In conversation with Massimiliano Gioni.

Lately on these pages, a discussion is going on over the opportunity of the use of the definition 'outsider'. Especially in the USA, it is judged as demeaning, discriminating and inappropriate, whilst in Europe, it is used in a much more unconcerned way. Mr Gioni curator of numerous international exhibitions including Manifesta 5 (2004), the 4th Berlin Biennale (2006), the 8th Gwangju Biennale (2010) and the 55th Venice Biennale (2013) shares his perspective on contemporary culture and self-taught art.

Illness and family functioning: theoretical and practical considerations from the primary care point of view.

The way in which the family copes with and adapts to illness of one of its members has a strong impact on the physical and psychosocial well-being of all members and on the shape and duration of the clinical course of the illness itself. The family doctor therefore should be able to evaluate the families' adaptation to illness and to promote successful coping strategies where necessary. This review illustrates how the family doctor's evaluation of the illness impact on family functioning is facilitated by a family developmental approach and by the use of a psychosocial classification scheme of illnesses.

Social problems as factors affecting medical consultation: a comparison between general practice attenders and community probands with emotional distress.

Comparison between general practice attenders and community subjects with emotional distress (as measured by GHQ-12) showed that women from a general practice sample reported more social problems than those from the community. In both men and women, problems with their spouse or partner were far more likely among general practice attenders than among community probands. Furthermore, women who consulted the general practitioners could count less often on the availability of friend confidants and had more well-defined physical disorder than their community counterparts. Results from a logistic regression analysis showed that in women (but not in men) problems in the relationship with spouse or partner increased the probability of being a general practice attender more than twofold. Physical health status did not exert a significant effect either in men or in women.

Psychosocial factors and chronic illness in childhood.

Chronic illness in a child requires successful organisational and emotional adjustment of the child and the family. The way in which the child and the family adapt to the illness will affect their psychological well-being and their quality of life. This review summarizes recent research findings on the relationship between illness factors, individual and family functioning, coping strategies and psychosocial adjustment. The findings are presented within the framework of three complementary theoretical models: the family developmental approach; the psychosocial typology of illnesses; and the process model of stress and coping. These models are useful for a better understanding of the complex interactions between illness, family and coping and offer to the professionals engaged in the care of chronically sick children, guidelines for assessment and the development of intervention programs. The review starts with examining the impact of chronic illness on the psychosocial adjustment of the sick child, his/her siblings and parents. Then psychosocial Stressors and risk factors in terms of illness and family related characteristics are discussed. Coping resources and strategies are presented which have been shown to be related to child and parental adjustment; and finally, successful intervention programs are described.

Marital relationships and somatic and psychological symptoms in pregnancy.

The relevance of marital relationships to somatic and psychological symptoms in late pregnancy was examined. Fifty-four primiparae at the 7th month of pregnancy completed the General Health Questionnaire (GHQ-28) and the Ryle Marital Patterns Test (RMPT), which was also completed by their husbands. Multiple regression analyses identified the husbands' ratings of nurturance behaviour as the best predictors of somatic and social dysfunction symptoms in late pregnancy. Higher perception of care by the husband was associated with a higher number of symptoms in wives. A high level of exchanged affection reported by wives is associated with lower levels of symptoms of anxiety and insomnia. The implication of these findings is discussed.

A community survey of psychotropic drug consumption in South Verona: prevalence and associated variables.

A cross-sectional community survey was undertaken to investigate the pattern of psychotropic drug consumption in 453 community residents of South Verona. Overall, 15.0% of the subjects were taking psychotropics (benzodiazepines 13.5%, antidepressants 2.2%, neuroleptics 1.1%). Prevalence was higher in females (20.0%), in those over 45 years (25%), in high General Health Questionnaire (GHQ) scorers (26.2%), and in subjects with physical ill-health (27.0%), with social problems (20.0%), with distressing events (22.0%) and with alcohol abuse (32.3%). Logistic regression analysis showed that age, sex, GHQ score, physical ill-health and life events were all significantly and independently associated with psychotropic drug consumption.

Social support, adversities and emotional distress in an Italian community sample.

The association of social support with emotional distress in relation to adversities such as social problems, physical health and undesirable life events was assessed in an Italian community sample of 222 men and 224 women. Univariate comparisons and logistic regression analyses showed that neither the quality of a confiding core relationship nor social support from kin confidants was related to adversities. In women only, social support from friend confidants exerted a statistically significant independent main effect together with social problems and undesirable life events in producing a greater probability of emotional distress. The implications of these findings are discussed considering the socio-cultural characteristics of Italian families and individual coping strategies.

The Ryle Marital Patterns Test as a predictor of symptoms of anxiety and depression in couples in the community.

The associations between marital relationships, as measured by the Ryle Marital Patterns Test, and symptoms of anxiety and depression as measured by the Interval General Health Questionnaire (I-GHQ), were assessed in 98 married couples in the community. Logistic regression analyses showed that symptoms of anxiety and depression in wives were best predicted by low ratings of affection exchange. Occupational class interacted with husbands' affection ratings, suggesting that in the nonmanual class only lower affection ratings were significantly associated with more symptoms. Anxiety in men was best predicted by low affection ratings while depression was best predicted by unemployment, by an affection discrepancy score indicating that more affection is given than received, and by a marriage which was rated as relatively more wife-dominated by wives and as relatively more husband-dominated by husbands.

Life events, social problems and physical health status as predictors of emotional distress in men and women in a community setting.

The main aim of this study was to construct logistic models of emotional distress (defined as a GHQ-30 score of 6 or greater) in a community sample of 226 men and 225 women. The independent variables included were: sociodemographic characteristics, physical health status, social problems and undesirable life events. Univariate comparisons showed that in both sexes undesirable life events and social problems were associated with emotional distress; in men the presence of physical symptoms and widowed, separated or divorced status also showed such an association. Separate logistic regression models for men and women confirmed the importance of undesirable life events and social problems as predictors for emotional distress. In women there was also a significant interaction effect between the two variables on emotional distress. Sociodemographic characteristics and physical health status did not exert a statistically significant effect in these models.

Geographical and urban-rural variation in the seasonality of suicide: some further evidence.

The seasonal variation of the suicides (n = 57,007) that occurred in Italy during the years 1969-1984 was evaluated using harmonic analysis, according to the method described by Pocock (1974). Monthly data were analyzed, separately for males and females, taking into account the setting (urban or rural) and the geographical location (Northern, Central or Southern regions). As compared with a previous study by our research group, a more precise (less aggregated) index of the urban-rural continuum was used. Rates for males were greater than those for females; urban were higher than rural rates; the seasonality was greater in the rural than in the urban settings and generally greater in males than in females in the Southern as well as in the Northern regions.

The perception of life events in two different cultural settings.

The perceived stressfulness of 63 life events was compared in a North Italian and a South Italian sample, using a 0-20 equal-interval scale. Each sample comprised 48 psychiatric patients and 34 relatives. Three-way analyses of variance for each event showed that South Italians consistently rated events as more upsetting, while patient or relative status and item order of the life event list did not affect the ratings. Multiple regression analysis showed that sociodemographic variables were not related to overall mean scaling scores with the exception of marital status which revealed a significant interaction with the city of residence. Southern Italians scaled recent events as more upsetting than events which had not occurred. This was not the case for the North Italian sample.