Consultation-liaison psychiatry in Italy.
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Cross-Cultural Comparison↗
Biomedical subjects
G A Fava
Publications and source records attributed to G A Fava.
Italian validation of the Symptom Rating Test (SRT) and Symptom Questionnaire (SQ).
Two self-rating scales of psychological distress, the Symptom Rating Test (SRT) and the Symptom Questionnaire (SQ), have been validated in translations in Italy. They were administered in several studies to psychiatric patients (neurotics and depressives), matched controls, and patients suffering from various organic illnesses (dermatologic disorders, hypertension, secondary amenorrhea and patients undergoing amniocentesis). The SRT and the SQ sensitively discriminated between psychiatric patients and normals, between different levels of psychological distress in several of the somatic illnesses, and detected significant changes in the psychological status of patients participating in medical procedures such as amniocentesis. The scales were found to be useful in research in psychiatry and psychosomatic medicine. The findings suggest that the Italian translations are valid and sensitive scales of distress and can apparently be used as effectively in research as the original. They are likely to be of value in cross-cultural research in Canada. Both scales may be helpful in the psychological assessment of Italian immigrants in North America and Australia, especially in those whose English is poor.
Adult↗
Hostility in women before and after amniocentesis.
Fifty women undergoing amniocentesis and a matched control group of pregnant women were administered the Symptom Questionnaire to evaluate changes in psychologic distress. They were divided into subgroups according to previous experiences of pregnancy (no previous pregnancy, previous live births and no terminated pregnancy, previous terminated pregnancy). The amniocentesis subgroups did not show changes in anxiety, depression and somatic symptoms significantly different from those of the corresponding control subgroups. Only hostility was characteristic of amniocentesis, and its patterns varied according to the previous history of pregnancy.
Abortion, Spontaneous↗
Psychological reactions to amniocentesis: a controlled study.
Fifty women who underwent amniocentesis and a matched control group of pregnant women were administered the Symptom Questionnaire to evaluate changes in distress. Anxiety, depression, and somatic symptoms had significantly decreased after the results of amniocentesis were communicated to the patient, but the decrease was similar in the normal control women. Hostility was higher in the amniocentesis group and decreased to normal levels after amniocentesis was performed, even before the results were communicated to the patient.
Amniocentesis↗
Depressive symptoms and abnormal illness behavior in general hospital patients.
There have been many accounts of depression and abnormal illness behavior in medical inpatients, but systematic studies of their prevalence and features in a general hospital are lacking. Occurrence and characteristics of depression and illness behavior were studied in 325 inpatients of a general hospital in the northern part of Italy. Patients were surveyed in six separate wards (medicine, surgery, dermatology, OB-GYN, orthopedics, and ophthalmology) and represented about 90% of their actual population during a one-week period. Two self-report scales were used for screening: the CES-D (scale devised by the Center for Epidemiologic Studies of Depression at NIMH) for measuring depression and the Illness Behavior Questionnaire (IBQ), developed by Pilowsky and Spence. Both scales were administered in their validated Italian translations. The customary cut-off point of 16 in the CES-D score revealed about 58% of the patients as depressed. A more conservative cut-off point of 23 still showed 33.5% of the patients as depressed. The IBQ scores of the depressed patients showed significantly (p less than 0.001) higher levels of general hypochondriasis, disease conviction, dysphoria, and irritability than the nondepressed patients. No relevant differences existed between wards in the amount of depression and IBQ scores, even when differences were adjusted for age, sex, marital status, and social class. Implications for psychosomatic research (sociodemographic characteristics of depression and illness behavior, bias in comparing hospital patients and controls in the general population, and so on) and treatment (consultation-liaison psychiatry) are discussed.
Depression↗
Depression and hostility in hyperprolactinemia.
1. Patients with hyperprolactinemia offer a unique opportunity to investigate the effects of prolactin on psychological states. Women with hyperprolactinemic amenorrhea rated themselves significantly more hostile, more depressed and more anxious than women with amenorrhea only and normal women. 2. The hyperprolactinemic patients were compared with a group of post-partum (7th day) women, matched for sociodemographic variables and prolactin levels. The post-partum women showed significantly less depression and anxiety than those with hyperprolactinemic amenorrhea but about the same levels of hostility. 3. Hyperprolactinemic males did not rate themselves more hostile and depressed than matched controls.
