Rivista di psichiatria最新文献

{"title":"The concept of Depression revised according to Freud and Lacan: a comparison with the modern psychiatric paradigm.","authors":"Michele Ribolsi","doi":"10.1708/4685.46998","DOIUrl":"10.1708/4685.46998","url":null,"abstract":"<p><p>This article compares two perspectives on depression: the modern psychiatric paradigm, which conceives of depression as an episodic nosographic entity with neurobiological underpinnings, sometimes accompanied by psychotic symptoms; and the Lacanian psychoanalytic framework, which understands depression as an affect secondary to a specific psychic structure and to the subject's relation to the Real. In Freud's work, depression may be endogenous (melancholia) or related to grief, whereas in Lacan's theory it may arise within any psychic structure (neurotic, perverse, or psychotic) and reflects a subjective renunciation of knowledge, carrying a fundamental ethical dimension. The paper discusses the clinical implications of Lacanian perspective: it is crucial to assess the possible presence of an underlying psychotic structure beyond the depressive affect, in order to prevent potential harm for the patients.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"61 2","pages":"62-67"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148034663","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":"Risk management in community-based psychiatry: an overview from global perspectives to the Italian context.","authors":"Giulia Listanti, Simone De Persis, Dalila Tripi, Stefano Ferracuti","doi":"10.1708/4685.46997","DOIUrl":"10.1708/4685.46997","url":null,"abstract":"<p><p>The management of risk associated with clinical processes is gaining increasing importance in both health policy and medical research. Data show that among mental health professionals, cases of violence and burnout are on the rise. Implementing appropriate risk management strategies in psychiatry should be considered a key objective. This study aims to provide an overview of the current state of psychiatric risk management, with particular focus on Italian community-based mental health services. Through a non-systematic review of international and national literature, we identify the main areas of risk in psychiatry, which can be summarized as: interpersonal violence, coercive interventions, environmental safety, adverse drug events, clinical errors, and professional burnout. In the Italian context, critical issues mainly concern the protection of staff well-being and safety, the management of forensic patients according to Law 81/2014, and the acquisition of informed consent. The National Action Plan for Mental Health 2025-2030 formally recognizes risk management as a field of action, outlining related priorities and operational strategies. For the effective implementation of risk management in community-based psychiatry, it appears to be necessary the dissemination of standardized assessment and monitoring tools, promote workforce continuous training, and strengthen the culture of consent and shared decision-making.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"61 2","pages":"51-61"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148034631","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":"A possible psychogenesis of the paraphilic behavior based on an interpretation of the film \"La Pianiste\".","authors":"Alessia Stoisman, Giacomo Ciocca","doi":"10.1708/4685.47002","DOIUrl":"10.1708/4685.47002","url":null,"abstract":"<p><p>This article aims to explore, through a psychological-narrative reading of the film \"La Pianiste\" (Haneke, 2001), specific dynamics that underpin paraphilic behavior. The focus is specifically placed on masochism and on the ambiguities surrounding the concept of consent within BDSM practices. The protagonist, Erika Kohut, is here described through the psychodynamic perspective together to the attachment theory. At the core of the analysis lies Erika's symbiotic and deeply oppressive relationship with her mother, which finds expression in self-harming rituals and submission fantasies. The erotic relationship and the sexual life of the protagonist, characterizing the film, poses a crucial question: how free is a \"yes\" in reality? While consent is often framed as a conscious and voluntary act, Erika's story reveals it to be a dangerously ambivalent terrain, shaped by unresolved psychic wounds. This work does not aim to stigmatize or pathologize BDSM practices, but rather to interrogate their \"shadow zones\": when do these practices become a space for reconstructing the Self, and when do they risk turning into a stage where unprocessed suffering is compulsively replayed?