Cognitive behavioral therapy for young people after l'aquila earthquake.

OBJECTIVE: Cognitive behavior therapy (CBT) emerges as the best validated therapeutic approach for children and adolescents who experienced trauma-related symptoms, particularly associated with anxiety or mood disorders. The aim of this study was to evaluate the CBT efficacy among young people exposed to L'Aquila earthquake, in 2009. METHODS: one year after the disaster, 39 young subjects as a case group (CBT treated) and 24 as a comparison group (no CBT treated) were evaluated with the Impact of Event Scale Revised (IES-R), the General Health Questionnaire-12 items (GHQ-12) and the Brief Cope. CBT was conducted in 12 sessions (once per week for 3 months). After CBT intervention, both groups were evaluated again with the same psychometric instruments. RESULTS: our results show a significantly decrease in post traumatic symptoms and psychological distress severity in CBT group. It was attributable to an improvement in each of three PTSD dimensions (intrusion, avoidance, and arousal) and in the total score of IES-R (p< 0.04). Among CBT treated group, subjects that adopted "planning/problem solving" coping strategies (p < .02) and "religiosity" (p < .045) show higher improvement in psychological distress. CONCLUSIONS: our findings show the efficacy of CBT and the influence of individual coping strategies in the improvement of posttraumatic stress symptoms and psychological distress among young people seeking help from an outpatients service for young people with psychiatric problems (the SMILE) after the catastrophic disaster in L'Aquila.

[Use of cannabis and psychopathological risk in onset psychosis]. / Uso di cannabis e rischio psicopatologico negli esordi psicotici.

AIM: The aim of the study is to assess the correlations between cannabis use and psychopathological features, disorder severity and global functioning in subjects with onset psychosis (schizophrenic and bipolar psychosis) and at risk mental state. MATERIALS AND METHODS: Sixty-seven consecutive subjects with diagnosis of bipolar spectrum disorder (N=49), schizophrenic spectrum disorder (N=5) and at risk mental state (N=13) were recruited from the SMILE (Service for Monitoring and early Intervention Looking at the fight against the onset of mental Even psychological youths' suffering). All subjects were assessed with the Self Report Symptom Inventory-90 (SCL-90), the Global Assessment of Functioning scale (GAF) and Clinical Global Impressions-Severity (CGI-S). Moreover, they were assessed for the cannabis use in the last month. RESULTS: The total sample was splitted in two groups: Group 1 of cannabis use subjects (N=30) and Group 2 of no cannabis use subjects (N=37). Group 1 subjects showed significant higher scores at psychoticism SCL-90 dimension and at CGI-S than Group 2 subjects. The higher scores at anger/hostility and psychoticism SCL-90 dimensions and at CGI-S seem to be discriminant features of Group 1 cannabis use subjects. CONCLUSIONS: The data reported suggest that cannabis use assessment in onset psychosis (bipolar and schizophrenic onset) and at risk mental state could add clinical information to the psychopathological and diagnostic description. Such information should be ''incorporated'' in the treatment choice model and outcome prediction assessment.

Decision making, impulsivity, and personality traits in alcohol-dependent subjects.

The aim of the study was to assess the relationship among decision-making (DM) ability (as measured by the Iowa Gambling Task [IGT]), impulsivity, and temperament and character traits in a long-term abstinent alcohol-dependent sample. Twenty-six abstinent alcohol-dependent subjects, referred to a Drug Addiction Unit of the National Health Service of L'Aquila, were evaluated using the IGT, the Barratt Impulsiveness Scale, version 11 (BIS-11), and the Temperament and Character Inventory 125-item (TCI-125) version. Twenty-four control subjects were recruited and assessed with IGT only. The clinical and control samples were significantly different in their IGT performance, the former sample making disadvantageous choices leading to lower scores. Significant negative correlations between IGT total score and BIS Non-Planning Impulsivity and a trend toward significance with TCI Novelty Seeking dimension were reported. Our data confirm the results of other studies suggesting DM impairment related to impulsive dimension as an important feature in subjects with alcohol dependence: the finding suggests a role of DM impairment in increasing proneness to a chronic relapsing course.

[Body image disorders and other psychiatric symptoms in aesthetic plastic surgery]. / Disturbi dell'immagine corporea e sintomatologia psichiatrica in pazienti candidati ad interventi di chirurgia estetica.

