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Biomedical subjects

R Canestrari

Publications and source records attributed to R Canestrari.

At least 19 recordsLinked to original sources
PubMed1998

Six-year outcome for cognitive behavioral treatment of residual symptoms in major depression.

OBJECTIVE: The authors' goal was to determine whether cognitive behavioral treatment of residual symptoms of depression might have a significant effect on relapse rate. METHOD: A 6-year follow-up assessment was conducted of 40 patients with primary major depressive disorder who had been successfully treated with antidepressants and were randomly assigned to either cognitive behavioral treatment of residual symptoms or standard clinical management. RESULTS: Ten of the patients (50%) in the cognitive behavioral treatment group and 15 (75%) in the standard clinical management group relapsed. The difference did not attain statistical significance. When multiple relapses were considered, patients in the cognitive behavioral treatment group had a significantly lower number of depressive episodes than those in the standard clinical management group. Patients responded to the same antidepressant drug used in the index episode; in two cases (4%), resistance occurred. CONCLUSIONS: The protective effects of cognitive behavioral treatment that were evident at 4-year follow-up faded afterward. Cognitive behavioral treatment of residual symptoms, however, improved the long-term outcome of major depression in terms of total number of episodes during the follow-up period.

Adult↗
PubMed1997

Cognitive deficits in the elderly: interactive theories and a study of environmental effects on psychometric intelligence.

Problems related to psychometric measures of intelligence are discussed with regard to both the general characteristics and metric properties (validity, reliability and sensibility) of mental tests, and interindividual differences (cultural background, education, life contents and age-cohorts). Currently used standard intelligence tests explore the structure of intelligence only in part, so a distinction must be made between true actual intelligence, potential inheritance of intelligence, and psychometrical or scored intelligence. The correct use of intelligence testing, however, does provide some relevant and objective information regarding the evolution of cognitive structure during adulthood and in relationship to aging. Cognitive performance in the elderly follows a downward curve that is not explained as a result of aging on physiological responses (i.e., reaction time delay, signal-noise ratio in the CNS, degenerative loss of cortical cells, etc.). Biologically based theories of intelligence cannot explain the large individual differences in cognitive abilities observed in subjects who have very similar physical characteristics. Cognitive approaches to intelligence enable us to better understand the causal factors of the cognitive deficits in the elderly, and an interactive model permits us to fully integrate both the individual differences in cognitive abilities and the large consistency in performances. We compared the cognitive performances of two groups of elderly subjects, ranging in age from 65 to 97 years; we observed some statistically significant effects on cognitive deficit that could be explained as fully deriving from emotional and extra-cognitive responses to environmental changes.

Aged↗
PubMed1996

Prodromal symptoms in obsessive-compulsive disorder.

Prodromal symptoms were investigated in 30 patients with obsessive-compulsive disorder. The large majority of patients (93%) reported at least one prodromal symptom before disease onset. Generalized anxiety, irritability, indecision, phobic and somatic anxiety occurred in about half of patients. Also common were depressive symptoms such as fatigue, lowered self-esteem, depressed mood, pessimism, impaired work, and guilt. The results suggest a close association of obsessions and compulsions with affective symptoms.

Adult↗
PubMed1996

Four-year outcome for cognitive behavioral treatment of residual symptoms in major depression.

OBJECTIVE: The authors' goal was to determine whether cognitive behavioral treatment of residual symptoms of depression might have a significant effect on relapse rate. METHOD: In an earlier study, 40 patients with primary major depressive disorder who had been successfully treated with antidepressant drugs were randomly assigned to either cognitive behavioral treatment of residual symptoms or standard clinical management. In both types of treatment, antidepressant drugs were gradually tapered and discontinued. In this study, a 4-year follow-up assessment was performed. RESULTS: Cognitive behavioral treatment resulted in a substantially lower relapse rate (35%) than did clinical management (70%). CONCLUSIONS: Cognitive behavioral treatment of residual symptoms reduces the risk of relapse in depressed patients, probably by affecting the progression of residual symptoms to prodromes of relapse.

Antidepressive Agents↗
PubMed1994

Cognitive behavioral treatment of residual symptoms in primary major depressive disorder.