</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"61 2","pages":"87-92"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148034638","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":"Promoting student Mental Health: longitudinal evidence from the psychological support service at Tor Vergata University in Rome.","authors":"Federico Fiori Nastro, Martina Pelle, Alice Clemente, Simona Colabrese, Michele Ribolsi, Giorgio Di Lorenzo, Enzo Fortuna, Alberto Siracusano, Cinzia Niolu","doi":"10.1708/4685.46999","DOIUrl":"10.1708/4685.46999","url":null,"abstract":"<p><strong>Aims: </strong>This study aims to evaluate the impact of the Tor Vergata University psychological support service in promoting well-being and mitigating psychological distress among students. The research sought to examine changes in overall functioning and psychopathological dimensions following participation in a structured counseling intervention, assessing its role as a preventive and supportive resource within the academic environment.</p><p><strong>Methods: </strong>A longitudinal study was conducted on 83 university students (mean age= 22.3±2.38 years; 69.9% female) who accessed the Sportello Studenti psychological support service. Participants completed standardized assessments at baseline (T0) and after seven counseling sessions held every two weeks (T1), with the Beck Depression Inventory-II (BDI-II), the Symptom Checklist-90-Revised (SCL-90-R), the Pittsburgh Sleep Quality Index (PSQI), and the Global Functioning: Role and Social Scales (GF: Role; GF: Social). Non-parametric paired comparisons (Wilcoxon signed-rank tests) were used to evaluate changes in psychological distress and functioning.</p><p><strong>Results: </strong>Following participation in the counseling program, students showed significant improvements across functioning domains, while depressive symptoms and general psychopathology significantly decreased.</p><p><strong>Discussion and conclusions: </strong>The results demonstrate that short-term counseling interventions delivered within a university setting can produce measurable benefits for students' mental health. The Sportello Studenti represents an accessible, preventive, and effective first-line service for addressing psychological distress in university populations. Future research with larger samples, control groups, and long-term follow-up is warranted to confirm these outcomes and further optimize psychological support strategies within higher education contexts.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"61 2","pages":"68-77"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148034623","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":"Growth and neuropsychological developmental correlates in children with autism and cerebral palsy - a pilot study.","authors":"Rouzha Pancheva, Melisa Ilhan, Rositsa Chamova, Stefka Tsvetanova, Krasimira Koleva, Miglena Georgieva, Rozalina Braykova, Stanislava Hadzhieva, Albena Toneva, Marco Fiore, Violeta Iotova","doi":"10.1708/4641.46505","DOIUrl":"10.1708/4641.46505","url":null,"abstract":"<p><strong>Background: </strong>Cerebral palsy (CP) and autism spectrum disorder (ASD) are neurodevelopmental conditions that affect physical growth and developmental outcomes. While distinct, both can influence neuropsychological development, yet limited research has examined how growth indicators relate to developmental profiles in these groups. This pilot cross-sectional study examines the relationship between physical growth and neuropsychological development in children with CP and ASD, and compares their developmental characteristics.</p><p><strong>Methods: </strong>This cross-sectional study included 27 children (CP: n=14; ASD: n=13). Anthropometric assessments included height-for-age (HAZ), weight-for-age (WAZ), BMI-for-age (BMIAZ), mid-upper arm circumference-for-age (MUACAZ), and skinfold thickness Z-scores (TSFAZ, SSFAZ). Neuropsychological development was measured using the Developmental Profile 3 (DP-3), covering physical, adaptive, cognitive, social-emotional, and communication domains.</p><p><strong>Results: </strong>Children with ASD had significantly higher scores in physical development (median: 83.5 vs. 54.0, p=0.006), adaptive behavior (81.0 vs. 53.0, p=0.003), and overall development (78.0 vs. 58.0, p=0.035) than those with CP. No differences were found in cognitive, social-emotional, or communication domains. In the full sample, WAZ significantly correlated with adaptive behavior (r=0.491, p=0.015) and overall development (r=0.439, p=0.032). MUACAZ and TSFAZ were also associated with specific developmental domains (e.g., MUACAZ and adaptive behavior: r=0.445, p=0.033). Linear regression analysis confirmed that WAZ significantly predicted neurodevelopmental scores (β=6.20, p=0.022), explaining 46.5% of the variance when adjusted for age, gender, and parental age (Adjusted R²=0.465; p=0.040).</p><p><strong>Conclusions: </strong>Children with CP show greater growth and developmental delays than those with ASD. Weight-for-age is a key predictor of neurodevelopment, especially adaptive behavior. These findings support integrating nutritional and developmental care in neurodevelopmental interventions.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"61 1","pages":"12-22"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158169","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":"Work-related stress in personnel of law enforcement: umbrella review.","authors":"Sonia Chiaravalloti, Shizuka Kibi, David Shaholli, Maria Vittoria Manai, Giuseppe La Torre","doi":"10.1708/4641.46504","DOIUrl":"10.1708/4641.46504","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this umbrella review is to review existing studies within the literature on the subject in order to verify the real association between occupational factors, stress and law enforcement, also identifying the main associated factors.