Biomedical subjects

A Pazzagli

Publications and source records attributed to A Pazzagli.

At least 19 recordsLinked to original sources

PubMed2001

Attachment processes in eating disorders.

Anxious and insecure attachment, fear of abandonment and difficulties with autonomy differentiate young women with eating disorders from their normal peers. This paper uses the Adult Attachment Interview (AAI) as the correlation between eating disorders and state of mind regarding attachment (7 females and 6 males) with anorexia nervosa and EDNOS. There was a higher frequency of dismissing or entangled states of mind. The sample is far too small to allow statistical inferences to be drawn about differences between men and women in the style of state of mind regarding attachment. An inference is none the less made with regard to the role of psychotherapy in these results.

Adolescent↗

PubMed1999

Effects of clozapine on awareness of illness and cognition in schizophrenia.

Awareness of illness is a crucial factor in schizophrenia, both for clinical management and psychopathological modeling. To date, there has been relatively little investigation of the influence of treatment with conventional versus atypical neuroleptics in relation to awareness and cognitive functions. The effect of clozapine treatment, compared with conventional neuroleptics, was studied in 22 schizophrenic patients in a crossover study. The P300 component of the event-related potential and scores on the Scale for Unawareness of Mental Disorder (SUMD), the Extrapyramidal Side Effects Scale (EPS), and Andreasen's Scales for the Assessment of Positive (SAPS) and Negative Symptoms (SANS) were studied at time 1 (conventional neuroleptic treatment) and time 2 (after 6 months of treatment with clozapine, in patients who interrupted the previous conventional regimen). Significantly increased P300 amplitudes were associated with clozapine treatment, together with heightened insight and reduced involuntary movements. The results confirm the effectiveness of clozapine not only in enhancing neurocognitive function, but also in increasing awareness of illness in schizophrenic patients.

Adolescent↗

PubMed1999

Awareness of illness and subjective experience of cognitive complaints in patients with bipolar I and bipolar II disorder.

OBJECTIVE: The authors' goal was to investigate the awareness of illness and subjective cognitive complaints of patients with either bipolar I disorder or bipolar II disorder during a phase of clinical stabilization. METHOD: They used a structured clinical interview, the Frankfurt Complaints Questionnaire, to determine subjective cognitive complaints, and the Scale of Unawareness of Mental Disorder to assess 57 consecutively enrolled patients with bipolar I or bipolar II disorder. RESULTS: Patients with bipolar II disorder had significantly less insight and a higher level of subjective complaints of stimulus overload than patients with bipolar I disorder. CONCLUSIONS: These results suggest that a severe deficit in self-awareness may constitute a distinguishing psychopathological characteristic of patients with bipolar II disorder. Further studies are required to determine if there are associated neuropsychological dysfunctions.

Adult↗

PubMed1999

The emergence of social phobia during clozapine treatment and its response to fluoxetine augmentation.

BACKGROUND: The underlying neurochemical basis of social phobia has yet to be fully explained, but there are suggestions of serotonergic and dopaminergic dysfunction. The atypical neuroleptic clozapine has been reported to induce anxiety symptoms, probably owing to its effect on serotonergic pathways. We report 12 cases of schizophrenic patients who developed social phobia during clozapine treatment. METHOD: Patients were assessed using the Structured Clinical Interview for DSM-III-R, Patient Version, Scale for the Assessment of Negative Symptoms, Scale for the Assessment of Positive Symptoms, the Liebowitz Social Phobia Scale, and the Brief Psychiatric Rating Scale. They were reevaluated after 12 weeks of cotreatment with clozapine and fluoxetine. RESULTS: In 8 of the 12 cases, symptoms responded (> or = 35% reduction in Liebowitz Social Phobia Scale score) with an adjunctive regimen of fluoxetine. CONCLUSION: Data are discussed in light of neurochemical mechanisms and cognitive adaptations that could explain the onset of anxiety spectrum disorders (such as social phobia) in clozapine-treated schizophrenic subjects during remission of psychotic symptoms.

Adult↗

PubMed1997

A setting including psychotherapy and psychopharmacological treatment in a case of anorexia nervosa with obsessive compulsive disorder comorbidity.

In this case report we describe the therapy followed with a patient affected by atypical anorexia purging, in a setting that includes both psychotherapy and psychopharmacological treatment. The aim of this presentation is to show how the patient's ambivalence towards the treatment was faced, and how this work both rendered effective the pharmacological therapy and enabled the progression of the psychotherapy. There is a discussion of the interaction between psychotherapy and pharmacological therapy and their possible beneficial action on the symptomatology.

Adult↗

PubMed1997

Relapse in young paranoid schizophrenic patients: a prospective study of stressful life events, P300 measures, and coping.

OBJECTIVE: The authors investigated the relationship of cognitive and coping characteristics to stressful life events at the time of relapse in patients with recent-onset paranoid schizophrenia. METHOD: Over 6 years, the authors collected data on 41 schizophrenic outpatients aged 18-28 years at recruitment. The patients were rated prospectively every 2 weeks with the Brief Psychiatric Rating Scale, Scale for the Assessment of Negative Symptoms, Scale for the Assessment of Positive Symptoms, Global Assessment of Functioning Scale, and life events measures. The Frankfurt Questionnaire of Complaints was used to analyze subjective complaints regarding cognitive and coping abilities. The P300 auditory event-related potential was measured at recruitment to provide an index of information-processing capability. RESULTS: Patients without severe life events during the 1 month before relapse had a smaller P300, more subjective complaints, and less coping capacity than did relapsed schizophrenic subjects who had severe life events in the month before relapse. CONCLUSIONS: Relapses in subjects without severe life events were associated with fewer cognitive resources and less coping ability. Patients with normal P300 and adequate coping resources seemed to be able to deal better with stressful life events.

