1,720,975 research outputs found
[Diagnostic interpretation of depressive symptoms from a psychodynamic point of view].
No full textThe principal aim of this study is: (i) to assess the rate of depressive disorders in a sample of patient in a psychotherapy service of the Department of Psychiatric Sciences and Psychological Medicine at the Sapienza University, Roma; (ii) to focus the psychopathological features of depressive patient through the SCL-90R scale; (iii) to evaluate the correlation between SCL-90R score and categorical diagnosis. The sample of this study includes 178 patients, who came to our service for a psychotherapy. The anamnestic and clinical information were collected for each patient. Each patient is submitted to the multidimensional scale SCL-90R in the curse of the first interview. A descriptive analysis of all the data collected was made and the principal links between SCL-90 R score and categorical diagnosis were detected. About 46% of the patients were depressive disorders following the DSM-IVTR diagnostic criteria. About 70% of depressive patients have psychoticism pathological scores, 60% have paranoic pathological scores, 70% anxiety pathological scores and 60% interpersonal sensibility pathological scores. The depressive dimension was pathological in about 77% of anxious patient and in 87% of patient with personality disorders. The DSM.IVTR categorical psychiatric diagnosis might underestimate important psychopathological dimensions which are underline through a dimensional scale as the SCL-90R and through a psychodynamic diagnostic instrument
Dalla crisi del paradigma neokraepeliniano verso una nuova nosografia psichiatrica. Il DSM-5.
No full textWith this article we intend to outline the story of American psychiatry starting at the end of the 19th
century until the present time, describing the cultural, political and economic context which culminated
in the development and diffusion of biological psychiatry and its nosography.
The diffusion of psychoanalysis and of A. Meyer’s psychological psychiatry, beginning at the end of
the Second World War until the end of the Sixties, determined such as an enlargement of psychiatric
diagnosis which no longer allowed one to distinguish a sane individual from an ill individual. This
“dimensional” model caused a slow process of de-medicalization of psychiatry which removed consent
and legitimacy from the discipline. The answer was the publication in 1980 of DSM III, the work
of a small number of psychiatrists known as the “Neo-Kraepelinians”. The new nosography based on
a categorial diagnostic system, emphasized what is directly observable and therefore measurable,
and not what is clinically significant. Whit DSM III and the successive versions the interest of the psychiatrists
moved from the clinical to the epidemiological research. In the attempt to take psychiatry
back to one of the medical sciences DSM III has in reality continued the process of undermining started
whit Meyer and psychoanalysis. And now with the forthcoming publication of DSM V, psychiatry
will be confused ever more with neurosciences
Valutazione del rischio di drop-out in un ambulatorio di psicoterapia psicodinamica. Studio clinico su un campione d 160 pazienti.
No full textThe principal aims of this study are: to assess the drop-out rate from a university psychotherapy service;
to indentify the period at major risk for drop-outs; to delineate a profile of the drop-out patient
through the research of a significant correlation between drop-out and social and clinical variables,
in order to prevent this adverse event.
The sample of this study includes 160 patients, which came to our service for a psychotherapy. The
anamnestic and clinical information was collected for each patient. The outcome is classified as
drop-out, discharged, and remainers. Each patient is submitted to the multidimensional scale SCL-
90R during the first interview. A descriptive analysis of all the data collected was made and the principal
links between clinical and socio demographic variables and drop-out, and between SCL-90 R
score and dropout were detected. About 42% of the patients were drop-outs, among which 86% by the
third session, and only 3% after 6 months of psychotherapy. The variables associated with drop-out
are: the young age, the fact of being single, of being unemployed, of being referred by the general
practitioner, the absence of previous psychiatric contact, and pathological score in the psychotic scale
of SCL-90R.
In conclusion: the drop-out percentage is high in psychotherapy; the higher rates of drop-out are in
the first three sessions; subjects at high risk are young, at the first contact with psychiatric services,
therefore are patients in an outset phase, with better feedback at the treatment. It is very important to
recognize these subjects to prevent the drop-out
Uno studio sulle caratteristiche di un campione di pazienti internati presso l'Ospedale Psichiatrico Giudiziario di Castiglione delle Stiviere e dimessi nella regione Lazio.
