1,721,155 research outputs found
Cannabis e Psicosi, un contributo di ricerca
No full textsi descrivono i dati relativi ad un campioni di pazienti affetti da disturbo psicotico all'esordio, come parte del progetto SGAP (Sicilian Genetic and Psychosis. tra i fattori di rischio implicati nell'insorgenza del disturbo si prende in esame il ruolo del consumo di cannabis mettendo a confronto i pazienti con un gruppo di cntrollo costituito da soggetti non psicotici. Emerge come l'età media di insorgenza del disturbo psicotico è stata più precoce per coloro che avevano fumato cannabis nel corso della vita (24.2 anni vs. 31.6 anni) mentre non è stata riscontrata nessuna differenza in relazione all'uso recente di cannabis
Opinions about people with schizophrenia among medical students: Findings from an Italian cross-sectional study
Full text linkBackground: Accumulating evidence suggests that stigmatisation toward people with schizophrenia (PWS) is common among healthcare professionals and represents a major barrier to care.
Aim: The study aimed at comparing the opinions about PWS among Italian medical students at different stages of education.
Methods: Study participants were 234 medical students, attending either the first three-years pre-clinical or the following three-years clinical stage. Participants read an unlabelled case-vignette of schizophrenia and completed the Opinions on Mental Illness Questionnaire.
Results: A greater proportion of students at the clinical stage identified schizophrenia in the clinical description, compared to their younger colleagues They were also more optimist about the efficacy of drug and psychological treatments and sceptical regarding the possibility of PWS to establish their own family.
Conclusion: This study suggests that medical training may benefit from providing information about recovery from schizophrenia and contact with PWS in the community
Cyber-victimisation and cyber-bullying: the mediation role of the dispositional forgiveness in female and male adolescents
No full textAccumulating literature suggests that the risk of perpetrating bullying is greater among those who have been bullied. The association between the transition from victim to bully and revenge aggression suggests the critical role of forgiveness. However, evidence on the mediating role of forgiveness on the victimisation-bullying association is still sparse. The aim of this study was to investigate the mediating effect of person's dispositional forgiveness (DF) on the relationship between cyber-victimisation (CV) and cyber-bullying (CB) and to explore the moderating effect of gender on this relationship. Four hundred eighty-one upper secondary students (n = 481, 47.8% females, mean age = 17.2, SD = 1.5) completed the Florence Cyber-Bullying - Cyber-Victimisation Scales and the Heartland Forgiveness Scale. Statistical analysis reveals significant direct and indirect effects between CV, DF, and CB latent variables. CV has a negative influence on DF and positive influence on CB behaviour. Furthermore, there was an indirect influence of CV on CB behaviour following the path through DF only in females. The results suggest that DF seems to decrease CB behaviours by buffering the adverse outcomes of being CV, particularly among female victims. The findings underline the relevance of forgiveness within preventative interventions against bullying and cyberbullying
Cannabis Use and the Risk for Psychosis and Affective Disorders
No full textObjective: This review discusses the relationship between cannabis use and psychotic, bipolar, depressive, and anxiety disorders, as well as suicide. It summarizes epidemiological evidence from cross-sectional and long-term prospective studies and considers possible etiological mechanisms. Methods: Systematic reviews and methodologically robust studies in the field (from inception to February 2019) were identified using a comprehensive search of Medline, PsychINFO, and Embase and summarized using a narrative synthesis. Results: Consistent evidence, both from observational and experimental studies, has confirmed the important role of cannabis use in the initiation and persistence of psychotic disorders. The size of the effect is related to the extent of cannabis use, with greater risk for early cannabis use and use of high-potency varieties and synthetic cannabinoids. Accumulating evidence suggests that frequent cannabis use also increases the risk for mania as well as for suicide. However, the effect on depression is less clear and findings on anxiety are contradictory with only a few methodologically robust studies. Furthermore, the relationship with common mental disorders may involve reverse causality, as depression and anxiety are reported to lead to greater cannabis consumption in some studies. Pathogenetic mechanisms focus on the effect of tetrahydrocannabinol (THC, the main psychoactive ingredient of cannabis) interacting with genetic predisposition and perhaps other environmental risk factors. Cannabidiol (CBD), the other important ingredient of traditional cannabis, ameliorates the psychotogenic effects of THC but is absent from the high-potency varieties that are increasingly available. Conclusions: The evidence that heavy use of high-THC/low-CBD types of cannabis increases the risk of psychosis is sufficiently strong to merit public health education. Evidence of similar but smaller effects in mania and suicide is growing, but is not convincing for depression and anxiety. There is much current interest in the possibility that CBD may be therapeutically useful
Do child abuse and maltreatment increase risk of schizophrenia?
