Giuseppe Maina

Università degli Studi di Torino, Torino, Piedmont, Italy

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Publications (138)330.69 Total impact

  • Giuseppe Maina, Gianluca Rosso, Filippo Bogetto
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    ABSTRACT: There is a paucity of controlled trials examining the efficacy of brief dynamic psychotherapy (BDT) in the treatment of major depressive disorder, especially in a long-term perspective. The aim of the present study is to evaluate recurrence rates in unipolar major depressed patients who are responsive to acute phase combined treatment with BDT plus pharmacotherapy in comparison with patients initially treated with pharmacotherapy alone. Subjects for this study were 92 patients who met criteria for remission at the end of a 6-month acute treatment phase for major depressive disorder, single episode, with combined therapy (BDT plus pharmacotherapy) versus pharmacotherapy alone. 41 (64.1%) subjects were remitters to combined treatment and 51 (61.4%) were remitters to antidepressants alone. The study included a 6-month continuation treatment trial with pharmacotherapy and a following perspective, naturalistic 48-month follow-up (without any treatment). Patients who received combined treatment, in comparison with those who were treated with pharmacotherapy alone, show a significant lower rate of recurrences of depressive episodes at 48-months naturalistic follow up (27.5% in comparison with 46.9%: chi(2)=3.525; df=1; p=.048). Inclusion and exclusion criteria may limit the generalizability of the results. Furthermore it may be unclear whether the effect is attributable to BDT per se as opposed to extra time with a therapist. The significant lower recurrence rates in a 48-month follow-up in the group of patients treated with the addition of BDT to medication in the acute phase support the view of the advantage in the long-term outcome of adding psychotherapeutic intervention to pharmacotherapy in the acute therapy of unipolar major depression.
    Journal of affective disorders 09/2008; 114(1-3):200-7. · 3.76 Impact Factor
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    ABSTRACT: Bipolar disorder type II (BDII) has been considered since its distinction from bipolar disorder type I (BDI) as a milder form, on the basis of cross-sectional symptoms intensity. Longitudinal data, on the contrary, do suggest that it is at least as severe as BDI, if not even more chronic and impairing. Few studies investigated differences in Axis II comorbidity in bipolar disorder patients according to bipolar subtypes, and none examined patients during prolonged euthymia. The aim of the study was to determine comorbidity rates for personality disorders in euthymic bipolar subjects, comparing bipolar type I and II disorders (BDI and BDII). 186 DSM-IV (SCID-I) bipolar disorder subjects were enrolled; all patients were euthymic for at least two months, as confirmed by a HAM-D<8 and a YMRS<6. Axis II comorbidity was evaluated through SCID-II. Differences in Axis II comorbidity rates were examined with the Pearson's Chi-square test. Of the subjects included, 71 had BDI and 115 BDII. At least a personality disorder was present in 42.5% of all bipolars, 43.7% of BDI and 41.7% of BDII. No differences were detected between the two subgroups for any single personality disorder. We relied only on the patients' reports in assessing personality disorders; the sample was made of subjects referred to a tertiary centre who were able to maintain euthymia. Our study confirms the high comorbidity rates for personality disorders in bipolar subjects and provides evidence that BDII, with regard to Axis II comorbidity, is as severe as BDI.
