Rivista di psichiatria最新文献

{"title":"Intimate partner violence and witnessing domestic violence: medico-legal implications, standards of proof, and institutional duties.","authors":"Andrea Cioffi","doi":"10.1708/4617.46257","DOIUrl":"https://doi.org/10.1708/4617.46257","url":null,"abstract":"<p><p>This editorial accompanies the comprehensive review on Intimate Partner Violence (IPV) and Witnessing Domestic Violence (WDV) published in this issue, with a focus on their medico-legal implications. It highlights how clinical consequences - ranging from chronic pain syndromes to psychiatric sequelae - must be translated into legally cognizable injuries through rigorous forensic evaluation. Particular attention is given to the recognition of children as 'primary victims' of WDV, the evidentiary value of medical documentation, the duties of healthcare professionals under mandatory reporting frameworks, and the quantification of psychological harm in civil compensation. The discussion also considers institutional liability for omissions, the reciprocal expectations between clinicians and courts, and the research priorities necessary to align public health and justice. Ultimately, IPV and WDV must be understood as violations of fundamental rights that demand integration of clinical expertise, forensic rigor, and legal accountability.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 6","pages":"227-231"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757546","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":"Assessing mental pain as a predictive factor of suicide risk in a clinical sample of patients with psychiatric disorders.","authors":"Giulia Lucca, Paolo Quaroni, Silvia Paparesta, Luca Ceroni, Camilla Callegari, Marco Innamorati, Maurizio Pompili, Nicola Poloni","doi":"10.1708/4617.46260","DOIUrl":"https://doi.org/10.1708/4617.46260","url":null,"abstract":"<p><strong>Background: </strong>Mental pain (psychache) is a key risk factor for suicide, surpassing traditional constructs like depression and anxiety. While its correlation with suicidal ideation is well-established, few studies have evaluated its predictive value for actual suicide attempts in clinical populations. This study aimed to evaluate whether mental pain predicts short-term suicide attempts in a clinical sample, and to assess its potential role as a screening tool in suicide prevention.</p><p><strong>Methods: </strong>A longitudinal study on 179 psychiatric outpatients recruited at the University Hospital of Varese between 2020 and 2022. At baseline, participants completed the Psychache Scale (PAS), Beck Hopelessness Scale (BHS), Beck Depression Inventory-II (BDI-II), and Columbia Suicide Severity Scale (C-SSRS), among others. Sociodemographic, clinical, and laboratory data were also collected. Suicide attempts were tracked over a 12-month follow-up. Binary logistic regression was used to identify predictors of suicide attempts.</p><p><strong>Results: </strong>Twenty-six patients attempted suicide during follow-up, with 24 cases occurring within the first 6 months. Higher scores on the PAS, BHS, BDI-II, and Columbia Severity Rating Scale (C-SSRS) were significantly associated with increased suicide risk. In logistic regression, the PAS emerged as an independent predictor: each point increase corresponded to a 3.8% rise in suicide attempt probability (p=0.015). The BDI-II showed the strongest model fit (R2=0.169). Unemployment and history of substance abuse were also significantly associated with increased risk. No significant associations were found with routine laboratory parameters.</p><p><strong>Conclusions: </strong>The PAS, alongside the BDI-II, BHS, and C-SSRS scales may serve as an effective tool for early suicide risk detection, especially in psychiatric and primary care settings. Mental pain appears to be a relevant short-term risk indicator, highlighting the need for targeted screening and prevention strategies. Further research should explore its application in general healthcare to enhance suicide prevention efforts.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 6","pages":"270-278"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757552","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 relationship between job satisfaction and mental health in healthcare professionals: a scoping review.","authors":"Antony Bologna, Tommaso Barlattani, Valentina Socci, Eleonora Sapone, Raffaele La Russa, Ferdinando Romano, Francesca Pacitti, Edoardo Trebbi","doi":"10.1708/4617.46259","DOIUrl":"10.1708/4617.46259","url":null,"abstract":"<p><p>The well-being and performance of healthcare professionals in non-emergency settings are significantly influenced by job satisfaction and mental health. This scoping review aims to provide an overview of the relationships between job satisfaction and mental health in healthcare professionals. A comprehensive literature search identified 24 relevant cross-sectional studies conducted in various countries, including Australia, Brazil, and the United States. The studies included a diverse range of healthcare