Anxiety Disorders: Maggini C

Salvatore P, Bhuvaneswar C, Ebert D, Maggini C, Baldessarini RJ. · Department of Psychiatry, Harvard Medical School, Massachusetts, USA. · Harv Rev Psychiatry. · Pubmed #18569038 No free full text.

Abstract: Emil Kraepelin proposed to separate psychiatric disorders with psychotic features into two major categories, dementia praecox (later schizophrenia) and manic-depressive insanity (later bipolar disorder and major depression). Over the past century, there have been many efforts to categorize conditions that do not fit readily in either group. These conditions include many cases of acute psychotic illnesses of limited duration, with recovery between recurrences. For some of these conditions, Karl Kleist proposed the term cycloid psychosis: acute features were psychotic, as in schizophrenia, but the course was episodic, as in manic-depression. His concept was later elaborated by Karl Leonhard and Carlo Perris, and validated by modern studies. Leonhard described three overlapping cycloid subtypes (anxiety-beatific, excited-inhibited confusional, and hyperkinetic-akinetic motility dysfunction forms); Perris proposed a more unitary syndrome with operational diagnostic criteria; and recent investigators have considered relatively affective versus thought-disordered subtypes. The cycloid concept is not explicitly included in standard international diagnostic schemes, but both DSM-IV and ICD-10 have broad categories for acute, recurrent psychotic disorders, whose validity remains insecure. We present two cases of probable cycloid psychosis, review the history of the concept, and propose that it be reconsidered as a clinically useful category whose validity and utility for prognosis and treatment can be further tested.

Marchesi C, Bertoni S, Maggini C. · Department of Neurosciences, Psychiatric Section, University of Parma, Parma, Italy. · Obstet Gynecol. · Pubmed #19461425 No free full text.

Abstract: OBJECTIVE: To evaluate the time to onset, duration, and risk factors for major and minor depression in pregnant women attending the Centers for Prenatal Care. METHODS: The presence of depressive symptoms and their severity were evaluated at monthly intervals in 154 pregnant women, using the Primary Care Evaluation of Mental Disorders and the Hospital Anxiety and Depression Scale. Comparisons between women with major and minor depression and nondepressed women were performed using the one-way analysis of variance with Bonferroni post-hoc analysis for continuous variables and with Fisher exact test for categorical variables. RESULTS: Major depression was diagnosed in 19 women (12.3%) and minor depression in 28 (18.1%), whereas the remaining 107 did not show any depressive symptoms. Depression was later in onset and had a longer duration in women with major depression (mean+/-standard deviation 5.6+/-2.8 months and 2.3+/-1.7 months, respectively) than in women with minor depression (3.5+/-2.2 months and 1.6+/-0.7, respectively; P=.007 and P=.04). The risk of developing major depression was predicted at the beginning of pregnancy by the presence of previous depressive episodes (odds ratio [OR] 9.5, 95% confidence interval [CI] 2.5-29.2) and conflicts with husband/partner (OR 7.8, 95% CI 1.02-62.7), whereas the risk of developing minor depression was predicted by being a housewife (OR 7.2, 95% CI 2.3-22.1), presence of previous depressive episodes (OR 4.7, 95% CI 1.4-15.3) and whether the pregnancy was unwanted (OR 2.4, 95% CI 1.0-5.7). CONCLUSION: Our study confirms that major and minor depression frequently affect pregnant women, particularly those with a history of depression, and they have different risk factors and onset and duration times. In most women, these disorders are present in a mild form (short duration and mild severity). LEVEL OF EVIDENCE: III.

Marchesi C, Ampollini P, DePanfilis C, Maggini C. · Department of Neuroscience, Psychiatric Division, University of Parma, Parma, Italy. · Eur Child Adolesc Psychiatry. · Pubmed #18427866 No free full text.

