Rivista di psichiatria最新文献

{"title":"Factitious disorder comorbid with borderline personality disorder and dysthymia: from medically unexplained physical symptoms to functional neurological disorder.","authors":"Carlo Lazzari,&nbsp;Ahmed Shoka,&nbsp;Marco Rabottini","doi":"10.1708/4113.41070","DOIUrl":"10.1708/4113.41070","url":null,"abstract":"<p><strong>Introduction: </strong>In this study, we introduce the concept of comorbidity between factitious disorder (FD), borderline personality disorder (BPD), dysthymia (DY), medically unexplained physical symptoms (MUPS) and functional neurological disorder (FND) characterising patients who may tend to exaggerate physical or psychiatric symptoms of presentation to a general or psychiatric hospital with a constellation of signs that do not receive confirmation from further clinical and instrumental assessments. The similarities between these syndromes and the constant presence of borderline personality in the psychopathology make it the possible link between all these syndromes.</p><p><strong>Materials and methods: </strong>The authors captured the typical appearance and characterisation of FD-BPD-DY-MUPS-FND (Com-1) syndrome in adult and non-forensic acute psychiatric hospitals in the United Kingdom (UK) and adjacent liaison psychiatric teams through case vignettes. Each case vignette merged similar clinical cases and was cross-analysed using information from various mental health and medical professionals and bridging primary and secondary carers' records.</p><p><strong>Results: </strong>The findings suggest striking similarities between the syndromes making borderline personality the bridge pathology for FD, MUPS and FND. The complexity of the diagnosis of these cases is discussed in the study, together with prototypical presentations.</p><p><strong>Conclusions: </strong>Improving the management of these often-occurring diseases requires multidisciplinary coordination across psychiatry, general care, neurology and surgery departments.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"58 5","pages":"205-219"},"PeriodicalIF":2.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41128906","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":"[Appreciation index of multifamily psychoanalysis within a territorial Mental Health Service.]","authors":"Walter Paganin,&nbsp;Sabrina Signorini,&nbsp;Aldo Salvatore Pantò","doi":"10.1708/4113.41072","DOIUrl":"10.1708/4113.41072","url":null,"abstract":"<p><strong>Aim: </strong>The aim of the present research is to assess the satisfaction levels of participants in a multifamily psychoanalysis group conducted within a territorial mental health service, following the model developed by Argentine psychoanalyst Jorge García Badaracco.</p><p><strong>Methods: </strong>To evaluate participant satisfaction in the therapeutic group, an anonymous satisfaction questionnaire was adopted and administered during each multifamily therapy session between 2016 and 2019. The sample consisted of designated patients and their family members participating in the groups.</p><p><strong>Results: </strong>The results obtained from measuring participant satisfaction during the specified time period indicate a consistent and increasing level of satisfaction with the group activities conducted by all participants.</p><p><strong>Discussion and conclusions: </strong>The obtained results indicate that the experience of multifamily psychoanalysis seems to be well-received and positively perceived by both users and family members, thereby contributing to an overall increase in satisfaction with the mental health service. The measurement of subjective satisfaction ratings in scientific literature is explored in relation to satisfaction, adherence, compliance, and treatment persistence, and can also be included as part of a broader set of variables aimed at identifying objective indicators of intervention outcomes in multifamily psychotherapies.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"58 5","pages":"226-236"},"PeriodicalIF":2.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41140283","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 advance directives (Ulysses Contract): the need for a specific law and a criteria proposal for its introduction.","authors":"Gianluca Montanari Vergallo,&nbsp;Matteo Gulino,&nbsp;Pasquale Ricci,&nbsp;Antonella Pastorini,&nbsp;Giuseppe Bersani,&nbsp;Raffaella Rinaldi","doi":"10.1708/4113.41074","DOIUrl":"10.1708/4113.41074","url":null,"abstract":"<p><strong>Aim: </strong>Advance healthcare directives in the psychiatric field raise more concerns and controversies compared to their use in other medical branches. We discuss the role of advance directives in this field and suggest a criteria proposal for the settlement of a comprehensive regulation on the matter.</p><p><strong>Methods: </strong>We analyse the existing law and discuss the ethical points in the Italian context and, in comparison, with the United Kingdom context.</p><p><strong>Results: </strong>Numerous studies have highlighted that psychiatric patients experience advance directives as an instrument to participate in therapeutic decision-making. Regarding the usefulness of advance directives, Italy and the United Kingdom did not approve deontological rules or laws. The United Nations Commission states that, based on the principles of the Convention on the Rights of Persons with Disabilities, it is necessary to respect the spatient's will, even if it is biased by psychic disorders.