PubMed Health⌕ Search

Biomedical subjects

Roberto Tatarelli

Publications and source records attributed to Roberto Tatarelli.

At least 19 recordsLinked to original sources
PubMed2006

Incomplete oedipism and chronic suicidality in psychotic depression with paranoid delusions related to eyes.

Self-enucleation or oedipism is a term used to describe self-inflicted enucleation. It is a rare form of self-mutilation, found mainly in acutely psychotic patients. We propose the term incomplete oedipism to describe patients who deliberately and severely mutilate their eyes without proper enucleation. We report the case of a 32-year-old male patient with a five-year history of psychotic depression accompanied by paranoid delusions centered around his belief that his neighbors criticized him and stared at him. A central feature of his clinical picture was an eye injury that the patient had caused by pouring molten lead into his right eye during a period of deep hopelessness and suicidality when the patient could not resolve his anhedonia and social isolation. Pharmacotherapy and psychotherapy dramatically improved his disorder.

Journal Article↗
PubMed2006

Death from suicide versus mortality from epilepsy in the epilepsies: a meta-analysis.

OBJECTIVE: Epilepsy is associated with an increased risk of mortality, which, however, is rarely due to the epilepsy itself; suicide, on the other hand, is a chief cause of death among persons with epilepsy. We conducted a meta-analysis to compare data reported in representative studies of suicide mortality in epilepsy with data on mortality from epilepsy in the general population. METHODS: We searched Index Medicus to 2006 through MedLine. We also searched the World Health Statistics Annual to ascertain rates of mortality from epilepsy in the age groups indicated in the studies on patients with epilepsy for specific years and countries. RESULTS: We selected 30 studies comprising 51,216 persons, 188 of whom committed suicide and died. Results obtained for each study were processed together to calculate, per 100,000 individuals in the general population per year, the mean number of suicide deaths expected in persons with epilepsy with respect to the current prevalence of epilepsy. We found that the number of suicide deaths among persons with epilepsy is the same as the number of deaths from epilepsy, suggesting that the former are not included in mortality rates for epilepsy. Also, we found that, according to data derived from cohorts we selected, 32.5% of all deaths of persons with epilepsy are due to suicide and at least 13.5% of all registered suicides are committed by these persons. Study findings may not generalize to other samples, settings, and treatments, thus perhaps tending to exaggerate the phenomenon actually attainable under broader clinical conditions. CONCLUSIONS: Our meta-analysis indicates that suicide deaths in persons with epilepsy are a disturbingly frequent phenomenon that should be addressed to reduce mortality among patients with epilepsy dramatically. In particular, mortality rates for persons with epilepsy do not include mortality from suicide, greatly underestimating death rates and the need for suicide prevention strategies for these patients.

Epilepsy↗
PubMed2006

Endogenous and exogenous cyclicity and temperament in bipolar disorder: review, new data and hypotheses.

In this special issue dedicated to Falret and the French contributions to the concept of cyclicity in manic depressive illness, we begin with a historical overview of the development of the concept of cyclicity and its fundamental significance in manic-depressive illness and we underscore how the concept fell into neglect only to reemerge in recent years. We then look at the intimate relationship between mania and depression. The hypothesis of the primacy of mania is discussed. The thesis is presented, supported by the examination of 100 consecutive index manias, that in most cases mania is triggered by external factors acting upon hyperthymic patients, determining an exogenous cyclicity. On the other hand, in BPII patients the temperamental mood instability (cyclothymia) is an inherent and decisive factor in determining the cyclic autonomous course of the disorder. Finally, a new distinction of Bipolar Disorders, based on premorbid temperament and course of the illness, is considered.

Bipolar Disorder↗
PubMed2006

Suicide soon after generalized tonic-clonic seizure. A possible peri-ictal phenomenon?

We report the case of 36-year-old woman who had suffered from focal-unilateral right febrile grand mal since she was 9 months old as a result of neonatal asphyxia. Over the years, a modification of the clinical picture occurred and eventually the patient suffered from paranoid delusions that impaired her ability to work. After many years free from seizures, she experienced one day a generalized tonic-clonic seizure that required hospitalization and, soon thereafter, she committed suicide.

Epilepsy, Tonic-Clonic↗
PubMed2006

Suicide and attempted suicide in eating disorders, obesity and weight-image concern.

Suicide in anorexia nervosa and bulimia nervosa is a major cause of death. Meta-analyses have shown that individuals suffering from anorexia nervosa and bulimia nervosa commit suicide more often than their counterparts in the general population; also a few studies have suggested that suicide is the major cause of death among patients with anorexia nervosa, refuting the assumption that inanition generally threatens the life of these patients. Data concerning suicide in bulimia nervosa, on the other hand, are still scarce but suicide attempts are easily found among cohorts of patients with bulimia nervosa, which constitutes a risk factor for completed suicide. Suicidality in obesity and individuals with disturbed weight status has been reported. Both in the case of bulimia nervosa and obesity more long-term follow-up studies need to be completed before the risk of suicide for such disorders may be compared with that for anorexia nervosa.