Adaptation, Psychological↗

PubMed1996

No evidence of linkage between schizophrenia and D2 dopamine receptor gene locus in Italian pedigrees.

Our purpose was to test the dopamine D2 receptor gene (DRD2), the tyrosine hydroxylase (TH) gene and the monoamino oxydase A (MAO-A) gene for linkage to schizophrenia and bipolar disorders. We have analyzed seven Italian families with schizophrenia and four families with bipolar disorders for a total of 68 individuals; 32 individuals were affected. Diagnoses were made using the structured clinical interview Schedule for Affective Disorders and Schizophrenia, Lifetime version (SADS-L). The results of our study provide no evidence of linkage between alleles at D2 dopamine receptor loci and schizophrenia or bipolar disorders. The markers TH gene and MAO-A gene give slightly positive or negative results suggesting the utility of further analysis on more informative families.

Bipolar Disorder↗

PubMed1995

The psychosis of fatherhood: a clinical study.

The psychosis of fatherhood is classified as an acute delusional disorder. It has been psychodynamically correlated with preoedipal conflicts. Common elements were identified in 6 men who were about to become fathers for the first time. Their personal histories and their clinical pictures were very similar. It is our hypothesis that up to the moment of facing the impact of becoming fathers themselves, these subjects had managed to avoid the oedipal conflict. As a consequence of this avoidance, they failed to identify with the father figure and to incorporate the paternal function into their symbolic universe. Once they accepted the concrete reality of fatherhood, these men underwent an acute psychotic crisis having inadequately interiorized paternal role models for themselves. We believe that this sort of psychopathological behavior becomes clinically manifest only when triggered by impending fatherhood.

Adult↗

PubMed1994

Absence of APP713 mutation in Italian and Russian families with schizophrenia.

A recent study has shown a mutation at codon 713 of the amyloid precursor protein (APP) gene in a schizophrenic patient. We have analyzed the MaeIII restriction site caused by that mutation in Italian and Russian families with schizophrenia. No mutations were observed suggesting that the APP713 mutation is unlikely to be linked to the pathogenesis of such a psychiatric disorder.

Alzheimer Disease↗

PubMed1992

Puerperal psychoses: a clinical case study with follow-up.

Thirty cases of post-partum psychotic disorders occurred between 1973 and 1987 and hospitalized at the Psychiatric Ward of Florence University were studied and followed up. A structured diagnostic interview was used, which explored DSM Ill-R diagnosis both for mood disorders and for psychotic features. The psychotic symptoms had started within 8 weeks of parturition in all cases. Only 36.7% of the patients showed no subsequent pathology after the puerperal symptoms. The diagnoses, both at the index episode and at the follow-up, revealed a great predominance of mood disorders and the absence of schizophrenia. The follow-up survey showed a greater proportion of bipolar disorders than it appeared at the puerperal onset of the disease. A high frequency of puerperal psychotic relapses has also occurred after subsequent deliveries during the follow-up period.

Adult↗

PubMed1986

Depressive relapses and incomplete recovery from index episode.

Of 101 patients suffering from primary unipolar depression who were followed up for at least 1 year after recovery from the index episode, 51 relapsed into a new depressive episode within the year of recovery. Only those variables related to the period immediately after discharge distinguished nonrelapsers from relapsers; relapsers showed higher levels of residual symptoms, inferior social adaptation, a more pathological mean personality profile, and lower tricyclic plasma levels, despite similar dosage. The data are consistent with the hypothesis of an incomplete recovery from the index episode as a risk factor for relapse within 1 year.

Antidepressive Agents, Tricyclic↗

PubMed1979

Psychopharmacological prospectives in the treatment of dementia.

1. Dementias have a complex etiology and pathogenesis which should be carefully evaluated in order to attempt a medical treatment. 2. Drugs are among the most frequent causes of dementias, particularly drugs with anticholinergic properties. 3. A similarity between the mental symptoms of anticholinergic poisoning and senile dementia has been observed. 4. Recent investigations have also presented a decrease of cholinergic activity in postmortem material of subjects with Alzheimer's disease. Also a number of data suggest that recent memory would be related to changes in the metabolism of brain acetylcholine (Ach). 5. The possibility that drugs stimulating brain cholinergic mechanisms might be used in the treatment of dementias is envisaged.

Central Nervous System↗

PubMed1979

Clinical response and tricyclic plasma levels during treatment with clomipramine.

Fifty depressed in-patients at two psychiatric units, one in Italy the other in England, were treated with clomipramine, either orally, or intravenously and orally. A comparison of clinical response with plasma levels of clomipramine and its metabolite, desmethylclomipramine, showed clear relationships especially in the case of desmethylclomipramine. In the intravenously-treated group this was linear, in the orally-treated group it was curvilinear. Plasma levels of desmethylclomipramine and administered clomipramine correlate highly. These findings, together with the fact that significant clinical improvement was observed in only 55% of the patients, suggest that titration of the administered dose to obtain more effective plasma levels of the metabolite might improve the clinical response to the drug in some patients.

Administration, Oral↗

PubMed1976

[The Rorschach test during chronic haemodialysis (author's transl)].

Twenty-eight patients undergoing chronic haemodialysis for renal failure and seven patients suffering from chronic uremia, but not on dialysis programs were submitted to the Rorschach test. The patients who were undergoing haemodialysis for less than one year showed higher signs of anxiety (shock and Hd responses); on the other hand patients undergoing the treatment for more than 5 years showed a generally worse quality response to the test. This bad performance was interpreted either as a sign of organic brain damage or as a worse cooperation in the test procedure.

Adult↗

PubMed1974