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.

Gastroesophageal reflux disease: alexithymia and attachment style.

Alexithymia and its relation with attachment style were evaluated in a group of 69 patients (men, M age = 46.4 yr., SD = 12.6; women, M age = 44.2 yr., SD = 14.4) affected by Gastroesophageal Reflux Disease. Two self-evaluation questionnaires were used for psychological evaluation, the 20 item Toronto Alexithymia Scale (TAS-20) and the Attachment Style Questionnaire (ASQ). The TAS-20 analysis showed that the clinical sample taken as a whole did not score in the alexithymic range. The inverse correlations between the Confidence ASQ subscale and the Difficulty Communicating Feelings TAS-20 subscale showed that communication of emotions could develop more easily within the framework of a relational context characterized by safety and confidence. In this group of patients this was represented by the referent caregiver.

Use of the Drawn Stories Technique to evaluate psychological distress in children.

This study evaluated the validity of analyzing children's drawings using the Drawn Stories Technique for psychodiagnostic assessment and clinical investigation of children. The research was conducted on a sample of 211 subjects (102 girls, 109 boys), 99 in primary school and 112 in secondary school. Three measures of psychological distress were given: the Drawn Stories Technique (considering two types of outcome of the stories as an index of psychological distress: story with a negative outcome and story with a positive outcome), and two self-report scales, the Anxiety Scale Questionnaire for Children and the Children's Depression Inventory. Analyses for both age groups indicate a prevalence of positive outcomes over negative outcomes, with a similar distribution in the two age groups. Greater anxiety and depression were found for subjects with a prevalence of negative outcome in the stories, and girls scored generally as more anxious and depressed than boys. These results indicate that the Drawn Stories Technique shows construct validity for use with children and is sensitive enough to detect their psychological distress, in terms of anxiety and depression.