Giovanni A Fava

University of Bologna, Bolonia, Emilia-Romagna, Italy

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Publications (280)1559.4 Total impact

  • Fiammetta Cosci · Giovanni A Fava
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    ABSTRACT: The Diagnostic and Statistical of Mental Disorders , Fifth Edition (DSM-5) somatic symptom and related disorders chapter has a limited clinical utility. In addition to the problems that the single diagnostic rubrics and the deletion of the diagnosis of hypochondriasis entail, there are 2 major ambiguities: (1) the use of the term “somatic symptoms” reflects an ill-defined concept of somatization and (2) abnormal illness behavior is included in all diagnostic rubrics, but it is never conceptually defined. In the present review of the literature, we will attempt to approach the clinical issue from a different angle, by introducing the trans-diagnostic viewpoint of illness behavior and propose an alternative clinimetric classification system, based on the Diagnostic Criteria for Psychosomatic Research.
    No preview · Article · Dec 2015 · CNS spectrums
  • Giovanni A Fava · Per Bech

    No preview · Article · Nov 2015 · Psychotherapy and Psychosomatics
  • Jenny Guidi · Elena Tomba · Giovanni A Fava
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    ABSTRACT: Objective: A number of randomized controlled trials in major depressive disorder have employed a sequential model, which consists of the use of pharmacotherapy in the acute phase and of psychotherapy in its residual phase. The aim of this review was to provide an updated meta-analysis of the efficacy of this approach in reducing the risk of relapse in major depressive disorder and to place these findings in the larger context of treatment selection. Method: Keyword searches were conducted in MEDLINE, EMBASE, PsycINFO, and Cochrane Library from inception of each database through October 2014. Randomized controlled trials examining the efficacy of the administration of psychotherapy after successful response to acute-phase pharmacotherapy in the treatment of adults with major depressive disorder were considered for inclusion in the meta-analysis. Results: Thirteen high-quality studies with 728 patients in a sequential treatment arm and 682 in a control treatment arm were included. All studies involved cognitive-behavioral therapy (CBT). The pooled risk ratio for relapse/recurrence was 0.781 (95% confidence interval [CI]=0.671-0.909; number needed to treat=8), according to the random-effects model, suggesting a relative advantage in preventing relapse/recurrence compared with control conditions. A significant effect of CBT during continuation of antidepressant drugs compared with antidepressants alone or treatment as usual (risk ratio: 0.811; 95% CI=0.685-0.961; number needed to treat=10) was found. Patients randomly assigned to CBT who had antidepressants tapered and discontinued were significantly less likely to experience relapse/recurrence compared with those assigned to either clinical management or continuation of antidepressant medication (risk ratio: 0.674; 95% CI=0.482-0.943; number needed to treat=5). Conclusions: The sequential integration of CBT and pharmacotherapy is a viable strategy for preventing relapse in major depressive disorder. The current indications for the application of psychotherapy in major depressive disorder are discussed, with special reference to its integration with pharmacotherapy.
    No preview · Article · Oct 2015 · American Journal of Psychiatry
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    Fiammetta Cosci · Jenny Guidi · Richard Balon · Giovanni A Fava

    Full-text · Article · Aug 2015 · Psychotherapy and Psychosomatics
  • Richard Balon · Giovanni A. Fava · Karl Rickels

    No preview · Article · Jun 2015
  • Giovanni A Fava · Richard Balon · Karl Rickels

