as a complementary tool in the relationship between the doctor and the patient, useful in making easier the overcoming of the conflicts and as a coadjuvant in a strategy of both psychopharmacology and psychotherapy.
The presence of depressive symptomatology in alcoholics has frequently been encountered in clinic... more The presence of depressive symptomatology in alcoholics has frequently been encountered in clinical practice, but the relationship running between the two pathologies remains a subject for discussion. The methodological difficulty of this evaluation is seen in a major discordance of reported data. Against this background, a group of subjects hospitalized in a neuropsychiatric environment has been assessed for incidence of alcoholic and depressive pathologies and their possible correlations. Of 428 hospitalizations for alcoholism, 350 (82%) presented a depressive pathology. These patients were distinguished by DSM III into three groups [a) adaptation disturbance with depressed mood; b) dysthymic disturbance; c) atypical depression]. Within these groups, the incidence of prior stress-inducing psychosocial events was assessed according to the criterion of growing seriousness of DSM III. The results after statistical processing are discussed and compared with reported data.
The goal of this study was to evaluate the prevalence and type of psychiatric disorders coexistin... more The goal of this study was to evaluate the prevalence and type of psychiatric disorders coexisting with burning mouth syndrome (BMS), to compare the clinical features of patients with BMS alone with patients with multiple diagnoses, and to investigate the number and severity of life events that occur before the onset of BMS. There were 102 patients with BMS, with no possible local or systemic causes, who were evaluated according to the diagnostic criteria of DSM-IV. All axis I diagnoses for which the patients met criteria at intake or lifetime were determined. Life events were evaluated for a period of 6 months before the onset of BMS. A statistical comparison between patients and a matched control group was performed first; moreover, patients with BMS alone were compared with patients with comorbid BMS. Although 29 (28.4%) BMS patients were not given any other lifetime psychiatric diagnosis, high rates of comorbid psychiatric diagnoses were found. The most prevalent concurrent diagnoses were depressive disorders and generalized anxiety disorder. No significant differences emerged in clinical features between patients with and without other current psychiatric disorders. The severity of life events, rather than in their number, was significantly associated with BMS. BMS has high psychiatric comorbidity but can occur in the absence of psychiatric diagnoses.
Successive daily injections of LSD-25 and UML (1-methyl-d-lysergic acid butanolamide) caused prog... more Successive daily injections of LSD-25 and UML (1-methyl-d-lysergic acid butanolamide) caused progressive depression of brain 5-HT levels in the rat. On the fourth day, the decrease was significant with respect to the highly significant fall observed after a single administration, whereas it had been shown earlier that conditioned behaviour is no longer affected by LSD-25 after 3 days and that simultaneous administration of a single dose of LSD-25 and UML is equally ineffective in this respect. Its depression of 5-HT levels, however, has now been shown to be equal to that of LSD-25 alone at doses that influence conditioned behaviour. The findings indicate that changes in such behaviour are not dependent on brain 5-HT levels and that no link exists between such levels and the psychotomimetic effect of LSD-25 in man.
A few studies have tried antipsychotic augmentation in obsessive-compulsive disorder (OCD) patien... more A few studies have tried antipsychotic augmentation in obsessive-compulsive disorder (OCD) patients who are non-responders to selective serotonin reuptake inhibitors. The aim of this study was to investigate the efficacy and tolerability of olanzapine addition to fluvoxamine-refractory OCD patients and to assess if a comorbid chronic tic disorder or a concomitant schizotypal personality disorder was associated with response. Twenty-three OCD non-responders to a 6-month, open-label trial with fluvoxamine (300 mg/day) entered a 3-month open-label trial of augmentation with olanzapine (5 mg/day). OC symptom change was measured with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Clinical Global Impression (CGI) scale. Differences between responders and non-responders were assessed with regard to age, sex, duration of illness, baseline Y-BOCS score, and comorbidity with chronic tic disorders or schizotypal personality disorder. A significant decrease of mean Y-BOCS score between pre- and post-treatment (26. 8+/-3.0 vs. 18.9+/-5.9) was found at endpoint. Ten patients (43.5%) were rated as responders. The most common side effects were mild to moderate weight gain and sedation. In our sample, three patients (13. 04%) had a chronic motor tic disorder, and four (17.39%) had a codiagnosis of schizotypal personality disorder. Concomitant schizotypal personality disorder was the only factor significantly associated with response. It appears that augmentation of olanzapine in fluvoxamine-refractory OCD may be effective in a large number of patients, including those with comorbid schizotypal personality disorder.
