Previous studies generally suggested that high levels of environmental noise are associated with subsyndromal states (psychiatric symptoms) more than with specific syndromes. The present study shows an increased risk for long-lasting syndromal anxiety states (Generalized Anxiety Disorder and Anxiety Disorder NOS), thus supporting the hypothesis of a sustained central autonomic arousal due to chronic exposure to noise.

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Validation of the Italian version of the Edinburgh Postnatal Depression Scale (EPDS) is described. Sixty-one post-partum women (aged 22-43 years) were evaluated. Degree of accuracy of the Italian EPDS was carried out by comparing results with those obtained by means of the clinical interview Present State Examination (PSE). Nine women (15%) were suffering from clinically significant depression. The best cut-off score of the Italian EPDS was between 9 and 10; this showed the highest sensitivity (100%) with a good specificity (83%). These results are concordant with the validation of the original English scale and of other translated versions. This study confirms that the EPDS is an extremely useful screening instrument that shows consistent psychometric features when translated and used in different community contexts.

SUMMARYThe aim of this study was to assess the impact of three different psychological interventions on the quality of life (QL) of elderly cancer patients with symptoms of anxiety and/or depression. Seventy-four patients were enrolled in the study. All were aged over 65 and had solid tumours or haematological malignancies, generally in advanced stages (m-IV). The cancer t r e m e n t was administered for a mean duration of 5 months and the mean number of chemotherapy cycles was 4. After stratification for the main prognostic factors, patients were randomly assigned to one of three groups: Group A, psychopharmacological treatment; Group B , treatment A plus social support carried out by volunteers and Group C, treatment as Group B plus structured psychotherapy. The planned duration of intervention was the same as that of the medical treatment. Patients who did not complete the planned chemotherapy nevertheless received all the planned psychological intervention. The evaluation of patients' QL was assessed using either uni-or multi-dimensional instruments to explore functional status and physical symptoms as well as psychological status at subsequent times during treatment (i.e., pre-treatment, mid-treatment and at the end of treatment). The present study shows that the combination of psychopharmacological treatment with either social support for patients and their relatives carried out by volunteers (SSV), or SSV plus structured psychotherapy (SSV + SP), yielded the best results in terms of QL in the long-term treatment of elderly patients with advanced cancer. According to the analysis these two 'integrated' approaches proved to be almost equally effective.

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Background: Marfan's syndrome is an inherited disorder of connective tissue associated with characteristic abnormalities of the skeletal, ocular, and cardiovascular systems. Marked clinical variability and age dependency of all manifestations of Marfan's syndrome may render the unequivocal diagnosis difficult in mildly affected, young subjects. Hypothesis: The study and care of a 32‐year‐old woman with evidence of Manfan's syndrome, several cardiac abnormalities, and paranoid schizophrenia led to an investigation of her consenting relatives to verify the penetrance of Marfan's syndrome and the degree of comorbidity between the disease and psychiatric disorders. Methods: The patient and 12 subjects belonging to three generations of her family underwent cardiovascular, skeletal, ophthalmologic, and psychiatric examinations. Two‐dimensional and Doppler echocardiography were performed. Results: One female index patient and six of her first‐degree relatives were found to be affected by Marfan's syndrome. All seven patients were found to have mitral valve prolapse associated with other cardiac abnormalities. Four of these patients were affected by the following psychiatric disorders: generalized anxiety disorder, major depressive disorder, paranoid schizophrenia (two cases). Six more relatives without Marfan's syndrome showed mitral valve prolapse in association with other echocardiographic features. Two of these were found to be affected by a major depressive disorder. Conclusions: The present data support the hypothesis that a psychiatric condition, associated with a significantly high frequency of cardiac involvement, may be part of the phenotype of Marfan's syndrome.