[Psychopathology, quality of life and social functioning in dialysis treatment and kidney transplantation patients]. / Psicopatologia, qualità di vita e funzionamento sociale in pazienti in trattamento dialitico e sottoposti a trapianto di rene.

OBJECTIVES: Psychiatric evaluation of organ transplant candidates is now routinely proposed also in Italy. This study purposed to assess the psychological status in patients on hemo-dialysis, peritoneal dialysis and renal transplantation; moreover other purpose is to investigate the possible differences among the three groups. MATERIALS AND METHODS: 157 subjects were consecutively enrolled, to the service of U.O. Trapianti d'Organo of San Salvatore Hospital in L'Aquila (Italy), between October 2007 and August 2009; 127 were in dialysis (80.9%), of which 101 were in hemodialysis (64.3%) (HD group) and 26 in peritoneal dialysis (16.6%) (PD group) and 30 (19.1%) Kidney transplant (PT group). The subjects were examined with clinical evaluation and through the following psychometric instruments: HAM-D, HAM-A, Jalowiec Coping Scale, STAI-Y1, STAI-Y2, DISS, SF-36. RESULTS: 30% out of our sample showed the presence of some psychopathological signs and symptoms, especially depression and anxiety. At HAM-D there were no differences between HD group (6.73; DS + 5.58) and PD group (5.27, DS + 5.63); the mean value at HAM-D in PT group was 4.4 (DS + 3.16) (p < 0.05). At HAM-A there were no differences between three groups. The HD group showed an higher value at STAI-Y1 (38.61; DS + 10.64) than PD (34.95; DS + 6.75) and PT (33.89; DS + 6.14) groups (p < 0.05). The quality of life (physical role, general health, vitality and role emotional) was lower in HD and PD groups, higher in group PT. The HD e PD groups showed a higher level of disability than PT group (p < 0.05). All subjects used "positive: coping styles. CONCLUSIONS: We consider essential to investigate the issues observed in this study, with the need to integrate psychosocial and functional needs assessment within a course of diagnosis and treatment for people who are undergoing dialysis procedures, or after waiting for a transplantation. Dialysis affects the quality of life, leading to limitations in activities and high level of disability. The PT group showed better quality of life and less impairment in functioning in the investigated areas. If the impact of psychological and/or psychiatric aid remains difficult to appraise, these results emphasize the impact of psychological status and the appropriateness of psychosocial support intervention on patients facing the transplant process or in dialysis treatments.

[Early diagnosis of dysmorphophobia and others dysmorphic disorders: a possible operative model]. / Dismorfofobia e diagnosi precoce: un modello operativo possibile.

AIMS: Body Dismorphic Disorder interest the 1-2% of the general population. It is characterized by an unfavorable prognosis and an elevated comorbidity with others psychiatric disorders. Approximately 6-15% of people with body image disorder refer for aesthetic surgery without any benefit indeed the outcome is, often, to request others surgery procedure. The aim of study has been to investigate the presence of dismorphophobia, others dismorphic disorders and psychiatric symptoms in a sample of patients candidates to aesthetic surgery procedure. MATERIALS AND METHODS: It has been recruited 109 patients of mean age 27.21 years, coming to the department of Plastic Surgery of L'Aquila (Italy). To all the patients have been delivered a questionnaire for socio-demographic data and two clinical standardized instruments: Self-report Symptom Inventory-Revised (SCL-90) and the Body Uneasiness Test (BUT). The psychometric and clinical evaluations have been performed by SMILE center (Service for Monitoring and early Intervention against psychoLogical and mEntal suffering in young people), the mission of which is to reduce the burden of mental suffering in young people by of an earlier recognition of signs and symptoms of psychiatric disorders. RESULTS: 42.67% of sample showed positive results to BUT, while 57.33% reported negative results. Moreover, BUT-positive subjects achieved significantly higher results in all SCL-90 items. CONCLUSIONS: A liaison between psychiatrists and plastic surgery equipe is essential for an early diagnosis of Dismorphophobia and others Dismorphic Disorders, to begin an eventual treatment and to supply indications for the surgical candidability. Our study confirm the high prevalence of body image disorders and the presence of other psychiatric symptoms and diseases in patients who demand aesthetic procedure. The detection of early signs of any psychiatric and psychological apparent discomfort represent a priority because this correlate, in most cases, with late diagnosis and intervention because awareness of these types of disease is usually very low and therefore the possibility that subjects with this type of problems are requested to psychiatric services is rare.