    Journal of affective disorders 09/2008; 115(1-2):257-61. · 3.76 Impact Factor
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    ABSTRACT: Whether or not to use antidepressants in patients with bipolar disorder is a matter of debate. Antidepressant treatment of bipolar depression has been associated with manic switch and cycle acceleration. Furthermore, recent studies have argued against the efficacy of antidepressants in the treatment of bipolar depression. Nevertheless, many clinicians continue to employ antidepressants, especially in the management of severe depression that is unresponsive to mood stabilizers alone. Because of the unclear risk-to-benefit ratio of antidepressants in bipolar disorder, we have performed an updated review of the relevant literature. In this article we examine (1) all randomized controlled trials (RCTs) evaluating the use of antidepressants in the treatment of acute bipolar depression and assessing the risk of antidepressant-induced manic switch and (2) non-RCT trials that evaluate the impact of antidepressant discontinuation after acute antidepressant response. A MEDLINE search of journals, covering the period from January 1966 to July 2007 and supplemented by bibliographic cross-referencing, was performed to identify the relevant studies. The keywords used were antidepressant, bipolar depression, bipolar disorder, switch, manic switch, antidepressant-induced mania, predictors, and antidepressant discontinuation. Criteria used to select studies included (1) English language and (2) studies published in peer-reviewed journals. Randomized, double-blind, placebo-controlled studies have demonstrated that antidepressants exert some efficacy in the treatment of bipolar depression in some populations of patients. Moreover, the risk of manic switch, although not totally countered, appears to be strongly reduced when antidepressants are given in combination with a mood stabilizer and when new-generation antide-pressants are preferred over old tricyclic antidepressants. Finally, some studies have proven that the continuous use of antidepressants after the remission of a major depressive episode helps to prevent further depressive relapses without causing a significant increase in manic relapses. Clearly, there is a place for antidepressants in bipolar disorder; however, it is important to be cautious and evaluate their use on a case-by-case basis. Looking at specific depressive symptoms might help physicians in making the choice of whether to prescribe or not prescribe antidepressants.
    The Journal of Clinical Psychiatry 08/2008; 69(8):1307-18. · 5.81 Impact Factor
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    ABSTRACT: The aim of the present pilot study was to investigate in a single-blind manner, over a period of 8 weeks, the comparative efficacy and tolerability of risperidone versus olanzapine addition in the treatment of OCD patients who did not show a >or=35% decrease in the YBOCS score after 16-week SRI treatment (defined as resistant). The study consisted of two different phases: a 16-week open-label prospective phase to ascertain resistance to SRI treatment and an 8-week single-blind addition phase for resistant subjects only. Ninety-six subjects with DSM-IV OCD (YBOCS>or=16) entered the open-label prospective phase; at the end of the 16-week period, 50 (52%) were judged to be resistant and were randomized to receive risperidone (1 to 3 mg/d) or olanzapine (2.5 to 10 mg/d) addition for 8 weeks. Overall, patients in both groups responded significantly, without differences between the two treatment groups; although no differences emerged for the proportion of patients reporting at least an adverse event, the profiles of adverse experiences differed significantly, being risperidone associated with amenorrhoea and olanzapine with weight gain.
    European Neuropsychopharmacology 06/2008; 18(5):364-72. · 4.60 Impact Factor
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    ABSTRACT: There are conflicting results regarding the association of maternal antenatal distress with preterm birth and low birth weight. This study investigated the association between maternal distress and intrauterine growth abnormality, low birth weight and preterm birth. Three mutually exclusive and homogeneous groups of pregnant women (with actual psychiatric disorder, with maternal psychological distress, and healthy comparisons) underwent fetal ultrasound examinations, uterine and umbilical artery Doppler velocimetry. Infant weight was measured and information collected on obstetrical features and sociodemographic factors. No differences emerged among the three groups of pregnant women in any ultrasound variables. Antenatal maternal psychiatric disorders and antenatal distress were not associated with an increased risk of preterm birth. Infants of women with psychiatric disorders had lower birth weight and higher percentage of birth weight below the 10th centile for gestational age (30%) than infants of healthy mothers (5%). These findings are preliminary and warrant further investigation in larger-scale study; they are limited by the heterogeneity of psychiatric diagnoses. Maternal psychiatric disorders are associated with a lower birth weight, but the effect is unlikely to be due to abnormal utero-placental or feto-placental vascularisation. Further studies should investigate other possible causes of lower birth weight associated with maternal psychiatric disorders.
