Quaderni Italiani di Psichiatria最新文献

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Assessment protocol of autistic and psychotic dimensions for community mental health centers engaging with child and adolescent psychiatry [Protocollo di assessment delle dimensioni autistica e psicotica per i Centri di Salute Mentale che si interfacciano con la Neuropsichiatria Infantile] 与儿童和青少年精神精神病学相互作用的精神健康中心的自闭症和心理维度评估协议

Quaderni Italiani di Psichiatria

Pub Date : 2012-01-01 DOI: 10.1016/J.QUIP.2012.01.007

D. Berardi, R. Keller, Michele Magnani, S. Palazzi, I. Tarricone

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La night eating syndrome 夜间进食综合症

Quaderni Italiani di Psichiatria

Pub Date : 2011-12-01 DOI: 10.1016/j.quip.2011.06.005

Lucia Godini , Giovanni Castellini , Carolina Lo Sauro , Valdo Ricca , Carlo Faravelli

Introduction

The night eating syndrome (NES) is a disorder that has been the object of interest in the scientific community only in recent years. For this reason, there are no universally accepted diagnostic criteria for this syndrome, and data in the literature on NES are often discordant. We conducted a critical review of the literature, which focused on the epidemiologic, psychopathological, and clinical features of NES, in order to provide a systematic analysis of the most relevant data in the field.

Materials and methods

We carried out a search of the PubMed and MedLine electronic archives and scientific books for studies and reviews regarding NES published since 1990.

Results and discussion

The reported prevalence of NES varies widely in both community and clinical samples. The core symptoms of NES are evening hyperphagia, morning anorexia, nocturnal eating, and insomnia. The syndrome is also frequently associated with important medical and psychiatric comorbidities. Thus far, there is a dearth of reliable data regarding therapeutic strategies for NES, although the results of some studies suggest that pharmacological (sertraline and topiramate) or psychotherapeutic (cognitive behavior therapy) interventions might be useful.

夜食综合征(NES)是近年来科学界才开始关注的一种疾病。因此，对于该综合征尚无普遍接受的诊断标准，而且文献中关于NES的数据也常常不一致。为了对该领域最相关的数据进行系统的分析，我们对文献进行了批判性的回顾，重点关注了NES的流行病学、精神病理学和临床特征。材料和方法我们检索了PubMed和MedLine电子档案和科学书籍，查找1990年以来发表的关于NES的研究和评论。结果和讨论报道的NES患病率在社区和临床样本中差异很大。NES的核心症状是晚上嗜食、早晨厌食、夜间进食和失眠。该综合征还经常与重要的医学和精神合并症有关。尽管一些研究结果表明药理学(舍曲林和托吡酯)或心理治疗(认知行为治疗)干预可能有用，但到目前为止，关于NES的治疗策略缺乏可靠的数据。

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引用次数: 1

Cover 封面

Quaderni Italiani di Psichiatria

Pub Date : 2011-12-01 DOI: 10.1016/S0393-0645(11)00044-2

引用次数: 0

Board 董事会

Quaderni Italiani di Psichiatria

Pub Date : 2011-12-01 DOI: 10.1016/S0393-0645(11)00045-4

引用次数: 0

La depressione maggiore resistente: update delle strategie di trattamento farmacologico 增强耐受性抑郁症:更新药物治疗策略

Quaderni Italiani di Psichiatria

Pub Date : 2011-12-01 DOI: 10.1016/j.quip.2011.08.001

Cesario Bellantuono

Introduction

A significant number of depressed patients has a treatment-resistant depression (TRD). Many clinical trials, as well as the STAR-D study, have shown that in major depression the initial response to treatment with an effective antidepressant drug is often unsatisfactory.

Material and methods

The aim of this review is to provide an updated overview of the psychopharmacological options available for the management of TRD.

Results

A number of therapeutic strategies such as switch, combination and augmentation has been assessed in TRD. The most widely used involves a combination between a second generation antipsychotic (SGA) and a serotoninergic antidepressant (SSRI-SNRI).