</p><p><strong>Conclusions: </strong>The Convention does not consider advance directives; instead, they just suggest using some support to have the patient regain their competence. In case this is unsuccessful, it is necessary to appoint a substitute decision-maker to express, even in the light of the advance directives, the will that the patient would have expressed if he had been competent.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"58 5","pages":"241-248"},"PeriodicalIF":2.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41150328","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":"Testing psychometric properties of Shared Decision Making Questionnaire - Physician Version (SDM-Q-Doc) in an Italian real-world psychiatric clinical sample.","authors":"Renato De Filippis,&nbsp;Matteo Aloi,&nbsp;Salvatore Reina,&nbsp;Antonia Cantavenara,&nbsp;Luca Steardo,&nbsp;Pasquale De Fazio,&nbsp;Cristina Segura-Garcia","doi":"10.1708/4064.40479","DOIUrl":"https://doi.org/10.1708/4064.40479","url":null,"abstract":"<p><strong>Objectives: </strong>The Shared Decision Making Questionnaire-Physician Version (SDM-Q-Doc) is the main tool assessing SDM relationship between patient and physician using the clinician viewpoint. It is reliable in all medical fields, and the validation of its Italian version was still missing. Our aim was to validate the Italian version of the SDM-Q-Doc in a clinical sample of patients suffering from severe mental illness.</p><p><strong>Methods: </strong>We approached 369 patients affected by major psychiatric disorders (including schizophrenia spectrum disorders, affective disorders and eating disorders) in a real-world outpatient clinical setting. We run the Confirmatory Factor Analysis (CFA) to test the SDM-Q-Doc structure. We calculated the correlations between the SDM-Q-Doc and the Observing Patient Involvement (OPTION) scale, used as comparing test, and McDonald ω coefficient to measure convergent validity and internal consistency respectively.</p><p><strong>Results: </strong>We reached a response rate of 93.2% (344 final participants). The CFA showed a very good fit compared of the Italian version of SDM-Q-Doc (χ2/df=3.2, CFI=.99, TLI=.99, RMSEA=.08, SRMR=.04). We found several correlations between the SDM-Q-Doc and OPTION scale supporting a robust SDM-Q-Doc construct validity, while internal consistency of the scale was McDonald ω coefficient .92. Further, inter-item correlations ranged from .390 to .703, with a mean of .556.</p><p><strong>Conclusions: </strong>This study confirms the suitability of the Italian version of SDM-Q-Doc, with good reliability and soundness even when compared to other languages validated versions and to OPTION scale. SDM-Q-Doc represents an easy-to-use physician-centered measure to assess patients' involvement in medical decision-making, well performing in the Italian-speaking population.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"58 4","pages":"167-174"},"PeriodicalIF":2.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9805492","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 psychological support for women who underwent a stillbirth during their pregnancy: the quality of midwifery care.","authors":"Martina Peracchini,&nbsp;Andrea Agostini,&nbsp;Alessio D'Angelo,&nbsp;Teresa Sicignano,&nbsp;Giancarlo Santoni,&nbsp;Enrico Finale,&nbsp;Mauro Ceccanti,&nbsp;Monica Napolitano,&nbsp;Marco Fiore,&nbsp;Luigi Tarani,&nbsp;Katarzina Anna Dylag,&nbsp;Marisa Patrizia Messina","doi":"10.1708/4064.40476","DOIUrl":"https://doi.org/10.1708/4064.40476","url":null,"abstract":"<p><strong>Purpose: </strong>This review aims to investigate the role of midwifery care in perinatal death. Specifically, it aims to investigate the type and implications in the clinical practice of psychological and psychiatric support interventions for women/couples.</p><p><strong>Methods: </strong>A scoping review was conducted following the PRISMA methodology. For this purpose, the following databases were queried: PubMed, APA PsycInfo, CINAHL Plus with Full Text, and ERIC, considering only studies published in the 2002-2022 time frame.</p><p><strong>Results: </strong>14 studies were found to be eligible by the literature review. These researches were divided into 3 macro-topics representing the most crucial factors in influencing the quality of care: the healthcare setting, the experience and training of caregivers, and the experience of parents.</p><p><strong>Discussion: </strong>The healthcare figure who experiences such a tragic event most closely is the midwife. The health and geographic context in which care is provided - understood to be low-medium-high resources - have a fundamental impact on the quality of midwifery care and caregiver satisfaction. The training was found to be incomplete, and midwives' experiences revealed how they felt unprepared. Parents' experiences indicate the need for multidisciplinary care, better communicability, and follow-up including psychological/psychiatric support for mothers who are increasingly alone in coping with bereavement. To date, there are no guidelines for psychological support for this specific event in the literature.