Rivista di psichiatria最新文献

Background: Cannabis is the most used recreational drug worldwide. Its use can increase the risk of developing psychotic disorders and exacerbate their course. However, little is known about the relationship between psychosis and withdrawal and the literature is still scarce.

Case presentation: In this study, based on an analysis of 4 patients referred to our mental health department and evaluated between 2019 and 2023, we describe psychotic features emerged after abrupt cannabis withdrawal and we attempt to explore its characteristics.

Conclusion: Although it is difficult to show specific mechanisms underlying the psychopathological alterations in cannabis withdrawal induced psychosis, it is clear that this serious clinical picture could be a risk factor for precipitating psychosis especially in a vulnerable group of patients. Clinicians should be aware of the possibility of a higher risk of psychotic onset associated not only with chronic cannabis use but also with its abrupt cessation.

Although descriptive psychopathology of obsessive-compulsive disorder (OCD) is well-established, this disorder still presents very enigmatic and puzzling aspects. Hence the usefulness for further contributions to better clarify the picture. For example, one of the most problematic manifestations of OCD consists in pathological doubt, whose origin, however, remains unclear. For this purpose, a psychopathological analysis of several cases of OCD, in which decisional uncertainty is involved, is conducted, as well as a rereading of a famous case by Freud. As a result, the existence of a new psychological phenomenon observable in OCD people is suggested. It is proposed to call it: "incompatibility perceived between unbiased commitment and satisfaction for an unexpected and effortless personal benefit" (ICB). In fact, when an OCD subject experiences a sense of commitment, be it interpersonal or impersonal, he/she will experience the satisfaction for an unexpected and effortless benefit that results from the commitment, as incompatible with the commitment itself. As result, the subject will consider the satisfaction for the benefit as true but inacceptable, whereas he/she will consider the sense of commitment as desirable but as false. This phenomenon not only seems to explain at least some cases of indecision typical of OCD, but sheds new light on some important explanatory concepts, such as 'ambivalence', 'self-ambivalence' and 'fear of oneself', called into question over time precisely to explain the varied psychopathology of OCD. Finally, it also seems to have important implications for psychotherapy.

Aims: Interest in the well-being of professionals working in psychiatric patient care contexts is growing in the literature. The aim of this study was to explore the perceived role and work experience of psychologist psychotherapists working in Mental Health Centers (MHC).

Methods: A qualitative research was conducted involving psychologists with a training in psychotherapy working in Lombardy who had at least 3 months of working experience in a MHC. A convenience sample was recruited by email through the Order of Psychologists. From November 2022 to March 2023, 3 focus groups were conducted online and were audio-recorded. In each focus group, a video stimulus was shown, followed by questions on the perceived role and work experience of the participants. Three psychologists analyzed the focus groups' transcripts according to thematic content analysis.

Results: We enrolled 21 psychologists (3 males, with an average age of 44.71 years (SD=9.09) and with an average of 8.49 (SD=8.81) years of work in MHC). Four themes emerged: epistemology of care, services' organization, role of the psychologist and work experience of the psychologist. Results suggest that the epistemology of care embraced, even implicitly, in the MHC contributes to influence the organization of services, the role of the psychologists and their work experience. In MHCs with a biopsychosocial epistemology, the psychologists felt their role was acknowledged and valued by the care team. This leads to experiences of valorization and appreciation.

Discussion and conclusions: Results highlight the importance of the epistemology of care in influencing organization of services and the perceived role and work experience of the psychologists. However, it is also possible that a more circular relationship between the different levels exists, whereby organizational practices could also influence the epistemology of care and the perceived role and work experience of the psychologist. The variety of experiences, within the same Region, suggest that there is a possible cultural and organizational autonomy in MHCs. A reflection on the epistemology of care and organizational practices adopted in MHCs is needed to promote psychologists' well-being at work.

Introduction: Information and communication technologies (ICT) offer many advantages but also have negative aspects. This study explores the level of stress caused by technology and its impact on productivity, analyzing individual perceptions and use of technology.