    Journal of Affective Disorders 05/2008; 111(2-3):214-20. · 3.30 Impact Factor
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    ABSTRACT: Treatment resistant patients with Obsessive-Compulsive Disorder (OCD) are those who undergo adequate trials of first-line therapies without a satisfactory response. Two major options are available for those patients: 1) augmentation with cognitive-behavioral therapy (CBT) or pharmacotherapy, and 2) switch to another compound or to another formulation. The first approach is to augment the serotonin reuptake inhibitor (SRI) with CBT or with another drug. In the first case preliminary data indicate that exposure and response prevention is effective. Pharmacological augmentation has been tried with several drugs; the effectiveness of antipsychotic (first and second generation) augmentation is well documented and subjects with comorbid tic may be particularly responsive to haloperidol. A second, although less established, augmentation strategy consists in adding another SRI. Other drugs like pindolol and morphine have shown efficacy in few controlled studies. The second approach, less studied, is switching from a serotonergic compound to another one (generally from a selective serotonin reuptake inhibitor to clomipramine or vice-versa), or to venlafaxine or mirtazapine. Finally, patients that failed to respond to oral clomipramine might benefit from switching to the IV clomipramine. The augmentation strategy should be considered in case of partial response while the switch strategy in absence of any minimal improvement.
    Current Drug Therapy 04/2008; 3(2):126-142.
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    ABSTRACT: The aim of the present randomized, single-blind, pilot study was to assess the efficacy of the addition of a second mood stabilizer, either olanzapine or lamotrigine, to lithium in patients with remitted bipolar disorder and comorbid anxiety disorder. Adult DSM-IV bipolar disorder patients with a current anxiety disorder and a Hamilton Rating Scale for Anxiety (HAM-A) score of 12 or higher, in remission from an affective episode for at least 2 months while on lithium maintenance treatment, were randomly assigned to receive 12 weeks of single-blind olanzapine 5 to 10 mg/day (N = 24) or lamotrigine 50 to 200 mg/day (N = 23) addition to lithium. The primary outcome measure was the HAM-A; secondary outcome measures were the Clinical Global Impressions-Severity of Illness scale and the Global Assessment of Functioning (GAF) scale. Data were collected from July 2005 to February 2007. Twenty-two patients in the olanzapine and 18 in the lamotrigine group completed the trial. Mean +/- SD final doses of olanzapine and lamotrigine were, respectively, 7.7 +/- 4.2 mg/day and 96.7 +/- 46.7 mg/day in the intent-to-treat sample (N = 47). Both olanzapine and lamotrigine were effective in reducing HAM-A scores from baseline to endpoint (paired t test for completers: t = 11.361, df = 21, p < .001 for olanzapine and t = 6.301, df = 17, p < .001 for lamotrigine). Both drugs were also effective on the secondary outcome measures. Olanzapine was more effective than lamotrigine at weeks 6 and 12 with a last-observation-carried-forward analysis on all 3 outcome measures, while such differences disappeared on the HAM-A and GAF at week 12 with the visit-wise analysis. The addition of a second mood stabilizer (olanzapine or lamotrigine) to lithium is effective in reducing anxiety symptoms in bipolar disorder patients with a co-occurring anxiety disorder.
    The Journal of Clinical Psychiatry 04/2008; 69(4):609-16. · 5.81 Impact Factor
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    ABSTRACT: Obsessive-compulsive disorder (OCD) often emerges in childhood or adolescence. The aim of the present study was to evaluate whether adult patients with prepuberal onset differ from subjects with later onset in terms of personality disorder comorbidity. The Structured Clinical Interview for DSM-IV Axis II Disorders was used to assess 148 patients with a principal diagnosis of OCD according to the Structured Clinical Interview for DSM-IV Axis I Disorders. The following two subgroups of subjects were selected according to the age at onset of symptomatology: patients with an early-onset (< or =10 years), and patients with a later onset (> or =17 years). Of the 148 patients screened for the present study, 33 (22.3%) had an early onset and 1369 (46.6%) had a later onset. With regard to personality disorders, early-onset patients showed more OC personality disorders (OCPD) than later onset patients. Our finding suggests that OCD in childhood increases the risk for developing OCPD in adulthood, or that early-onset OCD and OCPD share a common pathogenesis.
