BIPOLAR AND BORDERLINE PERSONALITY DISORDERS: A DESCRIPTIVE COMPARISON OF PSYCHOPATHOLOGICAL ASPECTS IN PATIENTS DISCHARGED FROM AN ITALIAN INPATIENT UNIT USING PANSS AND BPRS

Background: There is current scientific debate in consideration of the possibility to consider the Borderline Personality Disorder (BPD) as a mood disorder within the bipolar spectrum furthermore, authors reported about the challenging differential diagnosis of BPD and Bipolar Disorder (BD). Subjects and methods: 32 patients hospitalized in the Inpatient Psychiatric Unit in Perugia, discharged with a diagnosis of BD or BPD, were included. Factor analyses of BPRS and PANSS items were performed. Association between socio-demographic, clinical and psychopathological variables was tested using bivariate analyses. Results: Factor analysis identified 6 Factors, explaining 67.6% of the variance, interpreted as follow: 1) Euphoric Mania, 2) Psychosis, 3) Inhibited Depression, 4) Disorganization, 5) Psychosomatic features, and 6) Mixed features. Bivariate analyses identified statistically significant differences between BPD and BD according to: PANSS positive symptoms domain, BPRS total score, Euphoric Mania and Disorganization. No statistically significant differences came up on socio-demographic and clinical aspects. Conclusion: Even though the sample is small, interesting findings came out from our investigation. Our findings are in line with the current literature. Euphoric mood, is one of the aspects which best differentiated BD from BPD. Higher scores in Disorganization, BPRS and PANSS positive symptoms in BD may be related to the fact that our sample is a group of patients from an acute inpatient unit, so the impact of the symptoms severity for BD may be remarkable

CORRELATES OF INVOLUNTARY ADMISSION: FINDINGS FROM AN ITALIAN INPATIENT PSYCHIATRIC UNIT

Background: Involuntary admission is challenging in terms of providing the most effective but least restrictive care in accordance with the country’s regulations. A better understanding of correlates of voluntary versus involuntary admission legal status is crucial to improve clinical decision-making and effectiveness of the overall mental health care system. Subjects and methods: We collected chart-review data pertaining to 848 patients, discharged between June 2011 and June 2014, from an Italian inpatient psychiatric unit. Diverse sociodemographic and clinical variables were collected. Bivariate analyses and binary logistic regression were performed to examine correlates of involuntary admission. Results: Bivariate analyses showed that involuntary status was related to: the reason for hospitalization, not being on psychiatric medications at admission, and being admitted from another inpatient ward (in particular, from the emergency department). The final regression model identified four main variables independently associated with legal status: being admitted for psychotic features, suicidal behavior, or impulsive behavior, and not being on medication at admission (Nagelkerke pseudo R2=0.15, p<0.001). A strong association with length of stay was also documented. Conclusions: Understanding the causes and consequences of involuntary admission will enhance the field’s understanding of how to provide the most effective, but least restrictive, psychiatric care

PERSONALITY AND PSYCHOTIC SYMPTOMS AS PREDICTORS OF SELF-HARM AND ATTEMPTED SUICIDE

Background: Nonfatal suicidal behaviours (NSB), including suicide ideation, suicide plan and suicide attempt, constitute a serious problem for public healthcare services. Suicide gesture (SG) which refers to self-injurious behaviour with no intent to die, differs from NSB in a variety of important ways. The aim of this study was to investigate demographic and clinical characteristics of NSB and SG to examine whether self-injurers with intent to die differ significantly from self injurers without such intent. Methods: All admissions for NSB and SG to the Psychiatric Inpatient Unit of University / General Hospital Santa Maria della Misericordia, Perugia, Umbria, Italy, from January 2015 to June 2015 were included in a medical record review. Basic descriptive statistics and distributional properties of all variables were first examined. Bivariate analyses were performed using Chi-square tests for group comparisons and t-test for independent samples used when appropriated. Results: The study sample included 38 patients. Of these 23 had committed NSB (13.1 %), 15 had commetted SG (8.5%). Number of married NSB was significantly higher than the number of married SG (p=0.08). We found a significant difference between NSB and SG related to the item of impulse control that was poorer in SG than NSB (p=0.010). BPRS items of hostility (p=0.082), suspiciousness (p=0.042) and excitement (p=0.02) were found to be significantly higher in SG than NSB. Borderline personality disorder (p=0.032) and Passive-Aggressive personality disorder (p=0,082) diagnosed by the means of the SCID-II, were more represented in SG than NSB (p=0.044). Schizoid personality disorder was significantly related to NSB (p=0.042). No others significant differences were found. Conclusions: NSB and SG are different for many psychopathological characteristics. These results confirm the importance of classifying individuals on the basis of the intent to die. Additional research is needed to understand and elucidate psychopatological and clinical characteristics of the different categories of self-injurers to find risk factors specific to suicide attempts

Innovatività e Customer Satisfaction nelle compagnie assicurative: caso Instant Insurance "Al Volo"