No full textIntroduction: Although childhood abuse is a recognised risk factor for depression, post-traumatic stress disorder, and substance misuse, its role in the aetiology of psychotic disorder remained controversial. This is in part because the putative effect of childhood trauma on psychosis has been mostly evaluated by small, cross sectional, uncontrolled studies that raised methodological issues. Methods: Papers concerning the association between childhood trauma and psychotic disorders (to November, 2011) were identified using a comprehensive search of PubMed, Psychinfo, and Scopus and analysing reference list of relevant papers. A narrative synthesis was used to summarise results. Results: An association between childhood abuse and psychotic symptoms was consistently reported by large cross sectional surveys with an effect ranging from 1.7 to 15. However, we cannot conclude that the relationship is causal as lack of longitudinal studies prevent us from fully excluding alternative explanations such as reverse causality. Gender, cannabis use, and depressive and post-traumatic stress disorder symptoms appear to moderate the effect of childhood trauma on psychotic disorders. However, specificity of childhood abuse in psychotic disorders and, particularly, in schizophrenia has not been demonstrated. Conclusion: Although the association between childhood abuse and psychosis has been replicated, the etiological role of such early adversity has yet to be fully clarified. So far none of the studies reported support the hypothesis that childhood abuse is either sufficient or necessary to develop a psychotic disorder. It seems likely that any effect of childhood abuse on schizophrenia needs to be understood in terms of genetic susceptibility and interaction with other environmental risk factors. © 2012 Korean Neuropsychiatric Association
Traumatic Experiences and Obsessive-Compulsive Symptoms: The Mediating Role of Dissociation
No full textAccumulating evidence suggests that obsessive-compulsive symptoms (OCSs) are positively associated with exposure to traumatic experiences and dissociative symptoms in both clinical and community samples. The current study was aimed at investigating the relationships between traumatic experiences, dissociation, and OCSs. A sample of 333 community adults (56.8% females) aged from 18 to 56 years (mean [SD], 25.64 [6.70] years) completed measures on traumatic experiences, dissociative symptoms, and OCSs. A structural equation modeling (SEM) framework was used to test if dissociative symptoms mediated the relationship between traumatic experiences and OCSs. SEM analyses showed that dissociation fully mediated the predictive association between traumatic experiences of emotional neglect and abuse and OCSs in the sample. Accordingly, some individuals suffering from OCSs might benefit from clinical interventions aimed at processing and integrating traumatic experiences
Schizophrenia and virtual reality: A review of clinical applications
No full textAim: The use of virtual reality (VR) in psychtherapy and rehabilitation of psychiatric disorders has become more widespread. The key characteristics of virtual environments for most clinical applications are the enriched experience provided to the patient and the possibility of a high control of the interaction with the tool. This work presents an overview of the scientific papers dealing with current applications of Virtual Reality (VR) in patients with schizophrenia. Method: A search for articles was conducted using PubMed and PsycINFO with a combination of key words including schizophrenia, virtual reality, cybertherapy and rehabilitation. A total of 30 papers were found that discuss limits and potentiality of using VR in schizophrenia research and treatment. This search yielded several studies in which VR is employed for simulating schizophrenic symptoms or for assessing specific cognitive deficits and social disabilities in schizophrenia. Most of these studies compared the performance of patients with schizophrenia with that of healthy controls. Results: Two main topics showed the effectiveness of VR in the study and treatment of schizophrenia. The applications of VR in support of neuro-cognitive and social assessment of patients with schizophrenia can improve the accuracy of functional diagnosis. The use of VR environment for analysing psychological correlates and predictors of psychotic symptoms can advance the understanding of the disorder and provide more effective treatment. Conclusion: Despite many articles highlighted the great potentiality of VR-based rehabilitation treatments only a few specific programs were developed. They could be useful for the rehabilitation of cognitive and social functions through the engagement of patients in complex tasks and situations such as those found in everyday life
Using network community detection to investigate psychological and social features of individuals condemned for mafia crimes
