[Giovanni Jervis' thought about helping relationship]. / Il pensiero di Giovanni Jervis sulla relazione d'aiuto: un importante contributo nella formazione degli operatori in psichiatria.

The author describes Giovanni Jervis' thought about helping relationship starting from considering how he received inspiration from Jervis himself in developing a way of practising psychiatry which is always careful and respectful of others and of everyday life policy. The construction of mental wellness is a dynamic process that is pursued all life long: it concerns the way we work as well, on the one hand to overcome or at least to mitigate mental disorders, on the other hand to preserve the mental endurance of a Mental Health Department and its workers. Institutional therapy therefore maintains with realism and without idealistic illusions this double "maturity" goal, without because of this indulging in pessimism on human nature and on incurability: these pessimisms too often have had and still have an auto-justifying function for doing nothing or doing wrong.

Cortical sources of awake scalp EEG in eating disorders.

OBJECTIVE: To investigate quantitative EEG (qEEG) in anorexia nervosa (AN) and bulimia nervosa (BN) in comparison with healthy controls. METHODS: Resting EEG was recorded in 30 healthy females (age: 27.1+/-5.5), 16-AN females (age: 26.4+/-9.5) and 12-BN females (age: 27.0+/-6.3). Cortical EEG sources (delta, theta, alpha 1, alpha 2, beta 1, beta 2) were modeled by LORETA solutions. The statistical analysis was performed considering the factors Group, power Band, and region of interest (central, frontal, parietal, occipital, temporal, limbic). RESULTS: Alpha 1 sources in central, parietal, occipital and limbic areas showed a greater amplitude in Controls versus AN and BN groups. Alpha 2 sources in parietal, occipital and limbic areas showed a greater amplitude in Controls than in both AN and BN groups. Alpha 1 sources in temporal area showed a greater amplitude in Controls compared to both the BN and AN groups as well as in the BN group compared to AN group. Central alpha 1 source correlated significantly with BMI in patients. CONCLUSIONS: These results support the hypothesis that eating disorders are related to altered mechanisms of cortical neural synchronization, especially in rolandic alpha rhythms. SIGNIFICANCE: To our knowledge this is the first study by LORETA able to detect modifications of cortical EEG activity in eating disorders.

Stroop interference task and single-photon emission tomography in anorexia: a preliminary report.

OBJECTIVE: The aim of this preliminary study was to investigate the physiologic substrate of executive function in anorexia nervosa (AN) by assessing the relation between brain perfusion and Stroop interference task (SIT). METHOD: The classical SIT test and brain single-photon emission tomography (SPET) were evaluated in 16 AN females (mean age = 23.69 +/- 8.68 years; mean body mass index [BMI] = 16.19 +/- 1.53 kg/m2). The relation between the two examinations was searched by statistical parametric mapping (SPM 99) with a height threshold of p = .001. RESULTS: An abnormally low or a borderline SIT value was found in 25% of patients. A significant correlation between the SIT score and brain perfusion was found in the superior frontal gyrus of both hemispheres (Brodmann's area [BA] 6 in both hemispheres and BA 8 in the right hemisphere). No correlation was found in the anterior cingulate gyrus. CONCLUSION: BA 6 and BA 8 and the anterior cingulate are believed to be the basis of both error detection and immediate correction. Activity of BA 6 and BA 8 reflects this executive task in AN patients as well, whereas the lack of correlation in the anterior cingulate may suggest its blunted activity in AN patients, similarly to what is shown in other conditions characterized by impaired executive function, such as patients with depression, patients with schizophrenia, and abstinent drug abusers. However, these findings should still be quoted as preliminary, given some limitations of the study design, such as the lack of a control group, and the unfeasibility of controlling some relevant confounding variables, such as psychiatric comorbidity, medication, and the time interval between examinations, mainly deriving from the relatively few patients studied.

Eating disorders and their correlates in high school adolescents of Northern Italy.

OBJECTIVE: The study investigated eating disordered behaviours and life-habits correlated in a large sample of Northern Italian adolescents of both sexes. METHODS: The study had a cross-sectional design. 2595 students (2,146 responders; mean age 17.2 +/- 1.7 years) attending high schools in Savona (Italy) in April and May 2001 were sampled. To assess eating attitudes, the Inventory for the Screening of Eating Disorders (ISED) was self-administered. Inquiries regarding possible risk factors for eating disorders were also made: socio-economic status, body weight, smoking and alcohol drinking habits, illegal drugs use. RESULTS: Females scored significantly higher than males at ISED (13.4 +/- 7.7 vs. 7.6 +/- 5.8). 28.5% of females had a total ISED score above the cut-off point (18/19). Unhealthy eating behaviours were strongly associated with higher BMI, body image disturbance and illegal drugs use in both sexes; age had significant role only in males. No significant association between disordered eating behaviours and socio-economic status, smoking habit and alcohol consumption were found. CONCLUSIONS: Symptoms of eating disorders are quite spread in the Northern Italian female adolescents and associate with illegal drugs use. These data, with not negligible frequency of unhealthy eating behaviours and attitudes in males too, suggest that primary and secondary preventive interventions for teen-agers should be got ready.

[Surveying patients' and family members' satisfaction: the experience of the Mental Health Department in Savona]. / Rilevare la soddisfazione dei pazienti e dei familiari: l'esperienza del Dipartimento di Salute Mentale di Savona.

AIM: To point out the degree of satisfaction of psychotic patients and their family members in relation to the assistance given by the four Outpatient Mental Health Services in the Savona Department. METHODS: patients with a diagnosis of psychosis were selected among those visited during the period from the 1st of January to the 30th of April 2002. VSSS-54 item, was utilized. RESULTS: The analysis, conducted on 301 patients and 149 family members, highlighted: 1) a substantially positive assessment of the Services 2) the patients and their family members quite agreed on the evaluation of the different areas of satisfaction 3) Strong points: all the operators' human and professional skills 4) request of a better knowledge of the Service's programmes and more information to the public opinion 5) request of more collaboration with family doctors and other specialists 6) The worst criticism: the Service's response to night and holiday emergency. CONCLUSIONS: The patients and their family members reacted positively to the survey, that created more resistance on the part of the operators. The survey is not to be considered the final objective, but the point of departure for a new form of collaboration between the users and the operators.