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Thursday, 25.05.2017

Leonardo Tondo: Narrative report

Dr. Tondo has studied the course and treatment of bipolar (manic-depressive) and unipolar major depressive disorders since 1975.  He is a leading expert on long-term treatment of mood disorders and on medical approaches to suicide prevention.  He currently spends 50% of his time in clinical practice, 40%–45% in research and teaching, and 5%–10% on administrative duties.  In 1977, he established a specialized, research-based, mood-disorders clinic, the Lucio Bini Mood Disorder Center (named for the inventor of electroconvulsive treatment), affiliated with the University of Cagliari in Sardinia.  The Center has systematically collected clinical research data (now-computerized) involving more than 5,500 patients, 45% of them1998 diagnosed with affective illnesses.  It is the largest private psychiatric institution of its kind in the region and one of the largest in Europe.  The staff includes eight psychiatrists and five psychologists who provide a broad range of assessments and treatments.  Dr. Tondo is also affiliated with the same outpatient clinic in Rome, affiliated to the non profit organization Aretaeus. 

Dr. Tondo has taught university courses in clinical psychiatry, general and clinical psychology, and psychological testing for more than 30 years before retirement in 2009.  He has focused particularly on the course and treatment of bipolar disorders, based on prolonged, systematic experience with 1200 such patients.  His notable contributions include: [a] abrupt or rapid discontinuation of mood-stabilizing or antidepressant medicines, including among pregnant women, was strongly associated with markedly increased and earlier risk of illness-recurrence, rehospitalization, or suicidal behavior, whereas gradual dose-reduction decreased, and not merely delayed, adverse outcomes; [b] quantification of beneficial and adverse effects of long-term treatment with the best-established mood-stabilizing agent, lithium carbonate; these include marked reductions of all phases of bipolar disorder, and markedly reduced risk suicides and attempts in bipolar as well as unipolar-depressed patients.  More recently he led the most comprehensive review and quantitative analysis of risks of clinical mood-elevation (“switching”) associated with antidepressant treatment among patients with various mood disorders (Publication 108), and submitted research grant applications to continue this research under better-controlled, prospective conditions in his own Center.  He recently assessed the role of onset-age as a critical factor in differentiating types I and II bipolar disorders from unipolar depressed patients, including differential assessment of illnesses starting with depression before bipolarity is manifest; this work included both his Center and other patients provided by a growing series of international collaborations.  These and other studies have been strongly encouraged by Harvard Medical School collaborators including Professor Ross J. Baldessarini, founding director of the International Consortium for Bipolar Disorder Research at McLean Hospital, leading to many publications in outstanding international research journals.  In summary, Dr. Tondo's major contributions include establishment of a specialized mood-disorder clinical research center in Europe, with one of the largest systematically evaluated, treated, and followed cohorts of mood disorder patients ever collected.  His studies include clarification of onset, course, and treatment responses in major mood disorders, including long-term prophylaxis with mood-stabilizing treatments in bipolar disorders as well as adverse effects.  His contributions have been recognized by international awards for his research on the treatment of bipolar disorder and in the medical prevention of suicide.  

Leonardo Tondo
July 30, 2015