2,053 research outputs found
Tra disimpegno e necessità strategiche: le truppe statunitensi in Siria sotto l’ombra dell’America First
No full textASO Author Reflections: Hypertrophic Techniques Have an Impact on the Complexity and Outcomes of Minimally Invasive Major Hepatectomies
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DSM-IV obsessive-compulsive personality disorder: prevalence in patients with anxiety disorders and in healthy comparison subjects
No full textThe relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) has not yet been fully clarified. The aim of the present study was to analyze DSM-IV OCPD prevalence rates in OCD and panic disorder (PD) patients to test for the specificity of the OCPD-OCD link, and to compare them to OCPD prevalence in a control group of subjects without any psychiatric disorder. A total of 109 patients with a principal diagnosis of DSM-IV (SCID-I) OCD and 82 with PD were interviewed using the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) in order to assess the prevalence of OCPD. All patients with a coexisting axis I diagnosis were excluded from the study to eliminate confounding factors when evaluating the association between prevalence rates of OCPD and anxiety disorder diagnoses. An exclusion criteria was also a Hamilton Depression Rating Scale (HAM-D) score >/=16. A sample of comparison subjects (age 18 to 65 years) without any psychiatric disorder was recruited from people registered with two general practitioners (GPs), whether or not they consulted the doctor, in order to evaluate OCPD prevalence rate in the community. A significant difference was found between the prevalence of OCPD in OCD (22.9%) and in PD (17.1%) on one hand, and that in the comparison sample (3.0%) on the other. No differences were found between the two psychiatric groups, even when splitting the samples according to gender. Our study failed to support the hypothesis of a specific relationship between OCPD and OCD; we confirmed the higher prevalence rate of this personality disorder in OCD subjects with regard to the general population, but we also confirmed the higher rate of OCPD in another anxiety disorder which is phenomenologically well characterized and different from OCD, such as PD
Nocturnal panic and recent life events.
No full textRecent research has hypothesized an association between traumatic events and nocturnal panic (NP). The purpose of this study was to investigate whether the onset of nocturnal panic attacks is associated with a higher frequency of and/or greater severity of stressful or traumatic life events than that of patients with panic disorders (PDs) who experience daytime panic attacks (DPs) while awake. A secondary aim was to investigate whether NP is associated with specific life events at the onset of the disorder. Our sample comprised 129 subjects with PD (DSM-IV). We investigated the number and types of stressful life events that occurred in the year prior to PD onset using a semistructured interview. Of the sample, 28.7% had recurrent nocturnal panic attacks (NP group). Subjects with and without recurrent NP did not differ on any sociodemographic or clinical characteristic. Neither the number nor type of life event distinguished those with or without NP. The subgroup of patients with PD with recurrent NP appears to represent a variant of PD with a possible increased vulnerability to conditions of diminished arousal as a trigger of panic attacks. However, the hypothesis that this vulnerability might be determined by life events that occur in the period preceding PD onset was not supported by the findings of this study
Disturbo ossessivo-compulsivo e disturbo ossessivo-compulsivo di personalità: la relazione è specifica?
No full textHealth-related quality of life in obsessive-compulsive disorder subjects and their relatives [1]: Overview
No full textObsessive-Compulsive Disorder (OCD) is a severe and disabling condition that impairs quality of life in several mental and physical domains: results of the literature are consistent in indicating a poorer quality of life as compared to community norms worldwide; concerning functioning, the areas most affected are social relationships and family function- ing. Studies that compared functioning and quality of life across different mental disorders consistently found that OCD compromises quality of life to a similar degree as schizophrenia. Severity of obsessive-compulsive and comorbid depressive symptoms predicts a poorer quality of life in OCD patients, while age, gender, age at onset, or duration of the disorder do not influence quality of life.
Treatments are associated with significant improvements in quality of life; however, several studies failed to find a significant association between improvements in obsessive-compulsive symptoms and quality of life changes and other could identify a subgroup of patients with significant response in terms of reduction in symptoms but minimal improvement in quality of life. It is still to be determined whether these subjects could be offered additional interven- tions such as vocational rehabilitation or social skills training. Further studies are strongly needed to understand which baseline characteristics could predict quality of life improve- ments with treatment.
OCD impairs quality of life even in relatives of OCD patients. This impairment appears to be mediated through accommodation of the relatives to obsessive-compulsive symptoms of the patients and through the burden due to consequences of living with and caring for people with a chronic and disabling disease. This area of research is highly neglected; preliminary investiga- tions suggest that family involvement in treatment through psychoeducation is effective in reducing perceived burden and improving quality of life and might also be effective in ameliorating obsessive-compulsive symptoms of the patients, although this need to be demonstrated
L’integrazione dei trattamenti nel disturbo ossessivo-compulsivo: conoscenze attuali e prospettive future.
No full textRIASSUNTO. Scopo. Il trattamento del disturbo ossessivo-compulsivo (DOC) prevede l’utilizzo di inibitori della ricaptazione della serotonina (IRS) e della terapia cognitivo-comportamentale (TCC).La revisione si propone di discutere se:
a) la terapia combinata ab initio sia una strategia più efficace rispetto alle singole monoterapie; e b) la terapia sequenziale sia efficace nel trattare pazientiresponder con sintomiresidui, e nell’indurre una risposta clinica nei non responder.Metodi. Sono stati utilizzati gli archivi elettronici MEDLINE/PubMed e libri di testo scientifici prendendo in considerazione
tutti gli studi clinici controllati randomizzati scritti in inglese.In assenza di questi,sono stati considerati gli studi naturalistici in aperto. Sono stati revisionati 9 studi randomizzati e/o controllati riguardo l’utilizzo della terapia combinata ab initio versusTCC da sola; 6 tra trattamento combinato e IRS da soli. Per il trattamento sequenziale,sono stati considerati 2
studi con pazienti responder e 7 con campioni di pazienti non responder. Risultati. Dei 9 studi, 7 non ne hanno rilevato
alcun vantaggio rispetto alla solaTCC, 1 ha evidenziato una maggiore efficacia in pazienti bambini e adolescenti e 1 in pazientiseveramente depressi.Rispetto alla sola farmacoterapia, 4 lavori non hanno rilevato una maggiore efficacia della terapia combinata, mentre 2 studi erano positivi.Tutti glistudisul trattamento sequenziale erano positivi. Discussione. La
combinazione ab initio non rappresenta una valida strategia di trattamento in prima istanza nel DOC, a eccezione di pazienti adultiseveramente depressi e pazienti bambini o adolescenti.Al contrario,l’integrazione sequenziale delle due strategie di prima linea è efficace sia nel portare a remissione completa i pazienti con sintomiresiduisia nel determinare una
risposta clinica nei pazienti resistenti
Il ruolo degli interventi psicosociali per ridurre la DUI: l’esempio del disturbo bipolare e del DOC
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