Abstract: The present study evaluated whether different patterns of temperament may predict a different threshold of acceptability of obsessive-compulsive (OC) symptoms in adolescents. OC symptomatology was detected with the Leyton Obsessional Inventory-Child Version (LOI-CV) and temperament was assessed using the tridimensional personality questionnaire in 2,775 high-school students. According to the LOI-CV scores, the adolescents were classified as high interference (interfering, ego-dystonic symptoms) (HI), supernormal (noninterfering, ego-syntonic symptoms) (Sn) and controls (C) HI were 119 (4.3%), Sn 85 (3.1%) and C 2,571 (92.6%). The best predictor of belonging to HI or Sn groups was the temperament configuration of high Harm Avoidance (HA) and high Persistence (P). The feature that mainly distinguishes the two symptomatic groups were Novelty Seeking (NS) levels. Our data suggest that people characterized by pessimistic worry in anticipation of future problems, passive avoidant behaviour, rapid fatigability (high HA) and irresoluteness, ambitiousness, perseverance, perfectionism, enduring feelings of frustration (high P) might develop OC symptoms. Whether OC symptoms become ego-syntonic or ego-dystonic seems to mainly depend on NS levels: low NS might protect people (with the prevention of "exploratory and active behaviours" that may elicit loss of control on symptoms) from the development of interfering OC symptoms.

Marchesi C, Bertoni S, Cantoni A, Maggini C. · Department of Neurosciences, Psychiatric Section, University of Parma, Parma, Italy. · Psychol Med. · Pubmed #18366825 No free full text.

Abstract: BACKGROUND: Whether alexithymia is a personality trait that increases the risk of major depression (MD) is still debated. In this prospective study, alexithymic levels were evaluated before, during and after a depressive episode. METHOD: The alexithymic levels, the presence of MD and the severity of anxious-depressive symptoms were evaluated at intervals of about 1 month in pregnant women attending the Centers for Prenatal Care, using the Toronto Alexithymia Scale (TAS), the Primary Care Evaluation of Mental Disorders (PRIME-MD) and the Hospital Anxiety and Depression Scale (HADS). RESULTS: Sixteen women affected by MD, 21 affected by subthreshold depression and 112 non-depressed women were included in the study. Women who developed depression, compared to non-depressed women, showed similar TAS and HADS scores during the pre-morbid phase, a significant increase in the scores during depression and a significant decrease after remission, whereas no change was observed in non-depressed women. CONCLUSIONS: Our data suggest that in pregnant women alexithymia does not represent a personality trait that increases the risk of developing a depressive episode, and they support the hypothesis that alexithymia is a state-dependent phenomenon in depressed pregnant women.

Marchesi C, De Panfilis C, Cantoni A, Giannelli MR, Maggini C. · Department of Neuroscience, Psychiatric Section, University of Parma, Parma, Italy. · Psychiatry Res. · Pubmed #18234355 No free full text.

Abstract: Temperament and character were evaluated in patients with panic disorder (PD) before and after 1 year of pharmacological therapy to verify whether personality characteristics change after treatment. Therefore, 65 PD patients and 71 healthy subjects participated in the study. All subjects were evaluated with the SCID-IV, the Temperament and Character Inventory (TCI), the SCL-90, the Ham-A and the Ham-D. Patients were treated with paroxetine or citalopram. The TCI was re-administered to the patients at the end of the study. At the end of the study, complete remission was achieved by 31 patients (R), whereas symptoms did not disappear in the remaining 34 patients (NR). Before treatment, NR patients showed higher levels of harm avoidance (HA) and lower levels of persistence (P), self-directedness (SD) and cooperativeness (C) than healthy controls. Only HA levels were higher than normal in R, although they were significantly lower in R than in NR patients. These differences persisted after treatment. However, in NR patients the levels of SD and C worsened, whereas the difference between R patients and controls in HA levels (higher in R patients than in controls) disappeared after controlling the effect of residual phobic anxiety (higher than normal in R patients). Our data suggest that the high levels of HA found after remission may depend on the subsyndromal residual phobic symptoms, observed in R patients. Moreover, the persistence of anxious symptoms may have worsened the low levels of SD and C observed before treatment in patients who did not achieve remission.

