Peripheral benzodiazepine receptor messenger RNA is decreased in lymphocytes of generalized anxiety disorder patients.

BACKGROUND: The aim of this study was to assess whether the decrease of peripheral benzodiazepine receptor (pBR) number in peripheral blood mononuclear cells (PBMC), previously observed in patients with generalized anxiety disorder, is paralleled by changes in the relative content of messenger RNA (mRNA) encoding pBR. METHODS: Eight patients with a DSM-III-R diagnosis of generalized anxiety disorder were examined before, during, and after 2'-chloro-N-desmethyl-diazepam treatment. Eight healthy subjects were analyzed in parallel. The relative content of pBR mRNA was determined by reverse-transcriptase-polymerase chain reaction, using beta-actin as internal standard. Kinetic binding properties of pBR were measured using 3H-PK11195 as a ligand. RESULTS: pBR and pBR mRNA were significantly decreased in untreated generalized anxiety disorder patients as compared to controls (by 45% and 70%, respectively). Both pBR density and mRNA levels returned to control values during treatment or after withdrawal, which also coincided with recovery from anxiety. CONCLUSIONS: These results suggest that the turnover rate of pBR is reduced in PBMC of generalized anxiety disorder patients, and that this change occurs at the transcriptional level.

Paroxetine efficacy in the treatment of generalized anxiety disorder.

Recently, there has been a renewed interest in alternatives to the benzodiazepines for the treatment of generalized anxiety disorder (GAD). The aim of the present study was to compare the efficacy of paroxetine vs. imipramine and 2'-chlordesmethyldiazepam in 81 patients with a DSM-IV diagnosis of GAD. Approximately two-thirds of the patients who completed the study improved greatly or moderately on all three active drugs. During the first 2 weeks of treatment, 2'-chlordesmethyldiazepam treatment resulted in the greatest improvement in anxiety ratings. Both paroxetine and imipramine treatment resulted in more improvement than 2'-chlordesmethyldiazepam by the fourth week of treatment. Paroxetine and imipramine affect predominantly psychic symptoms, whereas 2'-chlordesmethyldiazepam affects predominantly somatic symptoms. Our results suggest that paroxetine is effective for the treatment of GAD.

Peripheral-type benzodiazepine receptors in anxiety disorders.

Peripheral benzodiazepine receptors (pBDZr) were analyzed in lymphocyte membranes from patients with anxiety disorders (generalized anxiety disorder (GAD), n = 15; panic disorder (PD), n = 10; obsessive-compulsive disorder (OCD), n = 18), other mental disorders (n = 40) and 50 healthy controls, by the specific binding of 3H-PK11195. The number of binding sites (Bmax) was significantly decreased in groups with both GAD and OCD as compared with age-matched controls, by 45% and 25% respectively, whereas the binding affinity (Kd) was the same in all disorder and control groups. Conversely, no changes in binding capacity was observed in the other disorder groups and particularly in the one with PD. The abnormality in pBDZr observed in patients with GAD was restored to a normal value after long-term treatment with 2'-chloro-N-desmethyldiazepam, which also coincided with their recovery from anxiety. Our data suggest that the clinical heterogeneity in anxiety disorders might be related to different biological mechanisms and that lymphocyte pBDZr might be useful in demonstrating these differences.

[Psychobiological basis of hypnosis. Neurophysiologic and psychosomatic considerations]. / Le basi psicobiologiche dell'ipnosi. Considerazioni neurofisiologiche e psicosomatiche.

On the basis of the psychosomatic model, an interpretation of hypnositherapy is proposed in the psychobiological context as an applicative example of oneness. With this technique a particular state of awareness, which hypnosis is, correlated biologically with considerable subcortical neurophysiological modifications in the individual, is added, as a facilitating context, into the activation of patients psychotherapy. Thereafter the neurophysiological characterisation of the hypnotic state such as activation of the right hemisphere, similarities between transhypnosis and synchronous sleep and the activation of subcortical mechanisms compared to the cortical are considered. In the hypnotic situation, two very special conditions which are extremely important in the biological context, operate: on the one hand the special physician/patient relationship, on the other the important psychosomatic implication deriving from the possibility of direct action on mesolimbic and hypothalamus following the reduced cortical activity. After examining the context of the physician/patient relationship in the clinical implication of the placebo, or non-pharmacological effect of the drug implied, the psychosomatic activation mechanisms that can be the reason for modifications in the symptom, including its improvement or actual cure are considered. In this context, the psychosomatic evaluational parameter inherent in cognitive evaluation to which the cortical filter is correlated, the emotional activation to which activation of the limbic system is correlated and, finally, the set of psychophysiological variations correlated to this limbic activation underlying behavioural and somatic modifications are reviewed.

[Psychotherapy and relaxation techniques]. / Psicoterapia e rilassamento.

Relaxation is a situation in which there is a dynamic balance of the neurovegetative and mental activities. It can be reached through the practice of definitive and suitable techniques which can also be used in psychiatric therapy. The paper lists some of the most common relaxation technique, giving their specific characteristics and eventual relationships with psychotherapies. The latter are in fact classified according to the implicit or active use of relaxation; on the contrary, those psychotherapies known to cause anxiety are also listed. Lastly, some observation are made regarding the opportunity of including a prescription for a relaxation technique during a course of psychodynamic psychotherapy.

[Acute transverse myelitis. Clinical and neuroradiological follow-up of a case in a child]. / Mielite trasversa acuta. Following clinico e neuroradiologico di un caso in età pediatrica.

The case of a ten years old boy who presented a sudden onset of tetraplegia is discussed. The benign clinical evolution, under corticosteroid therapy, the negativity of biohumoral examinations of the cerebrospinal fluid and the improvement of the NMR pictures allow the diagnosis of acute spinal myelitis. In the paper are also presented the neuroradiological pictures of myeloCT and NMR; the last one can, for its sensibility, discover little variations in the water contents of the nervous tissue and for its harmlessness can be used for serial examinations.