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2.
J Affect Disord Rep ; 3: 100067, 2021 Jan.
Article in English | MEDLINE | ID: mdl-35434690

ABSTRACT

Introduction: The need for "social distancing" to reduce the spread of Covid-19 is accompanied by an increase of social media use (SMU). Many people engage in intensive online activity to find information about the current Covid-19 situation and to interact about it with other users. The present study investigated the extent of SMU as Covid-19 information source and its relationship with stress symptoms and burden caused by the pandemic in Germany and Italy. Methods: Cross-national longitudinal (Germany, N = 501; 3-months period) and cross-sectional (Italy, N = 951) data on Covid-19 information sources, stress symptoms and burden caused by Covid-19 were collected via online surveys. Results: About 50% of the German sample and about 60% of the Italian sample frequently used SM as Covid-19 information source. Cross-sectional analyses in both countries revealed that SMU is positively associated with stress symptoms and experienced burden. Moreover, stress symptoms mediated the link between SMU and burden. This was also confirmed by longitudinal analyses in Germany (burden assessed three months after SMU and stress symptoms). Limitations: The mostly female and relatively young sample composition limits the generalizability of present findings. Only two European countries were investigated. Conclusions: The present findings reveal a potential negative impact of enhanced SMU on individual mental health state and behavior. Additionally, they emphasize the significance of a conscious and cautious use of SM as information source specifically during the pandemic.

3.
J Affect Disord ; 249: 226-233, 2019 Apr 15.
Article in English | MEDLINE | ID: mdl-30776664

ABSTRACT

BACKGROUND: The Mental Pain Questionnaire (MPQ) is a self-report questionnaire developed to assess mental pain. The aim of the present study was to test the clinimetric properties of the MPQ. METHODS: A sample of 200 migraine outpatients were enrolled; homogeneity of MPQ was assessed by Mokken Analysis; item-level severity and item-level sensitivity were calculated via Two-Parameter Logistic model; Total Information Function was evaluated to assess reliability of MPQ; internal consistency was calculated via Cronbach's alpha and Sijtsma and Molenaar rho; sensitivity and specificity were assessed via Receiver Operating Characteristic curves. RESULTS: The MPQ showed unidimensional factor structure; satisfactory homogeneity of the item and total score, except items 4 ("my pain is everywhere") and 6 ("I cannot understand why I feel this pain"); good discrimination, except item 7 ("I feel empty"); low information provided by items 4, 6, 7; good reliability for mild and high levels of mental pain; poor reliability for low levels of mental pain; acceptable internal consistency; acceptable sensitivity and specificity. LIMITATIONS: The sample size is barely sufficient to calculate item parameters; it is a monocentric study that enrolled outpatients from a tertiary facility; the study enrolled migraine outpatients not affected by other medical disease. CONCLUSIONS: The MPQ showed good psychometric properties. Items 4, 6, 7 should be considered with caution when migraine patients are evaluated. A score of at least 3 indicates mental pain clinically relevant, a score of at least 2 indicates distress. These data are preliminary and refer to migraine patients, results might be different in psychiatric populations.


Subject(s)
Migraine Disorders/diagnosis , Pain Measurement/standards , Pain/psychology , Surveys and Questionnaires/standards , Adult , Aged , Female , Humans , Male , Middle Aged , Models, Statistical , Patient Reported Outcome Measures , Psychometrics , Reproducibility of Results , Self Report , Sensitivity and Specificity
4.
Compr Psychiatry ; 69: 211-5, 2016 Aug.
Article in English | MEDLINE | ID: mdl-27423363