    No preview · Article · Apr 2015 · JAMA Psychiatry
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    ABSTRACT: The psychosocial implications of PCOS phenotypes have been investigated in different patient populations, but little attention was paid to adolescent and young women. The aim of this study was to evaluate the psychosocial correlates of PCOS and other hyperandrogenic states in a population of late adolescent and young females, and to provide a psychological characterization of specific clinical hyperandrogenic phenotypes. This was a cross-sectional study. High school female students, aged 16-19 years. The study protocol was designed with three possible levels of participation characterized by an increased level of commitment. For the specific purposes of this investigation, we focused on the subsamples of students whose clinical state was assessed by medical examination (n=835) and for whom additional laboratory tests were available (n=394). Psychological evaluation encompassed psychological distress, levels of stress, well-being, illness behavior, and quality of life (as measured by the Symptom Questionnaire, the Psychosocial Index and the Psychological Well-Being scales). Significantly higher levels of psychological distress and impaired well-being and quality of life were found among late adolescent and young women with isolated clinical hyperandrogenism compared to their normal counterparts. Furthermore, females with PCOS showed significantly greater hostility/irritability compared to healthy control subjects. These findings highlight the importance of early recognizing and adequately managing psychological distress in such patients. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    No preview · Article · Mar 2015 · Clinical Endocrinology
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    ABSTRACT: Background: Selective serotonin reuptake inhibitors (SSRI) are widely used in medical practice. They have been associated with a broad range of symptoms, whose clinical meaning has not been fully appreciated. Methods: The PRISMA guidelines were followed to conduct a systematic review of the literature. Titles, abstracts, and topics were searched using the following terms: 'withdrawal symptoms' OR 'withdrawal syndrome' OR 'discontinuation syndrome' OR 'discontinuation symptoms', AND 'SSRI' OR 'serotonin' OR 'antidepressant' OR 'paroxetine' OR 'fluoxetine' OR 'sertraline' OR 'fluvoxamine' OR 'citalopram' OR 'escitalopram'. The electronic research literature databases included CINAHL, the Cochrane Library, PubMed and Web-of-Science from inception of each database to July 2014. Results: There were 15 randomized controlled studies, 4 open trials, 4 retrospective investigations, and 38 case reports. The prevalence of the syndrome was variable, and its estimation was hindered by a lack of case identification in many studies. Symptoms typically occur within a few days from drug discontinuation and last a few weeks, also with gradual tapering. However, many variations are possible, including late onset and/or longer persistence of disturbances. Symptoms may be easily misidentified as signs of impending relapse. Conclusions: Clinicians need to add SSRI to the list of drugs potentially inducing withdrawal symptoms upon discontinuation, together with benzodiazepines, barbiturates, and other psychotropic drugs. The term 'discontinuation syndrome' that is currently used minimizes the potential vulnerabilities induced by SSRI and should be replaced by 'withdrawal syndrome'. © 2015 S. Karger AG, Basel.
    Full-text · Article · Feb 2015 · Psychotherapy and Psychosomatics
  • Giovanni A Fava · Jenny Guidi · Chiara Rafanelli · Nicoletta Sonino

    No preview · Article · Dec 2014 · Psychotherapy and Psychosomatics
  • Fiammetta Cosci · Giovanni A Fava · Nicoletta Sonino
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    ABSTRACT: Background: Affective disturbances involving alterations of mood, anxiety and irritability may be early symptoms of medical illnesses. The aim of this paper was to provide a systematic review of the literature with qualitative data synthesis. Methods: MEDLINE, PsycINFO, EMBASE, Cochrane, and ISI Web of Science were systematically searched from inception to February 2014. Search terms were 'prodrome/early symptom', combined using the Boolean 'AND' operator with 'anxiety/depression/mania/hypomania/irritability/irritable mood/hostility', combined with the Boolean 'AND' operator with 'medical illness/medical disorder'. PRISMA guidelines were followed. Results: A total of 21 studies met the inclusion criteria and were analyzed. Depression was found to be the most common affective prodrome of medical disorders and was consistently reported in Cushing's syndrome, hypothyroidism, hyperparathyroidism, pancreatic and lung cancer, myocardial infarction, Wilson's disease, and AIDS. Mania, anxiety and irritability were less frequent. Conclusions: Physicians may not pursue medical workup of cases that appear to be psychiatric in nature. They should be alerted that disturbances in mood, anxiety and irritability may antedate the appearance of a medical disorder.
    No preview · Article · Dec 2014 · Psychotherapy and Psychosomatics
  • Jenny Guidi · Giovanni A Fava