Amenorrhea↗
Losses, Hostility, and depression.
Forty outpatients with a primary unipolar major depression of recent onset and a matched control group of employees were administered the hostility scale of the Kellner Symptom Questionnaire, depression was rated with the Hamilton Rating Scale for Depression, and life events were recorded in a structured interview. In a subgroup of depressives who had not reported losses, there was an association of hostility and depression, whereas no such association was found in depressives who had reported losses. The findings are consistent with those of previous studies showing that hostility is largely limited to a subgroup of depressives. In a substantial proportion of the depressives, depression and hostility are independent affects.
Depressive Disorder↗
The Hamilton Depression Rating Scale in normals and depressives.
The Hamilton Rating Scale for depression (HDRS) has become the standard observer rating scale for depression, yet there are no adequate data from normal samples. The present study was carried out in northern Italy. The purposes were 1) to examine the ratings in normals and 2) to examine the scale's validity in the different language and culture. The scale was used in 40 normals and 40 depressives who were matched. Two self-rating scales of depression were administered: the Symptom Rating Test and the Symptom Questionnaire. The results show that the HDRS is a valid measure in that it sensitively discriminates between depressed patients and normals. The findings support Hamilton's view that only the first 17 items of the scale are appropriate for computing the score. The use of self-rating scales yielded additional information. The misclassification rate of the Symptom Rating Test was similar to that of the HDRS. The combined use of Research Diagnostic Criteria (RDC) and HDRS appears to be more reliable for the selection of depressed patients for research than the RDC only.
Ambulatory Care↗
Neurotic symptoms and major depressive illness.
Neurotic symptoms as measured by self-rating scales were studied in 40 patients suffering from a major depressive disorder and 40 control subjects matched for sociodemographic variables. The depressive patients reported significantly more symptoms (global neuroticism, anxiety, somatization, and hostility) than controls. The more severe were the depressive self-rated symptoms, the more intense was the neurotic symptomatology. A principal component analysis was carried out in depressives and controls. In both groups a first general factor reflecting severity was obtained.
Depressive Disorder↗
Psychological correlates of hyperprolactinemia in males.
In a previous study with hyperprolactinemic female patients, self-rated hostility, depression and anxiety were significantly higher than in other female patients. The study was repeated in hyperprolactinemic males, using the same psychological assessments. Hyperprolactinemic males were significantly more anxious but did not differ significantly in hostility and depression from other male patients. The findings support the view that the psychological effects of high serum prolactin levels depend in part on interactions with gonadal hormones.
Adenoma↗
Depression and illness behavior in a general hospital: a prevalence study.
Occurrence and characteristics of depression and illness behavior were studied in 325 inpatients of a general hospital in the northern part of Italy. Patients were surveyed in six separate wards (medicine, surgery, dermatology, obstetrics and gynecology, orthopedics and ophthalmology) and represented about 90% of their actual population during a 1-week period. Two self-report scales were used for screening: the CES-D for measuring depression developed by the NIMH and the Illness Behavior Questionnaire (IBQ) developed by Pilowsky and Spence. Both scales were administered in their validated Italian translations. Applying the generally used cut-off point of 16 in the CES-D score, about 58% of the patients were classified as depressed. This cut-off was derived from community studies in the US. Applying a rather more conservative cut-off point of 23 (derived from the scores of psychiatrically depressed patients in Italy), still 33.5% of the patients emerged as depressed. The IBQ scores of the depressed patients showed significantly (p less than 0.001) higher levels of general hypochondriasis, disease conviction, dysphoria and irritability than the nondepressed patients. There were no relevant differences between wards in the amount of depression and IBQ scores even when differences were adjusted for age, sex, marital status and social class. Implications for psychosomatic research (sociodemographic characteristics of depression and illness behavior, bias in comparing hospital patients and controls in the general population, etc.) and treatment (consultation-liaison psychiatry) are discussed.
Adult↗
[The irritable colon. A psychosomatic approach].
