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Biomedical subjects

E Sacchetti

Publications and source records attributed to E Sacchetti.

At least 19 recordsLinked to original sources
PubMed2005

Direct transition to long-acting risperidone--analysis of long-term efficacy.

This report presents data from the extension phase of a 6-month trial that evaluated the efficacy of risperidone long-acting injectable (RLAI) in stable psychotic patients requiring a treatment change. Patients continued to receive RLAI every 2 weeks for a maximum of 12 months from study entry. Symptoms were assessed using the PANSS after 1, 3, 6, 9 and 12 months of treatment (or treatment endpoint). Remission of severity criteria were defined as < or =3 points in all PANSS items suggested by the Remission in Schizophrenia Working Group.715 patients (63% male) entered the extension phase and 508 completed the 12-month study. The mean PANSS total score at Day 0 was 74.9+/-22.7. This was significantly reduced after 1 month (67.7 +/-22.3, p< or =0.001), with continued improvements over the 12 months of the study until treatment endpoint (59.7+/-21.9). Significant improvements from Day 0 to endpoint were also seen in the scores for all PANSS subscales and symptom factors. The proportion of patients who met the PANSS severity criteria for remission increased from 29% at Day 0 to 60% at endpoint, and the proportion of patients who met these criteria for < or = 6 months increased from 24% at Month 6 to 45% at endpoint. Treatment with RLAI for up to 12 months provided significant and sustained improvements in symptom control in patients with schizophrenia. These improvements may help patients to achieve and remain in remission.

Adult↗
PubMed2003

Quetiapine, clozapine, and olanzapine in the treatment of tardive dyskinesia induced by first-generation antipsychotics: a 124-week case report.

Our report of a patient with severe tardive dyskinesia (TD) who has been exposed to both typical antipsychotic and clozapine, olanzapine and quetiapine during a 124-week follow-up period supports the possible beneficial effect of atypical antipsychotics on pre-existing symptoms of TD. Persistently high AIMS scores during all the periods of treatment with typical antipsychotics contrast strongly with the drop in scores that occurs in strict chronological sequence after switching to both clozapine (45%), olanzapine (27.8%) and quetiapine (85%). Since the reversal to haloperidol from the three atypical agents was systemically associated with a return to high AIMS scores, it seems likely that the improvement noted with clozapine, olanzapine and quetiapine represents a temporary symptomatic effect rather than a sustained resolution of the disorder. The olanzapine-clozapine-quetiapine rank order of increasing effectiveness against TD symptoms suggests that this property, although shared by the atypical antipsychotics, is to some degree drug-specific. Patient- and/or drug-dependent mechanisms may be involved in this gradient of effect.

Amphetamine-Related Disorders↗
PubMed2001

Cytokine profiles in drug-naive schizophrenic patients.

A large body of evidence concerning immunological abnormalities in schizophrenic patients seems to suggest a role of the immune system in the multifactorial pathogenesis of schizophrenia. We investigated the production of various cytokines [interleukin (IL)-2, IL-4, IL-10, interferon (INF)-gamma] in drug-free (n=26) and drug-naive (n=7) schizophrenic patients and in healthy controls (n=33). Production of IL-2 and INF-gamma was significantly higher (respectively P=0.021 and P=0.001) in patients than in controls. These findings provide further evidence that immunological abnormalities are present in some schizophrenic patients.

Adult↗
PubMed2001

Depressive disorders and personality variables in HIV positive and negative intravenous drug-users.

BACKGROUND: Only a few reports investigated the prevalence of depression in intravenous drug-users with HIV infection, including both asymptomatic and symptomatic subjects. In the same group, the association of depression and personality diagnoses was also poorly researched. METHODS: A consecutive sample of intravenous drug-users was collected from patients admitted to an infectious disease clinic, another random sample was taken from out-patients attending a methadone maintenance treatment program. Subjects were first screened with the Hospital Anxiety and Depression Scale, and then all positive subjects were evaluated with the Composite International Diagnostic Interview. Depression was diagnosed according to DSM-IIIR. In-patients were also given a structured personality inventory (Karolinska Psychodynamic Profile). RESULTS: HIV-positive patients had a high rate of depression (major depression 36.2%, dysthymic disorder 7.1%) when compared to HIV-negatives (15.7 and 3.9%, respectively). In-patients had the highest rate of depression, irrespective of HIV clinical staging. A personality disorder was diagnosed in 36% of the sample, but these subjects were no more significantly depressed. LIMITATIONS: Poor detection of depression by the admitting physician may have led to selective hospitalization of patients with both HIV and mood disorder. The composition of the sample may also be biased by the help-seeking behavior of HIV patients who are also depressed. CONCLUSION: Physicians treating AIDS patients should be alerted to the high rate of depression in clinical HIV illness, in order to identify and properly treat depression.

Adult↗
PubMed2000

H(2) antagonist nizatidine may control olanzapine-associated weight gain in schizophrenic patients.