    Psychiatry Research 04/2008; 158(2):217-25. · 2.68 Impact Factor
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    ABSTRACT: Patients with bipolar disorder may be at greater risk for overweight and obesity than individuals in the general population. This risk may be due to the illness itself, to mediating factors (diet, life style) and/or to medications used to treat the disorder. This investigation explores the association between body weight and bipolar illness in drug-naïve patients. Weight and height were retrospectively obtained from 76 clinical charts of drug-naïve patients with bipolar disorder (DSM-IV-TR). A reference group for comparison was then selected from another psychiatric population (65 patients with obsessive-compulsive disorder) and investigated with the same methodology to estimate their BMI. A second focus was to examine the differences in baseline demographic and clinical characteristics between overweight and non-overweight bipolar patients. A total of 40.8% of the patients with bipolar disorder met criteria for obesity or overweight with significant difference in comparison with obsessive-compulsive patients (10.8%). The highest proportions of depression at index episode were in the overweight group (83.3%) with significant difference with the non-overweight patients (58.1%). Retrospective study. Weight measurement not in euthymic period. Overweight is significantly more prevalent in drug-naïve patients with bipolar disorder than in another drug-naïve psychiatric patients (OCD). In agreement with previous studies, the number of patients experiencing a depressive episode was significantly higher in the overweight than in the non-overweight group. These results suggest that the prevalence of overweight in bipolar patients is also influenced by the illness itself or mediating factors such as diet and life style than by pharmacologic treatment.
    Journal of Affective Disorders 02/2008; 110(1-2):149-55. · 3.30 Impact Factor
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    ABSTRACT: Few studies investigated the impact of anxiety disorder comorbidity on health-related quality of life (HRQoL) of bipolar patients and none examined bipolar subtypes differences. The aim of the study was 1) to determine comorbidity rates for anxiety disorders in euthymic bipolar subjects, comparing bipolar type I and II disorders (BDI and BDII), and 2) to compare within each group HRQoL measures in subjects with and without anxiety comorbidity. Comorbidity was evaluated through the SCID-I; HRQoL was assessed using the 36-Item Short-Form Health Survey (SF-36). All subjects were euthymic since at least 2 months, as confirmed by a HAM-D <8 and a YMRS <6. A comparison was made for SF-36 scores between subjects (all bipolars, BDI and BDII) with and without anxiety disorders. 105 patients were enrolled: 44 with BDI and 61 with BDII. Current and lifetime anxiety disorders comorbidities were 32.4% and 41.0% for all bipolars, 31.8% and 40.9% for BDI and 32.8% and 41.0% for BDII. BDI patients differed in several SF-36 domains from BDII subjects, which reported a poorer HRQoL. A current and lifetime comorbid anxiety disorder was associated with a poorer HRQoL considering all bipolars; when examining separately BDI and II subjects, however, the deleterious effect was restricted to BDI patients. The cross-sectional assessment of HRQoL, the generic instrument used (SF-36) and the small sample size. Our study confirms the high comorbidity rates for anxiety disorders in bipolar subjects and provides evidence that anxiety comorbidity impacts HRQoL in subjects with BDI and not BDII.
    Journal of Affective Disorders 02/2008; 105(1-3):297-303. · 3.30 Impact Factor
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    ABSTRACT: This study aimed to evaluate the prevalence of metabolic syndrome (MetS) in Italian patients with bipolar disorder (BD) and to determine the sociodemographic and clinical correlates of MetS in this patient population. Subjects with BD I and II were included. Sociodemographic and clinical characteristics, lifestyle information (alcohol and smoking habits and rate of physical exercise) and comorbidity for cardiovascular diseases and diabetes were collected. Patients were assessed for MetS according to both National Cholesterol Education Program Adult Treatment Panel III and International Diabetes Federation (IDF) criteria. MetS was evaluated in 99 patients out of 108 who were enrolled. MetS was present in 25.3% of the sample. Abdominal obesity was present in 50%, hypertension in 40%, high triglycerides in 34.7%, low HDL-C levels in 32.3% and fasting hyperglycemia in 11% of the sample. Prevalence of MetS was 30% when IDF criteria were employed. Of the investigated variables, age, duration of illness, rate of obesity and cardiovascular disease were higher in patients with MetS. After the regression analysis, only age and obesity were associated to MetS. MetS is highly prevalent in Italian patients with BD. Our 25.3% prevalence rate is consistent with the 21-22% reported in other European studies and lower than that in U.S. studies. Elderly and obese patients with BD are at particularly high risk for MetS.
