Biomedical subjects

Paola Rucci

Publications and source records attributed to Paola Rucci.

At least 19 recordsLinked to original sources

PubMed2026

Examining early-phase symptom trajectories in interpersonal psychotherapy versus antidepressant medication for adults with depression: A dynamic time warp network analysis.

BACKGROUND: Depression is characterized by substantial symptom heterogeneity, which is often concealed when examining total severity scores. Analyzing symptom-level change can improve our understanding of treatment effects and recovery processes. This study, therefore, examined dynamic symptom networks during early-phase interpersonal psychotherapy (IPT) and selective serotonin reuptake inhibitor (SSRI) antidepressant treatment, assessing patterns of symptom change across as well as differences between treatments. METHODS: Using weekly item-level Hamilton Depression Rating Scale (HAM-D) data from a randomized clinical trial comparing IPT and SSRIs for adults with depression, this preregistered study examined symptom trajectories in the first six weeks of treatment with Dynamic Time Warping (DTW). RESULTS: Depressive symptom trajectories and DTW-based symptom networks were largely similar for IPT and SSRI. In both conditions, changes in somatic symptoms of anxiety and middle insomnia tended to precede improvements in depressed mood. CONCLUSIONS: Early symptom change may occur outside the core affective domain, underscoring the importance of monitoring symptoms broadly. Symptom-level patterns may reflect patients' stage of recovery and provide clinically relevant information beyond total severity scores. The absence of differences in improvement patterns between IPT and SSRI suggest few indications for treatment selection based on baseline symptom profiles. Future research should replicate and extend these findings to subsequent treatment phases using more frequent assessments and a broader range of interventions.

Humans↗

PubMed2006

Association between illicit drug and alcohol use and first manic episode.

In light of the established influence of substance use on the onset, course, and outcome of bipolar disorder, we performed a retrospective chart review of patients with bipolar I disorder participating in a randomized controlled trial to further investigate the relationship between alcohol and substance use and first onset of mania. A total of 59.4% (N=101) of the 170 participants were determined to have a history of substance and/or alcohol use. Among the 101 participants with SU, use was coded in 10 (9.9%) as immediately preceding, in 50 (49.5%) as preceding mania, in 7 (6.9%) as following mania, and in 34 (33.7%) as indeterminable. Of the 10 participants with immediately preceding use, 5 experienced their first manic episode immediately after discontinuing a substance. Our findings support earlier reports detailing the high prevalence of substance use among patients with bipolar disorder. Treatments targeting alcohol and substance use among individuals with bipolar disorder are clearly needed, as are prophylactic treatments targeting adolescents and young adults who are at risk for either bipolar disorder or alcohol and substance related disorders.

Adult↗

PubMed2006

A relationship between oxytocin and anxiety of romantic attachment.

The formation of social bonding is fundamental for several animals, including humans, for its relevant and obvious impact upon reproduction and, thus, survival of the species. Recent data would suggest that oxytocin might be one of the mediators of this process. Given the paucity of data on the possible involvement of oxytocin in human attachment, the present study was aimed to explore the possible relationships between the plasma levels of this neuropeptide and romantic attachment in healthy subjects. Forty-five healthy subjects who volunteered for the study, were included in the study. The romantic attachment was assessed using the Italian version of the so-called "Experiences in Close Relationships" (ECR), a self-report questionnaire for measuring this parameter in adults. The results showed that attachment anxiety and oxytocin are positively linked in romantic attachment to a statistically significant degree (r = 0.30, p = 0.04), that is, the higher the oxytocin levels the higher the score on the anxiety scale of the ECR. The authors suggest the hypothesis that this link represents one of the biological processes resulting in those rewarding emotions related to romantic attachment.

Journal Article↗

PubMed2006

Reasons for substance use and vulnerability factors in patients with substance use disorder and anxiety or mood disorders.