No full textObjective: Only few studies have investigated social and personality characteristics of members of Italian organized criminal groups: Mafia, Camorra, ‘Ndrangheta, and Sacra Corona Unita. This study aimed to explore the most relevant social and clinical features of Mafia criminals and their psychopathic traits. Method: The Psychopathy Check List-Revised (PCL-R) and a socio-demographic questionnaire were administered to 30 condemned for Mafia crimes and imprisoned in the “Pagliarelli” district prison of Palermo (Italy). The results were investigated applying the methods of Network Theory. Results: The study identified two communities, which were statistically different in terms of history of juvenile delinquency, levels of education, and antisocial and deviant behaviours score at PCL-R. Conclusions: The onset of antisocial behaviour and educational achievement might be relevant variables in understanding mafia offences, as well as antisocial behaviours in general. Moreover, methodologies of Network Theory may be used to characterize real-world complex systems of sociological and clinical dates
The Relationship Between Childhood Trauma and Shame: The Mediating Role of Dissociation
No full textPrevious research has found significant associations among childhood trauma, dissociation, and shame. Furthermore, the clinical literature suggests that dissociation may foster feelings of shame in individuals who were exposed to childhood trauma. The current study aimed to test the potential mediating effect of dissociation on the association between childhood trauma and shame. The study sample consisted of 763 adults (479 females, 62.8%) from the general Italian population, aged between 18 and 65 years (M = 31.31, SD = 13.29). Self-report instruments assessing childhood trauma, dissociation, and shame were administered to participants via an anonymous online survey. Structural equation modeling showed that childhood trauma was associated with increased levels of both dissociation and shame. Moreover, dissociation partially mediated the predictive association between childhood trauma and shame. These findings suggest that dissociation might heighten the tendency to unconsciously reenact self-devaluation and self-blame in individuals exposed to childhood trauma, increasing feelings of shame
CAPIRE E GESTIRE LA VIOLENZA NELLA SCHIZOFRENIA
No full textIl problema della violenza nelle persone affette da schizofrenia pone spinosi dilemmi clinici e sociali. Da una parte, il comportamento aggressivo nella schizofrenia può essere una pericolosa, anche se rara, complicanza della malattia. I medici sono tenuti ad anticipare, valutare, gestire e ridurre i rischi di violenza dei loro pazienti, con interventi e trattamenti adeguati. D’altra parte, pazienti psichiatrici capaci di decidere autonomamente, spesso riducono o sospendono il trattamento nel corso del tempo, il che è un loro diritto, e in ogni caso molte cause di violenza non possono essere trattate con i farmaci (Swanson et al., 2008a). Inoltre, concentrarsi semplicemente sul potenziale di violenza dei pazienti, può rappresentare una grossa limitazione nel passaggio verso la “normalizzazione” dei servizi di salute mentale nel territorio; ciò potrebbe addirittura rafforzare la deleteria percezione comune che gli individui affetti da patologie mentali siano pericolosi in generale, e quindi può contribuire indirettamente al rifiuto sociale ed allo stigma di cui le persone con disabilità psichiatriche continuano a fare esperienza nel territorio.
I pazienti affetti da schizofrenia non sono, per la maggior parte, violenti. Tuttavia, la malattia conferisce un elevato rischio di violenza in confronto alla popolazione generale. Il rischio è ulteriormente aumentato da concomitanti disturbi da uso di sostanze e dalla non-aderenza al trattamento. La violenza nella schizofrenia è eziologicamente eterogenea.
Le evidenze empiriche supportano almeno due sottotipi alternativi di violenza nella schizofrenia: uno in pazienti con storia di comportamenti antisociali nell’infanzia e un altro in pazienti senza questo fattore di rischio. I sintomi psicotici positivi sono legati alla violenza nel secondo sottotipo, ma non nel primo. Questa eterogeneità ha implicazioni in termini di gestione clinica.
La violenza nei pazienti schizofrenici con storia di problemi della condotta nell’infanzia è probabilmente meno responsiva al trattamento farmacologico, e gli approcci non farmacologici aggiuntivi sono particolarmente appropriati nei pazienti in cui la violenza persistente non ha risposto ai soli farmaci. Esistono programmi cognitivo comportamentali promettenti. Una gestione efficace deve comprendere la capacità di avere a che fare con i disturbi da uso di sostanze in comorbilità e ogni sforzo deve essere concentrato nel mantenere l’aderenza al trattamento.
Il trattamento farmacologico dell’agitazione acuta e dell’aggressività si basa su forme iniettabili di farmaci antipsicotici atipici (ziprasidone, olanzapina e aripiprazolo). Anche il lorazepam è ampiamente utilizzato, a volte in combinazione con l’aloperidolo.
La clozapina è il farmaco di prima linea per il trattamento farmacologico a lungo termine del comportamento violento persistente nella schizofrenia. Altri antipsicotici hanno anche degli effetti anti-aggressivi, ma questi sono meno consistenti. Sono stati sperimentati gli anticonvulsivanti, il litio, i beta-bloccanti e gli SSRI, ma le prove per la loro efficacia anti-aggressiva sono limitate
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