Biomedical subjects

Andrea Raballo

Publications and source records attributed to Andrea Raballo.

11 recordsLinked to original sources

PubMed2007

Exploring the margins of the bipolar spectrum: temperamental features of the typus melancholicus.

BACKGROUND: Both the melancholic type of personality (TM) and the concept of temperament offer promising insights for the phenotypic characterization of mood-spectrum vulnerability. This research challenges the theoretical hiatus between the two psychopathological paradigms--the phenomenological and the neo-Kraepelinian--by means of an empirically-based approach. METHOD: Temperamental features were assessed through the Semi-structured Affective Temperament Interview (TEMPS-I) in an outpatient population of 116 clinically stable, euthymic subjects who suffered from a DSM IV major depressive disorder, previously enrolled for a study on the characteristics of major/unipolar depressive episode. The sample was subsequently evaluated and dichotomized according to the Criteria for Typus Melancholicus (CTM). RESULTS: The TM subjects exhibited statistically significant differences in the temperamental profile as compared to non-TMs (NTM). A specific association between TM and hyperthymic temperament (HT) was confirmed by binary logistic regression analysis, suggesting that the phenomenological distinction TM vs. NTM is supported by different predisposing Kraepelinian "fundamental states". LIMITATION AND CONCLUSIONS: Although it is uncertain whether the findings would generalize outside the Italian culture, they nonetheless delineate a strong aggregation between TM and hyperthymic temperament, indicating that (1) an integrative neo-Kraepelinian/phenomenological cooperative model is warranted to tap the complexity of the phenotypic diathesis for mood-disorders, and (2) the hyperthymic-melancholic type of personality rests on the margins of the bipolar spectrum. The main limitation of this study is that it enrolled a selected outpatient volunteer sample. A large scale study in general population is needed to confirm the hypothesis of a strong link between TM and HT and to shed light on the causes and meanings of this association.

Bipolar Disorder↗

PubMed2006

Typus melancholicus: personality structure and the characteristics of major unipolar depressive episode.

BACKGROUND: The melancholic type of personality (TM) has long been considered in continental and Japanese psychopathology as a relevant vulnerability trait constellation for the development of depression. METHOD: The symptom presentation in an outpatient population of 116 subjects suffering from a DSM-IV major depressive episode was rated according to the standardized documentation system of the Association for Methodology and Documentation in Psychiatry (AMDP). Personality features were explored by means of the Criteria for Typus Melancholicus (CTM). RESULTS: Statistically significant differences in depression-related psychopathological scores (i.e. higher level of guilt feelings, feeling of the loss of feelings, loss of vital drive and lower degrees of irritability and dysphoria) were found between TM and non-TM subjects, supporting the phenomenic specificity of TM depression at both symptom and subsyndromal level. LIMITATION AND CONCLUSIONS: Although our results were obtained in a selected sample of outpatients at an University Mental Health Center, they are indicative of psychopathological differences between TM and NTM in the core symptoms of depression. These differences highlight the importance of including TM criteria for phenotypic characterization of depressive disorder, suggesting that it may improve diagnostic and therapeutic practice and might be a reasonable psychopathologic endophenotype in investigating affective-spectrum vulnerability in at-risk populations.

Adult↗

PubMed2006

Self-centrality, psychosis and schizotaxia: a conceptual review.

The phenomenon of self-centrality denotes a qualitative modification of the psychotic experience. Transitory experiences of self-reference have regularly been found in subjects in the prodromic phase and at the beginning of psychosis or in the post psychotic phase, and are specifically identified in the semeiotics of Basic Symptoms. However, self-centrality, in addition to being a morphological organizer in the psychotic crisis, also manifests itself in schizotypal personality disorders and in first-degree relatives of schizophrenics (where it is correlated to the degree of schizotypal traits). In these subjects, manifestations of self-centrality of a lesser intensity could be an indication of a latent vulnerability trait, which could modulate personal and psychopathological expressions of the schizotaxic diathesis.

Humans↗

PubMed2005

Exploring depression in schizophrenia.