Full text linkAim. The aim of this study was: i) To identify socio-demographic and clinical data in a sample of inmates in the Criminal Mental Hospital (CMH) at Castiglione delle Stiviere; ii) to assess the presence of characteristics which could foresee the commission of a crime of psychiatric interest; iii) to assess the frequency of crime repetition. Materials and Methods. This study was carried out on a sample of 38 patients. A descriptive analysis of the sample was carried out and the associations among several variables were analyzed. Results. The sample is characterized by a high frequency of schizophrenia diagnosis (73.0%), the presence of hospitalization before the commission of the crime (68.4%) and the absence of criminal precedents (71.1%). For men the age of the commission of the crime is equal to 33.72±10.6 years and for women to 45.18±11.4 years (p=0.011). The time between the onset and the commission of the crime is longer in patients who have received therapy (treatment) than in those ones with no treatment (p=0.012). About 12% of the sample committed new crimes. Conclusions. The results showed previous criminal acts are not predictive for the commission of new crimes of psychiatric interest. However many patients had previous contacts with community facilities before their first admission to hospital and the treatment extended the interval between the onset of the disease and the commission of the crime. The relapse rate after the discharge was very low if compared with samples coming from other services that offered more custodial rather than rehabilitative facilities
Valutazione del rischio di dropout in una popolazione di pazienti affetti da disturbi dell'umore
Full text linkIntroduction. The aims of this study are (i) to assess the drop-out rate in an outpatient sample with mood disorder diagnosis in a psychotherapy unit; (ii) to focus clinical and sociodemographic variables related with drop-out; (iii) to delineate a psychopathological profile of the dropping-out patient through the SCL-90-R and OPD scores.Method. The sample of this study includes 90 depressive patients, which came to our service for a psychotherapy. The outcome is classified as drop-out and non drop-out. Each patient is submitted to the multidimensional scale SCL-90-R in the course of the first interview. At the end of the first visit each patient has been evaluated through the first and the fourth OPD axis. A descriptive analysis of all the data collected was made and the principal links between clinical and sociodemographic variables and dropout, between SCL-90-R score and drop-out, and between OPD scores and drop-out were detected. Results. About 42% of the patients were drop-out, of which 89% by the third session.The variables associated with drop-out are: pathological score in the paranoic and interpersonal sensibility scale of SCL-90-R, low compliance scores, low integration of defences, self perception, object's perception and link. Discussion. The drop-out rate in depressive patients turned out to be frequent. The patient's resources in terms of relationship, self-perception and object's perception are strongly related to the drop-out risk. These results are suggestive for the idea that the evaluation of drop-out risk in psychiatric patients must considerate the subjective aspects of the patient besides the clinical features
Evaluation of mental uneasiness, perceived stress and pathway of a care between a sample of 1560 university students
No full textAuthors' reply
No full textrevision of published data and discussion about impairment and quality of life for people at risk of developing psychosi
Liberiamo il Futuro: first results of an Italian early detection project.
No full textPsychotic-like experiences (PLEs) are commonly endorsed in questionnaires in community and clinical populations, especially by adolescents. Within the early detection project “Liberiamo il Futuro” (LIF), the prevalence of attenuated psychotic-like experiences (APLEs) in a sample of help-seeking adolescents (11–18 years) and the correlation with age, functioning and risk status is explored. LIF aims to identify subjects at high risk for developing a psychosis according to the ultra-high risk (UHR) and the basic symptoms criteria among help-seeking adolescents (11–18 years) and young adults (18–30 years). To identify patients with an increased risk of psychosis, the Prodromal Questionnaire (PQ-92) was administered. Patients endorsing 18 or more APLEs on its positive symptoms subscale were further assessed with the Structured Interview for Psychosis-Risk Syndromes and the Schizophrenia Proneness Instrument, Child and Youth version. At the time of writing, 171 11–18-year-olds were assessed. Ninety-eight (41%) passed the PQ-threshold, and 82 were further interviewed. With great overlap between the symptoms, 20 adolescents (24%) reported UHR symptoms, 44 (54%) cognitive-perceptive basic symptoms (COPER) and 30 (37%) cognitive disturbances (COGDIS). APLEs are common in adolescents seeking help for mental problems. Since APLEs might index a risk for a much wider range of psychopathology than psychotic disorders only, more research is needed to understand when APLEs signal an incipient psychotic illness and which features are associated with a worse outcome. To this aim, basic symptoms may help to distinguish young people at risk for developing a psychotic disorder from those at risk for other psychopathological disturbances.Psychotic-like experiences (PLEs) are commonly endorsed in questionnaires in community and clinical populations, especially by adolescents. Within the early detection project “Liberiamo il Futuro” (LIF), the prevalence of attenuated psychotic-like experiences (APLEs) in a sample of help-seeking adolescents (11–18 years) and the correlation with age, functioning and risk status is explored. LIF aims to identify subjects at high risk for developing a psychosis according to the ultra-high risk (UHR) and the basic symptoms criteria among help-seeking adolescents (11–18 years) and young adults (18–30 years). To identify patients with an increased risk of psychosis, the Prodromal Questionnaire (PQ-92) was administered. Patients endorsing 18 or more APLEs on its positive symptoms subscale were further assessed with the Structured Interview for Psychosis-Risk Syndromes and the Schizophrenia Proneness Instrument, Child and Youth version. At the time of writing, 171 11–18-year-olds were assessed. Ninety-eight (41%) passed the PQ-threshold, and 82 were further interviewed. With great overlap between the symptoms, 20 adolescents (24%) reported UHR symptoms, 44 (54%) cognitive-perceptive basic symptoms (COPER) and 30 (37%) cognitive disturbances (COGDIS). APLEs are common in adolescents seeking help for mental problems. Since APLEs might index a risk for a much wider range of psychopathology than psychotic disorders only, more research is needed to understand when APLEs signal an incipient psychotic illness and which features are associated with a worse outcome. To this aim, basic symptoms may help to distinguish young people at risk for developing a psychotic disorder from those at risk for other psychopathological disturbances
Youth mental health services in Italy. an achievable dream?