    General Hospital Psychiatry 01/2008; 30(4):318-23. · 2.98 Impact Factor
  • Andrea Fagiolini, Giuseppe Maina
    Drugs & Therapy Perspectives 01/2008; 24(7).
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    ABSTRACT: Relatively few systematic data exist on the clinical impact of bipolar comorbidity in obsessive-compulsive disorder (OCD) and no studies have investigated the influence of such a comorbidity on the prevalence and pattern of Axis II comorbidity. The aim of the present study was to explore the comorbidity of personality disorders in a group of patients with OCD and comorbid bipolar disorder (BD). The sample consisted of 204 subjects with a principal diagnosis of OCD (DSM-IV) and a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score>or=16 recruited from all patients consecutively referred to the Anxiety and Mood Disorders Unit, Department of Neuroscience, University of Turin over a period of 5 years (January 1998-December 2002). Diagnostic evaluation and Axis I comorbidities were collected by means of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Personality status was assessed by using the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II). Socio-demographic and clinical features (including Axis II comorbidities) were compared between OCD patients with and without a lifetime comorbidity of BD. A total of 21 patients with OCD (10.3%) met DSM-IV criteria for a lifetime BD diagnosis: 4 (2.0%) with BD type I and 17 (8.3%) with BD type II. Those without a BD diagnosis showed significantly higher rates of male gender, sexual and hoarding obsessions, repeating compulsions and lifetime comorbid substance use disorders, when compared with patients with BD/OCD. With regard to personality disorders, those with BD/OCD showed higher prevalence rates of Cluster A (42.9% versus 21.3%; p=0.027) and Cluster B (57.1% versus 29.0%; p=0.009) personality disorders. Narcissistic and antisocial personality disorders were more frequent in BD/OCD. Our results point towards clinically relevant effects of comorbid BD on the personality profiles of OCD patients, with higher rates of narcissistic and antisocial personality disorders in BD/OCD patients.
    Bipolar Disorders 11/2007; 9(7):722-9. · 4.62 Impact Factor
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    ABSTRACT: The aim of this study was, first, to examine health-related quality of life among relatives of Italian patients with obsessive-compulsive disorder and, second, to search for potential predictors of quality of life among these relatives. Health-related quality of life was assessed among 64 non-psychiatrically ill family members of 48 patients with obsessive-compulsive disorder by using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Structured Clinical Interview for DSM-IV Axis II Disorders were used to assess obsessive-compulsive disorder among the patients. Mean SF-36 scores of participants were compared with expected scores for 2,031 persons from the Italian general population (Italian norms) by using the one-sample t test. Correlates of health-related quality of life were examined by means of independent-sample t tests and Pearson correlations; variables significantly associated with SF-36 subscales were entered into a stepwise multiple linear regression analysis with the physical and mental components as dependent variables. Relatives of patients with obsessive-compulsive disorder showed a greater impairment in health-related quality of life in the SF-36 subscales of role limitations due to physical health, vitality, social functioning, role limitations due to emotional problems, and mental health. When a stepwise multiple linear regression analysis was performed with the physical component and the mental component of the SF-36 as dependent variables, female gender, older age, and the total score on the Family Accommodation Scale predicted a poorer score on the physical component, whereas the only predictor of a poorer score on the mental component was the patient's Y-BOCS total score. The study provides evidence that obsessive-compulsive disorder impairs health-related quality of life among family members of patients with obsessive-compulsive disorder, even among healthy family members. Involving family members in the treatment of obsessive-compulsive disorder could improve their perceived quality of life.