The psychosomatic concept of irritable bowel syndrome (IBS) is critically examined. Criticism of obsolete and uncontrolled views is oftered through a selective review of literature. A new formulation of the psychosomatic diagnosis of irritable bowel syndrome, which may apply to other somatic illnesses as well is given.
Colonic Diseases, Functional↗
Consultation psychiatry in an Italian child guidance center: a report on 200 referrals.
A consecutive unselected series of 200 children referred for psychiatric consultation to an Italian Child Guidance Center is included in this study. All diagnoses were made in accord with the third edition of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM III). Functional enuresis was the most common psychiatric disturbance (15 percent), followed by developmental reading disorder (14.5 percent) and mild mental retardation (12.5 percent). There was no case of attention deficit disorder with hyperactivity (hyperkinetic syndrome). All depressions were consequences of another disorder and remitted when the child received attention and care. In 20.5 percent of cases no psychiatric diagnosis was made and the child apparently had been referred because of emotional problems in the parent.
Adolescent↗
Life events and depression. A replication.
A study which was first carried out in the United States was repeated in Northern Italy. Life events reported to have occurred 6 months before the onset of illness were compared in 40 outpatients who had a first episode of primary depression, and a matched normal control group. Depressives reported significantly more events than the control groups, and had significantly more of the following: undesirable events, exits from the social field, events which had an 'objective negative impact' (rated as being traumatic) and 'independent events' (events which were unlikely to be a consequence of the depression); the last 2 were judged by a rater who was unaware whether the event had occurred in a depressed patient or in a control subject. There were no significant differences in desirable events, entrances into the social field and events which were within the subjects' control. These findings replicate previous results and are consistent with the view that certain recent life events play a substantial role as precipitants in some depressed patients.
Adult↗
Depression hostility and anxiety in hyperprolactinemic amenorrhea.
In order to evaluate the relationship of psychological distress to hyperprolactinemia, 20 patients with secondary amenorrhea were evaluated by a semi-structured research interview and administered the Kellner Symptom Questionnaire. Group A (10 patients with amenorrhea and hyperprolactinemia) reported significantly more symptoms of depression, hostility and anxiety than group B (10 patients with amenorrhea and normal basal levels of plasma prolactin). Both groups were significantly more anxious, depressed and reported more somatic symptoms than a normal control group (n = 10). 6 of the 10 patients in group A reported decrease in libido, while this was found only in 1 of the 10 patients of group B. The findings suggest that the syndrome of depression, hostility and anxiety in a woman complaining of amenorrhea, especially if associated with decreased libido and galactorrhea, can be a manifestation of hyperprolactinemia.
Adolescent↗
Consultation psychiatry in an Italian general hospital: a report on 500 referrals.
Five-hundred consecutive referrals to the psychiatric consultation service at the University of Padua School of Medicine have been reviewed. In 69% of cases concurrent physical and psychiatric disorders were reported. There was a prevalence of females, working class patients, and individuals with limited schooling. Depression was the most common psychiatric disorder in all classes of organic disease and accounted for 37% of all psychiatric diagnoses, followed by anxiety neurosis (18.6%) and drug dependence (13.8%). In 10.8% of cases no psychiatric diagnosis was made.
Adolescent↗
Life events and psychological distress in dermatologic disorders: psoriasis, chronic urticaria and fungal infections.
A consecutive unselected series of 60 in-patients suffering from dermatologic disorders (psoriasis, chronic urticaria and fungal infections of the skin) was examined. Twenty patients with each illness were included. Stressful life events immediately before illness onset, levels of psychological distress, and alexithymic traits were investigated. Patients with psoriasis and chronic urticaria were exposed to stressful life situations before disease onset and suffered from psychological distress (anxiety, depression, inadequacy) significantly more than those with fungal infections. Implications for psychosomatic research and treatment are discussed.
Adult↗
Towards a self-rating scale for alexithymia. A report on 150 medical patients.
A self-rating scale for alexithymia was administered to a consecutive unselected series of 150 medical patients suffering from essential hypertension, cardiovascular disorders, psoriasis, chronic urticaria, fungal infections of the skin and gastrointestinal disorders. The scale, an Italian version of a preliminary form of the Schalling-Sifneos Personality Scale, showed some interesting discriminating properties. Implications for the development of a self-rating scale for alexithymia are discussed.
Adult↗