Rivista di psichiatria最新文献

{"title":"[The role of psychiatry in the Emergency Department: the Psychiatric Fast Track model in the Emergency Department of Bolzano Hospital].","authors":"Anna Borghesani, Alessandro Briani, Patrick Clauser, Elena Carion, Andreas Conca","doi":"10.1708/4487.44877","DOIUrl":"https://doi.org/10.1708/4487.44877","url":null,"abstract":"<p><p>The Psychiatric Fast Track pathway at the Bolzano Hospital was established in 2023 to improve the management of psychiatric emergencies in the Emergency Department context. This brief document analyzes the current structuring of the pathway and its implementation in the practical reality of Bolzano and its surrounding area. The benefits of the pathway, the challenges encountered, and potential areas for improvement are discussed.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 2","pages":"78-80"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological counselling services at a Southern Italian university: utilization rates and characteristics of university students asking help.","authors":"Gaia Caldarelli, Barbara Pizzini, Marina Cosenza, Gaetana Affuso, Alda Troncone","doi":"10.1708/4487.44876","DOIUrl":"https://doi.org/10.1708/4487.44876","url":null,"abstract":"<p><strong>Aim: </strong>To assess the utilization rate of a university psychological counselling center in Southern Italy, a retrospective analysis of data collected from September 2018 to December 2023 was conducted.</p><p><strong>Method: </strong>Data were gathered through an online questionnaire, which was distributed to students seeking psychological help (SH) from University Counselling Service (UCS) at their first contact with the service.</p><p><strong>Results: </strong>The frequency of contacts with UCS (n=639) and the number of SH students who received psychological counselling (n=503) significantly differed over a 6-year period, with the highest number of interviews delivered after the Covid-19 pandemic (contacts: χ2=84.814, p<.0001; interventions: χ2=25.161, p<.0001). More than 40% of the SH students were medical students, followed by approximately 32% of students attending psychological courses. Differences were found across years in the type of course attended by SH students (χ2=54.323, p<.0001) and in dropout rates (χ2=24.427, p<.0001).</p><p><strong>Discussion and conclusions: </strong>The significantly higher demand for psychological help confirms the increased psychological distress in university students. The shift to online modalities and the broader dissemination of mental health literacy, particularly in the aftermath of the Covid-19 outbreak, may explain the significant increase in service utilization rates. These findings highlight the need for timely interventions to address the needs of SH students.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 2","pages":"71-77"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and management of tardive dyskinesia: from research to clinical practice.","authors":"Andrea Fagiolini, Paolo Barone, Antonello Bellomo, Emi Bondi, Carlo Colosimo, Giovanni Fabbrini, Giuseppe Maina, Maurizio Pompili, Michele Tinazzi, Antonio Vita, Alessandro Cuomo","doi":"10.1708/4487.44874","DOIUrl":"https://doi.org/10.1708/4487.44874","url":null,"abstract":"<p><p>Tardive dyskinesia (TD) is a chronic, often disabling hyperkinetic movement disorder associated with prolonged use of dopamine receptor blocking agents (DRBAs), particularly antipsychotics (APs) for psychiatric disorders such as schizophrenia and bipolar disorder. It manifests as abnormal, involuntary movements, often involving the orofacial region, extremities, or trunk, and is associated with significant physical and psychosocial impairment. TD is primarily linked to dopamine receptor hypersensitivity, oxidative stress, and genetic susceptibility, with a higher prevalence in patients treated with first-generation APs. However, second-generation APs (SGAs) have not eliminated the risk entirely, particularly in older adults and those with prolonged exposure. Diagnosis relies on clinical assessments such as the Abnormal Involuntary Movement Scale (AIMS) and comprehensive neurological evaluations. Treatment guidelines emphasize early detection, prevention through minimal effective doses of APs, and the use of VMAT2 inhibitors (vesicular monoamine transporter 2 inhibitors) as a first-line therapy in moderate-to-severe cases. VMAT2 inhibitors reduce dopamine signaling dysregulation without directly blocking D2 receptors, effectively managing symptoms in many patients. For treatment-resistant cases, deep brain stimulation and other non-pharmacological interventions offer promising alternatives. Current research underscores the complexity of TD's pathophysiology and the need for personalized approaches. Future directions include developing biomarkers for risk stratification, refining therapeutic strategies, and optimizing long-term outcomes through multidisciplinary care.