360 research outputs found
Psychopharmacological treatment and personality: Cognitive schemes changes during pharmacological treatments [Psicofarmaci e personalitá: Modificazioni degli schemi cognitivi in corso di trattamenti farmacologici]
No full textThe way to experience feelings, emotions, to express them, the particular kind of being, behaving, the meanings we attribute to ourselves, to others and to events, the importance given to situations and the way of facing them, are expressions that characterize ourselves and allow us to be distinct. In the tradition of cognitive psychology the subject isn't passive in receiving environmental imputes, but he has mental structures that direct him in the information choice and in the meaning attribution. To these structures has been given the name of cognitive scheme. The «psychological» nature of these cognitive patterns seems to exclude the possibility of a change by psychopharmacological treatment. The clinical experience suggests that psychotropic drugs are able to change these dimensions traditionally considered more «psychological», often subverting the usual behaviour patterns, and not only the symptomatology of the disorder. In literature only few studies concerning the connection between these mental structure and the psychopharmacological treatment exist
Affective temperaments and subthreshold symptoms spectrum in a clinical sample [Temperamenti affettivi e spettri di psicopatologia sottosoglia in un campione di popolazione clinica]
No full textObjective: Evaluation of subthreshold conditions and affective temperaments in a clinical sample; evaluation of relationship between temperament and subthreshold spectrum symptoms and comparison of the two related interviews TEMPS-I and MOODS-SR. Methods: Akiskal's Semi-structured Clinical Interview for Temperament (TEMPS-I) and the General 5-Spectrum Measure (GSM-V) has been distributed to a sample of 92 outpatients. Each patient then received the complete spectrum interview (MOODS-SR, PAS-SR, ABS-SR, OBS-SR, SHY-SR) corresponding to the domain of the GSM-V where more than 2/3rds of the items had been rated positively. Results: In our sample, 47 pazients out of 92 (51.08%) were rated positively for an affective temperament: 33 (35.9% of the whole sample) for depressive temperament, 8 (8.7%) for cyclothymic, 4 (4.3%) for hyperthymic and 2 (2.2%) for irritable. There was no significant relationship between temperament scores and diagnoses. Analysing the presence of subthreshold symptoms in the groups with an extreme affective temperament, 20 patients (45.5%) scored significantly on the mood spectrum, 5 (41.7%) scored significantly on the obsessive-compulsive spectrum, 4 (33.3%) scored significantly on the panic-agoraphobic spectrum and 7 (31.8%) scored significantly on the social-phobic spectrum (Table II). A Chi-Square analysis showed a positive correlation between extreme affective temperaments and mood spectrum scores (p = 0.031; OR = 5.174; CI = 1.051-31.07) (Table III), while no correlation was found between extreme affective temperaments and scores on the spectrum interviews related to anxiety disorders. Thus, the patient group with extreme affective temperaments had a greater chance of scoring positively also at the mood spectrum interview, compared to the group without an extreme affective temperament. However, the percentage of significant mood spectrum scores in the group positive for affective temperaments did not differ in a relevant fashion from the percentage of significant scores of subthreshold symptoms related to anxiety disorders. Conclusions: Conclusions emerging from this study should be viewed as preliminary due to the limited size of our sample. Albeit, a positive correlation was found between extreme affective temperaments and subthreshold mood spectrum features. Taking into account the different background approaches of the two questionnaires TEMPS-I and MOODS-SR, MOODS-SR could perhaps be considered as less specific but more complete as an instrument aimed at detecting clinically relevant different features of affective psychopathology. Our sample also shows how affective temperaments and subthreshold mood spectrum symptoms often coexist with full blown or subthreshold conditions other than affective disorders. This suggests that temperament questionnaires could be used for rapid screening seeking a specific risk of affective pathology, while interviews for subthreshold spectrum symptoms could be useful to examine and describe the specific and individual characteristics of each clinical case in a less subjective and more standardized way
Un sistema di archiviazione dei dati in psichiatria: il "Psychiatric Computing Facility". I primi tre anni di applicazione in una clinica psichiatrica universitaria
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Le diverse espressioni dell'ansia e della paura: per iniziare a comprendere il mondo di coloro che soffrono di disturbi d'ansia
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Endocrine and metabolic effects of medications used for bipolar disorder [Effetti endocrini e metabolici dei farmaci utilizzati nel disturbo bipolare]
No full textObjective: Patients with bipolar disorder suffer a disproportionate burden of cardiovascular and endocrine illness compared to the general population. While the exact pathogenesis of this excess morbidity is not completely known, biologic, behavioral, and sociodemographic factors have been implicated. Among biologic factors, a growing body of evidence suggests that several of the medications that are commonly used to treat bipolar disorder can contribute to several of the illnesses above. While the balance between risks and benefits of medication treatment in bipolar disorder is usually favorable, an increased knowledge of these risks is imperative, in order to avoid the impression that a disruption in physical health is an inevitable token for the patient to pay in order to achieve and maintain his or her mental health. The goal of this paper is to review the endocrine and metabolic effects of medications used for the treatment of bipolar disorder. Methods: This paper selectively reviews the literature on the endocrine risks of the medications used to treat patients with bipolar disorder. The manuscript focuses on the most practical and clinically relevant data and describes the possible strategies to prevent, monitor and treat the common endocrine illnesses that patients with bipolar disorder frequently develop during the course of treatment. Results: Most of the medications that are used to treat bipolar disorder can affect the endocrine system. However, differences exist from one medication to another. The potential endocrine and metabolic risks of olanzapine, clozapin risperidone, quetiapine, aripiprazole, ziprasidone, lithium, valproate, carbamazepine, lamotrigine, and topiramate are reviewed and discussed. A particular attention is given to the risks of weight gain, obesity, dyslipidemia, diabetes mellitus, hyperprolactinemia, thyroid and parathyroid illness, diabetes insipidus, and sexual and reproductive dysfunctions. Medications such as clozapine and olanzapine carry a high risk of weight gain and metabolic problems but most of the other drugs are not completely free from these risks. For instance, lithium, which remains one of the mainstay of treatment of bipolar disorder is associated with a considerable risk of weight gain and other metabolic and endocrine disturbances such as hypothyroidism, hyperparathyroidism and diabetes insipidus. Carbamazepine, which is not associated to a high risk of weight gain, carries a significant risk for dyslipidemia and electrolytic disturbances. Valproate is frequently associated with significant weight gain and may increase the risk of polycystic ovary syndrome. Conclusions: Almost all medications used to treat bipolar disorder carry a risk to cause or worsen endocrine or metabolic syndromes. However, the degree of risk is different for different agents and may be different from one patient to another. Particular attention in selecting the medication with the best risk/benefit ratio for each particular case is warranted. There is a general agreement that all patients identified as having, or developing, severe endocrine problems, such as the metabolic syndrome, should be referred to appropriate services such as a general practitioner, diabetologist, dietologist and other specialist service. The possibility switching medication should be considered even in the early stages of the development of endocrine/metabolic problems (e.g. in a patient whose weight increases more than 5% from initial weight) and balanced against the risk of losing efficacy
Neuroanatomical changes after Eye Movement Desensitization and Reprocessing (EMDR) treatment in Post-Traumatic Stress Disorder (PTSD)
No full textL' impatto della psicopatologia affettiva (sia conclamata che sottosoglia) sulla qualità della vita
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