Sarcoidosis: Psychotherapy and Long-Term Outcome—A Case Report

Sarcoidosis is a systemic, inflammatory disease of unknown aetiology, influenced by stressful life events and associated with a high incidence of alexithymic personality traits, and of depressive symptoms. The medical literature on sarcoidosis has called for a psychotherapeutic intervention to modify the perceived state of disease, the influence of stressful events and the depressive condition. Few studies have described cases treated with psychotherapy, and no information is available on its long-term outcome. We present the case of a patient with chronic sarcoidosis and periodical reacutizations with constantly pathological ESR. Twenty-four years after the diagnosis, a dynamic supportive-expressive psychotherapy for psychosomatic alexithymic patients was added to the medical therapy. At the beginning and at the end of the psychotherapy, and for the long-term outcome evaluations, Kellner's symptom questionnaire (SQ) was used to investigate psychological distress. The SQ scores, initially pathological, were normal at the end of the psychotherapy and for the following three years. Psychotherapy, without antidepressive drugs, resolved the depression. The depressive symptoms disappeared, along with the normalization and stabilization of the ESR. After three years, the outcome was positive. This is the first study describing a successful psychotherapy and its long-term outcome on a patient with sarcoidosis

Reconciliation of Time Perspectives as a Criterion for Therapy Completion

none3siGiancarlo Trombini, the main author of this article, has demonstrated in a series of empirical studies based on treatment examples from psychoanalytic psychotherapy that the development of relational dynamics in therapy can be assessed in an objectively verifiable way using a phenomenological criterion based on the narrative content of each session. This criterion is the comparison between the manifest dream and the subsequent associations (MDAC; Trombini, 2010, 2014, 2015). This is a contribution to the reflexive pole of analytic psychotherapy, which is, after all, characterized by a constant oscillation between the pole of reflection and the pole of a “dreaming reception.” The present contribution continues this research with the treatment of the concluding phase of therapy, which is related to certain turning points in the processes of change in therapy (Di Chiara, 2003).https://sciendo.com/article/10.2478/gth-2021-0005openTrombini, Giancarlo; Trombini, Elena; Stemberger, GerhardTrombini, Giancarlo; Trombini, Elena; Stemberger, Gerhar

Depressive Symptoms in Fathers during the First Postpartum Year: The Influence of Severity of Preterm Birth, Parenting Stress and Partners' Depression

Although preterm birth constitutes a risk factor for postpartum depressive symptomatology, perinatal depression (PND) has not been investigated extensively in fathers of very low (VLBW) and extremely low birth weight (ELBW) infants. This study explored paternal depression levels at 3, 9, and 12 months of infant corrected age, investigating also the predictive role played by the severity of prematurity, maternal and paternal PND levels, and parenting stress. We recruited 153 fathers of 33 ELBW, 42 VLBW, and 78 full-term (FT) infants, respectively. Depression was investigated by the Edinburgh Postnatal Depression Scale (EPDS) and distress by the Parenting Stress Index-Short Form-PSI-SF (Total and subscales: Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child). ELBW fathers showed a significant decrease (improvement) in EPDS, total PSI-SF, and Parental Distress mean scores after 3 months. Paternal EPDS scores at 12 months were significantly predicted by VLBW and FT infants' birth weight categories, fathers' EPDS scores at 3 and 9 months, Parent-Child Dysfunctional Interaction subscale at 3 months, and Difficult Child subscale at 9 months. This study strengthens the relevance of including early routine screening and parenting support for fathers in perinatal health services, with particular attention to fathers who might be more vulnerable to mental health difficulties due to severely preterm birth

The composition of PM1 and PM2.5 samples, metals and their water soluble fractions in the Bologna area (Italy)

Abstract In this study the metal composition of PM 1 and PM 2.5 samples collected in the surroundings of a municipal incinerator located in a suburban–farming area, less than 10 km away from Northeast of Bologna (Italy) was investigated. Seven out of eight monitoring stations were installed in a domain of 8x9 km 2 around the incinerator plant; the eighth station was placed inside the urban area of Bologna. The coordinates of four monitoring stations were selected on the basis of a preliminary study by using a dispersion model. Eleven metals (Al, Sb, As, Cd, Fe, Mn, Ni, Pb, Cu, V, Zn) were quantified in both the filter acid–digests and in the water extracts. The PM 2.5 collected in all the sites of the domain were highly correlated with exception of the urban site. The daily average metal concentrations in summer were 1.84% and 1.14% for PM 2.5 and PM 1 respectively, indicating that fine particles are less enriched in metals. Fe, Al and Zn were the most abundant elements, and they represented about the 80% of the total amount of the analyzed ones. The average water soluble metal compositions were 0.71% and 0.41% for PM 2.5 and PM 1 respectively. In the sites of the suburban–farming studied area the Principal Component Analysis (PCA) and Cluster Analysis revealed differences between water soluble metal compositions in PM 1 and PM 2.5 . The urban sites were characterized by lower total and soluble metals contents than the other PM 2.5 stations installed around the incinerator plant. However, no noticeable difference in the concentrations of metals in the particulate matter between the sites chosen as maxima of incinerator emissions and the control sites was observed