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 2","pages":"51-60"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Assisted suicide for patients suffering from severe depression. An unacceptable option that psychiatrists must fight with all their strength.]","authors":"Giovanni de Girolamo, Andrea Angelozzi, Anna Rita Atti, Corrado Barbui, Marcella Bellani, Giuseppe Bersani, Massimo Biondi, Paolo Brambilla, Roberto Brocca, Massimo Clerici, Danilo Di Diodoro, Giuseppe Ducci, Federico Durbano, Chiara Fabbri, Andrea Fagiolini, Lucio Ghio, Angela Iannitelli, Simonetta Martini, Emiliano Monzani, Giuseppe Nicolò, Pierluigi Politi, Antonio Preti, Maria Elena Ridolfi, Fabio Sambataro, Francesco Maria Saviotti, Leonardo Tondo, Alessandro Serretti, Antonio Vita, Diana De Ronchi","doi":"10.1708/4487.44879","DOIUrl":"https://doi.org/10.1708/4487.44879","url":null,"abstract":"<p><p>The debate on assisted suicide for patients suffering from severe depression raises complex issues spanning clinical, ethical, scientific, medico-legal, and cultural domains. This position paper asserts that such an option is unacceptable in the context of depressive illness, even in its most severe and treatment-resistant forms. Depression is not an irreversible or terminal condition: there are multiple therapeutic options available, including spontaneous and late remissions, and suicidal ideation must be seen as a core symptom of the disorder, not as a rational choice. Scientifically, there are no reliable biomarkers to define the \"incurability\" of depression, and prognosis is often uncertain. Ethically, the principle of non-maleficence prohibits physicians from contributing to a patient's death, while the vulnerability of individuals with severe depression impairs their decision-making capacity. From a medico-legal standpoint, it is extremely difficult to assess competence in such contexts with any degree of certainty. Culturally and symbolically, psychiatry must reaffirm its healing mandate and resist dangerous shifts that could legitimize stigma or suicidal contagion. In conclusion, psychiatrists cannot and must not adopt the role of facilitators of death. Instead, they are called to provide care, instil hope, and protect patients, even in the most challenging clinical scenarios.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 2","pages":"88-91"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lysergic psychoma and mental automatism: a clinical exploration of synthetic psychosis.","authors":"Alessandro Sarni, Giovanni Martinotti, Giuseppe Maina, Valerio Ricci","doi":"10.1708/4487.44875","DOIUrl":"https://doi.org/10.1708/4487.44875","url":null,"abstract":"<p><p>The increasing prevalence of Novel Psychoactive Substances (NPS) presents a significant challenge for both diagnosis and treatment, particularly due to the complex psychotic states they can induce. This paper explores the concept of lysergic psychoma, rooted in Bonhoeffer's exogenous psychosis model, and its relevance to modern substance-induced psychoses. Lysergic psychoma, characterized by vivid hallucinations, delusional thinking, and somatoesthetic disturbances, represents a critical stage where temporary psychotic episodes risk evolving into chronic psychosis. This condition is closely linked with mental automatism, a phenomenon initially described by De Clérambault, where patients experience uncontrollable, parasitic thoughts and sensations that disrupt normal cognitive functions. The study underscores the importance of recognizing mental automatism in the progression of substance-induced psychosis, particularly as NPS use continues to rise. It challenges traditional distinctions between endogenous and exogenous psychosis, suggesting a more nuanced understanding of the interaction between genetic predisposition, environmental stressors, and the neurobiological impacts of psychoactive substances. This work calls for refined diagnostic criteria and targeted interventions to address the growing mental health crisis associated with NPS use. Emphasizing early intervention and prevention, particularly among adolescents, is critical in mitigating the risks of these emerging psychotic disorders. Integrating historical perspectives with contemporary research, this study offers new insights into the psychopathological processes underlying substance-induced psychoses, providing valuable frameworks for clinical practice and future research.