Conclusions

SGA augmentation is a safe and effective option for the treatment of resistant depression. Thus far quetiapine is the only drug that has been approved for this purpose in Italy.

相当数量的抑郁症患者患有难治性抑郁症(TRD)。许多临床试验以及STAR-D研究都表明，在重度抑郁症患者中，使用有效的抗抑郁药物治疗的最初反应往往不令人满意。材料和方法本综述的目的是提供可用于治疗TRD的精神药理学选择的最新概述。结果对TRD进行了切换、联合、强化等多种治疗策略的评价。最广泛使用的是第二代抗精神病药(SGA)和5 -羟色胺能抗抑郁药(SSRI-SNRI)的结合。结论ssga增强术是治疗难治性抑郁症的一种安全有效的方法。到目前为止，奎硫平是意大利唯一批准用于这一目的的药物。

引用次数: 0

Sommario/Contents Sommario /高兴

Quaderni Italiani di Psichiatria

Pub Date : 2011-12-01 DOI: 10.1016/S0393-0645(11)00046-6

引用次数: 0

La compromissione del funzionamento sociale precedente l’esordio psicotico 精神病发作前的社会功能受损

Quaderni Italiani di Psichiatria

Pub Date : 2011-12-01 DOI: 10.1016/j.quip.2011.06.006

Elisa Mori, Domenico Berardi

Introduction

Treatment of schizophrenia is frequently associated with poor social outcomes, even when it improves positive symptoms. This observation suggests that the social deficits might be an independent psychopathological area that was present before the onset of psychosis. We conducted a short review of the literature to analyze published data on the premorbid social functioning of patients with psychosis.

Materials and methods

We conducted a short review of published reports (English only) of case-control trials that examined premorbid social functioning in patients with psychosis. The literature search was conducted electronically and involved the PubMed, EmBase, and PsychINFO databases (1988-2009). Search terms included [social adjustment] or [premorbid social adjustment] or [social development] and [schizophrenia] or [early psychosis], alone or in combination. The references cited in each single article were manually searched to complete the review.

Results

The literature search identified 23 studies that documented impairments in the premorbid social functioning of patients with psychosis. These deficits involved different areas of social performance, but they did not appear to be distinctive of schizophrenia. In fact, some studies with controls suffering from other psychiatric diseases failed to find significant differences between the premorbid social functioning of these patients and those with schizophrenia.

Conclusions

Further research should analyze premorbid social functioning in patients with schizophrenia to provide a more detailed description of its characteristic aspects.

精神分裂症的治疗往往与不良的社会结果相关，即使它改善了阳性症状。这一观察结果表明，社会缺陷可能是一个独立的精神病理领域，在精神病发作之前就存在了。我们对文献进行了简短的回顾，以分析有关精神病患者病前社会功能的已发表数据。材料和方法我们对已发表的关于精神病患者发病前社会功能的病例对照试验的报告进行了简短的回顾。文献检索以电子方式进行，涉及PubMed、EmBase和PsychINFO数据库(1988-2009)。搜索词包括[社会适应]或[病前社会适应]或[社会发展]和[精神分裂症]或[早期精神病]，单独或组合。每一篇文章中引用的参考文献都是手工检索的，以完成综述。结果文献检索确定了23项研究，这些研究记录了精神病患者病前社会功能的损害。这些缺陷涉及社会表现的不同领域，但它们似乎并不是精神分裂症的特征。事实上，一些对患有其他精神疾病的对照组的研究未能发现这些患者的病前社会功能与精神分裂症患者之间存在显著差异。结论进一步的研究应分析精神分裂症患者的发病前社会功能，以提供更详细的描述其特征方面。

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引用次数: 0

Prevenire si può, anzi si deve. Il caso della depressione in gravidanza e nel post-partum 预防是可以的，事实上是必须的。怀孕和产后抑郁症

Quaderni Italiani di Psichiatria

Pub Date : 2011-12-01 DOI: 10.1016/j.quip.2011.10.001

Claudio Mencacci

引用次数: 0

Gli antipsicotici di seconda generazione nella prevenzione delle recidive in corso di disturbo bipolare: focus su aripiprazolo e quetiapina 预防双相情感障碍复发的第二代抗精神病药:关注阿立哌唑和奎硫平

Quaderni Italiani di Psichiatria

Pub Date : 2011-12-01 DOI: 10.1016/j.quip.2011.09.001

Angelo Cerù

Introduction

Mood stabilization is an important goal in the treatment of bipolar disorder. In addition to well-established mood stabilizers (lithium, certain anticonvulsants), atypical antipsychotic drugs, including aripiprazole and quetiapine, have also been assessed for this purpose.