This cross-sectional study examined the reasons for substance use and the presence of vulnerability factors such as substance sensitivity, sensation seeking, and symptoms related to the attention deficit hyperactivity disorder (ADHD) in patients with substance use disorder (SUD) and comorbid mood and anxiety disorders by using the Structured Clinical Interview for the Spectrum of Substance Use (SCI-SUBS), a novel instrument designed to explore the spectrum of substance use and its clinical correlates. Study participants included 61 patients with SUD and mood or anxiety disorder, and two comparison groups including 35 patients with SUD only and 50 controls not in treatment for mental disorders or SUD. We found that patients with co-morbid mood or anxiety disorder had significantly higher scores on the SCI-SUBS domains 'substance sensitivity' and 'self-medication' as compared to those with SUD only. Scores on 'sensation seeking' and 'ADHD' domains were similar between both groups of patients and higher than in controls. Patients with comorbid mood or anxiety disorders showed a higher sensitivity to substances and were more prone to self-medication than those with SUD only. These characteristics should be taken into account in the diagnostic assessment and in long-term treatment to decrease the risk of relapse.

Adult↗

PubMed2006

The quality of life of the mentally ill living in residential facilities: findings from a national survey in Italy.

Quality of Life (QOL) is an outcome measure particularly useful to assess the effects of deinstitutionalization policies. To date no large-scale study has been conducted in residential facilities (RFs). Participants included 1492 subjects living in 174 RFs (20% of the total) randomly sampled in 15 Italian regions. Assessment instruments included the WHOQOL-Bref, the GAF, and the Physical Health Index (PHI). WHOQOL scores of residents were compared with those of healthy subjects (N = 65) and outpatients with schizophrenia (N = 162). Multivariate analyses were used to examine the relationship between selected patients' characteristics and WHOQOL scores. Mean WHOQOL scores of residents were similar to those of outpatients with schizophrenia, and substantially lower than those of healthy controls. Lower scores on WHOQOL domains were associated with schizophrenia and non-affective psychoses, unipolar depression, anxiety or somatoform disorders, shorter duration of illness, positive, negative or mood symptoms, lower GAF scores, no participation in internal activities, and PHI score. Our findings are consistent with previous studies. The present study highlights a marked difference between patients in RFs and healthy controls in the social domain. This suggests the need of well-designed rehabilitation plans, tailored to patients' needs, to foster the development of their independence and, ultimately, improve their QOL.

Adolescent↗

PubMed2006

Social anxiety and obsessive-compulsive spectra: validation of the SHY-SR and the OBS-SR among the Spanish population.

The study focuses on the adaptation into Spanish and on the validation of the Social Phobia Spectrum Self-Report (SHY-SR) and the Obsessive-Compulsive Spectrum Self-Report (OBS-SR). The questionnaires were designed to measure a broad range of subtle and atypical features related to social anxiety and obsessive-compulsive phenomenology, respectively. Sixty-two outpatients who met DSM-IV criteria for social phobia (SP, n = 20), obsessive-compulsive disorder (OCD, n = 22) and major depression (MD, n = 20), and 25 non-clinical subjects participated. The spectra questionnaires were administered along with the Liebowitz Social Anxiety Scale and the Maudsley Obsessional Compulsive Inventory. The instruments proved to have satisfactory internal consistency and test-retest reliability. Convergent validity with other instruments was excellent for the SHY-SR and moderate for the OBS-SR. Both questionnaires were able to detect differences between patients with the disorder of interest (SP in the case of the SHY-SR scores and OCD in the case of the OBS-SR scores) and either normal controls or patients with MD. Receiver-Operating Characteristic Curve analyses were conducted to determine cut-off values in the Spanish versions of the questionnaires denoting the presence of significant SP and OCD symptomatology. Are the questionnaires available on the website?

Adult↗

PubMed2006

Lifetime rhythmicity and mania as correlates of suicidal ideation and attempts in mood disorders.

