Sequestrati dalla vendetta: “rimanere chiusi fuori dall’oggetto”

RiassuntoA partire dal loro lavoro di psicoterapeute e attraverso alcuni frammenti clinici che si riferiscono ad un gruppo di adolescenti svoltosi in un quartiere a rischio di Palermo, le Autrici analizzano la dimensione mafiosa non restringendola al solo comportamento criminale; piuttosto declinandola lungo alcuni significanti: non identità e gruppo mafioso che colonizza e sottomette lo psichismo del singolo; fantasmi familiari potenti e spietati che impediscono il costituirsi di sé originali e autonomi; personalità impastate di indifferenza emotiva e vendicatività. Significanti che rendono conto delle vaste aree di desertificazione e pietrificazione – resistenza al cambiamento – avvertita dagli psicoterapeuti che prendono in carico giovani di famiglie mafiose. Parole chiave: mafia, psicoterapia, gruppo, vendetta, identità, resistenza, cambiamentoKidnapped by revenge: “being locked out of the object”Abstract Starting from their work as psychotherapists and by means of some clinical fragments which refer to a group of teenagers of a neighbourhood at risk in Palermo, the Authoresses analyze the Mafia dimension not limiting it to a criminal behaviour only. They rather decline it along some signifiers: non identity and mafia group which colonizes and subjugates the indi-vidual’s psychism. Powerful and merciless family ghosts who prevent from building original and autonomous selves. Personalities kneaded with emotional indifference and vindictiveness. Signifiers which account for the large desertification and petrification areas – resistance to change – that psychotherapists, who deal with young people belonging to Mafia families, are able to feel. Key word: mafia, psychotherapy, group, revenge, identity, resistance, chang

L'alessitimia come disturbo della regolazione affettiva

Alexithymia is a theoretical construct concerning the ability to contact our feelings and the ability to describe them in words. It is very useful in clinical experience and also in empirical research for its operationalization and applicability possibility. After more than 40 years from its original definition, with clinical observation of patients defined “psychosomatics” according a classic definition, alexithymia has become one of the most investigated disease in the last decades. This paper aims to explore etiopathogenetic hypotheses and contemporaneous prospective within which it is possible to understand the relevance of the construct both in clinical experience and in empirical research. Furthermore, the paper examines alexithymia assessment methods to provide a complete and updated description of tools now available for clinical research. We also wish to underline the fundamental limit in a detailed study on alexithymia: the absence of psychometric tools to assess the disease in developmental age. This limit is related to the difficulty of building research tools able to understand the developmental movement in emotional processing capacity during childhood. However, there are recent preliminary studies on children/teens and preteens which pave the way for research in this direction

The Rorschach method for obesity assessment: clinical study on a group of obese women

SUMMARY. Aim. The purpose of this study is to explore through the Rorschach method the psychological and personological profile of the woman with obesity. Methods. The Rorschach test was administered to 10 women with body mass index of 41.86±9.9 kg/m2 at the clinic for obesity surgical treatment at the University Hospital “Paolo Giaccone” of Palermo. Results. The quantitative and qualitative analysis of the Rorschach responses detected in the study show: limited practical and creative sense in managing daily life situations, rigid control of emotions, affective turmoil, sense of inadequacy; sufficient examination of reality and adaptation social. Conclusion. The Rorschach method can be the privileged instrument for obesity, for its remarkable projective value, because it allows to capture the psychic suffering of the obese person, the representation and the image of the self, to identify the interaction between psycho-physical state and emotional investments