</p><p><strong>Conclusions: </strong>Birth-death management should be a structured part of professional courses so that new generations of midwives can improve the quality of care for affected families. Future research should focus on how to improve communication processes, and hospital centers should adopt protocols adapted to the needs of parents, including a midwifery-led model policy based on psychological support for the mothers/couples involved, as well as increase follow-ups.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"58 4","pages":"143-153"},"PeriodicalIF":2.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9807879","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":"[Grief: from the physiological reaction to the psychopathology.]","authors":"Claudia Carmassi,&nbsp;Giulia Amatori,&nbsp;Andrea Cappelli,&nbsp;Enrico Brosio,&nbsp;Hélène Chauvel,&nbsp;Liliana Dell'Osso,&nbsp;Eric Bui","doi":"10.1708/4064.40477","DOIUrl":"https://doi.org/10.1708/4064.40477","url":null,"abstract":"The death of a loved one is a universal experience, and marker of the human condition. Grief, the cognitive, emotional, and behavioral responses to bereavement, is both a ubiquitous and a unique psychological process. Thus, health providers often find themselves in a dilemma, caught between the need to alleviate an individual's distress and impairment, and the danger of overly \"pathologizing\" their grief reaction. This chapter reviews how acute grief reactions generally evolve over time, the clinical presentation of complicated grief, and finally, other psychiatric disorders that might develop or be precipitated in the aftermath of the death of a loved one, particularly prolonged grief disorder.","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"58 4","pages":"154-159"},"PeriodicalIF":2.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803946","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 effect of modified electroconvulsive therapy on schizophrenia.","authors":"Hongbo Tao,&nbsp;Xuan Zhou,&nbsp;Yanqin Liu,&nbsp;Zhenlan Wang,&nbsp;Yunqin Liu,&nbsp;Zou Su,&nbsp;Qiuming Ji,&nbsp;Xianyun Yi,&nbsp;Xianghong Wu,&nbsp;Qing Zhou","doi":"10.1708/4064.40481","DOIUrl":"https://doi.org/10.1708/4064.40481","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical efficacy of modified electroconvulsive therapy (MECT) in patients with schizophrenia and provide a reference for the selection of safe and effective treatment options in clinical practice.</p><p><strong>Methods: </strong>A total of 200 patients with schizophrenia, who were admitted to Wuhan Wudong Hospital Psychiatric Hospital from January 2019 to December 2020, were selected as the study subjects. They were divided into an observation group and a control group (100 cases in each group) according to a random number table. The control group was treated with conventional antipsychotics (risperidone and aripiprazole), and the observation group was given conventional antipsychotics (risperidone and aripiprazole) with MECT. After 8 weeks, the clinical efficacy, cognitive and memory functions and the occurrence of adverse reactions between the two groups were compared.</p><p><strong>Results: </strong>The total clinical effective rate of the observation group was 90%, which was higher than that of the control group (74%), and the difference was statistically significant (p<0.05). The Wisconsin Card Sorting Test results of the observation group were better than those of the control group, and the cognitive function of the observation group was better than that of the control group (p<0.05). The Wechsler Adult Intelligence Scale-Fourth Edition index of the observation group was higher than that of the control group, and the memory function of the observation group was better than that of the control group (p<0.05). The overall incidence of adverse reactions in the observation group was lower than that in the control group, and the difference was statistically significant (p=0.001).</p><p><strong>Conclusion: </strong>The application of MECT in patients with schizophrenia can produce a good clinical curative effect, which is beneficial to the improvement and promotion of memory and cognitive functions in patients. Since the occurrence of adverse reactions is controllable, and safety is ideal, MECT has value in clinical application.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"58 4","pages":"183-189"},"PeriodicalIF":2.