OBJECT: The aim of our study has been to investigate the presence of alterations of body image and psychiatric symptoms in a sample of patients candidates to participate in cosmetic surgery. MATERIAL: It has been recruited 56 outpatients (M=12; F=44) of mean age of 37, 55 years (ds 13.31) consecutively afferent to the Plastic Surgery Ward at the University of L'Aquila. All patients were Plastic Surgery candidates. They have been evaluated by administration of the following instruments: Self-Report Symptom Inventory-Revised (SCL-90) and the Body Uneasiness Test (BUT). RESULTS: The sample was divided into two groups in order to BUT positivity (33.92% positive versus 66.02% negative). Both groups have showed statistically significant differences (p < 0.01) in all SCL-90 dimensions moreover the BUT positive patients have showed greater scores in all SCL-90 dimensions than BUT negative patients. DISCUSSION: Our data indicate the high prevalence of body image disorders and the presence of other psychiatric symptoms in Plastic Surgery patients. CONCLUSIONS: Our study confirm the importance of psychiatric evaluation in those patients. Therefore, a liaison between Psychiatric Service and Plastic Surgery is needed and the consequent psychiatric evaluation results essential to give indications for complete surgical cosmetic procedures.

[The decision making: neuroanatomy, functional exploration and mental disorders]. / Il decision making: neuroanatomia, esplorazione funzionale e disturbi mentali.

The term decision making indicates aspects of the executive functions related to the ability to modulate the reward and punishment perception, in order to operate advantageous choices. From the clinical point of view it appears a transnosographic trait that may influence the suicide risk and aggressive acts, increase interpersonal difficulties and modulate therapeutic response: an interesting link between clinical symptomatology and functional daily abilities. We conducted a literature review on its neurophysiology and neuropsychology and the implications in different psychiatric disorders such as schizophrenia, bipolar disorder, unipolar depression, suicide, obsessive-compulsive disorder, substances abuse, personality disorders, aggressiveness and pathological gambling.

Affective temperaments and residual symptoms in patients with mood and anxiety disorders.

Objective. Temperament conventionally refers to stable behavioural and emotional reactions that appear early in life and are influenced in part by genetic constitution. Few studies compared temperamental traits in anxiety and mood disorders even though some authors suggested a clinical and neurobiological continuum between them. The aim of the study was to compare temperamental traits and psychopathological dimensions in subjects with DSM-IV diagnoses of mood and anxiety disorders. Methods. A total of 101 clinically stabilized consecutive outpatients (45 subjects with anxiety disorders and 56 with mood disorders diagnoses) were evaluated. The brief version of Temperament Evaluation of Memphis, Pisa, Paris and San Diego (briefTEMPS-M) and Symptom Checklist-90 (SCL-90) were used to assess temperamental traits and psychopathological dimensions, respectively. Results. No significant differences between anxiety disorders and mood disorders subjects for TEMPS-M or SCL-90 mean scores were observed. Different TEMPS-M scores differentially affect residual clinical symptoms. Conclusions. Our data represent an indirect indicator of possible common diathesis between the two different disorders. The temperament "paradigm" could explain part of the residual symptomatology. The evaluation of affective temperaments seems to add considerable clinical information to psychopathological and diagnostic descriptions.

Premorbid intelligence of inpatients with different psychiatric diagnoses does not differ.

The diagnostic specificity of poor premorbid intelligence is controversial. We explored premorbid intelligence level in psychiatric patients with personality disorders, depressive disorders, bipolar disorders and schizophrenic disorders. 273 consecutively admitted patients and 81 controls were included in the study and tested with the 'Test di Intelligenza Breve', an Italian adaptation of the National Adult Reading Test. Significant differences between the clinical samples and the control subjects were found but not among the 4 clinical groups. The observation of premorbid IQ deficits in subjects with diagnoses other than schizophrenia suggests a common vulnerability diathesis, which is most likely to have a neurodevelopmental basis.

The effect of verbalization strategy on Wisconsin Card Sorting Test performance in schizophrenic patients receiving classical or atypical antipsychotics.

BACKGROUND: A number of reports showed en encouraging remediation in some patients' executive deficits thanks to the use of 'information processing strategies'. Moreover the impact of antipsychotics on cognitive functions of the schizophrenics is an important issue, especially if an integrated psychosocial treatment is needed. The aim of this paper is to evaluate different executive performance and response to verbalization, a strategy of the Wisconsin Card Sorting Test (WCST) remediation, in subjects on classical vs atypical antipsychotic (AP) treatment. METHODS: Sixty-three schizophrenic subjects undertook the WCST under standard and modified (verbalization) administration. Subjects were stratified by the kind of WCST response (i.e. good, poor and remediable) and AP treatment (i.e. atypical vs. classical). RESULTS: Subjects on atypical APs showed a better performance than those on classical ones. More poor performers who did not remediate were seen in the sample with classical Aps while subjects who remediated the performance were seen in the subgroup with atypical APs only. An increase of perseverative and total errors was seen in poor performers subjects on classical APs. CONCLUSION: Subjects on atypicals showed a better cognitive pattern in terms of WCST performance. Since the naturalistic assignment of medication we cannot draw conclusions about its effect on cognitive performance and its interaction with cognitive remediation potential. However the data lead us to hypothesize that subjects with potential room for remediation did so with the atypical APs.