De Panfilis C, Cero S, Dall'Aglio E, Salvatore P, Torre M, Maggini C. · Unit of Psychiatry, Department of Neurosciences, Parma University Hospital, Parma, Italy. · Acta Biomed. · Pubmed #17687813 links to  free full text

Abstract: BACKGROUND: To detect pre-treatment psychopathological predictors of compliance and outcome in a behavioural weight-loss program for obesity. METHODS: 68 consecutive obese outpatients were evaluated on a wide range of psychopathological variables before entering a behavioural weight reduction program. Baseline assessment included detection of psychiatric (Axis I) and personality (Axis II) disorders, anxiety and depression levels, temperament and character patterns, alexithymia, and eating attitudes. These variables were then tested as predictors of compliance and weight loss after eight months of active treatment. RESULTS: Baseline presence of Axis I diagnoses was found to enhance the likelihood of good compliance to treatment but to lower probability of good outcome. Different psychopathological (and specifically personality) predictors of outcome were found among patients with and without psychiatric disorders. CONCLUSIONS: These data suggest the need to perform a full psychiatric evaluation, including personality assessment, to implement obesity treatment strategies.

Marchesi C, Cantoni A, Fontò S, Giannelli MR, Maggini C. · Department of Neuroscience, Psychiatric Division, University of Parma, Parma, Italy. · Acta Psychiatr Scand. · Pubmed #16889591 No free full text.

Abstract: OBJECTIVE: In this prospective study, temperament and character were evaluated in patients with panic disorder (PD), before 1 year of medication therapy, to verify whether these factors influenced the outcome of treatment. METHOD: Seventy-one PD patients were evaluated with the SCID-IV, the Temperament and Character Inventory (TCI), the SCL-90, the Ham-A and the Ham-D. Patients were treated with pharmacotherapy and were evaluated monthly over 1 year. RESULTS: Before treatment, non-remitted patients showed higher levels of harm avoidance (HA) and lower levels of persistence (P), self-directedness (SD) and cooperativeness (C), whereas remitted patients showed only higher levels of HA. After controlling the effect of the confounding variables, the likelihood to achieve remission was positively related to SD score (OR = 1.12; P = 0.002), particularly 'self-acceptance' SD dimension (OR = 1.30; P = 0.02). CONCLUSIONS: Our data suggest that in PD: i) the evaluation of personality, using the Cloninger's model, confirms the presence of personality pathology as one predictor of non-response to treatment; ii) in patients with low SD a combination of medication and cognitive-behaviour therapy should be the most effective treatment.

De Panfilis C, Cero S, Torre M, Salvatore P, Dall'Aglio E, Adorni A, Maggini C. · Unit of Psychiatry, Department of Neuroscience, Parma University Hospital, Italy. · Obes Surg. · Pubmed #16839480 No free full text.

Abstract: BACKGROUND: Research about personality factors involved in successful outcome after bariatric surgery has led to contrasting results. The reasons for such discrepancies may include the lack of assessment of adaptive personality traits and of psychiatric co-morbidity, which may limit the reliability of personality findings. This study aimed to provide exploratory data regarding preoperative personality dimensions and weight loss prediction 1 year after laparoscopic adjustable gastric banding (LAGB). Both normal and deviant personality patterns were assessed by means of the Temperament and Character Inventory (TCI). Moreover, co-morbid psychiatric disturbances were evaluated both categorically and dimensionally. METHODS: 65 morbidly obese subjects applying for LAGB were evaluated preoperatively by means of the TCI, standardized diagnostic interview, rating scales and questionnaires to assess co-morbid psychopathology. After intake screening, 35 subjects (mean age 41.2, mean BMI 45.5) were accepted for and underwent LAGB. BMI reduction 1 year following LAGB was used as an outcome measure and entered as a dependent variable in a stepwise multiple regression analysis. TCI scores, presence and severity of eating, depressive and anxiety disorders, sex, age, level of education and BMI at baseline were tested as independent variables. RESULTS: Preoperative TCI 'Persistence' scores explained >40% of variance of BMI reduction 1 year following LAGB, irrespective of preoperative BMI, age, gender, educational level, psychiatric co-morbidity, psychopathology severity and other temperament and character features. CONCLUSIONS: Some personality dimensions, as measured by the TCI, may be involved in successful weight control after LAGB.