ABSTRACT

OBJECTIVE: The use of benzodiazepines (BDZs) represents a critical issue since a long-term treatment may lead to dependence. This study aimed at evaluating socio-demographic and clinical characteristics of BZD long-term users who followed a detoxification program at a tertiary care center. METHOD: Two hundred-five inpatients were evaluated. Socio-demographic (e.g., gender, age, education) and clinical information (e.g., BZD used, dose, reason of prescription) was collected. BZDs dose was standardized as diazepam dose equivalents and was compared via the Defined Daily Dose (DDD). Chi-square, Fisher test, ANOVA and Bonferroni analyses were performed. RESULTS: Females were more frequently BDZ long-term users than males. Hypnotic BZDs were frequently prescribed for problems different from sleep disturbances. Lorazepam, alprazolam, and lormetazepam were the most prescribed drugs. Lorazepam was more frequently used by males, consumed for a long period, in pills, and prescribed for anxiety. Lormetazepam was more frequently consumed by females with a high school education, having a psychiatric disorder, taken in drops and prescribed for insomnia. Lormetazepam had the highest DDD. CONCLUSION: A specific profile of BZD long-term user seems to exist and presents different socio-demographic and clinical characteristics according to the benzodiazepine taken into account.


Subject(s)
Benzodiazepines/adverse effects , Benzodiazepines/therapeutic use , Long-Term Care , Substance-Related Disorders/psychology , Substance-Related Disorders/rehabilitation , Adult , Anxiety Disorders/drug therapy , Anxiety Disorders/psychology , Dose-Response Relationship, Drug , Female , Humans , Lorazepam/analogs & derivatives , Lorazepam/therapeutic use , Male , Middle Aged , Sleep Initiation and Maintenance Disorders/drug therapy , Sleep Initiation and Maintenance Disorders/psychology , Substance-Related Disorders/diagnosis , Tertiary Care Centers
7.
Clin Psychol Rev ; 31(3): 418-27, 2011 Apr.
Article in English | MEDLINE | ID: mdl-21122963

ABSTRACT

The introduction of "dual diagnosis" had the merit of drawing attention on substance use among patients with mental illness. In due course, as what often happens with innovations, the concept of dual diagnosis displayed considerable limitations and was progressively replaced by comorbidity. This paper critically reviews the limitations of dual diagnosis and comorbidity and formulates an alternative proposal based on clinimetric methods. In many instances of diagnostic reasoning in psychiatry and in clinical psychology, the process ends with the identification of the disorders and their diagnoses. However, diagnostic end-points, the customary guidance of diagnostic reasoning, should be replaced by the conceptualization of disorders as "transfer stations," which are amenable to longitudinal verification and modification. Indeed, diagnoses might encompass a wide range of manifestations, seriousness, prognosis, and response to treatment that need to be evaluated. A new clinimetric approach which takes advantage of clinimetric methods (including macro-analysis, micro-analysis, staging, and evaluation of subclinical symptoms) is proposed. This approach may allow an accurate analysis of the different problem areas of each patient and their hierarchical organization and may yield important implications for mental health and substance abuse clinics.


Subject(s)
Mental Disorders/diagnosis , Substance-Related Disorders/diagnosis , Comorbidity , Diagnosis, Dual (Psychiatry) , Humans , Mental Disorders/epidemiology , Mental Health , Psychiatric Status Rating Scales , Substance-Related Disorders/epidemiology
8.
Psychother Psychosom ; 75(6): 376-83, 2006.
Article in English | MEDLINE | ID: mdl-17053339

ABSTRACT

BACKGROUND: It is speculated that clinical samples do not fully reflect the characteristics of eating disorders (EDs) as they are in the general population, especially in their lowest range of severity. The present article reports the prevalence of EDs in a community sample aged >14 years, their clinical and psychopathological features, and their course and outcome on naturalistic grounds. METHODS: The Sesto Fiorentino Study is a three-phase community-based survey where 2,355 out of 2,500 people representative of the population aged >14 years living in Sesto Fiorentino were evaluated by their own general practitioner using the Mini International Neuropsychiatric Interview plus six additional questions. All those who had positive results plus a probability sample of the non-cases were re-interviewed by psychiatrists using the Florence Psychiatric Interview. The subjects who reported ED symptoms were subsequently administered the Eating Disorder Examination (12th edition). RESULTS: Overall, the lifetime prevalence of EDs was 1.21%. More precisely, 0.42% had anorexia nervosa, 0.32% bulimia nervosa, 0.32% binge eating disorder and 0.32% eating disorder not otherwise specified. All the subjects suffering from an ED fulfilled diagnostic criteria for at least another DSM-IV axis I psychiatric disorder. At the moment of the interview, conducted a few years (average 7 years) after the onset of the disorder, 50% had fully recovered from EDs, 26.9% were currently affected by an ED, 23.1% showed a persistent body image disturbance and/or the presence of compensatory behaviours. CONCLUSIONS: Community surveys conducted by clinicians may provide useful additional information on the psychopathological features, natural course and outcome of these disorders on naturalistic grounds.