BACKGROUND: A consistent amount of empirical research suggests that depression, besides interfering with quality of life and social functioning, may influence other symptom dimensions in schizophrenia, thus constituting an important domain for treatment strategies, outcome, and prognosis. AIM: This study investigated the factorial structure of the Calgary depression scale for schizophrenia (CDSS) in a sample of schizophrenic patients and explored the relationships between such factors, major symptom dimensions and subjective experiences. METHODS: One hundred and sixty-one subjects were examined to assess the severity of schizophrenic symptoms (scored according to the five-dimensional model of Toomey et al. [28]), the distress due to the subjective experience of negative symptoms, and the degree of subjectively-felt cognitive-affective vulnerability (i.e. basic symptoms). RESULTS: Principal component analysis revealed CDSS to include three main factors, namely: "depression-hopelessness" (factor I), "guilty idea of reference-pathological guilt" (factor II) and "early wakening" (factor III). Whereas the last factor did not correlate with any of the other psychopathological domains, the first two factors revealed multiple correlations with both diagnostic symptoms and subjective experiences. CONCLUSIONS: The results confirm the threefold factorial structure of the CDSS previously reported by the authors of the scale and could shed further light on the psychopathological nature of the components of depression in schizophrenia. The specific correlation patterns with diagnostic and subjective psychopatholgy substantiate the clinical distinction between a general depression factor ("depression-hopelessness") and a cognitive-guilt factor ("guilty idea of reference-pathological guilt").

Adult↗

PubMed2005

Experiential anomalies and self-centrality in schizophrenia.

BACKGROUND: Contemporary psychopathological research has shown that some qualitative anomalies of the first-person experiential givenness qualify the subjective experience of schizophrenia. Such essential clinical features of schizophrenia have recently been condensed into 7 phenomenologically coherent clusters derived from the Bonn Scale for the Assessment of Basic Symptoms (BSABS). The experimental intent of this study was to test whether subapophanic self-centrality (i.e. a protopathic nondelusional form of intersubjective spatial disattunement) empowers the discriminant capacity of such a set of subjective experiential disturbances among different diagnostic groups. METHOD: Three comparably sized samples of outpatients with schizophrenia, obsessive-compulsive or mood disorders were examined with the BSABS. Logistic regression analysis was performed with diagnosis as the outcome variable. RESULTS: Elevated scores in self-perceived cognitive disorders and abnormal self-centrality were associated with DSM-IV diagnosis of schizophrenia. Self-centrality increased the discriminant capacity of the 7 designed a priori dimensions. CONCLUSIONS: These findings confirm the previously reported aggregation of some subtle qualitative alterations of subjective experience in schizophrenia, and suggest that a careful consideration of autocentric disturbances of intersubjectivity might enrich current heuristics on schizophrenic experiential vulnerability.

Adult↗

PubMed2004

Self-centrality, basic symptoms model and psychopathology in schizophrenia.

The study's aim was to empirically derive the psychopathological constellation associated with self-centrality (i.e. non-delusional self-referential attitude) by seeking an interpretation in the light of the 'Basic Symptoms Model' of schizophrenic psychopathology. Eighty-four patients with an established schizophrenic illness receiving maintenance treatment at the Psychiatry Section of the Parma University Neuroscience Department were examined. The Scales for the Assessment of Positive and Negative Symptoms, the Calgary Depression Scale and the Toronto Alexithymia Scale were administered to all subjects to determine levels of positive, disorganized, negative and depressive symptoms, as well as alexithymia. Subjective experiences, including non-delusional self-centrality, were explored by means of the Bonn Scale for the Assessment of Basic Symptoms. Logistic regression detected three different psychopathological domains (delusional, alexithymic, and basic body symptoms) strongly associated with self-centrality. Among these the most influential independent variable was basic body symptoms. These results suggest that impaired lived body experience (i.e. protopathic body disattunement) is a psychopathologic condition concomitant with the emergence of autocentric polarization of experience (i.e. self-centrality).

Adult↗

PubMed2004

Subjective experience of schizotropic vulnerability in siblings of schizophrenics.

Abnormal neuropsychological and cognitive functions in nonpsychotic relatives of schizophrenics are currently the subject of intense interest, mainly because of attention being focused again on the theoretical construct of schizotaxia. Contextually, in recent years the issues of subjective experiences have once again become central and respectable topics in psychopathological research. Among self-experiential disturbances, basic symptoms (BS), stemming from Jaspersian phenomenological psychopathology, are considered the first, protopathic, subjective reverberation of the neurobiological deficit of schizophrenia. Thus BS are expected to be detectable in nonpsychotic relatives of schizophrenia patients. The aim of the present study was to compare the degrees of such anomalous subjective experiences, assessed in siblings of schizophrenic patients, schizophrenia spectrum patients (schizotypals and schizophrenics) and nonclinical controls. Different profiles of BS were obtained in the samples. An increasing gradient of BS ranging from nonclinical to clinical samples, with unaffected siblings in the intermediate position, occurred for some of the BS clusters (i.e. 'thought, language, perception and motor disturbances' and 'impaired bodily sensations'). Other BS clusters (i.e. 'disorders of emotion and affect' and 'increased emotional reactivity') turned out to be typical of the clinical subgroups, whereas an enhanced tolerance to normal stress significantly distinguished the sibling specimen from the other ones. The heterogeneity of these patterns suggests that BS constellations may be underpinned by different psychopathological processes and that cognitive and bodily BS may be clinical target phenotypes for schizotropic liability screening.