The Focal Play Therapy: A Clinical Approach to Promote Child Health and Family Well-being

Eating and evacuation disorders can cause serious health problems for children. Early recognition and early treatment require a multifactor intervention based on a collaborative relationship between pediatricians, psychotherapists and other health professionals. In this context the Focal Play Therapy (FPT) with children and parents is a psychodynamic model of intervention that improves parental ability to cope with child's difficulties. Parental engagement in child interventions allows to understand child's symptoms within family dynamics and to build an alliance with parents that represents a crucial variable of an effective psychological support for children and families. In the present study data were collected from 17 parental couples and their preschool children at two time points (1st and 6th FPT sessions) marking the first phase of this intervention. This phase was aimed to the assessment of child's symptoms within family relationships and to the promotion of the alliance with parents. Families were in treatment at the Psychological Consultation Center for Children and Parents located at the Department of Psychology of the University of Bologna (Italy). This Center provides health assessment and intervention services to children and their families. We investigated the alliance from both parents and therapist points of view along with other parental and child outcome variables implied in clinical works with children and families. Alliance scores were obtained through the Working Alliance Inventory and the System for Observing Family Therapy Alliances, two measures used in individual and family settings, respectively. Parenting stress and parent-child interactions were investigated using the Parenting Stress Index and the Emotional Availability Scales. Furthermore, paired t-tests were run to detect changes on parental and child variables. Findings advise that special attention should be paid to the building of an early alliance with parents. In this regard the FPT is specifically designed to promote the parent-therapist alliance in the context of child health and family well-being

The relationship between knowing sign language and quality of life among Italian people who are deaf : a cross-sectional study

Deafness is a medical condition with important relational implications. This condition could affect well-being and self-esteem and cause social anxiety. Sign language is not only a simple mimic but can be considered as a different kind of communication that could be protective for those who have learned it. However, some people do not use sign language because they think it can be marginalizing. The present study aimed to compare the quality of life (QoL) between people who learned Italian sign language as their first language with those who had never learned it or learned it later. This cross-sectional study involved 182 deaf Italian adults (70.3% females) who were recruited from Ente Nazionale Sordi (ENS) and by the main online deafness groups. The present results suggest that the deaf condition does not seem to significantly affect the dimensions of QoL pertaining to satisfaction and self-esteem, while it could have an effect on preventing high levels of social anxiety and in particular, the group who learned Italian sign language showed significantlyless social anxiety than those who had never learned it

Hopelessness and burnout in Italian healthcare workers during COVID-19 pandemic: the mediating role of trait emotional intelligence

Objective: The study aims to assess the impact of COVID-19 on healthcare workers’ work-related stress during the first wave of the pandemic in Italy. The main objective is to investigate the existence of a positive correlation between hopelessness and burnout, assuming that burnout may be  a riskfactor for the development of hopelessness, and to analyze the role thattrait Emotional Intelligence (TEI) and changes in workload could have in this relationship. Furthermore, evaluate any significant differences in burnoutand hopelessness levels in the function of some demographic variables, such as gender, professional profiles, and different working zones of Italy, tobetter understand how the diverse diffusion of the pandemic had affected Italian healthcare workers. Methods: An online survey was used to collect data between April and June,2020, with 562 responses among nurses (52.1%) and physicians (47.9%).Demographics and changes in workload and work conditions were collectedthrough an ad hoc questionnaire. The Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), The Beck Hopelessness Scale (BHS), and the Link Burnout Questionnaire (LBQ) were used to assess Trait Emotional Intelligence(TEI), hopelessness, and burnout, respectively. Results: Correlation analysis showed a significant positive relationship betweenhopelessness and each burnout dimension. TEI showed negative correlations both with burnout dimensions and hopelessness. Significant differences in burnout and hopelessness levels emerged as a function of some demographic variables such as gender, professional profiles (nurses or physicians), and different working zone of Italy (northern or southern). Results showed that TEI partially mediated the relationship between hopelessness and every burnout dimension,while the interaction of changes in workload was non-significant.Discussion: The mediating role of TEI in the burnout-hopelessness relationship partly explains the protective role that individual factors had on healthcareworkers mental health. Our findings support the need to integrate considerations on both psychological risk and protective factors into COVID-19 care, including the monitoring of psychological symptoms and social needs, especially among healthcare workers

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