BACKGROUND: Olanzapine is temporally associated, in a number of patients with schizophrenia, with weight gain. H(2) antagonists, like nizatidine, have been shown to control appetite in overweight patients. METHODS: A patient with olanzapine temporally associated weight gain was treated with nizatidine as "add-on" therapy. RESULTS: Nizatidine treatment was associated with good control and subsequent reduction of weight after 4 to 5 weeks of therapy in a patient with repetitive episodes of weight gain during olanzapine treatment. Olanzapine was otherwise well tolerated and effective in controlling psychopathology. CONCLUSIONS: H(2) antagonist treatment with olanzapine may be a valid medical strategy in preventing and/or reducing weight gain in patients with schizophrenia. Controlled studies are recommended to confirm this observation.

Adult↗
PubMed1999

Variables associated with the hospitalization of psychiatric emergencies evaluated in the community.

We investigated hospitalization factors in acutely ill patients visited by psychiatrists at home. A series of 100 consecutive calls for psychiatric emergencies of a community mental health centre were investigated with a structured evaluation of psychiatric symptoms and aggressiveness (IEF, GAS, and VSAS). First order interactions were tested, and selected variables were tested with logistic regression analysis. Admission was significantly associated with GAS scores (low scores were found in 92.6% of admitted patients vs. 43.8% of patients not admitted), paranoid delusions (66.7 vs. 39.7%), and lack of social support (70.4 vs. 30.1%). Multivariate analysis confirmed a significant independent effect only for low GAS score and lack of social support. The study replicated some findings from research on hospitalization in emergency wards, while other factors, such as 'diagnosis' and 'suicide risk', were not significant.

Acute Disease↗
PubMed1992

The brain damage hypothesis of the seasonality of births in schizophrenia and major affective disorders: evidence from computerised tomography.

Although the excess of schizophrenic births in the winter and early spring has been replicated and some non-conclusive work supports the same seasonal birth trend in patients with major affective disorders, the aetiopathogenetic foundations of this phenomenon remain uncertain. The primary role of perinatal seasonal factors that predispose to the development of schizophrenia via induction of brain damage has been invoked, as has a tendency for patients to conceive during the spring and early summer. In order to test these two hypotheses, cerebral ventricular size and cortical atrophy in 206 schizophrenics and 107 patients with major affective disorders were assessed by CT and analysed in relation to month of birth. Compared with schizophrenics born during the remainder of the year, those born between December and April, particularly in cases lacking a family history of schizophrenia, showed increased chances for ventricular enlargement, but not for cortical atrophy. No association between season of birth and central or cortical atrophy was found for patients with major affective disorders. This suggests that the brain-damaging effect played by perinatal seasonal factors has both a disease and an anatomical specificity.

Adult↗
PubMed1991

CT scan abnormalities and outcome of chronic schizophrenia.

The authors evaluated the relationship between brain morphological characteristics assessed by means of computerized tomography and the 2-year clinical and social outcomes of 18 patients with chronic schizophrenia. Cerebral structural abnormalities, especially cortical atrophy, were associated with a poorer outcome in several areas of clinical and social functioning.

Adult↗
PubMed1990

Celibacy and fertility rates in patients with major affective disorders: the relevance of delusional symptoms and suicidal behaviour.

The celibacy and fertility rates of 186 patients with major affective disorders were analysed as a function of the presence or absence of histories of mood congruent delusions or suicidal behaviour in the depressive phases of the disease. Both delusional and suicidal histories were irrelevant to celibacy rates. On the contrary, delusional depressives had a reduced incidence of cases with 2 or more children and suicide attempters had both a lower frequency of high-fertility cases and a smaller mean number of children than nonattempters. The differences were apparently not attributable to the length of the fertile period of life spent in illness.

Adult↗
PubMed1989

Alpha reactivity in schizophrenia and in schizophrenic spectrum disorders: demographic, clinical and hemispheric assessment.

Alpha EEG reactivity was assessed in a carefully diagnosed sample of 84 schizophrenic and schizophrenic spectrum disorder patients, both under resting conditions (eyes closed and eyes open) and during two spatial-geometric cognitive tasks. The influence of the subject's demographic (sex and age), clinical (diagnostic subtypes, disease course, CT scan characteristics) and neurophysiological (hemispheric recording and different cognitive tasks) characteristics on alpha peak reactivity was analyzed by means of multivariate analysis of variance. The results indicated a significant effect of type of illness on alpha EEG reactivity, patients with a diagnosis of undifferentiated and disorganized schizophrenia having the lowest alpha reactivity levels. None of the other variables considered had any contributing effect. The results are discussed in terms of orienting responses and hemispheric CNS organization in functional psychoses.

Adult↗
PubMed1989

Renal function in chronic lithium-treated patients.

We investigated the renal function (urine volume, glomerular filtration rate, urinary osmolality and proteinuria) of 50 patients chronically treated with lithium carbonate for major affective disorder. No patient had any alteration in the parameters considered. No relationship was found between any of the parameters studied and duration of illness or lithium levels, both in serum and red blood cells. These results were confirmed by the administration of the DDAVP test to 10 patients of the original sample; no alteration of concentration ability was found. We suggest that the discrepancy between our findings and those of most authors was a result of the serum lithium level of our patient sample, which was lower than that usually used in other studies.

Adult↗