</p><p><strong>Methods: </strong>The databases used for this review were PubMed and Scopus. The following were used for the search string: \"work related stress\", (\"police\" OR \"public safety\" OR \"law enforcement\") AND review.</p><p><strong>Results: </strong>16 papers were retrieved, 8 of which were considered in the final analysis. The results indicate that organizational, operational and professional factors are the most reported causes of work stress in law enforcement. The adoption of measures to improve the organizational structure is of utmost importance. The relationships between colleagues or with managers were also important, as a poor working environment has been found to greatly increase the risk of stress. Health also plays an important role, acting on the decrease of stress. Interventions of aid for the management of stress can be mindfulness, psychotherapy and yoga.</p><p><strong>Conclusions: </strong>Mental disorders remain prevalent among law enforcement personnel and may have negative effects on officers' health and performance. Moreover, most research is based on observational studies, not necessarily indicating a causal relationship.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"61 1","pages":"1-11"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158172","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":"[Real-time experiences, physical activity, and biological outcomes in the personal recovery of patients in mental health supported accommodations: a non-randomized multicenter clinical trial.]","authors":"Alessandra Martinelli, Giovanni de Girolamo, Silvia De Francesco, Annamaria Cattaneo, Monica Almici, Sonia Bellini, Natale Salvatore Bonfiglio, Nadia Cattane, Floriana De Cillis, Cristina Festari, Alberto Redolfi, Roberta Rossi, Gian Marco Giobbio, Giovanni Battista Tura, Roberta Ghidoni","doi":"10.1708/4641.46508","DOIUrl":"10.1708/4641.46508","url":null,"abstract":"<p><strong>Purpose: </strong>In Italy, people with severe mental disorders (SMDs) are often residents in mental health supported accommodations (SAs). SMDs are associated with persistent symptoms, functional impairment, and social exclusion. Although the goal of SAs is to promote personal recovery, defined as living life to the fullest potential, the adoption of such approaches remains challenging. The study aims to assess the effectiveness of personal recovery-oriented compared with standard treatment in enhancing patients' functioning, integrating the assessment with biological markers and innovative digital technologies. In addition, the study investigates whether such interventions can reduce the burden experienced by caregivers and mental health professionals.</p><p><strong>Methods: </strong>EMPOWER-RES is a non-randomized multicenter clinical trial comparing patients in SAs receiving personal recovery-oriented treatment (n=36) and standard treatment (n=36). Patients will be matched by sex, age, and diagnosis. The personal recovery-oriented treatment will use the Mental Health Recovery Star, a tool that represents ten life dimensions and monitors the stages of change. Standardized assessments will be administered to patients, caregivers, and professionals baseline and after six months. A mobile application will collect real-time data on patients' daily experiences, mood and social interactions, while accelerometers will monitor their physical activity and sleep-wake rhythms.</p><p><strong>Results: </strong>Not yet available.</p><p><strong>Discussion and conclusions: </strong>The hypothesis is that personal recovery will significantly increase Personal and Social Functioning (PSP score ≥5 points at 6 months), reduce caregiver burden and professional burnout. The study will provide new insights to optimize mental health services and personalized therapeutic options for patients with SMDs living in SAs.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"61 1","pages":"37-50"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157865","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":"A distressing near-death experience with veridical perceptions during coma: psychiatric and clinical reflections from a rare case.","authors":"Francesco Sepioni, Antonio Metastasio, Manuel Monti","doi":"10.1708/4641.46507","DOIUrl":"10.1708/4641.46507","url":null,"abstract":"<p><strong>Background: </strong>Near-death experiences (NDEs) are profound subjective experiences that are reported by individuals who have been near death. These conscious experiences occur during critical states such as coma, cardiac arrest, or severe trauma. While the majority of NDEs are characterized by pleasant and often transformative elements like a sense of peace or connection to a higher consciousness, a significant minority of cases present with distressing, frightening, or even terrifying content. A key feature of NDEs is the out-of-body experience (OBE), where individuals feel as though they have left their physical body. Remarkably, some of these experiences include veridical perceptions, which are accurate observations of physical events that could not have been perceived from their unconscious state, and are later confirmed by third parties.