Sturge-Weber syndrome: a report of 14 cases

Sturge-Weber-Krabe syndrome (SWS), also known as encephalotrigeminalangiomatosis and named the forthfacomatosis, recall the names of the authors who first describedit in its basic clinical, radiological andanatomopathological aspects. We report here 14 cases of Sturge-Weber disease. In 6 of these, despite what had been previously described in literature, an extension of the angioma has been noted in other parts of the body. The study of these subjects stresses not only the need for a pharmacological/neuropsychomotor intervention, but alsothe need of a psychotherapeutic approach, for the emotional and affective implications thatcould derive from this syndrome. The reported cases are similar to those presented in literature for their main features. In particular, two elements are interesting: i) the exceptional diffusion of the red nevousto the whole hemicorpo; and ii) the evaluation of the way the patients live the disease, which has not beenpreviously considered in literature. We can conclude that SWS is a multisystem disorder that requires the neurologist to be aware of the possible endocrine, psychiatric, ophthalmological, and other medical issues that can arise and impact on the neurological status of the patients. and neuropsychomotor therapies, but also a psychotherapeutic support to patients. It should be noted that the literature does not take psychotherapeutic support into consideration

Borderline Personality in Patients with Poly-Diagnoses Treated for a Bipolar Disorder

Some patients with dysphoria, explosive behaviour, or suicidal ideation, may receive a diagnosis of, and treatment for Bipolar Disorder (BD) and, not infrequently. The coexistence of these two diagnoses has been explained in different ways. Some authors include the BPD in the bipolar spectrum; others are sceptical about the existence of real comorbidity, suggesting a misdiagnosis. This study aimed to assess the personality of this group of poly-diagnosed patients (PolyD) and hypothesised they had a pathological borderline organisation. Via the administration of the Schedler Westen Assessment Procedure (SWAP-200), we compared PolyD patients with those suffering from BPD or BD only. We performed two different MANCOVAs to test PolyD, BPD and BD patients’ differences in PD-factors, Q-traits and age. The sample comprised 45 patients (Mean age=43.3, SD=15.7; Females 57.7%, N=26). BD patients (N=15) did not present any personality disorder, they had a higher functioning and Obsessive Q-traits, and a lower Histrionic PD-factor than both PolyD (N=20) and BPD (N=10) patients. Compared to PolyD patients, BD had inferior PD-Borderline, PD-Antisocial factor and Dependent-Masochistic Q-traits, but there were no other differences with BPD patients. PolyD did not differ from BPD patients in any of the PD-factors and Q-traits. Our results suggest that PolyD patients are different from BD patients and propose to consider the pathological borderline personality as a central core of their disease

I disturbi della nutrizione e dell\u2019alimentazione nei maschi: una panoramica sulle ricerche nel periodo 2007-2017 = Eating disorders in males: An overview of research over the period 2007-2017

Introduction. Despite the extensive literature, the gender differences in eating disorders (ED) have been poorly investigated. Most of the studies, in fact, have been conducted so far on female samples, emphasizing the misleading belief that such disorders are of exclusive relevance of women. Aim. The review aim at highlighting as this preconception is still widespread among the male patients and the clinicians and as it represents an impediment to a correct diagnosis and a proper treatment planning. Method. Included studies were selected in the scientific literature published between January 2007 and December 2017 through the main databases, combining the words: \u201cmales\u201d, \u201ceating disorder\u201d, \u201canorexia nervosa\u201d, \u201cbulimia nervosa\u201d, \u201cbinge eating disorder\u201d. Results. Fifty-four studies have been selected in accordance with the followed methodological criteria. Discussion. Only recently, the attention of researchers have been also focused on male population: many differences between genders have emerged in prevalence, onset, phenomenology, diagnosis, comorbidity and outcomes of ED. The studies on risk factors have also pointed out significant differences between males and females, especially in relation to the different weight exerted by psychological variables involved in the aetiology of eating disorders. Conclusions. Compared with a little knowledge of ED in the male population, it is important to widespread the comprehension taking into account the gender perspective. The attention must be paid particularly to critical developmental periods, such as puberty and adolescence, where early detection and prevention of these disorders is of greatest importance, inside a conceptual framework which considers the mutual influence between biological and psychological vulnerability, and sociocultural factors

Acceptance of non-invasive computed tomography coronary angiography: for a patient-friendly medicine