Marchesi C, De Panfilis C, Cantoni A, Fontò S, Giannelli MR, Maggini C. · Dipartimento di Neuroscienze, Sezione di Psichiatria, Università di Parma, Italy. <> · Prog Neuropsychopharmacol Biol Psychiatry. · Pubmed #16678956 No free full text.

Abstract: OBJECTIVE: In this naturalistic and prospective study, personality was assessed in patients with panic disorder (PD), in order to evaluate whether personality features negatively influence the outcome of pharmacological treatment. METHOD: Before drug treatment, PD was diagnosed with the Structured Clinical Interview for DSM-IV disorders and personality was assessed with the Structured Interview for DSM-IV Personality Disorders. Moreover, all patients were evaluated with the SCL-90, the Ham-A and Ham-D. Then, patients were randomly treated with paroxetine (33.5+/-13.3 mg/day) or citalopram (34.7+/-15.2 mg/day) and were followed at monthly intervals for 1 year. Absence of full and limited-symptom attacks, anticipatory anxiety, phobic avoidance and depression for 3 months was used to establish remission. The effect of personality traits on each symptom domain was evaluated. RESULTS: Seventy-one patients completed the study. Remission rate was 76% for panic attacks and 46% for complete remission. When the effects of age, gender, age of onset and duration of PD, baseline SCL-90 phobic anxiety, Ham-A and Ham-D scores, Axis I comorbidity and the SIDP traits on remission were analyzed in a logistic regression, only borderline traits negatively influenced remission of panic attacks (OR=0.69; 95% CI=0.49-0.96; p=0.03), whereas the number of traits of each personality Cluster and the total number of SIDP traits did not affect the outcome of treatment. CONCLUSIONS: This study suggests that in PD patients, borderline features may negatively influence the response to monotherapy with SSRI drugs; therefore, other treatment strategies (i.e., combination of SSRI with psychotherapy) are needed to obtain remission in these patients.

Marchesi C, Cantoni A, Fontò S, Giannelli MR, Maggini C. · Dipartimento di Neuroscienze, Sezione di Psichiatria, Università di Parma, Italy. · Pharmacopsychiatry. · Pubmed #16555166 No free full text.

Abstract: OBJECTIVE: In this naturalistic and prospective study, patients with panic disorder (PD) were treated for one year 1) to verify the rate of patients achieving the resolution of full-symptom attacks, limited-symptom attacks, anticipatory anxiety, phobic avoidance and depression; and 2) to identify the predictors of symptom resolution for each domain. METHOD: One hundred patients with PD, according to DSM-IV criteria, participated in the study. In all patients, a baseline and a follow-up with monthly evaluations of SCL-90, Ham-A, Ham-D and panic diaries were carried out over a one-year period. All patients were treated with paroxetine or citalopram. RESULTS: Seventy-one patients completed the study, whereas the remaining 29 dropped out. Among completers, remission of full- and limited-symptom panic attacks was observed in 76 % of patients, whereas complete remission (resolution of panic attacks, anticipatory anxiety, phobic anxiety, and depression) was achieved by only 46 % of patients. Predictors of absence of symptom remissions were obsessive-compulsive disorder (OCD) and recurrent major depression (MD) comorbidity (for panic attacks), pre-treatment severity of anxious symptoms (for anticipatory anxiety), phobic anxiety (for phobic avoidance), and depressive symptoms (for depression). CONCLUSION: This naturalistic study shows that the high comorbidity of OCD and MD and the greater pre-treatment severity of anxious, phobic and depressive symptoms reduced the likelihood of achieving complete remission of symptoms in PD patients who completed the protocol, even though they were adequately treated with SSRI medication.

Marchesi C, Cantoni A, Fontò S, Giannelli MR, Maggini C. · Dipartimento di Neuroscienze, Sezione di Psichiatria, Università di Parma, Strada del Quartiere 2, 43100 Parma, Italy. · J Affect Disord. · Pubmed #16209891 No free full text.

