RESUMEN
The numbers of studies on the familial environment and personality of bulimic women have increased in recent years and results have revealed interesting features. In this study, we evaluated the temperament and character traits of patients with bulimia nervosa (BN) and their mothers and fathers, and we analyzed the correlation of temperament and character traits among members of these bulimic families. Finally, we tested the ability of the Temperament and Character Inventory (TCI) to discriminate between normal controls and bulimic subjects, their parents, and their families. Using the TCI, temperament and character features of 28 bulimic patients and their parents (23 fathers and 28 mothers) were analyzed and then compared with a control group of 29 women and their 27 fathers and 29 mothers. Data suggest that both temperament and character factors are involved in BN. Bulimic individuals were high in harm avoidance and low in self-directedness. Their mothers were distinguished by low self-directedness. The fathers were low in persistence. Harm avoidance of bulimic women positively correlated with harm avoidance and negatively with self-directedness of their mothers. The bulimic family had low self-directedness as a common denominator observed in all family members. The observation that both temperament and character have important roles in the etiopathogenesis of bulimia nervosa has important treatment ramifications. The TCI was useful in discriminating between normal controls and bulimic subjects, their parents, and the whole family.
Asunto(s)
Bulimia/psicología , Carácter , Padres/psicología , Trastornos de la Personalidad/diagnóstico , Trastornos de la Personalidad/psicología , Inventario de Personalidad , Temperamento , Índice de Masa Corporal , Bulimia/epidemiología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos de la Personalidad/epidemiologíaRESUMEN
BACKGROUND: Although several authors have suggested an important pathogenic role for psychosocial factors in 'functional' infertility, the extent to which depression, anxiety and expressed emotional patterns correlate to infertility is not yet clear. METHODS: This study included 156 infertile couples (recruited at intake) and 80 fertile couples, whose personal characteristics were recorded. They were examined using scales for the evaluation of the degree of psychopathology [Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D)], and anger expression [State-Trait Anger Expression Inventory (STAXI)]. The 156 infertile couples were then subdivided into groups based on the cause of infertility ('organic', 'functional' or 'undetermined'). The psychometric evaluation was double-blind with respect to the causes of infertility. RESULTS: Differences emerged in the degree of psychopathology between 'organic' and 'functional' infertile subjects and fertile controls. In women, logistic regression identified three variables able to predict the diagnosis subtype; these variables are HAM-A, HAM-D, and tendency toward anger suppression. In men, anger did not emerge as a predictor for diagnosis, whereas HAM-A and HAM-D did. CONCLUSIONS: The 'functional' infertile subjects of this sample showed particular psychopathological and psychological features, independent from the stress reaction following the identification of the cause of infertility.
Asunto(s)
Ira , Ansiedad/psicología , Depresión/psicología , Infertilidad/psicología , Represión Psicológica , Adulto , Ansiedad/etiología , Depresión/etiología , Método Doble Ciego , Femenino , Humanos , Infertilidad/etiología , Masculino , Escalas de Valoración Psiquiátrica , Psicometría/métodos , Distribución por SexoRESUMEN
BACKGROUND: Anorexia nervosa is a severe disorder that often responds poorly to treatment. At this time, little is known about pretreatment predictors of response. METHODS: A sample of 42 restrictor type anorectics was tested at the assessment phase and after 180 days retested using the Temperament and Character Inventory and Eating Disorder Inventory 2 along with other clinical evaluation instruments. After 180 days of treatment with multimodal 'network' therapy, the patients were divided into two groups. The first group included patients who showed relevant clinical improvement; the second group included patients considered 'not yet responding'. Data collected from the not-yet-responding group were compared by the t test with the other group's data to evaluate prognostic indexes. RESULTS: Diagnosis of personality disorder, which afflicted about 50% of patients, seemed not to be a relevant prognostic factor. However, a lower novelty seeking was characteristic of the nonresponder group. Higher levels of asceticism and maturity fears also characterized the nonresponder group. CONCLUSION: Present data suggest some elements that could be useful to focus pharmacotherapy, psychotherapy and family counseling on the current psychopathology of each patient.
Asunto(s)
Anorexia Nerviosa/terapia , Inventario de Personalidad , Adolescente , Adulto , Anorexia Nerviosa/diagnóstico , Anorexia Nerviosa/psicología , Ansiolíticos/administración & dosificación , Benzodiazepinas , Terapia Combinada , Dietoterapia , Terapia Familiar , Femenino , Estudios de Seguimiento , Humanos , Grupo de Atención al Paciente , Pronóstico , Psicoterapia , Resultado del TratamientoRESUMEN
Currently the therapy of anorexia nervosa is a relevant clinical problem. The percentage of patients who respond to short-term pharmacotherapy and psychotherapy is still low and the condition often leads to chronic pathology or death. The present study aims to determine outcome predictors beyond personality traits, eating psychopathology, or particular clinical features. Forty patients with restricter type anorexia nervosa were tested, at T0 and after 180 days, with psychometric tests and clinical evaluation instruments. Patients were then divided into two groups. One group included patients who showed relevant clinical improvement; the other included not-yet-improved patients. A lower Novelty Seeking, higher levels of Ascetism and Maturity Fears characterised the not-yet-improved group. Correlation showed evidence of diverse bonds between personality and psychopathology in the improved and not-yet-improved groups. The psychopathology of non-yet-improved patients seemed to be more linked to their temperamental features, whereas improved patients seemed to be more influenced by their character. Different levels of psychological functioning can be expressed. The present data suggest focusing pharmacotherapy and psychotherapy, even family counseling, with a progression more strictly related to the current personality functioning level and psychopathology of each patient.
Asunto(s)
Anorexia Nerviosa/psicología , Anorexia Nerviosa/terapia , Adolescente , Adulto , Terapia Combinada , Femenino , Humanos , Personalidad , Pronóstico , Escalas de Valoración Psiquiátrica , Psicopatología , Insuficiencia del TratamientoRESUMEN
We describe the case of a 48 year-old man whose Sorin bileaflet aortic prosthesis presented persistent systolic and intermittent diastolic failure due to fibrous tissue overgrowth in the left ventricular outflow tract.
Asunto(s)
Prótesis Valvulares Cardíacas , Falla de Prótesis , Válvula Aórtica , Estenosis de la Válvula Aórtica/cirugía , Ecocardiografía , Ecocardiografía Doppler en Color , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Earliest Recollections (ER) are very useful as they reveal information about a person's main aims and lifestyle, according to the Individual Psychology assumption of the inner coherence of the personality. This paper looks at the utility of analyzing ER in psychopathological research, diagnosis and therapy. Its purpose is to compare particular ER in a group of anorectic outpatients, a group of bulimic outpatients and in a control group. The results provide further evidence that ER are a useful instrument to identify various aspects of family dynamics, particular pathological nuclei which are often of the borderline type. They can also help to overcome the initial hostility towards any therapy that is often present in anorectic and assist the therapist early on in drawing a mental picture of the premises for understanding the lifestyle of the subject both as a child, and now as a patient.