PURPOSE: This study was done to evaluate the psychological state and anxiety of patients undergoing computed tomography coronary angiography (CTCA), and assess their acceptance and satisfaction compared to invasive conventional coronary angiography (CCA). MATERIALS AND METHODS: A total of 442 consecutive patients (282 male; mean age 57.7 ± 9.5 years) who underwent CTCA for suspected or known coronary artery disease were evaluated with the Endler Multimodality Anxiety Scales (EMAS) before and after the scan, and a questionnaire administered after the scan. Among the 442 patients, 181 had a history of CCA. Two radiologists assessed the image quality of CTCA. RESULTS: Anxiety was more intense prior to the scan (EMAS score 51.7 vs. 46.7, p < 0.01) and in patients with a history of CCA (EMAS score 55.5 vs. 49.1, p < 0.01). Women presented more intense anxiety (EMAS score 59.5 vs. 47.3, p < 0.01), higher mean heart rate (63.5 ± 7.6 vs. 60.7 ± 7.3 beats per minute, p < 0.01) and a lower image quality than men (p < 0.0001). CTCA proved to be more acceptable than CCA because of accurate preparation, lower concern prior to the examination, negligible pain, higher comfort, and greater overall satisfaction (p < 0.0001). CONCLUSIONS: Computed tomography coronary angiography is a patient-friendly imaging method because of the minimal perceived discomfort. Anxiety may affect CTCA image quality in women

The quality of life in developing age children with celiac disease

Aim. The moments that follow thè diagnosis of celiac disease and thè early stages of thè gluten-free diet are extremely difficult and complex for parents and child, because they face an important change punctuated by selfdenial and deprivation. The mairi objective of this research is to assess thè impact of celiac disease on quality of life in subjects in developmental age, taking into account thè perceptions of parents about thè child's illness, •with thè aitn to highlight thè effect of disease on thè child and thè entire family. Methods. The study included both parents of 45 children aged between 2 and 10 years, with established celiac disease. To evaluate thè effect of celiac disease on thè lifestyle of affected children and their families has been used, after having adapted to thè Italian context, thè Impact Scale of Childhood Diseases of Hoare and Russell (1995). This study shows that celiac disease is a conditìon that has a significant impact on both thè child and his family. Results and conclusion. The results obtained by administration of Impact Scale of Childhood Diseases to parents showed that subjects in developmental age with celiac disease could have difficulty on emotional level that affect child development and thè whole family context. Acceptance of thè illness by thè child depends mainly by how muc

Psychological distress and suicidal ideation in Sicilian Medical Students: The SMS-ME project

Background Medical students are at high risk for mental disorders, and the COVID-19 pandemic might have exacerbated psychological distress. However, no data are available for the southern part of Italy. The SMS-ME (Sicilian Medical Students’ MEntal health) project aimed to estimate the prevalence of and predictors of depression, anxiety, stress, and suicidal ideation in a sample of Sicilian medical students. Methods A web-based cross-sectional survey was carried out from September 2022 to December 2022. The study protocol investigated sociodemographic factors and clinical data including Depression, Anxiety, Stress Scale-21 (DASS-21), and a specific question addressing suicidal ideation frequency over the last six months. Multivariate regression models were assessed to examine the association between symptoms and relevant predictors and then regressed their residuals with suicidal thought frequency. Result We collected 1,866 records (age=22.5, SD=3.4; 65.2 % females). One out of four students presented highly severe depression (25 %) and referred to the presence of some suicidal ideation in the six months preceding the interview (26.1 %). DASS-21 scores, especially depression (F(5, 1,828)=58.8, p = 6.59–57), increasingly predicted the frequency of suicidal thoughts when above the sample's mean. Limitations The cross-sectional study design does not allow inferences on temporal relationships and the self-report strategy could be intrinsically biased by the person's feelings at the time of the interview. Conclusions High prevalence of anxiety and depressive symptoms and suicidal thoughts were observed among Sicilian medical students. The DASS-21 was a good predictor for suicidal ideation that Universities could use as a simple tool to assess the need for psychological healthcare in this population