Abstract: BACKGROUND: In this prospective study, Personality Disorders (PersD) were evaluated in patients with Panic Disorder (PD), before and after one year of pharmacotherapy to verify whether personality characteristics changed after treatment. METHOD: Sixty PD patients and 60 sex and age-matched normal controls participated in the study. All subjects were evaluated with the SCID-IV, the Structured Interview for DSM-IV Personality Disorders (SIDP), the SCL-90, the Ham-A and the Ham-D. Patients were treated with paroxetine or citalopram and were evaluated monthly for one year to assess the remission of symptoms. The SIDP was re-administered to the patients at the end of the study. RESULTS: Before treatment, PD patients showed a higher prevalence (60%) of PersD than normal subjects (8%). After treatment, PersD rate decreased (43%) due to the reduction of the rate of paranoid, avoidant and dependent PersD. When the effect of the treatment on personality traits was evaluated, we found that avoidant traits decreased only in remitted patients, paranoid traits decreased both in remitted and in non-remitted patients, and dependent traits decreased only in patients with major depression comorbidity. LIMITATIONS: The small sample size and the short length of the follow-up period of our study suggest caution in the generalization of our results. CONCLUSIONS: In our PD patients, an improvement of symptoms was associated with a reduction of paranoid, avoidant and dependent traits, with a normalization of paranoid traits and a persistence of avoidant and dependent characteristics. Therefore, our data suggest that in PD patients not only paranoid traits but also avoidant and dependent traits show, at least in part, a state phenomenon.

Raballo A, Maggini C. · Neuroscience Department, University of Parma, Parma, Italy. · Psychopathology. · Pubmed #15908754 No free full text.

Abstract: BACKGROUND: Contemporary psychopathological research has shown that some qualitative anomalies of the first-person experiential givenness qualify the subjective experience of schizophrenia. Such essential clinical features of schizophrenia have recently been condensed into 7 phenomenologically coherent clusters derived from the Bonn Scale for the Assessment of Basic Symptoms (BSABS). The experimental intent of this study was to test whether subapophanic self-centrality (i.e. a protopathic nondelusional form of intersubjective spatial disattunement) empowers the discriminant capacity of such a set of subjective experiential disturbances among different diagnostic groups. METHOD: Three comparably sized samples of outpatients with schizophrenia, obsessive-compulsive or mood disorders were examined with the BSABS. Logistic regression analysis was performed with diagnosis as the outcome variable. RESULTS: Elevated scores in self-perceived cognitive disorders and abnormal self-centrality were associated with DSM-IV diagnosis of schizophrenia. Self-centrality increased the discriminant capacity of the 7 designed a priori dimensions. CONCLUSIONS: These findings confirm the previously reported aggregation of some subtle qualitative alterations of subjective experience in schizophrenia, and suggest that a careful consideration of autocentric disturbances of intersubjectivity might enrich current heuristics on schizophrenic experiential vulnerability.

Marchesi C, Fontò S, Balista C, Cimmino C, Maggini C. · Department of Neuroscience, Psychiatric Clinic, University of Parma, Str del Quartiere 2, IT-43100 Parma, Italy. · Psychother Psychosom. · Pubmed #15627858 No free full text.

Abstract: BACKGROUND: In the present study, we evaluated whether patients with panic disorder (PD) in complete remission were more alexithymic than normal controls. METHODS: Fifty-two PD patients (both during the acute phase of the disorder and after at least 2 months of complete remission) and 52 age- and sex-matched normal subjects completed the Toronto Alexithymia Scale-20 and the Hamilton Rating Scales for Anxiety (Ham-A) and for Depression. RESULTS: A higher rate of alexithymia was found in PD patients than in controls (3.8%) both during the acute phase (44.2%; p < 0.001) and after remission of the disorder (21.2%; p = 0.008). During remission, PD patients showed: (1) Ham-A scores significantly higher than controls (p < 0.001); (2) only an elevation of the 'difficulty in identifying feeling' (DIF) dimension of alexithymia, and (3) a positive relationship between Ham-A scores and DIF levels (p < 0.001). CONCLUSION: After remission of panic attacks, phobic avoidance and anticipatory anxiety, PD patients are more alexithymic (even though the levels of alexithymia decreased after the resolution of the acute phase of PD) and anxious than controls. This finding might be explained by an overlap between cognitive aspects of PD and the DIF dimension of alexithymia, since alexithymic and anxious levels are positively related.