Anorexia Nervosa↗
PubMed2006

Hopelessness and suicide risk emerge in psychiatric nurses suffering from burnout and using specific defense mechanisms.

Burnout in psychiatric nurses is a phenomenon of great concern. We conducted an investigation of 120 nurses working in the psychiatric, general medicine/rehabilitation, and critical care/surgery wards to explore the correlations of level of burnout and defense mechanisms with hopelessness. The nurses were administered the Maslach Burnout Inventory, Gleser and Ihilevich's Defense Mechanisms Inventory, and Beck's Hopelessness Scale. The results indicate that burnout and some of the defense mechanisms predicted the level of hopelessness -- a predictor of suicide risk.

Adaptation, Psychological↗
PubMed2006

Suicidal intent in single-car accident drivers: Review and new preliminary findings.

This study addressed the issue of a possible link between single-car accident drivers and suicidal intent. In the international literature this topic has generated both positive and negative results. Some authors have stressed unconscious suicidal motivations in various single accidents. Nevertheless, refutation of such theory was demonstrated through experimental studies. We selected 30 single-car accident drivers who had been admitted to emergency departments and then hospitalized for an average period of 10 days. We administered the Reason for Living Inventory (RFL) and investigated their attitudes toward suicide. We also matched these patients with a control group of drivers who had never had a car accident. Results showed that single-car accident drivers were not exposed to a higher overall suicidal risk, though they reported a higher risk on the RFL Survival and Coping Beliefs subscale and often expressed tiredness of being alive. These patients had experienced more life events than controls. We conclude that, although suicide risk was low in our patients, they were engaged in looking for a solution to their problems in which the accident played a role in such a process. This behavior has some characteristics of the logic of suicidal individuals.

Accidents, Traffic↗
PubMed2006

Health-related quality of life in myotonic dystrophy type 1 and its relationship with cognitive and emotional functioning.

OBJECTIVE: To evaluate the health-related quality of life in myotonic dystrophy type 1 and its relationships with clinical, genetic, neuropsychological and emotional factors. DESIGN: Case-control study of a continuous series of patients with myotonic dystrophy type 1. PATIENTS AND METHODS: Twenty patients, and 20 age-, sex- and education-matched healthy controls underwent the MOS 36-Item Short-Form Health Survey (SF-36), an extensive neuropsychological battery and emotional functioning tests. RESULTS: Patients' SF-36 mean scores were lower than those of controls in all dimensions. The neuropsychological study showed a significant impairment in visuospatial and verbal abstract reasoning (p=0.001), visuospatial memory (p=0.002) and attentive functions (p=0.03) in patients with myotonic dystrophy type 1. The emotional assessment showed significantly high scores in anxiety (p=0.002) and depression (p=0.001), which occurred in approximately 50% of patients. Both physical and mental SF-36 areas were inversely correlated with age, duration and grade of disease, depression and anxiety and positively correlated with attentive control. SF-36 areas were not correlated with cytosine thymine guanidine expansion. CONCLUSION: Health-related quality of life is severely impaired in myotonic dystrophy type 1 and it is negatively influenced by severity and duration of disease as well as by specific cognitive deficits and changes in emotional functioning. Therapeutic intervention in this field could contribute to ameliorate health-related quality of life in myotonic dystrophy type 1.

Adaptation, Psychological↗
PubMed2006

Suicidal behavior in surviving co-twins.

Recent research has provided strong support for the existence of a familial risk for suicide, and efforts have been made to separate genetic from enviromental risk factors. Twin studies have played a major role in the identification of genetic factors, and the results indicate that the concordance rate for suicide is higher in identical than in fraternal twins (Baldessarini & Hennen, 2004). Moreover, Segal and Roy (1995) reported a significantly higher frequency of nonfatal suicidal attempts by monozygotic (MZ) than by dyzygotic (DZ) twins whose co-twins had committed suicide. However, doubts remain as to whether the increased risk of suicide in MZ twins is a response to the intense grief over the loss of a close relative, or whether a common genotype is associated with suicidal behavior. Sudden loss, which may carry a stigma in the case of a suicide, has been linked to increased persistent emotional stress and physiological changes (Epstein, 1993; Martin & Dean, 1993). A number of researchers have reported greater suicidal ideation among bereaved MZ twins as compared to DZ twins, suggesting that a loss due to suicide may increase the risk of suicidal behavior in the surviving co-twin (Segal & Bouchard, 1993; Segal & Roy, 1995; Segal et al., 1995). The aim of the present article is to address the issue of the intense grief experienced by twins after the co-twin suicide.