Subject(s)
Feeding and Eating Disorders/epidemiology , Adolescent , Anthropometry , Body Mass Index , Catchment Area, Health , Diagnostic and Statistical Manual of Mental Disorders , Drug Therapy , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/therapy , Humans , Italy/epidemiology , Prevalence , Psychotherapy , Severity of Illness Index , Somatoform Disorders/epidemiology , Somatoform Disorders/psychology , Surveys and Questionnaires , Treatment Outcome
9.
Eur Psychiatry ; 20(3): 299-303, 2005 May.
Article in English | MEDLINE | ID: mdl-15935432

ABSTRACT

UNLABELLED: Alcohol and panic disorders co-occur at a rate that exceeds chance significantly. Early experimental work suggests that alcoholic subjects, compared to non-alcoholics, are less sensitive to sodium lactate and that alcohol intake reduces the response to a 35% CO(2) challenge in Panic Disorder patients. The present study documents the direct pharmacological effect of ethanol infusion on CO(2) induced panic. METHODS: According to a placebo-controlled, double-blind, randomized, cross-over design 10 drug free panic disorder patients and 16 healthy volunteers underwent a 35% CO(2) challenge after intravenous infusion of a moderate dose of ethanol on one test day and of placebo on another test day. RESULTS: Compared to the placebo condition, the effect of the CO(2) challenge was significantly smaller after ethanol infusion (P = 0.041). DISCUSSION: A moderate dose of ethanol decreased the response to a 35% CO(2) without inducing pre challenge sedation. CONCLUSION: The results comfort earlier findings of a direct pharmacological effect of ethanol on panic.


Subject(s)
Carbon Dioxide/adverse effects , Ethanol/adverse effects , Health Status , Panic Disorder/chemically induced , Panic Disorder/diagnosis , Adult , Carbon Dioxide/administration & dosage , Cross-Over Studies , Dose-Response Relationship, Drug , Double-Blind Method , Ethanol/administration & dosage , Female , Humans , Injections, Intravenous , Male
10.
Eur Neuropsychopharmacol ; 15(4): 435-43, 2005 Aug.
Article in English | MEDLINE | ID: mdl-15925492

ABSTRACT

A literature search, in addition to expert survey, was performed to estimate the size and burden of panic disorder in the European Union (EU). Epidemiologic data from EU countries were critically reviewed to determine the consistency of prevalence estimates across studies and to identify the most pressing questions for future research. A comprehensive literature search focusing on epidemiological studies in community and clinical settings in European countries since 1980 was conducted (Medline, Web of Science, Psychinfo). Only studies using established diagnostic instruments on the basis of DSM-III-R or DSM-IV, or ICD-10 were considered. Thirteen studies from a total of 14 countries were identified. Epidemiological findings are relatively consistent across the EU. The 12-month prevalence of panic disorder and agoraphobia without history of panic were estimated to be 1.8% (0.7-2.2) and 1.3% (0.7-2.0) respectively across studies. Rates are twice as high in females and age of first onset for both disorders is in adolescence or early adulthood. In addition to comorbidity with agoraphobia, panic disorder is strongly associated with other anxiety disorders, and a wide range of somatoform, affective and substance use disorders. Even subclinical forms of panic disorder (i.e., panic attacks) are associated with substantial distress, psychiatric comorbidity and functional impairment. In general health primary care settings, there appears to be substantial underdiagnosis and undertreatment of panic disorder. Moreover, panic disorder and agoraphobia are poorly recognized and rarely treated in mental health settings, despite high health care utilization rates and substantial long-term disability.