workers, such as physicians, nurses, and nurse managers. Most studies report that higher job satisfaction is associated with better mental health outcomes, while lower job satisfaction is linked to symptoms of anxiety, depression, burnout, and psychosomatic complaints. The association emerges across professions and countries, although its strength varies according to organizational and contextual factors. These findings indicate that monitoring job satisfaction may help identify early vulnerability to mental health problems among healthcare staff. Interventions that improve working conditions and recognition of professional roles can enhance satisfaction and reduce the risk of psychopathological outcomes. Clinically, these patterns reflect dimensions of psychological distress (e.g., emotional exhaustion, anxiety, depressed mood), suggesting that brief workplace screening and early support may be warranted. Given that the included studies are predominantly crosssectional, causal inferences remain tentative and future longitudinal research is needed to clarify directionality and trajectories.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 6","pages":"253-269"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757559","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":"Cognitive preservation advantage and efficacy balance of magnetic seizure therapy in adolescent Major Depressive Disorder: a randomized controlled trial revealing efficacy cognition decoupling phenomenon.","authors":"Wei Wang, Yi Lu, Guo-Lin Mi, Xiao-Jing Li, Dan-Ning Zhang, Su-Fang Qi","doi":"10.1708/4583.45901","DOIUrl":"10.1708/4583.45901","url":null,"abstract":"<p><strong>Objective: </strong>To compare magnetic seizure therapy (MST) and modified electroconvulsive therapy (MECT) in adolescent major depressive disorder (MDD) regarding cognitive protection (assessed via the Montreal Cognitive Assessment, MoCA) and suicidality improvement (assessed via the Columbia-Suicide Severity Rating Scale, C-SSRS), with a focus on cognitive subdomains and the mediating role of cognitive changes.</p><p><strong>Methods: </strong>This analysis stems from a prospective, assessor-blinded randomized controlled trial (RCT, ChiCTR2500098032) conducted from March 1 to April 30, 2025, at Shandong Mental Health Center, enrolling 120 adolescents aged 13-18 with MDD, randomized 1:1 to MST (n=60) or MECT (n=60). Primary outcome was the Beck Depression Inventory-II (BDI-II) percentage reduction; secondary outcomes included MoCA subdomain scores, C-SSRS suicidality, and adverse events (CTCAE 5.0). Correlation, mediation (Sobel test), and repeated-measures ANOVA (RM-ANOVA) assessed the cognitive-suicidality relationship. Assessments occurred at baseline and 7 days post-treatment.</p><p><strong>Results: </strong>MECT yielded a higher BDI-II reduction rate, with no significant difference in response rate. MST significantly improved MoCA total score, particularly in memory, orientation, and executive function subdomains. MST enhanced suicidality outcomes, with a higher remission rate. The correlation between MoCA change and suicidality improvement was stronger in MST, with mediation analysis indicating a partial mediating role of MoCA improvement in MST. MST showed fewer adverse events and shorter reorientation time.</p><p><strong>Conclusions: </strong>In adolescent MDD, MST offers efficacy comparable to MECT for depression relief, with superior cognitive protection (especially memory, orientation, and executive function) and safety. The association between cognitive improvement and suicidality reduction suggests MST may indirectly mitigate suicide risk via cognitive preservation, providing a novel treatment option. Multicenter, long-term studies are needed to confirm these findings.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 5","pages":"196-201"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259073","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":"Light therapy as an add-on to standard care for perinatal depression: a 7-month follow-up randomized controlled study.","authors":"Emanuela Bianciardi, Irene Sferra, Giulia Castellani, Carolina Pinci, Elicio Marinucci, Ilaria Adulti, Rossella Mattea Quinto, Cinzia Niolu","doi":"10.1708/4583.45900","DOIUrl":"10.1708/4583.45900","url":null,"abstract":"<p><strong>Introduction: </strong>Many women with perinatal depression (PND) do not respond adequately to treatment, and perinatal insomnia remains particularly challenging to manage. The aim of this study was to evaluate the efficacy of light therapy (LT) as an adjunctive treatment to standard care in reducing symptoms of PND and sleep disturbances.</p><p><strong>Materials and methods: </strong>Outcomes were compared with a control group of women with PND who received standard care alone. A final sample of 15 women (7 in the LT group and 8 in the non-LT group) was recruited at the \"SOS MAMMA\" clinic at the University of Rome \"Tor Vergata.