BACKGROUND: The aim of this study is to establish to what degree variation in lifetime experience of rhythmicity and manic-hypomanic features correlates with suicidality in individuals with mood disorders and other major psychiatric diagnoses and in a comparison group of controls. METHOD: Suicidal ideation and attempts were investigated in a clinical sample, including 77 patients with schizophrenia, 60 with borderline personality disorder, 61 with bipolar disorder, 88 with unipolar depression, and 57 with panic disorder, and in a comparison group of 102 controls. Using information derived from the diagnostic interview and a self-report assessment of mood spectrum symptoms, subjects were assigned to 3 categories according to the maximum level of suicidality achieved in the lifetime (none, ideation/plans, and suicide attempts). The association of categorical and continuous variables with suicidality levels was investigated using multinomial logistic regression models. RESULTS: Suicidal ideation and plans were more common in unipolar depression (50%) and bipolar disorder (42.4%) than in borderline personality disorder (30%), whereas the reverse was true for suicidal attempts. In each of the study groups, the number and the type of mood spectrum items endorsed, including depressive and manic-hypomanic items and rhythmicity and vegetative symptoms, were associated with increased levels of suicidality. CONCLUSIONS: Our results suggest that the assessment of lifetime rhythmicity and manic-hypomanic features may be clinically useful to identify potential suicide attempters in high-risk groups.

Adult↗

PubMed2006

Characteristics of homicide perpetrators among Italian forensic hospital inmates.

OBJECTIVE: To identify distinctive clinical and social features of the psychiatric patients who committed homicide among inmates of Italian forensic hospitals. METHOD: Clinical and social characteristics of four cohorts of patients were compared: 64 inmates who committed or attempted homicide (Hs), their 64 matched controls from community services caseloads, 54 inmates who committed other crimes and their 54 matched controls from community services caseload. RESULTS: When compared with other inmates, patients who committed or attempted homicide showed less severe psychopathology (later onset of mental disorders, later contact with mental health services, lower disability scores) except for higher scores at BPRS "hostility" and "suspiciousness" factors; they also showed better premorbid adjustment (socioeconomic status, employment), and surprisingly better behavioural profile (fewer compulsory admissions, fewer previous criminal records, less substance abuse, less frequently in caseloads of community services). When compared with their matched controls, Hs had lower psychopathology, better adjustment, and a similar behavioural profile. CONCLUSIONS: Italian inmates of forensic hospitals who committed or attempted homicide have clinical features and personal histories which are far from the stereotype of the violent and dangerous psychiatric patients. The risk assessment procedures routinely performed in several countries may detect violent, but not homicidal behaviour.

Adult↗

PubMed2006

The Italian preadolescent mental health project (PrISMA): rationale and methods.

The Italian preadolescent mental health project (PrISMA--Progetto Italiano Salute Mentale Adolescenti) is the first Italian study designed to estimate the prevalence of mental disorders in preadolescents (10-14 years old) living in urban areas, and to analyse the demographic and biological correlates of emotional and behavioural problems. This paper describes the rationale, methods and the analysis plan of the project. The design of the study used a two-stage sampling procedure, one screening stage of emotional and behavioural problems in a large sample of subjects attending public and private schools and a second stage of diagnostic assessment in a sample including all high scorers and a proportion of low scorers. In the screening stage, parents of preadolescents were asked to fill in the Child Behavior Checklist (CBCL), whereas in the second stage preadolescents and their parents were administered the Development and Well Being Assessment for the assessment of mental disorders together with the Strengths and Difficulties Questionnaire and two scales (C-GAS and HoNOSCA) designed to evaluate the functioning of the preadolescent in different areas. Genetic samples were collected during the screening stage, after parents gave their informed written consent. The findings of this study are expected to allow an adequate planning of interventions for the prevention and the treatment of mental disorders in preadolescence as well as efficient health services.

Adolescent↗

PubMed2006

Suicidal behaviors and personality structure.