Materials and methods

This article reviews two studies on atypical antipsychotic monotherapy for mood stabilization: one that examined aripiprazole, the other quetiapine. Both studies had designs similar to those used to obtain regulatory approval of these drugs for long-term treatment of bipolar disorder.

Results

Aripiprazole prevented manic relapses but not the depressive ones, whereas quetiapine was able to prevent both types of recurrence. The safety profiles of the two drugs were compatible with previously reported data.

Discussion

Compared with aripiprazole, quetiapine seems to be more effective for the prevention of acute recurrences in patients with bipolar disorder.

情绪稳定是双相情感障碍治疗的一个重要目标。除了公认的情绪稳定剂(锂，某些抗惊厥药)，非典型抗精神病药物，包括阿立哌唑和喹硫平，也被评估用于此目的。材料与方法本文综述了两项非典型抗精神病药物单一疗法用于情绪稳定的研究:一项是阿立哌唑，另一项是喹硫平。这两项研究的设计都类似于那些用于获得双相情感障碍长期治疗药物的监管批准的研究。结果阿立哌唑对狂躁发作无抑制作用，喹硫平对抑郁发作和躁狂发作均有抑制作用。这两种药物的安全性与先前报道的数据一致。与阿立哌唑相比，奎硫平似乎更有效地预防双相情感障碍患者的急性复发。

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La risposta subottimale al trattamento antidepressivo: definizione e implicazioni cliniche 抗抑郁治疗的亚优反应:定义和临床含义

Quaderni Italiani di Psichiatria

Pub Date : 2011-09-01 DOI: 10.1016/j.quip.2011.06.001

Bernardo Carpiniello

Introduction

Insufficient responses to antidepressant drugs can be an important problem, with negative clinical and psychosocial consequences.

Materials and methods

On the basis of an extensive analysis of the existing literature, the authors provide a possible operational definition of suboptimal treatment response and review the available data on the frequency of this phenomenon and its implications.

Results

A suboptimal response to antidepressant therapy is defined as a partial response or one that includes residual sub-threshold symptoms. These responses are associated with an increased risk for recurrence/relapses, shorter times to recurrence/relapse, higher risks of disease chronicity and suicidal tendencies, reduced functioning, and increases in the costs of care. Suboptimal responses are observed in approximately 70% of all patients after the first cycle of treatment, but with repeated attempts at treatment, this rate drops to approximately one third of cases.

Conclusions

Given their frequency and negative consequences, suboptimal responses to antidepressant therapy can be a challenge for clinicians, and complex strategies (e.g., augmentation, add-on, or switching) are often needed to overcome the limitations of the treatment.

对抗抑郁药物反应不足可能是一个重要的问题，具有负面的临床和社会心理后果。材料和方法在对现有文献进行广泛分析的基础上，作者提供了次优治疗反应的可能操作定义，并回顾了有关该现象发生频率及其含义的现有数据。结果对抗抑郁药物治疗的次优反应被定义为部分反应或包括残余阈下症状的反应。这些反应与复发/复发风险增加、复发/复发时间缩短、疾病慢性化和自杀倾向风险增加、功能下降以及护理费用增加有关。在第一个治疗周期后，约70%的患者观察到次优反应，但在反复尝试治疗后，这一比例下降到约三分之一的病例。鉴于其频率和负面后果，抗抑郁药物治疗的次优反应对临床医生来说是一个挑战，通常需要复杂的策略(例如，增强，附加或转换)来克服治疗的局限性。

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