Epidemiologia dell’omicio-suicidio passionale in Italia

A survey has been carried out on the Italian newspapers over the years 1985- 2008. 662 cases of homicide-suicide occurred in Italy in that time span, 560 committed by men and 102 by women. About 24% of the cases (156) is ascribable to jealousy: 92.3% (144) was committed by men and 7.7% (12) by women. The homicide-suicide that can be explained through jealousy is the most common category among the cases considered. In about 34% of the cases the perpetrator had a criminal record, even specific to the category. The data raise questions about the actual possibility of protecting the victims and the need for preventive measures.Si è effettuata una ricerca tramite indagine sui giornali italiani nel periodo 1985 e il 2008. Nell’arco di tempo esaminato in Italia si sono verificati 662 casi di  micidio suicidio, di cui 560 perpetrati da uomini e 102 da donne. Circa il 24% dei casi (156) è attribuibile alla gelosia. Di questi il 92,3% (144) è stato commesso da uomini e il 7,7% (12) da donne. L’omicidio suicidio motivato da ragioni di gelosia risulta la categoria più frequente all’interno della casistica esaminata. In circa il 34% dei casi l’autore aveva dei precedenti penali, anche specifici. I dati sollevano il problema relativo alla effettiva possibilità di tutela delle vittime e la necessità di misure sociale di prevenzione

Shibari: Double Hanging During Consensual Sexual Asphyxia

We describe a case of shibari, a double hanging sexual asphyxia practice, which ended fatally for one of the two women involved. We present the autopsy findings and a psychiatric and psychometric evaluation of the surviving participant. The survivor had a borderline personality disorder, had suffered sexual abuse as a child, and had a history of illicit substance consumption, self-harm behavior, and sexual dysregulation. This case study raises doubts regarding the safety measures adopted by participants in masochistic practices and the engagement of people with psychiatric disorders in these extremely dangerous games. Further case studies of living participants in such games are likely to shed light on this practice and facilitate treatment

MMPI-2 in child custody litigation: A comparison between genders.

In recent years, several studies have addressed the issue of positive self-presentation bias in assessing parents involved in postdivorce child custody litigations. The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) is widely used in forensic assessments and is able to evaluate positive self-presentation through its Superlative Self-Presentation S scale. We investigated the existence of a gender effect on positive self-presentation bias in an Italian sample of parents involved in court evaluation. Participants were 391 divorced parents who completed the full 567-item Minnesota Multiphasic Personality Inventory-2 during child custody evaluations ordered by several Italian courts between 2006 and 2010. Our analysis considered the S scale along with the basic clinical scales. North-American studies had shown no gender differences in child custody litigations. Differently, our results showed a significantly higher tendency toward “faking-good” profiles on the MMPI-2 among Italian women as compared to men and as compared to the normative Italian female population. Cultural and social factors could account for these differences. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract

Plasma fatty acid lipidomics in amnestic mild cognitive impairment and Alzheimer's disease

Polyunsaturated fatty acids (PUFA) of the n-3 series have been linked to brain physiology and cognitive decline, but little is known about the other components of the complex fatty acids category. Here, we compared 30 molecular species pertaining to saturated, monounsaturated, polyunsaturated, and trans fatty acids, measured in plasma by gas chromatography, in 14 patients with a diagnosis of amnestic single domain mild cognitive impairment (aMCI), 30 patients with mild Alzheimer's disease (AD), and 30 healthy controls (HC). As no participants showed neuroimaging evidence of cerebrovascular disease, patients could be considered as purely neurodegenerative. We found differences in specific components of almost all fatty acid classes except n-3-polyunsaturated fatty acids. Compared with HC, aMCI and AD patients had higher levels of arachidic (C20:0), erucic (C22:1, n-9), and vaccenic acid (C18:1, n-9) and lower levels of cerotic (C26:0) and linoleic acid (C18:2, n-6). In particular, level of linoleic acid decreased and level of mead acid increased progressively from HC to aMCI to AD patients, and they were also inversely correlated in AD and aMCI patients. In conclusion, we found a previously unrecognized linoleic acid deficiency in the early phase of neurodegeneration that was strongly supported by an increased, compensatory mead acid level. These findings suggest the importance of creating new dietary manipulation strategies to counteract disease progression. © 2013 - IOS Press and the authors. All rights reserved

Variabili psicopatologiche correlate all'abbandono scolastico precoce in un campione di adolescenti help-seeker.