In this paper we suggest the potential clinical usefulness of two projective tests (Rorschach and Object Relation Technique) and of a clinical interview focused on the pathway to suicide, life events, and major life difficulties to better define subtypes of patients attempting suicide. Thirty-three hospitalized subjects who had attempted suicide in the previous 6 months were examined using an in-depth assessment of the pathway to suicide. The aims of this study were: (1) to compare, within a clinical sample of suicidal attempters, the psychopathological, personality, and psychosocial characteristics of subjects with mood disorders alone, personality disorders and dysfunctional personality alone, and mood disorders with personality disorders and/or dysfunctional personality; and (2) to analyze the relationship between the method chosen and the clinical characteristics of the subgroups.

Adolescent↗

PubMed2005

Multidimensional assessment of the Panic-Agoraphobic Spectrum: reliability and validity of the Spanish version of the PAS-SR.

The present study reports on the psychometric properties of the adaptation into Spanish of the Panic-Agoraphobic Spectrum Self-Report (PAS-SR). Drawing on a dimensional and longitudinal perspective of psychopathology, the PAS-SR was designed to measure a wide array of lifetime Panic-Agoraphobic features. Participants included outpatients with a DSM-IV-TR diagnosis of panic disorder (n=26) or major depression (n=28), and a normal control group (n=41). Internal consistency and test-retest reliability were excellent for the total score, and moderate to excellent for most domains. Significant and high correlations between PAS-SR scores and instruments measuring similar constructs indicated good concurrent validity. The findings support the discriminant validity of the questionnaire. Patients with a diagnosis of panic disorder attained higher scores than normal controls on all domains, and displayed higher scores than patients with major depression on five of the eight domains.

Adult↗

PubMed2005

Cross-cultural validity of the structured clinical interview for panic-agoraphobic spectrum.

BACKGROUND: We sought to develop a series of assessment measures of psychiatric spectrum conditions associated with major DSM-IV mood and anxiety disorders that might capture the true phenotypes underlying these disorders. The specific objective of this report was to describe the methods we employed to create instruments that could cross linguistic and national boundaries and to evaluate the comparability of results obtained when one of these instruments, the Structured Clinical Interview for Panic-Agoraphobic Spectrum (SCI-PAS), was administered in the United States and in Italy. METHOD: After developing, in parallel, the English and the Italian versions of the SCI-PAS, identical protocols were conducted in patients and control samples at the University of Pittsburgh and the University of Pisa to examine the reliability and validity of the interview. RESULTS: Total and domain scores on the SCI-PAS were strikingly similar in the US and Italian patient groups and in controls. In addition, similarly high levels of inter-rater and test-retest reliability were found at the two sites. Finally, virtually identical patterns of relationships were found between the domains of the SCI-PAS and established measures of the same constructs. CONCLUSIONS: The SCI-PAS displays similar reliability and validity properties in the two versions. This suggests that the instrument taps a phenotype that is consistent in American and Italian patient and control populations.

Adult↗

PubMed2005

Dual diagnosis and quality of life in patients in treatment for opioid dependence.

This study examined the relationship between quality of life (QOL) and dual diagnosis among patients in treatment for opioid dependence. The study sample includes 57 patients with opioid dependence alone (OD) and 41 with opioid dependence and a psychiatric axis-I disorder (DD), recruited in 2001 and 2004 at the Drug Addiction Services (SerT) of Bolzano and Pontedera (Italy). Participants were 73.5% males, with a mean age of 35.1 years (SD = 8.0). A comparison group of 45 healthy controls was also included. Assessments included a structured psychiatric interview (SCID) and a self-report quality of life assessment (WHOQOL-BREF). Patients with DD reported significantly (p < 0.05) poorer QOL in the physical and psychological domains as compared with patients with OD. Both groups of patients with and without DD showed significantly (p < 0.001) poorer QOL in the physical, psychological, and social domains with respect to healthy participants. The scores on the "relationship with environment" domain did not differ among OD, DD, and controls. The present study provides preliminary evidence that dual diagnosis is associated with poorer QOL and emphasizes the need to target treatment for the mental disorder concomitantly with the dependence problem in patients in treatment for opioid dependence.

