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Biomedical subjects

V Molinari

Publications and source records attributed to V Molinari.

At least 37 records · Page 2Linked to original sources
PubMed1997

Tolerability of clonazepam in demented and non-demented geropsychiatric patients.

OBJECTIVE: The tolerability of clonazepam in geropsychiatric inpatients was examined in patients with and without a diagnosis of dementia. DESIGN: Forward-looking retrospective study comprising consecutive patients placed on clonazepam. SETTING: A geropsychiatry unit of a large Veterans Affairs Medical Center. PATIENTS: All geropsychiatry inpatients placed on clonazepam over a 21-month period of time. MEASURE: Mini-Mental State Examination, Brief Psychiatric Rating Scale, Cohen-Mansfield Agitation Inventory and the Rating Scale for Side Effects were performed at admission and discharge as part of an ongoing database. RESULTS: Twenty-four geropsychiatric inpatients were treated with clonazepam (mean dose of 1.2 mg for a minimum of 2 weeks) during the 21 months studies. About one half of the patients had a primary diagnosis of dementia and the remainder had a diagnosis of an affective or psychotic disorder. Two of these patients were discontinued because they had responded to the acute need for clonazepam and a third patient was discontinued because of the development of sedation and confusion. For the remaining 21 patients, scores improved significantly on the Brief Psychiatric Rating Scale (p = 0.017), the Cohen-Mansfield Agitation Inventory (p = 0.011), the Rating Scale for Side Effects (0.004) and the Global Assessment of Functioning (p < 0.000), with no differences in amount of improvement between demented and non-demented patient groups. Scores on the Mini-Mental State Examination remained unchanged. CONCLUSIONS: Clonazepam shows promise as a benzodiazepine with good tolerability in the elderly.

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PubMed1996

The benefits of psychiatric hospitalization for older nursing home residents.

OBJECTIVE: To examine the demographic characteristics and treatment outcomes of nursing home residents admitted to a geropsychiatric inpatient unit. DESIGN: A retrospective cohort design based on an ongoing data base effort. SETTING: The geropsychiatric inpatient unit of the Houston Veterans Affairs Medical Center Hospital. PARTICIPANTS: All admissions to the unit from nursing homes during an 18-month period. MEASUREMENTS: Mini-Mental State Examination, Brief Psychiatric Rating Scale, Hamilton Rating Scale for Depression, Cohen-Mansfield Agitation Inventory, Rating Scale for Side Effects, and Global Assessment of Functioning were administered on admission and discharge. RESULTS: Paired t tests comparing change scores revealed significant decreases in general psychiatric symptoms (P < .001), depression (P < .001), and agitation (P < .001); significant improvement in global functioning (P < .001); with no significant changes in cognitive status (P = .485) or side effects (P = .120). When the patients were subgrouped according to reasons for admission, paired t tests revealed decreases in violence (CMAI Factor 1; P = .000), psychosis (BPRS thought disorder scale; P = .000 and hostility subscale; P < .008), and depression (HAM-D; P = .002). Four patients were discharged to less restrictive environments, all with chronic mental illnesses. CONCLUSION: Inpatient psychiatric hospitalization significantly benefits nursing home residents with and without dementia who are admitted for severe behavior problems.

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PubMed1996

The use and tolerability of fluoxetine in geropsychiatric inpatients.

BACKGROUND: The efficacy and tolerability of fluoxetine were examined in 31 patients admitted to a geropsychiatric inpatient unit who were initiated and maintained on a regimen of fluoxetine. METHOD: The Hamilton Rating Scale for Depression, the Brief Psychiatric Rating Scale, the Mini-Mental State Examination, and the Rating Scale for Side Effects were administered at admission and discharge, and scores were compared using paired t tests. Two patients were withdrawn from fluoxetine prior to discharge because of side effects; their data are not included in the analysis. RESULTS: We found significant improvement both in depressive symptoms and in general psychiatric symptoms and nonsignificant improvement in cognitive function. Fluoxetine was well-tolerated, and a significant decrease in the total scores of the Rating Scale for Side Effects was found. Subgroups of older patients (mean age = 75 years), less depressed patients, and demented patients were also examined. In all three groups, we found a statistically significant improvement in depressive symptoms, general psychiatric symptoms, and total side effects. CONCLUSION: Fluoxetine appears to be an effective and well-tolerated antidepressant in elderly inpatients of varying age, levels of depression, and psychiatric diagnoses.