Methods: This observational study used a questionnaire validated by Tarafdar et al., translated into Italian and administered online. Technological stress factors, role stress, and productivity were analyzed using SPSS 27. Multivariate analysis identified relationships between responses and various variables.

Results: The analysis of 1,746 individuals revealed a significant association between techno-overload, techno-invasion, techno-complexity, techno-insecurity, techno-uncertainty, and demographic and work-related variables. These factors affected productivity. Bivariate and multivariate analyses confirmed the interaction between technology, stress, and work efficiency. In particular, the female gender was associated with techno-overload (p=0.04), techno-invasion, and role conflict (p<0.001). Age was correlated with techno-invasion (p=0.001), techno-complexity (p<0.001), role overload (p<0.001), role conflict (p=0.046), and productivity (p=0.018).

Discussion and conclusions: Technology, while useful, can lead to technostress. The study highlights how various technological stress factors impact gender, age, and work-related stress. This observational study evaluates the phenomenon of technostress, both work-related and non-work-related, experienced by 1,746 individuals. The results particularly indicate that different technological stress factors significantly affect women, age, and work-related stress. Continued research is needed in this field to better understand and clarify the epidemiology, clinical presentation, and causes of the condition.

Aims: Military veterans exposed to stressful or traumatic events may experience adjustment difficulties in the post-deployment period, developing a high risk of mental health-related issues. Promising complementary practices such as Equine-Assisted Therapy (EAT) are now widely used, although standardized protocols are missing. The present study aimed to develop an EAT standardized intervention.

Material and methods: A total of 16 veterans were enrolled for the study (11 veterans for the EAT group and 5 veterans for the control group). The EAT lasted 9 months and both a quantitative (State-Trait Anxiety Inventory Scale; Hamilton Depression Rating Scale; Symptom Checklist 90 Scale; Warwick Edinburgh Mental Well-Being Scale) and a qualitative evaluation (observations and guided discussions) were carried out.

Results: While standardized scales did not show significant results, the qualitative evaluation revealed improvements in participants' attitudes and behaviors (autonomy, self-confidence, sense of agency), coping strategies, management of anxiety and the gradual overcoming of interpersonal difficulties.

Discussion and conclusion: The EAT intervention was particularly appreciated with a high adherence. The empathetic relationship with the horse allowed the participants to establish positive relationships within the group. A self-awareness process emerged during guided discussions and the EAT intervention allowed veterans to rediscover a new group identity. The intervention methodology proved feasible and sustainable although with important limitations due to the low number of participants, the lack of female veterans and the distance between the equestrian rehabilitation centre and the participant's residence. The present study highlights the potential of the human-horse relationship in managing adjustment difficulties, consolidating coping strategies and developing veterans' interpersonal skills.

The Covid-19 pandemic has enormously impacted health, the economy, and social organisations worldwide. Public health interventions such as vaccines, protective equipment and social distancing have brought profound changes in the general and clinical population's behaviour, with different levels of adherence to social and health standards. To understand these phenomena, it is essential to know how models and theories of social behaviour influence patterns of adherence to preventive measures in the context of the pandemic. Research on social cognition can explain behavioural variables and their impact on mental well-being, creating the basis for interventions that promote adherence to prevention rules. This PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) rapid review aims to identify and analyse current evidence on the pandemic's impact on social cognition components. First, we conducted a comprehensive literature review and discussed the findings narratively. Tables were constructed, and articles were sorted based on study characteristics. Finally, 14 eligible articles were identified. Our findings suggest that restrictions aimed at stemming infections and social isolation led to changes in patterns of social cognition in clinical and general populations. Among the clinical population, subjects with autism spectrum disorders and Parkinson's disease reported changes in social cognition. Among the general population, older adults and front-line workers also reported variations. Our results suggest that planning-oriented social cognition models could effectively promote adherence to preventive norms. These findings can help develop behavioural intervention models by identifying appropriate approaches for the general population and specific subgroups.