Adult↗

PubMed2004

Quality of life in patients with schizophrenia--comparison of self-report and proxy assessments.

BACKGROUND: While Quality Of Life (QOL) in subjects suffering from schizophrenia has been studied using a variety of generic or specific instruments, only very few studies have analyzed the agreement between patients and proxy ratings on patients' QOL. METHODS: We administered the World Health Organization Quality of Life assessment instrument (WHOQOL-100) to 292 patients and the Quality of Life for Proxies (QOL-P) to their proxies, respectively; the QOL-P is a 30-item instrument derived from the WHOQOL-100 and adapted for administration to a key informant. RESULTS: Agreement between patients and proxies on the four main QOL areas was highest for the physical area (intraclass correlation coefficient, ICC = 0.41) and lowest for the psychological area (ICC = 0.29). In line with the results of other studies comparing patients' and proxies' ratings, proxies generally underestimated patients' physical and psychological QOL. Moreover, the agreement between patients' and proxies' ratings was consistently higher across all QOL areas when the proxy was a relative compared to a non-relative proxy. CONCLUSIONS: The agreement between patients and proxies in QOL assessment is modest, but it is relatively higher when observable aspects of QOL are rated and when the proxy who makes the evaluation is a family member who has closer contacts with the patient. In order to obtain a comprehensive picture of patients' QOL, it would be advisable to compare patients' ratings with the assessments made by close informants.

Adolescent↗

PubMed2004

The mood spectrum in unipolar and bipolar disorder: arguments for a unitary approach.

OBJECTIVE: This study examined the extent to which individuals with a lifetime diagnosis of recurrent unipolar disorder endorse experiencing manic/hypomanic symptoms over their lifetimes and compared their reports with those of patients with bipolar I disorder. METHOD: The study group included 117 patients with remitted recurrent unipolar depression and 106 with bipolar I. Subjects had their clinical diagnosis confirmed by the Mini International Neuropsychiatric Interview and were administered the Structured Clinical Interview for the Mood Spectrum, which assesses lifetime symptoms, traits, and lifestyles that characterize threshold and subthreshold mood episodes as well as "temperamental" features related to mood dysregulation. RESULTS: The patients with recurrent unipolar depression endorsed experiencing a substantial number of manic/hypomanic symptoms over their lifetimes. In both patients with recurrent unipolar depression and patients with bipolar I disorder, the number of manic/hypomanic items endorsed was related to the number of depressive items endorsed. In the group with recurrent unipolar depression, the number of manic/hypomanic items was related to an increased likelihood of endorsing paranoid and delusional thoughts and suicidal ideation. In the bipolar I group, the number of lifetime manic/hypomanic items was related to suicidal ideation and just one indicator of psychosis. CONCLUSIONS: The presence of a significant number of manic/hypomanic items in patients with recurrent unipolar depression seems to challenge the traditional unipolar-bipolar dichotomy and bridge the gap between these two categories of mood disorders. The authors argue that their mood spectrum approach is useful in making a more accurate diagnostic evaluation in patients with mood disorders.

Adult↗

PubMed2004

Suicide attempts and ideation in patients with bipolar I disorder.

