Giancarlo Trombini

Bio: Giancarlo Trombini is an academic researcher from University of Bologna. The author has contributed to research in topics: Anxiety & Depression (differential diagnoses). The author has an hindex of 17, co-authored 49 publications receiving 712 citations. Previous affiliations of Giancarlo Trombini include Vita-Salute San Raffaele University.

Psychological reactions to thermography and mammography

Abstract: SUMMARY Psychological distress and illness attitudes were investigated in women undergoing thermography and mammography by means of two self-rating scales: the Symptom Questionnaire (SQ) and the Illness Attitude Scales (IAS). After receiving normal results from thermography, a significant decrease in anxiety, depression, somatic symptoms, hostility, worry about illness, concern about pain, and fear of dying took place. Women who, because of the thermography results, required mammography, displayed significantly less distress and fewer fears before mammography than before thermography. KEY WORDS-Thermography, mammography, psychological distress, thanatophobia, breast cancer.

Modifications of electrogastrographic activity during the viewing of brief film sequences.

Abstract: The experiment assessed the effects of two film sequences, a pleasant documentary and a distressful scene, on electrogastrographic (EGG), electromyographic (EMG), and heart-rate responses during digestion by 30 healthy students. The physiological measures were recorded before and during the projection of each film sequence. At the end of each viewing period, subjects completed a self-rating questionnaire on the emotional experience. Analysis yielded a significant increase in heart-rate and EMG values during the viewing of the film sequences and a significant decrease in amplitude of the 3 cycles per minute (cpm) wave of EGG during the unpleasant film. The type of film sequence had also a statistically significant effect on the self-ratings of emotional states.

Urethral Syndrome: A Study in Psychosomatic Urology

Abstract: The authors studied a sampling of 50 female patients diagnosed with urethral syndrome (urinary symptoms and pain without infection or organic lesion) on purpose to explore some psychological aspects. The evaluation procedure began with a complete urodynamic examination followed by a clinical interview. After this all patients were given three questionnaires: Symptom Questionnaire, Illness Behaviour Questionnaire and a Biographic Questionnaire prepared specifically for this study. Statistical analysis of the data showed higher levels of hostility, irritability, anxiety, dysphoria and depression in the group of patients than in the control group. There was also a marked tendency to suffer from psychophysiological symptoms.

A Psychosomatic Outpatient Clinic

Abstract: Current emphasis in clinical psychosomatic medicine is on psychiatric interventions in acute medical and surgical situations (consultation-liaison psychiatry and medical-psychiatric units). Little interest has been taken in psychosomatic interventions in chronic situations and outpatient settings. The functioning of a psychosomatic outpatient clinic (POC) is described. One-hundred consecutive referrals were analyzed. The most frequent diagnostic finding--according to DSM III criteria--was subsumed under the rubric of "psychological factors affecting physical condition," followed by affective illness, anxiety disturbances, and somatoform disorders. The results indicate that a POC may serve a specific and definable segment of patients, whose characteristics depart from the clinical populations in consultation-liaison psychiatry and medical-psychiatric units.

Focal Play-Therapy in the extended child-parents context. A clinical case

Abstract: Clinical practice and research on preschool children with eating and evacuation disorders showed the appearance and maintenance of psychosomatic protest behaviors when the family coercively imposes its system for eating and evacuation (CANESTRARI & TROMBINI 1975; BALDARO & TROMBINI 1989; BALDARO, TROMBINI & TROMBINI 1994; BALDARO 2002; E. TROMBINI 2002). The child’s basic need, the motivation to do by oneself (which appears around the second year of life) is frustrated (KEMMLER 1957; G. TROMBINI 1969, 1970; ARFELLI GALLI 1995). The pride in his performances and aspiration to grow up replace the past desire for help. He wants to be independent in all those activities which are at the limit of his capacities, therefore the freedom consciousness becomes the focus of self consciousness (METZGER 1959). The request to do by himself simply focuses on the “I do” which the family can either obstruct or encourage not only by stimulating the child but by also previously allowing him to develop satisfactory attachment relationships (BATTACCHI & GIOVANELLI 1988).

