Interpersonal sensitivity in the at-risk mental state for psychosis

Background Interpersonal sensitivity is a personality trait described as excessive awareness of both the behaviour and feelings of others. Although interpersonal sensitivity has been found to be one of the vulnerability factors to depression, there has been little interest in its relationship with the prodromal phase of psychosis. The aims of this study were to examine the level of interpersonal sensitivity in a sample of individuals with an at-risk mental state (ARMS) for psychosis and its relationship with other psychopathological features. Method Method. Sixty-two individuals with an ARMS for psychosis and 39 control participants completed a series of self-report questionnaires, including the Interpersonal Sensitivity Measure (IPSM), the Prodromal Questionnaire (PQ), the Ways of Coping Questionnaire (WCQ) and the Depression and Anxiety Stress Scale (DASS). Results Individuals with an ARMS reported higher interpersonal sensitivity compared to controls. Associations between interpersonal sensitivity, positive psychotic symptoms (i.e. paranoid ideation), avoidant coping and symptoms of depression, anxiety and stress were also found. Conclusions This study suggests that being 'hypersensitive' to interpersonal interactions is a psychological feature of the putatively prodromal phase of psychosis. The relationship between interpersonal sensitivity, attenuated positive psychotic symptoms, avoidant coping and negative emotional states may contribute to long-term deficits in social functioning. We illustrate the importance, when assessing a young client with a possible ARMS, of examining more subtle and subjective symptoms in addition to attenuated positive symptoms. © 2012 Cambridge University Press

I Say “no”. You Say “it Isn't”. About a New Understanding of the Concept of Negation

Introduction: In our opinion there is still confusion about the exact meaning of the term negation. As a consequence of this the importance of negation in the psychotherapeutic work is until now underestimated. Objectives For psychiatrists who work according to Fagioli's human birth theory the concept of negation is fundamental. Negation is a notion that refers to unconscious reality. Aims: The task of the psychiatrist is to identify and to interpret the negation in the deformed dream images during the psychotherapeutic process. Methods: In contrast to an intentional lie, which is communicated through verbal speech, negation corresponds to unconscious thoughts, which we can find in dreams. During sleep a transformation occurs, language is altered and expressed through images. Negation deforms the image. This deformation of the image happens in an unconscious process. This negation distorts the reality of the patient and his ability to interact with the other. Corresponding the relationship will be aggressive/destructive. The only way to identify this deformation is dream interpretation. Results: Through this therapeutic process the patient will be able to intuit and realize instead of negate the positive qualities of the other and integrate these into his reality. Only human interaction that is free from negation enable the patient to overcome the ideo-affective splitting, which allows recovery of positive affects and the possibility of developing evolutive relationships. Conclusions: Only a clarification of the term negation allows a psychotherapeutic process with the aim of developing evolutive relationships

Study on psychoeducation enhancing results of adherence in patients with schizophrenia (SPERA-S): study protocol for a randomized controlled trial.

BACKGROUND: Poor adherence to pharmacotherapy negatively affects the course and the outcome of schizophreniaspectrum psychoses, enhancing the risk of relapse. Falloon and coworkers developed a Psychoeducation Program aimed at improving communication and problem-solving abilities in patients and their families. This study set out to evaluate changes in adherence to pharmacotherapy in patients diagnosed with schizophrenia-spectrum psychoses, by comparing one group exposed to the Falloon Psychoeducation Program (FPP) with another group exposed to family supportive therapy with generic information on the disorders. METHODS: 340 patients diagnosed with schizophrenia and related disorders according to standardized criteria from 10 participating units distributed throughout the Italian National Health System (NHS), will be enrolled with 1:1 allocation by the method of blocks of randomized permutations. Patients will be reassessed at 6, 12 and 18 months after start of treatment (duration: 6 months).The primary objective is to evaluate changes in adherence to pharmacotherapy after psychoeducation. Adherence will be assessed at three-month intervals by measuring blood levels of the primary prescribed drug using high pressure liquid chromatography, and via the Medication Adherence Questionnaire and a modified version of the Adherence Interview. Secondary objectives are changes in the frequency of relapse and readmission, as the main indicator of the course of the disorder.Enrolled patients will be allocated to the FPP (yes/no) randomly, 1:1, in a procedure controlled by the coordinating unit; codes will be masked until the conclusion of the protocol (or the occurrence of a severe negative event). The raters will be blind to treatment allocation and will be tested for blinding after treatment completion. Intention-to-treat will be applied in considering the primary and secondary outcomes. Multiple imputations will be applied to integrate the missing data. The study started recruitment in February 2013; the total duration of the study is 27 months. DISCUSSION: If the psychoeducation program proves effective in improving adherence to pharmacotherapy and in reducing relapse and readmissions, its application could be proposed as a standard adjunctive psychosocial treatment within the Italian NHS