</p><p><strong>Case report: </strong>We present the rare case of a 25-year-old woman who sustained a severe traumatic brain injury following a high-speed car accident, necessitating her placement in a medically induced pharmacological coma for 20 days. Upon her recovery of consciousness, the patient recounted a deeply frightening NDE (scoring 28/32 on the Greyson NDE Scale) that included an OBE with specific, accurate perceptions of events that occurred while she was unconscious. These perceptions were later verified by medical personnel. Notably, the patient subsequently reported significant psychological and behavioral changes, including the complete resolution of her pre-accident suicidal ideation.</p><p><strong>Conclusions: </strong>This case offers compelling evidence that challenges conventional reductionist models of consciousness, raising critical questions about its neurobiological basis. It also underscores the profound transformative potential of distressing NDEs and their implications for psychiatric practice. We discuss the importance of acknowledging and exploring these non-ordinary states of consciousness to better understand their psychological and neurobiological underpinnings.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"61 1","pages":"33-36"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158191","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":"SonoMind: deep learning-based voice analysis for mental health monitoring.","authors":"Jacob Jithin, K S Kannan","doi":"10.1708/4641.46506","DOIUrl":"10.1708/4641.46506","url":null,"abstract":"<p><p>Depressive disorder is a major global health concern and is often underdiagnosed due to stigma, unreliable self-reporting, and limited access to proper mental health screening tools. Despite recent advances, most existing automated approaches depend on questionnaires or multi-modal data, while efficient and reliable voice-only clinical detection frameworks remain limited, creating a clear research gap. Motivated by the need for a non-invasive, objective, and privacy-preserving diagnostic alternative, this study proposes SonoMind, an adaptive deep learning framework for early depression detection using voice signals. The methodology incorporates Adaptable Spectral Pairing for effective noise reduction, SynchroSonic Learning for synchronized feature extraction, and Adaptive Krill-Wolf Optimization for optimal feature selection, followed by a neural classification stage. The framework was evaluated using the publicly available DAIC-WOZ clinical interview dataset. Experimental results show that SonoMind achieves 97.22% accuracy, 100% precision, 95.92% recall, 97.92% F1-score, MAE of 0.027, and RMSE of 0.1666. These results confirm the robustness and reliability of the system, demonstrating its potential as a scalable and supportive tool for mental health professionals in voice-based depression screening.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"61 1","pages":"23-32"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158162","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":"Intimate partner violence and witnessing domestic violence: a comparison of Italian and international evidence.","authors":"Jacopo Santambrogio, Tiziana R Fraterrigo, Giuseppina Muratore, Alice Del Corno, Emma Francia, Francesca Mosca, Jessica Maissen, Ester Di Giacomo, Fabrizia Colmegna, Elena Andreini, Sergio Terrevazzi, Antonio Amatulli, Michele Sofia, Antonino Zagari, Carlo Alberto Tersalvi, Emma Howarth, Massimo Clerici","doi":"10.1708/4617.46258","DOIUrl":"https://doi.org/10.1708/4617.46258","url":null,"abstract":"<p><p>The objective of this review is to examine the recent literature on intimate partner violence (IPV) and witnessing domestic violence (WDV) with a view to providing definitions, prevalence data for Italy and other countries, and for special populations (such as patients with severe mental illness), investigations into risk factors (alcohol, substances, child abuse) and the consequences for general and mental health. In addition to a free search with Google, Medline was interrogated, using PubMed and PsycInfo for both topics. A total of 757 publications were extracted from PubMed and 338 from PsycInfo for IPV and mental disorders, while 334 publications were found in PubMed and 205 in PsycInfo for WDV; updated epidemiological data was obtained from Italian websites (e.g. ISTAT, Office for National Statistics). We concluded that given the increasing incidence of domestic violence, health and academic institutions should frame the phenomenon in epidemiological and clinical terms, providing updated research data to the stakeholders in order to improve treatment and prevention practices.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 6","pages":"232-252"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757563","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}