PubMed Health⌕ Search

Biomedical subjects

M Savoini

Publications and source records attributed to M Savoini.

6 recordsLinked to original sources

A quantified analysis of sleep electroencephalography in anorectic adolescents.

BACKGROUND: Previous studies on sleep characteristics in anorexia nervosa have led to controversial results. This may be due to either the heterogeneity of the samples studied or to an intrinsic inadequacy of the scoring criteria. To obtain a more detailed analysis we have investigated sleep characteristics in a group of adolescents affected by anorexia nervosa using spectral analysis techniques. METHODS: After a baseline night, the sleep-electroencephalograms of 10 adolescent anorectic girls (age +/- SD = 14 +/- 2 years) and 10 age-matched control subjects were recorded and processed by a fast Fourier transformation routine. RESULTS: Anorectics showed an increased number of awakenings and wakefulness after sleep onset and a reduction of sleep efficiency and slow-wave sleep. Spectral analysis results revealed a significant reduction in the power spectral values of slow-wave activity (SWA; 0.5-4.5 Hz) band in all NREM-REM cycles of sleep and in the undisturbed and stable stage 4. Moreover the anorectic group was characterized by a concentration of SWA in the first NREM-REM cycle with an abrupt decay in the second part of the night. A positive correlation (r2 = .58, p < .01) between body mass index and the amount of SWA was found. CONCLUSIONS: Sleep of anorectic patients seems to be characterized by a weakness of SWA producing mechanisms. The positive correlation between body mass index and the amount of SWA appears to be consistent with the neurobiological consequences of the malnutrition state.

Adolescent↗

Long-term outcome of children and adolescents with anorexia nervosa: study of comorbidity.

Eighty-seven children and adolescents with anorexia nervosa, admitted to the Gaslini Department of Child Neurology and Psychiatry between 1976 and 1990, were followed up after a mean of 9.6 years. Outcome measures included the Morgan Russell Outcome Schedule as modified by Jeammet. Outcome was good in 43 (53%) cases, intermediate in 27 (34%) cases, and negative in 11 (14%) cases. No deaths occurred. Based on the Jeammet assessment schedule, the most significant items predicting outcome were insight; sexual, familial, and social relationships; and mental state. Gender of patients and early disease onset did not seem to be predictive measures. Poor outcome was associated with a severe initial clinical picture and length of in-patient treatment. In regard to comorbidity, mood and personality disorders seemed to be negative prognostic indicators, whereas anxiety disorders did not show prognostic value.

Adolescent↗

[Suicidal behavior among adolescents].

Some data from the literature on adolescent suicidal behaviour are reported: incidence, employed methods, warning signs, risk factors, some psychodynamic aspects. The purpose of this work is to contribute to the study on this matter by a research on 33 adolescents (12 males, 21 females: mean age 14 years, range 11.2-17 years) examined because of suicidal behaviour. The study method includes: anamnesis, psychodiagnostic inquiry, family and environmental investigation, psychiatric evaluation. Suicidal behaviour is characterized by low levels of determined self-elimination intent ("suicidal gestures") in 36% of cases (1 male, 11 females). Relapses are found in 35% of cases, with death in 1 case. The most frequently used methods is drug poisoning (65%). Most common place where suicidal behaviour takes place is at home (82%). Most show warning signs especially verbal threats. Some problem in the family situation (conflicts in the parental couple or between parents and children, psychopathologic disturbances in the parents) and frequent difficulties in school and social adjustment are evident. In 45% a depressed state was noted, in the other cases several psychopathologic disturbances have been found: hysteric neurosis, borderline personality, psychosis. In 30% of cases symptoms coexist with a self-injuring meanings (nervous anorexia, pseudo-epileptic seizures). Prevalent psychodynamic characteristics are: vulnerability in facing frustrating situations and research of support from inadequate parental figures: displacement from hetero-direct aggressive drives to an expiratory or revengeful self wounding behaviour. Some criteria for an emergency care and for a middle to long term treatment are mentioned, and the opportunity for collaboration between pediatricians and psychotherapists is suggested.

Adolescent↗

[Anorexia nervosa in adolescents. Clinical aspects of the diagnosis and a follow-up].

In a brief review of the literature, the diagnostic, prognostic and therapeutic criteria of anorexia nervosa in adolescence are considered. An interdisciplinary approach (child neuropsychiatrists, clinical psychologists, auxological pediatricians) was adopted in 52 cases with a diagnosis of anorexia nervosa (46 females, 6 males; mean age 14). The results of the analysis of somatic disturbances (weight loss, anomalous sexual maturation), psychological aspects (cognitive level, organization of the personality), environmental implications (familial, social and school adjustment; mother-child relationship; pedagogic modalities; social and economic factors) are reported. The data from a follow-up of 29 patients (26 females, 3 males; mean age 19) are reported, and the degree of recovery assessed as follows: 1) clinical recovery at somatic-adjustment level (79% complete, 17% with atypical characteristics); 2) achievement of a harmonic organization of the personality (48%). The paper concludes with some remarks on the treatment, prognosis and prospects for prevention of the condition.

Adolescent↗