No full textAbstract
AIM:
"Liberiamo il futuro" (LIF) project was designed to assess psychological problems of adolescents and young adults and to identify individuals at high-risk for developing a psychosis through a collaboration between a University team, Child and Adolescent Mental Health Services and Adult Mental Health Services. This paper presents the baseline demographic and clinical characteristics of the cohort, particularly the nature and severity of psychopathology.
METHOD:
All help-seeking young people aged 12-35 years residing in the health district involved in LIF were invited to participate in the study and completed a battery of self- report and interviewer-administered measures of psychopathology and functioning at baseline.
RESULTS:
A total of 338 adolescents and young people (mean age 17.42) participated in the study. The majority of the sample (n = 107, 35%) had an anxiety disorder, followed by mood disorders (n = 62, 21%). Only 35 (12%) participants had no psychiatric diagnosis. After a screening phase, 166 (52%) individuals were assessed to detect the presence of an Ultra High Risk (UHR) state. Of these, 38.60% (n = 64) met UHR criteria. Overall, the majority of the sample resulted moderately functionally impaired at baseline.
CONCLUSIONS:
LIF project showed that psychological problems, associated with impaired psychosocial functioning, are very common among help-seeking young people. The help-seeking behaviour of young people is in contrast with the barriers presented by the Italian community mental health system that is modelled around adults' requirements. A need of a strong, stigma-free, young oriented system of care for young people up to the mid-20s emerged.AIM:
"Liberiamo il futuro" (LIF) project was designed to assess psychological problems of adolescents and young adults and to identify individuals at high-risk for developing a psychosis through a collaboration between a University team, Child and Adolescent Mental Health Services and Adult Mental Health Services. This paper presents the baseline demographic and clinical characteristics of the cohort, particularly the nature and severity of psychopathology.
METHOD:
All help-seeking young people aged 12-35 years residing in the health district involved in LIF were invited to participate in the study and completed a battery of self- report and interviewer-administered measures of psychopathology and functioning at baseline.
RESULTS:
A total of 338 adolescents and young people (mean age 17.42) participated in the study. The majority of the sample (n = 107, 35%) had an anxiety disorder, followed by mood disorders (n = 62, 21%). Only 35 (12%) participants had no psychiatric diagnosis. After a screening phase, 166 (52%) individuals were assessed to detect the presence of an Ultra High Risk (UHR) state. Of these, 38.60% (n = 64) met UHR criteria. Overall, the majority of the sample resulted moderately functionally impaired at baseline.
CONCLUSIONS:
LIF project showed that psychological problems, associated with impaired psychosocial functioning, are very common among help-seeking young people. The help-seeking behaviour of young people is in contrast with the barriers presented by the Italian community mental health system that is modelled around adults' requirements. A need of a strong, stigma-free, young oriented system of care for young people up to the mid-20s emerged
Disorder, not just state of risk: meta-analysis of functioning and quality of life in people at high risk of psychosis
Full text linkBackground
The nosology of the psychosis high-risk state is controversial. Traditionally conceived as an ‘at risk’ state for the development of psychotic disorders, it is also conceptualised as a clinical syndrome associated with functional impairment.
Aims
To investigate meta-analytically the functional status of patients at high clinical risk for psychosis and its association with longitudinal outcomes.
Method
Three meta-analyses compared level of functioning (n = 3012) and quality of life (QoL) (n = 945) between a high-risk group, a healthy control group and group with psychosis, and baseline functioning in people in the high-risk group who did or did not have a transition to psychosis at follow-up (n = 654).
Results
People at high risk had a large impairment in functioning (P<0.001) and worse QoL (P = 0.001) than the healthy control group, but only small to moderately better functioning (P = 0.012) and similar QoL (P = 0.958) compared with the psychosis group. Among the high-risk group, those who did not develop psychosis reported better functioning (P = 0.001) than those who did.
Conclusions
Our results indicate that the high-risk state is characterised by consistent and large impairments of functioning and reduction in QoL similar to those in other coded psychiatric disorders
- …