    Psychiatric Services 08/2007; 58(7):970-6. · 2.01 Impact Factor
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    ABSTRACT: Breakthrough manic episodes are the rule in bipolar disorders; valproate and olanzapine are considered first-line treatments for manic episodes, nevertheless the two drugs have only been compared in monotherapy studies. In our study we compared the efficacy and safety of valproate and olanzapine added to lithium in the treatment of patients experiencing breakthrough manic episodes while on lithium monotherapy. Patients with bipolar I or II disorder (SCID-I), in treatment with lithium since at least one year, experiencing a manic or hypomanic relapse were randomly assigned to an open-label add-on therapy with valproate (500-1500 mg/day) or olanzapine (7.5-15.0 mg/day) for 8 weeks. The primary efficacy measure was the Young Mania Rating Scale (YMRS) total. Twenty-one patients were randomized to receive the add-on therapy with valproate (n=9) or olanzapine (n=12). Both groups showed a significant baseline to endpoint reduction in YMRS total and Clinical Global Impressions-Severity (CGI-S) scores (p<0.001). At endpoint, the mean reduction of YMRS total or CGI-S scores, as well as response or remission rates, was not significantly different between the groups. However, compared with patients in the valproate add-on group, patients treated with olanzapine add-on showed significantly greater reductions in the YMRS total and CGI-S mean scores at weeks 1 through 4 (p<0.05). The rate and profile of adverse events were numerically similar in the two groups. Open-label design and limited sample size. Both add-on therapies were efficacious in treating patients with manic or hypomanic relapse, however the olanzapine group showed an earlier response to treatment. These findings can help clinicians in understanding the value of adding other treatments to lithium in patients experiencing a manic or hypomanic relapse.
    Journal of Affective Disorders 05/2007; 99(1-3):247-51. · 3.30 Impact Factor
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    ABSTRACT: c1 Address for correspondence: Dr. P. Rucci, Dipartimento di Psichiatria, Neurobiologia, Farmacologia, Biotecnologie, Via Roma 67, 56100 Pisa. Fax: +39-050-835439 E-mail: rucci.paola@tiscali.it
    Epidemiologia e Psichiatria Sociale. 02/2007; 16(01):82 - 87.
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    ABSTRACT: The relative efficacy of supplemental psychotherapy in the treatment of depression is still a matter of debate. Moreover, the superiority of brief dynamic therapy (BDT) over supportive psychotherapies is not well established. The aim of this study is to compare the efficacy of BDT added to medication with that of brief supportive psychotherapy (BSP) added to medication in the treatment of major depressive disorder. A 12-month randomized clinical trial compared BDT (n = 18) with BSP (n = 17) combined with antidepressants in outpatients with major depressive disorder. Both psychotherapies were added during the first 6 months of the trial; all patients continued to be treated with only pharmacotherapy (paroxetine or citalopram) in the following 6-month continuation phase. Efficacy was assessed using the 17-item Hamilton Rating Scale for Depression (HAM-D), the Hamilton Rating Scale for Anxiety and the Clinical Global Impression (CGI). The data analysis was conducted on two samples: the per-protocol (PP) sample and the observed-cases (OC) sample. Thirty-two patients completed the study. Although at the end of the combined therapies (T2) no differences emerged between the two treatment approaches, the group of patients treated with BDT showed a further clinical improvement at the end of the study (T3): a significant reduction in symptomatology emerged on the HAM-D (PP sample: F = 75.154, p = 0.03; OC sample: F = 67.149, p = 0.022) and on the CGI total scores (PP sample: F = 78.527, p = 0.016; OC sample: F = 74.104, p = 0.007). The difference in remission rates on the HAM-D (75 vs. 12.5% at T3) is statistically significant favoring BDT. BDT combined with antidepressants is preferable to supportive psychotherapy combined with medication in the treatment of outpatients with major depression.