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 2","pages":"61-70"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Psychiatric oblivion\": considerations on the hypothesis of a law.","authors":"Giuseppe Bersani, Raffaella Rinaldi","doi":"10.1708/4437.44268","DOIUrl":"10.1708/4437.44268","url":null,"abstract":"<p><p>The introduction of a law on psychiatric oblivion, similar to the recent one for oncological oblivion, presents numerous complexities due to the differences between the two areas of illness, especially in terms of recovery and clinical stability. While a definitive cure is often achievable in oncological diseases, in severe mental disorders, such as schizophrenia or bipolar disorder, complete remission in the absence of therapies is rare. Even in cases of effective treatment response, patients may exhibit subclinical symptoms or cognitive and functional deficits, making the concept of psychiatric oblivion particularly problematic. Some diagnostic categories, such as brief psychotic disorder or postpartum depression, could theoretically benefit from oblivion legislation, given the potentially limited course and frequent absence of relapses. However, for the majority of psychiatric conditions the requirement of a long period of remission without therapy appears difficult to achieve. An alternative could be the introduction of criteria based on the stabilization of maintenance therapy, but this would require a more complex and less easily standardized clinical judgment. Other limitations are the residual vulnerability to relapses, the difficulty in determining a precise medical history and the influence of persistent social stigmatization, which could undermine the effects of oblivion. Therefore, the creation of a law on psychiatric oblivion would require a restrictive and selective approach, focused on specific diagnoses and long-term clinical remission criteria, tailored to the clinical and adaptive peculiarities of mental illness.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 1","pages":"43-49"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Detecting vulnerability and managing clinical and social outcomes of refugees and asylum seekers: the experience of Cultural Consultation in Bologna.]","authors":"Vincenzo Spigonardo, Leonardo Mammana, Delia Da Mosto, Ronak Khamooshi, Riccardo Rondelli, Giorgia Zanutto, Paola Rucci","doi":"10.1708/4437.44266","DOIUrl":"10.1708/4437.44266","url":null,"abstract":"<p><strong>Purpose: </strong>The Cultural Consultation Service of Bologna (SCC-Bo) is a transcultural psychiatric service situated within the International Protection Service of Bologna since January 2019. From its inception, the SCC-Bo has collected qualitative and quantitative epidemiological data that are stored in a database dedicated to documenting the Service activities and enabling research studies.</p><p><strong>Methods: </strong>The study recruited 211 refugees and asylum seekers referred to the SCC-Bo from January 2019 to June 2023 and assessed them in the following ways: severity of illness at intake as well as clinical outcomes (CGI scale), diagnosis, and pharmacological therapy.</p><p><strong>Results: </strong>The people referred to the SCC-Bo from January 2019 to June 2023 were 211: 55,9% (n=120) of them complained of new-onset psychological symptoms of moderate severity, while 26,1% (n=55) of them presented with severe symptoms. Mood disorders were most commonly diagnosed, with psychosis (20,8%, n=44) and PTSD (20,8%, n=44) also occurring frequently. The clinical outcomes improved in most of the refugees or asylum seekers followed by the SCC-Bo.</p><p><strong>Discussion: </strong>The SCC-Bo is implemented in a unique social milieu such as International Protection Service of Bologna, dedicated to the acceptance of people refugees and asylum seekers. The main goal of the SCC-Bo is to reduce barriers of care related to this peculiar social group providing psychiatric and psychological care as well as a liaison service to local health resources. The findings of this study support the rationale that this peculiar social group may suffer of psychiatric major disorders and may lack of specific clinical support.</p><p><strong>Conclusions: </strong>The SCC-Bo could be considered a model of psychiatric and psychological care appropriate to the context of the Italian reception of refugees. The SCC-Bo integrates scientific findings of transcultural psychiatric research into the psychological and psychiatric clinical approach towards refugees and asylum seekers.