The aim of this thesis is to specifically understand the construct of anxiety and its negative implications, highlighting the most suitable treatments in the treatment of this "disease", as defined by the WHO, which affects a large part of the population, not only Italian, but also worldwide. Only thanks to greater awareness will it be possible to intervene more effectively to cure this disease that afflicts more and more people, regardless of age. The first chapter investigates the definition of anxiety, with the aim of avoiding the improper use of the term, now an integral part of our vocabulary, distinguishing the normal and functional anxiety for the individual's survival, from the pathological one, at the basis of anxiety disorders. After a brief hint about the classification of latter, according to the diagnostic manual of the DSM5, their epidemiology was observed, in the Italian and in the European context. The second chapter includes the mechanisms of action thanks to which anxiety acts, in particular by observing the activation of the fear circuit and the role of Adenosine, Cortisol and Norepinephrine in the presence of an anxiogenic stimulus. Consequently, the long-term effects of its continuous stress, typical of the individual constantly anxious, were observed, at a psychological level, through cognitive distortions, and at a biological level, through the concept of allostatic load. In the third chapter, thanks to the numerous researches on the subject, the currently effective and most used treatments in the treatment of anxiety disorders were identified and described, including benzodiazepines, 5-HT1A serotonergic receptor agonists and barbiturates. In the fourth chapter, the treatment of anxiety through drugs of plant origin is considered: the phytotherapeutic drug is preferred by the average patient because, thanks to its plant origin, it is considered safe and therefore free of all the side effects usually associated with synthetic drugs. First, some natural compounds were treated (alkaloids, terpenes, flavonoids, phenolic acids, lignans, cinnamates and saponins) which, thanks to their biological activity, can have positive effects in the treatment of this pathology; Consequently, extracts of Lavandula angustifolia L., Crocus sativus L. and Passiflora incarnata L were taken into consideration. These extracts have shown a positive biological activity in the treatment of anxiety through the use of preclinical and clinical studies. Finally, the fifth chapter discussed the concept of health, at the basis of this work, defined by the WHO as a state of complete physical, mental and social well-being and not the simple absence of disease or infirmity. Some awareness campaigns have been mentioned regarding the concept of mental health and consequently the anxiety and disorders it causes, with the aim of increasing awareness and defeating many stereotypes behind these disorders.
L’obiettivo della presente tesi è quello di comprendere nello specifico il costrutto dell’ansia e i suoi risvolti negativi, mettendo in luce i trattamenti più idonei nella cura di questo “male”, così come viene definito dall’OMS, che colpisce gran parte della popolazione, non soltanto italiana, ma anche mondiale. Solo grazie ad una maggior consapevolezza si potrà intervenire più efficacemente per curare questa patologia che affligge sempre più persone, indipendentemente dall’ età. Nel primo capitolo si indaga la definizione di ansia, con l’obiettivo di evitare l’uso improprio del termine, ormai parte integrante del nostro vocabolario, distinguendo l’ansia normale e funzionale alla sopravvivenza dell’individuo, da quella patologica, alla base dei disturbi d’ansia. Dopo un breve accenno circa la classificazione di questi ultimi, secondo il manuale diagnostico del DSM5, è stata osservata la loro epidemiologia, nel contesto italiano e in quello europeo. Nel secondo capitolo sono stati compresi i meccanismi d’azione con i quali agisce l’ansia, in particolare modo osservando l’attivazione del circuito della paura e il ruolo di Adenosina, Cortisolo e Noradrenalina in presenza di uno stimolo ansiogeno. Di conseguenza sono stati osservati gli effetti a lungo termine della sua continua sollecitazione, tipica dell’individuo costantemente in ansia, a livello psicologico, attraverso le distorsioni cognitive, e biologico, attraverso il concetto di carico allostatico. Nel terzo capitolo, grazie alle numerosissime ricerche in merito, sono stati individuati e descritti i trattamenti attualmente efficaci e più