Rivista di psichiatria最新文献

Objective: The purpose of this study was to investigate the cultural adaptation and validation of the Children's Knowledge of Abuse Questionnaire (CKAQ-RIII). This tool, which is used in Iranian primary schools, examines children's understanding of the concepts of sexual abuse.

Materials and methods: A sample of 80 primary school children between 8 and 12 years of age was selected from schools in Iran. The questionnaire was administered three times: before and immediately after the Child Abuse Prevention Program and at the three-month follow-up assessment.

Results: The included children (n=80) completed the Persian version of the CKAQ-RIII during the three-month follow-up. The internal consistency of the CKAQ-RIII was high for the Inappropriate Touch Scale (ITS) and moderate for the Appropriate Touch Scale (ATS). Analysis of the Pearson correlation coefficients indicated a strong relationship between the ITS and ATS and the overall scores. The mixed-design analysis of variance (ANOVA) on the ITS showed that the children's knowledge increased after the intervention. In general, higher scores were observed for children in the fifth and sixth grades (11 to 12 years old) after the intervention, indicating greater concept knowledge. Repeated measures ANOVA was also performed on the ATS, which showed a significant increase in children's knowledge.

Conclusions: The Persian version of the CKAQ-RIII is an effective and reliable tool for assessing the level of knowledge of the concepts of sexual abuse in Iran.

Introduction: Group psychoeducation is effective in preventing relapse in bipolar disorder. It's indicated as an adjunctive intervention to pharmacotherapy for all outpatients. This retrospective, single center experience of group psychoeducation for bipolar disorder over a 6 years period, aims to assess severity of symptoms and comparative relapse episodes and intensity prior to and following psychoeducation as well as evaluating the decrease in hospitalizations and days of hospitalization.

Methods: Between 2014 and 2019 patients with a bipolar disorder were invited to attend a Colom model group psychoeducation (weekly 90 minutes sessions for 22 weeks). Depression and mania were assessed at baseline, following psychoeducation, 6 months and 12 months with the Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS). Patient specific hospitalization admissions data for 3 years prior to and 3 years following psychoeducation course were accessed. Subgroup analyses were performed according to patient sex and age with ANOVA methodology.

Results: Of the 95 eligible patients, 77 completed psychoeducation: 18 (19%) patients dropped out. Mean patient age was 45 years and 33 (43%) were male. Overall and subgroup specific YMRS and HDRS improved significantly throughout follow-up (p<0.01). Hospitalization analyses (45 patients; 58.4%) revealed a significant decrease in relapse and hospital stay days after psychoeducation, p<0.01.

Discussion: We provide evidence of applicability and efficacy of adjunctive psychoeducation in a real-world setting. Advantages observed were independent of patient sex and age. Analysis of the optimal number of sessions provided to patients according to efficacy and retention rates is required.

Conclusions: Despite inherent study design limitations, retrospective evaluation of a single-center psychoeducation program supports evidence of psychoeducation effectiveness in significantly reducing the severity of bipolar disorder and hospitalizations, despite a drop-out rate of 1 in 5.

Objective: To investigate the effects of electroacupuncture combined with paliperidone palmitate long-acting injection (PP-LAI) on withdrawal symptoms and neurotransmitters in methamphetamine (MA) addicts.

Materials and methods: A total of 109 methamphetamine addicts, who were treated in the hospital from October 2021 to October 2022, were selected. According to the random number table, the patients were divided into the study group (n=54) and the control group (n=55), in which the control group was treated with PP-LAI and the study group was treated with electroacupuncture on the basis of the control group; the methamphetamine withdrawal symptom score scale was used to assess the therapeutic effect before treatment and within 12 months after treatment; the changes of brain neurotransmitters dopamine, γ-aminobutyric acid, serotonin, acetylcholine values were compared between the two groups.

Results: 1) There was no statistical difference in MA withdrawal symptom scores between the two groups before treatment (p>0.05); 2) MA withdrawal symptom scores have a statistically significant difference between the study group and the control group after 3 and 6 months of treatment; 3) dopamine levels in the study group were significantly higher than those in the control group after 6 months of completion of treatment, and γ-aminobutyric acid values and 5- serotonin values in the study group were significantly lower than those in the control group (p<0.05).

Conclusions: Electroacupuncture combined with PP-LAI can partially improve the withdrawal symptoms and anxiety of methamphetamine addicts. This is a potential treatment for preventing relapse of withdrawal symptoms.