Adult↗

PubMed2004

Alexithymia and schizophrenic psychopathology.

This research is an attempt to gain a comprehensive insight into alexithymia in schizophrenia. Previous studies offered clinically-descriptive and phenomenologically oriented suggestions regarding alexithymia putative contribution in shaping schizophrenic psychopathology. However, the factorial structure of the scales used to assess alexithymia had never been applied to a schizophrenic sample as a preliminary step to interpret results, thus assuming the purported dimensions of the alexithymia construct (i.e. difficulties identifying feelings, difficulties describing feelings, and externally oriented thinking) to be transnosographically stable. In order to explore the psychopathologic meaning and interrelations with other schizophrenic symptoms, we evaluated 76 chronic schizophrenic outpatients using the 20-item Toronto Alexithymia Scale, standardized measures of positive, negative, disorganized and depressive symptoms, social and physical anhedonia scales, and the Bonn Scale for the Assessment of Basic Symptoms. The principal component analysis ofTAS-20 items revealed a 4-factor structure with multiple correlations with psychotic, disorganized, depressive, anhedonic dimensions and basic symptoms. The data suggest that alexithymia in schizophrenia is more heterogeneous than was previously recognized, and has several components, some of which are more state-related, and others of which are more like trait features. Those components are specifically correlated with both overt and subjective dimensions of schizophrenic psychopathology.

Adult↗

PubMed2003

Subjective experience of personality dimensions in 1st degree relatives of schizophrenics.

An increasing number of studies suggest the usefulness of both personality features and neurocognitive vulnerability as tools for isolating phenotypes associated with susceptibility to schizophrenia, however the clinical and heuristic topicality of self-experienced vulnerability has yet to be properly recognized. Biological relatives of schizophrenic patients (because of the familial/genetic load) constitute a promising and suggestive paradigm for addressing the psychopathological relationship between personality features and subjective experience of vulnerability. The current study found that 1st degree unaffected relatives of schizophrenics exceeded normal controls in schizotypal, paranoid, and borderline dimensions, and showed an overlap in the schizoid dimension of clinical Schizotypals (i.e. Schizotypal Personality Disorder Patients). Subsequent correlation analysis showed that schizotypal and schizoid traits are linked to specific domains of self-experienced vulnerability. Clinical heuristics is discussed.

Adult↗

PubMedDate not supplied

Depersonalization and basic symptoms in schizophrenia.

The purpose of this study is to examine the classic psychopathologic notion of depersonalization in the light of the Basic Symptom paradigm. A sample of 57 chronic schizophrenics was cross-sectionally assessed with the Bonn Scale for the Assessment of Basic Symptoms (BSABS) and contextually with specific scales testing positive, negative, depressive and alexithymic dimensions. In order to categorize depersonalized vs. nondepersonalized patients three specific BSABS items explicitly identifying the allo-/auto-/somatopsychic domains of depersonalization were used, according to the wernickian threefold definition. Depersonalized schizophrenics showed a semiological profile that was distinct from that of nondepersonalized schizophrenics (as regards basic, positive, depressive symptoms and alexithymia); patients with multiple co-occurring forms of depersonalization revealed higher levels of cognitive disturbance, lowering of stress threshold and greater alexithymia. Clinical and research implications are discussed.

Adult↗

PubMedDate not supplied

Subjective experience of language impairment and psychopathology in schizophrenia.

The principal concern of this paper lies in the exploration of the possible role of the subjective experience of language impairment in shaping schizophrenic symptomatology. A previous model embracing the basic symptom theory and the vulnerability paradigm hypothesized that (self-perceived) impairment of receptive and expressive language and alexithymia may play a relevant role in facilitating the development of a nonparanoid prototype of schizophrenia. The experimental protocol which led to this model [emphasizing the comprehensive notion of 'language capacity' as pathoplastic modulator of overt schizophrenic syndromes (i.e. pathoplastic model)] was replicated on a wider schizophrenic sample, assessing contextually with diagnostic symptoms, depressive symptoms, alexithymia, subjective experience of negative symptoms and hedonic capacity. Since schizophrenics with self-experienced language capacity impairment did not differ from other schizophrenics, as regards positive, negative and disorganized symptoms, but just in negative symptom-related distress, an alternative interpretation of the possible role of the subjective experience of language impairment in schizophrenic psychopathology is proposed (i.e. idioplastic hypothesis).

Adult↗