BACKGROUND: Suicidal thinking and behavior are common in individuals with bipolar disorder. METHOD: Suicidal ideation and suicide attempts were examined in 175 patients with bipolar I disorder (diagnosis confirmed with the Schedule for Affective Disorders and Schizophrenia or the Structured Clinical Interview for DSM-IV) participating in the Pittsburgh Study of Maintenance Therapies in Bipolar Disorder. Patients who attempted suicide before entering the study were compared with those who did not attempt suicide with respect to clinical and demographic characteristics. RESULTS: Twenty-nine percent of the patients had attempted suicide prior to entering the study. Suicide attempts happened at a relatively young age and in the first period of the illness. Greater severity of bipolar disorder, as indicated by a greater number of previous depressive episodes (p =.0009) and higher HAM-D-25 scores (p =.04), and higher body mass index (p =.03) were significantly correlated with a history of suicide attempts. None of the patients with a history of suicide attempt attempted suicide again. However, 5 patients without a history of suicide attempt did attempt suicide. Four of these patients did not display severe suicidal ideation at the assessment that preceded the suicide attempt. No subject completed suicide during the 11 years of the study. CONCLUSION: Greater severity of bipolar disorder and higher body mass index are significantly correlated with a history of suicide attempts. However, a treatment program in a maximally supportive clinical environment can reduce suicidal behavior in high-risk patients. In some cases, suicide risk is transient and may be preceded by a period of severe suicidal ideation that lasts only a few minutes or hours. In such cases, mental health professionals are unable to predict suicide attempts.

Adult↗

PubMed2003

Development and preliminary testing of the General 5-Spectrum Measure (GSM-V).

The Collaborative Spectrum Project has developed structured interviews and self-report instruments to assess the spectrum of symptomatology related to panic-agoraphobia, mood, social phobia, and obsessive-compulsive and eating disorders. In order to obtain a rapid pre-test on all five of these spectrum conditions, the authors sought to develop a brief instrument that would tap these conditions. This paper reports on 1) the procedures to derive this composite instrument, the General 5-Spectrum Measure (GSM-V), by selecting items from five existing spectrum instruments, and 2) preliminary testing of the internal consistency and test-retest reliability of the GSM-V. The GSM-V consists of 54 items grouped into scales that explore the five spectra described above. It was derived from existing data on five Structured Clinical Interviews that were designed to assess spectrum features by using multiple regression models. The GSM-V was administered as a stand-alone instrument along with the self-report versions of the spectrum interviews to a sample of 56 psychiatric patients in order to determine the internal consistency of its scales and the correlation with the parent spectrum measures. Moreover, to determine whether subjects would respond consistently to the same items on two different occasions (test-retest reliability), the GSM-V was re-administered within 1 month from the baseline. From each of the five spectrum interviews, items were selected that accounted for a significant proportion of variance of the total score of the parent instrument. The five sets of items so selected constitute separate scales. The scales of the GSM-V had a good to excellent internal consistency, excellent test-retest reliability, and proved to reproduce adequately the long-form measures. The GSM-V appears to provide a reliable alternative to the five longer spectrum interviews. It is envisaged that the instrument will be most useful as a pre-test to identify subjects with spectrum features that should be explored in greater detail. Additionally, it could provide a better characterization of patients with a syndromal level Axis-I disorder, who might require specific treatment strategies targeted to co-occurring subsyndromal conditions.

Adolescent↗

PubMed2003

Social anxiety spectrum.

The aim of this paper is to provide the prevalence rates of mild, moderate and severe symptoms of social anxiety in a sample of high school students and to analyze gender differences and associated impairment levels within these three levels of severity. Five hundred and twenty students were assessed with the Social Anxiety Spectrum Self-Report (SHY-SR), a questionnaire that explores social anxiety spectrum. By applying two cut-off scores determined on a separate sample by using ROC analysis, the large majority (73.3 %) of subjects were classified as low scorers, 9% as medium scorers and 17.7% as high scorers. Fears related to social situations were reported both by high and medium scorers. Functional impairment defined by avoidance and school difficulties was more common among high scorers, but it was also reported to a significant extent by medium scorers. Compared to low and medium scorers, high scorers showed a higher F/M ratio (about 4:1) and a more homogeneous symptomatological profile in the two genders. In conclusion, our report confirms, in line with the literature, that even moderate levels of social anxiety are associated with significant functional impairment and distress for the individuals.

Adolescent↗