Screening for Breast Cancer

Abstract: ContextBreast cancer screening in community practices may be different from that in randomized controlled trials. New screening modalities are becoming available.ObjectivesTo review breast cancer screening, especially in the community and to examine evidence about new screening modalities.Data Sources and Study SelectionEnglish-language articles of randomized controlled trials assessing effectiveness of breast cancer screening were reviewed, as well as meta-analyses, systematic reviews, studies of breast cancer screening in the community, and guidelines. Also, studies of newer screening modalities were assessed.Data SynthesisAll major US medical organizations recommend screening mammography for women aged 40 years and older. Screening mammography reduces breast cancer mortality by about 20% to 35% in women aged 50 to 69 years and slightly less in women aged 40 to 49 years at 14 years of follow-up. Approximately 95% of women with abnormalities on screening mammograms do not have breast cancer with variability based on such factors as age of the woman and assessment category assigned by the radiologist. Studies comparing full-field digital mammography to screen film have not shown statistically significant differences in cancer detection while the impact on recall rates (percentage of screening mammograms considered to have positive results) was unclear. One study suggested that computer-aided detection increases cancer detection rates and recall rates while a second larger study did not find any significant differences. Screening clinical breast examination detects some cancers missed by mammography, but the sensitivity reported in the community is lower (28% to 36%) than in randomized trials (about 54%). Breast self-examination has not been shown to be effective in reducing breast cancer mortality, but it does increase the number of breast biopsies performed because of false-positives. Magnetic resonance imaging and ultrasound are being studied for screening women at high risk for breast cancer but are not recommended for screening the general population. Sensitivity of magnetic resonance imaging in high-risk women has been found to be much higher than that of mammography but specificity is generally lower. Effect of the magnetic resonance imaging on breast cancer mortality is not known. A balanced discussion of possible benefits and harms of screening should be undertaken with each woman.ConclusionsIn the community, mammography remains the main screening tool while the effectiveness of clinical breast examination and self-examination are less. New screening modalities are unlikely to replace mammography in the near future for screening the general population.

Depression in the medically ill: An overview.

Abstract: Depressive symptoms and syndromes are common in the medically ill, although they are frequently unrecognized and untreated The authors review the epidemiology, differential diagnosis, clinical presentations, and response to treatment of this clinical problem They address such methodological issues in the current literature in this area as the advantages and limitations of standardized assessment measures and discuss treatment modalities for depression in the medically ill, including antidepressant medication and ECT This clinical problem warrants attention for a variety of reasons: its prevalence, associated morbidity, and treatability Elucidation of the mechanisms of depression in the medically ill may also contribute to a broader understanding of depression in other populations

Prevention of Recurrent Depression With Cognitive Behavioral Therapy: Preliminary Findings

Abstract: Background Cognitive behavioral treatment (CBT) of residual symptoms after successful pharmacotherapy yielded a substantially lower relapse rate than did clinical management in patients with primary major depressive disorders. The aim of this study was to test the effectiveness of this approach in patients with recurrent depression (≥3 episodes of depression). Methods Forty patients with recurrent major depression who had been successfully treated with antidepressant drugs were randomly assigned to either CBT of residual symptoms (supplemented by lifestyle modification and well-being therapy) or clinical management. In both groups, during the 20-week experiment, antidepressant drug administration was tapered and discontinued. Residual symptoms were measured with a modified version of the Paykel Clinical Interview for Depression. Two-year follow-up was undertaken, during which no antidepressant drugs were used unless a relapse ensued. Results The CBT group had a significantly lower level of residual symptoms after discontinuation of drug therapy compared with the clinical management group. At 2-year follow-up, CBT also resulted in a lower relapse rate (25%) than did clinical management (80%). This difference attained statistical significance by survival analysis. Conclusions These results challenge the assumption that long-term drug treatment is the only tool to prevent relapse in patients with recurrent depression. Although maintenance pharmacotherapy seems to be necessary in some patients, CBT offers a viable alternative for other patients. Amelioration of residual symptoms may reduce the risk of relapse in depressed patients by affecting the progression of residual symptoms to prodromes of relapse.