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9805493","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 murder of the surgeon Antonio Parrozzani and the relationship between sexual disorders and paranoid thinking.","authors":"Giacomo Ciocca,&nbsp;Tommaso B Jannini,&nbsp;Maurilio Di Giangregorio,&nbsp;Emmanuele A Jannini","doi":"10.1708/4064.40482","DOIUrl":"https://doi.org/10.1708/4064.40482","url":null,"abstract":"<p><p>In this study we aimed to describe the relationship between sexual disorders and paranoid thinking describing the historical case of murder of the famous surgeon Antonio Parrozzani and the pathological personality of his murderer. Parrozzani was killed by Francesco Mancini, his patient in the past. Mancini was obsessed by his sexual problems due to hypothetical injuries after an inguinal hernia surgery, made by Parrozzani. Following treatment, the murderer likely lived his surgery as a traumatic event and developed a paranoid thinking against the surgeon, breaking out with the dramatic homicide. Parrozzani's case highlights the strong relationship between paranoia and sexuality, and likewise this relationship can be considered as a prodromic factor for a psychotic onset. Moreover, this case, supported by two psychiatric assessments of murderer, remembers once again the association between violence and paranoia. Therefore, clinicians should take into account the danger of the possible presence of paranoid obsession together with sexual problems, to prevent psychosis onset or violent acts related to paranoid delusions.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"58 4","pages":"190-194"},"PeriodicalIF":2.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9805488","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":"[Conduct disorder in female adolescents: evidence from the FemNAT-CD Project.]","authors":"Erica Santaguida,&nbsp;Gianluca Paparatto,&nbsp;Gabriele Masi,&nbsp;Annarita Milone,&nbsp;Greta Tolomei,&nbsp;Pietro Muratori","doi":"10.1708/4064.40480","DOIUrl":"https://doi.org/10.1708/4064.40480","url":null,"abstract":"<p><p>Conduct Disorder is a diagnosis associated with behaviors at risk for the health and development of the subject, with high social costs and with serious consequences for the adolescent's life context. This disorder is predominantly found in the male population. However, girls with Conduct Disorder often have particularly severe and pervasive symptoms, with a high psychiatric comorbidity. The purpose of this article is to summarize the objectives of the project \"FemNAT-CD\", in order to promote greater knowledge of the clinical characteristics of females who show a Conduct Disorder in adolescence. This paper will describe studies related to FemNAT-CD project concerning neuro-biological, neuro-cognitive and clinical characteristics of Conduct Disorder in female adolescents as well as new psychotherapeutic and pharmacological approaches.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"58 4","pages":"175-182"},"PeriodicalIF":2.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9860340","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":"Psychopathological mediators between insecure attachment and psychotic features in a non-clinical sample: the role of depression and interpersonal sensitivity.","authors":"Rodolfo Rossi,&nbsp;Giacomo Ciocca,&nbsp;Valentina Socci,&nbsp;Tommaso B Jannini,&nbsp;Fiorela Gorea,&nbsp;Francesca Pacitti,&nbsp;Alessandro Rossi,&nbsp;Alberto Siracusano,&nbsp;Emmanuele A Jannini,&nbsp;Giorgio Di Lorenzo","doi":"10.1708/4064.40478","DOIUrl":"https://doi.org/10.1708/4064.40478","url":null,"abstract":"<p><strong>Introduction: </strong>Attachment styles represent a personality pattern critical to psychological health, with insecure attachment being a central factor in developing psychopathological characteristics of psychosis. However, its downstream psychopathological pathways remain unclear. This study aimed to investigate the putative psychopathological mediators in the relationship between insecure attachment and psychotic features in a non-clinical sample of university students.</p><p><strong>Methods: </strong>We recruited two non-clinical samples for a total of 978 subjects, 324 males and 654 females, and administered the Relationship Questionnaire (RQ) to assess attachment styles and the Symptom Check-List 90 (SCL-90) to assess psychopathological symptoms. Moreover, the Paranoia and Psychoticism subscales of SCL-90 were combined and used as a measure of Psychosis (PSY). A mediation analysis model was carried out to establish the relationship among variables.</p><p><strong>Results: </strong>Mediation analysis showed a total effect from RQ-Preoccupied and RQ-Fearful to PSY, respectively, 0.31 and 0.28. Direct effects from the SCL-90-R factor candidate mediator to PSY ranged from 0.51 for somatization to 0.72 for depression and 0.72 for interpersonal sensitivity. Indirect effects ranged from 0.08 for RQ-Preoccupied via hostility to 0.21 for RQ-Preoccupied via depression.</p><p><strong>Discussion: </strong>Our results show that the effect of insecure attachment on psychosis features is differentially mediated by some psychopathological dimensions, being depression and interpersonal sensitivity the most relevant ones. PSY feature, therefore, is predicted by other specific symptoms in the psychological context of insecure primary relationships.</p><p><strong>Conclusions: </strong>From a preventive and clinical point of view, our results could be relevant in informing the early-stage psychological treatment of pre-psychotic states and, in general, people experiencing sub-threshold psychotic symptoms.</p>","PeriodicalId":21506,"journal":{"name":"Rivista di psichiatria","volume":"58 4","pages":"160-166"},"PeriodicalIF":2.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9807884","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}