Although a significant amount of evidence indicates the efficacy of some antidepressants in treat... more Although a significant amount of evidence indicates the efficacy of some antidepressants in treating psychogenic pain and somatoform disorder, very few studies have investigated their possible therapeutic action in burning mouth syndrome (BMS). The purpose of this 8-week, single-blind study was to provide preliminary data on the efficacy and tolerability of amisulpride and the selective serotonin reuptake inhibitors (SSRIs) paroxetine and sertraline for patients with BMS. Seventy-six patients with BMS (diagnosed according to the criteria in the literature and integrating the Diagnostic Interview Schedule-Revised for a complete psychiatric assessment), with no possible local or systemic causes and without concurrent major depression, were randomly assigned to receive amisulpride (50 mg/day), paroxetine (20 mg/day), or sertraline (50 mg/day). Efficacy assessments included a visual analogue scale (VAS) for pain intensity, the Hamilton Rating Scale for Depression (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A), and the Clinical Global Impressions scale (CGI). All 3 treatment regimens resulted in a significant improvement from baseline in burning mouth symptoms at week 8 as demonstrated by the quantitative (mean reduction in VAS, HAM-D, and HAM-A scores) and qualitative (percentage of responders) analyses. Amisulpride showed a shorter response latency than the SSRIs. No serious adverse events were reported, and the incidence of side effects did not differ among the 3 groups. None of the patients who received amisulpride withdrew from the trial, whereas withdrawal from the trial occurred within the first week of treatment in 11.5% of patients (N = 3) treated with paroxetine and in 21.7% of patients (N = 5) treated with sertraline. The data suggest that amisulpride and SSRIs may be effective treatments for BMS; they are equally effective and equally well tolerated in the short-term treatment of BMS. Amisulpride is associated with better compliance within the first week of treatment and with a shorter response latency in comparison with SSRIs. This finding may indicate that amisulpride is especially useful at the beginning of drug therapy of BMS. Double-blind, placebo-controlled trials are needed to further document the efficacy of amisulpride and SSRIs in the treatment of BMS.
Background: Few studies investigated the impact of anxiety disorder comorbidity on health-related... more Background: Few studies investigated the impact of anxiety disorder comorbidity on health-related quality of life (HRQoL) of bipolar patients and none examined bipolar subtypes differences. The aim of the study was 1) to determine comorbidity rates for anxiety disorders in euthymic bipolar subjects, comparing bipolar type I and II disorders (BDI and BDII), and 2) to compare within each group HRQoL measures in subjects with and without anxiety comorbidity. Methods: Comorbidity was evaluated through the SCID-I; HRQoL was assessed using the 36-Item Short-Form Health Survey (SF-36). All subjects were euthymic since at least 2 months, as confirmed by a HAM-D b 8 and a YMRS b6. A comparison was made for SF-36 scores between subjects (all bipolars, BDI and BDII) with and without anxiety disorders. Results: 105 patients were enrolled: 44 with BDI and 61 with BDII. Current and lifetime anxiety disorders comorbidities were 32.4% and 41.0% for all bipolars, 31.8% and 40.9% for BDI and 32.8% and 41.0% for BDII. BDI patients differed in several SF-36 domains from BDII subjects, which reported a poorer HRQoL. A current and lifetime comorbid anxiety disorder was associated with a poorer HRQoL considering all bipolars; when examining separately BDI and II subjects, however, the deleterious effect was restricted to BDI patients. Limitations: The cross-sectional assessment of HRQoL, the generic instrument used (SF-36) and the small sample size. Conclusions: Our study confirms the high comorbidity rates for anxiety disorders in bipolar subjects and provides evidence that anxiety comorbidity impacts HRQoL in subjects with BDI and not BDII.
Bollettino della Società italiana di biologia sperimentale, Jan 30, 1979
In rat brain the tranylcypromine administration induces after two hours a 151% increase of seroto... more In rat brain the tranylcypromine administration induces after two hours a 151% increase of serotonin levels and a 50% fall of glycogen concentration. The activity of phosphorylase a and b and the glycolytic flow rate are unchanged.
While the worldwide prevalence of bipolar disorder is approxi-mately 2%, it increases to 6 % if t... more While the worldwide prevalence of bipolar disorder is approxi-mately 2%, it increases to 6 % if the broad bipolar spectrum subtypes are also considered. Among other psychiatric condi-tions, anxiety disorders are most frequently observed in bipolar patients. Anxiety can be a symptom of bipolar disorder, and was first recognized by Kraepelin in 1921 who described “anxious mania ” and also “excited depression”, which included a “great restlessness”. He specifically named anxiety as one of the com-ponents of this illness, but at present “anxiety ” is not generally considered as a symptom of bipolar disorder, but rather as a comorbid condition. However, comorbid anxiety disorders have a significant impact on clinical presentation and prognosis of bi-polar disorder in at least one-half of cases of bipolar disorder beyond the acute phase (in the euthymic phases). The aim of this study was to explore the correlation between anxiety and bi-polar disorder through a critical review of the rece...
Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale
The importance of certain psychological aspects during post-surgical rehabilitation of laringecto... more The importance of certain psychological aspects during post-surgical rehabilitation of laringectomized patients is being more and more emphasized in research on the subject. The aim of this study is to consider a group of 55 patients who had undergone a total laryngectomy 6 to 48 months previously. The patients studied spoke using an esophageal voice and were chosen from among a group of 400 operated in our Department. This investigation was carried out not only from an organic point of view but took into consideration the consequence of such an important disability in the personal psychological, social, domestic and relational sphere as well. The study was carried out through a partially guided interview whose aim was to obtain anamnestic information regarding psychological symptoms present at the moment of the interview, the amount of understanding of the patients and their relatives concerning the diagnosis and the signs of sinergy. The Zung scale for self-evaluation of depressio...
In a short communication addressed particularly to medical doctors, the Authors make a statement ... more In a short communication addressed particularly to medical doctors, the Authors make a statement about the concepts of psychoneurosis and psychosomatic disease, taking into consideration the hypothesis of a psychopharmacological treatment. The Authors consider the drug as a complementary tool in the relationship between the doctor and the patient, useful in making easier the overcoming of the conflicts and as a coadjuvant in a strategy of both psychopharmacology and psychotherapy.
The presence of depressive symptomatology in alcoholics has frequently been encountered in clinic... more The presence of depressive symptomatology in alcoholics has frequently been encountered in clinical practice, but the relationship running between the two pathologies remains a subject for discussion. The methodological difficulty of this evaluation is seen in a major discordance of reported data. Against this background, a group of subjects hospitalized in a neuropsychiatric environment has been assessed for incidence of alcoholic and depressive pathologies and their possible correlations. Of 428 hospitalizations for alcoholism, 350 (82%) presented a depressive pathology. These patients were distinguished by DSM III into three groups [a) adaptation disturbance with depressed mood; b) dysthymic disturbance; c) atypical depression]. Within these groups, the incidence of prior stress-inducing psychosocial events was assessed according to the criterion of growing seriousness of DSM III. The results after statistical processing are discussed and compared with reported data.
The goal of this study was to evaluate the prevalence and type of psychiatric disorders coexistin... more The goal of this study was to evaluate the prevalence and type of psychiatric disorders coexisting with burning mouth syndrome (BMS), to compare the clinical features of patients with BMS alone with patients with multiple diagnoses, and to investigate the number and severity of life events that occur before the onset of BMS. There were 102 patients with BMS, with no possible local or systemic causes, who were evaluated according to the diagnostic criteria of DSM-IV. All axis I diagnoses for which the patients met criteria at intake or lifetime were determined. Life events were evaluated for a period of 6 months before the onset of BMS. A statistical comparison between patients and a matched control group was performed first; moreover, patients with BMS alone were compared with patients with comorbid BMS. Although 29 (28.4%) BMS patients were not given any other lifetime psychiatric diagnosis, high rates of comorbid psychiatric diagnoses were found. The most prevalent concurrent diagnoses were depressive disorders and generalized anxiety disorder. No significant differences emerged in clinical features between patients with and without other current psychiatric disorders. The severity of life events, rather than in their number, was significantly associated with BMS. BMS has high psychiatric comorbidity but can occur in the absence of psychiatric diagnoses.
Successive daily injections of LSD-25 and UML (1-methyl-d-lysergic acid butanolamide) caused prog... more Successive daily injections of LSD-25 and UML (1-methyl-d-lysergic acid butanolamide) caused progressive depression of brain 5-HT levels in the rat. On the fourth day, the decrease was significant with respect to the highly significant fall observed after a single administration, whereas it had been shown earlier that conditioned behaviour is no longer affected by LSD-25 after 3 days and that simultaneous administration of a single dose of LSD-25 and UML is equally ineffective in this respect. Its depression of 5-HT levels, however, has now been shown to be equal to that of LSD-25 alone at doses that influence conditioned behaviour. The findings indicate that changes in such behaviour are not dependent on brain 5-HT levels and that no link exists between such levels and the psychotomimetic effect of LSD-25 in man.