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 1","pages":"27-37"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An exploratory follow-up study on the relationship between asylum application outcomes, language competence, psychological well-being, and social integration in Chinese fleeing religious persecution.","authors":"Massimiliano Aragona, Miriam Castaldo","doi":"10.1708/4437.44265","DOIUrl":"10.1708/4437.44265","url":null,"abstract":"<p><strong>Aims: </strong>This study explores the long-term outcome of Chinese refugees arrived in Italy fleeing reported religious persecution.</p><p><strong>Methods: </strong>Post-migration living difficulties (PMLD), psychological well-being and language proficiency about 9 years after the first arrival are the outcomes compared in two groups. One group includes persons that had not yet received a form of international protection, still living in Italy without visa (undocumented asylum seekers - UAS). The comparison group includes persons that had received a visa for international protection (refugees - R). The Chinese versions of the World Health Organisation - Five Well-Being Index (WHO-5) and the List of Migration Experiences (LiMEs) were administered.</p><p><strong>Results: </strong>Three UAS and three R were compared. R reported higher pre-migration traumas and PMLD in the two years after the arrival in Italy. At the evaluation about 9 years later, UAS reported lower scores at the psychological well-being and more PMLD. Moreover, they had not learned Italian, while R were fluent in the host language.</p><p><strong>Conclusions: </strong>Considering that the main difference between the two groups was having or not received a visa recognizing the reliability of their asylum request, we hypothesize that this is a key variable explaining the long-term well-being and social adjustment of these persons.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 1","pages":"22-26"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is theta/beta Neurofeedback effective for gambling disorder treatment? Insights from a case report.","authors":"Giorgia Allegrini, Elena De Rossi, Anna De Blasi, Lorenzo Scoma, Andrea Paulis, Ambra Salvati, Maria Sole Nicoli, Benedetto Farina, Claudio Imperatori, Alessandro Zarfati","doi":"10.1708/4437.44267","DOIUrl":"10.1708/4437.44267","url":null,"abstract":"<p><p>Several studies showed the effectiveness of theta/beta Neurofeedback (NF) training (i.e., decrease theta power and simultaneously increase beta power) in treating different psychiatric conditions characterized by impaired cognitive control. However, investigations concerning Gambling Disorder (GD) have not yet been conducted. Thus, the main aim of the present study was to investigate the effectiveness of 11 theta/beta NF sessions in the treatment of a patient with GD. A psychological and neuropsychological assessment was performed before and after NF. A general improvement in symptoms severity (i.e., general psychopathology, dissociative symptoms, and impulsivity) as well as in cognitive performance (i.e., executive functioning) was observed after NF. Moreover, a decrease of theta/beta ratio (i.e., a marker of executive control and cognitive processing capacity) was mainly detected in the mid-frontal cortex at the end of NF training. Taken together our results provide preliminary evidence of the effectiveness of theta/beta NF in enhancing top-down cognitive control in patients with GD.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 1","pages":"38-42"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Italian version of Metacognitive Training for the acute psychiatric setting: a pilot study.","authors":"Leonardo Procenesi, Carola Di Taranto, Gaia Cuccia, Alberto Siracusano, Cinzia Niolu, Giorgio Di Lorenzo","doi":"10.1708/4437.44263","DOIUrl":"10.1708/4437.44263","url":null,"abstract":"<p><strong>Aim: </strong>Metacognitive Training (MCT) is an effective intervention for treating various psychiatric conditions. This pilot study is a preliminary exploration of the use of an Italian version of MCT-Acute, an adaptation for acute care settings.</p><p><strong>Materials and methods: </strong>MCT-Acute was administered to inpatients in an acute psychiatric ward, and the outcomes were compared to those of a treated-as-usual (TAU) control group.</p><p><strong>Results: </strong>The MCT-Acute group showed significantly greater improvements in global functioning (GAF), internalized stigma (ISMI), and social behavior (SBS) compared to the TAU group. The PANSS subscales also improved significantly. At 12 months of follow-up, the MCT-Acute group had a lower readmission rate and better PANSS and GAF scores.</p><p><strong>Conclusions: </strong>Although preliminary, this study suggests that MCT-ACUTE is a feasible and effective intervention in acute care settings, with benefits that may last months.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 1","pages":"1-9"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}