Rivista di psichiatria最新文献

Obsessive-compulsive disorder (OCD) still presents several enigmatic aspects, especially when viewed only from a third-person perspective. Instead, things become more comprehensible if we try to reconstruct the patient's first-person point of view. In this paper, an analysis of obsessive doubts about the past, illustrated by clinical examples, allows us to show that obsessive doubts, unlike ordinary ones, do not arise from insufficient knowledge of what happened. Instead, they seem to arise from the fact that OCD patients perceive all the mental images in which a feared event occurs as a sort of window open to a possible world. So that the authentic drama of an OCD subject is that he/she will face every time an array of possible worlds without knowing which of them is the real one. Furthermore, a comparison is made between the hypothesis presented in this paper and one of the best-known models in the literature: the hypothesis of 'inferential confusion'. Finally, some implications for psychotherapy of OCD are discussed.

Objective: This umbrella review will provide a broad overview of the prevalence of vertical and horizontal bullying, the departments and the workers most affected by these attacks.

Methods: We included systematic reviews and meta-analyses examining the effects of bullying on healthcare workers. Data extraction and analysis was performed on all included studies. The research strategy was undertaken in May 2021 and included three electronic databases (PubMed, Scopus and Web of Science): a total of 435 articles were retrieved from the Abstract and, once duplicates and irrelevant articles were removed, a total of 19 useful articles were reviewed. A comprehensive search was done to retrieve articles based on a PRISMA compliant protocol registered in PROSPERO: CRD 42021268082.

Results and discussion: The general prevalence goes from 2 to 100%; for the individual healthcare workers, the highest prevalence is among nurses, 9-100%, followed by doctors 11.50-78.10%. Due to the heterogeneity of the studies, the other healthcare workers such as midwives, radiology technicians, administrative, employees were grouped and their prevalence goes from 3.30 to 100%. The results show that female nurses are significantly more likely to be abused than their male colleagues (women 3.60-100%; men 2.00-64.40%). The workplace in many studies was relevant for bullying: in particular, the most affected departments were emergency departments (2-100%) followed by intensive care units (17-84.80%).

Conclusions: Bullying is extremely present among health workers and must be adequately countered. It will be necessary to carry out further studies to deepen the knowledge on this matter.

The research aims to verify if the remote modality, introduced widely by Italian psychoanalysts at the lockdown, remains in clinical practice today, with specific reasons and characteristics. The authors hypothesize that the use of such modality, beyond health limitations, is a point of no return compared to the classical setting. Based on this hypothesis, an ad hoc online questionnaire was proposed; the subjects were also called upon to express an opinion on taleanalysis. Two hundred sixty-seven subjects responded. The results confirm a wide use of remote analysis even in the current situation; they also seem to indicate recognition by psychoanalysts of the emergence of new psychic phenomena in this type of setting, for example, childhood traumas that in the face-to-face analysis were unknown or inelaborate, usable in the treatment process.

Aims: Candidates for bariatric surgery are routinely screened for psychiatric disorders because abnormal eating behaviors are considered common among these patients. This study aimed to evaluate the frequency and persistence, in terms of one month-to-lifetime prevalence ratio, of binge eating disorder (BED) and the potential association with impulsivity features and bipolar spectrum comorbidity in a sample of obese patients undergoing a psychiatric evaluation for bariatric intervention.

Methods: Overall, 80 candidates to bariatric surgery were assessed consecutively over 12 months within the framework of a collaboration between the University of Pisa Psychiatry and Internal Medicine Departments. Patients were evaluated through structured clinical interviews and self-report questionnaires.

Results: The lifetime and last-month frequencies of BED according to DSM-5 criteria were 46.3% and 17.5%, respectively, with a prevalence ratio of 37.8%. Rates of formal bipolar disorder diagnoses were extremely low in patients with or without BED. However, patients with BED showed more severe dyscontrol, attentional impulsivity and bipolar spectrum features than patients with no BED.

Conclusions: The relationship of BED, impulsivity, and mood disorders in bariatric patients is more complex than usually reported in the literature. In particular, the presence of bipolar spectrum features should be systematically investigated in these patients because of their essential clinical and therapeutical implications.

Background: Media communication during the covid-19 pandemic has been relevant for the population to receive information about the ongoing number of cases, deaths, and social restriction measures. Notably, the effects of the communication methods on young adults during the covid-19 pandemic have not been studied. Therefore the present study aimed to investigate the influence of communication modality about covid-19 on the perception of risk and judgment among young adults.