A few studies have tried antipsychotic augmentation in obsessive-compulsive disorder (OCD) patien... more A few studies have tried antipsychotic augmentation in obsessive-compulsive disorder (OCD) patients who are non-responders to selective serotonin reuptake inhibitors. The aim of this study was to investigate the efficacy and tolerability of olanzapine addition to fluvoxamine-refractory OCD patients and to assess if a comorbid chronic tic disorder or a concomitant schizotypal personality disorder was associated with response. Twenty-three OCD non-responders to a 6-month, open-label trial with fluvoxamine (300 mg/day) entered a 3-month open-label trial of augmentation with olanzapine (5 mg/day). OC symptom change was measured with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Clinical Global Impression (CGI) scale. Differences between responders and non-responders were assessed with regard to age, sex, duration of illness, baseline Y-BOCS score, and comorbidity with chronic tic disorders or schizotypal personality disorder. A significant decrease of mean Y-BOCS score between pre- and post-treatment (26. 8+/-3.0 vs. 18.9+/-5.9) was found at endpoint. Ten patients (43.5%) were rated as responders. The most common side effects were mild to moderate weight gain and sedation. In our sample, three patients (13. 04%) had a chronic motor tic disorder, and four (17.39%) had a codiagnosis of schizotypal personality disorder. Concomitant schizotypal personality disorder was the only factor significantly associated with response. It appears that augmentation of olanzapine in fluvoxamine-refractory OCD may be effective in a large number of patients, including those with comorbid schizotypal personality disorder.
Although a significant amount of evidence indicates the efficacy of some antidepressants in treat... more Although a significant amount of evidence indicates the efficacy of some antidepressants in treating psychogenic pain and somatoform disorder, very few studies have investigated their possible therapeutic action in burning mouth syndrome (BMS). The purpose of this 8-week, single-blind study was to provide preliminary data on the efficacy and tolerability of amisulpride and the selective serotonin reuptake inhibitors (SSRIs) paroxetine and sertraline for patients with BMS. Seventy-six patients with BMS (diagnosed according to the criteria in the literature and integrating the Diagnostic Interview Schedule-Revised for a complete psychiatric assessment), with no possible local or systemic causes and without concurrent major depression, were randomly assigned to receive amisulpride (50 mg/day), paroxetine (20 mg/day), or sertraline (50 mg/day). Efficacy assessments included a visual analogue scale (VAS) for pain intensity, the Hamilton Rating Scale for Depression (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A), and the Clinical Global Impressions scale (CGI). All 3 treatment regimens resulted in a significant improvement from baseline in burning mouth symptoms at week 8 as demonstrated by the quantitative (mean reduction in VAS, HAM-D, and HAM-A scores) and qualitative (percentage of responders) analyses. Amisulpride showed a shorter response latency than the SSRIs. No serious adverse events were reported, and the incidence of side effects did not differ among the 3 groups. None of the patients who received amisulpride withdrew from the trial, whereas withdrawal from the trial occurred within the first week of treatment in 11.5% of patients (N = 3) treated with paroxetine and in 21.7% of patients (N = 5) treated with sertraline. The data suggest that amisulpride and SSRIs may be effective treatments for BMS; they are equally effective and equally well tolerated in the short-term treatment of BMS. Amisulpride is associated with better compliance within the first week of treatment and with a shorter response latency in comparison with SSRIs. This finding may indicate that amisulpride is especially useful at the beginning of drug therapy of BMS. Double-blind, placebo-controlled trials are needed to further document the efficacy of amisulpride and SSRIs in the treatment of BMS.
Background: Few studies investigated the impact of anxiety disorder comorbidity on health-related... more Background: Few studies investigated the impact of anxiety disorder comorbidity on health-related quality of life (HRQoL) of bipolar patients and none examined bipolar subtypes differences. The aim of the study was 1) to determine comorbidity rates for anxiety disorders in euthymic bipolar subjects, comparing bipolar type I and II disorders (BDI and BDII), and 2) to compare within each group HRQoL measures in subjects with and without anxiety comorbidity. Methods: Comorbidity was evaluated through the SCID-I; HRQoL was assessed using the 36-Item Short-Form Health Survey (SF-36). All subjects were euthymic since at least 2 months, as confirmed by a HAM-D b 8 and a YMRS b6. A comparison was made for SF-36 scores between subjects (all bipolars, BDI and BDII) with and without anxiety disorders. Results: 105 patients were enrolled: 44 with BDI and 61 with BDII. Current and lifetime anxiety disorders comorbidities were 32.4% and 41.0% for all bipolars, 31.8% and 40.9% for BDI and 32.8% and 41.0% for BDII. BDI patients differed in several SF-36 domains from BDII subjects, which reported a poorer HRQoL. A current and lifetime comorbid anxiety disorder was associated with a poorer HRQoL considering all bipolars; when examining separately BDI and II subjects, however, the deleterious effect was restricted to BDI patients. Limitations: The cross-sectional assessment of HRQoL, the generic instrument used (SF-36) and the small sample size. Conclusions: Our study confirms the high comorbidity rates for anxiety disorders in bipolar subjects and provides evidence that anxiety comorbidity impacts HRQoL in subjects with BDI and not BDII.
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