Subject(s)
Agoraphobia/epidemiology , Panic Disorder/epidemiology , Age Distribution , Age of Onset , Agoraphobia/etiology , Agoraphobia/therapy , Comorbidity , Epidemiologic Studies , Europe/epidemiology , Female , Humans , Incidence , International Classification of Diseases , Male , Panic Disorder/etiology , Panic Disorder/therapy , Prevalence , Psychiatric Status Rating Scales , Review Literature as Topic , Sex Distribution
11.
Psychother Psychosom ; 72(2): 95-101, 2003.
Article in English | MEDLINE | ID: mdl-12601227

ABSTRACT

OBJECTIVE: To compare the effectiveness of serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) for anxiety and mood disorders in a naturalistic setting. METHODS: 114 of 2,000 outpatients drawn from a private facility with a diagnosis of mood or anxiety disorder had two separate episodes during which they were treated once with a SSRI and once with a TCA. The drugs had to be in monotherapy and appropriate according to the recent guidelines. Key outcome measures included several rating scales, the results of which were combined into three measures of outcome: full response (no symptom), partial response (residual symptoms), poor response. RESULTS: TCAs produced a better response in 63 cases and SSRIs in 18 cases (p < 0.00001). When the outcome was dichotomized, TCAs were still superior (stricter criterion of full response: p = 0.0002; lower threshold: p < 0.0001). Considering depressive and anxiety disorders separately, TCAs remained superior in terms of efficacy (for depression: p < 0.0001; for anxiety: p = 0.026). Moreover, the second episode of illness showed a better outcome than the first (p = 0.0008). CONCLUSIONS: In those cases where two different antidepressants were prescribed over two different episodes of illness, TCAs were significantly more effective than SSRIs, regardless of the type of disorder and order of prescription.


Subject(s)
Antidepressive Agents, Tricyclic/therapeutic use , Anxiety Disorders/drug therapy , Mood Disorders/drug therapy , Selective Serotonin Reuptake Inhibitors/therapeutic use , Adult , Female , Humans , Italy , Logistic Models , Male , Middle Aged , Retrospective Studies , Treatment Outcome
12.
Implant Dent ; 9(4): 363-8, 2000.
Article in English | MEDLINE | ID: mdl-11307560

ABSTRACT

A new surgical crestal approach for implant placement in deficient alveolar ridges is presented. Drills of different and increasing lengths allow the surgeon to approach the membrane without risk of tearing it. The study is supported by 265 cases and a 6-year follow-up period (1994-1999). Implants that were 13 and 15 mm in length were inserted, respectively, in 205 and 60 cases. The alveolar ridge height varied between 4 and 10 mm. All implants were HA-coated and had a 3.25-mm diameter. The results of this investigation suggest that this is a reliable and predictable technique for the prosthetic rehabilitation of the maxillary posterior regions in the presence of anatomical restrictions for implant placement.


Subject(s)
Alveolar Ridge Augmentation/methods , Dental Implantation, Endosseous , Dental Implants , Maxilla/surgery , Maxillary Sinus/surgery , Osteotomy/methods , Alveolar Process/pathology , Alveolar Ridge Augmentation/instrumentation , Biocompatible Materials , Bone Matrix/transplantation , Bone Substitutes/therapeutic use , Bone Transplantation , Calcium Phosphates/therapeutic use , Coated Materials, Biocompatible , Dental Implantation, Endosseous/instrumentation , Dental Implantation, Endosseous/methods , Dental Prosthesis Design , Durapatite , Equipment Design , Follow-Up Studies , Forecasting , Humans , Maxilla/pathology , Osteotomy/instrumentation , Reproducibility of Results , Retrospective Studies
13.
Compend Contin Educ Dent ; 18(9): 940-2, 944, 946 passim, 1997 Sep.
Article in English | MEDLINE | ID: mdl-9533370