Drinking alcohol during pregnancy can cause congenital disabilities. J. Roquette, P. Lemoine and K.L. Jones were the first to describe these effects. In 1973, Jones and Smith coined the term Fetal Alcohol Syndrome to describe children with facial anomalies, poor growth, and learning difficulties. The caution against drinking during pregnancy has existed for centuries, including in The Bible (Judges 13:3-4). Maternal alcohol consumption is linked to congenital disabilities. To ensure safety, it is advised to abstain from alcohol during pregnancy. Fetal Alcohol Spectrum Disorder (FASD) was observed in paintings from the mid-19th century when artists began depicting moments and characters from everyday life. In 2005-2006, Italy conducted a groundbreaking study on FASD, the first in Europe. The study resulted in valuable research on FASD, contributing to prevention efforts. Unfortunately, diagnosing FASD remains a challenge in Italy. Early diagnosis and treatment are critical, and increasing the number of authorized centers to diagnose FASD is necessary to improve care. Educating ourselves about FASD is the key to creating a world where affected children receive the care they need. These guidelines include nine works dealing with all FASD aspects such as prevention, the effects on cognition, the epidemiology, the diagnostic criteria, the clinical aspects, the general effects on the body, the available treatments and the methods of detecting alcohol abuse in pregnant women.

Fetal Alcohol Spectrum Disorders (FASD) are pervasive disorders that impact various domains of functioning, including self-esteem, familiar and peer relationships, and academic success. The high rate of comorbidity may contribute to delayed diagnosis and treatment. Early diagnosis and intervention that aim at primary symptoms may prevent secondary disabilities and improve the outcomes. No intervention emerged as maximally effective across all symptoms and domains. Consequently, the complex pathophysiology of FASD emphasizes the need for individualized assessment and treatment by using a multimodal approach to intervention.

Fetal alcohol spectrum disorders (FASD) are a significant global challenge characterized by complex diagnosis and research. The diagnostic process is complicated due to overlapping symptoms with other conditions, as well as factors such as maternal nutrition, socioeconomic status, and mental health, which can affect the severity of FASD traits differently in individuals. Risky drinking behaviors are prevalent in young adults, especially those aged 20-24, which coincides with high rates of unplanned pregnancies, increasing the risk of FASD. Specific subpopulations, such as children in care facilities and specialized clinical settings, face higher FASD prevalence. Preventing alcohol consumption during pregnancy is crucial for maternal and fetal well-being. Yet approximately 10% of women worldwide continue to drink during pregnancy, with notably high rates in the European Region. Young adults, especially in countries like Italy, continue to consume alcohol despite legal restrictions, mirroring the drinking patterns of men and raising concerns for fetal health and development. Research findings regarding alcohol’s risks during pregnancy vary, emphasizing the need for increased education on this issue. Ethylglucuronide (EtG) is a reliable biomarker for monitoring alcohol intake during pregnancy, suggesting regular urine examinations throughout each trimester. Proactive education campaigns, particularly in educational institutions, and establishing early diagnosis centers are recommended to address FASD effectively.

Fetal Alcohol Spectrum Disorders (FASD) is an encompassing term used to describe a range of afflictions brought about by the consumption of alcohol during gestation. The detrimental effects primarily manifest in the central nervous system, growth, and distinctive facial features. Given that there are no known treatments for FASD, the meticulous screening for this condition in the earliest stages of pregnancy bears immense significance, ensuring the avoidance of the grievous consequences stemming from exposure to alcohol in utero. Screening measures for FASD encompass the assessment of alcohol biomarkers such as Phosphatidylethanol (PEth) in the maternal bloodstream, Fatty Acid Ethyl Esters (FAEEs) in the meconium, and Ethyl Glucuronide (EtG) in the meconium, maternal urine and hair. In particular, urinary EtG is highly sensitive and could be routinely used in pregnant women for detecting also occasional drinking. Questionnaire evaluations including AUDIT-C, T-ACE, and TWEAK, alongside a detailed Food Diary method to identify alcohol misuse and high-risk pregnancies, are also available. However, these questionnaires might provide an inadequate reflection of alcohol consumption in women due to their inclination to dissemble to comply with prevailing sociocultural expectations. Hence, this comprehensive review advocates for the indispensable integration of alcohol biomarkers detection in the course of pregnancy monitoring, as it constitutes a valuable tool for facilitating FASD screening.