Methods: A double-blind cross-sectional study was designed. Three hundred four subjects (age range19-25 years old) saw a 4-minute video concerning data communication on the covid-19 pandemic and compiled an online questionnaire about their perceptions. Two videos were randomized, one presenting the covid-19 data negatively (HARD video) while the other showed a positive ongoing resolution of the pandemic (SOFT video). Association tests and nominal logistic regression were used to evaluate differences in responses among the two groups.

Results: The two videos lead to different reactions. Participants showed higher disagreement concerning the video content in the "SOFT" group compared to the "HARD" group. The responses of the "SOFT" group were more to be optimistic (OR=2.87, 95% CI 1.311-6.27) than those who had seen the "HARD" video. The sense of helplessness was lower in the "SOFT" compared "HARD" group (OR=3.02, 95% CI 1.311-6.96). The perception of fear was higher for the "HARD" group (OR=2.91, 95% CI 1.21-7-02).

Discussion: The modality of data presentation influenced the perception and feelings about the covid-19 pandemic. Likely, pre-existing perception of a pessimistic perspective was present in both groups; thus, the video did not lead to any change in the behavior.

Conclusions: The phobic or counter-phobic reactions shown in the study participants highlighted the importance of the reliability of the information received and how previous feelings may influence the perception of the information.

Aim: To explore the expression of oxygenated hemoglobin (oxy-Hb) in the brain of patients with alcohol dependence. Further, to evaluate the diagnostic value of oxy-Hb in the cognitive impairment of patients with alcohol dependence.

Methods: Seventy-one alcohol-dependent adults and 70 healthy adults were recruited in the observation and control groups, respectively. The oxy-Hb level and scores of Wisconsin card sorting test, brief visuospatial memory test-revised, digital sequence test, digital span test, and continuous performance test were recorded and compared between the two groups. Further, the sensitivity and specificity of the oxy-Hb level for the diagnosis of cognitive impairment in patients with alcohol dependence were evaluated by drawing an ROC curve. Moreover, the correlation between the oxy-Hb level and cognitive function test scores was analyzed by Pearson's correlation analysis.

Results: During cognitive activities, the oxy-Hb levels in the observation group were lower than those in the control group (p<0.001). The area under the curve (AUC) of oxy-Hb was 0.930, and the sensitivity and specificity were 89.1% and 84.0%, respectively. The scores of responses administered, trials to compete first category, perseverative responses, and the perseverative response errors in executive function in the observation group were higher than those in the control group (p<0.001), whereas the correct responses score and categories completed score were lower than those in the control group (p<0.001). Similarly, the memory and attention scores of the observation group were lower than those of the control group (p<0.001). Moreover, the scores of correct responses, categories completed, brief visuospatial memory test-revised, digital sequence test, digital span test, and continuous performance test were positively correlated with the level of oxy-Hb (p<0.05). However, the scores of responses administered, trials to compete first category, and perseverative response errors were negatively correlated with the oxy-Hb level (p<0.001).

Conclusions: The oxy-Hb levels are reduced in patients with alcohol dependence and have high diagnostic accuracy for cognitive impairment in such patients.

Aim: Neurological Soft Signs (NSS) represent minor neurological signs related to non-specific cerebral alterations. They have been documented in many psychiatric disorders including schizophrenia (SCZ) and obsessive-compulsive disorder (OCD). Aim of this study was to determine and compare the incidence and severity of NSS in patients with SCZ, in patients with OCD, and healthy control subjects (HCs).

Methods: Using the Neurological Evaluation Scale (NES), this study investigated NSS in 15 SCZ patients, 14 OCD patients, and 15 HCs. PANSS and Y-BOCS were used to evaluate clinical picture in both groups.

Results: Patients with SCZ showed significantly higher scores compared to HCs in the NES total and each of the three NES subscales (Integrative Sensory Function, Motor Coordination, and Sequencing of Complex Motor Acts). Patients with OCD also showed significantly higher scores compared to HCs in the NES total, Motor Coordination and Sequencing of Complex Motor Acts, but not in Integrative Sensory Function. No significant differences emerged in the NES total and the various subscales scores between the two patients' groups.

Conclusions: Our results seem to confirm the presence of NSS in both SCZ and OCD. The different types of NSS presented by the two patients' groups versus HCs further supports the findings of widespread cerebral alterations in SCZ, on the other hand, with a preferential involvement of prefrontal and frontal cortex in OCD.

Vaccine hesitancy is a term used to refer to a series of attitudes ranging from reluctance to undergo vaccination to blatant refusal. In the context of the current pandemic, vaccine hesitancy is viewed as one of the ten major threats to public health. This narrative review, based on analysis of the most important literature reports on this topic, aims to illustrate the dimensions of vaccine hesitancy and the numerous sociodemographic and individual determinants involved, with particular reference to psychopathology, a somewhat neglected, but potentially relevant factor.