OBJECTIVE: Cognitive behavioral treatment has been used extensively in the acute phase of depression. The purpose of this study was to determine the applicability and effectiveness of this treatment modality in addressing the residual symptoms of primary major depressive illness. METHOD: The subjects were 40 patients with major depressive disorder who were successfully treated with antidepressant drugs. They were then randomly assigned to either cognitive behavioral treatment or clinical management of residual symptoms. In both subgroups, antidepressant drugs were tapered and discontinued. RESULTS: The group that received cognitive behavioral treatment had a significantly lower level of residual symptoms after drug discontinuation in comparison with the clinical management group. Cognitive behavioral treatment also resulted in a lower rate of relapse (15%) at a 2-year follow-up than did clinical management (35%), although this difference did not reach statistical significance. Most of the residual symptoms were found to have occurred also in the prodromal phase of illness. CONCLUSIONS: This preliminary study points to the potential clinical advantages of cognitive behavioral treatment targeted to the residual symptoms of depression.

Adult↗
PubMed1992

Prodromal symptoms in panic disorder with agoraphobia: a replication study.

The majority of 20 patients suffering from panic disorder with agoraphobia reported experiencing agoraphobic avoidance, generalized anxiety, and/or hypochondriacal fears and beliefs before the first panic attack. The results replicated those of a previous investigation and are in accordance with an increasing number of studies concerned with prodromal symptoms, epidemiologic surveys, and analysis of mechanisms of change upon treatment.

Adolescent↗
PubMed1990

Prodromal symptoms in primary major depressive disorder.

Prodromal symptomatology was investigated, by means of a modified version of Paykel's Clinical Interview for Depression, in 15 outpatients at their first episode of primary major depressive disorder. Compared to normals, generalized anxiety and irritability were significantly more frequent. Impaired work and interests, fatigue, initial and delayed insomnia were also reported. Four patients who relapsed upon discontinuation of antidepressant treatment displayed the same prodromal symptomatology as in the initial episode.

Adult↗
PubMed1989

Treatment of social phobia by homework exposure.

Ten consecutive patients suffering from DSM-III-R social phobia were treated by homework exposure assignments, without therapist-aided exposure or other cognitive-behavioral methods. The 7 patients who completed therapy displayed highly significant decreases in social phobic symptoms and anxiety. Such improvements were maintained on a 1-year follow-up.

Adult↗
PubMed1988

Obsessive-compulsive symptoms in agoraphobia: changes with treatment.

Ten patients suffering from agoraphobia with panic attacks reported significantly more obsessive-compulsive symptoms on the Comprehensive Psychopathological Rating Scale and Marks' Compulsion Checklist than healthy control subjects matched to the patients on sociodemographic variables. Behavioral treatment directed toward agoraphobia was associated with significant improvement in obsessive-compulsive complaints. On retesting, there were no significant differences in such symptoms between patients and controls. The results should alert the physician to inquire about the presence of agoraphobia in patients complaining of obsessive-compulsive disturbances.

Adult↗
PubMed1988

Prodromal symptoms in panic disorder with agoraphobia.

Of 20 patients suffering from panic disorder with agoraphobia, 18 reported experiencing agoraphobic avoidance, generalized anxiety, and/or hypochondriacal fears and beliefs before the first panic attack. The prevalence of these symptoms in the patients was significantly higher than the prevalence in 20 healthy control subjects. The results indicate that phobic avoidance in panic disorder with agoraphobia may not be secondary to the panic attacks, a finding that runs counter to the current DSM-III-R classification of anxiety disorders.

Adult↗
PubMed1987

A psychosomatic outpatient clinic.

Current emphasis in clinical psychosomatic medicine is on psychiatric interventions in acute medical and surgical situations (consultation-liaison psychiatry and medical-psychiatric units). Little interest has been taken in psychosomatic interventions in chronic situations and outpatient settings. The functioning of a psychosomatic outpatient clinic (POC) is described. One-hundred consecutive referrals were analyzed. The most frequent diagnostic finding--according to DSM III criteria--was subsumed under the rubric of "psychological factors affecting physical condition," followed by affective illness, anxiety disturbances, and somatoform disorders. The results indicate that a POC may serve a specific and definable segment of patients, whose characteristics depart from the clinical populations in consultation-liaison psychiatry and medical-psychiatric units.

Adult↗