[Some issues on nicotine dependence].
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Biomedical subjects
Publications and source records attributed to G Forza.
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The present study examined the characteristics and the possible psychopathological consequences of ecstasy (MDMA, 3,4-methylenedioxymethamphetamine) use. One hundred and fifty consecutive patients, presenting to the Padova (Italy) Addiction Treatment Unit and who had taken ecstasy on at least one occasion, were examined and studied using a semi-structured interview. Ninety-five percent of the patients had experimented with another drug of abuse at least once in their lifetime. Ecstasy was mainly self-administered at disco clubs, and reported acute psychoactive effects confirmed previous reports. Fifty-three percent of the total sample were found to be affected by one or more psychopathological problems; the most frequent were depression, psychotic disorders, cognitive disturbances, bulimic episodes, impulse control disorders, panic disorders, social phobia. Those who were free from any psychopathological problem, compared to the others, had taken a smaller number of MDMA tablets in their lifetime, for a shorter duration and with a lower frequency. Again, they were less likely to have used alcohol together with ecstasy but more likely to have used opiates. Longer-term, larger dosage (acute or cumulative) MDMA consumers were found to be at high risk of developing psychopathological disturbances. The results are discussed, taking into account both the ecstasy suggested serotonin (5-hydroxytryptamine) neurotoxicity and the various methodological issues pertaining to this kind of large-scale clinical study describing people for whom MDMA is far from being the only drug of abuse.
We studied the genetic pattern of inheritance of the ratio between circulating CD4+ and CD8+ T lymphocytes in a population of healthy donors. The distribution of the CD4/CD8 ratio in males and females was significantly different and was significantly affected by age. In 46 randomly selected families, the parental CD4/CD8 ratio significantly influenced the ratio in offspring. Complex segregation analysis of the data rejected the non-genetic hypothesis; among the genetic models tested, a major recessive gene with a polygenic component and random environmental effects was the most parsimonious model. These findings indicate that the ratio of CD4+ and CD8+ T cells is genetically controlled in humans.
This paper describes the role of gamma-hydroxybutyric acid (GHB) in the treatment of opiate withdrawal syndrome. In the two patients described, after having abruptly withdrawn from long-term methadone treatment, GHB was orally administered (each dose given every 4-6 h) for 8-9 days. The GHB showed both a high efficacy (some mild and transient symptoms attributable to opiate withdrawal were observed, but only in the first days of therapy) and a good tolerability (no clinical phenomena interpreted as GHB side effects were found). These results could be of interest in improving the pharmacological treatment of drug addiction.
In the area of Padua, northern Italy, fear of AIDS along with AIDS educational campaigns had reduced risk behaviours for HIV among intravenous drug abusers (IVDA) as early as 1987, although at that time 38% of seropositive cases still shared needles and only 22% of subjects used condoms. The present study has been conducted in the same area and with similar criteria to evaluate the effectiveness and limits of a sustained education campaign. Drug related and sexual risk behaviours and motivations preventing behavioural changes were investigated by direct interview in 190 IVDA. Fourteen percent of the participants, including 16% of the seropositive, were still sharing needles, mainly because they did not have works available at the time they were needed. Demographic features, drug-related characteristics and anti-HIV seroprevalence did not differ significantly between needlesharers and other drug abusers. Condom use was reported by 46% of subjects, but encouragingly enough this figure included 80% of the seropositives. While knowledge of seropositivity seemed to encourage condom use, a higher selectivity about partners and a negative attitude towards condoms were the most frequent motivations preventing safer sex. These results suggest that sustained AIDS education campaigns are being successful in maintaining and reinforcing the trend to risk reduction previously observed among drug abusers in this area. Nevertheless the persistence of risk behaviours in a consistent proportion of participants emphasizes the urgency of additional prevention strategies, such as syringe exchange or supply to the limited number of sharers and counselling to encourage safer sex.
The suicide attitude in a group of 34 postmastectomy patients was much more marked than in two control groups consisting of 103 medical patients and in 40 healthy subjects, respectively. In a limited sample comprising 23 subjects obtained by excluding the extreme percentile values, certain psychosocial variables (irritability, psychoticism, number of confidants, number of persons in the same household) were observed to be significantly associated with the suicide attitude in postmastectomy patients. On the other hand, no differences were evident, both regarding the interval of time following initial diagnosis and between married and single patients.
A sample of 208 pregnant women (78 before the voluntary termination of pregnancy, 63 admitted to hospital because of a threatened miscarriage, 67 at the outpatient clinic for a routine antenatal visit) performed a personality test (EPI) and two tests to evaluate psychological distress (SCL-90 and GHQ). The women who were about to abort exhibited a higher level of psychological distress which was also related to an underlying personality structure with neurotic traits. The group with a threatened miscarriage exhibited an intermediate level of psychological distress but a structure of personality similar to the antenatal group.