\" Participants in the LT group received 30 minutes of light therapy daily for five consecutive weeks. We performed a baseline clinical assessment, and the following psychometric instruments were administered from the T0, weekly for five weeks (T1-T5), after one months (T6): Edinburgh Postnatal Depression Scale (EPDS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory-II (BDI-II), Hamilton Depression Rating Scale (HAM-D). LT group underwent a follow-up six months later (T7).</p><p><strong>Results: </strong>The repeated measures ANOVA showed statistically significant Time × Group interaction effects of all psychopathological outcomes. LT-group showed greater improvements of depressive symptoms (BDI-II: Wilks' λ= .281, F= 3.42, η2= .719, p= .056; HAM-D: Wilks' λ= .290, F= 3.27, η2= .710, p= .062; EPDS: Wilks' λ= .134, F= 8.61, η2= .866, p= .004) and sleep quality (PSQI: Wilks' λ= .302, F= 3.07, η2= .698, p= .072) compared to the non-LT group. In the LT-group, the paired-sample t-tests comparing T6 with T7 showed improvements of BDI-II (t, 6= 3.81; Cohen's d= 1.44; p= .009) and PSQI (t, 6= 3.10; Cohen's d= 1.17; p= .021), indicating that the effectiveness was maintained over time.</p><p><strong>Conclusions: </strong>Light therapy proved effective as an augmentation treatment in women with perinatal depression, demonstrating sustained efficacy over time and strategic tolerability. We propose that LT is a valuable intervention that targets difficult-to-treat symptoms such as insomnia, and may allow for the use of lower doses of antidepressants - reducing concerns about potential adverse effects on the offspring.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 5","pages":"188-195"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259078","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":"Intellectual freedom: an endangered basic requirement of scientific publishing.","authors":"Giovanni A Fava","doi":"10.1708/4583.45899","DOIUrl":"https://doi.org/10.1708/4583.45899","url":null,"abstract":"<p><p>The intellectual capital of medicine is the creativity linking clinical practice and research. Intellectual freedom, that allows the emergence of new paradigms, is the basic component of scientific progress in medicine. There have been major threats to intellectual freedom in the past decades: financial conflicts of interest that allowed the drug industry to gain control of scientific societies, clinical practice guidelines and reporting investigations in meetings and journals; special interest groups suppressing the pluralism of viewpoints; financial thresholds for investigators reporting their data and views (open access journals); the totalitarian derive of Evidence-Based Medicine. Further, there have been growing attacks of publishers to the independence of editors and editorial boards, with the ensuing resignations of editors and members of the editorial boards. Such events recently occurred in a journal, Psychotherapy and Psychosomatics, that was a symbol of independent thinking, pluralism and innovations.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 5","pages":"183-187"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259045","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":"[Clinical psychoanalysis and the crisis of postmodernity: from liquidity to a new neo-victorian puritanism?]","authors":"Secondo Giacobbi","doi":"10.1708/4583.45904","DOIUrl":"https://doi.org/10.1708/4583.45904","url":null,"abstract":"<p><p>The liquidity of postmodernity would appear to have been displaced, within the mainstream, by a process of re-solidification under the aegis of strong values seeking cultural hegemony. The Author designates this shift as a form of \"neo-Victorian puritanism\", antithetical to the past in terms of ideological content yet equally prescriptive and homogenizing. At the level of clinical practice, its most salient effect manifests itself in the eclipse of sexuality as a theme, insofar as the clinician often refrains from engaging with it, not least out of concern for being perceived as deviating from the prevailing \"neo-Victorian\" cultural norm.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 5","pages":"223-225"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259068","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":"Effect of Ajwa dates adjuvant therapy on improvement of clinical symptoms and serum interleukin-1β (IL-1β) levels in schizophrenia patients.","authors":"Saidah Syamsuddin, Firdaus -, Erlyn Limoa, Irfan Idris, Sonny Teddy Lisal","doi":"10.1708/4583.45902","DOIUrl":"10.1708/4583.45902","url":null,"abstract":"<p><strong>Background: </strong>Inflammation plays a role in the etiology and pathophysiology of schizophrenia symptoms, through the effects of proinflammatory cytokines such as IL-1β. Ajwa dates are one of the non-pharmacological modalities that have anti-inflammatory and antioxidant properties. However, clinical trials are still limited in exploring the role of Ajwa dates as an adjuvant in the management of schizophrenia.</p><p><strong>Objective: </strong>To determine the effect of Ajwa dates adjuvant therapy on the improvement of clinical symptoms and serum IL-1β levels in schizophrenia patients. As well as determining the correlation between clinical symptoms and serum IL-1β levels.