Age Factors↗
PubMed1995

Relationship between affective disorders and Axis II diagnoses in geropsychiatric patients.

Twenty-four geropsychiatric outpatients and 52 inpatients diagnosed with affective disorders (ADs) via psychiatric evaluation were administered the Structured Interview for Disorders of Personality-Revised (SIDP-R). A chart review yielded 1-year relapse rates for the inpatient sample. Data indicate a 63% personality disorder prevalence rate for the total sample, and a 21% relapse rate for inpatients. No significant differences were found in PD rates between elderly depressed and bipolar patients, and there were no differences in relapse rates for those with and without PDs. Results were discussed in relation to the sizable frequency of PDs in this elderly sample of ADs, the possible effects of severe depression on the personality ratings of older adults, and the differential prognostic value of PDs for geropsychiatric inpatients versus outpatients.

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PubMed1993

Personality disorders in geropsychiatric outpatients.

36 geropsychiatric outpatients were administered a semistructured personality disorder interview derived from DSM-III criteria. Over half (58%) of this elderly sample met criteria for diagnoses of personality disorders, which have been shown to significantly affect treatment of Axis I symptomatology in young adults. Compared to a young adult outpatient sample of 298, older patients had significantly fewer disorders and multiple ones. The greater number of diagnoses yielded by the interview versus clinical evaluation approached statistical significance.

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PubMed1985

The prevalence of tardive dyskinesia in geropsychiatric outpatients.

The prevalence of tardive dyskinesia was studied in a geropsychiatric outpatient clinic. All currently active patients were examined using the Abnormal Involuntary Movement Scale (AIMS) and a standardized procedure. Data were collected on a number of previously reported risk factors. A higher prevalence was noted in both tardive dyskinesia and spontaneous involuntary movement disorders in this patient population. Only sex and duration of exposure to antipsychotic drugs were noted to be significant risk factors.

Aged↗
PubMed1983

The classification of paranoid disorders in the elderly: a clinical problem.

Data on the incidence of Paranoid Disorders according to modified DSM-III criteria in an outpatient geriatric clinic are presented. Results are consistent with previous research data which find paranoid symptomatology to be common in elderly psychiatric patients. The current definition of paranoid disorders is too narrow to encompass those elderly with good premorbid adjustment whose later life paranoid disorders often include hallucinations. The DSM-III paranoid subtype system does not have a separate category for chronic paranoid symptomatology which, although commonly seen in the old, is now subsumed under an atypical paranoid disorder classification. Further research into late life psychopathology may provide refinement of other diagnostic categories and a better understanding of the developmental relationship between personality disorder and major psychopathology.

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PubMed1981

Locus of control and its relationship to anxiety and depression.

This study proposed that the low-order-correlations reported in the literature between externality and two indices of pathology would be heightened if the externality construct was differentiated into defensive and congruent externality. Defensive externals, who have low expectations of success in achieving valued goals and adopt external beliefs as a defense against feelings of personal failure, should be prone to anxiety; congruent externals, with their sincere belief that reinforcement is not contingent upon their own behavior, fit into the "learned helplessness" paradigm and should become depressed. Sixty male and female college undergraduates were selected as Internal, Defensive External, and Congruent External subjects on the basis of their scores on Levenson's Internal, Powerful Others, and Chance scales, and administered the Self-rating Depression Scale and the Achievement Anxiety Test. Results of the study are equivocal. Congruent externality does manifest a significant positive correlation with depression, but this correlation is low. Defensive externality is significantly positively correlated with debilitating anxiety, but the correlation is greater for congruent externality. Internality is significantly negatively correlated with both depression and debilitating anxiety.

Adult↗
PubMed1981

Super-obesity: a psychiatric profile of patients electing gastric stapling for the treatment of morbid obesity.

This is a preliminary report designed to identify personality characteristics which are unique to those super-obese electing a surgical intervention for weight loss. We have laid the groundwork to determine prognostic signs for the success or failure of the gastric stapling surgical technique for the treatment of morbid obesity, Self-report rating scales, demographic data forms, and MMPI's were administered to super-obese subjects and psychiatric consultations performed preoperatively and at various intervals postoperatively. Patients report satisfaction with their weight loss and few physical or psychological complications in the immediate post-op period. The MMPI and psychiatric consultations identify fairly high levels of psychopathology in this group. An aggregate psychiatric profile of the female and male morbidly obese patient is discussed.

Adult↗