Marchesi C, Brusamonti E, Borghi C, Giannini A, Di Ruvo R, Minneo F, Quarantelli C, Maggini C. · Institute of Clinical Psychiatry, University of Parma, Parma, Italy. <> · Emerg Med J. · Pubmed #14988342 links to  free full text

Abstract: OBJECTIVE: In this study anxiety and depressive disorders were evaluated in patients admitted to an emergency department (ED) or to a medical department (MD). METHODS: The General Health Questionnaire-30 (GHQ-30) was administered to screen all patients (n = 719) consecutively admitted to an ED (n = 556) and to MD (n = 163) in a 120 day period. All GHQ-30 positive (score>4) underwent the Mini International Neuropsychiatric Interview, a structured interview to diagnose mental disorders according to DSM-IV criteria. RESULTS: Subjects positive to GHQ-30 were 264 (47%) in ED and 88 (54%) in MD. A mental disorder was diagnosed in 233 ED patients (42%) and in 77 MD patients (47%) (p = 0.70). The most frequent disorders were anxiety disorders in ED patients (18.1%) and depressive disorders in MD patients (21%) (p = 0.04). CONCLUSIONS: Anxious patients more frequently seek attention at ED, whereas patients with depressive disorders are more often observed in medical units. The improvement of quality of care, the waste of healthcare resources through unnecessary medical care, and the well known efficacy of appropriate treatments in patients with anxiety and depressive disorders make the diagnosis of these patients particularly important.

Marchesi C, Brusamonti E, Giannini A, Di Ruvo R, Mineo F, Maggini C. · Istituto di Clinica Psichiatrica, University of Parma, Italy. · Int J Psychiatry Med. · Pubmed #11841124 No free full text.

Abstract: OBJECTIVE: The present study examined patients during the year after the index hospitalization in an Emergency Ward (ED) to determine whether patients with depressive or anxiety disorders have a higher rate of readmission than patients without these conditions. METHOD: For this purpose, 165 subjects (85 diagnosed with DSM-IV depressive or anxiety disorders and 80 controls) were evaluated with the Hospital Anxiety and Depression Scale (HADS) and with the Duke Severity of Illness Scale both during the index hospitalization and one year later. Hospitalizations during the follow-up period were determined using the hospital database. RESULTS: During the follow-up period, depressed and anxious patients were more frequently rehospitalized in ED wards than controls (p = 0.006), after controlling for the effect of medical illnesses severity, marital status, living arrangement, and employment status. No difference was found regarding the admissions to wards different from ED. CONCLUSIONS: Patients with depressive or anxiety disorders use the ED ward more frequently than controls for the diagnosis and treatment of somatic symptoms.

Maggini C, Ampollini P, Gariboldi S, Cella PL, Peqlizza L, Marchesi C. · Clinical Psychiatry, University of Parma, Parma, Italy. · Acta Psychiatr Scand. · Pubmed #11401658 No free full text.

Abstract: OBJECTIVE: This study was undertaken to assess the prevalence of obsessive-compulsive symptoms in a population of Italian adolescents. Method: A sample of 2877 high-school students, 1463 males (51%) and 1414 females (49%), aged 16-21 years were assessed with the Leyton Obsessional Inventory--Child Version (LOI-CV). Two groups of subjects were defined as 'positive' on the screen: the high interference (HI) (i.e. all subjects who scored 25 or more in the interference score), and the supernormals (Sn). RESULTS: Females scored higher than males both on yes and interference scores. One hundred and nineteen (4.1%) and 87 (3.0%) constitute, respectively, the HI and the Sn groups. The most interfering symptoms were obsessions linked to dirt phobia, rumination and nail biting. CONCLUSION: The prevalence estimates of OCD symptoms confirmed the recent data of the literature that adolescent OCD symptoms are more frequent than was believed previously. Females showed more symptoms and more interference on personal functioning than males.

Salvatore P, Gariboldi S, Offidani A, Coppola F, Amore M, Maggini C. · Instituto di Clinica Psichiatrica, University of Parma, Parma, Italy. · Fertil Steril. · Pubmed #11384636 No free full text.