Aim: The Standards of Care (SOC-8) by the World Professional Association for Trans Health provide guidelines for the care of transgender and gender diverse individuals through safe and effective multi-professional interventions for physical and mental well-being. The aim of this work is to summarize the SOC-8 recommendations for childhood and adolescence, highlighting the importance of psychosocial assessment and available medical and surgical therapeutic options, and emphasizing the need for healthcare provider training.

Methods: The SOC-8 recommendations are based on scientific evidence and professional consensus from experts in transgender health, developing classification criteria and access to therapies, based on systematic literature reviews (PubMed and Embase).

Results: The SOC-8 underscores the importance of assessing and preserving gender identity, supporting prepubescent individuals from a psychosocial perspective, and ensuring adolescents access to medically and surgically conforming treatments according to local legislation. It is the responsibility of healthcare providers to understand and adapt international guidelines for an inclusive clinical practice of gender diversity.

Discussion and conclusions: Gender affirmation therapies in minors require comprehensive evaluation, parental involvement, and consideration of their cognitive and emotional maturity. Treatments should also focus on preserving fertility and accessing medicalized treatments which are beneficial to the well-being of transgender and gender diverse individuals.

Objective: In Eastern European countries, suicide rate are among the highest in the world and suicide attempts are among the most important risk factors. The aim of this study is to identify factors associated with suicide attempt (SA) in non-psychotic patients with suicidal ideation (SI).

Methods: Among 6204 consecutive adult patients (residents of Moscow) with non-psychotic mental disorders (NPMD), 361 individuals aged 18-77 years (median 24 years) were enrolled in the study after screening for lifetime SI with the Self-Injurious Thoughts and Behaviors Interview (SITBI). All participants were assessed for sociodemographic variables, psychiatric diagnosis, family history of mental disorders, history of abuse, sexual behavior, psychiatric treatments, suicide plan, SA, and nonsuicidal self-injury (NSSI). Results of multivariable analyses (MV) are presented as odds ratios (OR) with 95% confidence intervals (CI).

Results: 166 patients (46%) reported lifetime SA. In MV, variables associated with SA included smoking (OR 2.1; 95% CI 1.2-3.7), having made a suicide plan (OR 3.4; 95% CI 2.0-5.7), and scars covered by tattoos (OR 5.2; 95% CI 1.5-17.9). History of law violation (OR 2.0; 95% 1.0-4.2) was of borderline significance.

Conclusions: Transition from SI to SA in patients with NPMD was associated with smoking, suicide planning, history of law violation and presence of tattoos covering scars.

Objective: Hospitalization for Covid-19 has been recognized as a potentially traumatic experience. This longitudinal cohort study assessed the impact of psychological intervention for Covid-19 patients on anxiety, depression, and post-traumatic stress disorder (PTSD).

Materials and methods: Of 386 Covid-19 patients enrolled, 127 completed HADS and PCL-5 questionnaires at 2 months (T1), 6 months (T2) and 12 months (T3) after hospital discharge. Between T1 and T2, patients were offered the opportunity to receive psychological intervention: 92 did not request any psychological support (No support group), 15 received only one psychological consultation (Consultation group) and 20 received longer psychological support (Support group). Mixed ANOVAs were used to assess the psychological symptoms of the 3 Groups over Time.

Results: The No support group reported lower anxiety, depression, and PTSD than the other two groups. Anxiety and PTSD increased over time across groups. A Time x Group interaction was found for depression (F(2.124)=3.72, p<.05, pη2=.06). The Support group reported a decrease in depression from T1 (M=7.85) to T2 (M=7.05) and an increase from T2 to T3 (M=8.05), although not significant. The No support (T1 M=2.84; T3 M=4.36; p<.001) and the Consultation groups (T1 M=4.73; T3 M=6.33; p<.05) reported an increase in depression from T1 to T3.

Conclusions: Psychological interventions were appropriately allocated to patients with more severe symptoms. Most of the patients did not request psychological intervention. Long-term psychological support may have helped Covid-19 patients to contain depressive symptoms over time.

Introduction: Mental health disorders and chronic health diseases are highly prevalent and impactful consequences of distressful experiences among refugees, yet a comprehensive conceptual model encompassing biopsychosocial factors is lacking. This study aims to assess the relevance of widowhood to PTSD and major depression maintenance as well as to adverse health outcomes in a cohort of Bosnian refugees.

Methods: This longitudinal study included 526 subjects followed up for 3 years. The interviews were conducted in refugee camps in Varaždin, Croatia, in the Bosnian language. Data were collected using the Harvard Trauma Questionnaire and Hopkins Checklist-25, respectively. Physical health disorders were self-reported.

Results: Both at baseline and endpoint female gender and marital loss are associated with a statistically significant higher burden of psychological and physical health outcomes. This group showed higher rates of PTSD and major depression disorders, as high comorbidity with hypertension, cardiovascular diseases, asthma and arthritis.