    No preview · Article · Nov 2014 · Rivista di Psichiatria
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    ABSTRACT: The aim of this critical review was to outline emerging trends and perspectives of clinical pharmacopsychology, an area of clinical psychology that is concerned with the psychological effects of medications. The historical development of clinical pharmacopsychology (Kraepelin, Pichot, Kellner, Di Mascio, Shader, Bech) is outlined, with critical review of its most representative expressions and reference to current challenges of clinical research. Clinical pharmacopsychology is concerned with the application of clinimetric methods to the assessment of psychotropic effects of medications (including behavioral toxicity and iatrogenic comorbidity) and the interaction of drugs with specific and non-specific treatment ingredients. Clinical pharmacopsychology offers a unifying framework for the understanding of clinical phenomena in medical and psychiatric settings. Research in this area deserves high priority.
    No preview · Article · Sep 2014 · Rivista di Psichiatria
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    Emanuela Offidani · Giovanni A Fava · Nicoletta Sonino
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    ABSTRACT: The term "iatrogenic comorbidity" refers to unfavorable modifications in the course of an illness, with regard to its characteristics and responsiveness, which may be related to previous treatments. Some iatrogenic adverse events arising from either pharmacotherapy or psychotherapy cannot be subsumed under the traditional rubric of adverse effects and require careful evaluation. Children and adolescents are generally more likely to experience adverse health consequences after drug treatment. The use of antidepressant drugs in this age group may cause potential long-term detrimental effects, such as mood elevation that does not subside when drugs are discontinued and may predispose to the development of a bipolar disorder. The concept of iatrogenic comorbidity in children and adolescents has heuristic value in weighing potential benefits and risks associated particularly with psychotropic treatments.
    Full-text · Article · Jul 2014 · CNS Drugs
  • Giovanni A Fava

    No preview · Article · Jun 2014 · Psychotherapy and Psychosomatics
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    Nicoletta Sonino · Laura Sirri · Giovanni A Fava

    Preview · Article · Jun 2014 · Journal of Clinical Endocrinology & Metabolism
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    Giovanni A Fava · Jenny Guidi · Silvana Grandi · Gregor Hasler
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    ABSTRACT: Current diagnostic definitions of psychiatric disorders based on collections of symptoms encompass very heterogeneous populations and are thus likely to yield spurious results when exploring biological correlates of mental disturbances. It has been suggested that large studies of biomarkers across diagnostic entities may yield improved clinical information. Such a view is based on the concept of assessment as a collection of symptoms devoid of any clinical judgment and interpretation. Yet, important advances have been made in recent years in clinimetrics, the science of clinical judgment. The current clinical taxonomy in psychiatry, which emphasizes reliability at the cost of clinical validity, does not include effects of comorbid conditions, timing of phenomena, rate of progression of an illness, responses to previous treatments, and other clinical distinctions that demarcate major prognostic and therapeutic differences among patients who otherwise seem to be deceptively similar since they share the same psychiatric diagnosis. Clinimetrics may provide the missing link between clinical states and biomarkers in psychiatry, building pathophysiological bridges from clinical manifestations to their neurobiological counterparts. © 2014 S. Karger AG, Basel.
    Full-text · Article · Apr 2014 · Psychotherapy and Psychosomatics
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    ABSTRACT: The precipitating role of emotional stress in the development of congestive heart failure (CHF) is a long-standing clinical observation. We employed new clinimetric criteria for the assessment of allostatic overload (AO) in a sample of CHF patients, with regard to its associations with psychological distress and health status.Allostatic overload was assessed by a semi-structured interview based on clinimetric criteria in 70 consecutive outpatients with CHF. One observer-rated scale and two self-rating questionnaires for psychological distress were administered. Cardiac variables were also collected at intake.Twenty-three patients (32.9%) were classified as having AO according to clinimetric criteria. Significant differences were found with regard to gender, with women being more likely to report AO than men (23.5% versus 57.9%). Patients with AO presented significantly higher levels of psychological distress (based on scales administered) compared with those who did not. Among cardiac risk factors, hyperglycaemia was found to be significantly associated with the presence of AO.The use of the clinimetric criteria provides a global index for identifying distress that might adversely influence the course and progression of CHF. It may be of use in clinical practice, leading to therapeutic suggestions such as lifestyle modifications and psychotherapy to help patients deal with their difficulties. © 2014 The Authors. Stress and Health published by JohnWiley & Sons, Ltd.
    Full-text · Article · Apr 2014 · Stress and Health
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    Giovanni A Fava