Abstract: OBJECTIVE: To compare the psychopathology, personality features, and marital relationships of women undergoing in vitro fertilization (IVF) with those of control patients, and to compare IVF inductees with program veterans. DESIGN: Cross-sectional clinical study. SETTING: A university hospital. PATIENT(S): One hundred and one women undergoing IVF treatment. INTERVENTION(S): Psychometric tests were administered at first visit (baseline) of index treatment cycle. MAIN OUTCOME MEASURE(S): Achievement of pregnancy. RESULT(S): Women undergoing IVF show higher levels of anxiety and emotional tension than do controls. Although the infertile women showed no abnormal personality dimensions, the IVF group did have a particular psychological profile and a different marital relationship pattern when compared with the control participants. Between IVF veterans and inductees, there are significant differences with respect to psychopathology, psychological dimensions, and couple dynamics. The achievement of pregnancy is not associated with any special psychopathological, personality, or marital characteristics among the IVF women. CONCLUSION(S): The most crucial period in IVF procedures may immediately follow the end of the first cycle because of the high risk of patients dropping out of the program. To determine the most effective supporting therapies for women undergoing fertilization procedures it could be useful to consider the psychological and relational differences between veterans and inductees.

Marchesi C, Brusamonti E, Maggini C. · Istituto di Clinica Psichiatrica, Università di Parma, P.le Matteotti 9, 43100, Parma, Italy. · J Psychosom Res. · Pubmed #11053603 No free full text.

Abstract: OBJECTIVE: the present study was undertaken to gain a better insight into the relationship between alexithymia, anxiety, and depression. Two hypotheses were tested: (1) whether a depressive or anxiety disorder is associated with an elevation of one or more dimensions of alexithymia; and (2) whether alexithymia is an independent construct from depression and anxiety in patients with depressive or anxiety disorders. METHOD: a total of 113 patients with depressive or anxiety disorders (DSM-IV) and 113 control subjects completed the 20-item version of the Toronto alexithymia scale (TAS-20) and the hospital anxiety and depression scale (HADS). RESULTS: the TAS-20 total score was higher in depressed and anxious patients than in controls. This finding mainly depended on an increased score for "difficulty identifying feelings"(DIF), and (only in depressed patients) on an increased score for "difficulty communicating feelings" (DCF). The factor analysis of the TAS-20 and HADS items showed that depression is a construct different from alexithymia, whereas some overlap exists between anxiety and DIF dimension. CONCLUSION: our results suggest that in depressive and anxiety disorders, alexithymia and depression are separate constructs that may be closely related; in contrast, there are some overlaps between the DIF dimension and anxiety.

Ampollini P, Marchesi C, Signifredi R, Ghinaglia E, Scardovi F, Codeluppi S, Maggini C. · Istituto di Clinical Psichiatrica, Università di Parma, Italy. · J Affect Disord. · Pubmed #10357034 No free full text.

Abstract: METHOD: Forty-two patients with Panic Disorder (P), 18 with Major Depression (MD), 35 with both conditions (MIX) and 45 healthy subjects (C) were tested with the Tridimensional Personality Questionnaire and the Structured Interview for DSM-III-R Personality Disorders. RESULTS: A different prevalence of Dependent (P = 16.7%, MD = 5.6%, MIX = 41.4%, C = 2.1%) (P < 0.001), Obsessive-Compulsive (P = 4.8%, MD = 27.8%, MIX = 3.4%, C = 0%) (P < 0.001) and Histrionic (P =23.8%, MD = 0%, MIX = 31%, C = 4.2%) (P = 0.001) personality disorders (PD) was found among groups. Harm Avoidance (HA) (P < 0.001) and Reward Dependence (RD) (P <0.001) were higher in patients than in controls. As expected the patients with comorbid conditions (MIX) showed higher HA levels (P < 0.01) and a greater prevalence of PDs, particularly of Cluster C compared to patients with pure disorders. CONCLUSIONS: This study suggests that high HA and RD scores are associated with P, MD and MIX, and the former dimension is even higher in MIX patients.