Discussion: The results of the present study align with a wealth of literature studies linking marital loss to shifts in mental health and impaired physical health. A conceptual framework is provided for understanding how both mental health and physical health outcomes are highly dependent on social phenomena.

Conclusions: This investigation reinforces the hypothesis of the role of social bonds and marital support in recovery from trauma experiences. Further studies are, however, needed for a better understanding of the consequences of adverse events on trauma-exposed subjects from a holistic bio-psycho-social point of view.

Parental Alienation Syndrome (PAS) is a term addressed to describe negative, psychopathological feelings, thinking and behaviours, including hostility and fear, exhibited by children who have been alienated from one parent by the other parent. Despite its relevance in the clinical psychology field, theoretical and empirical contributions to understanding and deepening the many facets of this concept are still few. In particular, literature aimed at disentangling the alienating parent's psychological characteristics is scarce and fragmented. Our contribution encompasses a narrative review of scientific literature since the term PAS was coined in 1987 by Gardner, to delineate narcissistic proneness in alienating parents. Namely, considering the narcissistic drift the western society is going toward, we hypothesised that narcissism has a pivotal role in parents' alienating behaviours against the alienated ones. Firstly, the elements that emerged from our literature search confirmed our theoretical hypothesis, in terms of the likely role of narcissism/narcissistic marked traits in alienating parents. In the second section, we contextualised the phenomenon in a psychodynamic/psychoanalytic theoretical framework. Finally, based on previous findings/considerations, the developmental trajectories of children with PAS have been traced. An improved theoretical knowledge of this phenomenon, also in terms of the psychopathology associated with its genesis, means to refine the diagnostic and treatment tools to prevent it.

Introduction: Incestuous behaviors are often placed in family constellations that are highly dysfunctional from the perspective of communication between members and also with regard to the roles and expectations held in the family. The expert case being presented reflects these characteristics.

Methods: Beginning with an expert case of particular interest with respect to incestuousness and destructibility, the authors report considerations from a clinical criminological and forensic psychological-psychiatric point of view on the link between the two item.

Conclusions: A careful historical, anthropological, documentary reconstruction, the examination of the relational set-up of the various subjects involved, and not only the clinical and psychodiagnostic aspects, are the indispensable premises, in order to make overall sense of crimes in families of particular complexity, difficult to decipher, such as those exposed in the present scientific work.

Background: The Mini-Z is a questionnaire created to evaluate the levels of burnout in healthcare workers. It consists of 10 items rated using a 5-point Likert scale and one open question. It explores three outcomes (burnout, stress and satisfaction) and seven drivers of burnout (work control, work chaos, teamwork, values alignment with leadership, documentation time pressure, EMR use at home, and EMR proficiency). The aim of this study is to validate the Italian version of the Mini-Z, comparing it with the other most used scales.

Materials and methods: We recruited a sample of 120 healthcare professionals and administered all three questionnaires to each of them, after which we compared the answers and the scores of the results. A cross-sectional study among healthcare workers was conducted from May to July 2022. An online questionnaire was sent, by e-mail, to 120 healthcare workers (60.8% male, 39.2% female), aged between 18 and 60 years old (26.8% between 25 and 38 years old). They were invited to answer to an anonymous survey, consisting of three assessment instruments: Copenhagen Burnout Inventory (CBI), Maslach Burnout Inventory (MBI) and Mini-Z Inventory 2.0. The Mini-Z 2.0 is a new and easier tool to assess burnout syndrome, actually validated only in English. It was translated into Italian by reverse translation. Cronbach's Alpha coefficient, a statistical index, was used to assess its reliability. The last phase of the study compared the Mini-Z, the CBI and the MBI, by means of Pearson's coefficient, to highlight the Mini-Z's ability to be used for Burnout assessment.

Results: The analysis of the results showed that 18.3% of the interviewed healthcare professionals scored equal (2.5%) or higher (15.8%) than 40. The average percentage value was 33.35%, with a standard deviation of 6.3%. This emphasises, therefore, that this portion of employees is more or less satisfied with their working environment. The remaining portion of employees, on the other hand, 81.7%, scored below 40, emphasising an unpleasant and unjoyful working environment.

Discussion and conclusions: Burnout is very common among employees and especially among healthcare workers and a routine assessment seems to be necessary to be able to prevent the syndrome. The Italian version of the Mini-Z includes ten items, is more user-friendly and aims to assess not only Burnout subscales, as in the previous tests, but also well-being factors and has applied a rigorous approach, including forward translation, back translation and cognitive debriefing.