Capgras-like syndrome in a patient with an acute urinary tract infection.

Delusional misidentification syndromes are a group of delusional phenomena in which patients misidentify familiar persons, objects, or themselves, believing that they have been replaced or transformed. In 25%-40% of cases, misidentification syndromes have been reported in association with organic illness. We report an acute episode of Capgras-like delusion lasting 8 days, focused on the idea that people were robots with human bodies, in association with an acute urinary infection. To our knowledge, this is the first case report associating urinary tract infection with Capgras-like syndrome. Awareness of the prevalence of delusional misidentification syndromes associated with acute medical illness should promote diligence on the part of clinicians in recognizing this disorder

Medicina psicosomatica e Medicina di consultazione

La psicosomatica una lettura psichiatrica, la medicina di consultazione e la differenza con le consulenze psichiatrich

La psicoterapia come fattore di prevenzione. Una prospettiva sistemica.

In questo articolo, gli Autori definiscono dapprima il concetto di prevenzione, alla luce dei criteri recentemente proposti da una "scienza della prevenzione". Prendono poi in considerazione le potenzialità preventive della psicoterapia, in particolare quella sistemica, specialmente nell’arrestare l’evoluzione cronica della sofferenza psichica. Sotto questo profilo si sottolinea l’importanza dell’intervento dell’operatore che può diventare "fattore di rischio" oppure "fattore protettivo" nei confronti della situazione di disagio con cui si confronta. A conferma dell’efficacia preventiva della psicoterapia vengono sinteticamente presentate alcune ricerche: quella del CNR sulla prevenzione delle malattie mentali, e quelle di Onnis e coll. sulla prevenzione della cronicità dall’asma infantile, e dell’anoressia e bulimia dell’adolescenza. Si sottolinea, infine, l’importanza della formazione psicoterapeutica degli operatori, per una efficace programma di prevenzione del disagio psichico cronico, specialmente nel contesto dei servizi pubblici

L'assessment in psicoterapia sistemica: metodi di valutazione qualitativa e quantitativa delle dinamiche familiari.

When we talk about assessment in psychotherapy we run into a methodological issue connected to the need of objectiveness in clinical and experimental research, which are both supposed to develop as evidence based disciplines, this leading to the risk of undervalue the subjective aspects that arise from the psychotherapy practice. Assessment in psychotherapy is also the starting point for the expression of a diagnosis, of a psychotherapeutic plan, as well as evaluating the treatment efficacy by using assessment instruments suited to the complexity of the observed phenomena. The tools and methods of assessment of familial systems in systemic psychotherapy are still not as well-known as instruments for individual assessment; the most common psychometric test are quite calibrated to individual evaluation, rather than relational dynamics evaluation. The purpose of the current work is to highlight that some assessment tools, by evaluating some “relational parameters” connected to family interplay, can help systemic psychotherapist to shape his therapeutic work. These instruments, besides providing a multidimensional approach to the assessment of families, allow us to make both quantitative and qualitative evaluation of more variables, in order to speculate about family functioning. Particularly we want to present five evaluation instrument that we experimented during our clinical research: The Family Drawing Test, the Wyltwick Family Tasks (corrected version), the Family Relation Test, the Family Life Space of Mostwin (corrected version) and finally the Family Adabtability and Cohesion Evaluation Scale o FACES III. Every instruments make possible to carry out both a quantitative and qualitative evaluation of relational parameters, making them useful either in clinical practice or in research as well as individual instruments of assessment, giving strong help both to diagnostic phase and to treatment efficacy evaluation phase

La pratica terapeutica all'interno di un modello integrato di salute mentale: una esperienza nel territorio cubano.

In this work, Authors present the results of a ethnographic and anthropologic research evaluating the traditional medicines existing in Cuban specific field of the Havana. This research was carried out following theoretic topical suggestions from medical anthropology and ethnopsychiatry. These theories declare that each culture develops specific health and well-being standards, according to the belonging cosmovision, and that creates some methods and treatment arrangements in order to keep the psychophisical balance. These theories gave the same status to these different methods of cure, when these methods have any effectiveness and are able to make cultural identity stronger. This research carried out the traditional medicines census and cataloguing appearing in the Cuban field, monitoring if and how the application of traditional medicines could join the application of occidental medicine. The census provided the traditional medical practitioners cataloguing, their modus operandi, which diseases they treat, how much these methods are successful, and the therapeutic routes used by patients. This research was based on the tools of the ethnographic qualitative research: participant observation, open interview, half-arranged interview, the life histories compilation, videotapes

Exploring the correlation between perceived attachment security and levels of gh hormone in a sample of children with non-organic failure to thrive. preliminary findings