    Psychotherapy and Psychosomatics 02/2007; 76(5):298-305. · 7.23 Impact Factor
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    ABSTRACT: The aim of the present study was to compare health-related quality of life (HRQoL) measures in euthymic patients with bipolar I and II disorder. We included as comparison samples a group of subjects with recurrent major depression (RMD) and a group of non-psychiatrically ill individuals. HRQoL was assessed using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) in 253 subjects recruited in 5 Italian centers: 90 patients with bipolar I disorder, 52 patients with bipolar II disorder, 61 subjects with RMD, and 50 healthy comparison individuals. All subjects were evaluated with the Structured Clinical Interview for DSM-IV; psychiatric patients had to be in a euthymic state for at least 2 months prior to the inclusion in the study, as confirmed by a Hamilton Rating Scale for Depression total score < 8 and a Young Mania Rating Scale total score < 6. Data were drawn from a study that was performed from May 2003 to December 2004. When we compared the bipolar and RMD groups with the control group of non-psychiatrically ill individuals and controlled for differences in mean actual age, both bipolar subgroups and subjects with RMD had lower SF-36 mean scores on several subscales; differences in mean SF-36 scores were also detected between bipolar subtypes: bipolar II patients showed HRQoL that was poorer than that of bipolar I patients, even after controlling for age, age at onset, and length of illness, and equal to that of RMD subjects. Our study provides evidence that bipolar type II is associated with poorer HRQoL compared to type I even during sustained periods of euthymia and excluding residual symptoms. Interventions targeting rehabilitation and/or functional enhancement may be helpful to improve HRQoL, especially among patients with bipolar II disorder.
    The Journal of Clinical Psychiatry 02/2007; 68(2):207-12. · 5.81 Impact Factor
  • Epidemiologia e psichiatria sociale 03/2006; 15(1):71-6. · 3.16 Impact Factor
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    ABSTRACT: Our purpose in this study was to compare the prevalence and pattern of Axis I and II comorbidities between patients with and without nocturnal panic (NP) attacks. One hundred and sixteen subjects with panic disorder (PD; according to DSM-IV criteria) were included: We assessed Axis I and II comorbidities using the Structured Clinical Interview for DSM-IV Axis I and II disorders, respectively. Of the sample, 27.6% of subjects had recurrent nocturnal panic attacks (NP group). Subjects with NP did not differ from those without in any sociodemographic or clinical characteristics. In the sample (94 subjects), 81% had at least one lifetime comorbid Axis I disorder, without significant differences between subjects with and without nocturnal panic even when considering comorbidity rates for single disorders; a trend toward significance was found for anorexia nervosa and somatization disorder, which both were more frequent among subjects with NP. Concerning Axis II disorders, 49.1% of the sample (57 subjects) met the criteria for at least one personality disorder, without significant differences between patients with and without NP. No significant differences were detected in comorbidity rates for any single Axis II personality disorder. Personality might play a relevant role in influencing treatment approaches to PD, but it does not appear to be a differential focus of concern in patients with compared to those without NP.
    Depression and Anxiety 02/2006; 23(7):422-8. · 4.61 Impact Factor

Publication Stats

1k Citations
330.69 Total Impact Points

Institutions

  • 1989–2014
    • Università degli Studi di Torino
      • Dipartimento di Neuroscienze
      Torino, Piedmont, Italy
  • 2013
    • Azienda Ospedaliera Fatebenefratelli e Oftalmico Milano
      Milano, Lombardy, Italy
  • 2009
    • University of Florence
      • Dipartimento di Neuroscienze, Psicologia, Area del Farmaco e Salute del Bambino
      Florence, Tuscany, Italy
  • 2000
    • Ospedale di San Raffaele Istituto di Ricovero e Cura a Carattere Scientifico
      Milano, Lombardy, Italy