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Deaths by unintentional illicit drug overdose in Italy, 1984-2000
No full textAIM:
To determine whether there has been an increase in deaths by overdose in Italy, as elsewhere in the Western world, over the past fifteen years.
METHOD:
This study's conclusions are based on analysis of official data on overdose deaths attributed to illicit drug addiction and abuse (ICD-9 codes 304 and 305) from 1984 to 2000, drawn from two archives of drug abuse information: the Direzione Centrale per i Servizi Antidroga (DADE) of the Italian Ministry of the Interior (1984-2000), and the Health Statistics held at the Italian Central Statistics Institute (ISTAT) (1984-1997). Mortality rates have been calculated for both genders in the following age groups: 15-24, 25-34, and 35-44 years.
RESULTS:
Official data indicate that there has been a steady increase in the number of deaths by overdose in Italy over recent 15 years. This trend has affected both genders, but is more evident among males. Over the whole period females had consistently lower overdose rates than males. In both genders the age group 35-44 was subject to the highest mortality rate increase over the study period, however, the highest overdose rates for both males and females were observed in the 25-34 age group. Consistently higher rates were witnessed in the northern regions of Italy with an overall increase across all latitudes. However, the greatest increase over the study period occurred in the South. In 5190 cases evaluated by the Italian Forensic Toxicology Group, 95.9% of deaths were attributed to heroin, but in about half of these, mixtures of three or more substances (heroin, benzodiazepines, cannabinoids, cocaine, methadone) were found in the deceased at doses that were likely to have contributed to death.
CONCLUSIONS:
The increase observed in the rates of death by overdose is likely to be a reflection of increased use of illicit drugs in the general population. Reporting practice by forensic pathologists might explain the extent of attribution of cause of death to heroin. Drop-out from addiction treatment is a commonly observed antecedent of fatal opioid overdose, therefore, caution is required when establishing treatment protocol for patients. Interventions that aim specifically at improving patient compliance with medical and psychiatric therapies should be favoured
Psicobiologia dell'aggressività
No full textIn order to offer an exhaustive review of the literature concerning the relationship between mental disorders and the tendency to aggressive and violent behaviour, the authors describe the studies on the prevalence of this behaviour among psychiatric patients. After a brief historical introduction and a terminological note on the conceptual boundaries of this topic, the results of the main studies performed in the last thirty years on this subject are reviewed, taking into account both clinical and prison case histories. For each study the methodologies and their limitations are illustrated, paying attention to their social and relational biases. The results of the studies on prison samples indicate a higher prevalence of mental disorders among prisoners, but the possibility of extending these observations is limited by the factors influencing this sample composition: individuals suffering from mental disorders are at greater risk of arrest as a result of the behavioural difficulties determined by the disorder itself and of deficient supportive networks. Studies in the community also show a greater frequency of aggressive and violent behaviour among psychiatric patients, expecially in the presence of alcoholism and drug abuse, both conditions that, per se, expose the abuser to conflict and criminality. A greater risk of aggressive behaviour is also described in patients suffering from psychosis, especially in the case of persecutory delusions, in patients with associated neurological impairment (spectrum of soft neurologic signs) or with abnormal brain electrical activity detectable with EEG, and in patients with disorders characterized by impulsivity. The article concludes with a detailed description of the neurobiological basis of the aggressive behaviour, with indications on the possible efficacy of drugs action on the different neurochemical systems involved. The role of serotonin in the control of impulses, a factor that apparentely influences the whole range of aggressive behaviour, is emphasized
Dimensioni dell'aggressività
No full textMotivazioni di natura diagnostica, terapeutica e preventiva sostengono l'interesse dello psichiatra per lo studio dell'aggressività. Gli Autori illustrano gli aspetti muldimensionali dell'aggressività. Vengono sottolineati i significati adattativi e relazionali dei comportamenti aggressivi. Con il termine di aggressività vengono indicati, infatti, diversi tipi di comportamento che includono moduli innati di espressione motoria volti all'offesa, la difesa, la predazione ed il conseguimento e mantenimento di posizioni di dominanza in una qualunque gerarchia. Si tratta di moduli comportamentali di grande importanza per la sopravvivenza, e la loro espressione non può essere ricondotta al solo aspetto negativo del danno arrecato a terzi.
Gli aspetti emotivi ed affettivi sottostanti all'espressione di agiti aggressivi sono passati in rassegna, con attenzione particolare alla rabbia, alla paura, alla tristezza, alla vergogna ed al senso di colpa. La dimensione cognitiva dell'aggressività, che si esprime attraverso sentimenti di natura ostile, quali il cinismo, la sfiducia, il risentimento, la diffidenza, é anch'essa ampiamente descritta e posta in relazione con stati affettivi complessi quali l'odio e l'invidia.
In conclusione viene suggerita l'importanza di tenere sempre presenti i molteplici vissuti che accompagnano gli agiti aggressivi, come pure l'espressione di sentimenti ostili o comunque permeati di tonalità negative. Ciò potrà guidare nel suo intervento il terapeuta che si trovi a dovere fronteggiare un paziente problematico, la cui necessità di esprimere sentimenti di auto-affermazione può sempre essere incanalata verso modalità maggiormente positive.In order to offer an exhaustive review of literature concerning the relationship between mental disorders and the propensity to aggressive and violent behaviour, the Authors have, in this paper, described the manifold dimensions of aggressiveness.
The term "aggresiveness" describes many different behaviors related to the offense, the defense, predation, and the obtaining and mantaining of a position of dominance in hierarchical organizations. All are behavioral modules very important for survival, and their expression cannot be reduced to the harm which may be caused to third parties.
The emotional and affective elements linked to the expression of aggressive behaviors were described, paying attention to the affective states of rage, fear, shame and guilt. The cognitive dimensions af aggressive behaviors also were described, including the meaning of feelings like hostility, mistrust, cynicism, resentment, which were properly linked to more complex affective states such as hate and envy.
The Authors stressed the importance of understanding the manifold dimensions of aggressiveness when confronting a difficult to treat patient. This may aid the therapist to afford the need of empowerment of the aggressive patient in more socially acceptable manners
Season and suicide: recent findings from Italy
No full textSeasonal asymmetry in yearly suicide occurrence is a long-observed phenomenon in psychiatric, suicidological, and sociological research, and the effects of seasonal factors on suicidal behavior have been the focus of a number of earlier studies. Taking into account limitations of data and methods, these studies have generally favored interpretations based on psychosocial factors. Recent studies have challenged the widely held notion that seasonal effects on suicide are a unitary phenomenon, not influenced by age, gender, or circumstances of the act. In particular, the seasonal occurrence of suicides has been found to differ significantly between the young and the elderly, and differences have also been found between male and female cycles of occurrence. Suicides using violent methods have been shown to follow clearer seasonal patterns than suicides by less violent methods (such as drug or gas poisoning), possibly reflecting the greater impulsive component involved in the choice of a violent lethal means. In this paper, findings from Italy are used to illustrate the clinical implications of studies into the topic of season and suicide, with the aim of developing more effective preventative strategies
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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