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M Balestrieri

Publications and source records attributed to M Balestrieri.

48 records · Page 3Linked to original sources
PubMed1987

Long-stay and long-term psychiatric patients in an area with a community-based system of care. A register follow-up study.

In South-Verona, where a community-based system of care consonant with the provisions of the Italian psychiatric reform has been operating since 1978, case-register data show that Long-stay inpatient rates are decreasing, while rates of patients treated long-term outside the mental hospital (i.e. those in "continuous care for one year, receiving treatment in the community by the various out-patient and day-patient facilities and in some cases short spells of inpatient care") show a recent increasing trend. Long-stay inpatients on 31.12.1982 have been compared with long-term community patients on the same date. The two cohorts were similar in terms of basic sociodemographic variables and contained a similar proportion of psychotic patients. However, while 88% of the long-stay inpatients were still long-stay after two years, only 45% of the long-term patients in the community remained in long-term treatment over the same period. Using a log-linear model, diagnosis was found to be the variable with the highest association in the long-term cohort with subsequent pattern of use of mental health services.

Adolescent↗
PubMedDate not supplied

The management of affective disorders in the community.

Using two systems which routinely record information about the management of psychiatric disorders in the community (a drug prescription monitoring system and a psychiatric case register), a parallel study was conducted in South Verona on antidepressant prescriptions written by general practitioners (GPs) and on contacts for affective disorders with specialized psychiatric services, in 1983 and 1984. The extent of patient contact for affective disorders was approximately ten times greater at the GP level (in one year about 150 antidepressant prescriptions per 1000 adult inhabitants) than at the out-patient/community psychiatric service level. Similarly, the extent of patient contact at the latter level was approximately ten times greater than at the in-patient level. Patients with a diagnosis of affective disorder accounted for about 20% of the total number of patients contacting the specialized services in one year. The proportions of patients admitted to hospital, among those in contact with these services and assigned a diagnosis of depressive neurosis or a diagnosis of affective psychosis, were 34 and 33% (in 1983 and 1984) and 49 and 50% (in 1983 and 1984), respectively. There was a clear correspondence between monthly fluctuations in the extent of care for affective disorders provided at the two levels in 1984, but not in 1983.

Affective Disorders, Psychotic↗
PubMedDate not supplied

Seasonal variation in affective disorders. A case register study.

This paper reports the results of a study on seasonal variation in new episodes of affective disorders, conducted using the South-Verona psychiatric case register. We found evidence for a cyclical pattern in the occurrence of affective psychosis, but this was statistically significant only for the males: there was no cyclical variation in depressive neurosis. The advantages are discussed of case register data over hospital admission statistics for the study of seasonal variation. These are particularly marked in case register areas where community psychiatric care is well developed, as in South-Verona.

Adolescent↗
PubMedDate not supplied

[Expressions of depression in Alzheimer's disease. The current scientific debate].

UNLABELLED: This overview analyses findings coming from researches that considered the interaction between depression and Alzheimer's disease (AD). METHOD: Information was collected from the Medline database and from a reasoned manual analysis of the published studies. RESULTS: The prevalence of depressive symptoms in patients with AD is elevated (40-50%). The role of depression in the pathogenesis of AD (independent, prodromal symptom, factor of risk) still must be defined. Data on family history of depression suggest that AD could act as stimulus triggering depression from a basis of a genetic vulnerability. From a biological point of view the onset of depression could derive from an unbalance between cholinergic and noradrenergic systems. Psychological understanding sees depression as a reaction of mourning for the cognitive deficit. Current diagnostic instruments validated on patients with AD constitute a good aid for the clinician and the researcher. The identification of depression coexisting with AD is difficult, in absence of clear affective symptoms, since the cognitive, psychomotor and vegetative symptoms belong both to depression and to AD. The affective disorders most frequently reported are major depression and dysthymia. The use of antidepressant drugs with the lowest anticholinergic profile is strongly recommended. Good results have been obtained also using various psychotherapeutic interventions adapted for dementia sufferers. CONCLUSIONS: The current scientific debate is based on information still limited and sparse. Future analyses should consider a better definition of the hypotheses related to psychopathology in AD, a standardised definition of cases and selection procedures and a prospective longitudinal design.

Alzheimer Disease↗
PubMedDate not supplied

Are premorbid personality traits linked to the risk of Alzheimer's Disease? A case series of subjects with familial mutation.

BACKGROUND: The identification of the premorbid manifestation of Alzheimer's disease (AD) usually is carried out retrospectively by eliciting information from caregivers. However, the study of subjects with familial Alzheimer's disease (FAD) not yet affected by AD allows the direct identification of premorbid characteristics of the disease. METHODS: This is a psychometric assessment of 3 mutated and 5 control subjects, belonging to an Italian family associated with a missense mutation linked to the presenilin 2 gene. The assessment included an evaluation of personality traits, cognitive and affective condition, social disabilities, experiential and familial context. RESULTS: According to the MMPI, the mutated subjects did not show consistent personality traits. Also other questionnaires (HADS, WAIS, BDQ) were negative for definite cognitive or behavioural patterns. ApoE genotypes did not differentiate mutated from control subjects. CONCLUSIONS: Our results may be considered important for a better understanding of the pathogenesis of AD. The heuristic and practical importance of longitudinal prospective studies is emphasised.

Adult↗
PubMedDate not supplied

[En epidemiologic approach for the analysis of the demand and supply of psycho-psychiatric care in general medicine and in specialized services].

In this paper we present data collected in the area of Verona concerning indicators of demand and of supply of care in two settings, the general practice and the South-Verona Community Psychiatric Service. These data, obtained from the epidemiological studies conducted by our research group during the past ten years, emphasize similarities and differences existing in the two levels of care. In general practice the demand for care for psychological disorders is difficult to identify, because of the frequent somatic expression of these disorders; moreover at the level of psychiatric services the demand is frequently aspecific. As far as the supply of care is concerned, in both settings drug prescription is the most frequent treatment, however other interventions are also offered. For example, in general practice counselling and referral to the psychiatrist are often provided; in psychiatric services monitored during our studies a large range of treatments were supplied, often in an integrated way.

Family Practice↗
PubMedDate not supplied

Health-related quality of life in older people using benzodiazepines: a cross-sectional study.

Aim of this study is to investigate the QoL older people making regular use of BDZ. All subjects aged 65-84 years attending their General Practitioners were invited to fill in a questionnaire about their consumption of BDZ and all the subjects consuming BDZ to fill in the Medical Outcome Measures Short Form-36 (MOS SF-36) and the Primary Care Evaluation of Mental Disorders (PRIME-MD) questionnaires. A total of 2,246 subjects used BDZ and 1,109 (49.4%) of them filled in the MOS SF-36 questionnaire. 1,005 of these participants also completed the PRIME-MD questionnaire (90.6%). The presence of sleep disorders and the characteristics of the BDZ used were not associated with any score in the MOS SF-36 questionnaire, whereas the Prime diagnosis was the most important predictor, since subjects with depression and/or anxiety had a lower mean score on each scale than subjects without disorders. Among a sample of Italian seniors taking BDZ, QoL was associated with the presence of anxiety and/or depression. Age, gender, education and the presence of cardiovascular diseases or stroke were associated with specific aspects of QoL, when anxiety and depression were controlled for.

Age Factors↗