Introduction Short stature caused by growth hormone (GH) deficiency is one of the causes of the “Failure to Thrive” (FTT) condition. In absence of clear organic causes, several different psychosocial conditions may play a role in explaining the FTT phenotype. Advances in developmental psychology have highlighted the role of emotions and caregiving behaviors in the organization of child's personality and psychobiology, with the mother–son attachment bond being considered a fundamental developmental experience. The objective of the present preliminary study was to assess whether there are significant correlations between attachment styles and GH levels in a sample of subjects with non-organic FTT. Methods We enrolled 27 children (mean age: 9.49 ± 2.63) with non-organic FTT. Perceived attachment security was assessed through the Security Scale (SS) and its subscales focused on maternal and paternal security. Pearson partial correlation was used to test associations between GH levels and SS measures adjusting for confounding factors (i.e. age, gender and BMI). Results Across all subjects, GH was significantly positively correlated with general security (r = 0.425; P = 0.038) and maternal security (SSM) (r = –0.451; P = 0.027) and not significantly correlated with paternal security (SSP) (r = 0.237; P = 0.264). Discussion These findings preliminarily suggest that perceived attachment security may play a role in the etiopathogenesis of non-organic GH deficiencies and add to the accumulating evidence that attachment styles are associated with specific psychoendocrine underpinnings

Le dimensioni relazionali della alexitimia: risultati di una ricerca ad orientamento sistemico.

Relational dimension of alexithymia: results of a systems oriented research The term alexithymia, conied in 1973 by J. Nemiah and p. Sifneos, describes a set of feauteres initially attributed to psychosomatics patients, like difficulty in identifying, describing and communicating feelings, constricted imaginal processes, externally oriented cognitive style. Since the first theorizations about this personality construct arose, an extended discussion about its nosological classification, its onset and organic or mental illness related to it, took shape. Alexithymia has been studied over the years mainly in singleton; this lead to think that alexithymia is a personal feature only detectable in singleton. The working hypothesis is that alexithymic features exist not only in patient, but also in his relatives, even if by different measures and levels for everyone, according to the systemic point of view; we furthermore examin whether alexithymia is associated with somatization and how strongly. A set of questionaries, including SAR (Roman Alexithymia Scale) to explore alexithymia and SCL-90R (Self-Report Symptom Inventory- Revised) as a measure of general psychopathology, were administered to a sample of eighteen families referred to the U.O.D. of psychotherapy of the university “La Sapienza” in Rome, 59 persons in all. Data from the sample showed that alexithymia is not only a prerogative of “appointed patient”(the person in the family who shows symptom), but also a trait of personality shared by members of the family, proving the hipothesis that alexithymia is also a relational characteristic. In addition, a strong positive correlation (p <0.01) was found between alexithymia and somatization, the last one measured by the SCL-90R. It seems possible to see alexithymia by a different point of view, poorly explored until now, that is the “systemic point of view”, by which it is possible to bring this personality construct back to the origin, to consider it a relational deficit rather than a singleton deficit, and to give at the same time new meaning to somatic symptom

Cingulate cortex in schizophrenia: its relation with negative symptoms and psychotic onset. a review study

The cingulate cortex is a functionally heterogeneous region involved in diverse cognitive and emotional processes. It is a region of special interest to investigate the neurological substrate of schizophrenia. The aim of this paper is to review all the studies that investigated the relation between the cingulate cortex and two of the most important and little known areas of this disease: the psychotic onset and the negative symptoms.Relevant literature was identified through a search in PubMed, Web of Science, and Cochrane database. Search terms included negative symptoms, cingulate cortex, cingulate gyrus, schizophrenia, PET, SPECT, MRI, fMRI, BOLD, deficit schizophrenia, early-onset schizophrenia, psychotic onset, psychosis.9 studies evidenced a link between negative symptoms and hypoactivity of cingulate cortex, whereas 7 studies did not. A positive relationship between anterior cingulate cortex gray matter thinning and high risk for schizophrenia is well characterized in literature.In a large portion of patients hypoactivity of cingulate cortex underlie the presence of negative symptoms. In particular, ACC (anterior cingulated cortex) thinning seems to be related to the increasing social withdrawal that is characteristic of the psychosis prodrome. New therapies focused on the brain stimulation of the cingulate cortex could represent an important aid for patients with this kind of symptoms

Un approccio sistemico ai disturbi di panico. Protocollo di una ricerca.

Il presente lavoro discute la dimensione psicopatologica dei disturbi di panico (DP) e ne approfondisce gli aspetti legati alla ricerca clinica. Propone, poi i DP in una prospettiva sistemica come fenomeni complessi, analizzandone le componenti socio-culturali, individuali e familiari. In ultimo viene proposto un progetto di ricerca dedicato ai DP che valuta l’opportunità di un approccio integrato, tale intervento viene confrontato con l’usuale intervento psicofarmacologico