utilizzati nella cura dei disturbi d’ansia tra cui le benzodiazepine, gli agonisti del recettore serotoninergico 5-HT1A e i barbiturici. Nel quarto capitolo viene preso in considerazione il trattamento dell’ansia attraverso farmaci di origine vegetali: il farmaco fitoterapico viene preferito dal paziente medio perché, grazie alla sua origine vegetale, viene considerato sicuro e quindi privo di tutti gli effetti collaterali solitamente associati ai farmaci sintetici. In primo luogo sono stati trattati alcuni composti naturali (alcaloidi, terpeni, flavonoidi, acidi fenolici, lignani, cinnamati e saponine) che, grazie alla loro attività biologica, possono avere degli effetti positivi nel trattamento di questa patologia; di conseguenza sono stati presi in considerazione gli estratti di Lavandula angustifolia L., Crocus sativus L. e Passiflora incarnata L.. Questi estratti hanno dimostrato un’attività biologica positiva nel trattamento dell’ansia attraverso l’uso di studi preclinici e clinici. Infine, nel quinto capitolo si è discusso sul concetto di salute, alla base del presente lavoro, definito dall’OMS come uno stato di completo benessere fisico, mentale e sociale e non la semplice assenza di malattia o infermità. Sono state accennate alcune campagne di sensibilizzazione in merito al concetto di salute mentale e di conseguenza all’ansia e ai disturbi da lei provocati, con lo scopo di incrementare la consapevolezza e sconfiggere molti stereotipi dietro questi disturbi.
La fitoterapia nel trattamento dell'ansia
DESTRO, EDOARDO
2021/2022
Abstract
The aim of this thesis is to specifically understand the construct of anxiety and its negative implications, highlighting the most suitable treatments in the treatment of this "disease", as defined by the WHO, which affects a large part of the population, not only Italian, but also worldwide. Only thanks to greater awareness will it be possible to intervene more effectively to cure this disease that afflicts more and more people, regardless of age. The first chapter investigates the definition of anxiety, with the aim of avoiding the improper use of the term, now an integral part of our vocabulary, distinguishing the normal and functional anxiety for the individual's survival, from the pathological one, at the basis of anxiety disorders. After a brief hint about the classification of latter, according to the diagnostic manual of the DSM5, their epidemiology was observed, in the Italian and in the European context. The second chapter includes the mechanisms of action thanks to which anxiety acts, in particular by observing the activation of the fear circuit and the role of Adenosine, Cortisol and Norepinephrine in the presence of an anxiogenic stimulus. Consequently, the long-term effects of its continuous stress, typical of the individual constantly anxious, were observed, at a psychological level, through cognitive distortions, and at a biological level, through the concept of allostatic load. In the third chapter, thanks to the numerous researches on the subject, the currently effective and most used treatments in the treatment of anxiety disorders were identified and described, including benzodiazepines, 5-HT1A serotonergic receptor agonists and barbiturates. In the fourth chapter, the treatment of anxiety through drugs of plant origin is considered: the phytotherapeutic drug is preferred by the average patient because, thanks to its plant origin, it is considered safe and therefore free of all the side effects usually associated with synthetic drugs. First, some natural compounds were treated (alkaloids, terpenes, flavonoids, phenolic acids, lignans, cinnamates and saponins) which, thanks to their biological activity, can have positive effects in the treatment of this pathology; Consequently, extracts of Lavandula angustifolia L., Crocus sativus L. and Passiflora incarnata L were taken into consideration. These extracts have shown a positive biological activity in the treatment of anxiety through the use of preclinical and clinical studies. Finally, the fifth chapter discussed the concept of health, at the basis of this work, defined by the WHO as a state of complete physical, mental and social well-being and not the simple absence of disease or infirmity. Some awareness campaigns have been mentioned regarding the concept of mental health and consequently the anxiety and disorders it causes, with the aim of increasing awareness and defeating many stereotypes behind these disorders.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/35713