Genetics, Behavioral↗
PubMed2006

Treatment choice and psychometric characteristics: differences between patients who choose bariatric surgical treatment and those who do not.

BACKGROUND: Among the treatment options offered to patients with severe obesity are surgery and psychotherapy plus dieting. The treatment choice may reflect differences in the psychology of these patients. The objective was to assess the psychopathological differences between patients with obesity who choose surgery and those who choose non-surgical treatment to lose weight. METHODS: 100 patients with obesity (50 in the non-surgical group [NS]; and 50 in the surgical group [S]; 41 women and 9 men in each group) completed the MMPI-2 and the EDI-2; for the latter, data from 21 S and 24 NS women were available. Comparisons were carried out through analysis of variance. RESULTS: The NS group scored higher on the Pa (paranoia) and Pt (psychasthenia) scales of the MMPI-2 compared to the S group. No differences were found on the EDI-2; however, both groups scored higher on the drive-for-thinness and body-dissatisfaction scales, and the NS group scored higher on the bulimia and ineffectiveness scales. CONCLUSION: The MMPI-2 was able to distinguish between the NS and S groups, while the EDI-2 found significant eating-related psychopathology in both.

Adult↗
PubMed2006

Sex differences in reasons for living.

An analysis of responses by 837 Italian undergraduate students to the Reasons For Living Inventory indicated women scored higher but less consistently than in previous research on American undergraduates.

Adult↗
PubMed2006

Suicide after surgical treatment in patients with epilepsy: a meta-analytic investigation.

Suicide is a major issue in surgically treated epileptic patients. A meta-analysis was performed comparing suicides in a sample of such patients and in the general population. The Index Medicus and the World Health Statistics Annual were searched to ascertain the suicide rates in the age groups indicated in the studies of epileptic patients for specific years and country. 11 studies were selected, comprising 2,425 patients, 24 of whom committed suicide. Data obtained for each study were processed together to calculate the mean number of suicides per 100,000 individuals with surgically treated epilepsy for each year. This meta-analysis shows that suicide in patients with epilepsy after surgical treatment is more frequent than in the general population. Results are discussed with particular attention to possible causative factors.

Adolescent↗
PubMed2005

Suicide in the epilepsies: a meta-analytic investigation of 29 cohorts.

OBJECTIVES: Suicide in epilepsy is a major cause of death and is very often underestimated. We conducted a meta-analysis to compare data reported in representative studies of suicide in epilepsy with data for the general population. METHODS: We searched the Index Medicus until 2005 through MedLine. We also searched the World Health Statistics Annual to ascertain the suicide rates in the age groups indicated in the studies on epileptic patients for specific years and country. RESULTS: We selected 29 studies comprising 50,814 patients, 187 of whom committed suicide. Results obtained for each study were processed together to calculate the mean number of suicides per 100,000 individuals suffering from epilepsy for each year. CONCLUSIONS: Our meta-analysis shows that suicide in patients with epilepsy is more frequent than in the general population. Nevertheless, a number of cohorts of epileptic patients had a suicide rate lower than that of the general population. Possible explanations for this heterogeneous trend and risk factors are discussed.

Cohort Studies↗
PubMed2005

Suicide in borderline personality disorder: a meta-analysis.

Suicide is the major cause of death among patients with borderline personality disorder; however, the literature on completed suicides in such disorder is inconclusive, as suicide rates vary greatly among cohorts of patients. We searched MedLine, Excerpta Medica and PsycLit from 1980 to 2005 to identify papers dealing with suicide in borderline personality disorder. We also searched the World Health Statistics Annual to ascertain the suicide rate in the age groups for specific years and country. We selected eight studies comprising 1179 patients with a diagnosis of borderline personality disorder. Of these patients, 94 committed suicide. Results obtained for each study were processed together to calculate the mean figure for each year of suicides for 100,000 individuals suffering from borderline personality disorder. Our meta-analysis shows that suicide among patients with borderline personality disorder is more frequent when compared with the general population. All study analyses reported that patients with borderline personality disorder committed suicide more often than their counterparts in the general population. Suicide seems more alarming in the first phases of follow-up than during chronic phases of illness.

Borderline Personality Disorder↗
PubMed2005

Emergency staff reactions to suicidal and self-harming patients.

Staff in the emergency departments of hospitals are reported as being negative or ambivalent toward suicidal or self-harming individuals. According to the literature, these patients are subjected to stigmatization and lack of empathy. This phenomenon has been linked to a decreased quality of care offered to these individuals and to missing an important opportunity to prevent further suicidal behavior or repetition of deliberate self-harm. Also, protocols, proper guidelines and education for the emergency staff call for a revision and an implementation. In this paper, evidence suggesting staff attitudes toward suicidal and self-harming patients is reviewed. An overview of related issues such as clinical judgment, the use of scales and nurses' role is also included in this report.

Attitude of Health Personnel↗