L'abbandono scolastico precoce, precedente al conseguimento di qualsiasi forma di diploma, certificazione o qualifica, è un fenomeno di attuale attenzione nazionale ed internazionale per le importanti conseguenze economiche, sociali e relative alla salute. La dispersione scolastica è un fenomeno complesso e multifattoriale. Alla sua determinazione contribuiscono fattori socioeconomici, familiari, individuali relativi alle esperienze all'interno della scuola e psicopatologici. I disturbi psichiatrici ad esordio precoce, infatti, sono caratterizzati da sintomi che causano gravi difficoltà emotive, cognitive e sociali e, per tale motivo, costituiscono uno tra i principali fattori di rischio per l'abbandono scolastico in adolescenza. Tale studio si propone di verificare l'esistenza e la natura del rapporto tra psicopatologia e abbandono scolastico precoce in un campione di adolescenti help-seeker

EFFICACY OF THE COOPERATIVE ASSESSMENT METHOD (COOPAS) TO IMPROVE THE PSYCHIATRIC CARE OF HELP-SEEKING ADOLESCENTS

Background: Effective treatment of adolescents with psychopathological disorders is essential to reduce late psychiatric morbidity, poor functioning and disability. Objective: In this study, a new adolescents’ assessment method named “Cooperative Assessment” (COOPAS) was developed with the aims of early establishing a good therapeutic alliance and reducing symptoms in order to lower treatment dropouts. Method: To establish COOPAS efficacy, 136 helpseeking adolescents were consecutively recruited, evaluated with the COOPAS 8-week protocol and were followed up for 6 months to detect late dropouts. Hamilton rating scales for Depression and Anxiety (HAM-D, HAM-A), Global Functioning Role and Social Scales (GF-RS, GF-SS), Structured Interview for Prodromal Symptoms (SIPS), Clinical Global Impression (CGI), Working Alliance Inventory – Therapist Version (WAI-T), Therapist Response Questionnaire (TRQ) and Psychotherapy Relationship Questionnaire (PRQ) were administered before, after 4 weeks and at the end of the assessment. Results: At the end of the assessment, HAM-A and HAM-D scores showed a mean 25% reduction with respect to baseline and CGI, GF-SS and GF-RS were significantly improved. Similarly, WAI-T scale showed a significant increase in all the three subscales and patients transference patterns (PRQ) showed a decrease of the Anxious/Preoccupied and Avoidant/Counterdependent dimensions with a parallel increase of the Secure/Engaged one. After 6 months, dropout rate was 8.8%. Conclusions: COOPAS method has proven effective in early reducing depressive and anxiety symptoms, improving therapeutic alliance and reduce dropout rate in adolescents affected by anxiety and mood disorders

Diagnostic Efficiency of the Rorschach Perceptual and Thinking Index (PTI) in discriminating Ultra High Risk (UHR) Adolescent helpseekers from non-UHR

Introduction. Rorschach Perceptual and Thinking Index (PTI) is higher in adolescents at ultra-high risk for psychosis (UHR) in comparison with adolescents non-UHR patients, evaluated with the Structured Interview for Prodromal/Psychosis-risk Symptoms (SIPS). However, the diagnostic efficiency of Rorschach PTI has never been examined. The aim of this study is to evaluate the diagnostic efficiency of the Rorschach PTI in discriminating UHR from non-UHR adolescents helpseekers. Methods. A sample of 155 patients, 47% males, (14-18 years) were included and referred to the clinic for Anxiety and Mood Disorders in Adolescence (Department of Psychiatry of Sant'Andrea Hospital in Rome). Subjects met diagnostic criteria for the following DSM-5 diagnoses: Anxiety Disorders (30%), Depressive Disorders (40%), Bipolar Disorders (15%), Obsessive-Compulsive Disorders (10%); UHR patients were 19. The sample was evaluated with the Rorschach (calculated according to the standard Comprehensive System Method) and with the SIPS. The cut-off for the PTI index was fixed to 3. Results. Rorschach PTI reported the current efficiency diagnostic indexes: Overall Correct Classification (OCC) was 0,87; Sensitivity (SENS) was 0,63; Specificity (SPEC) was 0,90; Positive Predictive Power was 0,48; Negative Predictive Power was 0,94; Cohen’s k was 0,47. Conclusions. Rorschach shows a moderate ability to differentiate UHR from non-UHR adolescent patients, especially in the identification of the subjects that do not present UHR