    Preview · Article · Feb 2014 · World psychiatry: official journal of the World Psychiatric Association (WPA)
  • Chiara Ruini · Giovanni A. Fava
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    ABSTRACT: In this chapter we examine the clinical implications of happiness and psychological well-being. A specific psychotherapeutic strategy for increasing psychological well-being, well-being therapy (WBT), is described with special reference to the promotion of an individualized and balanced path to achieve happiness and optimal human functioning, avoiding the polarities in positive psychological dimensions. WBT has been tested in a number of randomized controlled trials. The findings indicate that optimal human functioning can be promoted by specific interventions leading to a positive evaluation of one's self, a sense of continued growth and development, the belief that life is purposeful and meaningful, the possession of quality relations with others, the capacity to manage effectively one's life, and a sense of self-determination. Such modifications are associated with enduring benefits.
    No preview · Chapter · Jan 2014
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    ABSTRACT: Psychology as a science offers an enormous diversity of theories, principles, and methodological approaches to understand mental health, abnormal functions and behaviours and mental disorders. A selected overview of the scope, current topics as well as strength and gaps in Psychological Science may help to depict the advances needed to inform future research agendas specifically on mental health and mental disorders. From an integrative psychological perspective, most maladaptive health behaviours and mental disorders can be conceptualized as the result of developmental dysfunctions of psychological functions and processes as well as neurobiological and genetic processes that interact with the environment. The paper presents and discusses an integrative translational model, linking basic and experimental research with clinical research as well as population-based prospective-longitudinal studies. This model provides a conceptual framework to identify how individual vulnerabilities interact with environment over time, and promote critical behaviours that might act as proximal risk factors for ill-health and mental disorders. Within the models framework, such improved knowledge is also expected to better delineate targeted preventive and therapeutic interventions that prevent further escalation in early stages before the full disorder and further complications thereof develop. In contrast to conventional "personalized medicine" that typically targets individual (genetic) variation of patients who already have developed a disease to improve medical treatment, the proposed framework model, linked to a concerted funding programme of the "Science of Behaviour Change", carries the promise of improved diagnosis, treatment and prevention of health-risk behaviour constellations as well as mental disorders. Copyright © 2013 John Wiley & Sons, Ltd.
    Full-text · Article · Jan 2014 · International Journal of Methods in Psychiatric Research

Publication Stats

7k Citations
1,559.40 Total Impact Points


  • 1980-2015
    • University of Bologna
      • Department of Psychology PSI
      Bolonia, Emilia-Romagna, Italy
  • 1982-2013
    • University at Buffalo, The State University of New York
      • Department of Psychiatry
      Buffalo, New York, United States
  • 2012
    • IRCCS Saverio de Bellis
      Bari, Apulia, Italy
  • 2003-2010
    • Università degli Studi di Siena
      Siena, Tuscany, Italy
  • 1993-2007
    • University of Padova
      • • Department of Statistical Sciences
      • • Department of Medicine DIMED
      Padova, Veneto, Italy
    • Buffalo General Medical Center
      Buffalo, New York, United States
  • 2005
    • University of Florence
      Florens, Tuscany, Italy
    • University of Ferrara
      Ferrare, Emilia-Romagna, Italy
  • 1991
    • Università degli Studi di Brescia
      Brescia, Lombardy, Italy
  • 1983-1985
    • Erie County Medical Center
      Buffalo, New York, United States