The Importance of Cooperation and Relative's Involvement in Combined Treatment for Eating Disorders: a Case Report

Introduction: The importance of combined treatment of EDs is widely acknowledged. We describe the good outcome of a combined treatment in a 43 year old woman, affected by severe Anorexia Nervosa \u2013 Binge Purging (BMI 9.1), since early adolescence. She sought treatment only after giving birth to her second-born when she became aware of her illness. Despite intensive treatment (as an inpatient in hospitals and specialized rehabilitation centres, and in Day Hospital facilities), her condition gradually worsened, and her personal, social, working and family functioning was severely compromised (Global Assessment of Functioning Scale 35), Methods: A multidisciplinary team including psychiatrist, psychotherapist, family psychotherapist, nutritionist, dietician, nurses was involved in treatment, working together to a common treatment strategy. The Psychiatrists role (psicopharmacology, therapeutic process, helping acknowledging and avoiding manipulation) and the nurses role (establishing a therapeutic relationship with the patient, assisting her during meals and supporting the overall therapeutic process), are discussed. Results: A gradual psychopathologic and somatic improvement occurred across a 12-months period: she spent two months in a Psychiatry ward, four more months in a rehab centre and six months in an ED therapeutic community. She gained weight (BMI 21.4) and regained an excellent personal, social and family functioning. She returned to her husband (they previously separated), and the relationship with her daughters, who previously rejected her, improved (GAF 90). Conclusions: The cooperation of the multidisciplinary equipe and the involvement of the patient\u2019s relatives succeeded in reducing anxiety, depression, dysmorphophobia and interrupting the manipulating attitudes typical of the illness

Editorial Group: a Long-term Rehabilitation Approach Developed at SC Psichiatria, Maggiore Della Carita Hospital in Novara

Introduction Our Psychiatry Ward offers several group activities to both inpatients and outpatients. Among these, the Editorial Group involves only outpatients (who had been previously admitted to the Psychiatry Ward as inpatients) in fair psychopathological compensation, carefully selected for this long-term rehabilitation approach. Aims To describe the Editorial Group activity. Methods The Editorial Group meets once a week at the Psychiatry Ward. It involves patients, nurses and a group leader who is a Psychiatrist. The psychiatrists' and nurses' role is to facilitate the group process and the exploration of the topics discussed. Members are encouraged to discuss their opinions about tales, movies and books; to share poems, paintings, photographs. The aim of this process is to eventually develop a Ward magazine which is published quarterly. Results Members' commitment is extended beyond the weekly meeting hour of the group; indeed, we have observed that patients in their free time spontaneously decide to spend time collecting material to share and drawing up the articles, which are assigned according to patients' aptitudes and preferences. A continued commitment to share daily life experiences and to express creativity, helps patients get involved in the Group, and eventually leads to something concrete and valuable to share with others, also beyond the Group. Both the leader and the other equipe members help patients listening to each others' opinions, ideas and personal experiences. Conclusions The Editorial Group helps patients improving emotional and relational skills, and stimulates cognitive resources. Moreover, it enhances creativity, promotes collaboration and stimulates curiosity

Assessment of humoral and cell-mediated immunity against Bordetella pertussis in adolescent, adult, and senior subjects in Italy

Humoral and cell-mediated immunity (CMI) against B. pertussis was assessed in a sample of adolescent, adult and senior subjects distributed in five different geographical areas in Italy. Most (99·1%) subjects had IgG anti-pertussis toxin (PT) antibodies exceeding the minimum detection level [⩾2 ELISA units (EU)/ml]. There were no significant differences between the genders; 6·2% samples recorded titres ⩾100 EU/ml. CMI was positive [stimulation index (SI) ⩾5] against PT in 39·0% of all samples. This study suggests that B. pertussis continues to circulate in age groups that have been previously considered to be uninvolved in the circulation of this pathogen and that adolescent and adult pertussis boosters may be of value in these populations. Nevertheless, over the last 10 years, large increases in vaccination coverage rates have contributed to reduce the spread of the aetiological agent, especially in the immunized population