ABSTRACT

This article reports the results of a study conducted from 1989 to 1995 of 423 hydroxyapatite-coated implants used for immediate tooth replacement after extraction in 353 patients with an age range from 15 to 68 years. The implants replaced teeth that were extracted because of periodontal disease, root fractures, and endodontic problems. Bone defects relative to the implant were treated with bone regeneration procedures using polytetrafluoroethylene (PTFE) membranes and resorbable collagen membranes with and without augmentation material (hydroxyapatite--188 cases, demineralized freeze-dried bone allograft--208 cases, and 27 cases without augmentation material). Histologic evaluation confirmed viability of the regenerated bone. The length of implants ranged from 8 mm to 18 mm, and a total of 284 PTFE and 139 collagen membranes were used. During the 1-year follow-up, 1 implant was lost and an additional implant failed during the 7-year follow-up, with a final success rate of 99.53%.


Subject(s)
Dental Implantation, Endosseous/methods , Dental Implants , Adolescent , Adult , Aged , Durapatite , Female , Guided Tissue Regeneration, Periodontal , Humans , Male , Membranes, Artificial , Middle Aged , Polytetrafluoroethylene , Retrospective Studies , Time Factors , Treatment Outcome
14.
Biomaterials ; 16(12): 917-20, 1995 Aug.
Article in English | MEDLINE | ID: mdl-8562780

ABSTRACT

Plaque-induced lesions can produce peri-implant bone loss with ultimate implant loss. Although the peri-implant tissues seem to be more resistant than the periodontal ones to plaque and calculus, they can produce a more extensive spread of the infection to the deeper tissues around implants. The case of a 45-year-old female patient is presented in which, over a three year period, there was a progressive loss of peri-implant bone and the formation of a periapical radiolucency with an external fistula. The implant was removed and examined with the cutting-grinding system. Microscopy examination showed that most of the hydroxyapatite (HA) was still adherent to the metal. There was a detachment in the area of the HA-titanium interface. The implant surface was almost completely covered by bacteria. Bacteria were also present in the bone medullary spaces surrounding the implant. The infection of the periodontal tissues had progressed into the alveolar bone, thus producing a localized bone infection. The cause of the implant failure is probably related to a defective connection of the abutment or to overloading of the implant due to the presence of interlocks in the prosthetic restoration.


Subject(s)
Dental Implants/adverse effects , Hydroxyapatites/metabolism , Maxilla , Osteomyelitis/etiology , Prosthesis-Related Infections/etiology , Bone Resorption/etiology , Chronic Disease , Female , Humans , Hydroxyapatites/chemistry , Maxilla/diagnostic imaging , Maxilla/pathology , Middle Aged , Radiography , Titanium/chemistry
15.
Pract Periodontics Aesthet Dent ; 6(2): 35-41; quiz 43, 1994 Mar.
Article in English | MEDLINE | ID: mdl-7670062

ABSTRACT

The current research on the application of guided tissue regeneration principles is focused on the use of absorbable matrix barriers in bone augmentation procedures in extraction sites and around implants. This paper presents two cases in which a new absorbable collagen membrane is used for guided bone regeneration. In the first case, freeze-dried demineralized bone was used with the membrane to place an implant in a fresh extraction site with a grave osseous defect. In the second case, the collagen membrane provided the augmentation of a narrow ridge where three implants were placed, without the use of allograft. In both cases, the barrier membrane demonstrated its applicability for bone regeneration with only one surgical procedure, without complications. The learning objective of this article is to update the knowledge of absorbable barrier membranes from the clinical experience of the authors.


Subject(s)
Bone Regeneration , Collagen/therapeutic use , Dental Implantation, Endosseous/methods , Guided Tissue Regeneration, Periodontal , Adult , Alveolar Process/physiology , Biodegradation, Environmental , Humans , Membranes , Middle Aged , Tooth Extraction , Tooth Fractures/surgery , Wound Healing
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