</p><p><strong>Methods: </strong>Quasi-experimental study with random group selection using a single blind method. The number of subjects was 60, divided into a treatment group that received risperidone 4-6 mg/day plus 7 Ajwa dates/day for 8 weeks and a control group that only received risperidone. Improvement of clinical symptoms was assessed using the PANSS score, and serum IL-1β levels were measured in the first week (baseline) and week 8, with enzyme-linked immunoassay.</p><p><strong>Results: </strong>The better improvement in clinical symptoms was observed in the treatment group. A significant decrease in serum IL-1β levels was observed in both groups after 8 weeks of therapy, but the treatment group showed a greater decrease compared to the control group. A significant correlation was found between the improvement of positive symptoms and general psychopathology symptoms with a decrease in serum IL-1β levels in the treatment group.</p><p><strong>Conclusions: </strong>Ajwa dates have an adjuvant effect on improving clinical symptoms and reducing serum IL-1β levels through their anti-inflammatory properties in schizophrenia patients receiving risperidone therapy.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 5","pages":"202-213"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259015","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":"Reframing causality in psychiatry: Massimo Fagioli's theoretical contribution.","authors":"Fiamma Rinaldi, Alice Dell'Erba, Valentina Mancini","doi":"10.1708/4583.45903","DOIUrl":"https://doi.org/10.1708/4583.45903","url":null,"abstract":"<p><p>This paper explores the concept of causality in Massimo Fagioli's works, in the context of his 'Human Birth Theory', especially with respect to propositions in Western philosophical thought and to the psychiatric debate. In the history of philosophy, the nature of cause-and-effect relationship has taken on three basic meanings: regular succession, rational deductibility and productive power. We propose how these are rethought in Fagioli's theorisation as follows: as psychic activity (reaction), as dynamic phenomenon in the context of an unconscious relationship, and as human creativity. In particular, Fagioli analyzed how, within sadomasochistic relationships, the subject unconsciously conceives a concept of cause as constant repetition, and how this dynamic is resolved pathologically with the annulment pulsion, through the psychic elimination of the external object. This makes it possible to regard interhuman relationships as irrational, unconscious dynamics. Finally, the concept of cause is reconsidered based on the internal emergence of new psychic contents for the disappearance fantasy - psychic human creativity - originating at birth. Implications for psychopathology, psychodynamics and psychotherapy are then discussed.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 5","pages":"214-222"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258987","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":"Catatonia and cognition: exploring the cognitive dimensions of catatonia as an overlooked aspect of schizophrenia. A systematic review.","authors":"Vjekoslav Peitl, Frane Paleka, Dalibor Karlović","doi":"10.1708/4548.45488","DOIUrl":"https://doi.org/10.1708/4548.45488","url":null,"abstract":"<p><strong>Background and objectives: </strong>Catatonia, a complex neuropsychiatric condition, is frequently linked to psychiatric illnesses, especially schizophrenia. While its motor and behavioral signs are well-recognized, cognitive deficits in catatonia are insufficiently studied. This systematic review investigates whether catatonia involves impairments in attention, executive functioning, and other cognitive areas, particularly in psychiatric conditions like schizophrenia.</p><p><strong>Methods: </strong>We performed a systematic literature review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. We searched PubMed, Scopus, and BioMed Central using terms related to catatonia and DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) cognitive domains, including only studies that specifically assessed cognitive deficits in individuals with catatonia.</p><p><strong>Results: </strong>Thirty studies were included, consistently revealing cognitive deficits in catatonia, especially in schizophrenia patients, affecting memory, executive functioning, attention, and perceptual skills. These deficits may reflect mechanisms shared with broader schizophrenia-related cognitive challenges.</p><p><strong>Conclusions: </strong>Cognitive deficits in catatonia, often neglected, are significant in schizophrenia, emphasizing the necessity for regular cognitive evaluations and further neurobiological research to enhance diagnosis and therapeutic strategies.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"60 4","pages":"165-172"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691317","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}