L'Islam: un pensiero diverso sulla realtà umana

This article explores how the Islamic world views the mental reality of human beings, pointing out the strong differences that emerge when compared to the Western world. The authors compare the Bible and the Koran, analyze a number of written sources and interview people of Islamic origin. It becomes evident that the West has always been influenced by the belief that original sin exists and therefore man is an innately wicked creature. This leads one to think that the reality of humans is one of scission and of conflict between good and evil, corresponding respectively to reason and irrationality. This type of thinking, evidently, does not allow us to carry out research into the human mind. In the Koran, instead, original sin is forgiven, and human reality is not viewed as split, offering the Islamic world the premises for carrying out research into the mental reality of humans, something, however, it has not done. (PsycINFO Database Record (c) 2012 APA, all rights reserved

IMPUTABILITA' E INFERMITA' MENTALE, NUOVO ORIENTAMENTO DELLA GIURISPRUDENZA

Some judicial reports related to some brutal crimes and the opinions expressed publicly by a number of experts from a variety of sectors, have led the authors to analyze the innovative position adopted recently by the Italian Magistrature on the delicate and age-old problem of the relationship between mental infirmity and criminal liability. The object in question is the sentence passed by the United Penal Sectors of the Court of Cassation of the 25 January-8 March which has finally amplified the juridic concept of “mental infirmity” to the point of including “personality disorders”, which had not hitherto impacted on a person’s liability, even though it has frequently been diagnosed in authors of atrocious crimes. Therefore, even personality disorders are now scientifically recognized as an element which can greatly undermine or exclude one’s capacity to “knowingly intend and desire” thereby diminishing criminal liability to the point of rendering a person not liable to indictment if at the time of the crime these disorders impair this capacity. A historical excursus of the legal system and forensic psychiatry, and a brief examination of the most relevant penal institutes that have constituted the basis of the sentence under examination, lead us to conclude that the latter could constitute an important departure point for a desirable opening of legal science to new acquisitions and the evolution of psychiatric science

Something must happen before first breath

Background: Definition and concept of the ‘beginning of human life’ are weakened by co-existing contrasting hypotheses based on humanistic or religious beliefs rather than scientific foundations. This plethora of conceptually distant views have important common concerns in different fields of science and shape, in turn, several societal aspects including laws related, for instance, to inheritance eligibility or abortion, end-of-life care and euthanasia, and reproductive technology. Also, they are fundamental to evaluate opportunity for resuscitation vs. palliative care in extremely preterm infants. In this article, we address one of the most common tenets in medicine: the acceptance that human life starts with first breath, even though several events are well-documented to take place before its occurrence. Main text: Several studies show how pivotal physiological events take place before first breath. Evidence of a number of neurological events occurring before first breath opens the way to the primacy of the Central Nervous System, given its immediate extra-uterine activation at birth. This activation eventually sets specific physiological conditions that allow the complex sequence of events determining the muscle activity associated with the influx of air in the lung and the settling of a continuous and successful extra-uterine respiration. We would like to invite the scientific community to endorse a clear-cut position against the paradigm of ‘first breath’ as the beginning of life. Herein, we also assume how, a still undefined, yet possibly specific quid in the external environment triggers further physiological response in newborns. Better understanding of the critical events that occur at the beginning of human life is likely to cause great concern and expectations in scientists, researchers and physicians working in the domain of brain, and its physiology, and mental health. Conclusions: The comparison between beliefs and evidence-based observations generates confusion, misperceptions and false expectations in society, hence, in the scientific and medical community. Different and more solid alternatives about the carachterization of the ‘beginning of human life’ are indeed available and require to be explored and defined