Analisi comparativa dei profili di personalità di pazienti affetti da disturbo borderline e detenuti con diagnosi di disturbo antisociale di personalità ottenuti tramite l’MMPI-2

Scopo. Nel disturbo borderline di personalità (DBP), i comportamenti violenti e aggressivi sono spesso presenti tanto che sarebbero un segnale prodromico del DBP e segnerebbero un’importante sovrapposizione con il disturbo antisociale di personalità (DAP). Nonostante le differenze cliniche tra i due quadri, tali sovrapposizioni potrebbero inficiare l’uso di strumenti di valutazione come il Minnesota Multiphasic Personality Inventory-2 (MMPI-2), tanto che alcuni autori hanno evidenziato come questo strumento, pur utile per individuare i soggetti con un disturbo di personalità, debba essere usato cautamente per differenziare tra DBP e DAP. Il presente contributo ha indagato i profili MMPI-2 di pazienti con DBP, in presenza di comportamenti aggressivi, a confronto con quelli di detenuti con DAP in assenza di DBP, al fine di meglio comprendere quali scale possano assimilare e quali differenziare i due quadri clinici. Metodi. Hanno partecipato 91 soggetti, di cui 30 pazienti con diagnosi di DBP e 61 detenuti con DAP. Sono state somministrate SCID-I e SCID-II da due valutatori indipendenti e MMPI-2. Risultati. I risultati hanno evidenziato l’elevazione nelle scale cliniche Pd, Pa, Pt e Sc per entrambi i gruppi, e un’elevazione della scala D, che è risultata significativa solo per il gruppo DBP. Inoltre, le scale di contenuto sono sembrate suggerire una maggiore presenza di problemi sociali, familiari e lavorativi nei pazienti con DBP. Conclusioni. Il presente studio mostra come il profilo di personalità rilevato dall’MMPI-2 nel confronto tra pazienti con DBP e detenuti con DAP sia in gran parte sovrapponibile. La scala clinica D, che misura la sintomatologia depressiva, accanto alle scale di contenuto correlate a problemi nel funzionamento sembrano essere le uniche in grado di differenziare i due quadri clinici, suggerendo come nei pazienti con DBP si possano osservare maggiori problemi nel funzionamento e nell’area dell’umore rispetto a detenuti con DAP

A pilot study on a new model for the study of patient-perceived quality of life in the surgical treatment of PAOD: The Surgical Peripheral Artery Disease Interview questionnaire

BACKGROUND: The aim of this study was to develop a structured interview for functional evaluation of surgical treatment of peripheral arterial obstructive disease (PAOD), in terms of postoperative quality of life (QoL), including both the constructs already present in the literature and the ones derivable from direct clinical experience. METHODS: We identified the most relevant constructs, including physical symptoms (PS), discomfort with bodily integrity (DBI), satisfaction for care (SC), impact on daily life (IDL) and social functioning (SF). We developed an 11-item questionnaire with answers on 5 points to be administered in form of structured interview by physicians, namely the Surgical Peripheral Artery Disease Interview (SPADI). A pilot administration of the interview was performed in 30 patients undergone femoro-popliteal bypass for PAOD in the previous months. Data were collected in a specific answer form, containing also information about the patients, the risk factors, the kind of treatment and the follow-up outcomes. RESULTS: We found excellent correlations between items and theoretical constructs. The exploratory factor analysis confirms four constructs, with functioning composed by impact on daily life and social functioning. The internal consistency of scales was good. The indices of physical and mental functioning were similar to those of general population. Data showed a low level of aggression, depression, tension, confusion and fatigue, confirmed by the results of Self Rating Depression Scale. About SPADI items, PS was in the average range, while DBI seemed to be almost absent; SC was good and, in the postoperative setting, patients perceived themselves as efficient (IDL) and their SF appeared to be good. CONCLUSIONS: In this preliminary study, SPADI was able to investigate dimensions that were not considered before and it may become a useful tool for supporting surgeons to an even more effective management of PAOD. Prospective validation of this questionnaire is mandatory

Personality Traits in Fibromyalgia (FM): Does FM Personality Exists? A Systematic Review

Fibromyalgia (FM) is the second most common rheumatic disease with many effects on patient's quality of life. It has been described as a chronic condition characterized by widespread musculo-skeletal pain, sleep disorders and prominent fatigue. Regarding the role of personality factors in fibromyalgia, researchers have focused both on personality traits and psychopathological aspects showing inconsistent results. In particular, several studies have examined the role of alexithymia in FM patients, a trait of personality characterized by difficulty in identification, recognition and description of emotions and feelings, while others have focused on a specific type of personality, such as type D personality (distressed personality). Other studies investigated personality in FM patients referring to Cloninger's model, a psychobiological model of personality that includes both temperamental and character dimensions of personality. Analyzing scientific literature on this subject seems well suited to provide a critical review of the latest studies and their results