Con un iniziale sguardo al nuovo contesto economico di riferimento quali le crescenti esigenze della clientela e la nascita di nuovi competitors per il mondo assicurativo, questo trattato vuole mostrare l’innovazione all’interno delle compagnie assicurative presentando anche un caso specifico. Dopo la presentazione del nuovo approccio di marketing e un’analisi sull’evoluzione di numerose startup tecnologiche specializzate nello sviluppo di soluzioni innovative, vengono presentati i principali cambiamenti in relazione alla distribuzione assicurativa, lo sviluppo di innovazioni di processo e di prodotto che consentono di andare in contro alle maggiori esigenze della clientela. Questi fenomeni hanno posto all’attenzione delle compagnie sulla necessità di procedere ad una rivisitazione della tradizionale teoria del valore al fine di adeguarla al nuovo contesto, Il ruolo rilevate della Customer Satisfaction quale driver di creazione di valore discende dalla sua stretta interdipendenza con la variabile reddituale, concepire un sistema operativo cliente centrico e incentrato al valore significa orientarsi verso il successo da parte dell’impresa. Numerose sono dunque le sfide per le compagnie, governare in maniera efficiente, estrarre ed utilizzare i dati raccolti in modo sicuro e veloce, accelerare i processi di vendita, presenteremo tutti gli aspetti principali delle innovazioni di processo e di prodotto che migliorano il lavoro dell’assicuratore aumentano la Customer Experience. Arriveremo infine alla presentazione di un caso specifico innovativo di Instant Insurance, generato dalla collaborazione tra una compagnia assicurativa (AXA Italia) e una start-up Italiana InsurTech (Neosurance). Il prodotto “Al Volo” come vderemo rivoluziona il modo di operare delle compagnie, esso fonda le sue radici su un’innovativa idea di business, quella di far diventare le compagnie assicurative partner del cliente (l’obiettivo che sta perseguendo AXA), con l’utilizzo di una particolare tecnologia esso consente di scegliere direttamente sullo Smartphone la copertura assicurativa calibrata sulle proprie precise esigenze, offrendo la “giusta protezione” quando e dove il cliente ne ha più bisogno. Queste nuovi orientamenti al cliente consentiranno alle compagnie, che si dimostreranno capaci di assimilare questa nuova cultura, di acquisire non effimeri vantaggi in un contesto variegato e contraddistinto da nuove pressioni competitive

BIPOLAR AND BORDERLINE PERSONALITY DISORDERS: A DESCRIPTIVE COMPARISON OF PSYCHOPATHOLOGICAL ASPECTS IN PATIENTS DISCHARGED FROM AN ITALIAN INPATIENT UNIT USING PANSS AND BPRS

Background: There is current scientific debate in consideration of the possibility to consider the Borderline Personality Disorder (BPD) as a mood disorder within the bipolar spectrum furthermore, authors reported about the challenging differential diagnosis of BPD and Bipolar Disorder (BD). Subjects and methods: 32 patients hospitalized in the Inpatient Psychiatric Unit in Perugia, discharged with a diagnosis of BD or BPD, were included. Factor analyses of BPRS and PANSS items were performed. Association between socio-demographic, clinical and psychopathological variables was tested using bivariate analyses. Results: Factor analysis identified 6 Factors, explaining 67.6% of the variance, interpreted as follow: 1) Euphoric Mania, 2) Psychosis, 3) Inhibited Depression, 4) Disorganization, 5) Psychosomatic features, and 6) Mixed features. Bivariate analyses identified statistically significant differences between BPD and BD according to: PANSS positive symptoms domain, BPRS total score, Euphoric Mania and Disorganization. No statistically significant differences came up on socio-demographic and clinical aspects. Conclusion: Even though the sample is small, interesting findings came out from our investigation. Our findings are in line with the current literature. Euphoric mood, is one of the aspects which best differentiated BD from BPD. Higher scores in Disorganization, BPRS and PANSS positive symptoms in BD may be related to the fact that our sample is a group of patients from an acute inpatient unit, so the impact of the symptoms severity for BD may be remarkable

Evolution of livestock farming systems and landscape changes

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Physical modelling of large-scale deformational systems in the South Polar Layered Deposits (Promethei Lingula, Mars): new geological constraints and climatic implications

<p>Deformation systems (DSs) locally affect the South Polar Layered Deposits (SPLDs) along the margins of the Promethei Lingula ice sheet (part of the southern Martian ice-dome). One example is the ‘S₂’ deformation system, characterized by a complex pattern of brittle and brittle–ductile structures related to kilometre-scale shear zones that deform the sequence. Moreover, soft-sediment structures affect one layer located at the base of the S₂. An earlier structural analysis suggested that: (1) two deformation stages (D₁, in which the shear zones developed, and D₂, in which the D₁ structures were reactivated by deep-seated gravitational slope deformation) occurred, driven by gravity; and (2) there are variations in the bulk composition of the SPLD (which is inferred to be mainly composed of water ice plus basaltic dust). This work supports these structural results through thermal and mechanical modelling of the S₂ sequence. Our modelling results suggest that several layers within the S₂ system are probably composed of, or are mixed with, CO₂ ice, and that the development of the observed deformation is inconsistent with present-day physical conditions. Soft-sediment structures probably formed under warmer surface temperatures during the past, with those warmer temperatures favouring or even triggering ice flow/basal sliding of the Promethei Lingula. </p

Impiego delle Prostaglandine per la sincronizzazione dei calori nella pecora ai fini della I.A

Use of Prostaglandins for oestrus synchronization and A.I. in the ew