Relationship between the Rorschach Perceptual Thinking Index (PTI) and the Structured Interview for Prodromal Symptoms (SIPS) in a sample of helpseeker adolescents

Introduction. Rorschach Perceptual and Thinking Index (PTI) has been proved effective in differentiating adolescents at clinical high risk for psychosis from non-psychotic patients, evaluated with the Structured Interview for Prodromal/Psychosis-risk Symptoms (SIPS). However, the relationships between SIPS and PTI criteria have not been explored. Objectives. The aims of this study were to investigate the relationships between the five PTI criteria, their main variables (X-%; WSum6; M-) and the SIPS subscales (Positive, Negative, Disorganization and General Symptoms). Methods. A sample of 117 help seeking adolescents, 68% females, aged 14-19 years, with anxiety, mood and bipolar spectrum disorders were included in the study. All were recruited at the first visit and evaluated with the Rorschach (according to the standard Comprehensive System Method) and the Structured Interview for Prodromal Symptoms (SIPS). Results. PTI Total score and PTI1 significantly correlated with SIPS negative, disorganization and general subscales (rs0,2–0,4; p<0.05); PTI2 with disorganization and general subscales (rs0,2–0,4; p<0.05); PTI3 with positive subscale (rs=0,22;p=0.02); PTI4 with positive, negative and disorganization subscales (rs0,2–0,4; p=0.02) and PTI5 with disorganization and general subscales (rs=0,2; p< 0.02). WSum6 significantly correlated with positive and disorganization subscales (rs=0,2–0,3; p<0.01); X- with disorganization and general subscales (rs0,2–0,3; p<0.02) and M- with disorganization subscale (rs=0,2; p=0.02). Conclusions. Rorschach PTI criteria and their main variables (X-%; WSum6; M-) show a mild to moderate correlation with specific SIPS subscales and might be helpful in identifying adolescents at risk for psychosis

Temperament and Character in Ultra-High Risk for Psychosis (UHR) compared to non-UHR helpseeking adolescents

Introduction. The psychobiological model of temperament and character indicates that personality traits are heritable and, during development, constantly influence one’s susceptibility to psychotic disorders. Objectives. The aim of this study was to investigate temperament and character in ultra-high risk (UHR) for psychosis helpseeking adolescents compared non-UHR ones. Methods. A sample of 75 help seeking adolescents, including 12 UHR and 63 non-UHR subjects, aged 14-19 years, with anxiety, mood and bipolar spectrum disorders were included in the study. All were recruited at the first visit and evaluated with the Temperament and Character Inventory-Revised (TCI-R) and the Structured Interview for Prodromal Symptoms (SIPS). Results. UHR patients showed significantly lower temperament traits of Novelty Seeking (NS) and Self Directedness (SD) with respect to non-UHR adolescents (NS: 95,9 ± 12 and 106,2 ± 12 respectively, U = 157, p = 0.02; SD NS: 106,1 ± 21 and 120,5 ± 17 respectively, U = 157, p = 0.02). Conversely, UHR adolescents showed a higher temperament trait of Harm Avoidance (HA) (125,1 ± 14 and 110 ± 19 respectively, U = 145, p = 0.01). Conclusions. UHR adolescents show reduced novelty seeking and self directedness temperament traits and increased harm avoidance with respect to non-UHR patients with mood and anxiety disorders